What do these test results indicate?

[assured]

I am a 43 yo female whose menstrual cycle stopped abruptly 5+ years ago following two early miscarriages.  I have 5 children, the last born prematurely at 33 weeks, then the two miscarriages.  Dr. was unable to induce a cycle with progesterone alone, but did cycle with combination BC. Have hot flashes, trouble sleeping, vag. dryness, lack of libido, fatigue... Recent test results indicate:

Serum test: LH 19.4  (range 0.0-76.3) (postmenopausal 15.9-54.0)
          FSH 15.6  (range  1.4-18.1) (postmenopausal 23.0-116.3)
          TSH 2.730  (range 0.350-5.500)

Saliva test: Estradiol  10  (postmenopausal 1-4; follicular 5-                             13; Luteal 7-20)
             Progesterone  92  (postmenopausal 5-95;    
                                Follicular 20-100; Luteal 65-500)
             Free Testosterone  15  (range 8-20)
             TSH  43  (range 26-85)
             Free T4  0.36  (range 0.17-0.42)
             Free T3  0.47  (range 0.28-1.10)
             Cortisol was low at noon and afternoon readings.

Thanks for any input.

Assured

[Machelle Seibel, MD]

It looks like you are in perimenopause and having some of the symptoms related to menopause. They may come and go over the next several years. The fact that you don't have bleeding with progesterone but do have bleeding with estrogen and progesterone means your uterine lining is working.

There are many things that could be going on. Some related to perimenopause; others related to being 43 and having 5 children and the stresses of that. There could of course be many other things as well.

Talk with your doctor about a short course of estrogen and progesterone, or even a low dose birth control pill for the hormones it provides and see if that helps. This assumes there are no medical reasons not to be on hormones.  Make sure your diet is good and balanced and that you have some time for yourself each day. It might also be helpful to see if you are anemic by checking a blood count and check your blood sugar to see it is not too low or too high.  You can try using the over the counter Replens for vaginal dryness. Apply it daily for one week then twice each week after that.

If the cortisol levels were abnormal, you should ask to speak with an endocrinologist to be sure there is not a problem with your adrenal glands.
Machelle M. Seibel, MD

[assured]

Forgot to add that my DHEA (not S) was 3  (range (3-10)

Assured

[borninquisitive]

Have you had your thyroid antibodies tested: anti thyroglobulin antibody (TGAB)  and thyroid peroxidase antibody (TPO)?

If a doctor will not run them, you can get tested provided a lab is nearby:

http://www.healthcheckusa.com/lab_tests/Thyroid_Screenings/Anti-Thyroid_Antibodies

http://www.healthcheckusa.com/locations.asp

Using code 12345 will get you 10% off.