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Dealing with Perimenopause

by Bobby
(Gainesville, Fl USA)

Hi Wray

I am 46 and started with severe symptoms a year ago. Anxiety, insomnia, skin rashes, tinnitus, sore muscles, depression and the list goes on. I realize now I have been estrogen dominant since my 20's. I had benign breast fibroedenomas, heavy periods, 3 miscarriages, stubborn belly fat though thin, a period of cyclical headaches, ovulatiion pain, morning sickness during my pregnancies. 7 months ago my dr put me on compounded bio identical progesterone. At only 50 mg a day it initially caused severe ed symptoms which I was not warned about. I quit immediately. At my drs request I started up again and at 100 mg a day. This seemed to help for several months but was always still edgy especially before periods and spotting for many days before. Then I got a terrible case of flu and all hell broke loose. Severe anxiety and insomnia, nausea, dizziness, depression etc. My dr confirmed estrogen dominance again but has not raised my dose. I have taken it upon myself to add Natpro and am using 400-500 mg a day in addition to my 100 mg from dr. It has been about 2 weeks now and I have had severe wake up so far- sore breasts, insomnia, anxiey, nausea, dzziness and skin issues. My sleep is getting a bit better and breasts are not as sore. My period is due today but had not started. I plan to use through my cycles at this point because I always feel bad when I stop for my period. I know I need to persist with the cream as I am still feeling anxious and tinnitus shoulder neck tension is awful.


Warmly


Bobby

Comments for Dealing with Perimenopause

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Feb 04, 2013
 Dealing with Perimenopause
by: Wray

Hi Bobby Peri-menopause is such a difficult time, I found it most awful. I was very stressed too, so it only made matters worse. I would agree with you, looking through your symptoms, that you were very low in progesterone. We have a few pages which cover some of them, see Breast Cysts, Breast Tenderness, Menstruation, Pregnancy, Anxiety and Migraines. Belly fat is caused by excess testosterone, see here and here. In fact high testosterone in a woman can cause severe PMS. Luckily high amounts of progesterone does suppress it. If bound to SHBG (sex hormone binding globulin) testosterone becomes inactive, progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone and severe PMS. You are lucky to have found a doctor who recognised Oestrogen Dominance, but 50mg/day with all those symptoms of yours would have made matters far worse. I don't blame you for quitting! Very pleased you've upped the amount, and that it is helping slightly, it does take time unfortunately. Thanks for trying the Natpro. Please rub some of the cream on your breasts, I've found this helps. It can upset the cycle but it does settle back in time. I would recommend using it daily as you say you will. Stopping allows oestrogen to rise again. Often 2-3 months is sufficient time, but it can take longer. It always depends on the severity of symptoms and how many there are, you have many! With the amount you're using you might find you don't bleed at all, as I've found 400mg/day and higher does stop it. Continued below
Feb 04, 2013
 Dealing with Perimenopause Part 2
by: Wray

Hi Bobby Please have a vitamin D test done. A lack of this reduces the benefits of progesterone, see here, here and here. Vitamin D is cheaper than progesterone, so getting levels up high, generally means less progesterone is needed. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Blood levels should be 70-100ng/ml (175-250nmol/L) and not the 30ng/ml (75nmol/L) most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although recent research indicates it should be 10,000iu's per day, see here. Let me know how you get on. Take care Wray
Feb 05, 2013
 Vit D
by: Bobby

Hi Wray

My dr actually put me on a loading dose of Vitamin D a month ago for 3 days at 50,000 units, then I was taking 10,000 units for 2 weeks and now 5,000 units daily. Last time my levels were tested my levels were 53 (last April). Too low. Hopefully my levels will come up now. I live in Florida.

