Low E2 solutions?

[RedTex]

Dr. Roseff,

I completed CD3 bloodwork a few months ago and my OB started me on a clomid/estrace vaginal/oral progesterone post-O protocol. My labs revealed normal FSH, LH, Test, TSH, DHEA, Prolactin, but my Estradiol was low at 21 (normal for this lab 30-100). Other info: ovulatory each cycle; ranges from 24-28 days (tends to be a short LP, but prog test was normal). No other medical problems except IBS and Hypothyroid (well treated).

My question is, does this protocol truly address my low E2 issues? I believe clomid tricks our bodies into making more estrogen, correct? If so, does this seem like a reasonable protocol or should another evaluation/treatment be considered for my Low E2? I have just completed 2 cycles which also required an HCG shot because I failed to ovulate on my own after a +OPK (5-7 days later). I have never had an anovulatory charted cycle.

Thank you very much,

RedTex

[Scott Roseff MD]

Hi RedTex,

With all due respect to the lab that reported the estradiol level, a cd3 E2 of 21 pg/ml (in my expert opinion) is normal. And, if a woman has normal, regular menstrual cycles, and IF she ovulates normally and regularly, then taking Clomid can potentially PREVENT her from getting pregnant or cause a miscarriage. Furthermore, oral progesterone is not approved by the FDA for use in assisted reproduction. Drugs like Prometrium can have serious side effects.

I strongly suggest you seek the advice of a board certified RE sooner rather than later.

I hope this helps,
Dr. Roseff in FL
(You may have been pregnant already if you were coming here!)

[RedTex]

Dr. Roseff,

I truly appreciate your opinion. I did have a thin lining of 5 on that unmedicated test cycle with the "low E2", but I now view it in different eyes.

I, too, am concerned about the use of oral progesterone in this off-label use and believe both of these issues will propel my trip to see an RE.

Thanks again, and also, thanks for donating your time and energy to this forum.

[Scott Roseff MD]

No problem, RedTex. I'm glad you'll be seeing an RE!

Good luck,
Dr. Roseff in FL