Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: rferdi on August 26, 2024, 03:01:35 PM
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This is my first time on cyclical HRT, after having started on continuous a couple of months prior and not feeling much benefit.
Switched to cyclical this month of August and the first week was difficult, but then it gradually improved to the point my worst symptoms had improved significantly, I'd say both the frequency and intensity were reduced to about half of what they used to be before cyclical, so that was great.
I took Utrogestan 200mg for 13 days (I wanted to take it for 12 but got it wrong somehow) from 14 to 26 inclusive. So yesterday night it was the first night of not taking it and I had a pretty rough night, with almost all of my worst symptoms coming back, although not quite as extreme as they used to be before HRT.
I just couldn't sleep (progesterone was amazing for making me sleep soundly through the night and I DO miss that), so I took a CBD supplement which helped me relax slightly. But I had the pounding throbbing heart throughout my whole body, pins and needles in feet and hands (though at least they didn't go numb), heart skipping beats several times before being able to fall asleep. I've slept very few hours and with interruptions, and since I got up I've been having almost all those same symptoms plus quite a bit of dizziness, and just feeling unwell overall.
This looks like a bit of a setback to me, seems like not taking progesterone last night has affected me quite negatively. Which surprises me as I thought the lack of estradiol was the main reason for my symptoms. Please could someone give me some enlightenment here, to try to understand what may be happening? Thank you :)
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rferdi, I can't talk about progesterone but my own experience with identical symptoms was low/fluctuating estrogen.
I've tried taking no P, 100, 200, 300 and 400mg of P. None of it made any difference to my symptoms. I mean, not consistently. Sometimes things seemed to get a bit better or worse but it's just because the symptoms fluctuate a bit anyway.
The only thing that helped was getting my E up.
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thanks again joziel, yes i know I probably need more E, I know you've had almost the same symptoms as me and that's what's helped you, and it'll most likely be the case for me. I just wanted to wait a bit more to give this current new regime at least a whole month if not 2 before making any changes. But we'll see how it goes I guess, I may try it sooner if things don't settle.
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Hi rferdi
Sorry to hear about your issues
What you may be experiencing is classic progesterone withdrawal - it's a bit like coming off a drug. There are physiological changes that occur in the body when you take progesterone (and when it produced by the body) and these are reversed when you stop taking it, or when it declines. Once the progesterone leaves your system after a few days you should feel better again, even notwithstanding your oestrogen levels though I agree these should be optimal. You haven't said what dose you are taking though? Also whether you are peri or post-meno as this will make a difference too? The sleep inducing qualities of progesterone are a different issue - it seems some women like this! At the right dose though oestrogen should not interfere with sleep and should help due to decreased flishes and sweats and general improvement in well-being. The downside of prog is the daytime sleepiness and head fog some of us experience so it's like being dulled mentally.
Hurdity x
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Hi Hurdity,
Thank you for your reply, I'm in peri, and I'm taking the equivalent to 2 pumps of Oestrogel (I'm using 2.5g of Oestraclin gel, which has 0.6mg estradiol per g.) and 200mg Utrogestan for the 12 days a month.
Yes progesterone really seems to suit me, so far I've not had any downsides, just a great overall feeling of relaxation and wellbeing and great sleep, while I'm on it. I didn't know about progesterone withdrawal, but I can see that's what must've happened. The worst day was the first one, and it's been improving gradually, now that's been 4 days without it I'm feeling better but still a lot worse than while I was taking it. Not just because I don't sleep nearly as well, but also because all my usual symptoms have intensified since I stopped.
I just got started on HRT really, and I know I still have to find my right estradiol dose. The previous couple of months before this I'd been on a continuous regime, using 1 spray of Lenzetto instead of Oestrogel, and it didn't help me much with my symptoms. Things began to improve quite a lot since I switched to cyclical in August, but I also changed from Lenzetto to Oestrogel so I'm not sure if the improvement is from the product change or from the cyclical regime, or from both. I guess I'll find out as I go.
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Hi joziel, I'd like to know what your regime is, I hope you don't mind me asking how much estradiol and progesterone you're taking and how many days of P every month. I know we're all different but just out of curiosity since your symptoms seem so similar to mine. You're also in peri as well, I think?
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I am 46yo and in peri. Started HRT at age 42yo. Have spent the last 3 years trying to resolve these symptoms which only began when I started taking it. (But stopping it didn't stop the symptoms!) I have none of my pre-HRT low estrogen symptoms, just this situation at night - which is bollocks.
I need to take utrogestan continuously because I have a history of endo. Not very severe or widespread but it doesn't take much for it to cause a lot of pain for some women. I had a lap for it in 2013, so I know I definitely have it as the surgeon saw it and lasered it out. (Not very reliable way to remove it.)
I have tried taking utrogestan sequentially, at the standard dose of 200mg and then also sequentially at a higher dose of 300mg, but I got the old familiar endo pains back in the old familiar places. So I moved to taking it continuously. I have zero endo pains if I take it continuously. This also made sense because I am taking higher levels of estrogen, so everyone seems happier if I take more utrogestan. It also can make me slightly sedated and woozy at night which, given my sleeping problems, was a good thing. (That effect seems to have stopped now, sadly.) I was taking 200mg continuously, but this became 200mg for the first half of the month and increased to 300mg the second half.
So it goes days 1-5 - no utrogestan (bleed)
Days 6-14 - 200mg
Days 14-26 - 300mg
I sometimes start to bleed around day 23, and will just stop there and go to day 1 if that happens. (In my 30s, I used to cycle every 35 days but in peri now, it's getting shorter at the moment.)
I take it all orally because I have no probs with progesterone.
Do I really need 300mg? I don't know. What usually happens is I start out at 200mg, planning to get to day 14 like that. And then I struggle with sleep at some point, and I think "oh, if I just take one extra utrogestan early, it might help with the sleep", so I then increase to 300mg. Then I think "I can't drop back down to 200mg or I might bleed early now" - so I just stay on 300mg for the rest of the cycle. ;D ;D Anyway, my doctors are all happy with that.
With estrogen, the goal is to get me between 450-650pmol and see how I feel at that level. So this is a work in progress because I don't absorb it well. Although it really wasn't clear for a long time that that was the problem, because I've never had rock bottom estrogen levels.
The lowest was around 198pmol on a 50mcg patch a few months after starting HRT. My highest ever was 450pmol - on a 37.5mcg patch(!), again shortly after starting. This is why blood tests are so useless. More recently, I always try to test during my period because my own estrogen will be lowest then (hopefully) so I can better see what I'm getting from HRT. On 6 pumps of gel I was around 325pmol. On 12 pumps of gel, I was 330pmol.....(!) - so I wasn't absorbing any of the extra 6 pumps there.
So now we've added in patches with the hope that a combo of gel and patch can get me high enough. My Newson doctor said she has many women on 300-400mcg of patches. I'm currently on 100mcg patch (will increase tomorrow to 125) and 12 pumps of gel. Well, it's supposed to be 12 pumps of gel except I had all this Sandrena left over and decided to use it up ;D I just can't throw estrogen out.
So I'm actually on a daily dose of 8 pumps of gel + 2 sachets of Sandrena + 100mcg patch (125mcg tomorrow). I split the gels AM and PM, so I do 4 pumps of gel and a sachet of Sandrena AM and the same PM.
But the general plan is to gradually increase the patches up to at least 200mcg if I still have any symptoms. And I think to decrease the gel to at least 6 pumps, seeing I was able to absorb more from 6 pumps than from 4. At that point I will re-test and see if I need to go higher on the patches. I would like to get as much onto patches as possible as they are much easier to deal with, but I do like having some gel as well (I use the leftover gel in each pump on my face ;D ;D )
Does that help?
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This is my first time on cyclical HRT, after having started on continuous a couple of months prior and not feeling much benefit.
Switched to cyclical this month of August and the first week was difficult, but then it gradually improved to the point my worst symptoms had improved significantly, I'd say both the frequency and intensity were reduced to about half of what they used to be before cyclical, so that was great.
I took Utrogestan 200mg for 13 days (I wanted to take it for 12 but got it wrong somehow) from 14 to 26 inclusive. So yesterday night it was the first night of not taking it and I had a pretty rough night, with almost all of my worst symptoms coming back, although not quite as extreme as they used to be before HRT.
