QuestionDear Sir,
I have quite a complicated question for you. I hope you can help me.
At the beginning of October, I (25,f) discontinued the BCP (Diane 35, I live in Europe). At the beginning of January, I started having some problems - oily skin, very oily hair, scalp acne, sweating problems, body odor). Also, I didn't have my period until 3 months after discontinuing, and then the next one maybe 1 and a half months later.
Then at the beginning of February, my hair started falling out in huge amounts. I panicked and got a hormone panel done by my OB/Gyn at the beginning of February. That showed that I had low estrogen, normal/low total testosterone and elevated free testosterone (1.6 while the reference range was 0.1 till 1.0). I immediately started taking the pill again on the 12th of February.
I later went to my endocrinologist who did an exam for PCOS. She didn't find any cysts, so she said that my free testosterone was only elevated because I had low estrogen (and therefore low SHBG). She said I had low estrogen because I am severly underweight. I am not normally that underweight but I had lost tons of weight due to a traumatic experience prior to coming off the pill. Maby that's why I never had this problem before when getting off the pill, my periods were always like clockwork and I have never had any hairloss or oily skin.
She told me to keep taking the pill and that all my symptoms would go away, and that I didn't need any further antiandrogen therapy because my total testosterone was rather low. Now I have been taking the pill for 2 and a half months and all my symptoms are gone, but I still have hairloss. My endocrinologist says that's normal as the pill takes time to change the level in the serum and then the hair cycle also takes 3 to 4 months.
Now my questions:
How much time does it take for the pill to change or balance hormone levels in your body?
I've read online that the pill reduces free testosterone by about a half. However, if it's only half, that's not enough! My endocrinologist said not to worry as now with the pill I have the same estrogen levels as I've always had with it and that my androgens have always been on the low side.
Is it true that now that I'm back on the pill (35 EE) I have the same estrogen levels as I've always had on the pill? Or do the low estrogen levels I had before still have an effect?
Please help! I want to trust my doctors, but I'm so scared the hairloss will never stop. Everytime I think about my hormone levels, hundreds of questions keep popping up in my head. Please help.
AnswerThe pill will normalize your estrogen levels almost immediately. I'm not sure how long it takes to change SHBG and free testosterone levels, but I would guess it's fairly quickly.
If the pill reduces your free testosterone by half, that would make it 0.8, which would be in the normal range. The pill also decreases testosterone production from the ovary.
When a woman takes the pill, her ovaries are pretty much inactive, so all her estrogen is coming from the pill. So it's true that you now have the same estrogen levels as you've always had on the pill.
Hormone changes often cause temporary hair loss. I would try to trust your doctors. It sounds like they're advising you well.
