How to interpret your bloodwork in perimenopause and menopause

[@ladylavie3067]

Dr Heather. My obgyn didn't ask for a DHEA level. I found this out from my alternative provider who conducted a complete thyroid panel as well as DHEA and cortisol. I already knew my testosterone level and progesterone as well as my fsh and estrogen. I was super low in my DHEA and despite taking progesterone and testosterone, still dragging . Now that I have been taking 5mg of DHEA daily, I feel so much better.

[@Zylann]

Thank you so much! Makes me trust myself again! Dr not paying any attention to symptoms.

[@lori639]

You should address the women who have non stop periods and it takes forever to be diagnosed because they have uterine cancer like I had. You talked about the absents of a period , but not about the prolonged periods that never stop. The good Lord blessed me , and I am extremely blessed to have been caught in time. All my thanks goes to God,. 🙏🙏🙏 Doctors proved to me that they did not know much themselves on this subject. If it would have been a fast growing type of cancer, I probably would have been dead before it was found .

[@Aam2008mui]

How did you find out that you to had uterine cancer?

[@katia121083]

I was just at yet another gyno and she told me all they can do is anti depressants to regulate body temperature when my main symptom was hot flashes and insomnia. WTH? I said no thank you next doctor. So frustrated.

[@chiaraboccelli4189]

Great job! These doctors just want to mess up our mental health giving pills and more pills!

[@VeeKayGreenerGrass]

Magnesium Glycinate puts me right to sleep. Ashwarghanda is calming (see other Ayurvedic herbs).

[@ascensionessentials]

They have all failed me too. Magnesium has helped me sleep and taking DHEA in the morning and using Progestelle oil at night before bed.

[@onewomansjourney760]

There are so many more symptoms in perimenopause! Labs are good as a base if starting HRT even in perimenopause. That's how I found out my testosterone is zero.

[@pattycastro6170]

Now in PCOS it’s challenging to define when PCOS transitions to perimenopause and menopause occur.

[@kathleenbaker2791]

5 months out! Praying to get to the full 12, last year was so rough with AUB, love you videos, they have helped so much!

[@heatherhirschMD]

Thank you! Come on ovaries and uterus :)

[@sasharandomly4221]

Had a full hysterectomy a month ago but still not on HRT. My surgeon said I don't need it unless symptoms but other than hot flash offered no other symptoms. Turns out I have symptoms. Ty youtube & facebook.

[@jenniferpurton1835]

Hello Heather! I am so glad you are doing these videos but more importantly I am thrilled about your new venture with MIDI Health. I had the great opportunity to see you twice when you were at OSU in 2017. Just waiting for you to start taking patients in Ohio!

[@carolineedmondson1547]

Thank you so much for your videos! They are so informative!

[@J3nniferLynn]

I went 18 months without a period then started getting them monthly. So I get that periods will trump the hormone levels, but this seems to be the exception to the rule. I haven’t had a period now for 8 months now and according to my blood work, I am post menopausal.

[@miakim354]

may I ask how old you are?

[@marsattacks3455]

Best explanation yet thank you ❤

[@duchessdelarue5983]

Unfortunately we have to do it all ourselves because there are so few providers that understand this. Same with thyroid and adrenal issues.

[@tanyam4826]

What you said is so true 😅 I’m 47 I had hysterectomy 6 years ago and started to have menopause symptoms last year but I just had my tests this week. My estrogen levels is 15 and my FSH value 92.4 but on the test results said I’m normal 😅 I’m confused 🤔 let see what my dr is going to tell me next week 😅

[@creatinghanley]

To me, logically, it seems that perimenopause is the 10 years before periods stop. When periods stop, that is pausing, hence that year is actually menopause. After that 12 month no-period is post menopause which is the remainder of a woman’s life.

[@marsattacks3455]

Ya I guess I am I've had alot of other symptoms mostly emotional ones all last year.

