Thank you, Marchlove and Mary G, we’re just scraping the surface of a huge iceberg, really.
Marchlove, I think it’s wondeful that someone without scientific background is so enthusiastic about science, it’s a fascinating world, and despite all its ups and downs, which are intrinsically linked to all things human, it’s the best source of reliable information we have so far. It’s not an easy task to navigate through so many articles, many of them are utterly useless (unfortunately no one is immune to media, money and vanity, scientists included).
Hi CrispyChick, maybe your own cycle is kicking in? If not, then you’re right, the progesterone cream is doing its job. Why are you having your hormone blood levels tested, specifically? If you’re in perimenopause they are bound to fluctuate, so it’s possible that the results won’t be very useful, but it will be interesting to know them all the same.
Regarding your symptoms, I agree with Mary G, your doctors should consider silent migraines instead of labyrinthitis. Maybe you have always been prone to hormonal migraines, the thing is both pregnancies and birth control pills might have been useful to counteract the normal cyclical fluctuation and you have never been diagnosed simply because, apart from those couple of times, you have never had proper migraines. In perimenopause the fluctuations are huge and neither birth control pills nor HRT might be enough to override your own hormones. If your current symptoms are caused by declining progesterone (and its role in balancing oestrogen actions in the brain), and if the progesterone cream is being absorbed, then you could stay a bit longer on a single dose, because hormones take time to achieve a steady state, at least in specific tissues like the brain (remember that progesterone half life in the blood is short), and constant changes are bound to take you back to square one, and actually cause more symptoms or worsen the current ones.
Are you taking any other medication? I think I’ve read you have been on testosterone and DHEA? Are you still taking them? If you are, which are the dosages (doses, number and frequency of doses)? Many drug interactions are possible when replacing hormones and pro-hormones (DHEA), particularly progesterone, which induces liver enzymes, mainly CYP3A4 which is extremely important to remove drugs and toxins in the liver and intestines (some antihistamines) and is also involved in the synthesis of cholesterol, steroids and other lipids. This enzyme is inhibited by grapefruit (fruit and juice) which can increase the bioavailability of many drugs and toxins. On the other hand, it can be induced by St. John’s wort preparations. You can read the most up to date information regarding these complex interactions here
https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and-drug-interactions-table-substrates-inhibitors-and-inducers Agnus castus also can interact with oestrogen and birth control pills, but I’m not sure you have taken it along with them? This interaction is anecdotal, because preparations vary and, being a supplement, they’re not subjected to extensive testing. You can read the European Medicines Agency monograph on Agnus Castus here
https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-vitex-agnus-castus-l-fructus-revision-1_en.pdfI’m going to post later on something that I think is relevant regarding progesterone metabolism, particulary the role of neurosteroid allopregnanolone on mood symptoms. Do you have any mood symptoms?
To sum it up, it’s complex. One radical option is to stop taking everything (assuming you’re not in need of contraception) because it’s impossible to know what your own hormones are up to while taking so many different drugs, even if you’ve not been taking them for some time, because some effects might take more time to wear off (some women become pregnant after missing one single dose of a contraceptive pill while others might take up to one year to have a successful pregnancy after stopping it). I would like to tell you my own experience, regarding perimenopause, menopause, migraines and HRT. I had the most horrendous time in late perimenopause, hot flushes, disturbed sleep, anxiety, panic attacks, aches and pains everywhere (diagnosed with fibromyalgia), migraines with aura, doom and gloom on a daily basis. I tried patches and Utrogestan for 3 months, they did absolutely nothing to help my symptoms, but also brought in another terrible one, suicidal ideation, besides worsening migraines (I had migraines my whole life, but I’ve never been pregnant and I only took the pill for 5 years in my 20’s). I decided to stop the HRT and brace myself for the war. The symptoms have subsided to a very manageable point. I still have some hot moments, but I have learned some useful coping strategies. I no longer have migraines (although they have turned into mild to moderate headaches, nothing compared to the previous ones though, accompanied by visual aura, nausea, vomiting, vertigo), no anxiety, no panic attacks. Aches and pains everywhere, but not all the time, most of them are probably connected to other causes, like lack of proper exercise, too much time spent in front of a computer/phone, and the lifetime migraine-associated pain syndrome; people predisposed to migraines will always have a high sensitivity to changes in routine (sleep, food, clothes, weather, you name it) and the brain usually responds with migraine symptoms, which do not always result in a headache, as Mary G has pointed out, the so called silent migraines. I don’t know if you can stop taking everything, because maybe you have to function properly at work, with kids, a husband and so on. I had to ditch almost everything in peri and I know this was a sort of privilege, albeit not without consequences. I feel much better now, I’m not symptom free (who is?) but I now have some sort of resilience that is enough to get on with life. We will never have 'our self back, our life back', this is wishful thinking, life goes on and we have to adapt to it. If you can stop taking all drugs (menopause related) for at least 3 months (I don’t know the science behind this, but it seems to work), and see where it will take you, and after that, start again, one drug at a time, giving each one of them another 3 months to stabilise, maybe it will be easier to figure out what’s the best regimen for you. It’s not the ideal thing to do, but it’s an option. You might even feel better on your own stabilising hormones and decide for a low dose HRT after you reach menopause, just for the sake of your bones and cardiovascular health. I haven’t decided that yet, but I have idiosyncratic drug reactions due to an overreactive immune system and general genetic ‘weirdosity’, that prevent me from taking many drugs, which hopefully is not your case.
Sorry again for the long reply.
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Topic: Is this the right place to discuss compounded hormones? (Read 111818 times)