I just couldn't sleep (progesterone was amazing for making me sleep soundly through the night and I DO miss that), so I took a CBD supplement which helped me relax slightly. But I had the pounding throbbing heart throughout my whole body, pins and needles in feet and hands (though at least they didn't go numb), heart skipping beats several times before being able to fall asleep. I've slept very few hours and with interruptions, and since I got up I've been having almost all those same symptoms plus quite a bit of dizziness, and just feeling unwell overall.
This looks like a bit of a setback to me, seems like not taking progesterone last night has affected me quite negatively. Which surprises me as I thought the lack of estradiol was the main reason for my symptoms. Please could someone give me some enlightenment here, to try to understand what may be happening? Thank you :)
Gosh this happened to me! You might want to join the Progesterone Withdrawal/Negative reaction support group on FB there is lots of posts on thee to help explain what may be happening!
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joziel that was very helpful, and thanks for such a detailed post. I wonder what were the peri symptoms you had when you started HRT, which I understand disappeared with it.
And then hasn't any doctor been able to tell you why would this other different set of symptoms appear (the ones that you described in another post that coincide so well with mine)? I don't understand, these are supposed to be due to low estrogen, but before you began taking HRT you didn't have them (though you did have others, also due to low estrogen, that went away with the HRT)? Quite confusing.
I'm also kind of wondering if progesterone is something one can sort of get addicted to?... I know it sounds silly since it's bioidentical and P is something we naturally produce anyway throughout our lives till menopause comes along. But I've also noticed the effects seem to decrease over time, with the same dose. Do you also get sleeping problems (and maybe other symptoms, like me) once you stop the progesterone for those 3 days or so?
More recently, I always try to test during my period because my own estrogen will be lowest then (hopefully) so I can better see what I'm getting from HRT.
This is good to know because every time I've had blood tests done to see my levels they've come back either too low or too high, but no doctor's ever told me there was a specific day when it was best to do them, which is yet another thing that makes me distrust so many of the doctors I've consulted with, unfortunately.
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Gosh this happened to me! You might want to join the Progesterone Withdrawal/Negative reaction support group on FB there is lots of posts on thee to help explain what may be happening!
Thanks for the info, I'll check it out!
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Before HRT, I had:
- Joint pain, especially on waking in the mornings or if I stayed in a position any length of time (knelt on the floor and then got up, for eg). I had pain in hips, knees, just felt stiff when I woke up. I had trigger finger in my little fingers when I woke (little finger would jerk up and down and wouldn't move smoothly) which is apparently a sign of arthritis. I had bloods done for arthritis which were all negative and I was referred to rheumtatology. They told me to see if HRT would help and come back if it didn't. GP was useless and said I was hypermobile and it must be because of that. (But I've been flexible all my life, that hasn't changed, so why would I suddenly get these symptoms?) I suggested it was peri-menopause but he said I was too young (at 42??). He did estrogen and FSH tests and told me they were fine so it couldn't be peri. I knew otherwise and just went to other doctors.
- Vaginal dryness. I actually thought this was thrush at first and treated twice for thrush, with no luck. Felt scratchy and burn-y and sore. I also had incredibly thick sticky/gluelike vaginal discharge a couple times which was like a mucous plug, it was gross. And at other times I would have a gush of runny watery stuff. Apparently this is all the cervix trying to lubricate itself, it goes either way. I had swabs done which were all normal and was given local estrogen, Vagifem and got Ovestin from Newson Health so I could have both and a ton of local moisturisers. I don't need any of that anymore, now my systemic estrogen is up. Which is good because it was a faff applying it all multiple times a day and my vag was taking over my life.
- Brain fog. I couldn't read and retain info. I would read and re-read the same sentence over and over again because I'd forget the start of it and the point of it by the time I got to the end. I'm pretty academic and a big reader so this was a problem. I couldn't think properly, my brain felt like it wasn't working.
- Constipation and gas/flatulence. Like humongous massive old people farts....
- Not wanting to do anything. Just wanting to sit around and wait, I had no idea what for. I wasn't depressed, just couldn't feel there was anything I 'wanted' or got excited about.
- Zero libido.
- Dry eye. I'd actually had this for years, my optician had told me about it - but I hadn't realised it was a low estrogen symptom until I started estrogen and it went away. It was associated with a watery/tearing eye as well, which would ruin any eye make-up and was really embarrassing. (I guess like the cervix, it goes both ways with all mucous-y things!)
- Migraines. I do still get these at times when I have a big sudden surge in estrogen, or if I drive and stare at the road for ages or am extra-tired. But the hormonal triggers are much reduced now.
I had no sleep problems, before though. I was always a very good sleeper my entire life. Head would hit the pillow and I'd be out for 8 hours or more. Self-employed so wouldn't need to set the alarm clock, just got up when I woke up. If I tried to stay awake lying on the sofa and watching a film, I was incapable of staying awake past 11pm. Just couldn't, no matter how much I tried. I would 'just rest' my eyes - and I'd be gone.
As for - has any doctor been able to tell me why this other set of symptoms appeared... There are thoughts and theories but not anything definitive. One is that they are due to the brain wanting extra estrogen (neurological symptoms) because the communication between brain and ovaries is going haywire.
One is that they are more due to a time of great fluctuations, hormonally, rather than simply high or low - when I started HRT, I also stopped the desogestrel POP which I'd been on for about 10 years. That suppresses your ovaries and keeps your estrogen quite low (and progesterone non-existent and testosterone low as well). So I went from a state of very low hormones, to adding all 3 hormones at once. My ovaries woke up because I'd stopped the desogestrel and started firing sharp shocks across my abdomen for a few months - they were doing weird things and probably increasing the fluctuations of hormones. (Stupid doctor question 'but how do you know it's your ovaries?' me: 'I can feel them.'. Doctor 'you can feel your ovaries?'. ??? ::)
And another theory is that there was no pattern to the rise and fall of hormones going on either. Our bodies are used to different hormone levels but across a cycle, which is predictable and has a pattern. They are not used to wild highs and lows lasting a few hours which have nothing to do with what time of the month it is. And that this causes the neurological stuff. So beforehand, the desogestrel was keeping everything low but constant - but it was too low. When I stopped it, I unleashed all the fluctuations.
With progesterone, I don't think 'addicted' is the right word. But there are people who say you need to take a break from it to reset the receptors, so that they can work again. But I do take a 5 day break and haven't noticed it working well again when I restart so not sure about that one! Maybe if I took it sequentially, I would really notice it when I started it - but I can't do that due to endo. I do find that if I take it with a little food, I absorb it even more and it hits me better (makes me sleepier). You could try that. It has to be a small amount of food and the same thing every night. (I usually have a coconut nibble healthy thing, I think the fat helps it absorb.)
Anyway, hope that helps! Really there is only experimentation. Keep trying things, dosages, products, keep experimenting until you find what works best for you. Because we are soooooooo far behind with women's health, that's the best we can do.
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I'm also kind of wondering if progesterone is something one can sort of get addicted to?...
I know someone who is currently pregnant for the 9th time and another who has 13 children so maybe ;)
However the definition of addiction includes a persistent and irresistible urge to do/use the substance or activity to the point that this is causing or threatening to cause harm - this doesn't occur with therapeutic progesterone.
Tolerance is another feature where a person starts to require more and more of a substance to achieve the same effect. Again there is no evidence of women increasing and increasing their progesterone doses and demanding more than they are prescribed.
If anything the issue with progesterone is many women dislike it and take less than the dose they need for endometrial protection.
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@joziel thanks for sharing your experiences, it's really helpful to me as a newbie to HRT, it's much appreciated.
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I also had the joint pain, vaginal dryness, brain fog, gas, dry eyes etc etc years before the horrible unbearable symptoms began, but I didn't even know what peri was then. I was completely ignorant about menopause, I never heard any woman in my family talk about this, or any other woman for that matter anywhere, ever.
Thanks again for all the valuable info provided joziel, HRT really is something that requires experimentation and patience. And women's menopause health is so ignored by the vast majority of doctors. I spent almost 3 years going to specialist after specialist, including gynaecologists, who NEVER even suggested the possibility of my symptoms being perimenopause.
For me progesterone actually works best when taken on an empty stomach, I did try taking it with food sometimes and every time I'd feel the good effects were very diminished (the great sleep etc).
