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[CrispyChick]

Right ladies (using micronised prog), talk me through my next trials.

I'm not finding the clinic very helpful, but it is helpful to gain access to different forms of prog.

So... I'm told that if it's making me woozy/spaced out/nauseous... Then I'm one of the few that can't tolerate prog... 🤔

I'm told it does not stimulate my estrogen receptors in small doses... Yet anecdotally a lot of women seem to experience this.

So I think she was trying to get rid of me... But I said I'd like to try a different route.

So... Mary, Dangermouse... Any others... Can you help??? Dangermouse you definitely experienced the stimulation of your estrogen with lower doses - am I right?

I'm getting the lozenge. 100mg - can by cut. She suggests I start on 25mg.

I also note (as someone mentioned before) I can buy utrogestan. Obviously that's 100mg full stop.

I also have some 25mg oral tablets left which I could try as 25mg or 50mg doses etc.

So... Shall I just start experimenting... Whats your thoughts/experiences on routes and doses???

She's also said take all month no breaks. Finally. She basically just agreed with whatever I said 🤷‍♀️

I clearly am very sensitive to hormonal changes, but given I've been taking breaks and changing dose left, right and centre... Its maybe not surprising. My only saving thought is the fact that the pill did this to me when I started, but these early symptoms did subside.

I have no other option but to keep trying... 

[VictoryV]

Hi CrispyChick,
Can you get repeat prescriptions without having actual consultations as you’re an existing patient? I don’t know how they operate, your post sounds like they aren’t overly helpful and you’re trialling on your own so perhaps don’t need as frequent consultations?

I hope you find the right method and amount soon, it’s crazy that you’re still battling this. X

[Uptick]

Hi Uptick
I was wondering if you’d be able to offer any insight into my symptoms.
I’ve been relatively stable on 25mg progesterone lozenges (taken orally due to gum ulcers when held in my mouth) until a couple of days ago when my specialist got me to increase to 50mg.
Oh no, irritable as hell ever since!
No nausea of dizziness, but mild headache and body aches.
You mentioned in an earlier post about progesterone metabolism, particularly the role of neurosteriod allopregnanolone on mood symptoms.
So when you’ve got the time I look forward to reading your thoughts on this aspect of progesterone sensitivity.
Many thanks xx

Hi Marchlove, sorry for the late reply. My thoughts are basically that every change in HRT will bring new symptoms which can or cannot subside with time (how long you have to wait can vary considerably, but 3 months seem to be the accepted time frame). If they don't subside, it's probably due to intolerance or imbalance with oestrogen levels. Trial and error. Regarding the role of allopregnanolone, I see that you have been reading about it. It's a fascinating area of research and there are some good reviews available. I don't understand why oophorectomised women are told to replace oestrogen but not progesterone and to a certain extent I also don't understand why progesterone in HRT is often referred as just for protecting the womb lining, if progesterone metabolites, such as allopregnanolone, have an important role in brain function. Here is an excellent article to get you started, let me know your thoughts, questions.  https://www.frontiersin.org/articles/10.3389/fmed.2020.479646/full

[Uptick]

Thanks Uptick

Yes, I guess my level has doubled... Still seems very very low. I'm no better anyway.

Hard to tell where I'm at as when I dropped from 150mg to 100mg I got a 6 day bleed... Then stopped the cream the week after for my period...which is now awol. So I'm all over the place.

I seemed to go narkier and impatient after dropping from 150mg to 100mg...but my estrogen dominance symptoms had calmed.

I'm headachy now I've stopped the cream, so despite no period, I'm going to restart.

I wonder if any of the ladies who take bio prog can give me any insight into their serum levels when supplementing???

Hi CrispyChick, you don't need high blood progesterone levels and they don't always correlate with tissue levels. I cannot advise on serum levels when supplementing, but I understand that many of your symptoms are likely due to constantly changing doses and routes of administration, if your body does not handle fluctuations in hormone levels well. I know it's hard to persevere when you're feeling down, but unfortunately it's either staying on the same regimen for 3 months or completely stopping HRT to find out what your own hormones are doing.