[@Sinbadizzy]

I wish that my doctors had been more helpful or educated, so i could have been more prepared or supported. I'm looking back at my last FSH test that was in 2019. It was at 6.8, the year before that it was 6.3. I really didn't have any major peri-menopause symptoms (very random and occasional night sweats, sporadic periods, anything from 15 days to 70 days; had a biopsy done for that) but no one would mentioned anything about the possibility of being peri-menopausal. And they didn't really support the hormonal testing, so i didn't push for it myself either. Needless to say, my 12 month anniversary of no periods was May of 2022 at the age of 45. I would be curious as to what my fsh lab work is now, but i guess it doesn't mean much since i know i am officially in menopause.

[@bethbilous4720]

This video did NOT explain lab work.

[@JJmikra]

Thank you very much for very useful information! I'm in Europe and it seems estrogen numbers in your examples are in different unit. What unit do you use for estrogen level in the US? My lab test results are in nmol/L for estrogen. For FSH, my results are in IU/L. I believe it's the same unit as yours.

[@SilverGirl72]

No periods since I’m on my 3rd IUD since 2006. My FSH is 90. No way to know what my periods would be doing without an IUD. Is it safe to assume I’m post menopausal given that lab result?

[@angelaneale6957]

I'm 48 and on the sronyx birth control pill. How will I know when I'm in menopause if the BCP is still making me have a period? What other birth control options are recommended? Does the BCP help to prevent heart disease, strokes, osteoporosis and the other diseases that HRT helps to prevent?

[@jessicastauffer1183]

I’m 38 years old. I had two periods in December and my last period start date was January 29th and it is now March 21st. I spotted two days ago but that’s it. My recent FSH test was 66.2 and my estrogen came back 371. I haven’t heard back from my doctor because it just came in today.. I have no idea what to think.

[@Lanainvestor]

Fish 66? It has to be below 25

[@soyicasweet99]

yeah that FSH is high. Did you ever find out why? because tumors can also cause high FSH. Mine was 38 in June after missing 2 periods and now in September is low again 3.4 with estrogen of 269

[@tanyabailey7791]

My lab work said today that my FSH was 2.2. I’m 49. Does this mean I’m nowhere near peri/menopause still?

[@miakim354]

I feel jealous. good for you!

[@LA2TXQueen1]

I have an FSH level of 6.8 mUI. Currently, Im still have periods but they are irregular. Sometimes ill get so hot then switch to being cold, my severe brain fog, weight gain, and the lost goes on. My doctor said it is just my PCOS symptoms. 😂

[@leahbel25]

I am very frustrated with my current GYN. I requested to increase my estadiol from 1mg to 1.5 mg due to returning of my hot flashes throughout the day. Per her own words, " FSH is a test that tells you what your estrogen levels have been for awhile and it was good three months ago so you shouldn't need to increase your estrogen. Maybe you need your testosterone increased." She literally compared the FSH test to a hgb AIC LOL. I am peri menopausal at age 49. Time to get a new doctor.

[@asmrwishes]

Research Siberian rhubarb

[@unnamed2737]

I was about to blow $400 on bloodwork for hormones but sounds like it wouldn’t tell me anything. I have the symptoms of perimenopause, 47, guess I just have to tough through it.

[@jc9371]

You don’t have to tough through it! You can ask for estradiol!

[@CYndibabI]

do women in perimenopause get hot 🥵 flashes OR does that happen MORE in menopause? my mom hardly got hot 🥵 flashes like only a few times that was it! I’m in perimenopause not sure what stage of perimenopause I’m in and I never 👎🏻 got a hot 🥵 flash with serious sweating! I have gotten a couple times like flushed face ❓which only happened 3 times but what I do get like once or twice a month I believe before period or before fertile week is a couple tiny small sweat beads above my lip 👄 but it’s not full on sweating or hot 🥵 flash SO my question is this normal is perimenopause? I wished I knew what stage of perimenopause I’m in!