I'll continue trying for sure, even though it can be rather discouraging sometimes. For example I was feeling fairly good just a week ago and today it's been quite bad... Anyway let's keep going :valkyrie:
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I know someone who is currently pregnant for the 9th time and another who has 13 children so maybe ;)
:lol:
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Yes, I had that 'slight improvement, getting hopeful, and then it backslides' all the time. Till I took more estrogen. Now the improvements are consistent. Not quite there yet, but just put 125mcg patch on today (along with all the gel) so let's see....
And yes, I've had an iron infusion, B12 shots every other day and trialled thyroid meds including T3, had multiple ECGs and echocardiogram, had 24hr urine catecholamine test, been referred to rheumatology, had countless doctors' appointments - what is the cost to the NHS of not treating or acknowledging menopause???
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Before HRT, I had:
- Joint pain, especially on waking in the mornings or if I stayed in a position any length of time (knelt on the floor and then got up, for eg). I had pain in hips, knees, just felt stiff when I woke up. I had trigger finger in my little fingers when I woke (little finger would jerk up and down and wouldn't move smoothly) which is apparently a sign of arthritis. I had bloods done for arthritis which were all negative and I was referred to rheumtatology. They told me to see if HRT would help and come back if it didn't. GP was useless and said I was hypermobile and it must be because of that. (But I've been flexible all my life, that hasn't changed, so why would I suddenly get these symptoms?) I suggested it was peri-menopause but he said I was too young (at 42??). He did estrogen and FSH tests and told me they were fine so it couldn't be peri. I knew otherwise and just went to other doctors.
- Vaginal dryness. I actually thought this was thrush at first and treated twice for thrush, with no luck. Felt scratchy and burn-y and sore. I also had incredibly thick sticky/gluelike vaginal discharge a couple times which was like a mucous plug, it was gross. And at other times I would have a gush of runny watery stuff. Apparently this is all the cervix trying to lubricate itself, it goes either way. I had swabs done which were all normal and was given local estrogen, Vagifem and got Ovestin from Newson Health so I could have both and a ton of local moisturisers. I don't need any of that anymore, now my systemic estrogen is up. Which is good because it was a faff applying it all multiple times a day and my vag was taking over my life.
- Brain fog. I couldn't read and retain info. I would read and re-read the same sentence over and over again because I'd forget the start of it and the point of it by the time I got to the end. I'm pretty academic and a big reader so this was a problem. I couldn't think properly, my brain felt like it wasn't working.
- Constipation and gas/flatulence. Like humongous massive old people farts....
- Not wanting to do anything. Just wanting to sit around and wait, I had no idea what for. I wasn't depressed, just couldn't feel there was anything I 'wanted' or got excited about.
- Zero libido.
- Dry eye. I'd actually had this for years, my optician had told me about it - but I hadn't realised it was a low estrogen symptom until I started estrogen and it went away. It was associated with a watery/tearing eye as well, which would ruin any eye make-up and was really embarrassing. (I guess like the cervix, it goes both ways with all mucous-y things!)
- Migraines. I do still get these at times when I have a big sudden surge in estrogen, or if I drive and stare at the road for ages or am extra-tired. But the hormonal triggers are much reduced now.
I had no sleep problems, before though. I was always a very good sleeper my entire life. Head would hit the pillow and I'd be out for 8 hours or more. Self-employed so wouldn't need to set the alarm clock, just got up when I woke up. If I tried to stay awake lying on the sofa and watching a film, I was incapable of staying awake past 11pm. Just couldn't, no matter how much I tried. I would 'just rest' my eyes - and I'd be gone.
As for - has any doctor been able to tell me why this other set of symptoms appeared... There are thoughts and theories but not anything definitive. One is that they are due to the brain wanting extra estrogen (neurological symptoms) because the communication between brain and ovaries is going haywire.
One is that they are more due to a time of great fluctuations, hormonally, rather than simply high or low - when I started HRT, I also stopped the desogestrel POP which I'd been on for about 10 years. That suppresses your ovaries and keeps your estrogen quite low (and progesterone non-existent and testosterone low as well). So I went from a state of very low hormones, to adding all 3 hormones at once. My ovaries woke up because I'd stopped the desogestrel and started firing sharp shocks across my abdomen for a few months - they were doing weird things and probably increasing the fluctuations of hormones. (Stupid doctor question 'but how do you know it's your ovaries?' me: 'I can feel them.'. Doctor 'you can feel your ovaries?'. ??? ::)
And another theory is that there was no pattern to the rise and fall of hormones going on either. Our bodies are used to different hormone levels but across a cycle, which is predictable and has a pattern. They are not used to wild highs and lows lasting a few hours which have nothing to do with what time of the month it is. And that this causes the neurological stuff. So beforehand, the desogestrel was keeping everything low but constant - but it was too low. When I stopped it, I unleashed all the fluctuations.
With progesterone, I don't think 'addicted' is the right word. But there are people who say you need to take a break from it to reset the receptors, so that they can work again. But I do take a 5 day break and haven't noticed it working well again when I restart so not sure about that one! Maybe if I took it sequentially, I would really notice it when I started it - but I can't do that due to endo. I do find that if I take it with a little food, I absorb it even more and it hits me better (makes me sleepier). You could try that. It has to be a small amount of food and the same thing every night. (I usually have a coconut nibble healthy thing, I think the fat helps it absorb.)
Anyway, hope that helps! Really there is only experimentation. Keep trying things, dosages, products, keep experimenting until you find what works best for you. Because we are soooooooo far behind with women's health, that's the best we can do.
studies show you absolutely can have tolerance/withdrawal
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031054/?fbclid=IwY2xjawFBRwhleHRuA2FlbQIxMQABHartZNtxZcpZcKERQ35znnplbP58D6P5kpHZXMt3v4UYRWY4BTWPNOJdlA_aem_BlY-88SZpgVmbR630ptuUw
Some excerpts from the "Screaming To Be Heard' book by Elizabeth Lee Vliet, MD.
'Many women have told me over the years that they have become depressed when they take progesterone or use the ‘wild yam’ progesterone creams. This is to be expected due to progesterone’s effects on the brain, since several metabolic breakdown products of the nature human progesterone molecule are very potent depressants of brain (CNS) function. One of the metabolites of progesterone (3-alpha-OH-DHP) has been found to be about eight times more potent as a CNS depressant producing antianxiety, sedative effects than the most potent barbiturate known today, methohexital. Studies looking at the anti-convulsant actions of 3-alpha-OH-DHP have found it to be more potent than clonazepam (Klonopin), a high-potency benzodiazepine used for epilepsy and panic disorder. Depressed mood occurring with progesterone is similar to the depressant effects on some women when taking Klonopin or Valium.
The neuroendocrine studies that have identified these progesterone metabolic products and their effects at brain receptors go back several decades, but much of this literature has not made its way into general clinical settings, particularly in the fields of psychiatry and gynecology. The progesterone metabolites above actually attach to GABA receptors, the same ones that bind the benzodiazepine drugs. At higher levels, progesterone actually acts very much like these anti-anxiety medications by attaching to the GABA receptor sites and causing release of the inhibitory neurotransmitter GABA, just as Klonpin, Valium, and the others in this group of medicines do. Inhibitory action at the GABA receptor complex causes decreased anxiety, decrease in seizures, increased sedation, delay in word recall and verbal responses, and potential increase in depression. The depressant effects seem to occur at higher doses than are needed for anti-anxiety effects, again similar to those effects we see with benzodiazepines. The depressant effects of progesterone are now thought to primarily occur from one of its metabolites, 3-alpha, 5-alpha-THP and allopregnanolone. Levels of allopregnanolone have been shown to correlate well with circulating levels of progesterone in the bloodstream.
An interesting observation in several studies is that progesterone given to either men or women produces effects like Valium (and other benzodiazepines) on such measurable variables as heart rate, blood pressure, respiratory rate, and the electrocardiogram patterns. It also causes quite pronounced daytime sleepiness for many, male or female. The flip side of this effect is that progesterone produces withdrawal effects similar to other medications that act at the GABA receptor, such as benzodiazepines and barbituates. This effect has been shown in men and women. This withdrawal syndrome increases anxiety, restlessness, insomnia, tearfulness, and other effects.
