Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: BrightLight on February 13, 2015, 07:38:06 PM
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Out of curiosity really (I feel shamefully lacking in my awareness of my hormones until now). Perimenopause is the period of time where ovulation and hormone production become erractic. Progesterone declines quicker than estrogen, most symptoms experienced can be assumed to be because of this lack of balance between the two. Mostly I read that estrogen is the presumed culprit of hot flashes etc
Does hormone replacement therapy stop this process or does it 'sit' on the top of it, as it were and top everything up to levels where they are not low and thus alleviate symptoms? Is that the aim of the game? ;) Will natural hormones continue to decline 'underneath'?
What I am wondering (because my jury is still marginally out on HRT as an option for me) is this - if estrogen levels are raised higher than ever during perimenopause and you add estrogen, aren't you going to create more symptoms or at the least very high levels of estrogen? I understand replacement when estrogen has started it's journey into true decline as this seems fairly obvious to replace it then, along with progesterone to get the balance that was there pre perimenopause.
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We need Hurdity here ::) ………. the HRT is to top up what our bodies should be making. We take HRT to lessen symptoms of hot flushes etc. as well as to protect heart and stave off osteoporosis.
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I'm going to watch the replies with interest.
Oestrogen dominance seems to be a buzz word on the US forum I follow. The emphasis seems to be largely on boosting progesterone, with one member saying that her doctor came close to killing her by prescribing oestrogen without realising she was already oestrogen dominant.2 years on and she's still not fully recovered. :o
I was wondering how HRT is prescribed, if the relationship between levels of oestrogen and progesterone isn't established by blood tests? Is this what makes trying HRT such trail and error for some women?
Does oestrogen really "fight back", when progesterone is introduced, as I've read? Is this why people feel worse before they feel better?
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The relationship between oestrogen and progesterone is 'natural'. Because hormone levels vary on a moment-to-moment basis and not only sexual hormones, then blood tests are reliably un-reliable! which is why my Gynae won't do 'em. He goes on symptoms.
As we age we don't need as much oestrogen :-\ ……. no longer required for child bearing etc. …..
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The more I think about this, the more I am interested - even if there is no easy answer and it is just theories.
I do believe in the concept of estrogen dominance - much as I believe some women have hormonal balance issues for a lot of their lives and also that menopause might just be a great opportunity to resolve them once and for all :)
I have always wondered if my body was operating in an unbalanced way and didn't pursue it with my Dr's because as they put it "unless you want children it doesn't matter" or "no there is no link to these things" - I am refering to several ovarian cysts, fibroids very young, cervical polyp and mild melasma for years. None of these issues caused me major hassle so I didn't pursue anything, but these are signs of estrogen excess I believe.
I really am wondering or perhaps hoping that my body will eventually be happier with less estrogen - just a theory :)
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The relationship between oestrogen and progesterone is 'natural'. Because hormone levels vary on a moment-to-moment basis and not only sexual hormones, then blood tests are reliably un-reliable! which is why my Gynae won't do 'em. He goes on symptoms.
As we age we don't need as much oestrogen :-\ ……. no longer required for child bearing etc. …..
These doctors are clever because when I look up my symptoms some of them overlap and are said to be caused by either of the hormones - I guess if you are out of balance a good doctor can tell from your symptoms - I wish we could :)
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The relationship between oestrogen and progesterone is 'natural'. Because hormone levels vary on a moment-to-moment basis and not only sexual hormones, then blood tests are reliably un-reliable! which is why my Gynae won't do 'em. He goes on symptoms.
As we age we don't need as much oestrogen :-\ ……. no longer required for child bearing etc. …..
These doctors are clever because when I look up my symptoms some of them overlap and are said to be caused by either of the hormones - I guess if you are out of balance a good doctor can tell from your symptoms - I wish we could :)
BrightLight, that's what I'm thinking. Whenever I look at my symptoms online, they are indicative of both low oestrogen AND low progesterone. I'm guessing that these symptoms checklists are not particularly sophisticated, and a specialist/experienced doctor can differentiate more accurately.
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The relationship between oestrogen and progesterone is 'natural'. Because hormone levels vary on a moment-to-moment basis and not only sexual hormones, then blood tests are reliably un-reliable! which is why my Gynae won't do 'em. He goes on symptoms.
As we age we don't need as much oestrogen :-\ ……. no longer required for child bearing etc. …..
These doctors are clever because when I look up my symptoms some of them overlap and are said to be caused by either of the hormones - I guess if you are out of balance a good doctor can tell from your symptoms - I wish we could :)
BrightLight, that's what I'm thinking. Whenever I look at my symptoms online, they are indicative of both low oestrogen AND low progesterone. I'm guessing that these symptoms checklists are not particularly sophisticated, and a specialist/experienced doctor can differentiate more accurately.
Yes and that's why I wish you well with Annie Evans - definately pays to have someone who has detailed knowledge and experience, many GP's just don't. The private GP I visited last week to talk through things did suggest my progesterone could have been very low in relation to estrogen and that if I do try HRT she suggested low estrogen as a start but she would need baseline bloods levels - I know they fluctuate but she wanted a guide to see if they were ok ish or 'in my boots' as she put it :) My regular GP will not give me blood tests, so I still have to decide whether I will pay for these - this journey is excruiating - just want to get on with things and stop working out the mystery.
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What are the symptoms for being estrogen. Deficient and the symptoms for protesterone deficeint.?
That's the thing Julie, I am not quite sure. Most of the symptoms of menopause like hot flashes are reported as estrogen deficient symptoms but in truth it's just a symptom of estrogen and progesterone being out of balance but we tend to focus on estrogen as deficient and I don't know why. For some women things like anxiety are said to be from falling estrogen but progesterone is a calming hormone too, ????
Here's a list of what each do in the body which :
Estrogen has many benefits. These include:
Preventing of heart disease
Stroke prevention
Osteoporosis prevention
Decreased Alzheimer's risk
Preventing urogenital atrophy
Preventing macular degeneration
Reducing menopause symptoms such as hot flashes, depression, and mood swings
Reducing memory loss
Reducing tooth loss
Reducing colon cancer
Progesterone has a number of physiological effects, usually to counteract the effects caused by estrogen. The effects and benefits of progesterone include:
Increases breakdown of fat
Protects against endometrial cancer
It is a natural diuretic
It is a natural anti-depressant
It exerts a calming, anti-anxiety effect
Increases libido (sex drive)
Helps prevent osteoporosis (when combined with estrogen)
Decreases PMS Symptoms
Decreases carbohydrate cravings
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Both play a part in everything as far as I can see - progesterone is good for heart health for instance and estrogen too. The thing is - it is definately reported that high estrogen can be damaging but I can't see the same for progesterone, so I wonder why estrogen is the priority to replace and the main focus???
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Hi Brightlight - You need Hurdity for your questions - she has a biology background and is very good at explaining these types of questions.
I think this idea of oestrogen dominance is a bit of a red herring. You are wondering about the balance of progesterone with oestrogen to control meno symptoms but if progesterone was key then women who have had a hysterectomy would need progesterone as well to relieve symptoms - they usually only need oestrogen to control their symptoms.
My understanding is that through the peri stage our hormones are fluctuating and declining and this will usually happen over some years. Whether with early ovarian failure the ovaries suddenly stop functioning and therefore stop producing oestrogen or whether there is a slow decline, I suspect that will vary from women to women. Even in post meno we still produce some oestrogen and I think this can depend on body fat - this is why women who have had a breast cancer that is oestrogen sensitive are given drugs to strip the body of as much oestrogen as possible to reduce their risk of the cancer coming back.
One of the main problems with the peri stage is the fluctuating of the hormones and this will give rise to symptoms kicking in and out. If you use HRT through this stage I'm sure there is going to be some dominance of oestrogen at times and I certainly found that I didn't feel good when I tried too high a dose of HRT when I was peri. BTW I think my peri stage lasted about 6 years.
One must bare in mind that through our reproductive years our hormone levels also fluctuate constantly and through pregnancy levels can be very high indeed - in the first 3 months one can feel sick and headachy as the body is producing extra hormones to keep the baby where it should be, then after that you start to feel really great because a different hormone balance kicks in. I believe the tendency toward girls being rather overweight these days actually increases the amount of oestrogen they produce - I could be wrong on this but I'm sure I read about this somewhere. One of the symptoms of anorexia is the cessation of periods due to lowered hormone levels - so body weight has a significant effect on hormones.
When I was given the Oestrogel with separate progesterone this was so much better. Oestrogel allows you to adjust your dosage to the amount that keeps symptoms under control - so in a way is ideal for the peri stage.
Interestingly women who have had a hysterectomy and take oestrogen only are actually less likely to get breast cancer!!!!
Hopefully Hurdity will be along with some science for you. DG x
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Oestrogen dominance seems to be the thing at Cemcor in Canada http://www.cemcor.ubc.ca/, where it is asserted that the theory that you need oestrogen during perimenopause is wrong, because oestrogen is actually at a higher level than normal. This should be treated with progesterone.
I am sceptical, myself. From what I remember of my human biology lessons, many years ago, there are complex feedback mechanisms. We only produce progesterone after ovulation, from the ovary where the egg has been released, so it is not in your system all the time, unless you are pregnant (or on the pill). And anyway, it gives me terrible constipation, so I do have a personal aversion to the idea ;D
Normally, you would produce oestrogen in the first half of your cycle, while the follicle is ripening in the ovary. This peaks as you ovulate. Progesterone is produced by the corpus luteum, which is what is left in the ovary when you have ovulated, and this produces a spike just after ovulation (you can measure this as a small temperature rise, if you chart your cycles). After a couple of weeks, this degenerates and the ovaries stop producing progesterone and oestrogen, their levels crash, and you have your period. (unless you are pregnant, then hormones from the fertilised ovum keep this going until the placenta takes over)
During perimenopause, the follicles in the ovary are a bit knackered. So sometimes, the FSH will be stimulating the ovaries to produce oestrogen and the follicle does not ripen, the levels go up and eventually crash and you might get a bleed, without ovulating. Or not get a bleed and start another cycle. Sometimes, it might be more prolonged, or shorter. Sometimes, the ovaries might not respond at all for a while, then start up. You might ovulate, but the egg is a bit past it, and the corpus luteum and bit past it and you get a sort of progesterone rise, or you could get a big one! Or you could ovulate normally for a while. So your oestrogen levels can fluctuate from very high to nothing, and progesterone levels are intermittent.
The possiblilities are endless. If you take progesterone all the time, it might help reduce the bleeding, and proliferation of the endometrium, like taking norithisterone does, or mirena coils but minipills, which have less progesterone don't usually have much effect. Smaller amounts may stop you ovulating when you are close to menopause, but I am not sure that helps.
I am sure that conventional hrt is fine - it has the progesterone which stops the endometrium proliferating, and the oestrogen which stops you hitting rock bottom. I am sure this helps your body's feedback systems stop levels from going sky high once you settle on it and help stabilise your levels.
This is just my take on it - hopefully someone will come along who can remember stuff ;)
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Thank you DancingGirl - wow I didn't know that breast cancer survivors were stripped of estrogen! You explain the rise and fall and effects of estrogen really well and that you did feel an imbalance and have adjusted it. Yes body fat is clearly related, that's why our bodies change shape shift I think ;)
It isn't so much that I think progesterone is 'the answer' I just wonder about 'too much' estrogen in general and why are the benefits/symptoms of progesterone not considered when using hormone therapy. I guess if the current protocol works then it works. Do some people need more progesterone than estrogen in their HRT - does it work like that?
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Oestrogen dominance seems to be the thing at Cemcor in Canada http://www.cemcor.ubc.ca/, where it is asserted that the theory that you need oestrogen during perimenopause is wrong, because oestrogen is actually at a higher level than normal. This should be treated with progesterone.