Warmly

Bobby
Feb 06, 2013
 Vit D
by: Wray

Hi Bobby Well that delights me! Evidently a doctor who's read the vitamin D papers coming out. Over 3600 were published in 2012. Let me know how you get on. Take care Wray
Feb 07, 2013
 Iodine reverse T3 T4 ratio
by: Bobby

Hi Wray

After 2 weeks at a high dose 500-600 mg a day I got a very light spotty period or it is so far. I have a question about iodine as I believe I may be lacking as my breasts still hurt especially under the armpit area. I had to come off Klonopin last year and have been off 7 months but the withdrawal period has been tough and my sleep returned for a bit, but this last month I had the flu and everything went out, my sleep, my cycle etc. My thyroid was tested several months ago and was normal but further testing of my reverse T3 T4 showed my ratio was way off. My dr opted not to treat it as he was afraid to agitate me any further as I am highly sensitive. I have been cautioned about iodine as others that have withdrew from Klonopin had bad experiences saying it wrecked their sleep for a long time. I can't afford to lose more sleep. I am also anemic my number I 11.1. I am taking iron citrate 25 milligrams to help with this for about a month now. One last question. How long do you need to wait after putting progesterone cream on before you can shower or swim? Thanks

Warmly

Bobby
Feb 09, 2013
 Iodine reverse T3 T4 ratio
by: Wray

Hi Bobby I'm sorry they gave you Klonopin, all benzos should be banned. I learnt from a friend how bad they can be, the damage they do, and the almost impossible task withdrawing from them. She sent me this paper here. Flu would have added huge stress to an already stressed body. It's evident your vitamin D needs to come up further, it's vital for healthy lungs, see here, here, here, and here. It could be you do need iodine for your breasts, and you say your thyroid results were way off, this needs iodine too. I have no experience with iodine and benzos, I have to take your word for it. You could try using it topically and see if that's better. I use Lugol's solution, 3 drops on my arm and rub it in with the dropper or finger tip. Or you could try adding seaweed to your diet, i.e. miso soup with wakame, or nori wraps. Progesterone is absorbed within minutes after applying it. But I suggest you apply it after the shower or swim. It goes i better when the skin is warm. Take care Wray
Feb 11, 2013
 Bleeding
by: Bobby

Fearfear Wray
I have been using a high dose for at least two weeks now 500-600 mg and am having cramping and a period though not heavy for over a week now. I thought amounts 400 mg or more stopped periods or am I just so deficient that even more is needed? I use about 300 mg before bed and in the morning and put more on during the day as well. Should I use even more? My sleep is a bit better but still not where it should be and my tinnitus is horrible. Thanks

Warmly


Bobby
Feb 12, 2013
 Bleeding
by: Wray

Hi Bobby Some women do respond to 400mg/day, but I have found others need far higher, evidently you do. The first time I heard progesterone stopped heavy bleeding or periods, was from a woman who wrote into the site. Her doctor had her on 900mg/day and she wanted to know if it was safe. I told her it was, but because her continual bleeding had stopped completely, to try reducing slowly to 600mg. She did, then down to 400mg, it was only when she was using this amount that her period came back, and it was normal to her relief. I feel it would be better to add 2000mg/day NAC (N-acetyl cysteine) and 2000mg/day taurine to your protocol, rather than increase the progesterone. Both these stop dysfunctional bleeding, see here. And our page on Menstruation for more info about NAC. I always ask people to take high amounts of vitamin D too, but you say your level is fine now. Remember you haven't been using progesterone for long now, 4 weeks at the high amount if I've calculated correctly. It can take 3-6 months to come right. You could try taking 4000mg/day inositol as that sometimes helps sleep. I wish I had something to tell you about the tinnitus, but I've found nothing that helps, and a complete absence of any reason why it should occur. It seems to baffle everyone. I have it very mildly so doesn't affect me. I do wonder if it could be caused by clenched teeth, which I do at night. And the tension sets up the noise. Let me know how you get one. Take care Wray
Feb 13, 2013
 Bleeding continued
by: Bobby

Dear Wray

My bleeding continues though not heavy now for about 9 days.
I take a large amount of glutathione builder which is whey protein and contains zinc, selenium, vitamin D, B-12 and B-6. I get 5,000-6,000 units of D alone in this plus I take 5,000 units in a capsule. I may try inositol though my sleep is getting a bit better. My acupuncturist has done a treatment that is supposed to stop bleeding but that was yesterday and so far I still am, however the cramping is much less today. I guess I will need to persist at the high amount 600 + mg a day until things finally balance. It is scary all you read about the effects of too much progesterone. My dr believes even with cream we only absorb half. He seems right. My tinnitus is loud unfortunately. I sleep with a sound soother. I have had it for a year now.

