Estradiol levels

Ask our Nurses your questions
1

Hi,
Been on zoladex for almost 2 years & letrozole since july. Told my oncologist that i dont have many menopause symptoms & hot flashes seem to come in waves so i was unsure whether i was in menopause.
She sent me for hormore blood tests. My level (didnt say which one) was 70. I asked what level it should be & she told me new guidance has said 88. However she now wants me to gwt hormone testing every 4 months so shes worried about something as this has never been mentioned during the last 2 year…it was something i pushed for. Oncologist is never very transparent & i have complained about this before but it makes no difference.
Ive googled & it says menopausal women should have an estradoil level of under 30.

What should the estradiol level of a women finished cancer treatment (triple positive) and havung been on zoladex & letrozole for 2 years?

Is hormone testing every 4 months standard practice?

What action can be taken if aforementioned medication is not surpressing estradiol levels enough?

2

Gosh - I’m sorry that you’re going through this. I started Letrozole 2 weeks ago (based on oestradiol levels of over 800!). I’ve been in peri-menopause for a while now, went 4 months without a period and luckily my oncologist tested my levels. The day I had my blood tests I started another period - one that lasted 2 months!
My oncologist has also said I need my levels to be below 30 as that’s the accepted level.
I was under the impression that the Zolodex should bring down the levels within 3 months and has suggested hormone testing every three months. I am desperate to get started as I have now had ER+ BC twice and I want to throw everything at it to not get it a third time.
Good luck to you - I’m not sure there is anything you can do but wait.
x

3

Hi,
Thanks so much for your reply. So sorry to hear youve had to go theough this twice.
A bit personal, but are you overweight? Dont answer if you dont feel comfortable.
I am and ive read that that is a risk factor for raised estradoil.
I wonder if one of the nurses could answer my questions & tell me whether losing weight would reduce my estradoil levels? Also how kuch would need to be lost to make a significant impact?

4

Are any of the nurses on the team able yo answer my questions?

5

I’m sorry you haven’t had a reply yet. The nurses cover the phones Mon to Fri 9am- 4pm and Sat 9am-1pm, and I think that is very similar to answering online questions as well. I hope you get an answer on Monday.

You might want to call 0808 800 6000 to speak to a nurse during the hours above if you don’t get a reply.

:smiling_face_with_three_hearts:

6

Hi Luskentyre1,

Thanks for posting.

As @naughty_boob explains we are open Monday to Friday 9am-4pm and the helpline is also open 9am to 1pm on a Saturday. Written responses are replied to during the week.

Monitoring hormone levels, most specifically oestrogen, whilst on breast cancer treatments such as letrozole (aromatase inhibitor (AI)) and Zoladex can be problematic.

There may of course be a reason why your oncologist is suggesting this, which would be helpful for you to know as it is unclear what guidelines they are referring to. It’s also not clear what blood test and level this figure is referring to so it’s difficult to answer your questions but sounds likely to be oestrodial.

You also ask if losing weight can affect oestradiol levels. The studies related to this appear to be in women without breast cancer and whether this affects their risk of developing breast cancer, not in women with a previous history of breast cancer.

Do speak to your team about this but if communication with your oncology team continues to be difficult, you may want to consider asking for a second opinion. This would involve seeing another specialist doctor who will give their opinion on your situation and help you to feel reassured that you are getting the most appropriate treatment and care.

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to more support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).

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Best wishes

Vic

Breast Care Nurse

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