I am sceptical, myself. From what I remember of my human biology lessons, many years ago, there are complex feedback mechanisms. We only produce progesterone after ovulation, from the ovary where the egg has been released, so it is not in your system all the time, unless you are pregnant (or on the pill). And anyway, it gives me terrible constipation, so I do have a personal aversion to the idea ;D
Normally, you would produce oestrogen in the first half of your cycle, while the follicle is ripening in the ovary. This peaks as you ovulate. Progesterone is produced by the corpus luteum, which is what is left in the ovary when you have ovulated, and this produces a spike just after ovulation (you can measure this as a small temperature rise, if you chart your cycles). After a couple of weeks, this degenerates and the ovaries stop producing progesterone and oestrogen, their levels crash, and you have your period. (unless you are pregnant, then hormones from the fertilised ovum keep this going until the placenta takes over)
During perimenopause, the follicles in the ovary are a bit knackered. So sometimes, the FSH will be stimulating the ovaries to produce oestrogen and the follicle does not ripen, the levels go up and eventually crash and you might get a bleed, without ovulating. Or not get a bleed and start another cycle. Sometimes, it might be more prolonged, or shorter. Sometimes, the ovaries might not respond at all for a while, then start up. You might ovulate, but the egg is a bit past it, and the corpus luteum and bit past it and you get a sort of progesterone rise, or you could get a big one! Or you could ovulate normally for a while. So your oestrogen levels can fluctuate from very high to nothing, and progesterone levels are intermittent.
The possiblilities are endless. If you take progesterone all the time, it might help reduce the bleeding, and proliferation of the endometrium, like taking norithisterone does, or mirena coils but minipills, which have less progesterone don't usually have much effect. Smaller amounts may stop you ovulating when you are close to menopause, but I am not sure that helps.
I am sure that conventional hrt is fine - it has the progesterone which stops the endometrium proliferating, and the oestrogen which stops you hitting rock bottom. I am sure this helps your body's feedback systems stop levels from going sky high once you settle on it and help stabilise your levels.
This is just my take on it - hopefully someone will come along who can remember stuff ;)
Thanks - you seem to have your head around this. I have not really understood entirely the progesterone only approach, but I do think it might have a role, although from your description I can see that in the natural cycle of things it wouldn't be in the body because an egg hasn't been released.
I can see that if someone didn't respond well to high estrogen that progesterone could treat some of the symptoms (?) Presumably some people's feedback loop isn't working properly and my thoughts are about how hormone replacement might just continue the trend - thinking it through, it probably does, but then you would adjust it. Just as you found progesterone didn't suit you, if estrogen made me feel unwell I can adjust it.
Beyond this balancing act in perimenopause progesterone as a medicine on it's own seems to have a lot of benefits - not just as an HRT. Estrogen isn't looking so friendly to me :) Seems to be one of those can't live with it, can't live without it to me.
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Have you considered trying a bioidentical progesterone cream, BrightLight?
I've read mixed reviews, but lots of positives among them. Worth a whizz, for research purposes?
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Have you considered trying a bioidentical progesterone cream, BrightLight?
I've read mixed reviews, but lots of positives among them. Worth a whizz, for research purposes?
I have, but to be honest the whole thing is still scaring me ha ha. I feel like the first time I went to Boots ALONE to get some tampax - it's all natural and normal they said - I felt so vulnerable and ignorant and worried........it was fine after the first step.
In all seriousness all the options seem like a real 'test and see' and right now I feel a slight sense of myself settling and the need to rest and recoup if that makes sense. Today I was thinking I can't even find the motivation to have the second blood test and the HRT chat with the GP next week. I might move it forward, there isn't a rush.
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Dahlia girl - what a great post - i think you explained things extremely well.
Bright light - I'm still unclear why you feel progesterone is so beneficial - maybe you've found some research that shows evidence for this?
There have definitely been a few ladies who post on MM who say they feel better when on the oestrogen plus progesterone stage of HRT - this has been ladies on Femoston HRT which has a progesterone that is considered close to our natural hormone. Progesterone can have a sedative effect as well so some women can feel calmer with this. However I'm not sure whether there is any symptom control or benefits for bones etc with the use of a progesterone only HRT. I was always under the impression that progesterone was include in HRT only because of the need to protect the uterus lining from building up ? I would love to be able to just use oestrogen alone as it's the progesterone that tends to give the pmt symptoms. Having said this I am now using the bio identical prog, Utrogestan, which seems to bring fewer negative effects.
It's an interesting discussion. Dg x
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If you're feeling good in yourself, where's the harm in relaxing for a while, you're right.
Had you never had the funny period, you may never have had the worry of having to make choices right now - so enjoy the lull!
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Ye sit back and think about what's best for you, take all the info in. Re the progesterone, as DG was saying I'm in Femoston and I'm one of those who feel much better on the oestrogen / progesterone part don't know why that is. Maybe because it is close to own. Another interesting thread Brightlight I'm learning a lot on these ! X
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Honorsmum - :) This is true - if I hadn't gone to the GP, I would never have had so much stress ha
Dancinggirl - I think there is another assumption I am 'following' the progesterone only bandwagon ;) My musing was more to do with me checking out how I feel right now and there is a bit of me that feels 'better' in myself and some sort of sense that estrogen didn't suit me, that's the wrong word, but that perhaps it was way off for a lot of my life. There is no doubt I have been responding to hormone levels going up and down for a year or more and those would be a mixed bag response to all the hormones.
Right now I am left with symptoms that don't seem typical of the ones I read that signify estrogen deficiency, so I just wondered if my body was 'missing' progesterone - not that I want to put it back necessarily, I was just curious - the low mood and anxiety are the defining/constant features of this experience for me and the private GP (although she fired loads of info at me at the time) said similar to you, that progesterone is a natural anti-depressant so I won't be able to manage it the same way perhaps I did with other types of low mood - because it's a chemical situation. Maybe I will balance out around the progesterone loss as well and all will be well. :) I am quietly concerned about the ongoing mental health aspect though.
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Ye sit back and think about what's best for you, take all the info in. Re the progesterone, as DG was saying I'm in Femoston and I'm one of those who feel much better on the oestrogen / progesterone part don't know why that is. Maybe because it is close to own. Another interesting thread Brightlight I'm learning a lot on these ! X
I am a naturally curious person and enjoy learning. Happy you are feeling good :)
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I'm another one who seems to feel better on the progesterone part of HRT - despite having had an awful time on the progesterone only pill many years ago. My whole cycle and the way I feel at various points seems to have gone awry over the past two years. Now I dread the end of a period when that used to be my happy time!
BrightLight, I was interested in your original question about the role of HRT in peri menopause when , on occasions, our own fluctuations can result in an 'excess' of estrogen. I'm sure this happens to me. My doctor, like Pixiegirl's (do read her previous post in New Members) believes that I therefore need something that will suppress my hormones for the next few years, rather than just top them up, til I am closer to 'normal' menopause age. She suggested Qlaira, designed specifically for this purpose, but I am slightly reticent to swap over until I hear more of others' experiences with this HRT/combined pill combo.
X
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Qlaira seems to popping up quite a bit at the moment as an alternative to HRT for the peri stage. As a contraceptive it has the double benefit through this stage of our lives - I think this is very interesting as it could balance things during these fluctuating years and act as a 'bridge'.
Brightlight - I do get your point that the lack of progesterone to trigger the periods through peri is an issue and our bodies are used this hormone doing it's stuff every month through our reproduction years.
All very interesting - I think this highlights the need for more tailoring.
AS Hurdity says, if there were more Well Women Centres with professionals trained to deal with women's issues then this would be more possible - it would free up GPs surgeries and make everyones life easier.
Dg x
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Regarding some women who feel better on progesterone here is some reading
http://www.npis.info/basicprogesterone.htm
A book to read is "Progesterone the Ultimate Women's Feel Good Hormone" by Dan Purser M.D
It is true that some women do feel better on progesterone as opposed to estrogen, usually women who make too much estrogen naturally. Check out the work of Dr Katherine Dalton a British Doctor.
http://www.womensinternational.com/pdf/progesterone.pdf
Why can't it just be accepted on MM that some women do well on a different regime and be glad for them.
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In answer to the original question, the extra hormones received will just cause side effects, if the dose is lowered or stopped according to how long the particular hormones are active in the body (latching on to receptors), the receptors will become inactive again.
Transgender take HRT too so not sure how it all works their bodies.
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Well what a long and involved thread!
I am like you BrightLight - naturally curious - which is why I studied science in the first place, and still enjoy learning - which is why I enjoy being a member of this forum because I am continually being challenged to look things up that I'm not clear about (sometimes unsuccessfully!) although it all takes up a lot of time!! Having said that I finished my Biology Degree over 40 years ago, and the research I did subsequently was not human biology or anything related so I am looking up everything just as much as everyone else! You had great answers from Dancinggirl and dahliagirl.
In terms of understanding what's going on in our bodies - I think I gave you the link to the article on this site about the biology of the peri-menopause and what happens to the hormones in our menstrual cycle? Now that you've read a lot more you may like to read it again as this is the clearest summary of what happens, without too much complicated biochemistry and terminology. http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php
The answer to your initial question is is that the biological process will just carry on even if you replace oestrogen through HRT ie HRT will not prevent the decline in ovarian function. However the added oestrogen will prevent the symptomns of oestrogen deficiency. This is why some women experience bleeding at odd times especially when taking HRT early in peri-menopause - because the cycle is doing its own thing. I can't explain how added oestrogen affects the cycling of pituitary hormones and the various hormone feedback mechanisms.
As for excess oestrogen - as CLKD said somewhere on the thread - progesterone normally balances oestrogen throughout your fertile years, because if it didn't, the uterus lining would over-thicken, could lead to endometrial hyperplasia and possibly cancer, and would shed erratically.
There was mention of progesterone in the body – yes it only exists at very high levels during the second half of the menstrual cycle – to prepare for pregnancy, and during pregnancy – which is its main function. However there is a very small amount of progesterone in men, in women during the first half of the menstrual cycle, and post-menopausally – so it is still there carrying out whatever function it does in the body aside from the major changes in pregnancy. That's why it is pointless testing for it.
In terms of oestrogen dominance – I think it's already been mentioned and also as above that oestrogen is dominant during the first half of the natural menstrual cycle – when women usually feel at their best once the period is over. As Dancinggirl says the concept is a distraction because it implies that if it is not “balanced†by progesterone there will be unpleasant symptoms until the balance is restored. The fact is - it is true that progesterone is needed to “balance†oestrogen – but only to protect the uterus lining. If this were not the case, as Dancinggirl points out, no-one who had had a hysterectomy and was on HRT would be able to function without feeling unwell. It is also not helpful because it doesn't take into account the symptoms and problems caused by absolute depletion of oestrogen per se.
Having said that – yes, due to anovulatory cycles additional progesterone may well be needed temporarily (as well as oestrogen), in order to thin the lining and prevent heavy bleeding. This protection cannot be provided by progesterone cream despite what some websites and advocates might suggest.
To keep this post relatively short - I'll comment on some of the other points separately
Hope my ramble is of some help - and doesn't repeat what others have said too much! :)
Hurdity x
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Interesting question Brightlight and I don't have the answer. I have however enquired to someone the question: what happens to any extra estrogen/progesterone that our body might receive from hrt over and above what is actually needed. Where does it go?! If we have too much vitamin c, I believe it expels from the body in our wee!! Where do excess hormones go? Are they absorbed elsewhere into the body?
If I receive a response, I'll let you know :))
You asked what happens to the oestrogen and progesterone that we don't need? It is very unlikely (and undesirable)that you will achieve levels of oestrogen through HRT that is the same level as the pre-ovulatory peak – and our bodies are not designed to have these high levels all the time except during pregnancy. The hormones exist in a dynamic equilibrium through hormonal feedback mechanisms at cellular and glandular level. Estradiol is converted interchangeably to estrone and vice versa. I haven't looked into the complexities of this - realms of biochemistry and endocrinology that only specialists would know :)
With tablet HRT, I have read that most of the estradiol is converted to estrone and estrone sulphate in the liver and much of this is eventually excreted in the urine (although some is converted back to estradiol – so I've read) – which is why higher doses are needed than with transdermal HRT.
Much of progesterone is also metabolised by the liver and is an unstable compound so high doses are needed to be taken orally to achieve the right level.
A continuous supply is needed to maintain serum concentrations of estradiol and progesterone at whatever level is desired, because it is continuously being metabolised and excreted. In the body before menopause these hormones are supplied continuously at the appropriate time, mainly by the ovaries, but also the adrenal gland (not sure about the prog but I presume so!).
I'm not sure if that's what you were asking??? if so - well I tried! If not - could you be more specific?! :)
Hurdity x
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I was wondering how HRT is prescribed, if the relationship between levels of oestrogen and progesterone isn't established by blood tests? Is this what makes trying HRT such trail and error for some women?
Does oestrogen really "fight back", when progesterone is introduced, as I've read? Is this why people feel worse before they feel better?
Oo-er - I haven't come across the idea of oestrogen "fighting back" - what on earth is this?!!!!! Such anthropomorphisms...... must be one of those weird websites ;D (sorry honorsmum!).