The binding of progesterone metabolites to the GABA receptor complex appears to be one of the primary reasons that high doses of progesterone help decrease anxiety in some women with severe PMS. The doses typically used for PMS treatment may run anywhere from 400-1600mg a day and produce blood levels actually higher than the levels of progesterone seen in the third trimester of pregnancy. Such high doses are actually providing a pharmacologic effect on the brain, similar to benzodiazepine medicines, rather than a physiologic one mimicking the levels and functions of a normal menstrual cycle. At these higher doses, the anxiety-relieving metabolites of progesterone are found to be depressogenic, much like what happens to some people when taking higher doses of Valium or Ativan over a period of time. The brain actions are essentially the same, but then over time, it can make depressed, dysphoric moods worse.
Frye and Duncan (1994) showed that, in rats, diminished pain sensitivity correlated well with the relative binding actions of various progesterone metabolites at the GABA receptor complex. They looked at several different compounds, and those that were strongly bound to GABA receptors showed he greatest reduction in pain, while the GABA antagonist compounds such as DHEA-S did not improve pain sensitivity.'
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I'm also kind of wondering if progesterone is something one can sort of get addicted to?...
I know someone who is currently pregnant for the 9th time and another who has 13 children so maybe ;)
However the definition of addiction includes a persistent and irresistible urge to do/use the substance or activity to the point that this is causing or threatening to cause harm - this doesn't occur with therapeutic progesterone.
Tolerance is another feature where a person starts to require more and more of a substance to achieve the same effect. Again there is no evidence of women increasing and increasing their progesterone doses and demanding more than they are prescribed.
If anything the issue with progesterone is many women dislike it and take less than the dose they need for endometrial protection.
addiction and tolerance are 2 seperate things (one is psychological and one is physiological)
tolerance can happen with any GABA affecting substance including progesterone there are multiple studies on it
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None of that really makes much sense to me or my situation.
I stop progesterone for 5 days every month to allow a bleed. I notice no difference, no increase in anxiety, no 'withdrawal'... I do not sleep any worse for having stopped it.
When I use it (at any dose, 100, 200, 300 or 400) I have no day time sedation or sleepiness, I am not depressed, I do not have low mood - and I don't sleep any better for taking it.
It appears not to do much to me, beyond protecting my uterus. Which it must be doing as I'm not getting break through bleeding or endo symptoms.
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Yes, I had that 'slight improvement, getting hopeful, and then it backslides' all the time. Till I took more estrogen. Now the improvements are consistent.
I'll let you know once I begin increasing estradiol if I get improvement as well. I'm trying to be patient and not increase just yet, as I've been on this new regime for just a month.
Interesting how progesterone affects everyone differently. You don't notice anxiety or any of that but, do you notice any of your symptoms get worse? Because that's mostly what I noticed the day after I stopped it. However I do sleep a lot better when I take it, I can notice how I start getting super relaxed and sleepy about an hour after taking it. Doesn't this happen to you?
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No, none of my night time symptoms get any better or worse when I start or stop progesterone. After 3.5 years of starting and stopping it, I'd have noticed by now!
And no, I don't sleep any better for taking it, as said above. When I first began it, I did notice a strong sedative effect where I almost felt a bit dizzy and spacey and like I'd taken something - although it still wasn't enough to help me sleep with the horrendous night time symptoms I was getting.
But now that sedative effect has worn off and it seems to have no effect on me.
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Interesting how progesterone affects everyone differently.
When I was in peri and had insomnia progesterone helped me to treat that symptom, but now when I am post meno, progesterone has an opposite effect on me, it causes insomnia. The same hormone and the same body, but effect it has on the body is different. The relationships between sex hormones are too complicated, I went through 3 stages peri, meno and post and I still have more questions, than answers about how the hormones work.
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AnonoMiss, thank you for the book excerpt from Elizabeth Lee Vliet. I asked if progesterone could be somewhat addictive, or habit-forming, or could it create physiological dependence in some way, because one time in what feels like another life I went through an extremely difficult and challenging benzodiazepine withdrawal, more than 10 years ago. Long story, but I'll just say it was the worst time of my life and I'm so glad I did survive it (because some people don't). Hurdity suggested in an earlier reply to my original post that it might be "classic progesterone withdrawal", and that's the very first time I heard of it.
When I took progesterone for the first time its potent effect did sort of remind me a little bit of the calming, sedating feeling I used to get with benzos. However, when I stopped the P what happened wasn't that I felt anxious, restless or tearful, nor did it ever made me feel depressed (when I was on it or when I stopped it).
What happened was that all my worst peri symptoms came back, though not as strong as they were before. And one more of those symptoms was insomnia, which was something that improved immediately once I took progesterone, and also immediately went back to what it was as soon as I stopped taking it, which is something I dreaded it would happen.
I've been learning lately about PCOS which I was diagnosed with as a teen, and for that reason I was put on the pill at 16, and took it for 25 years non-stop. I've learnt that women with PCOS have a chronic lack of progesterone, and also of estradiol since the mechanism involving aromatase that transforms testosterone in estradiol doesn't work properly in us, and so we don't make enough of it. Therefore we're left with too much testosterone, creating a cascade of effects amongst which there's the fact we don't ovulate and so our bodies never make enough progesterone.
I've been thinking lately that maybe my body's been starving for progesterone my whole life, getting only a false version of it in the form of the synthetic progestin that was in the pill, and also getting a fake artificial form of estradiol in it. So for many many years I've been sort of functioning without my natural hormones being balanced, or being sufficient. And so I have a feeling that now my body is for the first time getting the bioidentical forms of the two hormones it had actually been craving for and desperately needing for decades. And well I'm not sure what I'm saying here as I need to do a lot more research, reading and thinking about this, but I think HRT may be exactly what my body has been needing all my life, even before perimenopause began, I'd say from my teenage years, my PCOS could probably have been treated and corrected with bioidentical HRT.
Anyway I sort of went off on a tangent there sorry but as for the progesterone I'll keep researching and reading and experimenting and closely watching what happens in myself, although the fact that progesterone is what we naturally make all our lives, it being a natural thing that belongs to our bodies, unlike benzodiazepines, makes me think it couldn't be detrimental. But I'll keep looking into it as I for sure wouldn't want to go through anything remotely similar to what I went through with benzo withdrawal. I just suspect that just may not be the case for me, but it's too soon to say that.
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rferdi, I also have taken oral contraceptives most of my adult life...
I took a progestin pill (norgesterone) from about 21-30, then I tried to come off - and was off it for 5 years. During those 5 years is when the endo got bad, so I was told to go back on again.
I tried Norgesterone again, but it just resulted in constant ongoing bleeding of sludgey dark blood (which it hadn't done the first 10 years I was on it), so I switched to desogestrel POP. I was back on from 35-42yo.
Which is all to say that from the age of 21, I was only off a form of progestin only birth control for 5 years until the age of 42 - when I stopped and began HRT.
And I do wonder if some of my current struggles are due to all that, somehow.
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But now that sedative effect has worn off and it seems to have no effect on me.
I see, who knows maybe after some more time taking it that'll happen to me too. I hope not, seeing how much it helps me sleep.
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And I do wonder if some of my current struggles are due to all that, somehow.
Yes, it's a valid question for sure, worth looking into. I honestly don't know much about endometriosis, but if lack of progesterone is in any way related to it (which I don't know), and you were getting relief from fake progesterone in the form of that contraceptive for so many years, instead of getting the real thing, that intrigues me.
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Yes, that is exactly what happens with endo. Progesterone suppresses it. I don't know if I wasn't producing enough progesterone at that time (30-35). I had bloods run on the NHS and they told me everything was normal, but I don't know if they even tested progesterone or where in my cycle I had the bloods done.
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When I was in peri and had insomnia progesterone helped me to treat that symptom, but now when I am post meno, progesterone has an opposite effect on me, it causes insomnia. The same hormone and the same body, but effect it has on the body is different. The relationships between sex hormones are too complicated, I went through 3 stages peri, meno and post and I still have more questions, than answers about how the hormones work.
Yes, totally agree it's very complicated, how can its effects in one same person change from doing one thing, then the complete opposite. I like how thanks to progesterone I can now sleep through the night most of the time, something I haven't been able to do for the last few years now. Or maybe by the time I reach meno I'll be sleeping well again if my estradiol is in the right level, we'll see what happens.
