Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: jedigirl on March 28, 2015, 01:43:04 PM
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Today I saw my counsellor, a fantastic lady who specialises in womens health especially infertility and menopause. We discussed why i might be feeling so horrible again and she feels strongly that i may have too much estrogen, based on the fact that i feel sick(my body trying to expel it), my period comes before i finish my progesterone(also my body trying to get rid of lining ie estragen) my night sweats and palpitations have resurfaced mildly and my left kidney is sore(also trying to expel), and where in my cycle this sickness has come.
I trust this lady more than the GPs. She was the one who suggested i go for the 1-25 days on Utrogestan which worked brilliantly for two months. Her theory is that my progesterone levels are naturally none existent or very low so i need the Utrogestan but I am still naturally producing some estrogen and adding the estragel is giving me too much. She recommends that i drop my Estragen gel to one pump a day and see if it helps.
I know this is unusual but does anyone else feel they are low on progesterone not estragen and is anyone on progesterone only HRT?
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http://www.cemcor.ubc.ca/resources/progesterone-not-estrogen-hot-flushes-perimenopausal-and-menopausal-women
hmmm food for thought?
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It's unfortunate that most of the information I've found so far about the benefits of progesterone-only supplementation has been written by those with a commercial interest. Often, an article that reads well and makes sense will have an ad for a progesterone supplement at the bottom or bobbing around in the margin. There does seem to be a small but strong school of thought that peri women have too much oestrogen and too little progesterone, and anyone who feels like they've got raging PMT (which occurs when prog levels are crashing) will be able to identify with that! It's also unfortunate that to make any changes to our regimes involves (or ought to...) yet another trip to the GP. Please can you let us know how your new regime works out?
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Thanks Freda,
at the moment I will be just reducing my estragel not eliminating it but it has set me thinking and reading up.
Yes the information I've seen so far suggest that especially in peri oestrogen is high and its progesterone that is low, at least until menopause.
Its all so confusing. I just want to be well and if i never heard the hormones again it would be too soon >:(
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Yes I do think that's my current situation and its how things evolve as hormones decline, progesterone lowers first. Coupled with years of chronic stress which lowers progesterone, I am certain this is what is mainly happening for me.
I'm not treating it with hormones right now and focussing on stress reduction and hope the ratio of estrogen to progesterone gets a bit more balanced. Just lately I have has bad water retention, nausea, sore breasts and according to a private GP I saw my periods indicate low progesterone in terms of the thinner quality and 'breakthrough' bleeding type of flow. Not ovulating is part of this too, maybe, but progesterone being low is my guess.
Whether people are selling products on the back of low progesterone symptoms or not, it makes total sense to me that symptoms can be attributed to the ratio being way out and adding estrogen is not going to help.
Hope you feel better with your new plan
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I'm certain I'm oestrogen dominant AND feeling it
I've been on oestrogen only hrt since age 32, and at 45 developed sudden symptoms which gp didn't help me with. Now at 48 another set of symptoms added
My oestrogen was low but progesterone was 1 or -1 2 weeks ago
I shall see how my new oestrogen patch works next week as opposed to the tablet I've been using (that's if she prescribed the right dose (forever doubtful of gps)) and If things persist I will look into progesterone too. I don't have a uterus but I've looked this up and if you need prog to balance your hormones, whether you have a uterus or not, then you need it !
Xx
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Hi jedigirl
There is a lot of confusion about this not helped by, as Freda says, most of the info advocating progesterone supplementation as a way of relieving symptoms - coming from companies that want to sell it to you! Properly conducted placebo controlled trials do not seem to provide the same evidence - I gather results are mixed, and not consistent.
Yes it is the case that once peri-menopause becomes established and you skip periods - then progesterone is missing due to anovulatory cycles. In this case, in the early stages, if there are no symptoms of oestrogen deficiency, then progesterone supplementation ( not cream!) eg through utrogestan (in the second half of the cycle) may well help regulate cycles. Very soon though the oestrogen deficiency symptoms will appear so this needs supplementation too.
