Time To Increase The Meds

After stalking my email through the day yesterday I received an email last night with the results from my early morning appointments. Things are looking good so far. I do have to double my Estrace dose but so far all medication is still oral. Next step will be another round of lab work and monitoring on Tuesday. Which also means another day of hitting refresh on my email every 30 seconds.

Test Results

Below are the results from your CD9 appt:

Hormone level:

E2(85)

LH(5.7)

P4 (0.3)

FSH(pending)

Ultrasound:

Endometrium lining thickness: 7.3 mm semi-laminar

Right side follicles: quiet

Left side follicles: quiet

After reviewing your results today, below is Dr. Yelian’s  recommended treatment plan:

1) Increase Estrace 2mg to 2 tablets by mouth twice a day( total 8mg per day) daily, starting CD9 (3/20) and continue

2) Follow up  on CD13 (3/24) for blood work and ultrasound

LH in Adult Females

Luteinizing hormone (LH) is a glycoprotein hormone consisting of 2 noncovalently bound subunits (alpha and beta). The alpha subunit of LH, follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), and human chorionic gonadotropin (hCG) are identical and contain 92 amino acids. The beta subunits of these hormones vary and confer the hormones’ specificity. LH has a beta subunit of 121 amino acids and is responsible for interaction with the LH receptor. This beta subunit contains the same amino acids in sequence as the beta subunit of hCG and both stimulate the same receptor, however, the hCG beta subunit contains an additional 24 amino acids, and the hormones differ in the composition of their sugar moieties. Gonadotropin-releasing hormone from the hypothalamus controls the secretion of the gonadotropins, FSH and LH, from the anterior pituitary.

In both males and females, LH is essential for reproduction. In females, the menstrual cycle is divided by a midcycle surge of both LH and FSH into a follicular phase and a luteal phase. This “LH surge” triggers ovulation thereby not only releasing the egg, but also initiating the conversion of the residual follicle into a corpus luteum that, in turn, produces progesterone to prepare the endometrium for a possible implantation. LH is necessary to maintain luteal function for the first 2 weeks. In case of pregnancy, luteal function will be further maintained by the action of hCG (a hormone very similar to LH) from the newly established pregnancy. LH supports thecal cells in the ovary that provide androgens and hormonal precursors for estradiol production. LH in males acts on testicular interstitial cells of Leydig to cause increased synthesis of testosterone.

Reference Values

> or =18 years
Premenopausal
Follicular: 2.1-10.9 IU/L
Midcycle: 20.0-100.0 IU/L
Luteal: 1.2-12.9 IU/L
Postmenopausal: 10.0-60.0 IU/L
Source: http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8663

For references on what E2, P4, FSH, and Estrace are; click here to read my previous post.

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