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Not sure if my symptoms would be considered severe enough for a higher dosage

by Shalny
(NYC)

I'm 46 and was diagnosed with PCOS about 13 yrs ago. I have insulin resistance/high insulin, elevated testosterone, hair loss and visceral belly fat. I was on metformin for a while, lost a few pounds and got pregnant 11 yrs ago. The metformin made me sick so I stopped it. At the beginning of my pregnancy, I was given progesterone suppositories because I was low. Everything went well after having a c-section, except that little by little my periods began to get heavier, more painful and my PMS (bloating, irratibility, weepy hopelessness) worse. I read Dr. Lee's book and did a saliva test through the mail and it came back as low progesterone so I bought some cream and didnt notice any real effect. When I couldnt get pregnant again, I went to a fertility specialist and his testing came back as low progesterone and slightly elevated testosterone. I again tried progesterone cream and again noticed nothing. I figured exercise and diet might help but not much results with exercise and I have a very difficult time staying away from carbs and sugar. I tried using sugar free products but now I hear that they cause surges in insulin. In the meantime my hair continues to thin and fall out and my period gets worse. I still have cycles but day 2-4 has gotten so bad that I can barely leave home. My hair has me in tears and I'm so frustrated with my belly/weight but it was my period that forced me to search again before trying ablation and i found your website. Also, I battle with low iron ferritin and had a parathyroidectomy 2 yrs ago. Phew...that was a mouthful! After reviewing your site, I'm interested in trying progesterone again. What dosage would you recommend I start with?

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Sep 10, 2014
 Not sure if my symptoms would be considered severe enough for a higher dosage
by: Wray

Hi Shalny Yes what a mouthful! PCOS is such a difficult thing to deal with. The high testosterone is causing the Hair Loss. There are supplements one can take which reverses the Insulin Resistance. It's difficult to tell how much progesterone you would need, but in severe cases we suggest about 400mg/day. It is a question of trial and error. But progesterone alone won't reverse the IR or PCOS, it does need help from the supplements. You might like to look through our page on How to use Progesterone Cream. I would also suggest you consider following a Ketogenic Diet. This effectively counters any sugar cravings you might get. It will help reduce the belly fat which is caused by testosterone too. It causes an increase in visceral fat, see here and here. Take care Wray
Sep 10, 2014
 Thanks
by: Shalny

Thanks for responding so quickly Wray. AS far as the PCOS goes, I've researched it ad nauseum and tried every supplement over the past years. I did order NAC and inositol as suggested by your site. I've tried them in the past and didn't notice any difference. It's possible that I didn't take the proper dosage and/or wasn't patient enough to continue past a couple of bottles (it gets so expensive). I think barberry may have helped a little. But I will try again at the dosages you recommend. I take a slew of other supplements including 5000iu Vit D. Diet is so hard since my cravings get so bad especially at night. I can get off sugar if I can have grains or get off grains if I can have sugar. Never both though. Possibly a dopamine issue too. cont...
Sep 10, 2014
 thanks cont.
by: Shalny

I'm ready to begin my journey with progesterone to help me with my heavy periods and PMS. Hopefully I'll be successful this time, so I want to make sure I do it right. I've read much of the advice you've given others, so am I right that I should take it twice daily for 2-3 months even though my cycles are fairly reg? If symptoms persist or get worse, I should increase dosage. If symptoms get better, I can reduce dosage little by little and start to follow my cycle by applying progesterone in the luteal phase only. How long does it usually take before most people notice a change in symptoms so I know when to modify dosage if necessary? Also, do you offer a measuring tool to help with application? lowering dosage in such small increments seems tricky. I am thinking of starting with 1 tsp 2x a day just because it seems easier than fussing with fractions.
Also, Should I expect my period to become erratic while on it daily? I am concerned that you said bleeding may get heavier at first. Does that always happen? Thanks for your time.
Sep 11, 2014
 Thanks
by: Wray

Hi Shalny If you look on our PCOS page you'll see we've put together a supplement which has all the necessary ingredients. It doesn't taste nice, I take a similar one in a small amount of fruit juice. I think you'll find once you include a large amount of fat in your diet the cravings will go. MCT oil is one of the best as it's not converted to fat in the body, but is used as if it was a carbohydrate. I forgot to give you our page on Menstruation, it gives a list of supplements which effectively stop heavy bleeding. I do recommend using progesterone twice a day, but it so much depends on the individual. And yes I have found increasing is necessary if the initial amount brings no response. But please don't forget it's not a quick fix, it can take 3-6 months before any lasting benefit is felt. We don't have any measuring spoon, as the amounts used vary so considerably. The 1tsp 2x a day sounds a good start, but you'll have to experiment. Your period could become erratic, although some women find it doesn't. There is no hard and fast rule with progesterone therapy, I wish there were! Take care Wray
Sep 16, 2014
 before I begin
by: shalny