[@renus6015]

Same issue I have

[@jenm1948]

Very helpful and thorough explanation! New subscriber here. I hope you can see this question of mine. My Estradiol is in 260 level, periods are getting erratic at times 2x a month. Had tubal ligation 13 yrs ago.Taking spironolactone for acne 75mg also for hypertension. Is there a connection for all the symptoms I am having like erratic period, breast tenderness, acne, headcahes, joint pains and fatigue hot flashes and night sweats. Pls throw any opinion as they want me to undergo endometrial biopsy and repeat estrogen blood test. Turning 47 in few months.Thanks appreciate your input.

[@ideiaamor856]

Thank you very much Dr. Im wondering if you still work with Midi health. Are you still seeing patients at Midi health pls?

[@melkerner]

How can I convince my perimenopausal Wife to actually address this instead of going with her "great" OBGYN who simply says, everything is fine - it's a nightmare!

[@Somebodysomewheresometime]

Tell her she’s gonna get fat and heart disease lol

[@andreagriffin2485]

I have had a total hysterectomy 17 years ago complete surgical menopause.Been off hormones/ estradiol for approximately last 11 years I am now experiencing extreme uti like symptoms vaginal dryness etc went to the doc she drew blood for an estradiol test and a FSH test while waiting on my results she’s starting me in 1 mg estradiol daily orally for 21 days then stop for 7 days and 1 gram estradiol gel 0,01 to be administered 3 times a week until we get my results back and at that time we will adjust why do I need a FSH test if I haven’t had a period in 17 years?

[@marsattacks3455]

My estrogen was 34, then couple months later 245... Is this perimenopause I think it is ..my cycles haven't stopped but they are all over the place.

[@SOLOE110]

What if you’ve been on the pool for 25+ years and don’t know if you’re in perimenopause or menopause because you were getting a withdrawal bleed from the pill and have no idea whether it’s menopause or not?

[@DeniseMiller-ev3py]

A big thing about hormones is that weight makes a huge impact to sometimes more then age does . I’m a young under weight woman and my lab s said I was low estrogen. Silly me took fats out of her diet big mistake 😳hadn’t had a period in 3 months and the doctor had a talk with me about gaining weight which is interesting. Never take fats completely out of your diets ladies specially if your underweight like me

[@susanryan6648]

Hi Heather, I've seen a couple of your great video's and they are very interesting and educational. A tip I would like to share is the one I got from my then gynaecologist (in The Netherlands, NL), is to have a period / menstruation dairy. I've been recording my periods since 2008 (I had my tubes tied/ tubular ligation surgery done then in NL). I write down their duration, frequency/interval and intensity of my periods, which provides me great insight and information and I can discuss that data here (in Ireland) with my g.p. / family medicine doctor or gynaecologist. I'm 51 years old and in perimenopause for the last 2 years and don't take HRT medication. Thanks for your insights and tips, much appreciated ;-)

[@heatherhirschMD]

Love love love this! So amazed you have all that great data to help you!

[@susanryan6648]

@@heatherhirschMD thank you very much Heather 🥰.Hopefully other women will also keep a menstruation diary 🤗

[@586Rexford]

I am 62 years old, on HRT and have a A1C level of 5.7. Should I be concerned?

[@marzenarongione4968]

Please check my reply in general section I did it by accident

[@jenniferfuicelli4570]

what if we have partial hysterectomy? how do we gauge blood work

[@amylothamer8869]

I am 52 and a active runner. I haven’t had a period in 10 years my fsh was 3.7 and lh .7. I don’t know what to think. I am 5’2 110lbs

[@soyicasweet99]

interesting

[@Hindikahaniya8989]

Maam my mom age is 52 and her fsh is 19.65 she having heavy period . I want to know in how much she will get menopause...? Please reply

[@Sirie7206]

My FSH is 2.5 IU/L what does this mean?

[@ascensionessentials]

If I'm getting blood work done from a lab on my own, what labs do I get drawn? Besides a Thyroid panel? Thanks!

