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[Mary G]

Blue Kingfisher, I'm really sorry to hear that, it must be so disappointing.

First of all, yes, you can use the lozenges cyclically but you would need to take about 50mg every day for a couple of weeks and I would suggest you do this on a longish cycle.

Before trying that, I would suggest you continue with the Oestrogel and stop the progesterone for a few weeks to see if you feel any better.   If you feel a massive improvement, then the progesterone must be the culprit but if not, it could be that Oestrogel doesn't agree with you or the dose needs tweaking.

I hope that helps.

[Blue Kingfisher]

Thanks Mary G, I didn’t realise the 10mg of progesterone lozenge was a low dose. I also wrote on my last message that I didn’t take a lozenge last night but I did - this is just me getting confused because I feel so bad.

I feel worse after applying the oestrogel & very agitated….this is strange as I thought this would make me feel better if the progesterone was too much.  This now makes me think perhaps I’m better off at this stage not assuming pg is the villain after all….? I will try sticking with the lozenges again tonight & see if symptoms improve over the next few days.

I’ll soon know if this is the right or wrong thing to do & then it might be if I start to feel the progesterone coma that I need to ease off. I’m generally woken up every morning around 5am with a sudden urge to evacuate my bowels……does anyone else get this? I’m wondering if this is my body excreting excess oestrogen now? I do notice that this subsides when I’m on progesterone but then I tend to get constipation.

I’ll see how it goes, I don’t think I can feel much worse so don’t feel I have a lot to lose. If this doesn’t work then I’ll look at trying the sequi option with a higher pg dose, very helpful to know this is an option! What is a longish cycle…..? Taking pg on days 1-7 of each month?

[dangermouse]

What I have learnt is that DIM helps metabolise the oestrogen in the Phase 1 of liver function. Then if you do too much of that, Phase 2 gets blocked so things like Cal-DG and milk thistle support this phase and produce lots of bile to help the process along the intestines. I found DIM gave me an occasional quote strong headache for 3 days but felt good otherwise and the headache didn't return. Cal-DG made me quite lethargic and had intense salt cravings (milk thistle also gives me that!), so perhaps connected to the extra bile production. I'm finding powdered Vit C less intense but helping to move those pathways along more gradually.

I also read that DIM does not lower oestrogen, just stops it recirculating (which causes the nausea etc) and it also stops testosterone from converting to oestrogen, thus boosting your testosterone. Whereas, Cal-DG lowers both oestrogen and testosterone, presumably it drags it out through the bile. Occasional use makes me feel better the next day though.

Hi dangermouse - do you have any academic references to studies where any of this is shown? Especially with regard to steroid hormone metabolism and the interplay between oestrogen and testosterone? I would be grateful for any links - maybe a separate thread?

Hurdity x

These are some of them and the last is not research but excerpts from a book:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2783856/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048776/?crsi=662497358

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571834/

https://fortwaynephysicalmedicine.com/blog/the-benefits-of-dim

[Mary G]

Blue Kingfisher, it's all starting to make sense now.   The bowel problems sound like oestrogen evacuation and this is something that dangermouse can explain far better than me but it sounds like you are offloading excess oestrogen.   The fact that you bowels slow down when you introduce progesterone would bear that out.   This happened to me once I was very post menopause and now I can only tolerate a low dose of oestrogen - see my thread in the post menopause section where I talk about my consultation with a gastroenterologist.   

Re the long cycle, I meant that you could try using oestrogen only for about 6 weeks and then use the lozenges for your progesterone phase but you would need to either take 100mg for 7 days or 50mg for two weeks otherwise it won't be enough to provoke a good bleed and clear the womb lining.

I would be inclined to reduce the gel, keep going with the progesterone and see what's happens.  I think it's probably a case of tweaking the dose to get the balance right.

Have you considered taking melatonin for the insomnia?

[dangermouse]

Lots of replies ladies 

I'm feeling brighter now I'm back down to my 50mg. Still stupidly woozy with nausea and an odd head feeling, but yesterday after 2 full days on 100mg prog cream - I was experiencing symptoms I've never felt before.

Proof of absorption. I think so.   

Blue kingfisher - I can't help you, but I'm assuming if you are on lozenges you use a compounding pharmacy and prescriber??? You also confirm absorption  . I'm sure one of the more experienced ladies can help.

I think you're absolutely right Sam. These bhrt clinics are fully booked. Some have closed to new customers, others you need to book up to 2 months in advance. Where are all the ladies using this bhrt...? Not in this forum it would seem.🤔.

There really needs to be a place on this forum for us to opely discuss these 'alternatives'. We are all woman trying to find a route through this stage of our lives. I personally find the advice I have received from Mary, Dangermouse and Sam invaluable.

Whether there is science behind it or not, we should be able to discuss. From what I've read there are studies demonstrating absorption and others not 🤷‍♀️, but there is nothing recent. I'm not normally a synic, but I'm now left wondering if the 'scientific' answer of the pill, with it's artificial progestin, hasn't in some way left me in this unbalanced state. We're the generation that started popping the pill in our late teens and continued all through our lives - is there science to show how it may/may not harm your long term hormonal balance?

That said, if someone can point me to a conventional treatment, under the NHS, I'll greatfully take it. All ideas welcome 😁

We're all just striving for the same thing - quality of life.

Yes, my BHRT clinic was only seeing current clients as they had been overwhelmed.

Glad things have settled a little on the lower dose. I was surprised I could tolerate a high dose last year as I had struggled before but was probably when oestrogen was too high.

[dangermouse]

Re the bowels, as oestrogen is a stimulant and progesterone is calming, it could be simply that, one speeds up and one slows down bowels, even before you take account of hormone/liver metabolism.