Seriously though - Honorsmum – as CLKD said blood tests won't help in deciding what oestrogen and progesterone you should have because these vary so much, and in addition the level at which you will experience symptoms will also vary and is not absolute and even so during peri-menopause your own levels will still fluctuate so it is impossible to get it absolutely right! This is why it can be preferable to have separate oestrogen and progesterone so the quantities can be adjusted somewhat - although the response is not immediate as some people like to feel!
Hurdity x
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I was wondering how HRT is prescribed, if the relationship between levels of oestrogen and progesterone isn't established by blood tests? Is this what makes trying HRT such trail and error for some women?
Does oestrogen really "fight back", when progesterone is introduced, as I've read? Is this why people feel worse before they feel better?
Thank you, Hurdity!
It was on the US Facebook group - members there say that oestrogen actually fights back when you start introducing progesterone, in cases of oestrogen dominance. To quote, "oestrogen has a hissy fit and fights to stay dominant, but after a couple of weeks, the two settle down."
Oo-er - I haven't come across the idea of oestrogen "fighting back" - what on earth is this?!!!!! Such anthropomorphisms...... must be one of those weird websites ;D (sorry honorsmum!).
Seriously though - Honorsmum – as CLKD said blood tests won't help in deciding what oestrogen and progesterone you should have because these vary so much, and in addition the level at which you will experience symptoms will also vary and is not absolute and even so during peri-menopause your own levels will still fluctuate so it is impossible to get it absolutely right! This is why it can be preferable to have separate oestrogen and progesterone so the quantities can be adjusted somewhat - although the response is not immediate as some people like to feel!
Hurdity x
According to the site, Progesterone Therapy, introducing progesterone stimulates the oestrogen receptors, making oestrogen dominant - hence why people feel worse initially.
Does that make sense?? Or is it marketing mumbo jumbo?
My initial post was in relation to, you guessed it, the US Facebook group I'm in - maybe the posters got the idea from the Progesterone Therapy site? ???
I'm happy to put myself firmly in the safe and expert hands of Dr Annie Evans!
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I understood it to be the other way round but I think it might be a question of terminology. I have read that oestrogen stimulates the activation/expression of progesterone receptors - such that the physiological effects of progesterone are amplified in the presence of oestrogen. This stands to reason regarding pregnancy when both hormones play a huge role. In the uterus though I understand that progesterone intereferes with the oestrogen receptors so that the lining does not thicken - but that may be a role specific to uterine function as oestrogen casues "proliferative" changes in the uterus, and progesterone changes it to "secretory" - ready for implantation by the fertilised egg. Perhaps this is the fighting referred to?! Really I know very little about it and this is what I've managed to pick up though odd bits of reading. Sorry but I am suspicious of any progesterone site because of the huge marketing behind the cream over the pond!
Hurdity x
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Qlaira seems to popping up quite a bit at the moment as an alternative to HRT for the peri stage. As a contraceptive it has the double benefit through this stage of our lives - I think this is very interesting as it could balance things during these fluctuating years and act as a 'bridge'.
Brightlight - I do get your point that the lack of progesterone to trigger the periods through peri is an issue and our bodies are used this hormone doing it's stuff every month through our reproduction years.
All very interesting - I think this highlights the need for more tailoring.
AS Hurdity says, if there were more Well Women Centres with professionals trained to deal with women's issues then this would be more possible - it would free up GPs surgeries and make everyones life easier.
Dg x
I would definately sign the 'petition' for well women centres. Interesting about Qlaira as an option.
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Regarding some women who feel better on progesterone here is some reading
Thank you for the links - interesting to me and I enjoyed them.
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In answer to the original question, the extra hormones received will just cause side effects, if the dose is lowered or stopped according to how long the particular hormones are active in the body (latching on to receptors), the receptors will become inactive again.
Transgender take HRT too so not sure how it all works their bodies.
That's what I thought and now appreciate that some HRT's are 'adjustable' which I guess limits this.
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Well what a long and involved thread!
I am like you BrightLight - naturally curious - which is why I studied science in the first place, and still enjoy learning - which is why I enjoy being a member of this forum because I am continually being challenged to look things up that I'm not clear about (sometimes unsuccessfully!) although it all takes up a lot of time!! Having said that I finished my Biology Degree over 40 years ago, and the research I did subsequently was not human biology or anything related so I am looking up everything just as much as everyone else! You had great answers from Dancinggirl and dahliagirl.
In terms of understanding what's going on in our bodies - I think I gave you the link to the article on this site about the biology of the peri-menopause and what happens to the hormones in our menstrual cycle? Now that you've read a lot more you may like to read it again as this is the clearest summary of what happens, without too much complicated biochemistry and terminology. http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php
The answer to your initial question is is that the biological process will just carry on even if you replace oestrogen through HRT ie HRT will not prevent the decline in ovarian function. However the added oestrogen will prevent the symptomns of oestrogen deficiency. This is why some women experience bleeding at odd times especially when taking HRT early in peri-menopause - because the cycle is doing its own thing. I can't explain how added oestrogen affects the cycling of pituitary hormones and the various hormone feedback mechanisms.
As for excess oestrogen - as CLKD said somewhere on the thread - progesterone normally balances oestrogen throughout your fertile years, because if it didn't, the uterus lining would over-thicken, could lead to endometrial hyperplasia and possibly cancer, and would shed erratically.
There was mention of progesterone in the body – yes it only exists at very high levels during the second half of the menstrual cycle – to prepare for pregnancy, and during pregnancy – which is its main function. However there is a very small amount of progesterone in men, in women during the first half of the menstrual cycle, and post-menopausally – so it is still there carrying out whatever function it does in the body aside from the major changes in pregnancy. That's why it is pointless testing for it.
In terms of oestrogen dominance – I think it's already been mentioned and also as above that oestrogen is dominant during the first half of the natural menstrual cycle – when women usually feel at their best once the period is over. As Dancinggirl says the concept is a distraction because it implies that if it is not “balanced†by progesterone there will be unpleasant symptoms until the balance is restored. The fact is - it is true that progesterone is needed to “balance†oestrogen – but only to protect the uterus lining. If this were not the case, as Dancinggirl points out, no-one who had had a hysterectomy and was on HRT would be able to function without feeling unwell. It is also not helpful because it doesn't take into account the symptoms and problems caused by absolute depletion of oestrogen per se.
Having said that – yes, due to anovulatory cycles additional progesterone may well be needed temporarily (as well as oestrogen), in order to thin the lining and prevent heavy bleeding. This protection cannot be provided by progesterone cream despite what some websites and advocates might suggest.
To keep this post relatively short - I'll comment on some of the other points separately
Hope my ramble is of some help - and doesn't repeat what others have said too much! :)
Hurdity x
I do appreciate you taking the time to write, thank you.
I know have the role of hormones clear in the regular cycles and also that HRT tops up our natural hormonal pattern that continues 'underneath' during perimenopause.
I can see that within the cycle progesterone is a balancer to estrogen for the lining etc and without getting hung up on the 'phrase' estrogen dominant my main premise is that both hormones have a role to play both in the reproductive arena and the rest of the body and that some symptoms might respond to progesterone better than estrogen and I really can see that progesterone alone - above and beyond regulating menopausal symptoms alone, could have some uses.
I view it that many woman have an ongoing hormonal imbalance prior to menopause and that menopausal symptoms are just another 'expression' of that imbalance. I can't see why the individuals metabolism of these hormones, whether they are her own or biodentical would change. So HRT might keep the cycle going and the hormones afloat but also might continue to create hyperplasia, polyps, fibroids, cysts etc So I guess I am interested in a wider consideration of hormonal effect and as said earlier, a well woman clinic would help women take a closer look at things and tailor treatment to suit them.
I can see that there are so many useful things that hormones do in our bodies and having read all these useful and informative posts I have a clearer idea about the different approaches, need and solutions that they can provide. Whether they are in the form of conventional HRT, biodentical prescribed, herbs, plants or indeed a yam cream. ALL of it is relevant in my eyes, some has scientific evidence, some symptoms need more sure fire approaches like HRT, some women might benefit from progesterone only cream early in their hormonal imbalanced lives. I can see why it all exists - why it is a mindfield and why it is hard to access individualised support 'out there'. Thanks again for sharing your knowledge :)
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I was wondering how HRT is prescribed, if the relationship between levels of oestrogen and progesterone isn't established by blood tests? Is this what makes trying HRT such trail and error for some women?
Does oestrogen really "fight back", when progesterone is introduced, as I've read? Is this why people feel worse before they feel better?
Thank you, Hurdity!
It was on the US Facebook group - members there say that oestrogen actually fights back when you start introducing progesterone, in cases of oestrogen dominance. To quote, "oestrogen has a hissy fit and fights to stay dominant, but after a couple of weeks, the two settle down."
Oo-er - I haven't come across the idea of oestrogen "fighting back" - what on earth is this?!!!!! Such anthropomorphisms...... must be one of those weird websites ;D (sorry honorsmum!).
Seriously though - Honorsmum – as CLKD said blood tests won't help in deciding what oestrogen and progesterone you should have because these vary so much, and in addition the level at which you will experience symptoms will also vary and is not absolute and even so during peri-menopause your own levels will still fluctuate so it is impossible to get it absolutely right! This is why it can be preferable to have separate oestrogen and progesterone so the quantities can be adjusted somewhat - although the response is not immediate as some people like to feel!
Hurdity x
According to the site, Progesterone Therapy, introducing progesterone stimulates the oestrogen receptors, making oestrogen dominant - hence why people feel worse initially.
Does that make sense?? Or is it marketing mumbo jumbo?
My initial post was in relation to, you guessed it, the US Facebook group I'm in - maybe the posters got the idea from the Progesterone Therapy site? ???
I'm happy to put myself firmly in the safe and expert hands of Dr Annie Evans!
If there were an expert near me that resonated, I would be there like a shot :)
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I understood it to be the other way round but I think it might be a question of terminology. I have read that oestrogen stimulates the activation/expression of progesterone receptors - such that the physiological effects of progesterone are amplified in the presence of oestrogen. This stands to reason regarding pregnancy when both hormones play a huge role. In the uterus though I understand that progesterone intereferes with the oestrogen receptors so that the lining does not thicken - but that may be a role specific to uterine function as oestrogen casues "proliferative" changes in the uterus, and progesterone changes it to "secretory" - ready for implantation by the fertilised egg. Perhaps this is the fighting referred to?! Really I know very little about it and this is what I've managed to pick up though odd bits of reading. Sorry but I am suspicious of any progesterone site because of the huge marketing behind the cream over the pond!
Hurdity x
I think it might be a bit of both - I have read that many receptors in the body can be occupied by both progesterone and estrogen and some 'tasks' in the body can be done by both and some be either. I do read more about progesterones potential role in functions beyond fertility - things like improved brain function, the fogginess that comes with menopause and certainly the emotional/mental health aspects.
There is a lot of marketing for the progesterone creams, I can see that now. Sadly a lot of useful natural products are sold in not so good ways and low quality which is a shame, when they could be useful. Very hard for consumers to wade through the myriad of websites and claims. I don't discount it though. Natural ingredients (Yam) can't be patented by pharmaceutical companies which is the other side of it. More and more natural ingredients are creeping in, being regulated and prescribed, which I think is great.
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Hi everyone
Thank you Hurdity for stepping in and doing such great posts on this thread. I think Brighlight's curiosity is sparking some very educational stuff.
BAck in my 30s after I was first diagnosed and I resisted taking HRT, I tried chinese medicine - this involved brewing up a whole lot of herbs and stuff each day which I then had to drink. Chinese medicine goes back thousands of years and has been proved to be extremely good at treating many things - I believed I was doing something 'natural'. I know acupuncture can be extremely beneficial but that is a different thing to what I was taking!!!!. I think this stuff did work to a point but, as I was peri menopausal, my cycle and hormones may well have been fluctuating so looking back I can't say for sure whether it was the chinese brew or not. I then read somewhere about what type of things went into chinese medicine and that in fact much of it could be very toxic - I then decided that it was better to go down the conventional route and follow my GPs advice and take HRT. One mustn't forget that HRT has been and continues to be extensively researched and there are many ongoing studies. I tried many different remedies and herbs through my 3 year break from HRT in my early 50s - spending a great deal of money in the process - with no positive outcomes. I am not saying others should not pursue alternative ways of managing their menopause and this site offers some good advice on alternative therapies etc. Many drugs and treatments are derived from plants and other natural sources and the newer HRT preparations are bio identical so by definition are 'natural'. HRT replaces what our bodies would normally produce unlike many drugs that actually work to block or stimulate unnatural processes in our bodies e.g. steroids, chemotherapy etc. I think the worry for many of us is the exploitation that arises when people desperate for a cure or remedy can pursue a course of treatment that has not been studied rigorously. I feel sure that if for example Yams have anything to offer the drug companies would exploit them to the full. If you do some internet research I think there are some proper controlled trials that have been done on all sorts of herbs and remedies e.g. St John's Wort has been well studied and shown to be beneficial in mild to moderate depression, however it can interact with other medicines so has to taken with caution. There is some evidence that phytoestrogens can help some menopausal women - I wish I could say it helped me. I'm vegetarian so eat a diet high in things like soya and I tried taking Red Clover as well.