Lack of progesterone due to lack of ovulation is only thought to be a problem due to bleeding and lack of it should not give rise to any symptoms. This is where the prog cream companies will have you believe it does!
The pmt symptoms from the prog crashes are due to a reversal of the physiological changes in the body that occur when progesterone reaches high levels in the second half of the menstural cycle, to prepare the body for pregnancy. The most important point about this, is that the negative symptoms are not sustained for more than two or three days once the body has adjusted - so it can't be argued that the body needs progesterone just to stop these symptoms (although I know some women who tolerate it well prefer to take it all the time because of this - ie prevent the pmt), because they disappear quickly!
I can understand the difficulty of any form of HRT during early peri-menopause or the late reproductive phase (when periods are still regular and before peri-menopause properly starts) - because oestrogen levels are still rising and falling normally - and from what I have read, can rise to extreme levels. Because your cycle is still going on, then I can see that sometimes at the pre-ovulatory peak especially, this might be too much - briefly, while your cycle is strong and give rise to symptoms. Two pumps is medium dose and many post-menopausal women have this dose.
Sounds like a good idea to try to supplement with 1 pump for a while and see how you get on. Any oestrogen supplementation requires progesterone if you have a uterus to prevent thicking of the womb lining.
Not sure about the idea of the body trying to expel it? What is "it"? During pregnancy women feel sick when oestrgoen ( and progesterone) levels are increasing rapidly - but these are essential hormones!
The bottom line is - it is unlikely that you would "feel" that you are low on progesterone, (except through increased bleeding) but you do still need it!
Anyway do hope you feel better soon.
Hurdity x
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I'm not treating it with hormones right now and focussing on stress reduction and hope the ratio of estrogen to progesterone gets a bit more balanced.
Stress reduction can only be of benefit - great! However it won't alter the production of progesterone to any significant level - because this is produced by the corpus luteum after ovulation and acts on the uterus lining. The progesterone produced elsewhere in the body (from the adrenals) in the first half of the menstrual cycle and during post-menopause is miniscule compared to the this and the ratio of O to P during these phases is irrelevant. The crucial time that the ration needs to be right is after ovulation to protect the uterus lining. It is the lack of ovulation that disrupts this.
Hurdity x
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I'm not treating it with hormones right now and focussing on stress reduction and hope the ratio of estrogen to progesterone gets a bit more balanced.
Stress reduction can only be of benefit - great! However it won't alter the production of progesterone to any significant level - because this is produced by the corpus luteum after ovulation and acts on the uterus lining. The progesterone produced elsewhere in the body (from the adrenals) in the first half of the menstrual cycle and during post-menopause is miniscule compared to the this and the ratio of O to P during these phases is irrelevant. The crucial time that the ration needs to be right is after ovulation to protect the uterus lining. It is the lack of ovulation that disrupts this.
Hurdity x
I still feel that stress has a role to play in my own personal situation, in combination with anovulation which can be stress related as well. My GP has advised this to be the case and also that low mood is often because of low progesterone. The hypothalamus and pituitary are involved and although progesterone only produced in small amounts in ovaries and adrenals when hormonal imbalance is concerned, I think that we are are all individual and whose to say that these small changes in hormone levels wouldn't cause symptoms - I honestly think they do. If estrogen is dominant then the symptoms are due to this ratio being out, whether that's high estrogen or low progesterone doesn't matter, I don't think estrogen should always be added.
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Thanks all,
Hurdity,
I think when the counsellor was explaining my body trying to expel, she meant the excess oestrogen. It makes sense to me as I'm curently at the stage in my cycle when i would be producing my highest levels of oestrogen as well as adding estragel.
Maybe I am low on oestrogen as feel I have probably been in peri a few years now but it is the imbalance between my progesterone level and oestrogen level that is making me feel horrible, with the oestrogen being too high comparatively.