[@bubblesbubble5264]

Can you cover a segment on estrogen face cream ? For example Alloy sells it . If estrogen helps thicken vaginal tissue and helps with vulvodynia, can it therefore be beneficial for decreased collagen in your face?

[@MsQ275]

don't waste your $, I used it for 3 mos and saw no difference

[@missmel9605]

How do you know WHAT HRT to take IF you are menopausal?

[@tdean5840]

I was just at my yearly appointment with my gynecologist, and I told her my symptoms are being extra crabby, my periods are closer together and more painful, and I wake up all night during sleep. She told me she could prescribe me antidepressants, anti-anxiety pills and the pill. So disappointing. 😖

[@darnettaanderson7990]

So frustrating... I refuse to ever let myself be medicated again with anxiety or anti depressant meds. Felt worse on all that was prescribed.

[@cozinha8945]

My FSH level was 125. Im still getting periods, much lighter, every month. Very odd.

[@jodierichardson9631]

Hi i had a total hysterectomy still have ovaries left. I have menopausal symptoms but FSH is 4 and oestradiol is 876 does this still mean im perimenopausal. I have been prescribed Estrogel im about to start it today ? Thanks

[@soyicasweet99]

your numbers are actually really good. the fsh is good and the estradiol is nice and high which is nice. I don't see why they prescribed estrogel for you.

[@marzenarongione4968]

Yes you should It’s no diabetes yet and most doctors will ignore it until it’s too late and you will need medication The menopause can definitely contribute to insulin resistance Definitely start following very healthy diet and exercise

[@mariarufino5888]

I’m in menopause since 2018. Hot flashes are extreme! My hcg level is now 14! What does this mean? Is pregnancy possible?

[@WhitneyYork]

Any reason why my estradiol would be 120ish 6 months post total hysterectomy? In “surgical menopause” but…not, no symptoms for close to a year. Had severe endometriosis, worried about a recurrence.

[@lf7065]

Did you have a BSO? If you did, it is very unusual. Your adrenal glands must be in top form! I'm jelly! 🙂

[@DeeplyRootedLifeCenter]

Do labs matter when you are post menopausal and having symptoms you need addressed?

[@heatherhirschMD]

No, not really, because we know you are menopausal! More helpful if you start on HRT and want to check levels after starting.

[@aquarius-md3ll]

What about ex ample the last period I ve just got was with help of duphaston and fsh 82? It will be considered a period and I will count 1 year from that period if I go 12 months or I have to see when period was coming without medicine?

[@cenalanier6703]

Great video

[@Truth_Seeker86]

So then how would you know what hormone to supplement then and how much? I'm having this problem for the past few years progressively getting worse. (I'm soon to be 38) I'm going through hell! Shorter bleeding days, weight gain in waist and belly, tension headache daily varying in intensity, anxiety through the roof, heart racing especially in the mornings, major weakness and fatigue worse in the mornings but lasts all day/night, muscle tension everywhere, unrestful sleep, mood swings, on and off metallic taste in mouth, bouts of nausea, starting to get very very hot at night the week before my period but yet my feet are usually cold, insane armpit odor no matter how many times I shower and no matter what type of deodorant I use, rage, fear, racing thoughts, dry burning eyes, bone density loss in my mouth my dentist said, receding gums - dentist is worried about the integrity of my bottom teeth bc they're slightly loose!, brain fog, low libido (broke up witj my 8 yr partner due to all of this shit recently, cant work now so I'm on disability. This has ruined my life. I'm a single mom with no family, no car and no money to boot. What should I do? Should I try progesterone since it's progesterone that goes steadily down first at the early stages of peri leaving a woman essentially estrogen dominant? Any advice anyone? Blood work looks great doc said 🤬🙄🥳🥴

[@jh9912]

Can you start estrogen if you are perimenopausal ? I have heard that you could start it within 10 yrs of beginning menopause symptoms.

[@jacquelinel8231]

Yes!! If you are experiencing symptoms, you should be treated based on your symptoms.

