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What Causes Low Estradiol And AMH Levels?

Posted on Thu, 11 May 2017

Question: Hello Dr. As mentioned earlier, I had recurrent UTIs and also unusual PMS like breast swelling, short breaths and cramps before the onset of periods. My cycle is regular and is 26 day cycle. My doc recommended hormone tests last week for my symptoms and did it on the 2nd day of my period. While I assume other hormones are fine, my Estardiol (E2) test is showing <5.0 pg/ml and AMH shows 2.3 ng/ml. I am 29 years now and I am afraid if I am endangered with severe infertility issues. I am yet to consult my doc with reports. So anxious and worried. Please let me know if this is a serious issue and what will be the course of treatment? Also, can this be cured soon?

Answered by Dr. Deepti Verma (4 hours later)

Brief Answer:
Repeat test advised

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
Low estradiol and AMH levels are suggestive of decreased number of follicular production in the ovaries.
However, the confirmation should be done by a repeat test in next cycle.
In this scenario, you should plan early pregnancy and if the infertility issues are there, then you should go for assisted reproductive technology like in vitro fertilization.
There is no treatment for increasing AMH and Estradiol levels.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Deepti Verma (34 minutes later)

Thank you doctor. So, a natural pregnancy is possible in this scenario? Or is there a way to stimulate follicle production? What could be the reason behind this issue? I really want to conceive faster and naturally. I am hesitant to venture into stuff like IVF immediately. Every month a week before my periods, I undergo lots of symptoms just like pregnancy and my periods come in. This leaves me depressed. So my UTIs and these symptoms could be a sign of low estradiol?

Answered by Dr. Deepti Verma (5 hours later)

Brief Answer:
try to conceive naturally for at least one year

Detailed Answer:
Hi dear,

Natural pregnancy is possible in this scenario.

Moreover, I will suggest you to try to conceive naturally for at least one year before going for infertility treatment.

UTIs and premenstrual symptoms are not at all signs of low estradiol.

Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Deepti Verma (12 days later)

Hello doctor. Thanks a lot for the detailed explanation. I consulted a Uro and did a KUB scan. Shows cystitis and bladder inflammation. He also did tests like Mantoux, urometry and all are fine. Seems my PVR is little higher. My urine reports are normal too. While this is existing, my another complaint is that I get weird symptoms exactly 8 days before my period. Breast swelling, right abdomen cramping and mouth dryness until I get my period. Is this coz of my estradiol? Also, I consulted an endocrinologist and he says my hormone reports show error as estradiol cannot be so low. However, I am repeating the test again. My question is these symptoms indicating something serious? My periods are regular, no PCOs or any other complaint. Are these hormonal? I am confused as every cycle we keep trying for pregnancy but I get these symptoms end up having period. Kindly advise.

Answered by Dr. Deepti Verma (3 hours later)

Brief Answer:
Not indicative of any serious situation

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
Symptoms like breast engorgement, abdomen swelling, and mouth dryness 8-9 days prior to menstruation is suggestive of premenstrual syndrome.
No, these symptoms are not suggestive of any serious situation.
These are generally hormonal imbalances.
Proper treatment will lead to pregnancy.
So, get the test repeated and get the further treatment accordingly.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepti Verma (16 hours later)

Thanks a lot, doctor. I have been consulting so many gynecs and have not found a solution yet. I would have consulted you, if you were in XXXXXXX :) my endocrinologist said if my hormones are low, (LH) injections can be given and it is treatable. Is that right? Because I want to conceive naturally and don't mind if it is just injections. Will those have side effects? If I may ask, can you refer or know some of your gynec friends practicing in Chennai?

Answered by Dr. Deepti Verma (7 hours later)

Brief Answer:
Yes, injections can be given

Detailed Answer:
Hi dear,
I am happy to have helped and comforted you.
Thanks for appraisal.
Yes, LH and FSH injections can be given in the patients with low levels of these hormones in the body and are unable to conceive naturally.
I will again strongly suggest you to try for natural conception for at least 6 months.
If there is no pregnancy in that time period, then you can go for infertility treatment in any good infertility center.
Sorry, none of my gynaec friends are in XXXXXXX
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepti Verma (15 hours later)

Thank you so much doctor. As there seemed to be some fault in my reports, I am consulting another gynec just to check on those reports. I'll get back to you again in case of any doubts.

Answered by Dr. Deepti Verma (20 minutes later)

Brief Answer:
Happy to help

Detailed Answer:
Hi dear,
You can get back to me anytime for your query.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Deepti Verma (23 hours later)

Hello Dr. I consulted the gynec and she confirmed that my hormone reports are wrong. She has just asked me to come for an in-cycle scan this time. Just 3rd and 13th day. Otherwise she asked me not to worry. She is only focussing on my UTI now. Now as I am due for period in a week, my cramps are sharp and annoying. I told her that and she said it could be due to age and not of a concern. But this morning the pain was again sharp on the right. It stays not more than a second. Still, it is a discomfort. Should I just not notice it? She has prescribed Norflox for 21 days every night to wash off UTI if any. Can I go ahead with that? I don't want to take antibiotics and get resistant again. I took a lot tablets till now. Please advise.

Answered by Dr. Deepti Verma (5 minutes later)

Brief Answer:
Follow the advice

Detailed Answer:
Hi dear,
The sharp pains can be due to premenstrual symptoms, urinary tract infection or pathologies like endometriosis.
First of all the urinary tract infection should be treated.
Norflox is given for a prolonged duration if the urinary tract infection is recurrent and troublesome.
It is fine to take the tablets as advised and resistance will not develop if you take the antibiotic consistently.
Once the UTI is treated, and even the pain perisists, then a laparoscopy should be done to rule out any pelvic infection and endometriosis.
Regards
Dr Deepti Verma
OBGYN

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Above answer was peer-reviewed by : Dr. Kampana