I'm no expert by any means and am open to all advice, I just feel this sounds right for where I am right now.
Annie0710 do you have your levels tested and how? My gp always says " we dont test stuff like that!"
Brightlight, I think you're right that even the smallest imbalance can affect us, maybe some of us are more sensitive than others. I am 7 stone something and petite, with a fast metabolism. I seem to feel every change during my cycle.
Thank you for your input ladies :thankyou:
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I think like Hurdity says that low progesterone shouldn't likely be the cause of any symptoms such as low moods etc else women on estrogen only ie no uterus wouldn't be feeling so well would they :-\
Surely we only have to "suffer" progesterone to protect/or she'd the lining ?
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Jedigirl it seems logical to me that we all have our 'natural' balance where symptoms settle and as you say, both hormones can be low but the ratio be out. It will be great if you have discovered the change to your routine that relieves your symptoms better.
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If high oestrogen in relation to progesterone caused problems - then as dazned says most women who have had hysterectomy would never feel well on HRT. Also most women would feel bad in the first half of their menstrual cycle - when in fact they feel at their best (once bleed etc has finished).
In peri-menopause it is very difficult to feel well all of the time due to the hormone fluctuations and the best you can do is make some sort of intervention/plan for yourself and hope you feel better overall. By the time you've sorted it out you may well be onto the next stage - tough being a woman isn't it! I'm still happy I am one though and wouldn't want to come back as a man - unlike many on here who state this preference!
Hurdity x
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Hurdity could you have a look at the utrogestron support thread if you have time please and answer some of my question s
Thanks x
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When I had my hysterectomy at 32, my oestrogen plummeted, so 2mg daily did me the world of good. At that time I am sure I was still ovulating because I would get tender breasts (but no other hormonal symptom-ever) and I assume still producing progesterone. I had a relatively high sex drive and enjoyed it til the end iykwim all was dandy until I was 45 then a huge onset of symptoms, I was never told the results of the blood test just that I was peri and because I am on max dose of oestrogen there's nothing they can do. Then months ago on top of the c£&p way I was feeling ANOTHER lot of symptoms came on. I looked up my recent ones and it all points to progesterone deficiency/oestrogen dominance
I know I don't need progesterone to protect my uterus but the most recent blood test confirmed my suspicions that my progesterone is or is almost non existent plus I'm not getting tender breasts anymore so I'm guessing I've stopped ovulating
I don't think anyone can go by general rules. If our bodies are reacting to a deficiency surely it should be supplemented ?
Xx
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jedigirl - What kind of "counsellor" is she, because she sounds a lot like the naturopath I saw for a while, who ended turning me into a complete basket case. Her method was to "rid" my body of estrogen, while supplementing me with progesterone cream. Of course I know now that my poor body couldn't afford to lose what little estrogen it had, because I was going out of my brain with insomnia, anxiety, depression and hot flushes, and more progesterone was something I didn't need, and that's why I ended up in a complete mess - and dependent on diazepam.
However, I was probably further along my peri/post meno journey then than you are now. I suspect that with the way all my symptoms hit me literally overnight, I may have gone straight from "normal" to post-meno pretty quickly. Having said that, just tread carefully my lovely. :-*
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She's a women's health counsellor, specialises in menopause and infertility. Also trained in reflexology and acupuncture. Shes not anti hrt, in fact she reassured me that I need it, but after having a relapse we looked at my symptoms and cycle together and she suggested reducing the estragen to see if it helps. I'm monitoring carefully believe me x :)
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I'm never going to understand the apparent dismissal of progesterone, it's logical that it forms part of the symptom picture. Menopausal symptoms could be seen as a form of PMT and progesterone is recognised as part of that. Why fear progesterone and not oestrogen? ;)
Adding any hormones is a tricky business in my opinion and I'm sure the doctors that work with both hormones are taking due care with their patients. My GP that mentioned progesterones role in my symptoms was very balanced in her information and gave me a general picture and was quite honest to say that NO hormone therapy can get things 'right' and we can't know for sure what is going on with cycles and transition, it's not exact and as such we can try various things. Seems sensible to me.