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Yes, totally agree it's very complicated, how can its effects in one same person change from doing one thing, then the complete opposite. I like how thanks to progesterone I can now sleep through the night most of the time, something I haven't been able to do for the last few years now. Or maybe by the time I reach meno I'll be sleeping well again if my estradiol is in the right level, we'll see what happens.
It’s all about balance and not about certain hormone. In peri my body was losing progesterone faster than estrogen and that caused imbalance between 2 hormones. Adding progesterone put my hormones back to normal balance. In that case progesterone stopped all my peri symptoms including insomnia. In post meno, when the body doesn’t produce the hormones like before, we just guess when adding the hormones to our bodies. If progesterone dose is too much it causes insomnia. I am currently on tablets, which give me two different phases: estrogen and progesterone/testosterone. I can’t sleep on progesterone/ testosterone phase, I had to move it to day time and leave estrogen phase to sleep at night. Different balance = different results.
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It's not really common for too much progesterone to cause insomnia.
If you can't sleep on the progesterone phase, you might be having a paradoxical reaction to progesterone. For some women, P can cause anxiety... that would get worse, the most you took.
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If you can't sleep on the progesterone phase, you might be having a paradoxical reaction to progesterone.
I never had a paradoxical reaction on progesterone in my life. Do you really believe it can appear suddenly at the age of 53? :)
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It’s all about balance and not about certain hormone. In peri my body was losing progesterone faster than estrogen and that caused imbalance between 2 hormones. Adding progesterone put my hormones back to normal balance. In that case progesterone stopped all my peri symptoms including insomnia.
Hi AngelaH, So you didn't need to take any estradiol during peri, and progesterone alone took care of all your symptoms, that's something I heard some menopause doctors say (all in favour of HRT). I was very curious to see if that would be helpful for me, so I tried taking Utrogestan alone 100mg for a month, back in June, but I didn't notice any help other than the improvement in insomnia.
Maybe I should've tried it for longer, but then I found this gynaecologist who convinced me to add the estradiol and do cyclical. I tried it and it did help quite a bit the first 3 wks or so but now I'm not sure as some days are better than others (for example today's not a good day).
I agree it's about balance, I can't wait to find mine. I think perimenopause is a lot more difficult to treat and get the proper balance because of the wild hormonal fluctuations, especially of estradiol. I guess menopause should be easier, since you don't make E or P anymore. Testosterone in my case I'm very much looking forward to it going much lower, as I've had too much of it my whole life because of PCOS, and have been on medication for years to decrease levels of it.
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You said that 'too much P can cause insomnia'. I don't know if there's any evidence of that.... beyond your personal experience. It's not something I've heard of anywhere else. Too much P tends to have the opposite effect and leave women feeling very sedated.
I also tried P alone, rferdi, and it did nothing for my night time symptoms.
The increase in estrogen is doing great for me at the moment. Last night I slept till 7.30am and had good relaxed deep sleep and dreams, like I haven't had for the last 3.5 years. It's such a relief. I'm on 125mcg patch and 10 pumps of gel and will be increasing the patch to 150mcg this Friday.
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You said that 'too much P can cause insomnia'. I don't know if there's any evidence of that.... beyond your personal experience. It's not something I've heard of anywhere else. Too much P tends to have the opposite effect and leave women feeling very sedated.
I also tried P alone, rferdi, and it did nothing for my night time symptoms.
The increase in estrogen is doing great for me at the moment. Last night I slept till 7.30am and had good relaxed deep sleep and dreams, like I haven't had for the last 3.5 years. It's such a relief. I'm on 125mcg patch and 10 pumps of gel and will be increasing the patch to 150mcg this Friday.
You said It's not something I've heard of anywhere else. Too much P tends to have the opposite effect and leave women feeling very sedated. But the same time you have to lift up your estrogen level to make yourself sleep!!! Sex hormones work together, it’s a right balance between them which makes us feel great or feel ill. It’s not about numbers on the blood tests, probably your progesterone level is not high in numbers, but it may be high for that amount of estrogen that you have in the body. So by lifting your estrogen up you bring your balance close to right and you can sleep. Another thing I can think about, the body can use progesterone to make cortisol. If we experience stress during day, the body will make cortisol at night and by the very early hours in the morning it will keep the body awake. When it comes to sex hormones everything becomes too complicated and that is much more than “estrogen is happy hormone” and “progesterone is sleepy one”, and some people even call progesterone as a devil hormone.
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Hi AngelaH, So you didn't need to take any estradiol during peri, and progesterone alone took care of all your symptoms, that's something I heard some menopause doctors say (all in favour of HRT). I was very curious to see if that would be helpful for me, so I tried taking Utrogestan alone 100mg for a month, back in June, but I didn't notice any help other than the improvement in insomnia.
I agree it's about balance, I can't wait to find mine. I think perimenopause is a lot more difficult to treat and get the proper balance because of the wild hormonal fluctuations, especially of estradiol. I guess menopause should be easier, since you don't make E or P anymore. Testosterone in my case I'm very much looking forward to it going much lower, as I've had too much of it my whole life because of PCOS, and have been on medication for years to decrease levels of it.
I believe I have quite long history of low progesterone in my body. Symptoms like hot flashes and itchy skin, as well as a weak bladder I started experiencing in my 30s. But GPs never suggested hormonal imbalance was responsible for that, and never suggested to check progesterone. In peri things went even more worse, more and more symptoms appeared, they made my life hell, but not for long, because I started heavy bleeding I was fitted with Mirena coil (no estrogen added) and this is how I realised that low progesterone caused all my symptoms through my 30s and 40s. Mirena stopped all symptoms just overnight and I had my happy life back for next 2 years until I reached menopause. Unfortunately meno and post meno symptoms appeared and now is not so easy for me to find that “magic” treatment. When my hormones reached the floor level I started feeling really ill. Transdermal HRT made my symptoms worse for more than a year. Now I am on Tibolone and this first time since I started HRT when I am starting feeling better.
But we all are different, probably meno and post meno will help you feel better after so many years struggling with hormonal imbalances in your body.
I don’t think personally Utrogestan is suitable for progesterone treatment, the doses are too much for that. You will have to adjust estrogen levels for it. It is designed to do heavy job for uterus. For therapeutic effects the body needs much lower doses, from my point of view and from my experience.
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" It’s not about numbers on the blood tests, probably your progesterone level is not high in numbers, but it may be high for that amount of estrogen that you have in the body. So by lifting your estrogen up you bring your balance close to right and you can sleep. Another thing I can think about, the body can use progesterone to make cortisol. If we experience stress during day, the body will make cortisol at night and by the very early hours in the morning it will keep the body awake."
I think you missed the part where I said I've tried zero progesterone, 100, 200, 300 and 400mgs and had exactly the same symptoms and no change in them.
It is not about progesterone at all for me. It is about estrogen and getting estrogen high enough.
Forget about any ratio or whatever, it is debatable whether there is such a thing needed (beyond protecting the uterus).
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I think you missed the part where I said I've tried zero progesterone, 100, 200, 300 and 400mgs and had exactly the same symptoms and no change in them.
Forget about any ratio or whatever, it is debatable whether there is such a thing needed (beyond protecting the uterus).
You mentioned somewhere you didn’t have problems with sleep before you started HRT.
I can’t forget about ratio or whatever because putting the hormones in right ratio in peri made me completely symptoms free, I was back to my normal life. Any medical professional will tell you that meno symptoms are all about wrong balance. This is why not everyone has them at first place.
Anyway, joziel, I wish you the best and good luck with your treatment. :)
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I didn't have problems with sleep before. But the hormonal (estrogen) fluctuations which started when I stopped desogestrel and began HRT caused this.
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You mixed up hormonal balance in your body by doing that. I wish I knew that “magic formula”, which suits everyone, but even NHS and scientists can’t help us. :'(
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There is no magic formula, only trial and error for each of us at the moment.
We don't even understand why things work the way they do. We should be clear on the level of uncertainty.
There is nothing to suggest that it was about 'hormonal balance', rather than fluctuating estrogen - able to fluctuate because I stopped the desogestrel.
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I also tried P alone, rferdi, and it did nothing for my night time symptoms.
The increase in estrogen is doing great for me at the moment. Last night I slept till 7.30am and had good relaxed deep sleep and dreams, like I haven't had for the last 3.5 years. It's such a relief. I'm on 125mcg patch and 10 pumps of gel and will be increasing the patch to 150mcg this Friday.