Also progesterone slows transit in pregnancy to ensure maximum nutrient absorption.

[Blue Kingfisher]

Took another lozenge and was hot all night with chronic insomnia but I’ve been here before & remember it starts to subside after a few days of taking the lozenges daily. I think I then start to sleep really well from memory. I’ll see if that’s still the case by the end of next week I’d imagine.

I take lemon balm & magnesium to help me sleep but nothing would have worked last night I’m sure. Too much hormonal transition going on!

Over the past few months, since being on the lozenges….for about 5-7 days of each month I feel really hyped up (hardly any sleep but can function well all day - not like now) but then I seem to literally crash & burn big time & that’s when I feel I’m poisoning myself every time I apply oestrogel.

I wonder if I’ll feel better on one lozenge a day if I’m on a lower dose if oestrogel I.e. could the oestrogel be driving the hyper state followed by the crashes?

I’m on thyroid meds but I keep that dosing very consistent.

Yes CrispyChick I get my lozenges from a prescription via a compounding lab.

[CrispyChick]

Bluekingfisher. Sorry you're feeling so bad. Me too. It really is awful.

So you are only on 10mg lozenges and you get big impact? That's really interesting.

Suppose the lozenges give more of a guaranteed hit than my cream. I'm up to 50mg this week. First month I've to take it for 21 days (last month I took 25mg for 10 days). Feeling dreadfully dizzy and nauseous today. Perhaps a bit vague too. This is all my 'normal' though - horrific as it is. I got a migraine yesterday afternoon and have had some weird head pressure this week, but that was mostly on the 4 days I hiked up to 75 and 100mg due to desperation, so I think that's the ups and downs - but shows I'm absorbing!

So, your clinic say you're low in both prog and estrogen??? You're saying the estrogen makes you feel poisoned - that's exactly what I got with classic HRT (the estrogen part) and some of the higher dose contraceptive pills.

The other thing is... And I say this with a large pinch of salt, but lots of articles talk of estrogen kick back, as in when u start taking prog it reawakens more estrogen receptors and makes it work harder. Some go as far to say reduce your estrogen dose when starting prog. 🤷‍♀️ I've no idea if that's the reality or not - but I'm holding onto the estrogen kick back idea to explain why my worst symptoms are still coming...

[dangermouse]

This was being discussed on that FB you left, and the owner wrote this, in case helpful (but I would say it's a hypothesis rather than a fact):

"Estrogen kickback is a made up word that is referring to a bio chemical reaction that happens when you begin to supplement progesterone is stimulates estrogen receptor‘s causing a type of tug-of-war between progesterone and estrogen. If you have a severe progesterone deficiency and the dose is too low the estrogen will continue to “kick back“ and you will keep having a estrogenic symptoms. This can last a very long time if your progesterone deficiency  Never gets corrected. That’s why raising the dose for some women is useful. If you are applying tiny doses throughout the day of 3% or 10% eating every hour is not necessary.
The idea is to have some form of carbohydrate in the system so that the progesterone can bind to the receptor and get absorbed. This is particularly a big problem with women who fast or skip meals."

[dangermouse]

This is interesting too:

"Hi... My daughters blood test on day 21. After being on DIM her Progesterone: 68,2 nmol/l
Oestradiol :1093 pmol/L
Endocrinologist quite happy that progesterone has come up as it was on 0,3 in the  last 2 blood tests."

I wonder if it's raising my progesterone levels as the DIM makes me feel more like I am on the prog cream but in a more stable way.

[CrispyChick]

Oh. Interesting about the DIM Dangermouse. I will be trying mine, but I'll wait to see if any affect from the calcium d glucarate first...

Yes, there was lots on that fb page about estrogen kickback... I got scared off when I realised they were advocating folks to take up to 1000mg prog cream 

[Mary G]

Sorry to throw this into the mix but my doctor at the clinic said that some patients with Mirena coils also like to use compounded progesterone for the calming/balancing effect.

This is probably one for you dangermouse but I'm wondering how synthetic progesterone fits into all of this, if any of you have tried a coil in the past and how you reacted to it?

[dangermouse]

Hey, I was always ok on the norethisterone in my combined pill but taking it alone (POP) made me feel awful.

The only good results I felt from synthetic hormones was how the ethinyl estradiol over-rode my own hormones and the norethisterone was the best of the progestins to suit me. The one in the mirena from taking as a pill made me depressed.

I find bioidentical hormones much more therapeutic, when you can actually feel them and your own hormone volatility isn't crowding them out.

[Mary G]

Very interesting dangermouse.   I was on Eugynon 30 from age 16 to late 20s and didn't have any migraines.   It contains the same progesterone as the Mirena coil and the ethinyl you mentioned.   I did gain weight and develop allergies though.

I didn't have time to go into detail with doctor about the patients she mentioned (time is limited as you know) but it would seem they use the compounded hormones to try to override the side effects from the coil - low mood and breast pain for example - and balance things out.

I'm amazed that you liked norethisterone, I found it was lethal for my migraines once menopausal.

I still think it's strange that I didn't have silent migraines while taking the pill pre menopause.

[CrispyChick]

Is it because the progestins attach to your prog receptors, so you stop producing prog of your own...? And progesterone is the calming hormone. Hence my suspicion of the mini pill ultimately unbalancing me. All that time with no progesterone.

I was on combined pills during my twenties and then the mini one after my kids... Can't recall why. I was on cerazette and it always made me a little flat.

I'd take flatness now though 

So, I wonder if this is the same reason Sam is taking prog cream, whilst on the mini pill.

P. S ladies I tried pretty much every pill available in 2020...the bad, the very bad and the ugly!!!!