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Forum Name: Endocrinology Topics

Question: POF and FSH Levels


 stephyg - Wed Jan 10, 2007 2:02 pm

Hi there

I was diagnosed with POF in 1999, I have been on HRT since then, I have tried different sorts including Prempak-C, Kliofem, Estracombi TTS and I am now on Evorell and Norethisterone. I am 23 years old and i don't seem to be getting any answers. When i was 17 i had my FSH levels tested they were way off the scale at 126. Last year i had my FSH levels tested again and they had gone down to 43 or something. I was wondering if this was normal, whether it meant that my ovaries were starting to function again or if it was just the HRT that was giving this reading? The doctor seems to think that it is an antibody problem and has advised me to go back in two years to have blood tests for my thyroid. Its all so confusing. But still.

I know the chance of my ovaries working again are very slim, but if my FSH are going down then is there any hope??? and i have not had any assessment about my HRT as i have now been on them for nearly 7 years.

Thanks for reading!!

Stephyg
 Dr. Chan Lowe - Wed Jan 10, 2007 9:09 pm

User avatar An initially elevated FSH level is consistent with ovarian failure, though this is not the only cause. FSH is counterregulated by estrogen. FSH stimulates estrogen production. As the ovaries make estrogen, the pituitary gland senses the estrogen and decreases its production FSH. (A little simplified but it works.)

If the ovaries are failing, the pituitary makes more and more FSH to try to induce estrogen production. Once you start on hormone replacement, the pituitary senses this hormone and decreases the production of FSH, leading to a lower level. A persistently elevated FSH in the presence of HRT would indicate a different disorder.

Unfortunately, if you do have ovarian failure it is unlikely that your ovarian function will return. Regarding HRT, there are many, many choices. Keep working with your doctor to find one that works well for you with minimal side effects.

Regarding the antibody testing, ovarian failure may be due to an autoantibody the body is producing that attacks the ovaries. When the body is making one autoantibody it not uncommonly will also make others. So, testing thyroid function is an important step to look for autoimmune thyroid damage as well.

Hope this helps.

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