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Follicular Woes

by Katie
(Reno, NV)

Hi all! Ever since the birth of my son in 2010, I have had awful migraines that are most definitely connected to my cycle. I am 30 at the moment. I was 27 when my menstrual migraines started in a severe way. I have had migraines since puberty (age 16), but they got much much worse after I had a baby.

The migraines will typically begin a day or two before my period starts. This is how I know my period is coming because it is not super regular - One month it is 35 days, the next it is 28 days, the next it is 31 days, etc. My migraines include visual problems, fatigue, nausea, anxiety, confusion, and brain fog. They occur during my period and continue a week or two after my period. The last week or so of my cycle, I typically feel fantastic. I understand this is the polar opposite of what other women typically experience with PMS, so I haven't been able to find much via google about my specific problem. Usually women feel better during the follicular phase...I feel worse.

I have a short history with natural progesterone cream: I started using it at the advise of my mother-in-law earlier in the year. I used it every day all through the month twice a day. And it seemed to work! However I noted that my pants got significantly tighter - and it was not due to bad eating or lack of exercise. I panicked and I stopped using the cream. My symptoms returned with a vengeance. I experience migraine with aura for the first time, my skin broke out like a was 15 again, I felt terrible. I saw my primary doc who is open to natural treatments. He suggested I try the cream again for one week before my period applying only once at night to avoid any weight gain, for he thought maybe I had been using too much. I did that last month and it did not affect my symptoms. I experienced bad cramping, mood swings, migraines: the usual list of problems during the first part of my follicular phase.

I should add that last month I used some strips from the drug store to predict when my ovulation occurs. I figured it would be good information to have. It happened pretty late...about day 26 of a 35 day cycle (i have a tracker on my phone).

Using the cream only in the luteal phase seems counter intuitive to me. Especially since the luteal phase is when I seem to feel good anyway! If anybody out there has a similar issue: terrible symptoms in follicular phase...I would really appreciate any advice. I'm open to trying natural progesterone again. I've got a tube of Pro-gest in my medicine cabinet ready to go. I am concerned about weight gain - but if it is temporary, I can deal with it.

Thanks in advance,
Katie

Comments for Follicular Woes

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Sep 24, 2013
 Follicular Woes
by: Wray

Hi Katie We should feel good during the luteal phase, but if progesterone doesn't peak, or insufficient is produced, it will leave oestrogen dominant. These women will feel awful, usually during the last week of the luteal phase. At the end of the cycle, i.e. 2-3 days before bleeding, progesterone begins withdrawing. If this occurs too fast or it drops too low, PMS occurs, which causes many women to get PMS, this is what's happening with you too. Any amount of symptoms can occur, with you it's the Migraines, plus fatigue, nausea, Anxiety etc. But with the very short luteal phase you have, it's leaving you very short of progesterone. But evidently your oestrogen is remaining higher than normal. It's the ratio of the two which is significant, a high oestrogen to progesterone ratio causes all our symptoms. This paper here shows the length of the follicular phase in 6 women. It also shows the patterns of oestrogen during the follicular phase too. You'll notice in some it drops low which it should do, but in others it remains higher. A higher than normal oestrogen level in the follicular phase would explain why you feel so awful. With a short luteal phase, it means your follicular phase is very long. With the very long cycle you have some months, i.e. 35 days, this will make the follicular phase even longer. All this means you are producing excess oestrogen in ratio to progesterone. Has anyone checked you for PCOS? This could account for the very erratic cycle lengths you have. I would suggest using the progesterone throughout your cycle, even during bleeding, for 2-3 months, or until you feel stable. This will make progesterone the dominant hormone, which it should be. We run Saliva Tests which show the change in the ratios before and after using about 100mg/day. It might correct your cycle length too. I feel you will need at least 200mg/day, possibly more. This will be 12.5ml of the cream you have, or 2.5 metric teaspoons. Stopping progesterone cold turkey, or reducing too much, too quickly, allows oestrogen to rise. Continued below
Sep 24, 2013
 Follicular Woes Part 2
by: Wray

Hi Katie It's not surprising your symptoms returned. It should be used a minimum of twice a day too, as levels begin dropping after about 13 hours. The weight gain is caused by using too little progesterone, it will stimulate oestrogen. So although some symptoms are helped, some are worsened. Generally Oestrogen Dominance sets in at some point. We have two other pages you could look through, How to use progesterone cream and Menstruation. Please have a vitamin D test done too. Take care Wray
Sep 29, 2013
 trying therapy again
by: Katie

