Dr. Rachel Rubin

It looks kind of like the stock market. Actually, it goes up, it goes down. And it's not even just checking it every three months. If you check it every 10 days, you're going to see a fluctuation. I'm obsessed with looking at the menstrual cycle. I'm obsessed with talking about numbers here because it is so fascinating and we are not taught to think this way.

It looks kind of like the stock market. Actually, it goes up, it goes down. And it's not even just checking it every three months. If you check it every 10 days, you're going to see a fluctuation. I'm obsessed with looking at the menstrual cycle. I'm obsessed with talking about numbers here because it is so fascinating and we are not taught to think this way.

And so I have a lot of curiosity about it. So, for example, when you're in your, let's call it healthy reproductive years. And by the way, nobody is the book. You talk a lot about continuous glucose monitors. I would love continuous sex hormone monitors. And unfortunately, I know there'd be a lot of unintended consequences and bad things that would come of it.

And so I have a lot of curiosity about it. So, for example, when you're in your, let's call it healthy reproductive years. And by the way, nobody is the book. You talk a lot about continuous glucose monitors. I would love continuous sex hormone monitors. And unfortunately, I know there'd be a lot of unintended consequences and bad things that would come of it.

But I'd be very interested because the book says are low. So if you have your period that you're bleeding, that's day one. your low is not zero. In fact, it's probably somewhere 40, 50 is probably what the low should be of estradiol. And that's picograms per milliliter, as opposed to testosterone, which we do nanograms per deciliter, as you know. So let's say 50 is your low.

But I'd be very interested because the book says are low. So if you have your period that you're bleeding, that's day one. your low is not zero. In fact, it's probably somewhere 40, 50 is probably what the low should be of estradiol. And that's picograms per milliliter, as opposed to testosterone, which we do nanograms per deciliter, as you know. So let's say 50 is your low.

Then you go at ovulate and that's in your mid cycle. And usually it's about 150. Let's say ish. Maybe it's 200, 300, whatever it is. Pregnancy, your level is 3000 or higher, right? It's very high. And so if you're in your normal reproductive cycle, you go from 50 to 150. So let's use the gas tank analogy.

Then you go at ovulate and that's in your mid cycle. And usually it's about 150. Let's say ish. Maybe it's 200, 300, whatever it is. Pregnancy, your level is 3000 or higher, right? It's very high. And so if you're in your normal reproductive cycle, you go from 50 to 150. So let's use the gas tank analogy.

You're at a quarter tank at 50, and you go to three quarters tank at 150, then down to a quarter tank. You can drive wherever you want to go during that time. What happens in perimenopause, and it is this chaos and erratic fluctuation where your body is just wanting more hormone than it has. Your brain, your FSH is telling your eggs to do more than they can. Sometimes they overshoot.

You're at a quarter tank at 50, and you go to three quarters tank at 150, then down to a quarter tank. You can drive wherever you want to go during that time. What happens in perimenopause, and it is this chaos and erratic fluctuation where your body is just wanting more hormone than it has. Your brain, your FSH is telling your eggs to do more than they can. Sometimes they overshoot.

So now you are overflowing gas. I had a lady come in, her day one, her estrogen was 200, and her day 10, her estrogen was 900. So this is this wild fluctuation in perimenopause.

So now you are overflowing gas. I had a lady come in, her day one, her estrogen was 200, and her day 10, her estrogen was 900. So this is this wild fluctuation in perimenopause.

And that video is so fantastic. We actually were talking about it before doing this podcast about that video. And I said, you know, if you asked most OBGYNs to draw the menstrual cycle, many of them wouldn't be able to do so. It's incredibly complicated. And it's so confusing. And we think our doctors know everything. And unfortunately, they don't.

And that video is so fantastic. We actually were talking about it before doing this podcast about that video. And I said, you know, if you asked most OBGYNs to draw the menstrual cycle, many of them wouldn't be able to do so. It's incredibly complicated. And it's so confusing. And we think our doctors know everything. And unfortunately, they don't.

And so what happens is estrogen, you have your period, your lining of your uterus is shedding, your estrogen is kind of at its all time low.

And so what happens is estrogen, you have your period, your lining of your uterus is shedding, your estrogen is kind of at its all time low.

Right. In this non-pregnancy state, you didn't make a baby, you're shedding the lining, your estrogen's about 50, let's say, to make it easy. Now it's starting to go up, up, up, up, up, and you're developing this follicle. So this egg is developing, and then the LH is sort of your brain's marker of, okay, it's time to ovulate.

Right. In this non-pregnancy state, you didn't make a baby, you're shedding the lining, your estrogen's about 50, let's say, to make it easy. Now it's starting to go up, up, up, up, up, and you're developing this follicle. So this egg is developing, and then the LH is sort of your brain's marker of, okay, it's time to ovulate.

So that's when you pee on a stick and you're trying to check if you're ovulating, it's checking your LH levels. And so you're going to see this increase in LH that happens, again, everyone's a little bit different, but it happens kind of mid-cycle, day 10 to 14, somewhere along that, again, urologist, not gynecologist.

So that's when you pee on a stick and you're trying to check if you're ovulating, it's checking your LH levels. And so you're going to see this increase in LH that happens, again, everyone's a little bit different, but it happens kind of mid-cycle, day 10 to 14, somewhere along that, again, urologist, not gynecologist.