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I'm never going to understand the apparent dismissal of progesterone, it's logical that it firms part of the symptom picture. Menopausal symptoms could be seen as a form of PMT and progesterone is recognised as part of that. Why fear progesterone and not oestrogen? ;)
Adding any hormones is a tricky business in my opinion and I'm sure the doctors that work with both hormones are taking due care with their patients. My GP that mentioned progesterones role in my symptoms was very balanced in her information and gave me a general picture and was quite honest to say that NO hormone therapy can get things 'right' and we can't know for sure what is going on with cycles and transition, it's not exact and as such we can try various things. Seems sensible to me.
Apparently in ancient times Chinese Empresses used to digest the urine of teenage girls (dried and treated) - in this way they got the whole gammut of hormones that they'd have had when their bodies were at their peak. It's logical that if we're replacing hormones, we look at balance so that our hormones are the levels they should be naturally (or would be before they started to give up on us). Bright Light I don't understand why any significant hormone would be missed out of the list either, natural progesterone has some very good protective properties so why would this be overlooked?
I hope you manage to get the balance right Jedigirl,
GG x
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I definitely suffered immensely from low progesterone for a couple of years. After a year or so I was placed on progesterone and my symptoms went away (during that time my estrogen levels were normal). Later on my estrogen dropped and then I went onto full hrt. Whether people believe we need progesterone or not is up to you! I felt very ill without sufficient progesterone and much much better with daily progesterone. Even when I eventually went onto full hrt, I still feel better on daily progesterone. My specialist also strongly believes balance is necessary and that progesterone has many functions and benefits besides purely creating a bleed - a very simplistic way of looking at the role of progesterone .... One thing it definitely does for example, is increase insulin resistance so all those women feeling ill with low blood sugar may well consider adding some progesterone rather than eating non-stop sugary snacks!
As to all those women with hysterectomies who are perfectly happy without progesterone - I do not believe this is the case! A simple scan of these websites reveals many are taking progesterone in some dose, despite no apparent medical need!
At the end of the day hoh ugh I see no need to prove or disprove the benefit of either progesterone or full hrt - let people try both of neither and do what works best for them!!
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I would have thought that with the complicated feedback loops of the menstrual cycle, that the disintegration of the corpus luteum and reduction of progesterone would help restart the oestrogen and FSH for the next cycle. Ovulation does not always happen during perimenopause, because the oestrogen levels produced by the ovaries are falling, so replacing progesterone towards the end of the cycle may help here, and probably some oestrogen as well.
Sometimes several follicles try to ripen at the same time, and you can get too much oestrogen all at once. I have no idea if hrt would help with this or not. :o Having some oestrogen with your progesterone probably stops your levels reaching rock bottom, and setting off overcompensating surges.
I keep reading that menopause is when periods end, but that seems very very simplistic. There seems to be so much up and down to put up with, both before and after periods end that periods seem to be only a small part of it. (although they certainly make their presence felt in many dysfunctional ways).
I think the best way would to be to go back on to combined oral contraceptives, knock out the whole system and have nice level hormones. This served me well for years moodwise, but knocked out libido and all the progestogen made my bowels very sluggish.
Anyway, I have found an animated diagram which shows you some of the feedback mechanisms. Hope you find it fun ;D
http://highered.mheducation.com/sites/0072495855/student_view0/chapter28/animation__positive_and_negative_feedback__quiz_1_.html
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It's unfortunate that most of the information I've found so far about the benefits of progesterone-only supplementation has been written by those with a commercial interest. Often, an article that reads well and makes sense will have an ad for a progesterone supplement at the bottom or bobbing around in the margin.
There are 15 ads in the margin on the home page on this site... ;) Sometimes as well if ads are placed by google (as in the bottom of the front page), the site owner doesn't actually choose what is shown there, but it's autofilled depending on the browsing habits of the viewer.