Glad you're getting so well with the increase. I wonder if you wait 2-3 months before you make any changes to your dose, and do you not get any symptoms each time you do change something?
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Angela H yes we're all so different and can react so differently even with the same treatment. I do hope meno & post meno is an easier time for me. I'm glad that you've started feeling better with Tibolone.
I don’t think personally Utrogestan is suitable for progesterone treatment, the doses are too much for that. You will have to adjust estrogen levels for it. It is designed to do heavy job for uterus. For therapeutic effects the body needs much lower doses, from my point of view and from my experience.
I'm interested to know what progesterone product did you use during your peri years that helped you so much, and at what dosage, if you don't mind sharing.
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I no longer wait 2-3 months, no. Experience with all this has shown me that I notice the effects of an increase within 2 weeks. I also know that I don't absorb well and I have a ways to go, to get my estrogen into the ballpark we want it to be at.
It's now reached the point, after doing this slowly for years, that I am 3 years into this and still haven't got it where it needs to be - so by this point I would rather overshoot and come back down to find the point where symptoms return, than spend so long dialling it up and suffering in the meantime. But as I get higher I will wait longer between increases because I'm likely to be approaching where I need to be.
Even my Newson meno doctor has told me I can increase every 4 weeks.
Things didn't stay as great as they began a couple of weeks ago. There has been a definite improvement generally - but still not even one single normal night of sleep. Interestingly, I'm getting more night sweats - I think because I now am sleeping deeper, that I'm not aware I'm getting hot until I get sweaty. Before, my sleep was so crap and light I would wake up and throw the covers off when I got hot. I also am quite chilled when I first get into bed, with cold feet and just feeling cold. I have a hot water bottle on my feet(!). Then I'll wake up in the night, sweating.
I increased my dose again today to 150mcg patch. Still on 10 pumps of gel (well, 6 pumps of gel and 2 sachets of Sandrena). I don't think the Sandrena does anything and I couldn't absorb above 6 pumps going by bloods - so I'm probably on 6 pumps of gel. I will stay on this dose a full month.
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@joziel
I also don't wait 3 to 6 months to assess changed - I think it's one of those NHS fallacies designed to reduce patient demand!
I do seem to absorb well (fingers crossed that continues)and can feel the benefit or not of any change fairly swiftly.
I am carefully making progesterone changes on a monthly basis. Under suggestion from you lovely ladies I have increased my Oestrogen to see if that makes my progesterone days any better. I started P last night so it's too early to assess, previously I've struggled 5- 7 days in).
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After 3 years I can see why you do what you do joziel. I hope the new increase with the patch goes well. I'm an HRT newcomer but I can see it's a bit of a rollercoaster ride at least for now. My intention is to wait the two months to assess, I need to know more and to have more experience with how my body absorbs and reacts. Although bad days like today make me doubt sometimes I'll get to the two months before I try an increase in estradiol.
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I think the problem is that the advice to wait 3 months or whatever, is putting all side effects and changes together. Things like mood, breast tenderness, bleeding, migraines, and neurological symptoms like some of us have.
When in reality, I don't think ALL these symptoms take 3 months before you know where you're at. Things like bleeding can do, and breast tenderness. These are slow hormonal things. But the neuro symptoms like I have (for me anyway) react much more quickly to dose changes (better or worse) - for changes relating to it acting like a neurotransmitter in our brains, those changes will be relatively fast. I can tell within 48 hours if things are going in the right direction - and after a week for sure. And things then tend to plateau there. They don't continue to improve after that.
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We don't even understand why things work the way they do. We should be clear on the level of uncertainty.
There is nothing to suggest that it was about 'hormonal balance', rather than fluctuating estrogen - able to fluctuate because I stopped the desogestrel.
When we use hormonal birth control options the body becomes “lazy” to produce original amounts of hormones, because now it relies on some supply from birth control pills/coils. When we stop using them, withdrawal of some amount of hormones happens, it creates hormonal imbalances in the body. During reproductive years it usually takes a little bit time for the body to adjust production of hormones back to normal. But in peri it may not be happened any more because the body starts declining production of the hormones naturally. On the other side adding birth control in peri may help to restore the right balance. Meno symptoms are symptoms of hormonal imbalances. You can have the same symptoms in your reproductive years if your hormones are out of balance. Every single woman goes through menopause, the time when sex hormones naturally fall down but not every one experiences meno symptoms, because when the hormones are falling down, keeping the right balance, the body doesn’t experience meno symptoms.
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I'm interested to know what progesterone product did you use during your peri years that helped you so much, and at what dosage, if you don't mind sharing.
For me Mirena coil did the good job. My body was low in progesterone, though the estrogen level was still sufficient. Imbalance between normal estrogen and low progesterone gave me horrible meno symptoms, severe hot flashes and night sweats, itching skin, insomnia, anxiety and depression, panic attack, brain fog, loss of memory, fatigue, I felt like nothing was working in my body any longer, I was dead physically and mentally. I started bleeding nonstop eventually. Mirena coil was fitted and all symptoms were gone overnight. My body is very sensitive to sex hormones, nothing works locally and goes straight to the whole body. This is why the Mirena was so effective for me. It’s not supposed to work for everyone unfortunately.
We don’t really have a choice of progesterone products through NHS, they use progesterone for uterus job only, it seems like they don’t recognise the role of progesterone for other parts of the body, so the only option we really have is birth control products.
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"When we use hormonal birth control options the body becomes “lazy” to produce original amounts of hormones, because now it relies on some supply from birth control pills/coils. "
No, that's not really an accurate description of what happens. The synthetic hormones in birth control products suppress our natural hormone production. It's not about our body becoming 'lazy', but suppressed or dormant.
"On the other side adding birth control in peri may help to restore the right balance. "
Again, birth control does not contain natural hormones which our bodies produce, but synthetic hormones - which they have never made. Adding something foreign and not naturally occurring in our bodies does not "restore the right balance" although it can address certain symptoms. Only Zoely and Qlaira birth control contain body identical estrogen and no birth control contains body identical progesterone.
"Every single woman goes through menopause, the time when sex hormones naturally fall down but not every one experiences meno symptoms, because when the hormones are falling down, keeping the right balance, the body doesn’t experience meno symptoms."
Again, that is a massive supposition with zero science or research behind it and is really just your opinion, not fact. We simply don't know why some women experience many symptoms and others experience none. There isn't enough research out there and not even conjecture which makes consistent sense.
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Again, birth control does not contain natural hormones which our bodies produce, but synthetic hormones - which they have never made. Adding something foreign and not naturally occurring in our bodies does not "restore the right balance" although it can address certain symptoms. Only Zoely and Qlaira birth control contain body identical estrogen and no birth control contains body identical progesterone.
Again, that is a massive supposition with zero science or research behind it and is really just your opinion, not fact. We simply don't know why some women experience many symptoms and others experience none. There isn't enough research out there and not even conjecture which makes consistent sense.
It’s a very interesting point, but my body absolutely doesn’t see the difference between synthetic and naturally produced sex hormones, the same time it refuses to recognise bio identical as its own.
There is statistics how many women experience meno symptoms. You can look around yourself too, my mum never struggled with menopause like me and she never took HRT. OK, what is your own explanation why meno symptoms do appear?
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As I said, Angela, even the best scientists don't have the answers for that yet.
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As I said, Angela, even the best scientists don't have the answers for that yet.
They don’t have the answers how to treat effectively everyone, but in 21st century they have some knowledge/ideas why meno symptoms appear.
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We do not have scientific research demonstrating conclusively why some women but not others experience menopausal symptoms.
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We do not have scientific research demonstrating conclusively why some women but not others experience menopausal symptoms.
OK, I understand your point of you. :)
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AnonoMiss, thank you for the book excerpt from Elizabeth Lee Vliet. I asked if progesterone could be somewhat addictive, or habit-forming, or could it create physiological dependence in some way, because one time in what feels like another life I went through an extremely difficult and challenging benzodiazepine withdrawal, more than 10 years ago. Long story, but I'll just say it was the worst time of my life and I'm so glad I did survive it (because some people don't). Hurdity suggested in an earlier reply to my original post that it might be "classic progesterone withdrawal", and that's the very first time I heard of it.
When I took progesterone for the first time its potent effect did sort of remind me a little bit of the calming, sedating feeling I used to get with benzos. However, when I stopped the P what happened wasn't that I felt anxious, restless or tearful, nor did it ever made me feel depressed (when I was on it or when I stopped it).
