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Clinical Information about LH and FSH and the Post Menopausal Hormone Panel

The Expanded Post Menopause Panel is the new generation of saliva tests. It includes the 6 hormones – estrone (E1), estradiol (E2), estriol (3), progesterone (P1), DHEA, testosterone - plus FSH and LH measurements.

LH & FSH

The pituitary Luteinizing Hormone(LH) & Follicle Stimulating Hormone(FSH) are gonadotrophins which regulate ovarian function. Both FSH & LH are stimulated by hypothalamic GnRH (Gonadotrophin Releasing Hormone). LH has a pulsatile rhythm which varies throughout the cycle. Stress and high cortisol have an adverse effect on LH but not on FSH. Stress renders women more estrogenic and less fertile, and more prone to proliferative diseases. In perimenopause, there is a growing scarcity in ovarian follicles. LH & FSH production show respectively, a three and seven fold increase over the values found in young menstruating women. The Expanded Post Menopause Hormone Saliva Test Panel simultaneously measures the levels of the two neurohormones FSH & LH and the corresponding concentrations of E2 and P1. Using this panel, progression towards menopause can be more accurately predicted before clinical symptoms set in. Early preventive treatment can be initiated to minimize bone loss, and other somatic symptoms.

Salivary LH & FSH

The new generation of saliva tests for LH & FSH developed at Diagnos-Techs allows measurements 100-1000x more sensitive than routine serum/blood tests. By coupling levels of FSH to E2 and LH to P1, the sensitivity of the ovary to the gonadotropins can be objectively evaluated. As a woman approaches menopause, FSH and LH requirements to illicit the same E2 and P1, responses become higher. This relation has predictive diagnostic implications . It allows earlier intervention before clinical symptoms become evident. Bone loss concerns can be addressed predictively. Pro-active nutritional, hormonal, and therapeutic strategies can be tailored to each woman’s need. Furthermore, as the FSH/E2 and LH/P1 relations change with time, therapeutic modifications that reflect the changing needs are implemented. The FSH and LH measurements also allow detection of microadenomas of the pituitary gland. It is worth noting that stress (increased cortisol and ACTH) has significant adverse effects on LH and P1 production but minimal effects on FSH and E2. The imbalance induced by stress can lead to estrogen dominance with its proliferative states­Fibroid and breast cyst growths, endometriosis aggravation, edometrical hypertrophy, etc.

Case Studies: Estrogen Overdosing

Purpose: To demonstrate the typical estrogen overdosing in post-menopause women in attempts to control somatic symptoms, including hot flashes.

Background: The recent Women's Health Initiative Study (JAMA 2002; vol 228(3):321-333) on HRT re-affirms our long held position that use of synthetic or natural hormone replacement therapies based on symptoms only, and without ongoing monitoring, carries with it grave health risks. Many late and early post-menopausal women are given estrogens of various types to control somatic symptoms, including hot flashes. The physicochemical anatomy of a hot flash consists of a rapid drop in estrogen coupled with a low progesterone. It is not a dearth in the absolute value of estrogen. Consequently, the continual estrogen treatment, usually prescribed, will overdose the woman while it mitigates somatic symptoms. It blunts the rapid fluctuations in estrogen by overriding endogenous production.

Patient History & Data
Age: 50 yrs. Female
Last Period: 3 yrs earlier
Bone density changes: Sub-Clinical or minimal
Initial Symptoms: Hot flashes, emotional and concentration problems
Treatment: Placed on estrogen patch; no hormone monitoring done
Outcome: Control of somatic symptoms, increased aggression and irritability, with tender breasts

Patient sought further help and a Post Menopause Hormone Panel was ordered.

PHP-1™ Report Summary
  Hormone Levels Normal Ranges
DHEA: 6 ng/ml 3-10 ng/ml
Testosterone: 27 pg/ml 8-20 pg/ml
Estrone: 35 pg/ml 26-64 pg/ml
Estradiol: 45 pg/ml 5-13 pg/ml
Estriol: 42 pg/ml 14-38 pg/ml
Progesterone: 53 pg/ml 100-300 pg/ml

Remarks: The report showed sufficient DHEA and testosterone, mild estriol excess, elevated estradiol, and very depressed P1 values. The induced estrogen excess (about 400%) coupled with low progesterone increases breast tissue proliferation, and irritable/aggressive behavior.

Case Management: Estrogen dose was cut by 65% to prevent override. 20mg BID of sublingual liquid progesterone was given. Retested later. Hormone levels were acceptable and all symptoms were under control.

Source: Diagnos-Techs Clinical and Research Laboratory. Used with permission.