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[CrispyChick]

Good advice Marchlove.

I'm definitely going to try just at night.

I know you're also right about the dose, but this is my 4th month and I've had enough. All the American sites say you need between 100 and 200mg min for ED. Just to put it in context my ratio is 12. It should be between 100 and 500.

I'm loathed to do yet another month where it just antagonises my estrogen - if that is indeed what is going on. 

That said... Last night was awful and as I've taken nothing this morning, if I continue at that dose, it'll be even higher tonight.  I'll decide at 9pm 

[dangermouse]

Hey, I wasn't prescribed 200mg, was just told to take as much as I could as I got more used to it, they were happy for that to 400mg if that is what it took.

I also found the earlier notes from my endocrinologist re progesterone as I was so sensitive:

'Start progesterone 25mg once a week and make sure you feel ok until you very gradually start to increase it to every night'.

Maybe for you, as suggested, you need to let it all out of your system and then start low dose like this?

I do remember when I was struggling the most that having a couple of weeks break and then starting again my body didn't over-react which surprised me as it felt like a vaccine where my body now had a memory of it and it accepted it after a 2 week break.

Obviously another strategy again but something to consider. Hope that doesn't confuse even moreso! 

[Mary G]

Re my earlier post and overriding the cycle, I should add that some women find the contraceptive pill works well for them and suppresses the cycle/oestrogen spikes.

Oestrogen spikes cause a whole host of problems for women in peri menopause.

[Marchlove]

Yes dangermouse that is more or less what my specialist is doing with me. Sort of desensitisation, perhaps like a nut allergy, so your body slowly begins to accept the progesterone is not an enemy but a natural balance to estrogen.
Sounds weird I know, but that’s what I feel  is slowly happening with me.

[Blue Kingfisher]

OMG I can totally identify with the trials and tribulations of progesterone that is being discussed here! I probably understand very well how Crispy is feeling on the higher dose of pg but I can also say finding the right rhythm (sequi/conti/on-off routine) PLUS the right delivery mechanism seems to be key for me.

I upped my pg lozenge from 10mg to 20mg for a few nights in a row and a black cloud started to engulf me. My digestion was so slowed down I could barely eat. I felt hot, dizzy, nauseas, depressed etc. Increasing the lozenges for me on a conti regime at least is not the answer. This isn’t something one can push through, I’ve tried that approach before, it didn’t work, it won’t work for me. I do think the point Dangermouse made is very interesting in looking at old notes with the 25mg pg once a week advice until it settles & your body can handle more. I also tried lowering my ostrogen dose (before I tried upping the pg), again, wrong direction for me.

I think I’m either going to have to hobble along very slowly taking a 10mg or 20mg lozenge every few days or try a sequi routine. I’m not going to take a lozenge tonight and play it by ear whether to try the pg every few days route or give my body a longer break & try sequi.

I do find once I’ve given my body a break from the pg that it’s then delighted to receive it. It then has a calming effect on my body but if I take it continuously for too long (over 3 days) it’s NOT good.

The delivery mechanism is also a very strange phenomenon to me. I couldn’t tolerate 100mg Utro vaginally when I was on sequi (I’m taking proper suicidal thoughts) but I could tolerate the 200mg Utro pessary better. Go figure. Must be something to do with the different way they are composed and deliver in my body. It wasn’t ideal on the 200mg pessary as the swings from high to low pg were an issue for me & unfortunately couldn’t tolerate it conti.

The only issue I’m worried about now is how bad the withdrawal will be if I try sequi! I won’t take a lozenge tonight and see how I feel. Probably the safest route is the every few days route.

I was also very interested to read Marchlove is taking the lozenge just before dinner rather than bedtime. That’s something I will also try when I take the lozenges hoping it gives it more time to be out of my body by the morning!

Blue x

[CrispyChick]

How are you feeling Blue?

