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How should I continue?

by Tanja
(Slovenia)

I started using progesterone cream more than two months ago. I started with small doses (40 milligrams a day) since I did not know the truth about how much progesterone cream should be used. Fortunately after a few days I found this website and immediately increased the dose. The reason why I stated using natural progesterone cream was that I had had very low level of progesterone for many years (I am 30 now). I was on contraceptive pills for 9 years and I believe that they mess up my hormonal system. Since I stopped taking them I did not get period (for 3,5 years) and in all this time all my hormones were very low (progesterone was 1,2 nmol/l). Yesterday I got the results of blood test which took place 14 days ago and they showed that my progesterone level was 17 nmol/l at that time. I was amazed that it has risen so much. Of course I was very happy that I am not progesterone deficient anymore but on the other hand I am starting to feel a little confused about how to proceed. Right now I am taking 160 milligrams a day (divided in three doses). Should I gradually decrease the dose? I still did not get my period. I would really appreciate some guidelines.

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Jun 01, 2013
 How should I continue?
by: Wray

Hi Tanya I'm pleased the website helped you. Unfortunately all drug based Contraceptives have the potential to harm. You could try stopping the progesterone and see if it causes a period to occur. It's the drop in progesterone at the end of a cycle that allows the MMPs to break down the lining. There's more info about this on our Menstruation page. It could be too early to work as your level is not very high. The range for the luteal phase is 15.9 to 63.6 nmol/L, so yours is at the low end. There's more info on our Hormone Testing page. If a period should occur, it will be ± 2 days after stopping the progesterone. If it doesn't occur, I suggest starting it again, but using a higher amount, maybe 200mg/day. Continue with that daily for a few weeks before you try stopping again. There's no telling how long it will take to regulate your cycle, it will be trial and error. Please have a vitamin D test done, this is also essential for a normal cycle, plus a lack of it reduces the benefits of progesterone. For more info on vitamin D levels, test kits etc see the following websites, Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Blood levels should be 70-100ng/ml or 175-250nmol/L, and not the 30ng/ml or 75nmol/L most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. You don't have PCOS, but on this page is a list of nutrients which all help to start ovulation and get a cycle going again. It might be worth considering taking them. Take care Wray
Jun 01, 2013
 Dear Wray,
by: Tanja

thank you very much for your answer. I have just read through your Hormone Testing page and I think that regarding menstruation there might be a problem regarding the levels of other hormone as well. FSH is within the range (4,69 E/L) but LH is very low, only 0,37 E/L (but it was much lower a year before - only 0,17 E/L). What do you think?
Regarding vitamin D I have already ordered a test from Birmingham hospital and I am waiting for it to arrive.
You are also recommending magnesium supplements but I am wondering how do I know if I am magnesium deficient or not and if I am what supplements should I take, in which form, for how long...?
I also read through PCOS pages and I realized that regarding nutrition I should not have problems because I eat healthy and I alrealy follow the majority of listed guidelines.
Your suggestion is that I experiment and stop using progesterone cream to see if I get menstruation but I think that I should wait a little bit and use it for at least 3 more weeks (to complete a 3-months cure) and then try. I can not do any harm if I continue using it, right? I am making such a great improvement that I am a little scared to stop using my beloved progesterone cream and I feel that I want to wait a little more to be sure that I have used it long enough to let it do its job.

Thank you for your answer in advance!
Jun 01, 2013
 Dear Wray
by: Wray

Hi Tanya LH is needed to encourage the follicles in the ovary to secrete testosterone. But one of it's other roles is to initiate ovulation. It could be you are not ovulating, the pill can stop it. Progesterone can help get the cycle going again, but the reason I suggested you tried some of the nutrients on the PCOS page was to stimulate ovulation. So although you are eating well, it needs far more than food to correct the damage done by the pill. Only by having a magnesium test will you know if you need it or not. It is low in our soils now, unless you eat organic vegetables. If low I recommend about 800mg/day to begin with, then it can be reduced to about 250mg/day. The best forms are those bound to an amino acid, although magnesium chloride is very good. I'm happy you wish to continue using it for a full 3 months, a good idea. I'm delighted you're making so much improvement, you didn't mention what symptoms you had in your first post. When you do stop please be aware of adverse symptoms. If you get any I would suggest starting it again and continuing using it for longer, before attempting to stop. Let me know how you get on. Take care Wray
Jun 01, 2013
 Dear Wray
by: Tanja