I think my message is to be very careful about self medicating without some good professional advice - be it conventional medicine or so called 'natural remedies'.
I do believe that we are a pioneering generation that is questioning and demanding more from all aspects of our lives. Managing the ageing process including the menopause is actually making great strides and I hope that our experiences will pave the way for our daughters to have better options than we have had. We were the generation that were the guinea pigs for the contraceptive pill - do you remember all the scares about that? I suffered with terrible period pains and The Pill enabled me to have a career.
My daughter attends a Family Planning Clinic in London and they were determined to find the right contraceptive Pill for her - she actually ended up with something called 'The Ring'!!! this is basically transdermal so little is absorbed systemically and it suits her really well.
I'm sure drug companies are working on finding better and safer hormonal treatments - after all if they can find a truly safe treatment for menopause symptoms wouldn't that be GREAT.
DG x
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Dancinggirl - chinese herbs are really strong and I have only once used them via a highly respective practitioner, but I still had a reaction that was too strong for me. With any complementary medicine, I think it's really important you find the pracitioner that suits you and I do agree that sticking with regulated, standardised medicine is far 'safer' in a lot of ways. There is definately a small list of herbal medicine products that have been licensed including St Johns Wort, so there are products you can 'safely' take.
I'm still not sure there aren't benefits in yam and other ingredients, if more money were put into research the benefits and dangers would become clear - until then, I do agree that for the majority it's wise advise to find a good professional to address health.
I am fully aware and respectful of the power of complementary and herbal medicine and approach it with nearly as much caution as I do conventional medicine. Natural does not been safe - some essential oils used in the incorrect ways can cause serious issues. The whole issue of regulation of herbs, plants and complementary medicine is another massive topic and I appreciate that right now, the mainstay treatment of symptoms for hormonal issues is HRT but as you say the future will be quite different and yes, hopefully 100% guaranteed safe x
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BrightLight if you are interested in finding out about natural progesterone cream check out
wellsprings-health.com/pages/serenity-natural-progesterone-cream
Its a British site, you can buy the cream there as well as a combined cream with estrogen called 20-1 cream. (not to be used with conventional HRT)
You will find many women and doctors talking about it.
They have a free downloadable e book.
By the way progesterone cream is made from Mexican Wild Yam (Dioscorea Villosa) though it is still synthesised in the lab.
Another thought its nice to know that if Doctors insist that women come of HRT at 60 there is something they can use for themselves to ease the shock of abrupt drop in hormones.
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BrightLight if you are interested in finding out about natural progesterone cream check out
wellsprings-health.com/pages/serenity-natural-progesterone-cream
Its a British site, you can buy the cream there as well as a combined cream with estrogen called 20-1 cream. (not to be used with conventional HRT)
You will find many women and doctors talking about it.
They have a free downloadable e book.
By the way progesterone cream is made from Mexican Wild Yam (Dioscorea Villosa) though it is still synthesised in the lab.
Another thought its nice to know that if Doctors insist that women come of HRT at 60 there is something they can use for themselves to ease the shock of abrupt drop in hormones.
Thank you, I wrote to Wellsprings last week to ask some questions and I am talking with a herbalist/naturopath next week to get their view on a short/long term health plan for me.
I have come into this situation all of a sudden, my menopause didn't come slowly and it's really rattled my belief system - I believe that to be well we need to address the root of the problem and not just the symptom. Even biodenticals don't quite sit well with me because for me the root of the problem is not really my hormones ;) However, I think I might need some support from hormone replacement therapy of some kind while I sort the rest.
I appreciate your viewpoint, interest and experience in wholistic medicine.
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Thank you BrightLight
On a lighter note another of my passions is health, beauty and ant- aging, and I did do a Beauty Course at College too. Though Holistics was my favourite.
It does help to keep my mind active and young at heart, well I hope it does ::)
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Getting some support from HRT may well be the answer BrightLight, a light might be switched on and you could see things in a completely different light.
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I fear dementia more that anything else, so I think staying curious and learning new things is terribly important.
Interacting with everyone on this site is really good stimulus for our brains. HRT does keep me far more alert - I know my driving is better; before I went back on HRT I was feeling like a menace on the road as I was struggling to concentrate!!!! :-X. DG x
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SilverLady - I haven't ever been one for skincare and beauty knowledge, but I think that might be on the agenda too - so grateful for the chubby cheeks that held up until recently ;) As you can tell, I am determined to find the right combination of things for me at the right time and yes.
I think I am really sensitive to changes, maybe because I trained as a bodyworker, but I can feel the shifts happening, the adjustments and going to let that continue for a month or so more until I make firm choices. For instance my skin although it's lost some (a lot) of tone and plumpness over the last year, the redness, greasy, dryness that was going on and off is actually calming down since I haven't had a period. Tight muscles are not so tight, jaw clenching at night that started last year seems to have gone..............it's all been replaced with other, equally surprising things, but..........on somedays I am completely in awe of my own body. I have never been pregnant so I haven't experienced any metamorphosis before (since puberty and I can't remember that). :)
Dancinggirl - I work at home now, but a few years ago the ladies at work, all a bit older than me encouraged me with brain gym, saying they were really into it. I understand now!
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Brightlight - I trained as a dancer and performed professionally as a dancer, singer and actress for 12 years - all thanks to The Pill as without it the period pains would have prevented this career. After I went back on HRT at the age of 53, my energy went up so much that I started to dance again and actually started my own class teaching adult beginners ballet with other forms of dance. It was great fun. The beauty of dancing is that it is a form of brain gym - you have to use all parts of the brain and you can't dwell or think about anything else. The group of ladies who attended my class found it was great therapy for body and mind - they were aged between 25- 70. Classes like Pilates I find the brain can wonder onto your anxieties and stresses but when you have to concentrate on learning a dance routine you cannot think about anything else, the endorphins are flowing and it lifts your mood like nothing else.
Since moving to Suffolk I haven't done these classes - maybe I should start doing them again.
RE; skin and beauty - I suffered with spots and had a very greasy skin till I got to the meno and it's one of the plusses for me that my skin is that bit drier so fewer spots. The thing I don't like is the effect of gravity on my body!! Also my skin has gone all papery - nature is kind in making us go longsighted - as long as I don't look at myself with glasses on I can't see the lines± ;) Dg x
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DancingGirl - yes, do the classes again :) One of the things over the last year, which I now realise my hormones were part of, is that I have really stopped being so in my body, I have had achey shoulders and general lack of fluidity. I am getting it back now and really agree with you about mind/body connection with certain activities. When you have to follow some rules or technique and move at the same time it's so good for everything.
I am definately hating the gravity
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BrightLight if you are interested in finding out about natural progesterone cream check out
Its a British site, you can buy the cream there as well as a combined cream with estrogen called 20-1 cream. (not to be used with conventional HRT)
You will find many women and doctors talking about it.
They have a free downloadable e book.
Another thought its nice to know that if Doctors insist that women come of HRT at 60 there is something they can use for themselves to ease the shock of abrupt drop in hormones.
silverlady - you know commercial links are not permitted on this site - the link is to the site which sells the cream ( I have omitted the link from the quote) and as such is promoting that particular cream which the company itself does.
Also re coming off HRT at 60 or any particular age - buying progesterone cream will not ease the drop in hormones - the way to do this if needed is to eg cut patches or take the pills every alternate day ie a tailing off regime - not to switch to buying an unproven commercial cream!!! It is the drop in oestrogen our bodies need to acclimatise to.
BrightLight - I can see you are reading as much as you can and trying to find out about all aspects of menopause and treatements for it - but I'm afraid you won't get a balanced reply from wellsprings as it is in their interests to sell it to you. It is just the women in your position - entering peri-menopause when symptoms tend to come and go as cycles become irregular and hormone leves fluctuate - the these products are targeted at.
For you and anyone else reading this I urge to to read this American neutral ( ie not a company) academic review of bio-identical hormones which includes progesterone cream. The US (science mainstream) is concerned about all the hype and the big marketing machine and theories behind all this too!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219716/
The paper is thorough but the abstract is brief and to the point:
Progesterone creams and natural or bioidentical compounded estrogen preparations are being promoted to consumers as safe alternatives to conventional menopausal hormone therapy and as health-promoting tonics. No reliable data support these claims.
I realise you have issues about bio-identical hormones too (I presume you mean the unregulated compounded ones) but it is worth reading. :)
Hating the gravity?! Is that what I think you mean? I understand your shock in the changes that are happening to your body - I've got used to mine now but do look in horror sometimes when I'm on the floor in my exercise classes when I see the skin hanging from my upper arm :o
Dancinggirl - I wouldn't find it possible to get stressed in Pilates because of the work involved in all the muscle groups and the concentration on repetitions or holding a difficult position. I do wish for it to end though sometimes! Also the Zumba class - which is a type of fitness dancing I suppose - involves an enormous amount of brain work, trying to work out the moves and wiggles before the muisc for that one finishes!
Hurdity x
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I wasn't 'stripped of oestrogen' following breast disease treatment. I tried to take Tamoxifen which lessens oestrogen production but it made me SO ill I had to stop it - in fact it almost killed me. I was prepared to take the risk as it was only a possibility that it would stop the disease returning. I didn't feel ill prior to surgery nor after, no pain but I was emotionally fragile.
Tamoxifen can increase womb cancer. A friend of mine had this happen :-\ ……… Another friend died anyway despite surgery followed by Tamoxifen.
Menopause is natural. I felt ill at certain times during my menstruating years. Every month. But it did have a pattern …. ish ::)
I think some ladies are getting too bogged down by what their bodies are doing naturally ::) - don't you remember how you felt in the couple of years prior to beginning periods ????? feeling unsettled, irritable, weepy, scared ……. without knowing why and without having access to anyone who could tell me why ……….. but our Lives moved on with or without the botheration of periods: boys ::), exams., getting a job, driving test …….. marrying, child-rearing/not, divorce/not ………. I don't believe that the body can be over-loaded with oestrogen or progesterone for very long otherwise we would cease to function completely.
We are forgetting that it isn't only sexual hormones that play a part in our daily survival but we must remember adrenaline and the other hormones which play an important part in keeping us upright!
Many products that can be bought on-line or in UK Chemists are aimed at our life-style from feeding babies to where we are now! and often are on the shelves in order to make money for the Companies - whereas if we kept to a healthy diet, good exercise plan, plenty of fresh air, alcohol as and when ……… we would do just fine! I rarely look on the shelves to see what I might require …….. if I'm ill I go to the GP if not, once I get going each morning, I generally get through each day without too many problems. It wasn't always so but now ;)
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"silverlady - you know commercial links are not permitted on this site - the link is to the site which sells the cream ( I have omitted the link from the quote) and as such is promoting that particular cream which the company itself does"
Hurdity the address I gave purposely deleted the www. so it was not a direct link.
You are not a moderator and I resent you deleting anything in my post, this for Emma to do not you.
There was nothing wrong in my post.
Also I don't see how you could have you could have omitted anything in my post.
If you objected to anything have I have posted PM Emma and she will decide.
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I totally disagree that we should be taking anything from the wild for use - once a preparation is discovered that can be beneficial it should be synthesised …….. which enables a regular, safe 'purity' of product. When my dog was ill I was advised to use green lipped mussels - from the wild, harvested in their 1000s …….. :'( …….. NO WAY! ::)
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CLKD from my post
"By the way progesterone cream is made from Mexican Wild Yam (Dioscorea Villosa) though it is still synthesised in the lab"
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I saw - that's what triggered my memory about the green lipped mussels ……… there were other pain relief preparations that were on offer for my dog which had been proven in the Lab..
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Its what HRT preparations are made of too, the ones the NHS GP prescribes.
Sorry CLKD not your fault, but I am fuming and I think my days on MM are coming to an end.