I have a question for all those on bhrt 'alternative' progesterone. So most of you seem to be on lozenges. I know the clinics all run via blood tests, so I'm just wondering how well you absorb on the progesterone??

My thoughts are that I'm maybe not absorbing enough via the cream, therefore the small amounts going in may only be antagonising my estrogen.

I've read a lot. Like everything out there. It seems any tests on transdermal progesterone show high rates in saliva and capillary blood (finger prick) but serum and whole blood show low levels.

What method of testing do you have done? My MG doc did not seem fussed if I opted for finger pricks 🤔 although, I have actually gone for the blood. I'm now glad I did, so it's comparable with my first tests.

So, do your bloods show you absorb well???

I recall Dangermouse saying she absorbed the cream well, but I can't find the post - also wondering about method of testing???

I ask this because:

a) I still feel lousy (not any worse on my 150mg, but not better)
b) I'm curious that those on estrogen are not given cream
c) when I had my first progesterone trial in Dec it was 25mg capsules - the first 5 days were horrific with my estrogen synptoms, then I seemed to switch and go narky and irritable but my ED symptoms went. But I haven't felt that switch at all with the cream. (I remember the narkiess well as we had the in laws to stay 🤣)

Thanking you x

[Marchlove]

Both transdermal and lozenges absorb well. The reason I know is from my mood. Low and flat if too high. Physical - aches if too high.
Lower energy. But, when you hit the sweet Goldilocks dose- mellow, calm, in love in a nice way.

Tests wise, I’ll hunt out a Dutch test article about the pros and cons of all the various test options and post it here.  xx

[Marchlove]

I came across this which is very complicated. I’ve been wondering about the half life of sublingual estradiol.
From what it says under that section I’m thinking I should split my dose.
Need to print it out and study it more fully, although I think it will take ages to sink in!
https://en.wikipedia.org/wiki/Pharmacokinetics_of_estradiol
x

[CrispyChick]

It is a minefield Marchlove...

That's where I've been with all my searching. Certainly the wiki page on progesterone as a medicine states that transfermal prog has shown inadequate absorbancy 🤷‍♀️.

That's me taken 5 doses of 150mg at night. I'm now over the spaced out woozy feeling and instead my original symptoms are back with a vengeance!!! I am seriously on the edge of giving up. Its torture to live with these symptoms every day.

At 25mg my symptoms were very high. At 150mg my symptoms are just as high. 

[Blue Kingfisher]

I’ve just done 2 nights of no progesterone and will see how I go. It’s too early for me to draw any conclusions so I’ll have to play it by ear. I have to decide at some point if I’m going to allow a withdrawal or hop on & off pg. if I do, I’ll be trying the lozenge pre-dinner like Marchlove does in the hope the pg side effects are less by the morning. I’d just like not to feel exhausted & nauseas every day!

Re different tests…..this I suspect is complicated but I know from experience, extremely annoying that the medical practitioners don’t appear to be united on. I was at the Studd clinic who use blood serum testing and they advised despite my application of 5 pumps oestrogel daily, that I wasn’t absorbing well enough and my oestrogen levels needed to be higher. Eventually I moved away from the Studd clinic and I’m now at a different one who has access to more different types of progesterone (creams, lozenges etc as well as classical HRT). They use saliva testing & advised my oestrogen was too high…..I’m now alternating 3 pumps one day 2 pumps the next. Frankly, I don’t care who is right….I’d just like to feel better!

 Marchlove, I also did a Dutch Test a few years ago, again saliva testing & again advised my oestrogen levels were too low. I’m wondering if I should come off progesterone altogether and either do sequi on a long cycle or stay on oestrogen only whilst I wean myself off HRT over a couple of months. It doesn’t seem to be helping me currently!  Ha! So easy to type that idea! I suspect putting it into practice will be the highway to hell!! Having to hold a job down though all of this is quite a challenge I.e. trying not to look like I’ve been dragged through a hedge backwards on Teams calls 

Crispy, are the clinic you are under advising you to up you pg like you are doing? What do they say about your symptoms?

