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[Izetta]

I have been away for awhile, been having a dreadful time day to day now.

I did receive my hormone panel from Genova, and my doc was very surprised to see my levels.
My ratio of progesterone to estrogen is scarily off the charts low.
progesterone being super low and estradiol being way too high.
He was miffed.
I have been taking 3 months now low doses of bio progesterone and small amt of bioidentical estrogen and have not felt better whatsoever even worse than before i started them. He is upping the dose super high for progesterone and eliminating the estrogen altogether, and then taking DIM to clear the estrogen.

Does anybody have thoughts regarding such low progesterone and low tolerance of bio identicals? My main concern is the depression and anxiety and lack of sleep. My other symptoms are minimal compared to these.
Thanks in advance

Izetta

[Dancinggirl]

Izetta
This type of treatment is not standard on the NHS for good reason. I'm not convinced that saliva tests can give a true picture of what is going on - even blood tests will often vary from day to day, particularly in the peri meno phase. I would assume you are still peri menopause? This will mean your own hormones are fluctuating.
If your depression, anxiety and lack of sleep have emerged with the menopause, then you would probably be better with a low dose of an approved HRT that will control you hormones better.  Progesterone is known to give PMT symptoms so higher oestrogen is preferable I believe. Lack of progesterone will cause erratic or problematic bleeding and will also cause fluctuation in mood. The whole thing of controlling our hormones is difficult and it is trial and error.
I would suggest you see your GP to be referred to a gynaecologist or menopause clinic to be fully assessed.  Look at the options under treatments on this site.
I assume you are looking at lifestyle -  e.g. diet, exercise, relaxation techniques etc?
I feel for you - I am in my early 60s, and, though not on full HRT now, still suffering with meno symptoms. The bio identical progesterone was the most problematic for me.  I did best with the Mirena and separate Oestrogel used daily - this kept me on a relatively even keel.
DG x

[Hurdity]

I agree with Dancinggirl. Your ration of oestrogen to progesterone is only relevant for womb protection. If you are post-menopausal or nearly so then your absolute overall level of oestrogen will be low and getting lower all the time  (subject to the odd spike from your cycle) and replacing this is the aim of HRT - to eliminate flushes and sweats primarily as well as other menopause symptoms, and confer other health benefits longer term ( bones, heart etc). If you are not ovulating then yes your progesterone will be low - but you only need it in large amounts for pregnancy and with HRT for womb protection.

There was a recent thread about Bioidentical Hormone replacement Therapy here - and some detailed posts from Dana which mention about saliva tests - the consensus view is that they do not give an accurate picture of your hormone status.

https://www.menopausematters.co.uk/forum/index.php/topic,37209.0.html

The right oestrogen at the right dose should make you feel much better - but if you have a uterus then a progestogen is also needed and it is this which can be problematic for some women.

I use Estradot patches ( "body-identical" estradiol) together with utrogestan ( micronised "body-identical" progesterone) cyclically on a long cycle vaginally - and have been doing this for 6 years ( on HRT for 10 years) and feel fine. I started last peri-menopause at almost 54.

Sorry to hear about your depression and anxiety - if this is hormonal then increasing oestrogen should help. If there is another reason then you will need to consult your  doctor about other treatments or self-help strategies like mindfulness.

Whatever you decide I hope you find something that works and let us know how you feel

Hurdity x

[dangermouse]

I've also had this problem, I think its quite common in perimenopause when progesterone has been making a steady decline, anovulatory cycles produce even less and oestrogen is surging high in an attempt to boost the likelihood of a pregnancy with a waining egg supply.

I haven't had a saliva test before, it doesn't seem to be common in the UK, although my tests at London Bridge Hospital (for gut issues) all went via the Genova lab. However, in peri I think its often better to rely on symptoms rather than tests, particularly as hormones can have massive highs and lows from hour to hour.

I'm not sure of your actual symptoms but I have found progesterone cream to be very effective for throwing out some of the oestrogen but it can then cause more problems with more oestrogen then circulating in the blood-stream whilst the bowels are getting rid of it. I also had a bad reaction to DIM but do wonder if it was just working really well and I should have just had a smaller dose!

Another option for you, if the progesterone is just not working for you, and if the DIM doesn't help, is to take a high amount of oestrogen to take over your cycle, like how the pill works. I cannot take this option as I have silent migraines from the high oestrogen but I think a few women here have found this works for them, its just getting through the initial weeks until things calm down.

[CLKD]

I would never pay for saliva tests - if they are reliable then they would be available on the NHS.

[Hurdity]

Hi Hope22 - CLKD is referring to saliva tests that Izetta has reported on ie for sex hormones - oestrogen and progesterone. I can appreciate your comments about NHS being slower to adopt newer treatments because of the approvals process - but in this case (ie oestrogen and progesterone) it has been demonstrated that saliva testing is not an appropriate way to obtain reliable readings for these hormones so results cannot be interpreted in the same way as conventional testing (blood tests). Do have a look at the link to the other thread I gave in my post below because Dana has explained (and quoted) in detail about this.

Saliva testing of other hormones like cortisol is a different issue - a friend told me about this but not sure how widespread this is on NHS - but I won't pursue it on here as off topic - maybe you might like to start a new thread as it is interesting?

Izetta - have you had any more thoughts about what to do in the light of our comments?

Hurdity x