[@MistyMorningMangoes]

There are two of the letter “r” in “frustrated”.

[@miakim354]

I'm a 49.5 y.o woman and have never had children . I had regular periods until July 15th this year with about 25-35 day cycle. My last period lasted 15 days (so long and I only had small amount of brown blood spots for the last 5 days though) and there has been no period ever since . I went to obgyn 3 days ago and had my FSH and E2 level tested. The test result was shocking and frustrating. I can't believe my FSH level is 59.9 and E2 is below 5....(I had the same test at the same clinic in Feb this year and the test result was : FSH- 7.3/ E2- 473) I feel suspicious there is something wrong with the test result this time. Even if I haven't had period since early August, is that possible my FSH level skyrocketed and E2 dropped that much in just 7 months? I appreciate your advice and any comment on my situation...

[@soyicasweet99]

No that doesn't mean you are in menopause yet. I haven't had a period since june 9th and it is now September 5th. I had FSh and Estradiol done on June 13th and FSH 30.6 and estradiol 43. Then I just had it done 08/28/24 and my FSh was 4.8 and estradiol 225. So you see it changes. This is the first time my FSH has ever been high and the second time this year that I went 2 months without a period. April and May I didn't get a period either. So I feel I am in peri-menopause but definitely not full menopause because it has not been a year without periods. I don't have children either and I will be 48 on October 9th.

[@lindaabel8233]

I have a question why would my estrogen be on higher levels if I’m in menopause and I’m only using vaginal hormones cream? I haven’t had a period in 14 months. My E2 is 178

[@lf7065]

It can go systemic in some women.

[@freedombug11]

I feel frustrated because I'm 9 minutes into this video and it's not about what I thought. I don't need a "diagnosis" of perimenopause which is super obvious. I only wanted to know how to interpret bloodwork for the purpose of knowing how to treat it. And I already had figured out that bloodwork means pretty much nothing, but then I want to know WHY do they ALWAYS, ALWAYS, ALWAYS take bloodwork immediately when you say you think you're in perimenopause? I don't care about knowing what diagnosis I have, that's so unnecessary, it's so completely obvious, I only want to feel better.

[@jeranjed]

Then watch another video

[@freedombug11]

@@jeranjed If you didn't like my comment, then read another comment.

[@jeranjed]

@freedombug11 why would you complain about it just because it wasn't what you were looking for? That doesn't make it an invalid video.

[@freedombug11]

@@jeranjed It's feedback. For some people it will have been what they were looking for, for me it wasn't. That should be considered useful information for a content creator. The title of the video should have been "Does my bloodwork mean I'm in perimenopause?" Instead it sounded like it could have had the information I wanted, so I wasted my time on it. Why would you complain about someone else's comment? You're a complainer calling me a complainer. We all complain about things we don't like it. Let it go.

[@starbettypink]

please clarify the unit of measure ( FSH 35 ? ) thank you

[@yosiposi]

mUI/mL

[@marzenarongione4968]

We really can’t trust too many western doctors these days. Even though lab work is not as helpful to you it may be helpful as a baseline when starting HRT or a reference for the future. During menopause a lot of things get out of control and can be easily missed . Baseline of overall health is a great idea when starting HRT. Many problems are related to hormonal imbalance and not only sex hormones but all hormones in a body since they all work together. Thyroid panel especially T3, LFT’s, inflammation markers, A1C are just a few that could be missed. Many women don’t do regular yearly check ups and only get a chance to get lab work done when visiting GYN. It isn’t expensive to add few extra labs but for some reason many doctors don’t want to do it. I wonder if they really don’t know what to do with it… Or maybe is the insurance/ revenue issue…

[@donzelleendres9109]

Is Texas in Network yet?

[@bc15540]

Can FSH and estrogen be checked while taking oral contraceptives?

[@heatherhirschMD]

Great question! NO NO NO! they will always show a LOW FSH - even if you were 90 years old! These are called false negatives.