I read through PCOS page once again but I am not sure which nutrients to stimulate ovulation you have in mind. What exactly should I try?
Regarding magnesium test I would like to know how and where I can get tested? I do eat quite a lot of organic raw vegetables but I might still be deficient.
My simptoms regarding hormonal imbalance were skin problems (impurities, comedonal acne mostly), I do not have period for 3,5 years, poor circulation, tiredness, mood swings,...After 2 months on progesterone cream I noticed major improvement of my skin issues, my circulation improved, I have more energy and I am emotionally much more stable. Progesterone cream is a true miracle!
Jun 05, 2013
 Dear Wray
by: Wray

Hi Tanya I'm delighted the progesterone is helping you, it certainly transformed me. My circulation improved no end, I used to get chilblains each winter and haven't since starting progesterone. The nutrients are all in the complex, but if you wanted to take them individually, they are vitamin D, N-acetyl cysteine, inositol and arginine. The amounts to take are all on the complex page. You will need to take the B vitamins listed too, as these are co-factors for the amino acids. But if you feel the progesterone is helping you, why not stick to that and then add the other nutrients if you feel you need more help. I'm not sure where in Slovenia you can get a magnesium test, maybe your doctor could help. But if you eat lots of raw veggies, you are probably fine. We do have a page on Acne you could look through. Take care Wray
Jun 05, 2013
 Dear Wray
by: Anonymous

Thank you so much for all the support, I am very grateful! I will let you know how am I doing after a month or two.
Yours faithfully, Tanja
Jun 21, 2013
 Dear Wray
by: Tanja

It will soon be 3 months since I started using natural progesterone cream and these days I intend to stop using it and see what happens, but before I do it I would like to ask you a few questions.
1. Right now I am on 100 mg daily dosage, which is the smallest amount that you recommend, so do I stop using it all at once or should I reduce gradually?
2. I am on a raw vegan diet for 3 weeks now and before that I was vegetarian for years. I think that it one of the reasons why I have not had period for such a long time. In the past few years my progesterone level was very low (due to long term usage of contraceptive pills as well) and levels of all other hormones as well, but natural progesterone cream helped me to rise those levels significantly. Regardless of that I still think that I will not get my period back until I am not raw vegan diet but I would like to know if I am ovulating because I know that having menstruation is not necessary needed for ovulation. What is your opinion in this case?
Jun 27, 2013
 How should I continue?
by: Wray

Hi Tanya I'm so sorry I missed this, we have been having problems with our server site so maybe that's why. To answer question 1 you should stop using it all at once, the amount is not high. But please watch for any Oestrogen Dominance symptoms. If they should appear, please start the progesterone again. It's interesting you think the vegan/vegetarian diet might be partly responsible for the lack of periods. It could be you're not getting enough fat, and I mean saturated fat. So please try to incorporate coconut oil into your diet, that might help. And if you go off the raw vegan, butter too. These are interesting papers, see here and here. Not only is fat essential but so is protein for normal egg development, do you think you're getting enough? Your diet should contain about 25% protein, see here. Or another way of looking at it is you should be getting 0.9 to 1.0g protein per kg per day of lean body mass. If you are interested in working out how much you are getting, the USDA National Nutrient Database is the best resource. The best way to check for ovulation is the mini-microscope. I will also post this reply on your other page. Take care Wray
Jun 28, 2013
 Dear Wray
by: Tanja

Thank you, your answers help me so much. You suggested that I stop using cream all at once and watch for estrogen dominance symptoms. Regarding that I have to tell you one thing: as I already told you my skin improved a lot since I started using progesterone cream, some days it was better, some days a little worse but it was slowly improving. The improvement was even better since I went on a raw vegan diet (4 weeks ago). But suddenly a few days ago it got much worse and I was really surprised because I did not know why it happened. Yesterday I went to check my progesterone level and it was 1,08 µg/L. Since I can not follow my menstrual cycle yet I can only guess that I am in a follicular phase or I might be in ovulatory phase. I have One Step Ovulation Tests at home and I an going to do them every day to see if I have LH surge. Later I might buy mini-microscope.
Regarding my diet I will consume more coconut oil and protein as you have suggested and see if I will get my period back but I still think that there are small chances for this to happen since I read a lot about it in relation to diet.
Jun 29, 2013
 Dear Wray
by: Wray

Hi Tanya I'm taking a guess here, but the worsening of your skin could mean you had just reached the point when you should have ovulated. It's always been believed, and still is by everyone including the medical profession, that progesterone is only produced by the corpus luteum after ovulation. But as far back as 1930 it was thought there must be another source. This was confirmed in the 1960's, and re-confirmed in the 1980's, that there is an exponential rise of progesterone about 50 hours prior to ovulation. This surge comes from the brain, see here, here, here and here. Oestrogen also rises exponentially about 50 hours prior to ovulation. Unless there is the progesterone surge too, there is nothing to counter the oestrogen effect. This explains why many women get migraines, seizures, palpitations, panic attacks and asthma attacks around ovulation. A worsening of skin problems would also occur if prone to those. Bleeding occurs 12-14 days after ovulation. So you could count the days from the time of your skin worsening and then stop the cream if you wish. Whether it will cause a period or not I don't know. The 100mg/day you are using is probably not enough for this, it would need to be much higher, at least 200mg/day. You could increase to this and then stop when you think the time is right. Let me know how you get on. Take care Wray
Jun 29, 2013
 Dear Wray
by: Tanja