What happened was that all my worst peri symptoms came back, though not as strong as they were before. And one more of those symptoms was insomnia, which was something that improved immediately once I took progesterone, and also immediately went back to what it was as soon as I stopped taking it, which is something I dreaded it would happen.
I've been learning lately about PCOS which I was diagnosed with as a teen, and for that reason I was put on the pill at 16, and took it for 25 years non-stop. I've learnt that women with PCOS have a chronic lack of progesterone, and also of estradiol since the mechanism involving aromatase that transforms testosterone in estradiol doesn't work properly in us, and so we don't make enough of it. Therefore we're left with too much testosterone, creating a cascade of effects amongst which there's the fact we don't ovulate and so our bodies never make enough progesterone.
I've been thinking lately that maybe my body's been starving for progesterone my whole life, getting only a false version of it in the form of the synthetic progestin that was in the pill, and also getting a fake artificial form of estradiol in it. So for many many years I've been sort of functioning without my natural hormones being balanced, or being sufficient. And so I have a feeling that now my body is for the first time getting the bioidentical forms of the two hormones it had actually been craving for and desperately needing for decades. And well I'm not sure what I'm saying here as I need to do a lot more research, reading and thinking about this, but I think HRT may be exactly what my body has been needing all my life, even before perimenopause began, I'd say from my teenage years, my PCOS could probably have been treated and corrected with bioidentical HRT.
Anyway I sort of went off on a tangent there sorry but as for the progesterone I'll keep researching and reading and experimenting and closely watching what happens in myself, although the fact that progesterone is what we naturally make all our lives, it being a natural thing that belongs to our bodies, unlike benzodiazepines, makes me think it couldn't be detrimental. But I'll keep looking into it as I for sure wouldn't want to go through anything remotely similar to what I went through with benzo withdrawal. I just suspect that just may not be the case for me, but it's too soon to say that.
Hello, I realise this is an older post but I found your response so interesting. I’m in a similar boat to you: I was pretty much starved of natural endogenous progesterone until about 6 months ago when Utrogestan was added to my HRT regime. I had no periods in my teens or 20s due to exercise associated amenorrhoea (I was a runner and was underweight). In my 30s I went on the oral contraceptive pill, which I was in until my 40s. I had anovulatory cycles in my mid-late 40s and menopause at age 51. Thereafter I had Mirenas until age 59 when I started on Utrogestan - vaginally. I felt marvellous on it for 5 months: good sleep (at last), reduced anxiety and a general sense of wellbeing. But that has worn off and my sleep is bore terrible again. So my conclusion is that I developed tolerance to the brain effects (on GABA receptors) of progesterone metabolites.
How are you doing now?
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Hello, I realise this is an older post but I found your response so interesting. I’m in a similar boat to you: I was pretty much starved of natural endogenous progesterone until about 6 months ago when Utrogestan was added to my HRT regime. I had no periods in my teens or 20s due to exercise associated amenorrhoea (I was a runner and was underweight). In my 30s I went on the oral contraceptive pill, which I was in until my 40s. I had anovulatory cycles in my mid-late 40s and menopause at age 51. Thereafter I had Mirenas until age 59 when I started on Utrogestan - vaginally. I felt marvellous on it for 5 months: good sleep (at last), reduced anxiety and a general sense of wellbeing. But that has worn off and my sleep is bore terrible again. So my conclusion is that I developed tolerance to the brain effects (on GABA receptors) of progesterone metabolites.
How are you doing now?
Hi Tabitha73, are you taking the progesterone orally, and is it continuous or cyclical? And at what dose? I'm now in month 8 of cyclical use of Seidigestan (I'm still in perimenopause -52 years of age- and started HRT in April last year, but I was put directly on a continuous regime, which didn't suit me) and I still notice the progesterone is helping me sleep much better than on the 2 weeks when I'm not taking it, however yes it's true its sedative effect doesn't seem to be as potent as it was in the beginning.
This does concern me a bit sometimes, it seems tolerance development is different in each woman. What I noticed from the beginning of taking P is that if I took it with food still in my stomach I wouldn't get as much of a sedative effect, whereas if I made sure to take it on an empty stomach the effect was very intense. That's still the case for me, so I try to always take it at least 4 hours after dinner, and I don't eat anything else till next morning.
I'm sorry that you're not getting the sleep benefits anymore, my sleep was terrible too without the P during the 2 weeks I don't take it. I recently found a supplement that's helping me quite a bit, it actually has a sort of similar effect as P in the GABA receptors, it's related to allopregnanolone as well, just like P. Thanks to it I can sleep quite well during those nights when I'm off the progesterone, its sedative effects feel very similar.
The name's PEA or palmitoylethanolamide, it's sold as an anti-inflammatory and pain relieving supplement, but it also has calming effects. I've been trying it for the past couple of months, at different dosages, and interestingly I've noticed whenever I take it on an empty stomach the sedative effect is much stronger and happens faster, just like with P. I'm a bit concerned about developing tolerance as well though, so still learning more about this supplement. I don't know if this could also help you?
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rferdi thanks for the new to me idea of palmitoylethanolamide, I've just googled it and it sounds like something I might want to try.
As an update, I'm now on a total of 275mcg of patches, plus 6 pumps of gel before bed. At last test, I was at 650pmol but that was on 200mcg patches and the 6 pumps. I have another Tasso test from Randox on the way, which I'll do either this cycle or next. It is ridiculous being on this dose and only have access to 25 Estradots now, due to the shortage. I have a million patches stuck on me. (Part of the reason I increased is because each patch gets a dirty ring around it and doesn't stick on the very edge, so if you are getting your dose from multiple smaller patches, I reckon you are getting less than from fewer large patches.)
I am also on more utrogestan because my last Tasso Randox test showed that my levels were only just into the acceptable range and if I'm on this much estrogen, really it should be higher for the ratio. I am taking it all vaginally now, 300mg in the evenings and 200mg in the mornings. Part of the reason for this is that in the UK (and I think in Europe), we can only reliably test progesterone if we take it vaginally (or rectally). This is because of the metabolites which are produced when you take it orally which cause false highs - they show as proper progesterone when they are not, they are metabolites waiting to be excreted. In the US, they have LC-MS progesterone tests which are reliable for oral P - but we don't have those in the UK. (I've tried...) SO - if you want to know how much P you're getting, it seems you can't take it orally in the UK.
Plus, Dr Felice Gersh believes that taking P orally and getting all these sedative effects could be not great for dementia risk and cognition as we get older. I mean, no one's done the research to find out what happens if older women take oral P for decades and have all this GABA stuff sedating them at night....
Anyway, sleep-wise, things are ok-ish but not totally normal. I'm getting between 6-7 hours total, whereas 8 would be normal for me before this mess began. I still have faint tingling in my feet. My hands often go numb still and I also get joint pain in my fingers when I open/flex them in my sleep, which was one of my original pre-HRT symptoms that seems to have come back again. I still often wake around 5am - although I can now usually have a wee and go back to sleep. I don't think I'm getting enough deep sleep, going by how I feel and by my Apple Watch - about 30mins many nights, but I have got up to an hour and once even an hour and 15 mins ;D So things are liveable now but not normal for me.
One new avenue I'm exploring is vitamin A. I did the Ancestry DNA test and downloaded the raw data. Ancestry flagged that I don't convert beta carotene to vitamin A well - I have a 69% reduction in conversion. I also have another gene which causes low circulating levels of vitamin A. So it is very likely I am vitamin A deficient, although it is hard to test for because most of it is stored in the liver and blood tests don't show a deficiency well. But I did some ChatGPT ing and apparently it can cause neurological symptoms, like peripheral neuropathy (tingling) and autonomic nervous system issues at night - plus starting HRT can (in many ways) cause a borderline deficiency to become a clinical one - which would make sense for me, seeing this all originally began when I started HRT.
SO - I've been taking 10,000IUs of vitamin A and will continue that for 6 months and see where I am. It's only been a week so far but I am actually feeling like the tingling has lessened a bit...