I do share your cynicism though, but mainly to do with the big pharmaceuticals who make billions from HRT across the globe - no wonder they have the bottomless pockets for the slick marketing and PR campaigns so our GPs tend to think of a brand name as if it was a generic substance.. Yep, I'm a cynic.... :)
GG x
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I definitely suffered immensely from low progesterone for a couple of years. After a year or so I was placed on progesterone and my symptoms went away (during that time my estrogen levels were normal). Later on my estrogen dropped and then I went onto full hrt. Whether people believe we need progesterone or not is up to you! I felt very ill without sufficient progesterone and much much better with daily progesterone. Even when I eventually went onto full hrt, I still feel better on daily progesterone. My specialist also strongly believes balance is necessary and that progesterone has many functions and benefits besides purely creating a bleed - a very simplistic way of looking at the role of progesterone .... One thing it definitely does for example, is increase insulin resistance so all those women feeling ill with low blood sugar may well consider adding some progesterone rather than eating non-stop sugary snacks!
As to all those women with hysterectomies who are perfectly happy without progesterone - I do not believe this is the case! A simple scan of these websites reveals many are taking progesterone in some dose, despite no apparent medical need!
At the end of the day hoh ugh I see no need to prove or disprove the benefit of either progesterone or full hrt - let people try both of neither and do what works best for them!!
Thanks for sharing your experience, I'm seriously considering finding a way to supplement progesterone. Did your specialist prescribe it for you, before full HRT?
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Yes I was prescribed progesterone - initially in a bio-identical cream - no not the kind you can buy over the counter - this gave me 60mg applied twice per day. We then switched to utrogestan - really exactly the same thing. I managed very well on this for a long time. I initially thought I had pmdd as my symptoms were so severe (headaches, vertigo, heart racing, terrible anxiety and panic etc) but it turned out that I needed progesterone. The easiest way is probably to get a prescription for utrogestan and try that! It took around 4 weeks for me to settle on it so don't be discouraged if it doesn't work straight away ...
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Thank you Suzy. The brand name has been mentioned to me by a private GP I consulted a while back and she indicated that I have the option to try this on its own. My regular GP wasn't so open to any discussion. Thanks again.
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Because I'm still waiting for my clinic date after initially going to my doc right back in December, I've decided to supplement with a small amount of progesterone in the interim and have been using 50mg per day. I've recently had the best nights sleep I've had in around 10 months so I'm really hoping this is linked. I have been feeling a little drowsy today so I may cut the dose but I'm watching to see how it goes first. If it sees me through to the clinic appointment then that's a bonus, if it's working I may ask for the same dosage but on prescription. If this whole area is trial and error I may as well get the ball rolling.
GG X
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Because I'm still waiting for my clinic date after initially going to my doc right back in December, I've decided to supplement with a small amount of progesterone in the interim and have been using 50mg per day. I've recently had the best nights sleep I've had in around 10 months so I'm really hoping this is linked. I have been feeling a little drowsy today so I may cut the dose but I'm watching to see how it goes first. If it sees me through to the clinic appointment then that's a bonus, if it's working I may ask for the same dosage but on prescription. If this whole area is trial and error I may as well get the ball rolling.
GG X
GG, was this prescribed ?
Xx
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Good for you Geordie Girl, I agree its trial and error whichever way we address these issues. Hope it continues helping.
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Hi Annie,
I haven't had anything prescribed yet although my doctor admitted that it sounded like I needed progesterone (after I'd put my argument forward) but she was "of her depth so would refer me to the clinic" I've started with 50mg just as a start but aim to cut it to 25mg. I'm intrigued to see if the sleeping issue I've had is on its way out or whether it's just been a fluke. I'm also taking notes with regard to memory, and how many times a day I struggle to remember words etc as that was becoming a major issue for me.