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I read your comment as "cream is made from Mexican Wild Yam (Dioscorea Villosa) though it is still synthesised in the lab" as if it is made mainly from Wild Yam :-\ and only occasionally synthesised ……. the way it is written does not indicate that it was discovered as beneficial from Mexican Wild Yam and is now synthesised ………… ::) - savvy?
Humans have no right to continue harvesting from the wild herbs, plants, animals that could be beneficial - unless they can be synthesised correctly, processes which take years of research and stabilisation. Whereas in the 'wild' various Tribes know what in the Jungle is safe to use ;) ……..
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Wild Yam cream is completely different to Natural Progesterone cream
Wild Yam cream is a herbal cream from the natural plant.
Natural progesterone cream is made from Progesterone USP, the raw material is from Mexican Yam which is synthesized in the lab distributed as micronized powder in bulk to the Pharmaceutical Companies to be made into the HRT preparations. The same with Soy.
This how Compound Pharmacies in America make up their individual hormone preparations, and Progesterone cream is made from.
https://www.spectrumchemical.com/OA_HTML/chemical-products_Progesterone-Micronized-Powder-USP_P1834.jsp
I hope I have made myself clear on this.
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CLKD - I think it's wise to remember the whole body has a part to play in this period of our lives, adrenals etc and that given a good base of health, food, excercise and stress management , balance and symptoms might just happen without too much distress. Sadly, I do think our bodies can remain in a hormonal imbalance, well at least they revert to it, sort of like a bad habit ;)
Silverlady - I am very sorry that I have indirectly caused upset for you, I appreciate you sharing. You are explaining the differences well.
Hurdity - I really do see how this site is trying to make sure women are not misinformed, misguided etc but it should be clear from my posts that I am approaching things with eyes wide open and am able to form my own judgement on whether this company selling products responds to me in a way that gives me confidence in their product. To me, it is no different than asking questions of our GP's and other sources on the efficacy of medication they prescribe. It isn't a given that everyone finds 'comfort' in regulated products or statistics, sometimes the attitude of the healthcare provider is important too - albeit 'unregulated', which of course carries risks. Isn't it swings and roundabouts with all these things?
I do not think that biodentical hormones are 'natural' - I have worked in the natural health industry and this whole issue of natural is a bit frustrating - both from the point of view of claims, perceptions and understanding. No hormone replacement system that we are discussing is natural. I view it with the same risks as HRT on one level but......if I need a bridge in the short term I can choose between a prescription from my GP (if he will provide it) or from a company selling it, or someone prescribing it -either way I want to be able to tailor any treatment I choose.
All that being said, I have also been a moderator and realise that community management is intrinsic to keeping the tone and approach of the forum. I really did think there would be a wider variety of discussion beyond management of HRT etc and it seems that really there isn't and perhaps the underlying premise of the site doesn't suit me.
There really are a lot of solutions out there, to all sorts of issues that relate to menopause, be it the hormone replacement aspect, stress management, herbal remedies to help ease minor symptoms, mindfullness coaching and many of them are regulated, used by some doctors and offer a great range for a great number of women. There are some great websites out there that don't sell anything and still discuss all these choices.
It's a complicated subject and perhaps the value of this forum really is in helping women manage their HRT - that is certainly needed and a great resource. I think unless I am taking HRT, I might bow out for now.
Thanks everyone for the input and discussion.
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Hormone Replacement Therapy is not a 'natural' way to deal with menopause which is a 'natural' progression of ageing. HRT helps ease some symptoms that some ladies suffer ……. and I mean 'suffer' in the true sense of the word. I have been lucky. The worst for me was vaginal atrophy and certainly without treatment I wouldn't have got rid of symptoms.
Some things that are 'natural' are dangerous …….. many of the garden plants we choose are natural and dangerous ……… the hormonal imbalance doesn't always last, it is, like periods, something we have to push on through. Other ladies benefit from HRT for the rest of their lives as long as GPs agree to prescribing it.
From reading on here it seems that many ladies suddenly hit the wall of menopausal symptoms without warning :-\ …. which is a shock and can take the rug from under their feet.
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I really despair. Silver Lady brings an alternative view to many things, progesterone cream, health care, skin care.
I really think that others members should respect that and stop picking at what she says.
It happens time after time.
Not everyone has a deep interest in the ins and outs of scientific studies but we read with interest.
Could the other members who bring interesting information to the forum be afforded the same respect.
Every time someone mentions progesterone cream and Silver Lady responds she gets shot down.
I think this is unacceptable and as Brightlight says....her eyes are wide open and she can form her own judgement...
Please let this be a forum where all views are treated with respect.
We no longer have forum moderators from our members SL....I should know....I was one.
Honeyb
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Please don't be sorry Bright Light this has been happening to me for many years. It was highlighted by a poster a few days ago that many are driven away by some members attitude.
As I said I am seriously considering leaving MM now because this is only one of many put downs I have had over the years though this time not so subtle.
I really do hope you find the peace and answers you are looking for.
One thing I will add there are some nAtural health sites out there with very gentle people who have do have open minds, my mistake was trying to combine natural medicine idea's with mainstream on MM.
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I think that would be a real shame SL.
You have the same right to voice your opinions as the rest of us.
If Dr Currie thought there was no place for alternative therapies she would not have included a section on it......that to me says it all.
Keep posting please.
Honeyb
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Not been on the forum long but I agree with HB . We all have to find our own way through this time in our lives as it affects us all to different degrees. Silver lady is very knowledgeable about many things and finds lots of info, no one has to read it and certainly we can decide for ourselves on whether to take anything further. I for one would miss the interesting links she provides. Sharing experiences and helping each other can only be a good thing surely and everyone should feel welcome to join in this process.
Thorntrees
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It was me that asked whether BrightLight had considered bioidentical progesterone cream.
When I first started reading about perimenopause, it seemed an obvious starting point - at worst, it might prove to be a slightly expensive moisturiser.
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Progesterone cream, when mentioned is like a red rag to a bull for some reason.
I cannot think of one single occasion where it has not caused a falling out. Of course newer members do not know that and why should they.
It's an interesting subject that should be open to discussion the same as any other subject on the forum.
Why SL gets shot down is a mystery to me.
Honeyb
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Please don't be sorry Bright Light this has been happening to me for many years. It was highlighted by a poster a few days ago that many are driven away by some members attitude.
As I said I am seriously considering leaving MM now because this is only one of many put downs I have had over the years though this time not so subtle.
I really do hope you find the peace and answers you are looking for.
One thing I will add there are some nAtural health sites out there with very gentle people who have do have open minds, my mistake was trying to combine natural medicine idea's with mainstream on MM.
Thank you - I am sure I will find my solutions, I have managed so far in life with each curve ball that has been thrown :) Many of my friends try to combine natural medicine with mainstream and if I manage to find the middle road, it will help them as well. They all struggle one way or another to do this. I really think it is the way forward and the US and Australia do it - yes, in the US they tack it onto 'selling' but that is their culture for everything, in Australia it is an everyday approach. Information on women in menopause over there, show a distinct difference in the use of HRT, much less because they embrace many other treatments - there isn't a right or wrong is there? We are all just looking to meet on common ground.
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It was me that asked whether BrightLight had considered bioidentical progesterone cream.
When I first started reading about perimenopause, it seemed an obvious starting point - at worst, it might prove to be a slightly expensive moisturiser.
Yes, ha. I need moisture in my skin :) Not to open up a can of worms but amongst my surfing there has been scientific research that does show progesterone cream is good for skin - it was a small study. So maybe hormones will be in skincare in the future.
The results of this study demonstrate that topical 2% progesterone acts primarily in increasing elasticity and firmness in the skin of peri- and postmenopausal women. These effects in combination with good tolerability make progesterone a possible treatment agent for slowing down the ageing process of female skin after onset of the menopause.
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Progesterone cream, when mentioned is like a red rag to a bull for some reason.
I cannot think of one single occasion where it has not caused a falling out. Of course newer members do not know that and why should they.
It's an interesting subject that should be open to discussion the same as any other subject on the forum.
Why SL gets shot down is a mystery to me.
Honeyb
X
Yes, I didn't know progesterone was a not so good word ;)
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Hello silverlady,
What you say is always interesting and informative - please keep posting!
Jenna x
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Hi Ladies, I haven't posted for a while as I have been struggling to find my own balance for the past 5 years. But I have always found silverladys information very informative and helpful. My symptoms started 6 months after I was made to come off the depo jab and I have been to hell and back ever since trying to find a balance. Even went to see Proff Studd who prescribed his usual routine, oestrogel, testosterone gel & utrogeston. However even though he kept telling me to increase my dose, my symptoms continued. I have had numerous wasted visits to the doctors re my severe symptoms only to be fobbed off each time.
In desperation I had a mirena inserted over a year ago, and for the first twelve weeks, it was like a miracle, ALL OF MY SYMPTOMS VANISHED. Sadly after twelve weeks they returned.....
I saw another speacilist last week, who explained to me that my body obviously craved & needed progesterone. He said that the initial boost from the mirena had balanced my hormones, but after twelve weeks it had started to decrease the amount that was released. So he has advised to have the mirena removed and to trial Femseven Conti for two months, if this is successful I can then revert back to using the depo jab alongside oestrogel. So today I am going ahead with this and will have the mirena removed and try the new patches. I will keep you posted on the outcome. Cacey x
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Hi Ladies, I haven't posted for a while as I have been struggling to find my own balance for the past 5 years. But I have always found silverladys information very informative and helpful. My symptoms started 6 months after I was made to come off the depo jab and I have been to hell and back ever since trying to find a balance. Even went to see Proff Studd who prescribed his usual routine, oestrogel, testosterone gel & utrogeston. However even though he kept telling me to increase my dose, my symptoms continued. I have had numerous wasted visits to the doctors re my severe symptoms only to be fobbed off each time.
In desperation I had a mirena inserted over a year ago, and for the first twelve weeks, it was like a miracle, ALL OF MY SYMPTOMS VANISHED. Sadly after twelve weeks they returned.....
I saw another speacilist last week, who explained to me that my body obviously craved & needed progesterone. He said that the initial boost from the mirena had balanced my hormones, but after twelve weeks it had started to decrease the amount that was released. So he has advised to have the mirena removed and to trial Femseven Conti for two months, if this is successful I can then revert back to using the depo jab alongside oestrogel. So today I am going ahead with this and will have the mirena removed and try the new patches. I will keep you posted on the outcome. Cacey x
Sounds like you might have found out what is right for your body, fingers crossed. I started this thread because I do believe we are all different and some women won't fit into the 'norm' as it were. I really believe my body also needs progesterone, I can't prove it, but it's obviously possible. Thanks for posting.
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Silverlady has left the forum...she has reverted to being a guest. I think this is such a shame and does not do MMs reputation any good at all.
Honeyb
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I am sad about that Honeybun and I have decided not to post anymore of my 'thoughts' or explorations :(
I had a good look around the main pages of the website today and there is lots of information on alternative ways to approach symptoms, with good guidelines on things that have more research than others and a book list that includes John Lees book that has an 'alternative' view of hormone imbalance that includes the role of progesterone. Also some advertisers that are selling products - so clearly some things are endorsed by menopause matters.
Personally when I understand how my body works and why it might be doing what it is doing I feel better, regardless of whether I can 'fix' it or not. Taking a whole body view of menopause feels good to me, takes the pressure off somehow. Makes it less daunting.
For anyone wanting to understand their risk of osteoporosis and how to really know what to do about it (if you don't feel you want to take HRT or are in two minds) I have sought advice from The National Osteoporosis Society who were very helpful and have a great leaflet on HRT and other ways to manage bone health. You can do a simple risk assessment using the FRAX calculator which if you google you will find.
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I'm part way through a huge book by Jonathan Wright and Lane Lenoard on bio identical hormones and it's a real eye opener. Whilst the big drug companies have the huge budgets to push the sale of horse hormones, they have very little interest in bio-identicals because they can't patent them. That said, despite the lack of the multi million pound spends, this hasn't stopped the research, a lot of which has been carried out in Europe where the use of bios is much more widespread. There are a wealth of studies that also investigate the role of progesterone on our bodies, and the benefits this has on insomnia, depression, oestrogen related blood clots and bone density to name just a few. (Check out the PEPI study of 875 women, which used saw gains in bone density against a placebo group when progesterone or even progestin was used).