Hi Wray,
I just have a few more questions. Is it true that I don't have to worry about rotating application sites and that I can apply anywhere, or should I only apply to thin skinned areas and switch around? Also, if I forget an application every once in a while, will it set me back and create problems?
Also, I am planning to order another brand while I wait for Natpro to be in stock, and I'm concerned that there may be a delay between finishing one order and waiting for another to arrive (especially since at such high doses, the bottles will be done quite fast). What is the best way to avoid this happening and if it does, will this be a major setback causing symptoms to return tenfold?
I'm already stressing about running out.. Is it any wonder I'm having issues. lol
Sep 17, 2014
 before I begin
by: Wray

Hi Shalny I'm sure I covered the application sites in the how to use page? Otherwise you could look at our page on Progesterone Misconceptions. I'm sorry about the stock outs, hopefully they will be a thing of the past soon. Stock has come in but unfortunately it goes out as quickly. We knew this would happen in the early days, but it will settle down once there's sufficient to cover all orders. I can't really advise on how you will feel if you run out of progesterone, that will only be apparent once you start and then stop it. Most women have found it's best not to do that. Take care Wray
Sep 19, 2014
 some more questions
by: shalny

I've been reading thru a lot of information on the forums. Very eye opening. But still looking for some clarification.

Do high insulin levels cause high testosterone or is it the other way around?

It seems that so many are so sensitive to changes in the application of progesterone that it makes me wonder, if Progesterone is applied only during the luteal phase would symptoms return during the follicular phase?

Just curious but if so many women are estrogen dominant and have too much estrogen, phyto and xeno, then wouldn't menopause be delayed?

I would like to take a saliva test but not sure of a reputable company. Do you have a recommendation?

Is it easier to calculate a more accurate starting dosage based on the results of saliva testing?

What is the best way to go about finding a physician that offers bio identical hormone therapy?

Thanks so much for all the advice and help you offer. You and your site are an oasis in the desert of desperation and frustration.
Sep 23, 2014
 some more questions
by: Wray

Hi Shalny I've no idea where you got the info that testosterone and insulin are in any way connected as they are not. Symptoms can return during the follicular phase, which is why we suggest using the progesterone daily if symptoms are severe. Menopause is governed by the loss of eggs in the ovaries, not the amount of oestrogen. ZRT Labs are excellent. A test is not necessary to work out how much progesterone is needed. This can vary on a daily basis depending on how much stress is being experienced, on food and drink, vitamin D levels, and more. Most women don't bother with finding a doctor who understands progesterone therapy, they are very far and few between! Take care Wray
Sep 25, 2014
 pcos
by: Chloe

I have been reading your conversation with Wray, as it really tugs on my heartstrings when I hear PCOS.

Believe me I know those sugar and carb cravings are intense and very hard to overcome. But sugar, makes us want more sugar, it's a hard cycle to break.

My story is long and its somewhere in these pages. I went through hell to get diagnosed with PCOS. And likewise, PCOS gave me hell right back.

I wanted the meds, supplements and progesterone to cure everything. I added this, modified that etc. But the truth of it is with PCOS, diet is vital for progress, it enables supplements to work, and have progesterone do it's very best work. You may get some results, but if you want the relief you deserve, diet is the 1st to change. It's as important to PCOS as a healthy diet is to diabetics. No getting around it. The progesterone speeds up our metabolism / body temperature, so it really helps the weight come off as well. It's not such a struggle as you might remember. And apple cider vinegar appears to be helping as well. A few days on this diet have crushed my carb cravings, so everyday you will not feel you have to fend them off. Next for me is real exercise, ughhhhhhh!
Sep 25, 2014
 Thanks Chloe
by: Shalny

I really appreciate your advice. You're right, PCOS is hell. First in getting to the diagnosis and finding out it's all not in your head and that you're not just making excuses for lazy bad behavior. Then it's dealing with treatment and finding what works for you. What's worse is when I told my ob/gyn that I had it, she said, "ok, if you have it, you have it. Nothing you can relly do." Really!! You got nothin else?? I was screaming on the inside! I haven't been back since. It was up to me to fend for myself. All my endo wanted to do was keep me on meformin whch worked at first but made me feel awful. I do exercise and I have tried apple cider vinegar. It hasn't seemed to make much of a difference in weight or sugar cravings but i do feel better. Wray suggested adding good fat like MCT oil to help with cravings. I have been taking EV coconut oil before meals and I've been eating a couple of crackers or rice cake with orgainc butter when the bad cravings hit at night. I think it's helping to keep me away from the sugar,(Thanks Wray), but it's only been a week.
I'm interested in the progesterone because my periods have gotten really heavy and I can't function for several days out of the month. I am hoping that they ease some of my PCOS symptoms too, but I know there is no panacea. :(
Sep 25, 2014
 re: Testosterone/insulin
by: Shalny

