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@kathleen1314 , thanks for your thoughts on this! All my levels are being checked via blood tests. I'm taking estradiol via the patch...does that count as topical? My progesterone is oral.
The breast tenderness really seems to be linked to progesterone. When I lower progesterone dose, the breast tenderness gets better. My provider says based on my blood levels, I seem to take up progesterone at a higher rate than she sees in most of her patients.
My provider has been looking at the ratio of progesterone to estradiol and wants my progesterone lower compared to estradiol. In researching this ratio, I've been unable to find anything much on an ideal ratio. Dr Doug Lucas does mention it, but I haven't seen it anywhere else. Do you know of any research related to this?
Replies to "@kathleen1314 , thanks for your thoughts on this! All my levels are being checked via blood..."
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@wondering1
Yes, the patch is considered a topical transdermal application.
Some sources say Progesterone to Estradiol ratio should be:
In saliva testing, the optimal ratio of progesterone (Pg) to estradiol (E2) in healthy, cycling women during the mid-luteal phase is generally considered to be in the range of 100:1 to 300:1, or up to 300 times more progesterone than estrogen. This high ratio reflects the crucial need for progesterone to balance the effects of estrogen. I also found this in research to be an optimum level.
According to ZRT Laboratory (Salivary Steroids) and related clinical guidelines, the optimal salivary ratio of Progesterone (Pg) to Estradiol (E2) during the mid-luteal phase is generally considered to be 100 to 500. This ratio helps balance the effects of progesterone against estrogen, with a ratio below 100 often indicating estrogen dominance.
The saliva test will spell out the ratio with the results from the saliva test.
Hormones testing is one of those changing, evolving tests. In the past, all hormone tests have been so iffy in all venues, saliva, serum etc that doctors went mainly by symptoms. The problem is many of the symptoms like breast tenderness can apply to more than one hormone although estradiol is usually the culprit. Saliva testing in particular is evolving, probably lead by saliva testing being used for some many other things like cancer tests,measure biomarkers for inflammation, cardiovascular risk, and diabetes etc. etc But...many doctors were trained the old way to only use serum....this is before topical HRT began to be used so frequently....and now the research is saying that the serum will not pick up the transdermal topical accurately. Doctors are still catching up and hopefully the tests will be transformative for all of us sooner than later.
The below might be very helpful for you.
Here is some research with amounts of estradiol and an oral progesterone.
https://www.ncbi.nlm.nih.gov/books/NBK493191/.
copied from the above research "Micronized progesterone 100 mg to 200 mg orally nightly is an excellent starting point. With a standard dose of 0.05 mg estradiol daily in patch form, 200 mg of daily micronized progesterone protects the endometrium. With lower doses of estrogen, lower doses of progesterone may be adequate"
Also, great news in one of largest population studies of hormones ever done the progesterone group was the only one that showed a 0%increase in breast cancers.
https://cemcor.ubc.ca/resources/does-taking-progesterone-alone-or-estrogen-increase-womens-risk-breast-cancer/