Wray, Thanks for taking the time to write such an in depth response. Its nice to have someone hear me and not shrug their shoulders like I'm crazy! I'm on my 8th day of using cream again. I'm at that point in my cycle where I normally feel good, so its tough to say if its helping. Time will tell. I'm currently smearing a little on throughout the day, probably every 3 to 4 hours. I'd estimate I'm using around 100 mg per day. At your advice I may up that to 200 mg. The thought of using a large amount doesn't scare me anymore as I've been weighing myself every day and no weight gain. That's what prompted me to stop the therapy in the first place. Fingers crossed for a pain free cycle next time around. I will keep you posted. 😊
Oct 02, 2013
 trying therapy again
by: Wray

Hi Katie A high amount of progesterone won't cause weight gain, it's the low amounts which do. But do let me know how you get on. Take care Wray
Oct 10, 2013
 wow
by: Katie

Hi there,

Just wanted to check in and share something. So I've kept the dose high, probably around 200mg throughout the day. I probably should measure...but I've just been eyeballing the amounts. I felt really good, all the way up until the start of my period. It started Tuesday morning. And it wasn't so bad. So I decided to take the advice of the instructions on the back of the protest container and stop usage for the duration of my period. I left my house sans cream and headed to work. I had home visits with clients that day. I made it through one visit and wound up in the WalMart parking lot clutching a bottle of Tylenol, waiting to be ok to drive. The Tylenol never did work. I went home and called off the rest of the day. I sprawled on the couch the entire afternoon with severe fatigue and went to bed early. I have never missed work for my period before. How embarrassing!

Next day, I dragged...literally...by bum out of bed and somehow made it to the office. The brain fog was serious. I could not think clearly enough to write a sentence. I felt I would cry at any second and my heart raced with anxiety. I wanted to go home and shut out the world. I went home for lunch and decided any side effects from protest could not be as bad as my current symptoms. I slathered on some cream. A lot. One hour later, the fog began to clear. I put on more, I felt even better. I went home at the end of the day and applied again. Not 100% but I no longer wanted to curl up and die. I used a large amount before bed and this morning I am myself again.

My lesson? Don't be afraid. Keep using continuously. Taper slowly. Wow!!!
Oct 10, 2013
 wow
by: Wray

Hi Katie I take a tube with me wherever I go! Comes in handy when others have a panic attack, or a fall or burn. Or I feel I need it. I also have a tube in the bathroom, by my bed and in the kitchen for burns. Eyeballing is fine, I can't be bothered to measure it exactly either. But having used it so long now I have a feel for how much I'm using. Please do as I suggested, use it daily through any bleeding too. And at least twice a day, although hourly is a better choice if symptoms are bad. Take care Wray
Feb 13, 2015
 same symptoms
by: Shannon

I have the exact same symptoms as you and thought I was the only one having the worst of it during the first half of my cycle...migraines, muscle aches, fatigue, and crying spells! I use progesterone but if I use too much it makes me very depressed. The last 7-10 days of my cycle I feel wonderful even though I might get a premenstrual migraine right before my period starts. If you find anything that helps let me know!
Feb 15, 2015
 Me, too!
by: Aliisa

I'm so glad I found this thread. I've been using natpro now for awhile but just increased it to 600ml/day 13 days. I dabbled at lower levels but and followed my period but no relief. So I also get my worst symptoms shortly after my period end. Cramping, dizzy, fatigue, shaky. I just am finishing bleeding and the cramping is starting again. It is freaking me out because I'm thinking I'm already on 600ml/day. I'm so glad to hear other people have symptoms in the follicular phase, too. I started getting scared that maybe the progesterone won't work. My prog to Est is 84:1 and my FSH is 29 on day 20 of cycle. My LH is normal. I'm 36.

Wray - will it get better?

Am I on the right path? I did have a good run of about 7 days of feeling better so overall I'm seeing improvement.
Feb 22, 2015
 Me, too!
by: Wray

Hi Aliisa Please see the answer I gave you on the page you started, the link is here. Don't forget to read the page I gave you on Insulin Resistance. And have a vitamin D test done, it could be this is all you need, and not high levels of progesterone. Take care Wray
Dec 11, 2017
 Aha!
by: Crystalboat

Hi,
I am so excited to find this thread, even though I realize it was a very long time ago!! I have had very similar symptoms, all starting as I enter the follicular phase, like clockwork. Dizziness, brain fog, fatigue, headaches, etc...my Dr. has no idea what is going on as all of my labs, ultrasound, ECG, etc are coming back as normal.

I suspect estrogen dominance (after multiple miscarriages, it was taking progesterone when I got pregnant that gave me a successful pregnancy, even though my hormone levels had been testing fine). It is definitely something that is connected to my cycle. I typically feel great after ovulation and up until the last day or so of my period.
These symptoms started out of the blue about 4 months ago, my youngest is now 21 months.

I'm curious about whether you did bloodwork before determining that you were progesterone deficient or if you just assumed due to your symptoms? Can bloodwork show progesterone as being within normal levels even when there is actually an issue?

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