Hi Wray,
Throughout my PCOS research I have read that high insulin levels stimulate the ovaries to produce testosterone. I'm not sure which books/sites have said that though.
On your site, I've been reading through the forum and I saw where you told someone that high testosterone may put you at risk for IR.
I was just hoping for some clarification. There's just so much information and doctors are of very little use.
Sep 25, 2014
 testing
by: Shalny

I just went on the ZRT website and I can't find saliva testing for progesterone, only blood spotting tests. I was under the impression saliva testing was best. What should I do?
Sep 30, 2014
 testing
by: Wray

Hi Shalny I've looked again at the link I gave you and it's very clear, they offer saliva, blood and urine testing. Top line, the second picture says Saliva Test Kit. Then if you look in the left hand menu, the second in the list says Saliva Testing. If you're not sure please write to them. I'm pleased you're off the metformin. If you get cravings, please just eat the butter by itself, leave out the crackers. Glutamine can help stabilise blood glucose too. It is in the protocol we make for PCOS, the inositol too, which studies have found is just as effective as metformin, without the adverse effects. Please also see our page on Menstruation, there's a protocol on it which I know helps heavy and/or continual bleeding. Often the progesterone needs help. I've looked again at the insulin/testosterone issue, but can't find any studies except the following, see here, here and here. In fact this paper says…. "These results indicate that acute hyperinsulinemia of 12- to 16-h duration does not increase serum testosterone "…. see here. If you do come across studies which show high insulin levels stimulate the ovaries please let me know. Testosterone does increase the risk for Insulin Resistance, there are plenty of papers on this page. Take care Wray
Oct 01, 2014
 testing
by: Shalny

Thank you Wray. I checked the ZRT site again and I realize that I did see the test kits, but I want to test progesterone only. I don't want to pay for the whole kit but I may have no choice. They only offer blood spotting for pg by itself. Perhaps another lab offers it. I will do more searching.
Oct 20, 2014
 missed periods
by: Shalny

Hi Wray, I wanted to pick your brain a little. I began adding NAC and inositol to my supplement regimen about 6 weeks ago as suggested to help with PCOS and my heavy bleeding. I wanted to wait until my following period to begin progesterone. The strange thing is that I am still waiting for it which is very rare for me. I never miss a period and if anything, my cycles have gotten shorter and heavier. Could the added supplements be causing some changes? Could it be coincidental that menopause is beginning and my estrogen is dropping, and if so, does that mean I may no longer need progesterone? I did happen to notice that I keep having cramps as if I'm getting my period. I'm bloated and breaking out all over my chin (I never break out). This is all new to me, and I'm not sure if I'm reacting to the supplements or what. Do you have any suggestions on how I should proceed? I really appreciate any advice you have to offer.
Oct 21, 2014
 missed periods
by: Wray

Hi Shalny You are in Peri-menopause, so anything is likely to happen. P-M can last years in some women, over 5 years for me. It's only when you have had no period for a year that you can consider yourself in Menopause. So please re-read the P-M page again to get a handle on what is happening. Take care Wray
Oct 21, 2014
 Some concerns
by: Shalny

Hi Wray, I was wondering if I could pick your brain a little. As suggested, I began adding inositol and NAC to my supplement regimen for PCOS and heavy bleeding about 6 wks ago. I didnt start progesterone yet. I wanted to wait until getting my period. Unusually, I haven't gotten it. I have never missed a period ever. M cycles just kept getting shorter and heavier. My last period was on 8/29 and it was the worst one yet. I'm wondering if the supplements may have had anything to do with it or is it just coincidental that menopause is kicking in? If so, does this mean that my estrogen levels are dropping and that I may not need the progesterone anymore? I did notice that I keep getting cramps as of my period is coming and I'm bloated a lot. Also, I'm breaking out all over my chin and I never break out. I'm so confused about what's happening. Any insight you can give would be greatly appreciated.
Oct 21, 2014
 re: some concerns
by: shalny

Please disregard the previous post. My computer has been acting up and I didn't realize the missed periods post went thru.

I read the peri menopausal page but it didn't list anything about the cramping or acne. Are these common when periods are missed as well? I did not experience these symptoms before missing my period even though I'm sure I've been perimenopausal for a while.

Regarding progesterone, I guess I'll begin using it now instead of waiting for my period.

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