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A few questions regarding NAC, and endometrial lining and Aygestin

by Shalny
(NY, USA)

1. I've been taking NAC 1000 mg 2x a day as recommended for heavy periods. I understand that it inhibits MMPs which are responsible for the breakdown of endometrial lining. What I don't understand is if the lining is prevented from fully breaking down, what happens to it? Won't it have to be shed eventually? Won't it keep building each subsequent period?
2. My dr. said that she believed my excessive bleeding was mainly due to my lining being out of phase. What does that mean exactly? I can't seem to find much when I google it.
3. She wanted to put me on Aygestin to control the bleeding and get my lining back in phase. When I asked about bioidentical progesterone she said it wasn't strong enough. It was 10 mg 2x a day by mouth. Everything I read on this site says topical is stronger than oral, so how can the aygestin be stronger?

The reason I'm not asking my dr. these questions is because I went against her orders and bought Natpro instead of filling her prescription. I understand how busy you guys are and how many questions you get, but I'd really appreciate hearing your insight when you get a chance. And I'd love to hear from anyone else that has experience with this. Thanks so much for educating us and giving us a natural option.

Comments for A few questions regarding NAC, and endometrial lining and Aygestin

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Aug 20, 2015
 Similar Question
by: Anonymous

I too have a lining that is too thick. My paps were normal and the year before I had a biopsy of the lining which was also normal. My new doctor wanted to do another biopsy. I did not take his suggestion, but instead stopped the bio identical hormones I was taking and started progesterone therapy as outlined on this site. I presently take about 600 mg daily and have been at it for one year. I too would like to know if I am suppose to see any evidence of this lining shedding or does your body simply absorb it. Haven't found anyone that knows that answer. Anybody??
Nov 20, 2024
 Where does unscheduled lining go and bioidentical P too weak to stop heavy bleeding?
by: Anonymous

I realize this is old, but I would love to know the answer. I was told similar info at my Gyn appt yesterday about bioidentical progesterone not being strong enough and I have considered the heavy bleeding protocol for next month because I lose 700ml in 2 days. I was wondering what happens to the lining if I slow or stop the shedding. Thanks!
Nov 22, 2024
 Where does unscheduled lining go and bioidentical P too weak to stop heavy bleeding?
by: Joy

Hi there

With all due respect to your Gyn, that is incorrect. Please ask your Gyn to provide research backing this up. Perhaps he/she needs to do some serious research. My guess is that he/she is pushing for surgery. Please consider trying the heavy bleeding protocol it has helped countless women if used correctly. I wouldn't wait for next month either, start now and use it every day with no breaks at all. You do have to get your bleeding under control as it could lead to anemia.

You do not state your age but I assume you are in Peri-Menopause. It can be a torrid time for most women. Please read the How to use Progesterone Cream and Estrogen Dominance pages.

Progesterone therapy will clear the lining of the uterus. The lining is a build-up of excess estrogen. Many doctors suggest a D and C. This is unnecessary, progesterone does the job with no evasive surgery or side effects.
Nov 23, 2024
 My background and lots more questions. :)
by: Anonymous

Thank you so much for your response! I would like to give you my background and whole picture so far. You are right that I'm I am almost 49 and perimenopausal. I have suffered with heavy periods for 8 years, but the last 3 months have increased by 40%. I have spotted a good amount on day 16 during the last 2 months. Yes, I have suffered anemia. I had to have an iron infusion in June and I agree this needs to stop! :) The infusion still left my ferritin low and I'm supplementing iron 2x/day. I will have my iron levels re-checked next month.

I chose this gyn office because womwn rave about their BHRT treatment and I was hoping to get my therapy partially covered by insurance. I was hoping the prescription would be more concentrated to reduce the amount I need to apply. I tried progesterone cream and sublingual oil about 3 years ago on my own, but I found it cumbersome to try to rub in so much cream every day. It did reduce my periods some, but I somehow didn't see the heavy bleeding protocol and was doing only the P without the supplements. I gave up applying the cream after forgetting and here we are. I also do have a fairly stressful lifestyle with 4 children - my husband is a firefighter paramedic who is gone for 48 out of every 72 hrs... so I do it all for the family while hes away, plus I work. I realize that the stress/sleep deprivation probably raises my cortisol, usurping my P. At the onset of the heavy periods, I saw 2 Dr's who dismissed my symptoms and told me to either do Mirena or The Pill, an ablation or a hysterectomy. I didn't like that answer and haven't been to a dr for this in the 8 yrs since! But I can't live this way. I miss work, and can hardly leave the house for those 2 heavy days!

