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Forum Name: Endocrinology Topics

Question: Hormone imbalance?


 dj26 - Mon Jul 09, 2007 5:10 pm

Hello,

I am writing about my wife: 32 years old, female, no past diagnoses, no past surgeries, I don't know of any related family history, and no current medications.

My wife has struggled with a series of symptoms for approximately one year now - fatigue, lack of sex drive, mood swings, gaining weight around her midsection and unable to take it off, water retention, specifically in her legs, inability to deal with stress, dry hair, bad skin, depression.

I should specify that she is by no means heavy (5'2", 120 lbs), but she is very aware of her body and has noticed that she has put on weight and is unable to take it off. She works out approximately 5 times a week with a mixture of cardio work, weight training, and bikrham (hot) yoga. She takes this very seriously and trains more like an athlete than your typical woman who works out to stay thin.

She believes these symptoms can be traced back to a rather traumatic event at her job, which happened at the same time that she was training for a half marathon. As she puts it, she's never felt the same since then.

My father-in-law is a doctor, which I mention, because it helps explains why my wife is fixated on identifying the underlying cause of her issues. She has gone to many doctors for blood work, convinced that she has a hormonal imbalance. Her progesterone levels consistently seem very low - around 3 during the mid-luteal phase (I think I have this correct) of her cycle. The one endocrinologist she has seen said this wasn't an issue and wanted to put her on anti-depressants, which as you can imagine infuriated her to no end. Her OB/GYN also was not overly concerned with her blood tests, although from what I can see her progesterone was outside of the appropriate range (too low) and her testosterone is at the very bottom of the acceptable range. Her thyroid test have all come back normal.

During all of this, we recently found at that she was pregnant. We are trying to get pregnant, although my top priority is getting her to a point where she can feel "normal" on a daily basis. We found out that she was pregnant about 3 weeks after conception and she miscarried at approximately 4 weeks after conception. Interestingly, she had gotten blood drawn that day and we found that her HCG level was only 300 and her progesterone level was 1.7.

The last piece of the puzzle is that she used to use progesterone cream, prescribed by her father, but since she never really knew why she was taking it, she ultimately stopped on her own. I can't point back to that time and say she was fine while on the cream and then things went south after she stopped, but I have to admit, I am frustrated that her father didn't tell her not to go off the cream, since he is now saying that she was on it, because her progesterone has always been low.

Her father has also been talking a lot about adrenal fatigue, since she has extreme difficulty dealing with stress - things that I see as just normal life/work difficulties, will set her off into a terrible fit of crying and a sense that "things shouldn't be this hard." I have to admit that I go back and forth on daily basis between thinking this is a hormonal issue and thinking that it is completely a psychological issue (which I do understand is a medical issue in it's own right).

Ok.. long post, I know. Here's where I'm at now. We have an appointment with a reproductive endocrinologist and what I'm wondering is if there is anything we can do to be as prepared as possible for this appointment (blood tests, saliva tests, etc.) I am extremely frustrated with how long we have been dealing with this and I want to do anything possible to make this next doctor's appointment productive. Any suggestions on how to present these issues so that the doctor looks at if from a general "all the time well-being" issue and not a fertility issue. I feel like my wife is slowly becoming less and less functional and I am desperate for a doctor to make an attempt at a diagnosis.

Thanks you so much for taking the time to read this and I appreciate any thoughts you might have.
 Dr. Chan Lowe - Fri Jul 20, 2007 6:40 pm

User avatar Your situation sounds difficult. Something seems wrong and yet it isn't being found. In these cases it is always best to be persistent and continue to follow up with her doctors.

She may want to have her cortisol levels checked. Low cortisol levels can produce nearly all of her symptoms.

Additionally, given that her progesterone is a touch low, your reproductive endocrinologist may recommend she take progesterone supplementation during the first part of pregnancy.

I think presenting her case the way you have here is a quite effective way to get a good overall picture. You may also want to discuss the exercise issue as excess exercise can have endocrinological consequences. (I'm not sure your wife fits this category but it may be worth exploring.)

Best wishes.

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