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[MIS71MUM]

Just a quick question regarding the above.

A lot is mentioned on the forum about oestrogen levels, but what about progesterone?

Happily, my oestrogen have increased from 126 nmol to 530 nmol over the last 6 months.  However, during that the, my progesterone levels have decreased from 1.9 nmol to 1.2 nmol.  My blood tests were taken 5 days about my Mirena was fitted.

I have decided to continue on my 37.5 estradot for the forseeable future and may even possibly drop down to 25 mg if I can.

I know these values fluctuate wildly but does anyone know whether we should concentrate on getting the balance of these right rather than raising the oestrogen alone?

It just seems strange that many ladies report back with oestrogen levels but I haven't seen many progesterone levels on the forum.

[Annie0710]

My prog are Minimal, @zero at the last result , I've not got a uterus though so no concern

But I wanted to say was doesn't prog oppose oestrogen? So if you're on both you would, in effect, not be having the full oestrogen dose because of prog ?

I may be wrong but that was what my well woman nurse was telling me

X

[Annie0710]

Sorry Menomale I didn't mean to suggest it's a nothing hormone although I do read here a lot that it's not necessary (apart from thinning the uterus ?)

I put myself on it for 6 months at the beginning of this year and I swear I felt better, plus drifted off into lovely sleeps each night

X

[dangermouse]

I wish I could join in with the hormone level comparisons but the place I go to like them taken on day 21 so mine are much higher (oestrogen 348 and progesterone 29.1).

It was annoying as I felt dreadful the week before and much better on the day of the test so I'm guessing nothing abnormal will be deemed from them.

I believe we need progesterone but supplementation seems to not be fully bioidentical due to some of the terrible side effects women here report. My own makes me feel wonderful (day 21 being my favourite cycle day and ovulation being my worst!).

What types of prog made you feel better Annie? I'm seeing Jan Toledano (an endocrinologist specialising in HRT) on Monday to see what she thinks.

[Annie0710]

It was 100mg utrogestan Dangermouse x

[dangermouse]

Oh that's good to know thanks as I haven't tried that one. My GP tried to prescribe it after looking it up on this site but the computer system wouldn't let it go through.  My friend was on it via Studd but his whole regime made her much worse.

[Annie0710]

I think the only way you'll know is by trying it

The well woman nurse at our surgery went crazy at me for trying it as ice had a hysterectomy but I was quite sure it couldn't harm me, the worst could be that it gave me side effects, or no change in symptoms

She researched it all then came back to me saying I'm eligible for Tibolone (this would imitate or get me producing )oestrogen/progesterone/testosterone and so said there should be no harm in trying progesterone
X

[Hurdity]

We do continue to make progesterone post-menopause and yes we do need and use it - it is produced in the adrenal glands post-menopause so I understand. As far as is known, it is only needed in very large amounts during pregnancy where it leads to many physiological changes. It is not accepted that there is any medical need for supplementation post-menopause because we usually produce enough for our own needs.

Obviously adding oestrogen as part of HRT then requires a dose-dependent amount of progesterone to protect the endometrium. Also synthetic progestogens can have adverse effects elsewhere in the body than the positive (intended) effect on the endometrium - and the effect on the breast is of special concern from the research.

I don't think it is a question of needing to balance them at all (except for the endometrium) but adding oestrogens as part of HRT is only a crude approximation of the hormonal mix that is disrupted as a consequence of menopause so can sometimes (?) have more effects than desired - hence the side effects because of the  mode of delivery - which results in unwanted metabolic by-products and sometimes extremes in levels ( due to daily dosing). Maybe because of this additional progesterone helps some women - but the main point about this is that they often have opposing rather than balancing effects - progesterone is a sedative, and can cause fatigue and have a depressive effect, and can interefere with the  beneficial effects of oestrogen - although I am not clear how this is mediated. Personally I would be wary of adding progesterone because of this....

Oh dear it's getting late and I'm rambling 

Hurdity x

[dangermouse]

I think it's more important in perimenopause because oestrogen levels are still relatively high so you feel the lack of progesterone more, as that hormone gradually falls from our 30s but oestrogen stays high until it starts to fall as we get closer to menopause.

This is certainly clear with my current peri cycle where I feel better in the second half. I also feel ok days 2-5 of cycle which I guess is closer to hormone levels in post menopause, as I don't feel the strong imbalance from the high oestrogen and low progesterone.

[MIS71MUM]

Thanks for the replies.

For me as I'm true peri and not having a regular cycle, I've no idea where in my cycle, if any, I truly am! it's good to know that I have been absorbing the oestrogen through the patches.

I would imagine now the Mirena will be doing what it should, but didn't want to now overdo the oestrogen.

I too, whilst on HRT femoston and evorel, have struggled most mid cycle, when Oestrogen at highest, then really enjoyed the first 10 days of combi.

I think I'm just worried that my results indicate that I don't need too much Oestrogen at the moment or maybe should reduce to 25mg as I feel more anxious when the oestrogen is too high and low progesterone.

[dangermouse]

That's interesting thanks!

I've been on a high absorbent progesterone cream 25mg twice per day since Thursday and normally at this day of my cycle I am in a hyper nervous state but since yesterday I've felt strangely normal. Not sure how much is placebo, as I was hopeful this might work, I guess time will tell!

I've also had really good energy levels which I wasn't expecting progesterone to provide but may just be a result of being more balanced.

[dangermouse]

Mine is also a compounded cream, it's micronised progesterone in Versabase which is a newer highly absorbed method of delivery.

My endocrinologist wants me on 50mg (and may go on lozenges after that) but said I'm to start low and build up. I felt dreadful a few days ago, as I was the cycle before (when my oestrogen levels go too high), so I am surprised as I just didn't think creams could be that effective.

Will certainly keep you updated although I think most here need oestrogen so mine is a more unusual case.

[dangermouse]

Oh yes they combine them at my one in London too which keeps price down as you just pay for the one which is then balanced for what you individually need and they use estradiol, testosterone and DHEA if you do need it (none of mine were low).

I haven't gone through NHS as their oral micronised progesterone is too potent for my needs. Also they are pushed to breaking point so I've not had a good service or been given referral options. Sometimes you just have to pay if they aren't helping you, as complaining got me nowhere.

The base is apparently very important with transdermal HRT and I read on a hysterectomy site that new formulas are popping up and you can ask your pharmacy to use them. There may even be an NHS licensed one is on its way as they said on a menopause programme this week that new products were in the pipeline.

[dangermouse]

Yes, money plays a big part unfortunately!

At least most women have access to natural oestrogen and progesterone via the NHS now, even if its not yet perfect.

[dangermouse]

Yes, although I'd rather pay for the bespoke amounts even when my hormones become more meno standard (unless they match me perfectly) as feeling balanced is of more value to me than anything else I could spend my money on.

It's good that the NHS is trying to use natural hormones though where and how they can.