[@MLagarde0425]

@@heatherhirschMD Dr. Hirsh, My Doctor put me on BC because I had an early set of menopause at 37 due to ovarian failure. What about if the BC make you still having a period? My E2 is still low, FSH is low, but the BC stop the brain frog and hot flashes. I have my sanity back. Are there better option? Like bio-identical hormones? I’m 41 now. Are you doing virtual consultation? I live in Florida. I would like to have a consultation with you. Thank you.

[@SoCalRegisteredNurse]

Why is it ok for men to go to these “low T clinics,”‘but women have to go through so many awful symptoms that a lot of practitioners don’t know how to handle or diagnose? It seems that they hand out testosterone to men like it’s candy. I really hope that they explain to men that testosterone related prostate cancer increases due to too much testosterone Edit: typing errors

[@BunnyTree]

My father ended up w cancer using those clinics. They didnt routinely run bloodwork.

[@SoCalRegisteredNurse]

@@BunnyTree That’s awful. I’m so sorry.

[@stephanieferguson5672]

I found out today that I must stop my transdermal HRT, for a upcoming plastic surgery in 2 weeks. Really don’t understand why… so bummed. I’m so scared of all my symptoms rushing back in. I use estradiol patch, testosterone compound cream, progesterone compound cream, and I use the estradiol cream vaginally. Any suggestions what I can do while stopping my HRT for two weeks? 😢

[@emilyencapsulated9540]

They are probably concerned about risk of blood clots. You should be able to continue taking topical estradiol + testosterone, but you'll need to consult with your gynecologist. Usually surgeons are ok if they get the "green light" from another specialist because they will be sharing the liability. Good luck with your surgery and recovery 💜

[@kristinabeck2174]

Wish I seen this video 3 years ago

[@michelea2107]

This is a great help. I was 44 in Nov. my last period was August 6 so 7 months ago. Thinking something is legit wrong i went to Obgyn she did my labs FSH level 85.1 LH 36.9 and Estradiol

[@HodanHared]

My fsh 45 can I get pragnant

[@VADACHE]

Forget about period : I don’t remember anymore what’s period .. all the video talking about Period😒

[@WilbertWilliams-j1f]

Lakin Streets

[@8181Shannon]

I am 50 and have not had a period in 1 year and 5 months now and I have been so frustrated with my OBGYN. She is one of the 5 hormone specialist in my state. I went to her about vaginal dryness and urinary problems and she did a vaginal exam and said everything looks good. Sent me on my way. Continued to have the dryness problem went to my GP and he put me on Estridol cream 1mg vaginal. Went to my OB for my yearly and let her know he put me o.n The Estridol well she got a little mad and said you need to let me take care of your hormones I am o e of 5 top specialist in the state. I said oh ok? At this point I was thinking I came to you and you did nothing! So time has gone by just went to my next yearly and she examined me and said do you have any concerns I proceeded to tell her I have NO libido she and I quote said “well if I had a magic pill for that I would be rich”😮 at this poi t I was shocked. So then she says here is an Arthur of a book to get and download the Rosey app. Wait what Really…….? At that point I shut down! She said anything else.? I said no because I honestly felt like she was not listening to me. I have done a ton of research since then and there are and were other options that could have been done. Testosterone is one. Sad thing is I didn’t even get to the other issues, not sleeping, Brain fog, night sweats come back every once in-awhile, lack of being able to concentrate, muscle ton reduced i train for competitions and have never had this problem, hair thinning. So now I’m not sure where to turn! I have seen her for 29 years and it sucks I have to now find someone else.

[@jacquelinel8231]

Have you tried Midi Health, My Alloy or any other number of online telehealth providers for your symptoms? I would suggest reaching out to one of them; I love Midi Health, they take my insurance, use FDA Bio Identicals and I am HEARD!! In addition, I would see another doctor, she was dismissive of your symptoms, and while we ALL go through Menopause as women, we do not need to suffer through the symptoms. Good luck, I hope you can find someone to help you.