Yesterday I noticed that my skin started improving so the worsening was from Monday to Thursday (4 days). It was definitelly something hormonal going on. If my understanding of what you wrote is right I could have had ovulation from the day that skin worsened and if that is the case there is no point for me to do One Step Ovulation Tests anymore. Now I should wait about 3 weeks and then starting testing again on daily basis, right?
You suggested that I count the days from the time of my skin worsening and then stop the cream and see if I get period but you think that 100mg/day that I am using is probably not enough. I was using 180mg/day for about a month and a half and then I gradually reduced because I was thinking that if I wanted to stop that is the right way to go. I wanted to stop using it these days and I should do it until the 3rd of July because I have an appointment with my gynecologist on 18th and she wants me to be at least 2 weeks off the cream to do the hormonal tests otherwise she won't do it. What matters to me the most is that I get my hormones under control and I trust you much more than I trust my gynecologist and I really appreciate every advice that you give me. I really would not want to mess anything up, I was on progesterone cream for more that 3 months, I was using the right amounts I think and I would want to end it in the right way as well. But I am quite confused right now, I do not know what to do, would you help me out please?
Jun 30, 2013
 Dear Wray
by: Wray

Hi Tanya Yes I do believe your worsening skin was due to your ovaries trying to ovulate but not doing so. And you didn't get the progesterone surge prior to ovulation, which would lead to a worsening of symptoms. The problem with no cycle is there is nothing to follow. So making a guess that the time of skin worsening was around 'ovulation' time, then you would begin bleeding 12-14 days after this. That's when I suggested you stop the progesterone. I don't know if the 100mg will cause a period or not, but it might be worth trying as you've been using it for 3 months now. It's best to drop down from a higher amount, rather than gradually reducing it, as this could start bleeding when you don't want it to. I find it extraordinary that doctors ask their patients to stop the progesterone to do a test. What does that show them? Only the level the patient used to have, and it was one which in all cases is far too low. Why else does the woman have bad symptoms? A progesterone test should always be done mid-luteal phase, i.e. ±7 days after ovulation or before bleeding. This is when progesterone peaks, but so does oestrogen. If the test is done at any other time it's meaningless as progesterone will always be low. You don't know when your mid-luteal phase is, and of course nor does your doctor! So you would need to stop in about 7 days if I've worked it out correctly, this is only 4 days after the 3rd, so I don't think it will make any difference to your tests. Why not do that, at least you'll get to 'try' to follow a possible cycle, if my guess is right. Let me know how you get on, particularly how you feel when stopping the progesterone. I would be very interested to hear what your results are! Take care Wray
Jun 30, 2013
 Dear Wray
by: Tanja

I will do as you have suggested and take progesterone cream for another 7 days and then stop and see if bleeding occurs. Of course I will let you know how I am doing. Thank you so much for guiding me!
Jul 11, 2013
 Dear Wray
by: Anonymous

As you suggested I increased the dose on 200mg a day and then I stopped using cream 3,5 days ago but I did not get mentruation in the following days. I did get a feeling sometimes like it could come but the bleeding did not occur. I am wondering what to do now, should I start using progesterone cream again? Should I check my progesterone level first? Otherwise since I stopped using the cream I did not notice any difference regarding the way I feel or. changes regarding my skin or anything negative. Everything seems the same as it was.
Jul 12, 2013
 Dear Wray
by: Wray

Hi Tanya This is puzzling but it could be because you're not ovulating. I suggest you stay off the progesterone for 14 days and then start it again for 14 days. You don't know what your cycle is, so it's a start using the average cycle length. Let's see if this helps. I also still feel you need those nutrients listed on the PCOS page to help initiate ovulation. Please look through the page again and consider taking them, I can't think what else you could do. There are papers on the page you can read about each individual nutrient and how it got ovulation going again. Take care Wray
Jul 15, 2013
 Dear Wray
by: Tanja

I read through PCOS page once again and I decided to eat more natural sources of foods that are high in nutrients which are listed to help initiate ovulation. Since I am on 80/10/10 raw vegan diet I eat as much whole, fresh, organic, ripe foods as possible and I am trying to stay away from supplements, which I did take in the past but I experienced no significant improvement. Now I really feel that nature is the best healer and I have deep faith that with time things will sort themselves out all right. There might be some other factors that are contributing as well, which are not physical but psychological in nature. I did a lot of research in the past years and have come to many possible conclusions. I know that our conscious and subconscious mind plays a huge role in what is going on in our bodies. So I am working on it too.