4 days ago i had a consult with the BHRT gyn and she was appalled that no one did at least an ultrasound 8 years ago. She did a vaginal ultrasound and on day 21, my endometrium measured 17.75. I also had a 1.8cm simple cyst on one ovary and a 2.4cm complex cyst on the other one. She gave me a saliva test kit to take on my next day 19. So, i feel hesitant to start the protocol with progesterone before day 19 of next cycle in case it throws off my test? Would it?

They did an endometrial biopsy yesterday to verify whether it is simple hyperplasia or more before starting progesterone. My blood test for ovarian cancer markers came back very low (13). She says she would recommend D and C only if there are abnormal cells found in the biopsy, for further study of my endometrium, or medical D and C using 10 day course of progestin depending on the results. It sounded to me like she wants to clear the lining for a "clean slate" and then start progesterone based on the results of my saliva test. I clarified that the progestin suggested would be only for 10 days and after shedding my lining and looking at my saliva test results, she would prescribe bioidentical progesterone. The thing is, she told me she almost never prescribes long term p4ogestin, but in the next sentence she told me the Mirena is very effective at treating endometrial hyperplasia!

What I'm hearing is that she wants to try to help me shed the lining and start from scratch and then start P and monitor the thickness with ultrasounds from there. I have a followup ultrasound scheduled in 6 weeks. She did not seem as focused on hysterectomy this time - she just expressed concern for my quality of life and stress levels while waiting for menopause since we don't know how many more years I will be dealing with this while I wait.

I guess my questions are, does her recommendation sound reasonable? If I do heavy bleeding protocol now and take every day, will it skew my saliva test results? Dont i need a baseline to refer to? Can I do a 10 day course of bioidentical P instead of progestin and bring the same result? If so, how much per day? Would using progestin for 10 days be detrimental or how bad can the effects be - would it affect the efficacy of bioidentical P used afterward? Is this just a matter of the gyn being impatient?

I found one study about 100mg vaginal micronized P P used day 10-25 significantly regressing endometrial hyperplasia over 3 months. But it is from 1994. Do you know of more recent studies that I could present to her? If you have read all of this, THANK YOU from the bottom of my heart!
Nov 24, 2024
 My background and lots more questions
by: Joy

It makes me sad to read stories such as yours. Why doctors refuse to acknowledge the benefits of progesterone is beyond me. That is way too long to be suffering from heavy bleeding. I am shocked at the treatment that you have been given. How could those doctors dismiss your symptoms like that? Your bleeding will intensify during peri-menopause. May I suggest that you try grass-feed ox liver capsules? They are brilliant and do not cause constipation etc like other iron supplements.

If you find topical progesterone cumbersome, try suppositories. I do recommend the heavy bleeding protocol sooner rather than later. If not followed as stated you will be wasting your time. Once you have your tests back, please share them here. The test should be done approximately 7 days after ovulation or before bleeding. A bit difficult if one does not have a regular cycle. You can also compare your tests on the Hormone Testing page. Stress is a killer. Not only does it reduce the benefits of progesterone, but also vital nutrients. Your adrenals are also taking strain which will affect cortisol levels. Please consider trying the adrenal fatigue cocktail. Progesterone is a calming hormone so it will help cortisol levels.

Adrenal Fatigue Cocktail
* 125ml Orange Juice or *Grapefruit Juice, you are looking for vitamin C
* 1/4 teaspoon Celtic Sea Salt or pink Himalayan
* 1/4 teaspoon Cream of Tartar

Mix the above at the start of the day with enough liquid for two (2) applications i.e. 8oz/125ml of orange juice. Drink it mid-morning, as well as mid-afternoon. In addition, any time that you are feeling particularly anxious it would be advisable to prepare another mixture and take it.

All drug-based Contraceptives have the potential to cause harm. Were the side effects of the Mirena discussed with you? It is a dreadful device. I had the ablation before I knew about the benefits of progesterone. Had I known then, I wouldn't have had it. Please do some research on hysterectomies see here. You might also like to read the page on Ovarian Cysts and see how progesterone is beneficial.

As mentioned in my previous post, progesterone will shed the lining. Your doctor seems a little confused. She suggests the Mirena which is a progestin, then she says she doesn't prescribe long-term progestin. Well, that makes no sense. I do not believe that any woman needs to take extra estrogen. There are well over 100 estrogen mimics in our Environment as it is. Why take more? The Estrogen Dominance page explains most of the adverse symptoms.

Once we know your test results, a ratio can be worked out. Whilst each hormone result is important, it is the ratio between progesterone:estrogen that is important.

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