Q. My estradiol level is low. Will taking DHEA help in increasing the same?

Answered by
Dr. Vidyaprem
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 02, 2020

Hello doctor,

I had a miscarriage two months ago resulting in a Dand C at 10 weeks.

I am now pregnant (4 weeks and 3 days) and taking 400 mg Progesterone suppositories once per day due to low progesterone levels both in the last pregnancy and in the weeks leading up to the confirmation of this pregnancy. However, my doctor has told me that my estradiol is very low, and that is concerning me.

My results so far:

14 DPO

Hcg 69 U/L

Progesterone 77 nmol/L

Estradiol 220 pmol/L.

Two days later:

16DPO (yesterday),

Hcg 129 U/L,

Progesterone 75 nmol/L,

Estradiol 239 pmol/L.

Is my pregnancy doomed because of my very low estradiol? I was hoping my doctor would prescribe estrogen medication but he does not seem to think that would be an option. Why would he decide that? Do you think estrogen supplementation would help? Instead he is having me take 25 mg daily of DHEA. Do you think this will help and is it safe to take in pregnancy? Will eating foods high in phytoestrogens e.g. soy help increase my estradiol?

Also, do you think my low Hcg levels are a bad sign? At 12DPO they were 15U/L so they increased rapidly to 69U/L on day 14 but then slowed a bit to get to 129U/L on day 16.

I am due for another blood test tomorrow. I really do not want to lose this pregnancy, but these low numbers are making me worry.

Dr. Vidyaprem

Obstetrics And Gynaecology
#

Hello,

Welcome to iclinq.com.

I saw your concern. The normal levels of estradiol in early pregnancy can vary from 188 to 2400 pmol/ l. Similarly, progesterone can vary from 12 to 90 nmol/l. HCG (human chorionic gonadotropin) has doubled, which happens only in a healthy growing fetus with good trophoblastic activity.

Do not worry much about estradiol, it has no big significance in treating previous early miscarriages. Everything looks normal. Continue progesterone for luteal support and prenatal vitamins as prescribed. Above all stay positive and confident.


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Thank you doctor,

The reference ranges I have read say that estradiol levels in the first trimester are normal between 188 to 2400 pmol/mL (rather than pmol/L). If my levels are 239 pmol/L (not per ml) are not my levels concerningly low?

Dr. Vidyaprem

Obstetrics And Gynaecology
#

Hi,

Welcome back to icliniq.com.

Yes, it is low, but estradiol levels are not great predictors of early miscarriages as the HCG and progesterone. It is not routinely done in many centers as it produces unnecessary concern and nothing much can be done about it.

Regarding progesterone, yes it definitely helps in maintaining the luteal phase. Maybe we can add Ecospirin 150 mg to improve the uterine blood flow in such previous miscarriages and nothing can be done about increasing estradiol levels, at this point in time.


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