Pgdiol/E2
Based on the optimal luteal levels of urinary Pgdiol (about 1300-2000 µg/g creatinine) an optimal working range for the ratio of this progesterone metabolite to estradiol was established based on the median level of urinary estradiol (1.37 µg/g creatinine). Thus the optimal working ratio of urinary Pgdiol to estradiol in the premenopausal woman during the peak luteal phase should be in the neighborhood of about 1000 to 1500.
IMPORTANT NOTE: Topical progesterone raises urinary Pgdiol very little even with pharmacological dosing (50-300 mg), likely because topically delivered progesterone is excreted primarily in bile/feces. In sharp contrast, oral progesterone therapy raises urinary Pgdiol to levels much higher than seen in premenopausal women (luteal phase), without raising blood, salivary, or tissue levels of progesterone very much. For these reasons, we suggest for those individuals using oral, topical, or vaginal progesterone to evaluate the active bioavailable levels of progesterone in saliva or capillary blood (not venipuncture serum).
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What does it mean if your Pgdiol/E2 result is too low?
A lower ratio, associated with higher estrogens and symptoms of estrogen dominance, is commonly seen in women approaching menopause (perimenopausal) and is often successfully treated by lowering the estrogen level with improved diet, exercise, and nutritional supplements that increase estrogen elimination, and/or by increasing progesterone with supplementation.
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