Until recently I have been using the Mirena coil which includes a progestin. I didn't realise I was peri menopausal, I've had no flushes, moods, depression or a host of other side effects I'd normally expect. The hormone on the coil is meant to last 5 years, I had mine if for much longer than this and in the last year I've started to experience insomnia and forgetfulness. I have no idea if there's any link at all between the declining amount of progestin and these effects but am hoping to check this shortly with bio-identical HRT. Let's see.
I'm not sure why something synthetic can be seen as better than something natural, in effect both bio and non bio HRT have their roots in natural substances - one in plants, the other in horse pee. The difference is the molecular structure of the bio-identical is identical to our own hormones, the latter isn't. (No great surprise unless any of us have equine roots :-\ ).
There is so much conflicting information on HRT and indeed so many GPs who are misinformed or simply spout the latest PR blurb from expensive drug companies. Personal experience is probably the most reliable route, and finding something that agrees with your body. Unfortunately we're unable to gauge longer term risks on this, but we do know what does and doesn't make us feel more like our usual selves.
GG x
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Reading through some of the links on this (really interesting) thread, I also wonder whether my own personal lack of progesterone has contributed to a recent breast cyst - my own progesterone (or progestin from the Mirena coil) having previously balanced my oestrogen, and once it's gone.....mayhem.
Hm, more food for thought.
GG x
P.S. I've just noted that the link which is critical about bio-identicals is written by someone employed by a drugs company making billions from flogging the non bio versions. Call me a cynic....
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Hi Ladies, thought I would give you all a quick update re starting Femseven Conti, as not sure if I need more oestrogen or progesterone? My night sweats have increased, dreadful sinus type headache, joints stiff, feeling low, no energy, even starting to get flushes during the day, which I have never had before. I went to see the doc yesterday, who was useless as said I need to take strong painkillers every four hours for the next three months, as that should clear the headaches!!
On a positive note I have no anxiety. So not sure if I can try and increase the oestrogen alongside the patch as I have lots of oestrogel sitting in the drawer. I would really appreciate any input as my symptoms are slowly getting worse. I have been trying to find the right HRT for the past seven years, I am now 51 and wonder how much longer I will be struggling to find the right dose. Cacey x
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Oh Casey - you poor thing. I assume you had an early menopause so this is why you have been on HRT for so long?
From what you are telling us the HRT is simply not helping much and the increase in your meno symptoms would indicate you possibly need a different treatment.
I wouldn't add any more oestrogen as the patch is carefully balanced and if you add some oestrogel you may get problems with your womb lining building up and problematic bleeding occurring.
Femseven conti will be giving you continuous synthetic progesterone which often gives side effects for many women. Taking any progesterone continuously can cause problems so have you considered going back to a sequential HRT? I'm 59 and using a sequi regime because I don't want to use progesterone all the time.
You also mention you have some Oestrogel in the drawer, why did you stop using this and what progesterone did you use with it - were you using the Oestrogel with progesterone continuously or sequentially?
Have you tried Utrogestan as a progesterone?
I have also noticed that many women seem to need a SRRI like Citalopram alongside HRT to get full symptom relief. I have a colleague at work who uses both and is doing much better - there are a few women on this site doing the same. The idea of taking strong painkillers continuously for 3 months seems crazy to me!!
I get these sinus type headaches - I think it's because the sinuses dry out or respond to different environments that causes extra sensitivity. I have found that using a saline spray regularly seem to help. I've been using Sterimar which I bought online - I use it mornings and before bed and find I don't get so bunged up at night and my sinuses are less irritated.
Why not ask to be referred to a Meno Clininc if there is one in your area or be referred to a gynae for an assessment?
You could consider taking a break from HRT for 3 months to see how you feel and then start fresh with perhaps 2 pumps of Oestrogel daily and Utrogestan (bio identical progesterone) used sequentially. You could then increase the Oestrogel a bit if you feel you need to.
Also, are you taking Omega 3 for your joints? At this time of year most of us will be Vitamin D deficient due to lack of sunshine and this can cause aches, pains and fatigue.
DG x
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Hi Dancinggirl, thank you so much for informative reply. I was put on this regime by a specialist, as all of my problems started when I came off the depo (over 6 years ago) I have tried numerous HRT, Had the mirena for over 18 months, but the specialist felt that I needed more progesterone, hence the Conti patch, I have been on this new regime for the past couple of weeks, but my body is very sensitive to any changes and whilst I know I need a settling in period, I definetly feel that my symptoms are creeping up again, hence not knowing which hormone is lacking. I have made another appointment with the specialist next week, and will ask him to check bloods, as my last appointment with him, he refused to do them. He did suggest going back on the depo, but I think at my age this would be the wrong thing, as my bone density scan has already come back as
low:(( So frustrating as I would just like some clear guidance, which seems lacking even from the specialist... I had to laugh as he said " I looked healthy and was obviously very good at making an effort to keep fit" I explained that all was not as it appears, as due to feeling so rough I am unable to attend the gym and struggle to walk my two dogs" Most mornings I wake up feeling like I have the worse case of flu and struggle to push through and maintain a normal life!! Cacey x
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You may need to give things longer to settle - it's probably early days to tell whether this patch is going to work for you or not. Is your specialist a gynae? I'm not sure why he/she should think you need more progesterone??? It is usually the progesterone that gives the side effects and one usually feels good on the oestrogen only phase in a sequential HRT. It tends to be Oestrogen that reduces meno symptoms and progesterone is mainly used to prevent the womb lining from building up. I know there are some that believe progesterone is important for symptoms but I'm personally not convinced??? There are many ladies who feel really good on the more bio identical progesterones - I am using Utrogestan and do feel quite good on it but I'm not sure how I would feel if I used it continuously.
It does sound to me as though you are possibly progesterone intolerant so if you could try the Oestrogel with Utrogestan, if you haven't already tried it, this might be an option worth pursuing. Try it sequentially first to see how you feel. Have you considered an SRRI like Citalopram to see if that helps as well?
DG x
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Hmmmm...if I look back to the original question of whether estrogen sits on top of our regular hormones I would have to say I don't think so. PS Sorry for the massive nerdishness.
Hormones are on a negative feedback loop with the hypothalamus and pituitary. The pituitary secretes pulses of GnRh to which stimulates FSH to be produced. FSH stimulates the production of estrogen from the ovary and the 'ripening' of an egg to be released. A surge in the LH causes ovulation. The 'ruptured egg sac...for lack of a better description' matures and produces progesterone in the second half of our cycle. If you don't ovulate..you don't make progesterone that month. So...if you think about thyroid hormone as a similar negative feedback loop for instance ..it should work the same way.
Thyroid stimulating hormone ( from the brain) stimulates production of thyroid hormone. If you have low thyroid hormone the negative feedback loop causes an increase in TSH because the brain is 'working harder' to produce more thyroid hormone. When you start a hypothyroid patient on thyroid hormone this 'down regulates' TSH...this is how doctors tell if their treatment for hypothyroidism is successful...a drop into the normal range of the TSH.
It should work the same way for gonadal hormones. FSH stimulates production of estrogen. The lower the estrogen the higher the FSH. If you 'add back' estrogen into the system the negative feedback loop will down regulate FSH, which will in turn down regulate our internal production of estrogen. So essentially I don't think we're 'topping up' I think we're taking over our ovaries a little bit. So in theory if you increase your dose of estrogen to a certain level...it should 'turn off' our production of FSH and completely shut down the function of our ovaries..the same as the birth control pill. Being on the pill stops your ovarian function due to this same negative feedback loop. John Studd uses this same negative feedback loop to treat severe PMS...he puts women on 100ug of transdermal estrogen ....to shut down their cycles, as it's the cycling that causes so many of the symptoms of the peri portion of this trip.
There is a paper (not yet published, but I am awaiting eagerly) on whether 50ug of transdermal estrogen with a Mirena coil will completely shut down ovarian function in this way.
There is decent evidence that our levels of estrogen are ON AVERAGE higher in very early menopause ( meaning sometimes its low too) , followed by an overall absolute drop in our estrogen ( slow decline). Our symptoms are caused both by the changes in hormone levels ( think roller coaster) and the absolute lower level of estrogen. So adding estrogen should both help flatten the roller coaster ( avoiding both the highs and the lows) and also increase our absolute level of estrogen.
Nerd alert.
Tara
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Very well put Tara (no nerds I can see) :) . The last paragraph makes a lot of sense in "flattening out" the roller coaster.
:-*
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Hi Tara
Interesting what you say, as I am another one stuck in that roller coaster. Give me Alton Towers any day!
However, both the specialist and my GP said that at 43, the reason HRT was causing 'new' symptoms was because it was topping up my hormones, not controlling them. Therefore I was having, on occasions, excessive highs . As a result, I am now experimenting with Qlaira which is an HRT style low dose contraceptive pill. It's too early to draw any conclusions yet but, in general, I have more energy and much less anxiety. (On the down side, the progesterone phase seems to be causing my hair to shred - annoying, as when I was on bio identical Utrogestan I always preferred the progesterone phase!).
x
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Casey: was the GP of the opinion that you take pain relief as required for 3 months or 3/4 times daily ………. I know that withdrawal from headache pain relief can mimic the symptoms for which the patient initially took the medication !
If you are getting crashing fatigue then thyroid function test etc. is the way to go perhaps? No good fighting for hormone blood tests because they are reliably unreliable ::)
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Hi Tara, not at all nerdy - thank you for this information; really interesting to read. I'm reasonably intelligent(!) but when it comes to science nothing seems to stick! You're saying about the absolute need for estrogen, can you tell me where progesterone comes into all this? Sorry, I need easier explanations :-\ x
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Hi, I also wanted to add the following, particularly to Cacey's post but it may be relevant to what Tara has said.
I'm just 52 and 2 years no period, so a bit different from you Cacey in that sense. Looking back however, I realise that for the past 6 years or so my body has been showing reactions to changes in hormone levels (fortunately for me not at all as severe as many ladies out there) but I didn't know there were things that could help. I simply thought you carry on with periods, then bam one day they stop and you carry on but no burden of periods. How naive!
ANyway, I due to tiredness levels (not thyroid) I started on Fenseven conti patches. I tried it for 6 weeks and I know many of you ladies out there will, quite rightly, say I didn't give it long enough, but I just felt it was too strong. The nausea, irritability, headaches, strange feelings in my legs persisted. I initially felt an increase in energy levels but that abated. Anxiety increased then one night I had such a skull cracking headache and truly thought I might die, I removed the patch and did not put another one on. That was maybe 3/4 weeks ago. For a couple of weeks, I had all the symptoms that I experienced some while ago, night sweats etc and I wondered, is this because I had higher levels of estrogen in my body, and I'm 'coming down' from it? I felt dreadful and 2 weeks ago went to my GP, crying etc, and I asked to go on the ultra low dose Femaston. I have not taken it yet. Since last Thursday (it's Saturday today) I have felt on top of the world. Is it still the minute bits of estrogen still in my body maybe?
Over the past couple of weeks, I have
eaten small amounts of nuts/seeds in the day (no time to make an HRT cake)
Every other day take menopace (was taking daily)
Metatone tonic every day
A red flesh grapefruit everyday (in the evenings after tea, I love them!)
So, I thought I would give it 6 weeks post Femseven and see how I feel, and at that stage think about taking the Femaston. They are tablet form and I know the indication is that patches/ gel are best but there seems to be nothing at this dose level out there.
I don't know if this helps anyone and for those with science backgrounds I'd appreciate your thoughts.
All the best.
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Hi Sunnydays and welcome to MM.
Many women find the conti HRt gives problems because of the continuous progesterone. Femseven patches unfortunately have the synthetic progesterone which many women also have problems with. Femoston is popular because the progesterone is closer to our own so is kinder.
I think you are right to give yourself a break from HRT to see how you feel - your diet looks great. You have the Femoston to try if you wish but as and when you do try it you may find it takes a bit longer to show benefits because it is such a low dose so you would need to persevere for at least 3 months to see whether it's working. If you are then feeling well on Femoston but want greater relief from symptoms you could go up to the slightly higher dose of Femoston.
Tablet HRT if absolutely fine at your age - it's when you get to 60 that transdermal is advised.