Warmly

Bobby
Feb 15, 2013
 Bleeding continued
by: Wray

Hi Bobby Please add those nutrients I suggested, they really do help. You might like to read this comment about it, see here. Otherwise it will be necessary to increase the progesterone, see here. The nutrients are far cheaper, plus they are powerful antioxidants needed to inhibit the inflammation. I'm still trying to find out from the people who tell me excess progesterone has adverse side affects what they are. So far no one has told me! The blog sites do a disservice, as I believe people are getting confused by oestrogen side effects. They give over 1200mg/day via IV transfusion to people in comas due to a Traumatic Brain Injury. None of them had bad side effects, only good, they recovered. Dr Dalton would give up to 2400mg/day to her patients with post natal psychosis, with only good results. Finally a recent study to come out of the TBI studies found even with exceptionally high amounts, there were no toxic side affects, only good, see here. A customer recently sent in this paper here. Although about epilepsy, it shows how much damage oestrogen can do if in excess. Your doctor might be right about only absorbing half the progesterone, it really depends on the carrier used for it. We've found the progesterone in Natpro is absorbed very well from Saliva Tests we run. Please consider taking those two nutrients. Take care Wray
Feb 16, 2013
 NAC
by: Bobby

Dear Wray

I am not willing to take NAC. Please read.

N-Acetyl-Cysteine (NAC)
N-Acetyl Cysteine (NAC) is a synthetic version of Cysteine that is rapidly converted to the amino acid Cysteine. NAC supplements are moderately effective, but dosing is limited due to the toxic side effects (such as headaches, dizziness, blurred vision) associated with Cysteine Supplementation. NAC decreases Zinc, so supplementing with additional zinc and copper is recommended along with Vitamin C to prevent the Cysteine from converting to Cysteine, which can form kidney and bladder stones.

Recent Study on NAC:
According to recent research at The University of Virginia, N-Acetyl-Cysteine forms a red blood cell derived molecule that makes blood vessels think they are not getting enough oxygen. This leads to pulmonary arterial hypertension (PAH), a serious condition characterized by high blood pressure in the arteries that carry blood to the lungs. The results appeared in the September 2009 issue of the Journal of Clinical Investigation.


Have you anything to dispute this info?

Warmly

Bobby
Feb 17, 2013
 NAC
by: Wray

Hi Bobby This must be the paper you are referring to here. I'll reserve judgement on it until they've done human trials. Although I dislike the use of animals in trials, they have proved life saving for humans. Is it a price worth paying, I don't know. As in many trials, the affect of a substance in humans can vary from the animal trial. In the meantime it hasn't stopped the use of NAC for oxidative stress conditions ranging from A to T, it could be down to Z, but I haven't found those. NAC is better absorbed than cysteine itself, hence it's use. I take it daily, up to 3000mg/day and have never experienced any 'toxic' side affects! I'm very aware of a zinc deficiency as I get the tell tale white spots on my finger nails, I have none now. And the 'prevent the Cysteine from converting to Cysteine', presumably that's meant to read 'cystine'? Cystine kidney stones are rare and occur in people with cystinuria, the treatment seems simple enough, see here. Although cystinuria is not treatable, being a genetic disease. There are thousands of studies on NAC, and evidently the researchers, doctors and hospitals who use it will continue to do so. So will I! I don't dispute anything, I give papers to people to make up their own minds. Certainly the women with heavy bleeding have been helped by it, the choice is theirs not mine. You could log on to PubMed and have a look for yourself, see here. This is one of the latest studies they have, on it's use in psychiatry of all things, see here. Thanks to you I've now saved it on my computer and will give it to anyone who has depression. Plus "...disorders including cocaine, cannabis, and smoking addictions, Alzheimer's and Parkinson's diseases, autism, compulsive and grooming disorders, schizophrenia, depression, and bipolar disorder." Pubmed lists 120 papers on depression alone, 33 on schizophrenia, 30 on bi-polar, 2157 on cancer, 940 on acetaminophen poisoning (it's the best antidote there is), with a total of 13776 studies. 94 of which were published this year. I'm happy with it's safety, and it's efficacy too, it seems others are too and don't find it only 'moderately effective'. Take care Wray
Feb 18, 2013
 NAC
by: Joy

