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[Marchlove]

Progesterone- Friend or Foe

https://www.sciencedirect.com/science/article/pii/S0091302220300479

[Perinowpost]

Interesting article. It depends on your own individual response/biochemistry of course, but for me it is definitely foe. I have recently given myself a 3 month break from progesterone (back on it now 😔), and it’s the best 3 months I’ve had in a long time x

[Marchlove]

Hi All

I know a lot of ladies on this thread are taking or trialing compounded but I was wondering if you would be able to support Postmeno3’s thread called, I think, ‘HRT shortages, an action plan for MM?’
You just have to post YES in the thread
x

[Mary G]

Marchlove, thanks for the link, it was very technical but it certainly explains why so many women have problems and I think it might also be the reason so many of us start having migraines.

Re progesterone, I would say it depends on the type ie natural or synthetic, the dose and whether or not you were progesterone intolerant pre menopause.

I think the reason why so many women struggle with it (particularly Utrogestan) is because they are overloaded with it.   100mg in one hit is far too much for most women.   

Am I eligible to support Postmeno's petition?   I don't live in the UK, I was struck off the NHS and as of two years ago, I am no longer British! 

[Marchlove]

Yes far too much in one bit to be sure!

I don’t think it matters if you technically aren’t British as it’s a MM letter/petition and you’re definitely a member of MM! X

[Mary G]

For Lisa_Oz.

[Lisa_Oz]

Thank you, Mary. I am meeting for a follow up appointment with the clinic tomorrow before I start my prescription because I have so many questions and do not want my mood to get worse. Originally, she advised trying Utrogestan 100 vaginally for at least 7 days a month if I wanted to stick to traditional NHS meds. I made it to 4 days and had to stop. Felt so low it was scary.

I’ve been on Oestrogel for 2 1/2 weeks now 1 pump.

My new prescription is
Estradiol 0.25mg/ Progesterone 25mg per 0.3mL dose cream in HH base x 50mL   1 pump twice a day
Testosterone 0.5mg per 0.3mL dose cream in HH base x 30mL 1 pump a day

I don’t know the equivalence of the Estradiol amount to the 1 pump Oestrogen. I would like to keep it the same amount for now. I probably should have asked for progesterone only cream but my mind is not good right now.

Also, I don’t want to add Testosterone right away because I am soooo sensitive to everything.  Plus, my understanding is that you only add testosterone after you have the correct dose of estrogen. 

If this works…oh how I need it to work…I am ok with having regular scans to check my uterus.

I am also due to meet with my GP Monday about my low mood. I’m on a new antidepressant, vortioxetine,  prescribed by a psychiatrist since May. Originally seemed ok but I’m so much worse now. Hard to separate hormones from my clinical depression which I’ve had for 20 years. But I think I want to go back to sertraline.  I was good on that for years but I was also on bupropion at the same time. In 2020, it became unavailable in the UK (I’m American, moved here 5 years ago). I’m actually willing to get it filled in the US when I visit my family. Nothing is easy these days! But even so, when I was on sertraline on its own, I seemed better. Now I can barely function.  Anxiety and depression at it’s worst. Again, not sure what is caused by hormones and what is caused by the antidepressant.

 I have tried with him and others at the practice to find other forms of progesterone that I can tolerate. Their only suggestion is Mirena. Mirena terrifies me. If it made my mood lower, I could not cope. I’m barely hanging on now.

[Marchlove]

Hi Lisa

I’m sorry to hear how miserable you are feeling, my heart goes out to you as I was also in a dreadful place mentally.

I’ve not posted on this thread for awhile, I’ve been meaning to but as I still have some ongoing physical issues I’ve delayed doing so. The physical issues I believe are primarily thyroid related so are not really relevant to this thread, so I should have posted before.

I’ve finally settled, 90% I’d say, on the following-
Compounded Biest cream which is 1mg Estriol and the same as you 0.25mg Estradiol.
However I only use this once a day in the morning.
Compounded progesterone cream 30mg which I also use once a day in the morning.
I do not use testosterone anymore as it made me too irritable but use oral Dhea 5mg and Pregnenolone 20mg, both of which I use once a day in the morning. You should not use Dhea without having had a cortisol/Dhea saliva test.
Regular scans.

Like you I would be interested to know how 0.25mg estrogen cream equates to one pump of estradiol?
But I believe it is a lot lower, it certainly feels so.

I have a comt gene mutation, which is fairly common. What this means essentially is it that estrogen causes me anxiety in anything but low doses.

As far as mood goes I eventually managed to wean myself of AD’s and I now take otc Lithium Orotate 5mg, one with breakfast and one at lunchtime. This has been an absolute life saver for me but unfortunately you should not take it with AD’s.
Looking back I probably could have introduced it sooner when I had got myself onto a very low dose of AD, but at the time lithium orotate hadn’t come into my radar so this wasn’t an option.

Yes as you say it probably would have been better to have the E and P separately but I wouldn’t get overly stressed about it right now.

It might be a good idea however to just start with one pump of the combined cream in the morning for a few months before you increase. Don’t expect to feel better straight way but hang on in there and you’ll win through.

All in all Lisa, I think you have made a good choice for yourself going forward and I wish you every success.

Sending you hugs

M x

[Lisa_Oz]

Thank you Mary. Your comments help and I am happy you have found what works.  I have some questions for you that I will post when I’m feeling better. Went to the gym in the hopes it would help but it hasn’t.

I did get my period last night. It’s gone now but still have cramps. That might explain my especially low mood this week.

I really appreciate you taking the time to post xxx

[Mary G]

Lisa, low oestrogen levels affect serotonin levels hence the reason so many women need ADs as well as hormones to feel good. 

Low serotonin levels have different manifestations in different people and with me it was the main cause of my silent migraines along with wildly fluctuating hormones and too high a dose of progesterone.  In others, it causes crippling anxiety and depression.

Have you tried amitriptyline?  I think it's popular in the US.  For me it's a wonder drug and not only has it helped to prevent my migraines, it has improved my gut health.  It's a TCA that simply makes more serotonin available in the brain. 

If you don't feel confident about trying something new, then stick to what you know works well for you.

I would give the cream a fair crack but be prepared to increase the oestrogen component.   You have regular scans so you can afford to play around with dosage.  Holding off on testosterone for now is a good idea.

Finding the right combination of meds is really miserable and takes time but when you do finally get there it's worth it.

Marchlove, I'm so pleased you are doing well now.

[Mary G]

For Rollergirl.

[Rollergirl]

Thank you 

[Mary G]

For Anonymous1.

[Penguin]

For Anonymous1.

Hi, I am wondering what country you are in, is it Spain? Are you working with a specialist at all and, if so, would you be willing to DM me their name please? I'm looking at alternative options to estrogel/utrogestan at the moment and willing to travel (within Europe) to find the right person to help me as I am now really desperate. Thanks in advance 🙏

[Mary G]

Penguin, I will send you a PM.