It is also worth considering the sequential version - just because you are technically post meno doesn't mean you can't have a withdrawal bleed anymore - many of us choose to stay on a sequi HRT so the progesterone doesn't cause too many problems. DG x
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Well I'm a vet and not a human doc.. although I would like to have a good vet as my doctor...we look at the whole animal and try to give them just one diagnosis. Human docs are trained to look at people in packages: gastrointestinal tract, cardio, pulmonary, urogenital etc. I think this is half the reason it takes women so long to get to the 'perimenopause' diagnosis...we have to work our way through individual specialities. :(
Briony I'm 42 so 'young' as well. Although I think it started in my late thirties the crap really hit the fan when I hit forty. About 6-8 months prior to the onset of the bad stuff I lost about 45lbs rather quickly, and purposefully by giving up grains and sugar. BUT little did I realize at the time, I removed a boat ton of estrogen from my system by doing this ( estrogen was coming from fat tissue- estrone). I think I would have ended up in the same place, but think I drop kicked myself into this by the weight loss. Bummer.
Your doc and GP are right in one sense ...you're 'topping up' your absolute low levels of estrogen..but you're also reducing your own bodies production of estrogen by taking estrogen. It's a weird and complex system.
So some of us have symptoms of roller coaster hormones: headaches, tinnitus, PVC's, etc. These symptoms are often due to hormone fluctuations ( be they high OR low). We also have an absolute deficit of estrogen : think vaginal dryness, low libido, depression, hair loss, collagen breakdown, dry eyes etc.
Most of us have symptoms of both roller coaster hormones, PLUS absolute low levels.
By taking estrogen you are 'topping up' your absolute low levels of estrogen ( meaning your lows should never get too low I think they say most women feel 'optimal' when their lowest estrogen is above 200 or so...different studies, different findings). But because of the negative feedback loop..you are also lowering your bodies own production of estrogen ( if you supply it from outside your body, your body will stop producing as much). So taking estrogen should theoretically both 'flatten' the highs and lows, as well as increasing the overall basal level of estrogen.
Depending on the route you take your estrogen...the daily fluctuations in and of themselves can cause symtpoms. So say you take an oral estrogen...this causes a quick spike in your blood levels of estrogen, followed by a steady decline in your estrogen over the 24 hours until your next pill. In some women this is enough to cause them to get headaches ( or other distressing symptoms) because of the rapid shifts from high to low within the 24 hours. Thats why patches work better for a lot of women...more steady state delivery.
As far as progesterone goes, I think it's very much an individual reaction to all chemicals. Governed by our health, our hormone sensitivity, our body fat composition, our mental health ( although I don't think this plays nearly the role that most docs would have you believe), and our genetics. Some women feel great during their pregnancy when their progesterone levels are through the roof high. Some women feel like garbage all pregnancy long. And yet other women feel like the bottoms fallen out right after delivery when your hormone levels drop through the floor. Some women get baby blues, some women get post partum psychosis. Individual.
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Oh - as an aside we now have a MenoMatters Vet ;) to add to the MM Choir, MM Cooking group etc..
Thanks dogdoc ………. obvious now ::)
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Yes, just realised dogdoc - vet! Thank you Tara.
Re the spikes in estrogen levels with a pill form, is there any value in breaking it in half and taking half in the morning and half at night - keeps it more even maybe? The problem is Tara, there doesn't seem to be a way of getting a low dose in a non tablet form.
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Intelligent knowledgable women - I started this post to understand better, I have definately gained insight, although no closer to really seeing how we can 'treat' this up and down in a way that is 100% easeful and positive - so I guess that is an insight in itself :)
We can do what we can to lessen the ups and downs and trial and error is unavoidable I think - whatever means you use to try and balance things. So individual and complex .
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Technically it's supposed to get easier post menopause, because there are no ups and downs. Only a steady low. Then you really are just topping up your hormones. It's the perimenopause that's the roller coaster. I am hoping and praying that at menopause it will become a smoother ride...but I don't really think life is ever that easy.
Sunnydays...there may be some benefit to splitting the dose ( but I'd ask my doctor or Dr. Currie on here before I changed any medications) If any of you are interested in a very nerdy book there's one called " Screaming to be Heard" by Dr. Vliet. The first chapter I sobbed uncontrollably reading it because she hits the nail on the head so well...millions of women, trying to explain to their doctors what is going on, and NOT being listened to. Most of the book I will concede is pretty dry and there's a lot of pathophysiology in there that I think most people would need a pretty good background in biology to get through.
She has an interesting anecdote about a woman in there who got migraines whenever she went on estrogen. In the end they needed to break her tablet into 4 doses a day ( pain in the butt!!)...but this kept her estrogen dose steady enough.
Not sure what the doses in the UK are for estrogen patches. Here the lowest dose I believe is 14ug, but 25ug are easily obtained...I have been using Estradot. It sticks well and is about the size of my thumbnail.
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That's estrogen only isn't it Tara? What do you use for the progesterone bit if you don't mind me asking?
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It's the Canadian version of Ultrogestan...here its prometrium but its micronized progesterone. 200mg for 10-12 days mid cycle onward.
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We are a Mine of Information ;D
How's the weather over there?
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I'm part way through a huge book by Jonathan Wright and Lane Lenoard on bio identical hormones and it's a real eye opener. Whilst the big drug companies have the huge budgets to push the sale of horse hormones, they have very little interest in bio-identicals because they can't patent them. That said, despite the lack of the multi million pound spends, this hasn't stopped the research, a lot of which has been carried out in Europe where the use of bios is much more widespread. There are a wealth of studies that also investigate the role of progesterone on our bodies, and the benefits this has on insomnia, depression, oestrogen related blood clots and bone density to name just a few. (Check out the PEPI study of 875 women, which used saw gains in bone density against a placebo group when progesterone or even progestin was used).
The term "bioidentical hormones" is really a term that shouldn't be used because it has different meanings in different countries. In countries like USA, Canada, and Australia it means compounded hormones, which most menopause experts don't advocate. Bioidentical is actually a non-scientific term, and most regular doctors don't use it. It is a term that has been adopted by the alternate medical community to try to convince women that it is the only way of getting “natural†hormones, and this is totally untrue.
The people who advocate compounded hormones (and it sounds like that is what the authors of the book you mentioned are doing) always seem to push this lie that drug companies don't use "bioidenticals" because they can't be patented, and this is not correct. They are just playing into the insecurities and confusion of women who are suffering the effects of menopause.
Drug companies already manufacture "bioidentical" hormones in the form of patches, gels, pills and capsules and they are prescribed as estradiol and progesterone by a regular doctor and dispensed by a regular pharmacist. This is something that these compounded hormone advocates always neglect to say, despite the evidence. They always just refer to the equine estrogen and progestin HRTs, without acknowledging that there are other natural types of HRT readily available.
In some cases, companies will even prescribe these compounded hormones over the phone/internet without you ever sitting face to face with a doctor. The treatment will be based on a saliva test which is even more unreliable than a blood test. Most doctors don't even bother with a blood test because of its unreliability. In my early stages of menopause I investigated one of these companies, and it was going to cost me in excess of $100 per month to get some creams posted to me, but I never actually got to talk to the doctor prescribing them. This was also about 4 years ago, so I'm sure it would be more expensive now. They seem to be able to get around the non-doctor thing because they aren't specifically regarded as “medicationâ€.
Some other ladies have mentioned the book by Dr Elizabeth Vliet called "Screaming to be Heard", and IMO that would be a far better book for you to read than the one you are reading. It can be a bit heavy going in places, I will admit that I haven't read it cover to cover, by it is a very good reference book if you need to know something.
Of course women should be free to use whatever treatments they want in menopause, but they should always make their choice after they know ALL the information, and not just go by the purposely skewed information given by these advocates of compounded hormone treatments. These are just a few of the downsides.
• Compounded hormones are expensive to buy
• It has been found that some doctors prescribe compounded hormones either because they get kickbacks from the compounding pharmacy, or they themselves own the compounding pharmacy
• No studies have confirmed that using progesterone topically (ie as a cream rubbed on the skin) will sufficiently oppose the estradiol/estrogen to protect the uterine lining
• These hormone creams are made in a private compounding pharmacy so there is no overall quality control, and it has been found that incorrect ingredients and quantities have been used
These are just also a few links to recognised medical experts/sites that don't support compounded hormones.
http://www.studd.co.uk/bioidentical_hormones.php
http://www.menopause.org/publications/clinical-practice-materials/bioidentical-hormone-therapy/compounded-bioidentical-hormones-what%27s-the-harm-
http://www.menopause.org.au/for-women/information-sheets/34-bioidentical-hormones-for-menopausal-symptoms
https://www.youtube.com/watch?v=9XfpAATJkC8
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Thank you Dana - excellent and informative post. DG x
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Great response Dana.
CLKD it's cold and snowy but I detect a trace of spring :))
Tara
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Thanks Dana - you've explained in much more detail, and also from personal experience, what I covered briefly in my post on the other thread a few days ago but think it got missed! I have a few more links on there - but also the Vliet Bio-identical Youtube one + a couple more too if anyone wants to look here:
http://www.menopausematters.co.uk/forum/index.php/topic,27241.0.html
Will bump it up for those who are interested in this important and interesting topic :)
Hurdity x
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:thankyou:
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Compounding pharmacies / aseptic pharmacy services are regulated and licensed by the MHRA and not just left free reign to be slap dash. Many of these services are in hospitals.
Naturally the pharmaceutical companies would like these services not to be available, they make far more money if their branded product is sold...
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Hi Ladies, thought I would give you all a quick update re starting Femseven Conti, as not sure if I need more oestrogen or progesterone? My night sweats have increased, dreadful sinus type headache, joints stiff, feeling low, no energy, even starting to get flushes during the day, which I have never had before. I went to see the doc yesterday, who was useless as said I need to take strong painkillers every four hours for the next three months, as that should clear the headaches!!
On a positive note I have no anxiety. So not sure if I can try and increase the oestrogen alongside the patch as I have lots of oestrogel sitting in the drawer. I would really appreciate any input as my symptoms are slowly getting worse. I have been trying to find the right HRT for the past seven years, I am now 51 and wonder how much longer I will be struggling to find the right dose. Cacey x
Why doesn't the doctor check your hormone levels rather than guessing? To simply prescribe painkillers is shocking - a friend was prescribed anti depressants even though her tests showed clearly she was oestrogen dominant. The more I hear about our GPs, the more I fear for our survival!
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Hi Ladies, thought I would give you all a quick update re starting Femseven Conti, as not sure if I need more oestrogen or progesterone? My night sweats have increased, dreadful sinus type headache, joints stiff, feeling low, no energy, even starting to get flushes during the day, which I have never had before. I went to see the doc yesterday, who was useless as said I need to take strong painkillers every four hours for the next three months, as that should clear the headaches!!
On a positive note I have no anxiety. So not sure if I can try and increase the oestrogen alongside the patch as I have lots of oestrogel sitting in the drawer. I would really appreciate any input as my symptoms are slowly getting worse. I have been trying to find the right HRT for the past seven years, I am now 51 and wonder how much longer I will be struggling to find the right dose. Cacey x
Why doesn't the doctor check your hormone levels rather than guessing? To simply prescribe painkillers is shocking - a friend was prescribed anti depressants even though her tests showed clearly she was oestrogen dominant. The more I hear about our GPs, the more I fear for our survival!
That's my other concern about starting HRT - how do you know you're not oestrogen dominant without blood tests?
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That's my other concern about starting HRT - how do you know you're not oestrogen dominant without blood tests?
How do you know what any of your hormones are doing without tests? Surely this should be the starting point for many conditions?
It's false economy if this is missed due to the cost, surely it costs much more to treat a patient longer term with the wrong drugs as a guess (albeit an educated one)?
I'm really struggling to get my head around this approach to be honest. x
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Both play a part in everything as far as I can see - progesterone is good for heart health for instance and estrogen too. The thing is - it is definately reported that high estrogen can be damaging but I can't see the same for progesterone, so I wonder why estrogen is the priority to replace and the main focus???
This is exactly what is confusing me !
I had my hysterectomy back in '99 aged 32, within a year I was on oestrogen due to ovaries going into shock and led a happy and healthy life until 3 years when boom ! My body and mind fell to pieces. Docs fobbed me off with ADs and said I was peri menopausal.
My symptoms have never gone since but I've developed even more recently and am not prepared to let this lie any longer. I have symptoms of oestrogen dominance and do not want to stop taking it to balance out. What if I am low in progesterone ? Why can't I have progesterone even though I have no womb ? If it is oestrogen dominance progesterone could help ? Plus give me back some degree of sexual desire that suddenly left me a few years ago
Would progesterone harm me without a uterus? It didn't for all those years I was naturally making it after the hysterectomy
Why oh why is being female so damn confusing ?
I feel like 3 years ago I went to bed as a sexy outgoing 45 year old and woke up looking and feeling like great great grandmother !