I also take NAC daily with NO side effects.

It is such a pity that people do not research matters as well as you do Wray. I wonder how many people actually read the material that you provide them to back things up?
Feb 18, 2013
 I also take NAC daily with NO side effects.
by: Wray

Hi Joy Bless you for your support. Glad to hear you're not having adverse side affects from taking NAC. Hypertension is worrying, but my blood pressure is still low, and that's after years of taking it. So it could be rats react differently to NAC than humans? Take care Wray
Feb 18, 2013
 Thank you!
by: Bobby

Dear Wray
Thank you for getting back to me in great detail on this NaC. I will read all the info you have sent. It seems there is a lot of bad info on NAC just like all the misinformation on progesterone, which it still astonishes me that this is the only website promoting high amounts of progesterone. If I hadn't found you I would still be using too little or worse non at all. Last night I couldn't fall asleep and just kept putting a little more cream on, eventually it worked. I have to tell you I am using close to 1000mg a day and my bleeding has not stopped. Could it be the progesterone is cleaning things out?
I'm puzzled.

Warmly

Bobby
Feb 19, 2013
 Blood Test
by: Bobby

Dear Wray

After a month on Natpro my test came back Estrogen 135. Progesterone 7. My body is not absorbing the progesterone cream. Dr wants me on a oral pill of 200 mg at night. I know I will hardly get any of it, but what can I do? Why am I not absorbing the cream? I was using high amounts of 600 or more. Am even using vaginally at night as you suggested.
Please help.

Warmly

Bobby
Feb 19, 2013
 Thank you!
by: Wray

Hi Bobby Glad the info was of help. Yes plenty of misinformation about too many things, I did a page on Progesterone Misconceptions, my view of course. You have to do so much sifting to find the truth, very time consuming. Luckily I have the time, well try to, as it's imperative I give the right info to people. The internet is a wonderful resource, especially PubMed, brilliant site that. It's quite possible ours is the only site suggesting high amounts, as I met Dr Dalton who advocated them. I had read all Dr Lee's books too, and others that came out around 15 years ago. But I understood why Dr Dalton used such high amounts, she had patients who needed it. If the amount we made in the luteal phase, i.e. 5-20ng/ml, up to 40ng/ml some papers say, was sufficient, then why supplement? Evidently it isn't. Bleeding is explained on our Menstruation page. It isn't only a case of increasing progesterone ad infinitum, that does suppress oestrogen and the MMPs which break the lining down. But if taurine is low, dysfunctional bleeding will occur, so that needs to be added too. And of course the NAC inhibits the MMPs, so stops them breaking the lining down. And finally vitamin D levels need to be high. All three of the above, progesterone too, are powerful anti-inflammatories and antioxidants. I might, with further research, find other nutrients which help. I only found the info on taurine about a year ago. So please read the papers on NAC, and hopefully they will convince you to try it. And ale the taurine, and of course the vitamin D. Take care Wray
Feb 22, 2013
 Blood Test
by: Wray

Hi Bobby Has it occurred to your doctor that you might be using it all up! You have a huge list of symptoms that all need to be addressed. I've found it can take 3 to 6 months for this to occur. As you say oral progesterone is mostly lost......."The liver and gut region removed a mean of 96 per cent of the progesterone entering these tissues" see here. There are many things which cause progesterone to drop too. Please look through the list and see if there are any which could be affecting you. These are some of them........