I hope you're making progress :)
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Hi joziel, so much interesting information in your post. My god I don’t know how you deal with all those patches, I’d be really stressed out. There should be other options for women who need that amount of estradiol, other than sticking a million patches on! >:(
I'm a work in progress here, I've recently increased my estradiol a bit, and I'm noticing improvements in many of my symptoms, which some of them were very similar to yours (pounding heart, fluttering heart, internal vibration, tingling hands/feet, dizziness etc). I'm a bit slow when it comes to increasing my dosage, I’m now on 3 sprays of Lenzetto a day (I switched from Oestrogel to Lenzetto a couple of months ago), but I've noticed a definite improvement doing 1 spray in the morning and 2 at night. This time around however I'm allowing a couple of months only to assess before another increase (before I’d wait much longer).
My last blood test, which I did on day 3 of my cycle (I think that's the best time?) showed 49,45pg/ml. Pg/ml is the measure labs do here in Spain, not pmol. But according to a conversion chart that should be about 182pmol. Here in Spain is more difficult than in the UK to find a doctor who's well-informed enough to prescribe HRT, fortunately I found a couple of them who are included in my health insurance plan, however they have limitations, like for example my current doctor told me 3 sprays of Lenzetto would be the maximum dose she prescribes. So if this is not enough for me I'll have to find another doctor willing to go for a higher dose (I'm already on the hunt for this).
As for progesterone, I also took the blood test on the same day, maybe I should've done another one on day 21 or so, specifically for progesterone. But this one shows 0,81pg/ml which is 2.97pmol. Not sure what the desirable range is. My doctor looked at all these results and said it's all fine, but I don't trust her judgment entirely, I've noticed every doctor has a different set of rules and info they go by, and may interpret results in completely different ways. For example she told me to take less vitamin D3 because I was at 77ng/ml, and I should be about 50, yet a different doctor last year told me up to 100 is optimal.
We don't have Tasso Randox testing here, however I'm sure there must be something equivalent, but I've not looked into it as I get all blood testing with health insurance, the only downside is a doctor has to request it. I'm very interested in the LC/MS progesterone tests, I'm gonna find out if this is something they do here. I suppose if you take progesterone vaginally, you don't get the sleepy side effects do you?
I watch Dr. Felice Gersh's videos too, and I like her approach a lot. I can tell you if I had the money I'd definitely have her as my doctor. I did see her in a few videos lately where she talks about this issue she sees with taking progesterone, one was an interview with someone, she explained in detail and it did make sense. What I understand is that when taken orally we absorb part of the progesterone and the rest is metabolized into something else, (I think allopregnanolone?) and I think the allopregnanolone then affects the GABA receptors which is what makes us sleepy.
Talking about allopregnanolone, this PEA palmitoylethanolamide supplement has become a life saver for me when it comes to sleep, during my 2 weeks off progesterone. I get deep sleep, about 7 hours nightly. If my stomach is empty I take 400mg and that's enough, if I've had a late dinner or have snacked something not long before bed and notice I still have food in my stomach then I'll take 600mg for the same effect. Palmitoylethanolamide increases levels of allopregnanolone, which is what makes it sleep-inducing. I myself wouldn't take it on the same nights when I take progesterone though, I don't know how they could interact with each other, but on the nights off I have no problem. However I'm still a bit worried about how all this allopregnanolone (from progesterone and from PEA) could potentially be habit forming, because of how its effects seem to be very similar to benzodiazepines (https://pubmed.ncbi.nlm.nih.gov/9316828/). I need to find out more, but for now this is helping me a lot.
How very interesting what you've found out about vitamin A. In the same blood test I got 0.53mg/L of vitamin A, which is supposed to be normal but on the lower range, I wonder if you got your levels tested, and if you know what test is reliable for vitamin A. I eat/drink a fair bit of dairy every day, so I'm not sure I need supplementation, but I'm looking forward to hearing about your progress taking the 10.000IU's.
Oh just make sure it's not synthetic vit A, (I think the natural form is Retinyl Palmitate). But I guess you must know this already ;)
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rferdi, as you may remember, I'm in Spain too and with Adeslas which is probably similar to your health insurance company. With blood tests, I get slip from the gynaecologist but I've got a load of A4 sized tick box forms which the doctor gave me and photocopied them so I just tick all the extra tests that I want to have (over and above the hemograma) like hormones, all the thyroid tests, vitamins plus the all the cancer marker tests. It's one hell of lot of tests and I do it once a year. The lab then send the results directly to me a couple of days later.
I also found doctors unhelpful with HRT but I just do my own thing and buy Oestraclin and Darstin which I find very good and obviously I'm scanned and checked by the gynaecologist every year plus I have yearly breast scans. I like Lenzetto because it's so user friendly but unfortunately it was too weak and my migraines returned.
I hope that helps.
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Hi rferdi - Lenzetto is very low dose, as a product. So it's not used much here because women end up needing too many pumps of it to get enough. You will probably have more luck switching to Oestrogel or patches - even if you stay at the max licensed dose, you will get more from those than from Lenzetto (on average).
182mpol is very low, so you def need more... 270pmol is the minimum just to protect bones.
I didn't test vitamin A because that just tests the levels in the blood and not what is stored in the liver. And you'd need to be really really low in the liver before that showed in the blood. So I decided just to supplement and see if I felt better. Yes, I'm on retinyl palmitate...
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rferdi, as you may remember, I'm in Spain too and with Adeslas which is probably similar to your health insurance company. With blood tests, I get slip from the gynaecologist but I've got a load of A4 sized tick box forms which the doctor gave me and photocopied them so I just tick all the extra tests that I want to have (over and above the hemograma) like hormones, all the thyroid tests, vitamins plus the all the cancer marker tests. It's one hell of lot of tests and I do it once a year. The lab then send the results directly to me a couple of days later.
I also found doctors unhelpful with HRT but I just do my own thing and buy Oestraclin and Darstin which I find very good and obviously I'm scanned and checked by the gynaecologist every year plus I have yearly breast scans. I like Lenzetto because it's so user friendly but unfortunately it was too weak and my migraines returned.
I hope that helps.
Hi Mary, thank you, I don't always get that type of form with the boxes that you can tick unfortunately, though I did a couple of times before and I also ticked the ones with all the extra tests. But I hadn't thought of photocopying them, I'll definitely do that next time that's a great idea. Yes the lab also sends me the results directly as well, the doctor won't have them till I bring them to the consultation.
I know you do your own thing, that's understandable and I'll probably have to start doing the same, unless I find the doctor I'm looking for. Fortunately most pharmacies won't object to selling the products without a prescription (though it's happened to me a few times lately, but I've found it depends on the region, for example pharmacies in Catalonia tend to be less problematic).
I decided to switch to Lenzetto from Oestraclin just because of the convenience as far as application, I'm giving it a chance. I may have to switch back to the gel, we'll see.
I hope all is well with you :)
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Hi rferdi - Lenzetto is very low dose, as a product. So it's not used much here because women end up needing too many pumps of it to get enough. You will probably have more luck switching to Oestrogel or patches - even if you stay at the max licensed dose, you will get more from those than from Lenzetto (on average).
182mpol is very low, so you def need more... 270pmol is the minimum just to protect bones.
I didn't test vitamin A because that just tests the levels in the blood and not what is stored in the liver. And you'd need to be really really low in the liver before that showed in the blood. So I decided just to supplement and see if I felt better. Yes, I'm on retinyl palmitate...
Thanks joziel, I didn't know the exact numbers, I know there's a new thread on here specifically about this, I'll have a look. My gynae of course said that level is perfectly fine... I'm trying Lenzetto because of how convenient it is but yes I may have to switch back to the gel.
Yesterday I had a very bad day with lots of nausea late in the evening, and as soon as I applied the 2 sprays of Lenzetto the nausea began to disappear, and I was fine about an hour later. So yes that's very clear evidence that symptom was low estrogen.
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rferdi, do you have Sandrena gel there? It is another option if you've tried Oestrogel before. It's made in Europe. I think it might be called Divigel there, as that's what it's called in Ireland I think...
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rferdi, do you have Sandrena gel there? It is another option if you've tried Oestrogel before. It's made in Europe. I think it might be called Divigel there, as that's what it's called in Ireland I think...
I don't know, I'll have to ask at a pharmacy (doing a quick search I've not been able to find it). I see it's also estradiol hemihydrate, does it absorb better, is it better than Oestrogel?
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Different people have different preferences really. I tried it and couldn't absorb it as well as Oestrogel - but everyone is different. It's body identical..