[Marchlove]

Thank you so much Uptick, the article is very interesting.
I’ve only had a quick read through so need to have a longer look, but my initial thoughts which are in line with what you have been saying to me and CrispyChick is that the body needs consistency to give it time to hopefully adjust.
Interestingly, I has a zoom with my specialist yesterday who immediately told me to revert to the 25mg dosage.
From what I’ve read the allopregnanolone levels do not seem to differ between women with PMS/PMDD and healthy controls.

I thought you might be interested in this study, albeit on a small group of women.

https://www.researchgate.net/publication/318993298_The_steroid_metabolome_in_women_with_premenstrual_dysphoric_disorder_during_GnRH_agonist-induced_ovarian_suppression_effects_of_estradiol_and_progesterone_addback/fulltext/598a6063aca27243585176a6/The-steroid-metabolome-in-women-with-premenstrual-dysphoric-disorder-during-GnRH-agonist-induced-ovarian-suppression-effects-of-estradiol-and-progesterone-addback.pdf?origin=publication_detail

Also, noticed in the article a brief mention of the CAR and high morning cortisol, which I have, so I recently changed from taking my magnesium and zinc at night to first thing in the morning.

I’ve sort of given up with worrying about serum levels of anything. As you say it’s what’s in the tissues that matters so my approach will be to stay steady, low and consistent.

The article did mention however the importance of the progesterone and estrogen ratio but made no further comments about what that might be?

The only test I really rate is the cortisol and Dhea saliva test. Without that I would be in a far worse position than I am now.

Thanks again Uptick, you’re a star x

[CrispyChick]

Thanks ladies.

It does make perfect sense to stay consistent for 3 months. Very difficult when you're experiencing bad symptoms... However, also made all the more difficult by our 'experts' currently telling us to up /reduce a dose 

Although not consistent with my dose, I did consistently try the prog cream for 3 months  . I'm on day 2 of the troche - although experiencing bad side affects, like nausea... I don't feel spaced out like I did on the cream. It really is time to try an alternative route for me.

Marchlove - you mention a prog/estrogen ratio. There is an omni calculator for that. I'm using it, but obviously it is based on serum levels of both. The one useful thing to come from my expensive doc is highlighting the fact that my estrogen is not high, but a good normal level, but because my prog is low, my ratio if off, causing an imbalance and symptoms. I've  always felt my symptoms were caused by imbalance.

You may, or may not find this calculator useful

https://www.omnicalculator.com/health/pg-e2-ratio

[Marchlove]

Hi CrispyChick

Thank you for the calculator, as you say based on serum levels it might not be useful.

The nausea did settle for me on 25mg. I took it near food which helped and now I can take it away from food with no issue.

I now take mine at 6pm so that the increase in wee is over before bedtime, so that’s helped as well.

I would advise you not to change again at the moment though CrispyChick, see it through if you can x

[CrispyChick]

Oh... You got nausea on the 25mg troche Marchlove???

If that's what you mean, that's fabulous to hear. Obviously not the fact u had nausea, but the fact it is common and does subside. I always take after food.

Today I've taken 25mg. So I'll be on 50mg a day. I felt headachy waiting for last night's dose, which happend before, so I think morn and night doses for me should be the same.

So yes, here I intend to stay for a while. Been very aggitated since morn dose and now woozy again. But hopefully I can get through this. I believe the troche should be giving me a much bigger hit than the cream. So I think i prefer that - as the cream is a bit of an unknown quantity.

Increase in wee? Did I read that right??? I'm not getting that symptom. How we all differ 😁

[CrispyChick]

Actually Marchlove - I thought you'd had mouth problems and stopped using troche???

Edit - just checked back... So 25mg x 2 a day, troche taken orally is your best fit so far??? I have 25mg oral tablets in my cupboard...i wonder why they haven't switched u to those?

Which clinic do you use Marchlove???

[Marchlove]

Yes you’re correct I couldn’t use it as a troche due to causing mouth ulcers so they said to swallow it instead and that cured that one thing!

