#oestrogen levels

[indizombie]

After making it through perimenopause and menopause, people's mood and cognition tend to stabilise — yet oestrogen levels remain low. Why is this? For the most part, our brain will adjust to lower oestrogen levels, and many symptoms will ease. But for some women, this new normal might make them more vulnerable to neurodegenerative conditions. For instance, two-thirds of Australians with dementia are women. No-one knows for sure why that is, but one theory points the finger at oestrogen. One of oestradiol's benefits is it has a protective effect on the brain, so take it away and you might increase brain inflammation — something that's implicated in conditions such as Alzheimer's disease, Dr Gurvich says. "But this is more of a hypothesis at the moment, and an area that's really just starting to be uncovered."

Belinda Smith, ‘How changes in oestrogen levels before, during menopause can affect how we think and feel’, ABC

[ukftm]

I've been on T (gel) for a year and my estradiol levels are still very high. T levels are good. I don't really want to get a hysterectomy/oophorectomy right now and I also don't really want blockers, but obviously the important thing is that I don't do any damage longterm, so I was wondering if you know of any worries about too-high estradiol being dangerous in men (whether cis or trans, I guess)?

I know of people who have had good testosterone levels and high oestrogen levels, and they’ve been told by their endocrinologists that the high oestrogen isn’t really a problem at all. If you’re with a GIC or endocrinologist you could ask their thoughts, as obviously everyone’s different, but I don’t think it’s something you need to worry about urgently.

~ James

[ukftm]

My testosterone levels seem fine but my blood test always shows that oestradiol is way too high (like a teenage female) I’m 24 and have been on T for 4 years. I have blood tests but no one monitors them as my doctors refuse to get involved. Is there anything I can do to lower it? Thank you :)

Really you need to be making any changes under the supervision of someone medically trained, and it’s really not acceptable that nobody is monitoring your bloods (I don’t mean to imply this is your fault! - simply that it’s not good that neither your GP nor gender clinic seem to have picked up on this).

Obviously I don’t have any background information so don’t know what you’ve already tried, but there are a few options for trying to get your bloods appropriately monitored:

Clarify to your GP what the NHS expects of them (assuming you have been prescribed by an NHS gender clinic). See here for specific guidance to GPs from NHS England.

Talk to your GP about being referred to a local endocrinology team if they don’t feel competent to monitor your bloods in accordance with the responsibilities outlined in the document above.

Ask your gender clinic to reiterate any shared care agreements/clarify what they expect your GP to do or to send them.

Look into moving to a more trans-friendly GP practice. See here for a database of trans-friendly GPs.

Getting appropriate monitoring and support from someone might be particularly important if medical intervention is needed to deal with this particular issue. The most common way I’ve seen high oestrogen levels dealt with is by an additional prescription of hormone blockers, so it’s worth trying to get this monitoring issue sorted to establish if this is the appropriate way forward for you.

~ James