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Estrogen Levels in Perimenopause

Catherine McDiarmid-Watt | Tuesday, February 09, 2016 | 0 comments

Image: Mother and daughter, by Margaret Wyker, on Flickr
From a post on Power Surge board:

Estradiol levels tend to fluctuate dramatically during the perimenopausal transition. There is significant overlap of the expected range in menopausal women with values observed during normal menstrual cycles.

Estradiol results obtained with different assay methods cannot be used interchangeably in serial testing. To monitor a patient's serial results it is best to ensure that the same methodology is used each time the test is performed.

Estradiol is the primary reproductive hormone in non-pregnant women. This steroid hormone plays an important role in normal fetal development and in the development of secondary sexual characteristics in females.

Estradiol influences the maturation and maintenance of the uterus during the normal menstrual cycle. Levels of estradiol steadily increase during the follicular phase of the menstrual cycle in association with the growth and development of the ovarian follicle.

As the follicular phase proceeds, estradiol exerts a negative feedback control on the pituitary, resulting in a drop in FSH levels. Near the end of the follicular phase, there is a dramatic increase in estradiol levels.

At this point the feedback of estradiol on the hypothalamus becomes positive and produces the mid-cycle surge of LH which immediately precedes ovulation. After ovulation, estradiol levels initially fall abruptly, but then increase as the corpus luteum forms.

At the end of the cycle, levels fall off in anticipation of the initiation of the next follicular phase. During pregnancy, the placenta produces estradiol. Estradiol levels are generally low in menopause due to diminished ovarian production.

Estradiol levels have been found to correlate with follicle size.

Estradiol Levels :
Reference Interval (pg/mL)Menstruating Female
(Day of cycle relative to LH peak)
Follicular (-12) : 19-83
Follicular (-4) : 64-183
Midcycle (-1) : 150-528
Luteal (+2) : 58-157
Luteal (+6) : 60-211
Luteal (+12) : 55-150


Estradiol (the most potent estrogen) has a familiar monthly pattern. The monthly cycle begins with the follicular phase, which is followed by the midcycle, then the luteal phase.

The beginning of the estradiol cycle is the follicular phase, which represents the baseline levels of estradiol before estradiol levels are increase with and after ovulation. The midcycle spike is associated with ovulation. Note that estradiol levels are higher during the luteal phase than in the follicular phase.

Estradiol activity in the younger premenopause female is so well defined that the plotting of estradiol levels can be used to evaluate fertility.

During perimenopause there are often erratic shifts and unpredictable spikes of hormones (red line), including estradiol 1, 2, 3.

Hormones may actually fluctuate back and forth between premenopause and postmenopause levels.

These fluctuations can cause migraine headaches, weight gain, mood changes, and bleeding irregularities in both perimenopause and postmenopause women.

In postmenopause, estradiol fluctuations are less severe than during perimenopause, but will continue for years after menopause.


From an article on Power Surge, Your Hormones.

According to Aeron Lifecycles Laboratories (Pete uses them for his saliva testing) it says the following about estradiol:

"Ranges given for postmenopausal and older populations are representative of normal, unsupplemented hormone levels and not necessarily those which will provide maximum well being. For example, an estradiol level of 0.7 pg/ml falls within the normal range for a postmenopausal woman, but is probably insufficient for heart

(Dearest note: We've had more updated news about hormones and heart protection since this article was written) and bone protection. Titration to more youthful target ranges is important to discuss with your healthcare provider."


Don't get your knickers in a twist regarding lower estrogen levels.

Remember the recently halted Women's Health Initiative study regarding HRT and heart health.

Although Power Surge recommends that any woman wanting to use HRT at least use the naturally compounded hormones that Pete compounds, I'd first consider an alternative like soy isoflavones which is known to provide heart health -- according to many nutritionists, the FDA, Dr. Chris Northrup, and Dr. Susan Love and Dr. Susan Lark.

All of whom have been guests in Power Surge -- in fact, recently Dr. Susan Lark, a well-known M.D. who's very much into alternative medicine has said, "Start including soy foods in your diet. Take 50-150 mg. of soy isoflavones per day.

Not only will soy help to protect against bone loss; it will help protect against breast cancer as well."

Photo credit: Mother and daughter,
by Margaret Wyker, on Flickr
Some rights reserved

Image: Perfect Hormone Balance for Fertility: The Ultimate Guide to Getting Pregnant, by Robert A. Greene M.D. and Laurie Tarkan. Publisher: Three Rivers Press (April 29, 2008)-Perfect Hormone Balance for Fertility: The Ultimate Guide to Getting Pregnant
by Robert A. Greene M.D. and Laurie Tarkan

-- You have more than one hundred hormones circulating in your body – reproductive hormones, pregnancy hormones, sex hormones, metabolic hormones, and stress hormones – relaying messages from tissue to tissue, organ to organ, brain to body, and body to brain.

An equilibrium, a perfect balance in both partners, often determines your ability to conceive and support a pregnancy.

When your body is imbalanced, conception becomes very difficult. Luckily, hormonal imbalances can be corrected.

Drawing on the latest research in this field – which links underlying hormonal issues with infertility in men and women – Dr. Robert Greene, fertility specialist, ob/gyn, and reproductive endocrinologist, has created the Perfect Balance Fertility Program to help patients attain the optimal hormonal health that is necessary for conception.

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About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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