I have checked my vitamin D level and magnesium as well and they are both just perfect, and so was vitamin B12 when I checked it for the last time. I am also lucky that my thyroid is healthy and I am feeling well both physicaly and psychologicaly, especially since I learned how to cope with stress in everyday life. So I really think that I am on right path to balance my hormones it just might take some time and patience.

I will do as you suggested and start taking progesterone cream again in the beginning of the next week and will be taking it for 14 days. Should I check my progesterone level 7 days before I stop using the cream? I can do it only if I pay for it and I would like to know if I have any benefits from doing it.
I am also wondering if my progesterone stabilised in the last 3,5 months that I was continously using cream?
And one more question: if I would skip one cycle and stop using progesterone cream for a month or so (I would like to do it in the mid August because I have an appointment with my gynecologist at the end of the month) would I mess anything up? I wouldn't want to start from the beginning when it comes to progesterone level.

THANK YOU so much for your answers!

Tanja
Jul 18, 2013
 Dear Wray
by: Wray

Hi Tanya I'm delighted you seem to be coming right at last, such good news. Stress does play havoc with us, and can stop the reproductive cycle too. If you did the Birmingham Hospital test, which earlier you said you'd written off for, then a good level to them is a very low level to most specialists! They have as adequate 50nmol/L, whereas the minimum should be 125nmol/L, some suggest 175-250nmol/L, is your level above 125nmol/L? See the Vitamin D Council and GrassrootsHealth websites for more info. I see no reason to check your progesterone level. It seems you're doing well so it would be an unnecessary cost. If your symptoms have gone or almost gone, then your progesterone is now stabilised or dominant, which it should be. I don't recommend stopping the progesterone for a full cycle, not when you've had such success with it. I see no point either. If your gyn wants to run tests, then it should be done while still using the progesterone. Otherwise it will drop back to where it had been when you started it. Take care Wray
Jul 19, 2013
 Dear Wray
by: Tanja

My vitamin D level was 59 nmol/L but that was before summer and now I am sure that it is much higher because I spend quite a lot time outside. I will check it in september again to see the improvement.
OK I will not stop using progesterone cream for a full cycle but regarding my gynecologist who wants me to do it, should I just act like I did, can she figure out that I am still using it when she gets the results?
And one more question: you wrote that if I stop using the cream my progesterone level will drop back to where it had been when I started. Does this mean that I will have to use the cream all my life? I was hoping that with the right diet and lifestyle I could help my body to restore its own ability to produce enough progesterone naturally.

Kind regards,

Tanja
Jul 20, 2013
 Dear Wray
by: Wray

Hi Tanja 50nmol/L is very low, specialist are now saying it should be a minimum of 125nmol/L. Others suggest it should be between 175-250nmol/L, I try to keep mine above 225nmol/L. When you say 'quite a lot of time outside', I hope you don't put on sunscreen until you've been in the sun for about 20 minutes, and it should be daily too to get enough sun and therefore vitamin D. Yes your gynae will see the results are higher, so it's up to you what you do. You have only just started using progesterone, so it will take time for it's affects to be fully appreciated. Given this time, I would hope you can stop using it. Take care Wray
Jul 20, 2013
 Dear Wray
by: Tanja

I do not use sunscreen, I am rather careful about exposing myself within the safe hours and I am checking UV index as well.
I decided to use progesterone cream for at least a few months and then do the tests at my gyn. Just one more question: how long do you suggest that I continue to use progesterone cream on mothly basis (2 weeks on, 2 weeks off) before I can do a longer break (a full cycle)? Is 3 months enough or is it better to wait more?

Thank you for all your help during this time!

Tanja
Jul 21, 2013
 Dear Wray
by: Wray

Hi Tanya The best time to get in the sun is between 10am and 2pm, any earlier or later and you won't make vitamin D. For more info on vitamin D levels, test kits etc see the following websites, Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Blood levels should be 70-100ng/ml or 175-250nmol/L, and not the 30ng/ml or 75nmol/L most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. I don't understand why you want to take a longer break. You can stop it any time you wish, but you said your skin had break outs when you did. Take care Wray
Jul 21, 2013
 Dear Wray
by: Tanja

Thank you for the information about hours when vitamin D is produced, I will have it in mind.
I do not want to stop using the cream until my body needs it, I am just thinking that maybe someday if the future things will change and my hormones will come in balance naturally.

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