My GP 10 years ago recommended the combined pill for perimenopause as she said that HRT was not strong enough to override peri volatility. It worked for a few weeks but the very high surges broke through.
I have been using CHAT GPT and found the medical advice, and the way it remembers all of your history, better than any real life medical experiences. One thing it threw up was that I was sensitive to any blood flow changes, hence why vasodilators (most herbs, magnesium, oestrogen fall under this), which causes me the nausea and dizziness.
It also explained that progesterone-only HRT initially stimulates the circulating oestrogen causing good effects but after a few days (depending on where you are in menopause) the P will dominate and cause low oestrogen symptoms which does make sense when I’ve had blood tests that’s show E to be very low. In early peri (before wild fluctuations) you can be in an oestrogen dominant state instead, so the progesterone-only makes you feel worse for a few days as it stimulates oestrogen further but then better as it rebalances the high oestrogen. (Please note that the ‘dominance’ word, derived from how they would measure combined pills, is important as they offset each other and it’s all about achieving balance between the two).
It explained that as I am sensitive to the blood flow changes, oestrogen HRT would still make me feel worse but that micro-dosing could help to gradually allow it in - it suggested 10mg of progesterone and a cocktail stick tiny smidge of oestrogel, which you gradually raise over months and months, as an option.
It also suggested that my new pro-metabolic diet could equally provide complete hormone balance without needing exogenous hormones - or it said I could try both.
I was going to do the micro-dosing this week but have already started to feel better from the diet. I am now able to tolerate milk, for the first time in 15 years, and I am already feeling some hormonal stability and more energy, where I have been dragging myself around for the last 10 years! So am going to leave off the micro-dosing for now.
What I have also learnt, which may help you Crispy, is that hormones do not just return to normal after having taken or restricted them. They take at least a 30 day cycle to start to settle and rebalance themselves, and I suspect 3-6 months to properly complete this.
Also, any emergency body function systems that the brain turns to, such as using stress hormones to produce energy after prolonged fasting or low nutrition, also need to have a prolonged period of re-feeding to recognise that food is available. It can then turn off those emergency systems and switch back to the ones that need sugar to function. This will then gradually improve energy levels, concentration, sleep, digestion, mood etc as the emergency states are to keep you alive at the cost of these.
Sometimes just stopping everything and letting the body come to a balance all by itself, albeit with adequate nutrition, can be the most powerful thing that we can do.