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[Samantha369]

Hi, I'm 47, still regular periods but lighter, every 28 days.  Not on any medication. 
Main symptoms are mainly in luteal phase, last 10 days of cycle, mood drops , anxiety,  rumination,  fatigue and extreme care cravings like off the charts that are really uncontrollable and this is find quite distressing.

I did get my bloods done on day 20 of my cycle in September 2024 when I was also having these symptoms. I know there conflicting views on where blood tests in perimenopause are useful or not. But my oestradiol looks to be  nearly 3 times higher than what it should be in luteal phase . Was thinking of trying progesterone cream?? Anyone any thoughts on my high oestradiol and lower progesterone??

Oestratradiol 330 (82 - 125 luteal phase range)

Progesterone  24.9 (13.1 - 46.3 luteal phase range)

Testosterone  0.584 (0.29 - 1.67 optimal range)

[CrispyChick]

It is well documented that progesterone levels drop first.

Unfortunately this doesn't seem to be acknowledged in the UK by the BMS or NHS. So the only solution offered is estrogen - which you've spotted can often remain relatively high in early peri.

It then starts to swing, massively. And only drop steadily towards the end of peri.

That said, I've been down that route and couldn't get prog only to work for me. It was supported by a UK bhrt clinic.

There are also otc progesterone creams. I've tried onas and biovea. I liked onas. There is very little harm in trying one I'd say. But be patient. May take a month or two.

You won't get much support for this on this forum, but there are FB groups who follow original only approach for early peri.

When I tried conventional HRT, the estrogen part sent me bonkers. I really wish it would work for me. But, even now in the massive swinging part of peri (low E symptoms last month, high E symptoms this month) I doubt adding extra E will help me. It needs to descend first. And I wish it would!!

So yes, give it a go. 👍

[CrispyChick]

I should add, that's not a high E level on your bloods. But it's not low either. Mine was similar when I went to bhrt clinic.

Your P is not actually particularly low either, mine was sitting at 3 pmol. This was 5 years ago. And I still have plenty E most of the time. 

[joziel]

Blood tests are pointless during peri-menopause. Your estradiol could test at 50, 6 hours later.

That 320 could be a surge, which happens very frequently during peri and causes these symptoms.

Best bet is to trial some HRT - not just progesterone.

[CrispyChick]

Sorry, I disagree joziel.

It is well documented that prog declines first, whilst estrogen goes on a rollercoaster. So many woman do not need estrogen in early peri, yet the NHS is a one size fits all model.

Yes, blood tests are unreliable. But...I've tested loads over the years - you know your own body. Mine always corresponds to how I feel.

I have never ever, until this year, tested low on E at any point. And never ever had classic low E symptoms until this year. Yet I've suffered with hormonal upheaval for years.

Like I said, there will be little support for P only on this forum - but there is plenty elsewhere. And it's a very common approach in other countries.

[Samantha369]

Hi CrispyChicl, thank u so much for your very helpful reply,  really appreciate it. Yes I have read lots about the progesterone only approach and how it can help in early perimenopause also. I am going to try the Emerita progest one first as it is the one that has caught my eye initially,  I did read up on the Onas one though so will keep that in mind  . I am going to use it initially for the 10 -14  days before my period first , kinda for the pms method as I don't want to start with a 3 week stint for peri, I am very reactive to things so want to try a little first ! Righly or wrongly !! But have read of loads of people having success with the creams but sure down the line oestrogen may be required when it drops. Sorry you did not have success with the progesterone only. Thanks for comments on bloods, good to know 

[joziel]

There's nothing wrong with trying P only first, or using it, but at age 47, it's unlikely to be enough for the vast majority of women.