Xx
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That's my other concern about starting HRT - how do you know you're not oestrogen dominant without blood tests?
How do you know what any of your hormones are doing without tests? Surely this should be the starting point for many conditions?
It's false economy if this is missed due to the cost, surely it costs much more to treat a patient longer term with the wrong drugs as a guess (albeit an educated one)?
I'm really struggling to get my head around this approach to be honest. x
My GP would only test FSH - which came back as "normal" when tested on a random day in my cycle.
Then I saw a specialist last week, who listened to my symptoms and experiences so far and agreed that I was in perimenopause and suggested the mirena coil with oestrogen gel.
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Would progesterone harm me without a uterus? It didn't for all those years I was naturally making it after the hysterectomy
Progesterone wouldn't - this is the natural hormone produced by our bodies and if you do a google on it, you'll find it mentioned on cancer websites too. It is an anti-carcinogen and protects against breast and uterine cancer. It helps not just prevent osteoporosis but promotes the building of new bone density. It helps cardio vascular and cognitive functions. It protects against fibroids and cysts.
Progestin and progesterone are the synthetic hormones and these may ... They don't possess the properties of our natural hormone.
There are a lot of links on this (I won't post any as I've just been banned for posting up links ??? ) however a search on the benefits of progesterone will list a number. x
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I had my hysterectomy back in '99 aged 32, within a year I was on oestrogen due to ovaries going into shock and led a happy and healthy life until 3 years when boom ! My body and mind fell to pieces. Docs fobbed me off with ADs and said I was peri menopausal.
Shocking. Simply shocking.
GG x
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Hi GeordieGirl
???
where did you get that from, in regards to that they are not as good as our own hormones?
"progestin and progesterone are the synthetic hormones and these may ... They don't possess the properties of our natural hormone"
http://en.wikipedia.org/wiki/Progesterone
These work fine for me ;)
:-*
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Links can be referred to as long as they don't advertise or ask for money!
Or one can send a PM to Members with the details ;)
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Hi GeordieGirl
???
where did you get that from, in regards to that they are not as good as our own hormones?
"progestin and progesterone are the synthetic hormones and these may ... They don't possess the properties of our natural hormone"
http://en.wikipedia.org/wiki/Progesterone
These work fine for me ;)
:-*
I think, but not sure as it's all totally confusing, that progestins work fine if you have a uterus because it protects it.
In my case having no uterus, I have been on oestrogen only hrt because I had no womb to protect. However in recent years I am presenting symptoms that may indicate oestrogen dominance, if that's the case, natural progesterone is what I may need to alleviate the problems.
Please don't take this as true, I'm a beginner here !
Xx
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Hi GeordieGirl
???
where did you get that from, in regards to that they are not as good as our own hormones?
"progestin and progesterone are the synthetic hormones and these may ... They don't possess the properties of our natural hormone"
http://en.wikipedia.org/wiki/Progesterone
These work fine for me ;)
:-*
There are countless studies that prove the superiority of progesterone versus progestin. The most notable is the PEPI study, but an ongoing report of over 50k women in France also highlights differences - these are summarised below, at the bottom I've noted just a handful of the reports:
Differences between Progestin (medroxyprogesterone) and Progesterone:
PROGESTERONE sustains pregnancy and the developing foetus. Used to prevent miscarriage. PROGESTIN may cause birth defects if taken during pregnancy, can cause masculinisation in some female foetuses.
PROGESTERONE builds bone, increases bone density and helps prevent osteoporosis. PROGESTIN can decrease bone density, as reported in young women who regularly use an injection of Provera as a form of contraception.
PROGESTERONE decreases the risk of blood clots, working with oestrogen to protect against cardiovascular disease. Normalises blood clotting. PROGESTIN may cause blood clots, which can lead to cerebral and myocardial infarctions. (strokes and heart attacks)
PROGESTERONE is a diuretic, PROGESTIN can cause fluid retention.
PROGESTERONE is a natural anti depressant that can relieve headaches. PROGESTIN can cause depression, mood swings and headaches.
PROGESTERONE helps maintain normal blood sugar levels. PROGESTIN can exacerbate diabetes mellitus.
PROGESTERONE relieves breast tenderness and protects against fibrocystic breast disease. PROGESTIN can cause breast tenderness, swelling and pain. (According to NHS direct ) Women who take progestins frequently complain about annoying side effects like breast tenderness, skin irritations, depression, breakthrough bleeding, swelling and other unpleasantries. These side effects could be the reason so many women quite conventional HRT early. The main side effect of progesterone is sleepiness.
The claim that progesterone may protect against breast cancer is backed up by a big ongoing French study of 54,548 menopausal women, comparing what happens to those who take progesterone in their HRT with those who get progestin.
The latest report has found that after eight years, while those on progestins have a raised risk of breast cancer, those on progesterone don't. As a result of this research there has been a change in prescribing in France. “After the WHI study, many women had stopped taking oestrogen pills,†says Dr Virginie Ringa of the French Institute for Health and Medical Research, Le Kremlin-Bicêtre, Paris. “Now they are taking an oestrogen patch together with progesterone which is taken orally.
According to Dr Michael Schumacher of the French Institute for Health and Medical Research: “ There is evidence that progesterone has beneficial effects on the breast tissue, on blood vessels and for strengthening bones. Many of the benefits of progesterone comes from the fact that while oestrogen stimulates cells, progesterone calms them down. As a result, one striking claim for progesterone is that it might lower your risk for dementia.â€
In the brain, oestrogen and progesterone combine to protect cells, while progestins reduce this protective effect.
While the Women's Health Initiative (WHI) study showed that combining progestins with oestrogen slightly raised the risk of strokes and breast cancer, Schumacher's work (as well as similar studies below) explains how progesterone can lower these dangers.
1.- PEPI trial : The Postmenopausal Estrogen/ Progestin / Progesterone Interventions.
2. Dai D, Wolf DM, Litman ES, White MJ, Leslie KK. Progesterone inhibits endrometrial cancer cell growth and invasiveness; down regulation of cellular adhesion molecules through progesterone B receptors. Cancer Research 2002; 62 881-886
3. Leonetti HB, Anasti JN, Litman ES. Topical progesterone; an alternative to progestin in hormone replacement therapy. Obstet and Gynecol 2003;101, 85
4. Steinbery D, Transdermanl progesterone cream as an alternative to progestin in HRT Health Med 2005
5. Montz FJ, Bristow RE, Bovicelli A, Tomacruz R, Kurman RJ Progesterone treatment of early endometrial cancer, American J Obstet Gynecol 2002; 186; 651-657
6 Moyer DL, Felix DC The effects of progesterone and progestins on endometrial proliferation. Contraception 1998
7 Miller BE, De Souza MJ, Slade K, Luciana AA. Sublingual administration of micronized estradiol and progesterone – effect on biochemical markers of bone metabolism and bone mineral density. Menopause 2000, 318:326
8. Chlebowski, Rowan T., 2009. Breast cancer after use of estrogen plus progestin in postmenopausal women, New England Journal of Medicine, February 5, Volume 360:573-587.
I have previously used a progestin for many years as a form of birth control. I had minor side effects with it which soon wore off - what I don't know however is whether this had any longer term effect on my body? Reading the studies and reports doesn't reassure me.
Although not huge money spinners for the pharmaceutical companies (natural progesterone can't be patented) progesterone is available as branded producsts in HRT , eg Utrogestan, Prochieve, Prometrium, Crinone.
HRT is such a personal thing and what works for one may not work for another, but information is key in this. Unfortunately our GPs seem to fob too many off with a box based on little more than guess work and a list of products on screen. :-\
GG x
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Although not huge money spinners for the pharmaceutical companies (natural progesterone can't be patented) progesterone is available as branded producsts in HRT , eg Utrogestan, Prochieve, Prometrium, Crinone.
So GG, if she says I need natural progesterone, do you mean these are some if the brands ?
Xx
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Although not huge money spinners for the pharmaceutical companies (natural progesterone can't be patented) progesterone is available as branded producsts in HRT , eg Utrogestan, Prochieve, Prometrium, Crinone.
So GG, if she says I need natural progesterone, do you mean these are some if the brands ?
Xx
Hi Annie - I haven't checked all of them (I'm not sure about Prometrium?) so it's worth double checking. Crinone and Cyclogest are also available as gels. I suspect there may be more? I think there are a number of people on here using Utrogestan in various guises.
I suspect the main thing with any replacement therapy is getting the right dose which seems to be a bit of educated guesswork initially but our bodies usually tell us if something's out of kilter...
GG X
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Although not huge money spinners for the pharmaceutical companies (natural progesterone can't be patented) progesterone is available as branded producsts in HRT , eg Utrogestan, Prochieve, Prometrium, Crinone.
So GG, if she says I need natural progesterone, do you mean these are some if the brands ?
Xx
Hi Annie - I haven't checked all of them (I'm not sure about Prometrium?) so it's worth double checking. Crinone and Cyclogest are also available as gels. I suspect there may be more? I think there are a number of people on here using Utrogestan in various guises.
I suspect the main thing with any replacement therapy is getting the right dose which seems to be a bit of educated guesswork initially but our bodies usually tell us if something's out of kilter...
GG X
Thank you GG
I've been on oestrogen orally for years now but am interested in the gel route if she says progesterone is needed (which I firmly believe it is)
I'm kinda getting excited that there is a light at the end of this pitch black tunnel :)
Xx
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For my own personal curiosity I sent off a saliva test for Progesterone and Oestradiol and the results come with caveats as I know they might not be accurate, they are a snapshot only, they could refer to annovulatory cycles and they change everyday but I just wanted to see if I had low/zero estrogen. I am not thinking of treating with hormones right now, it was curiosity that prompted it.
I also took it on the 'wrong' day - it was meant to be day 21 when both hormones are at peak - it was day 3 ooops
Anyway I have low progesterone and bang in the middle of the range oestradiol. The ration of progesterone to oestradiol is towards the low end. All of this supports to some extent that in perimenopause progesterone levels are the first to drop and therefore it could be assumed that any symptoms I have had are largely due to this imbalance and not ovulating. That's how my logic works - but I am willing to accept I am probably seeing this all far too simplistically :)
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Hi Brightlight,very interesting to hear about saliva test guessing you had to pay was it expensive? And I might be quite wrong,often am :-\ but if you did it on day 3 wouldn't you expect progesterone to be low as that usually comes towards end of cycle unless you are taking it every day I guess ! ;)
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Hi dazned yes it was expensive, I sent it off a while ago now, in the midst of my confusion about why the doctor said I was postmenopausal after one FSH test. Yes, progesterone should be low on day 3, so in some ways it reflects a normal situation - although the ratio they also gave said there should be more progesterone in relation to oestradiol. The progesterone was at the lower end of the range for the follicular phase and the oestradiol was bang in the middle of the range.
Obviously I appreciate it doesn't give a full picture by any stretch of the imagination and suspect I am not ovulating and stress is playing a part in the low progesterone - so my approach is still to focus on stress reduction and for me, any knowledge of what my body is doing is helpful with that
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Hi BrightLight
As you say salivary tests are of no help in telling you absolute levels of sex hormones but are only useful to help determine if a woman is ovulating in a normal cycle - which is why tests are done in the luteal phase when progesterone is at its peak. I'm not even sure they are carried out routinely on NHS because they are so limited - but someone will know I expect. If you are peri-menopausal and your cycles are becoming irregular they aren't really any help at all in that you wouldn't know when to take the sample because you would need to know you were having a more or less regular cycle before you started if you see what I mean!
Progesterone is expected to be extremely low in the follicular phase and in post-menopause - and deficiency should not cause obvious symptoms other than anovulatory cycles, which can lead to heavier bleeding I understand. It isn't really necessary to know the levels except re pregnancy, because they are so low.
Hurdity x
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Hi Hurdity
That's right, saliva tests for these hormones aren't used in the mainstream system yet and I didn't read the instructions properly - the best time for a sample day 21. The results showed the ranges for each phase of the cycle and I was having a period that month, so I knew it was day 3, but yes, day 21 might be tricky with irregular cycles.
I was under the impression that progesterone was linked to low mood and anxiety and some reference to skin health and I'm still unsure why is is said the the level of progesterone and the ratio has no bearing on any symptoms. It seems logical to me that breast tenderness for example could be due to the ratio of low progesterone to estrogen during perimenopause and as you say heavy bleeding and anovulatory cycles.
I did the test mainly for the oestradial levels - if they were non existant, I would be thinking further about hormone treatment. So, it was useful to me in that regard - even if they are swinging about.