u/Certainly-a-duck

24F who started experiencing menopause symptoms at 23 while still cycling regularly. First lab was done at 23. All labs done during luteal phase. Symptoms included hot flashes, vaginal atrophy, irregular periods, night sweats, difficulty sleeping, dry eyes, tachycardia, low libido, muscle wastage, dry skin, fatigue, moodiness, unexplained high cholesterol. Symptoms worsened overtime and cycle became less regular. All symptoms helped with synthetic hormone along with vaginal estrogen.

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First lab (already experiencing symptoms at 23)

-Estrogen at 266 pmol/L (normal range 220-850)

-Progesterone at 30 nmol/L (normal range 15-90)

-FSH at 2.5 IU/L (normal is under 7)

-LH at 2.1 IU/L (normal is under 15)

-AMH 15.1 pmol/L (normal range 8.7 - 83.6)

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Second lab done as symptoms worsen (23 luteal phase)

- Estrogen at 44 pmol/L (normal range 220-850)

- progesterone at 1.6 nmol/L (normal range 15-90)

- FSH at 7.1 IU/L (normal is under 7)

- LH at 6.0 IU/L (normal is under 15)

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3rd lab done as symptoms worsen (24 luteal phase)

- Estrogen at 116 pmol/L (normal range 220-850)

- progesterone at 1.7 nmol/L (normal range 15-90)

- FSH at 5.4 IU/L (normal is under 7)

-LH at 3.4 IU/L (normal is under 15)

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Negative for PCOS, thyroid issues, addisons, adrenal issues, and STIs.

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Birth control and vaginal estrogen was started after 3rd lab and greatly improved symptoms, but total symptom management has not been reached.

If it's not primary ovarian insufficiency... what is it? Is HRT recommended to treat symptoms?

I post too much here:( An update: I am in search of a second opinion (I have 2 appts set up and will turn to telehealth options if those 2 fail). I have FINALLY gotten a hold if my labs. I've accounted for where I was in my cycle when I had my blood drawn... I wasn't expecting what I saw.

First labs (done by a walk-in when I was already having symptoms of low estrogen at 23yr, levels all normal):

-Estrogen at 266 pmol/L (normal range 220-850)

-Progesterone at 30 nmol/L (normal range 15-90)

-FSH at 2.5 IU/L (normal is under 7)

-LH at 2.1 IU/L (normal is under 15)

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Second lab done by a menopause specialist at 23yr, some levels abnormal

- Estrogen at 44 pmol/L (normal range 220-850)

- progesterone at 1.6 nmol/L (normal range 15-90)

- FSH at 7.1 IU/L (normal is under 7)

- LH at 6.0 IU/L (normal is under 15)

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3rd lab done by a menopause specialist at 24yr, some levels abnormal

- Estrogen at 116 pmol/L (normal range 220-850)

- progesterone at 1.7 nmol/L (normal range 15-90)

- FSH at 5.4 IU/L (normal is under 7)

- LH at 3.4 IU/L (normal is under 15)

My menopause specialist has been withholding substantial treatment for years because of these labs. For 2 miserable years, I have been told that my estrogen and everything looks fine and PERHAPS I was a tiny bit low on the 2nd lab, but in reality my estrogen and progesterone were very low for the 2nd and 3rd lab. She's been throwing around POI as a diagnosis but also treating me like I don't have any abnormal labs. My FSH and LH were never given a chance to rocket upwards because I was still cycling when the labs were taken, and then I was started on birth control which would suppress my FSH anyways. Meanwhile I was suffering from just about every peri-menopause symptom under the sun and wishing I'd just die already. Idk if this is POI... but my estrogen and progesterone are not fucking normal. No wonder birth control wasnt enough to resolve my symptoms. Not even taking 2 birth controls at once is enough (I know I shouldn't be doing that, just hella desperate). I recovered from a 10 year eating disorder at 22yrs. My bone density was at risk and I had precious years to max out on bone density before I reached peak age. Those years were WASTED.

My menopause specialist sucks. She must have a doppelganger going to recertification meetings for her. I BEGGED her for HRT again. I explained that out of desperation I started taking 2 birth controls at once and the increased dosage helped me greatly. I explained that the vaginal estrogen dosage was still way too low. I explained that my boyfriend has had a vasectomy and I am not interested in a contraceptive and that my libido is very important to me.

Her response:

1. Put me on another birth control... this one is a combo patch with the SAME DOSAGE AS THE LAST PILL (the same pill that led me to desperately take 2 pills at once). The thinking here is that I might absorb it better because its a patch.

2. NOT increase my vaginal estrogen dose because of cancer risk. (I am taking 10mcg vaginally every 3 days, and 0.1mg/ml of estrogen and 1mg/mL of testosterone every 2 days and my vulva and vagina are wasting away painfully.

3. Suggest daily coconut oil for atrophy pain.

4. Plan to put me on a bioidenticle estrogen + Slynd (a mini pill) for progesterone management if the current treatment fails. This will not address my libido concerns.

5. Wait for an endocrinologist referral to come through to help with bioidenticle HRT prescriptions (that she should be qualified to do herself). This may take years.

6. Tell me to rebook in 2 months (better than 3, but devastating when I can tell that the treatment isn't enough in about a week.)

Everytime I go in there it's like walking into an advertising firm. There's products and treatments and brochures everywhere. 1 1/2 years ago she diagnosed me with pretty severe vaginal atrophy and said she will not prescribe me vaginal estrogen until I attended pelvic floor therapy. The upfront cost was $270 and every 2 weeks after that it was $180.

I'm calling support to view my labs so I can finally see what's going on myself. I cannot trust her to put me on a reasonable dose of hrt in 2 months. I cannot trust her to keep increasing my dosage until complete symptom management. It's been 2 years of suffering. Going on HRT in 2 months feels like a win, but not when I remember she's prob gonna start me on the lowest dose possible and force me to wait while suffering again.

I'm in alberta Canada. Any reccs for drs? I've already been referred to an endocrinologist but I need help soon. I can't live like this.

I had severe vaginal atrophy that has been half ass managed for 2 years now. I hate the way my vulva looks. Despite suppositories and compounded estrogen and testosterone cream, my stupid junk is dry and thin and looks like someone took a meat tenderizer to it. I am the beef pieces in your Chinese buffet chow mein. My pelvic floor therapist suggested catheter lidocain. My menopause specialist is too cautious to treat me properly. I don't want to have to slather on creams and shit every other night just to have a "functional" vagina. I dont want to have to schedule sex with my partner around my treatment. I don't want to be unable to use toys or do finger stuff. I am 24 and I don't deserve this. I just want to be normal. I want to feel sexy when I take my panties off.

In 2 days from now I am going to beg my doctor for HRT and a stronger cream... but I have doubts. I am feeling so down right now. I feel so ashamed and Inadequate. I wish I could show Dr's a picture of my vulva before all this so I can demand that this isn't good enough. I NEED more hormone

I've heard that in menopause age women, FSH doesn't really start to skyrocket until after periods have stopped (not during the perimenopause years). I know a lot of us have had perimenopause symptoms leading up to a diagnosis... When did your FSH rise? Were you able to convince your Dr to give you HRT before the FSH was out of the normal range?