Menstrual Cycle Hormones

Whenever someone asks me about levels of menstrual cycle-related hormones during their cycle and the answer isn’t obvious I go to the figure below from Wikimedia (this article). What I love about it is that it shows the average (bold blue line) and then the biological variability around that average (dark blue shaded area)… and then also how much this can vary between cycles and between women.The figure is based on a study performed in 2006 that measured hormone levels in 20 ‘normally cycling women’ not on birth control pills. The data were reanalyzed in 2014 and these figures created.

One example of when I might refer to these figures is if someone tells me that they’ve just had blood drawn, they don’t know what cycle day they’re on (e.g. have not yet had their first post-HA or first postpartum period), and LH was measured at 17 and estradiol at 215 pg/mL. I can check these figures and see that that most likely corresponds to just before ovulation. If LH is 17 and e2 is 85 pg/mL that might mean that ovulation has just occurred. If LH is 17 and estradiol is 30 pg/mL then I might suggest inducing a bleed and testing a hormone panel to determine if PCOS might be in play.

I think what is unique and particularly helpful in these figures is the inclusion of variability so one has an idea of the typical range for these hormones. Let me know if you have any questions!

Nico

 

 

Femara or Clomid for Ovulation Induction?

Summary: If you are not ovulating naturally even after working on recovery, and want to use medication to induce ovulation for pregnancy, Femara (letrozole) is preferable to Clomid (clomiphene)*.

letrozol3d

 

 

Letrozole, By MindZiper – Own work, CC0, https://commons.wikimedia.org/w/index.php?curid=15991603

 

In No Period. Now What? (NPNW), our book on hypothalamic amenorrhea recovery, Chapter 21 covers the oral medications that can be used to encourage ovulation. We discuss how soy isoflavones, Femara, Clomid, and tamoxifen reduce estrogen levels to encourage an increase in follicle-stimulating hormone (FSH) that in turn leads to growth and maturation of eggs. These medications can be used when pregnancy is desired, but also to “jump-start” menstrual cycles*. It is really important to note that these meds are unlikely to work without progress having made toward recovery in the form of increased eating, reduced exercise, and reduced psychological stress – all of which you can read about in earlier sections in our book.

clomifene_ball-and-stick

 

 

Clomiphene, by MarinaVladivostok (Own work) [CC0], via Wikimedia Commons

 

 

We also cover research comparing pregnancy rates, likelihood of a multiple-gestation pregnancy, uterine lining thickness, and other metrics between Femara (letrozole) and Clomid (clomiphene citrate) to help women decide which choice is optimal for them. (Tamoxifen is an alternate that is rarely used, so there is not a large body of research to reference, although in many ways it is preferable to Clomid based on fewer effects on the uterine lining.) We also discuss dosing recommendations, what to do if the first cycle doesn’t work, and much more. 🙂

Our conclusion in NPNW is that if one is trying to get pregnant, Continue reading

Getting the word out!

Helping women with hypothalamic amenorrhea / female athlete triad / missing periods to recover–regain their cycles and realize how much needless energy has been spent on food, exercise, and appearance–has been my passion for the last ten years. For many years I helped women on the HA forum at FertileThoughts.com, but since 2012 my posting there slowed down as I worked on the book.

Now that the book is done… it’s really time to get the word out. We’ve gotten so many positive reviews and comments on our work, like what Amanda said recently,

I want to take a moment to thank you from the bottom of my heart. I’m almost done your book and can see that you’ve poured years and years of your life, heart and soul into that book and raising awareness around HA. I can’t tell you how much I’ve learned and how motivated I’ve become to continue to work on my health and hormonal integrity and to incorporate BALANCE into my life. Not to mention that this book will spearhead an increased awareness of HA and hopefully a new understanding of the importance of maintaining female health……THANK YOU!!!

Meret Boxler, whom I met on a hypothalamic amenorrhea support group on Facebook, has been working on being compassionate with herself, redefining her view of what healthy is and looks like, and focusing on the positives in her life. As a former radio DJ creating a podcast series seemed a natural next step – and she wanted to interview ME!  So I am super excited to share that interview with you. Take a listen, and if you enjoy, please subscribe to her feed, give her lots of likes, and reviews would be fantastic.

LU 003: Nicola Rinaldi – No period. Now what? Health issues from overexercise and too little food.


Subscribe on iTunes (Apple), or on Stitcher (Android)

Shortly thereafter, having gained some confidence from the interview with Meret (on top of which it was a really enjoyable conversation), I was directed to a video on YouTube that contained misinformation about HA and its causes. So I immediately thought that doing my own video would be another fantastic way to get the word out about our hypothalamic amenorrhea recovery book along with basic information about HA that it’s important for people to understand. That video is below – and again, if you could like and comment that would be stellar – the more likes, the more people will be able to find it and educate themselves about missing periods and the effects on our health.

Thanks so much!!! xox Nico