Pre Menopause??

I have been having night sweats.  I wake up so hot and sweaty and then get so cold.  I have no sex drive, headaches and just in general my head feels cloudy.  I had my blood work run my FSH is 2.4 and my estrogens total serum is 27.  my gp says that I may be going into menopause and to call my obgyn.  I had my uterus out at age 29 and still have ovaries, but no menstrual cylcle to judge by.  I am of normal weight, exercise 5 days a week.  I have ADH and ALH and know I can not take hormones, but the night sweats are making me crazy.
Thanks

Doris

[Machelle Seibel, MD]

Hi Doris,
Your blood work suggests you are not in menopause. Your FSH is 2.4 which is very low and not diagnostic for menopause and your estrogen is 27 which is also very low (could be due to menopause but also other causes). It is hard to say without more history and possibly other labs and an exam, but it sounds more like hypothalamic amenorrhea. That is the medical term for no periods due to too much exercise, or stress or poor diet. Rarely it is due to a tumor in the pituitary gland. I realize you have no uterus so the term is more a description of your symptoms even though the menses part is not able to be used.

It does sound like your body is low on estrogen production. I do not know why you cannot take estrogen but if you could, it would likely help your symptoms. You might also check your blood levels of prolactin and testosterone. If the first is high, that could be a cause. If the testosterone is low, so could that.

You need a little more evaluation to come up with the best suggestions for treatment. Also check your blood levels for thyroid hormone (TSH and T4). You might also check your fasting blood sugar and be sure your symptoms are not due to a low blood sugar. Another cause for some of the symptoms can be depression. However, it does not sound like menopause from your blood work.
Machelle Seibel, MD

[sisterone]

Thank you  I will follow up on this.

Doris