Estrogen levels

KathyL624,

I just logged on to this site for this specific reason! I am trying to educate myself on the estrogen levels that are "normal" after chemo in pre-menopausal women. Although....I doubt there is a "normal" ;-)

Here is why I am wanting to learn more~after a slow and steady climb since August, 2015 in my estradiol level post chemo (Aug 2015 <5pg/mL, Feb 2016-25pg/mL, May 2016-90pg/mL, Sept 2016 335pg/mL), I learned yesterday that the bottom has fallen out. Coincidentally, I told my Oncologist yesterday before she had the results that I felt the best I have mentally/emotionally (my poor husband!) in a very long time. At my last check in September, 2016, it had climbed up to 335 pg/mL but yesterday, it is back down to <5 pg/mL, which was what it was right after I finished chemo.

I am not sure why I am hung up on these #'s, especially given the fact that I feel so much better hormonally. Given that my bc was hormone positive (both estrogen and progesterone), I tend to get a little hung up on that Mother Nature has in store. I should maybe also mention that I have not had a period in 22 months (the only GOOD thing to come out of all of this!), was pre-menopausal at dx and am on Tamoxifen. How about you, have you had yours tested? So glad you inquired about this topic, I hope to learn more.

Amy

I am not certain that zero estrogen is possible, but I am no medical professional. My reason in saying that is because even if you have your ovaries removed, your adrenal glands still produce some sort of estrogen. I am not sure what kind of level it *should* be however given that my pendulum has swung (what I would call) pretty drastically, <5 might be the lowest level that it can report. All of this is just speculation on my part, based on my own personal experience and what I have discussed with my MO. I hope you find the answers you are needing! ;-)

Onc said estradiol level fluctuation during the day is normal. Fasting and testing at specific time of the day and cycle aids in consistency. Normal ranges:

Post-Menopausal = <10 pg/mL

Follicular phase = 39 - 375 pg/mL

Luteal phase. = 48 - 440 pg/mL

Mid-Peak phase = 94 - 762 pg/mL

6 - 8 pg/mL mid-day after fasting 10 hours (while "off" an A.I.) in post-menopausal phase. While on Arimidex ?? My onc refuses to test my estradiol.

Almost 60, and have been menopausal for years. I will most likely be prescribed an Aromatase Inhibitor. Did 4 rounds of TC, bi-lateral mastectomy, even though the surgeon felt that there was no reason to remove the healthy breast along with the one that had the tumor. Estrogen is still produced by adrenal glands. DR says there is no need to measure estrogen prior to taking AI. So how is its effectiveness monitored? Is there a "safe" level of estrogen ? Concerned about side effects of AI, alternatives to AI, and feeling confident that it is doing any good.

I had a period just before chemo started then no more. So when it was time to take an AI, my MO

had my Estradiol levels checked ever 2 weeks for 2 months to make sure I was in menopause. He

said that is one of the hardest levels to check, so sent my blood tests to Mayo Clinic as he said they

do one of the best jobs on this.

After I was on the AI for two years, my side effects start lessening. So he checked my Estradiol

levels again to make sure the drug was working. It was!

My oncologist insisted on two sets of lab values a few months apart before switching me to letrozole.

For clarification: the adrenal glands do not produce estrogen itself when ovarian function ceases. Instead, a similar class of molecules called androgens are changed by the aromatase enzyme into our favorite female hormone (this conversion likes to take place in fat tissue which is why weight control is so important)

In some people, tamoxifen can be metabolized more rapidly than average. This leads to a concern that it might not be around long enough in their system to adequately block receptors. There are tests available commercially to assess this phenomenon but agreement on clinical significance is lacking.

Thanks for sharing .. I went for bloodwork on Tuesday to have Estradiol checked - waiting for results!!

WeAreConnected,

Thanks for sharing. I'm only halfway through the talk. And very interested. I'm trying not to feel bad, though, about listening to these two men talk women's issues. Ugh. Just now, the way they said, psychosexual functioning "libido" and dropped their eyes. I had such a strange sense that there is still such awkwardness with what is culturally acceptable for women's sexuality. Until society straightens that out, breast cancer may never see a cure. Anyway I'm going to keep watching and see about your thinking above.

And it was also even evident again in their discussion of male breast cancer and the fact that it's "good" according to these doctors that men don't experience menopause.

to me it looks like the e2 levels are around 40 in post menopausal women and that on an AI it can go to negligible amounts below 10. Is that how you see it? One thing that came through very clearly is that there would be nothing good said about Tamoxifen, "an old actor to usher off the stage." So these doctors would ignore any potential benefits of Tam to push their work with AIs.

One thing I am wondering is what purpose there is to measuringyour estradiol levels?

Very Interesting Video.. I have been on Tamoxifen now for 10 months & waiting on Estrodial results .. I had my ovaries removed last June so it sounds like I might be better off switching from Tamoxifen to an AI. My MO said last year my plan would be 2-3 years on Tamoxifen then 7-8 years on an AI ... I might push for the AI now

WeAreConnected:

http://ascopubs.org/doi/pdf/10.1200/JCO.2015.62.37...

This is the longer article I was looking for that I had read- the other link I posted looks like a summary of the findings in this article. I'm sitting in the MOs office as I write this. About to have Lupron #4 and receive my script for Aromasin. Happy Valentines Day! Bye bye estrogen... My MO already said if the AI is too much, he will switch me to Tam. Hope you're feeling well today

WeAreConnected:

Thanks for sharing the info about Estradiol testing thru Mayo Clinic.

Here is a recent publication. Perhaps you already shared it on this site somewhere. I can't remember where I found the link:

Is Estradiol Monitoring Necessary in Women

Receiving Ovarian Suppression for Breast Cancer?

"Tamoxifen has for decades been the cornerstone for management of early and metastatic breast cancer for both pre- and postmenopausal women. Treatment with adjuvant AIs for 5 years reduces relative 10-year breast cancer mortality rates by approximately 15% compared with tamoxifen in postmenopausal women.There- fore, an AI should be the preferred option for postmenopausal patients, whereas the optimal adjuvant endocrine treatment of pre- menopausal women is still controversial.3 OFS with gonadotropin- releasing hormone agonists (GnRHa) in combination with AIs became an appealing approach to further improve survival in premenopausal women, as demonstrated for the postmenopausal group. "

http://ascopubs.org/doi/pdf/10.1200/JCO.2015.65.34...