GG x
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I agree it's trial and error - definitely! When I used to read the lists of too much/too little estrogen/progesterone I just got in a right state cause they all seemed to overlap! Now I know what symptoms I have that relate to too much or too little of one or the other.... Really just learned this over time and I also had frequent blood tests for the first 6 months. It does get easier but keeping a diary and not changing too much too quickly is a great way to go.
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A bit of feedback - it's been around 3 weeks now since I started using progesterone cream and my sleeping is getting soooo much better. It's been stressful at work this past couple of weeks and yet I'm still managing to get a good night's sleep, almost unheard of in the last 10 months or so. It's not every night, some nights I've been sleeping for 5 hours before needing the toilet, but it's 4 nights out of 5 which I'm pretty delighted with. It's actually 40mg per day I'm using which I'm happy with and it seems to suit me without any side effects, I'm splitting this into morning and night time doses. I'm not tired in the day either so it's a good balance.
I'm also wondering (a bit random this) if my pubes are thickening. I did get rather sparse and the epilator was retired but I'm feeling a little bushier. That may just be my imagination but I'll see how it goes - when I need to plait my pubes I'll know for certain ;D . My head hair did thin out a fair bit and doesn't take me half as long with the straighteners as it used to, it'll be interesting to see if the progesterone effects this in any way.
My memory doesn't seem any better at all, does HRT usually help this or would that be another hormone? Perhaps a slightly higher dose may help.
Anyway, up to now I'm relatively pleased with the results.
GG x
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GG
that's good you've got no side effects. Do you mean head hair has thinned more since the cream ?
I can't afford to thin anymore, I've never had thick hair but in recent pics I think I can see through mine :-(
In off everything now til end of April when they do more bloods
Last couple of days severe exhaustion has set in. I'm on day 3 of vagifem and so far no problems (but no noticeable improvement either)
My double vision is getting worse and I'm struggling using pc and reading spreadsheets at work but seeing the specialist tomorrow so hoping for more info
Hope you continue to sleep well
Xx
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that's good you've got no side effects. Do you mean head hair has thinned more since the cream ?
I can't afford to thin anymore, I've never had thick hair but in recent pics I think I can see through mine :-(
No, mine thinned before using the cream. It's always been really thick and bushy, it's more manageable now but I'm hoping it'll stop there or even regrow (probably a bit ambitious that last bit but who knows...). I've read that progesterone deficiency can cause thinning hair so I'm watching closely - I suspect I wouldn't really notice any great change until much further down the line with head hair though, probably a good few months for any change to take effect.
My eyesight was great until recently when it took a huge dive and although I can see fine at whatever level I'm focusing at, I struggle adjusting one distance to another, ie if I'm reading my phone for 15 minutes, anything a further distance away is blurry. I guess that's as good as an excuse as any not to read the news on my phone on a morning.
I am tempted to try a very small DHEA supplement (10mg) but I want to be able to isolate what is and isn't helping me so I'll leave that until further down the line. A friend is prescribed DHEA for fibromyalgia and it's really helped her, I'm just not sure if I actually will need it.
Have you tried progesterone yet Annie? I've never had problems with periods or PMT or anything hormonal until the menopause so I guess I tolerate progesterone well. That could also be due to the very low dose I'm using too though? I think Utrogestan is prescribed in 100mg and 200mg amounts so I'm only using less than a half of that currently.
GG x
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No I haven't yet because he's stopped my oestrogen too :-(
I'm on nothing because he says he wants MY hormone levels tested end April
I've been reading up tonight, my muscles are hurting everywhere and I'm wondering whether testosterone (or lack of it ) is to blame, very disappointing to read that there's no real help on the NHS (hip and back are painful too)
I've had terrible exhaustion today, I work half day on a Wednesday and couldn't wait to get home to sleep, each time I roused I couldn't stay awake so drifted off again, came to bed about 10.45 drifted off and the toe/ankle cramps kicked in and I've been awake since
Xx