[Marchlove]

So here is zrt labs article on accurate testing

https://www.zrtlab.com/sample-types/hormone-testing-for-different-supplementation-types/

I’ll try and find the Dutch test article about it x

[Marchlove]

Oh and this is even more interesting regarding progesterone testing!

https://www.zrtlab.com/media/2124/the-science-of-dried-blood-spot-testing.pdf

[CrispyChick]

Yes! That's exactly what I'm talking about Marchlove.

Lots of studies saying progesterone is much higher when tested in saliva or finger prick versus serum. However, some claim (as your article does) that the saliva  /finger prick is the accurate dose. Others claim its whats in the blood that counts.

Certainly when it comes to endometrial protection - they say the saliva/finger prick grossly overestimates what gets to the endometrium. Obviously being on progesterone alone, that's not a problem for me.

I think I'm happy I'm sticking with serum for this next test. For consistency. The last thing I need is to be told my progesterone is too high when I've felt dreadful on all the doses I've tried 🙄.

For an extra £40 I could do my own finger prick test... Will see how my bloods go first.

Just another added confusion. I feel like I've been born 100 years too early. They seem to know the science, but total dispute about what it actually means.

I totally agree Blue, I don't care what tests are right either, but I feel like I may have to care if it affects my treatment.

I'll maybe ask my doc at next consult.

Blue, my clinic don't seem keen to advise  between paid consults - I'm awaiting a reply to my question from Thurs. Not particularly impressed with them, but for consistency, I'll stick just now. I'm throwing lots of money at this, so I've just booked another consult earlier than I was meant to. They did tell me last time, up to 50mg for a month, then up to 100mg for the next month. I've gone to 150mg off my own back. I'm not any worse for doing so, but I'm just as bad. I didn't really want to pay £140 to be told to increase again  . I can't go any higher now or I'll run out of cream.

I do feel like my mood is dipping mid aft, so I probably need to try split dosing again now the spaciness is less.

[Blue Kingfisher]

That’s fascinating Marchlove! This gives me confidence that I’ll rely on the saliva test for now (which means I’m heading in the right direction by reducing my oestrogen). Interesting to read that the dry blood spot test would probably be most accurate for me going forwards, due to the lozenges I’m taking but…..it says not to apply any hormones with your hands several days before testing…..wonder how I’d put the oestrogel on….with my foot? 

I’m feeling much better this afternoon so I can only deduce that’s the progesterone level coming down. I’m not lulled into any false security though…..tomorrow morning could be a whole different ballgame!

Crispy, I think you’re doing brilliantly with the cream & keeping a logical approach. What sort of test did you take to determine you needed pg only? As I said, I’ve had both blood serum & saliva which gave totally different results & therefore totally different treatment paths……it’s so nice for these practioners to practise their theories on me 

Blue x

[CrispyChick]

I have just remembered that my doc said we are doing these next bloods 'to see if I'm absorbing'. They offer serum as their standard bloods. You'd have thought they'd be used to this issue then?!?

I'm hoping Dangermouse pops on cause she definitely told me she was shown to absorb cream - be good to hear what type of testing that was.

If I don't show to be absorbing the creams in my serum levels, then I'm guessing they might try a different route. Given that I'm getting no better... That might not be a bad thing. After all, the nhs go on symptoms alone... Maybe because of this testing discrepency. 

I might, just might, order myself a finger prick and take it the same day   

The only concern raised from my doc about finger pricks (I asked cause I thought it might be cheaper) was contamination. I do wonder how the serum is not contaminated though if they go in your arm where you rub the cream. 🤷‍♀️.

I'm probably over thinking as usual.

Blue, it was blood serum test that showed my low prog. But, from what I read, that would be true results, its the transdermal application that can differ between blood and saliva etc.. Not your own.

Im glad you're feeling better this aft. Any respite you get is wonderful. I hope you get a good stint of feeling better. X