I use the Harpal clinic.

So I’m sticking with 25mg once a day at 6pm to see if I settle further.

Got to have a scan soon. x

[CrispyChick]

There's actually some really useful charts on prog absorption on Wikipedia.

Really helpful for me to see the difference between average cream absorption and oral and troche. 

[Uptick]

Thank you so much Uptick, the article is very interesting.
I’ve only had a quick read through so need to have a longer look, but my initial thoughts which are in line with what you have been saying to me and CrispyChick is that the body needs consistency to give it time to hopefully adjust.
Interestingly, I has a zoom with my specialist yesterday who immediately told me to revert to the 25mg dosage.
From what I’ve read the allopregnanolone levels do not seem to differ between women with PMS/PMDD and healthy controls.

I thought you might be interested in this study, albeit on a small group of women.

https://www.researchgate.net/publication/318993298_The_steroid_metabolome_in_women_with_premenstrual_dysphoric_disorder_during_GnRH_agonist-induced_ovarian_suppression_effects_of_estradiol_and_progesterone_addback/fulltext/598a6063aca27243585176a6/The-steroid-metabolome-in-women-with-premenstrual-dysphoric-disorder-during-GnRH-agonist-induced-ovarian-suppression-effects-of-estradiol-and-progesterone-addback.pdf?origin=publication_detail

Also, noticed in the article a brief mention of the CAR and high morning cortisol, which I have, so I recently changed from taking my magnesium and zinc at night to first thing in the morning.

I’ve sort of given up with worrying about serum levels of anything. As you say it’s what’s in the tissues that matters so my approach will be to stay steady, low and consistent.

The article did mention however the importance of the progesterone and estrogen ratio but made no further comments about what that might be?

The only test I really rate is the cortisol and Dhea saliva test. Without that I would be in a far worse position than I am now.

Thanks again Uptick, you’re a star x

Hi Marchlove, thanks for the article link, it's very interesting, especially the results on sulfated metabolites, mainly DHEA-S. Many doctors who call themselves naturopaths swear that it is more important to dose DHEA-S than DHEA in menopausal women. Maybe they are onto something.

My morning cortisol levels were tested 3 times when I was perimenopausal and having anxiety/panic spikes at 3-4 am (cortisol? adrenaline?), but the results came back normal. Maybe I should have slept at the surgery lol.

As for the estradiol/progesterone ratio... it's a minefield, isn't it? There seems to be no rhyme or reason. They're supposed to fluctuate to control the normal reproductive cycle, but what's normal about that when it comes to the brain? Some women feel better during the luteal phase, some during the few days around ovulation, some only get relief after their period, many have horrible PMS, PMDD and some 'sail through' the whole process.

Thank you for your kind words, trying to understand the science behind menopause is a challenge, I really appreciate your interest and contribution 

[Marchlove]

Ah Uptick, that’s interesting what you say about naturopaths preferring Dhea-s. When I was using Dhea cream I couldn’t get in with it but am doing fine so far with low dose oral.

Seems like the sulfated form is only obtained from oral during the liver bypass.

This article explains quite well.

https://www.zrtlab.com/blog/archive/difference-dhea-dheas-brain-health/

The Dutch test do a nighttime waking cortisol test, using a swab, rather than having to gather loads of saliva in a tube. That might have worked for you rather than camping at the surgery!  Unfortunately the Dutch test is rather expensive compared to other cortisol/Dhea tests, but I don’t know of another lab who does the nighttime test.

Upwards and onwards we go…. xx

[CrispyChick]

You two sound very knowledgeable on DHEA.

Why would I need it??? My level is 4.4.looks OK to me. But my clinic had me start DHEA and Testosterone as a cream.

I stopped a, while back, as I was worried it might increase my estrogen, vwhen I'm trying to increase my prog.

But! I stopped after I had bought a rather large tube of my compounded cream, so I might restart in future.

So... What would it do for me??? The DHEA I mean. 

[Marchlove]

Nothing or cause more trouble unless you need it! You have to test CrispyChick and not just Dhea but cortisol. x