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[Turtle45]

Hi, I’ve been struggling for the last two years with anxiety, brain fog and various other symptoms. I’ve been tried on various HRT combinations but without any benefit.  I have all the symptoms of peri but because the HRT didn’t help drs have disregarded this.
I’ve had various blood tests and the last two times it has show relatively high oestrogen and very low progesterone. I have no idea where on the cycle the tests have fallen as my cycle is all over the place but I wondered if it could be oestrogen dominance that is affecting me and by having estrogel it is not helping.
I have however had high levels of progesterone given to me at one point so I also wondered if I was not absorbing progesterone or am sensitive to it (I’ve had PMDD since I was a teen)
I know I am clutching at straws but if anyone knows I should go about investigating this I would greatly appreciate it

[CrispyChick]

Hi.

I'm sorry to say, I dont think you're looking in the right place if you think you have estrogen dominance - or certainly, don't call it that.

The UK (Be it the NHS or British meno society) don't believe in it.

However, it's commonly known that progesterone is the first hormone to decline and in other countries (think Canada and Europe) it is common place to be put on prog only treatment in peri. Also, progesterone is heralded in those fields for pms. But, ask any UK based 'expert' and it's estrogen all the way. If you look into the work of Katarina Dalton - using natural prog for pmdd.

It's mind boggling. But, it's where we are. I've been down that route myself. I certainly believe in it. I've had plenty of estrogen all the way through my treacherous peri, so HRT makes me worse.

The BHRT clinics (like Marion Gluck) do understand and attempt to treat estrogen dominance. And that's with natural progesterone - usually compounded creams and trouches, but they do use utrogestan too.

For me, unfortunately I don't tolerate natural prog. And I think it's the fluctuations in peri that are causing my awful symptoms. If you tolerate natural progesterone - it's very easy to try progesterone only.

There are Facebook groups deal with estrogen dominance. You could have a look at those.

If you still have your HRT, and it included utrogestan, then you can easily try progesterone only for a while. That'll give you your answer to if it helps or not. You'll know very quickly if you're sensitive to it. Make sure it's natural progesterone, progestins don't act in the same way.

If it does help, you can play with dosage. Access to the bhrt clinics costs a lot. So you're better having a utrogestan trial first. But bear in mind it's quite strong. I can't tolerate 100mg progesterone at all, for example.

The best time to test is day 21 as that'll show your E and your P - which should be over 30 if you ovulated. Appreciate it can be hard to gauge day 21 if your cycle is erratic.

Hope that helps. I hate to see others in a position like this simply because the BMS dont agree it's a thing. It's ridiculous. How can it be a thing in other countries??? Good luck. X

[Turtle45]

Crispy chick thank you so much for your long post. There is more info in that than I have found from any doctor.

Progesterone only is the only thing I haven’t tried so I’m going to give it a go.  Do you think (and you may not be able to answer) that you still take progesterone for 2 of 4 weeks?

I am so sorry that you have suffered so much but I really to feel and understand your pain.  Thanks again for taking the time to write.

[CrispyChick]

Ah. Now that's a hard one. The general consensus is it should be taken only in the luteal phase - as would be in your own cycle.

But some say take it continuously for a few months to bed in then start cycling it.

If you're just trialling, makes sense to trial from day 14 of a cycle to start with. Then decide at day 28 (or a period) if you're going to stop for follicular or continue. There will be a bit of trial and the usual error I'm afraid.

If you do find it works for you - you can continue to get your HRT from your GP,  but only take the Prog. They'll think you're loopy if you tell them.

It's all so wrong. But we are where we are. There's not much on this forum about prog only, so it is worth looking at some of the face book groups. But be careful as some advocate extremely high levels of P.  Which is unlikely to be good for you either. 

[Turtle45]

Thanks again. I’ve been on utrogestan for a couple of weeks the came off it for the break and had a really awful period. I also felt a lot more depressed which is weird. When I went back on it yesterday I swung back from depression to more anxiety. I don’t know if it is just situational rather than caused by the progesterone but I’m all over the place.

[CrispyChick]

Yeah, I'm not sure to be honest.

Some say progesterone is calming. But I've also found it can increase my anxiety.

But I do believe fluctuations and changes are the biggest problem. So now you've decided to try prog only, give it a good few weeks to see. Then I guess you'll know if solo prog is beneficial to you or not.

There is an estrogen dominance Facebook group. Also the group totes merry peri I see lots of people recognising that in earlier peri both E and P are hot necessarily needed and plenty on that site using P only. So worth a search. There are not many P only woman in this forum. I assume they just leave.

[bombsh3ll]

In a natural cycle progesterone is only detectable in the luteal phase, so people doing DIY testing (there are very few instances where clinicians would order a progesterone blood test) often end up concerned about low progesterone when they have simply tested before ovulation has occurred.

The simple answer is if you feel you would benefit from therapeutic progesterone only, you just try it, and have your answer. Unlike estrogen, there is no problem with taking progesterone solo if that meets your needs.

If not, you could try an alternative approach of just shutting it all down and stopping the chaos with a combined pill taken continuously like I do, which adds back a stable low dose of estrogen and progestin that is the same every day.

This keeps you bleed free and on an even keel hormonally. I take Zoely which is often recommended in PMDD because it contains 17 beta estradiol and NOMAC which is a really neutral progestin in terms of tolerability.