lack of or drop in vitamin D.... are you taking it, or missed a dose, or spent a lot of time indoors?
dark days.... especially winter, probably because vitamin D drops in winter due to lack of sun
high oestrogen.... aromatase, which converts testosterone into oestrogen, is working over time, or SHBG (sex hormone binding globulin) is low, this binds oestrogen making it inactive
high testosterone.... SHBG is low, this binds testosterone making it inactive. Sugars drop SHBG, they also drop progesterone levels
high LH.... the pituitary is working over time trying to make an egg develop, secrete testosterone and oestrogen, and then ovulate
high FSH....the pituitary is working over time trying to make an egg develop, secrete testosterone and oestrogen, and then ovulate
high stress...... this converts most of the available progesterone into cortisol
high adrenaline (comes from stress or excitement, and a drop in blood glucose)..... this stops progesterone entering the cells
sugars of any kind.... they drop progesterone, plus dropping blood glucose, plus dropping SHBG
large meals..... because of the increased metabolic clearance of progesterone
alcohol.... this reduces progesterone levels and increases the androgens, ie testosterone
insulin.... increase caused by eating large meals, sugars, or meals containing sugar or starchy carbs
high level of phytoestrogens in the diet.... ie grains and legumes, soy milk, tofu etc these all act as oestrogen
oestrogenic herbs.... often given to women to help with symptoms

Have you noticed any change in how you feel, as that's the best barometer. Although a month is too soon to my mind to see any. Take care Wray
Feb 22, 2013
 oral progesterone
by: Bobby

Dear Wray

I am getting 10,000 units D a day currently. I am pretty careful about estrogen in my diet what about flaxseed?
good or bad? I eat fermeted cabbage, take digestive enzymes, probiotics, only drink spring water or filtered, no caffeine, no sugar exccept manuka honey and fruit. I take hig quality supplements, 400 iu E, coq10,raw vitamin c, raw vitaminvB-12, high quality pure fish oil, bovine adrenal support, glutathione buiider and take epsom salt baths every night, i also take tart cherry for sleep. I am just starting to drink bone broth also. I should mention I had
7 nercury amalgrams replaced 4 months ago and I am sure have some toxicity.

My dr ordered me off all progesterone for 5 days. It is day 2 and Im no worse off. Actually bleeding seens to be lessenning. By the way I had him muscle test me with Natpro and he said it was good. So when I start on oral progesterone in 3 days, I plan on using the cream too, since ill be lucky to get 20 mg from 200 mg. However it might help me sleep.

Warmly

Bobby
Feb 24, 2013
 oral progesterone
by: Wray

Hi Bobby All oils contain phytoestrogens, in fact all plants do, so does meat. It's unavoidable. The lignans in flax contain the highest level. The three most active phytoestrogens are....isoflavones (daidzein, genistein, formononetin, biochanin A and glycitein), lignans (enterodiol and enterolactone) and coumestans (coumestrol, trifoliol). Daidzein is found primarily in legumes. Genistein is found primarily in legumes, ie lupin, broad beans, kudzu, with soybeans having the highest content. Formononetin is found in red clover, black cohosh, lima beans, mung beans, clover and alfalfa sprouts. Lignans are polyphenols found notably in linseed (flax) and sesame seeds. Also cereal brans, kale, broccoli, brussels sprouts and cabbage. Lignans are converted to enterodiol and enterolactone by bacteria that live in the intestine, these have weak oestrogenic activity. Coumestrol belongs to a group of phytochemicals known as coumestans. It is found in lima beans, pinto beans, split peas, clover, soy and alfalfa sprouts. Alfalfa and clover sprouts are the foods with the highest amounts of coumestans. There is a further mycoestrogen called zearalenone. It's a potent oestrogenic metabolite produced by some moulds such as Giberella and Fusarium. Zearalenone is a mycotoxin causing infertility and abortion in animals, especially pigs. It is heat-stable and found worldwide in grains such as maize, barley, oats, wheat, rice, sorghum and bread. The following papers list the phytoestrogen content of foods, with seeds, legumes and grains having the highest content, see here. Even foods of animal origin contain them, see here. Fermented foods are excellent, as are all the other nutrients you take. I'm delighted to hear the muscle testing was positive, others have tested it and found it so. Let me know how you get on. Take care Wray
Mar 15, 2013
 Grateful to have found you!
by: Jayne

Hi Wray. I have all the symptoms of oestrogen dominance. I have fibroids, ovarian cyst and multiple complex. breasted cysts. I was having extreme Pms and horrid bleeding plus terrible on and off depression with suicidal thoughts. My joints were in agony. Knees and elbows! Plus a reacurring rash in the same area. Insomnia and heart palpitations big time. I honestly thought I was losing it. I am a person who exercises every day and eats pretty healthy. I was giving up until progesterone! As most others I followed low dose directions had relief at first and then it all came Back of course until I found you a few days ago. So now I am going for 200 a day and will see how it goes. Desperate to be me again! Thank you for sharing all your experience and information!
Mar 16, 2013
 Grateful to have found you!
by: Wray

Hi Jayne I'm delighted you've opted for the higher amount, do let me know how you get on. But if you have horrid bleeding you will need about 400mg/day. If I read the 'horrid' to mean heavy. Extreme PMS can be caused by high testosterone. If bound to SHBG (sex hormone binding globulin) testosterone becomes inactive, progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone and severe PMS. We do have pages on Fibroids, Ovarian Cysts and Breast Cysts. If you have fibroids, please have a vitamin D test done. There's evidence a lack causes them, it certainly shrinks them if you get your level up high, see here, here, here and here. Plus a lack of vitamin D reduces the benefits of progesterone. Take care Wray
Jul 14, 2017
 Perimenopause
by: Anonymous

I am taking 175 of progesterone trogue and I am bleeding light, off and on throughout the month.

This week I have terrible cramps, not sleeping. Naturopath has me not taking on day 28 of cycle for three days.

The difficulty is my cycles fluctuate, like this month I stopped on day 22 because I started spotting on day 19... is this normal?
Jul 21, 2017
 Perimenopause
by: Joy

I am afraid that you are experiencing problems because troches are not the best delivery method as 50% is being destroyed by the gut and liver. Please consider switching to a good organic progesterone cream such as Natpro. It should be used for 2-6 months every day before positive signs are felt. It is advisable that when in peri-menopause to continue using the cream every day. If you read the posts by Wray, she explains what is needed but please read How to use Progesterone Cream

What is your Vitamin D3 level? This will also have an affect, if deficient it reduces the benefits of progesterone making it vital. Co-factors are also needed.

Please read this thread, especially those posted by Wray and read these pages and the study reference papers.

Estrogen Dominance - https://www.progesteronetherapy.com/estrogen-dominance.html#axzz3fNOYF0aj

How to use Progesterone Cream - https://www.progesteronetherapy.com/how-to-use-progesterone-cream.html#axzz2mglwLvMr

Peri-Menopause - https://www.progesteronetherapy.com/peri-menopause.html#sthash.QEwaZB9G.dpbs

Delivery Methods - https://www.progesteronetherapy.com/progesterone-application-methods.html#axzz2cxfbj1W9

Vitamin D3 - http://www.progesterone-info.com/benefits-of-vitamin-d.html

Magnesium - http://www.progesterone-info.com/magnesium.html
Jul 21, 2017
 Feeling better
by: Anonymous

My progesterone troche was increased to 250mg with 3mg testosterone added to it because it was low, when taken on my 19th day of cycle it was 13 and my estrogen was still high.

Is it normal to be off balance for a few months until adjustments are working? I came off birth control in April and started bioidentical. Feeling better but assuming will take a few months to feel great?

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