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PND and Anxiety and severe PMS

by anonymous
(NY)

Hi Wray,

I suffered severe postpartum anxiety with the birth of my daughter 3 years ago (onset was about 5 hours after delivery). Very bad PMS followed. After suffering for a year I finally got on an antidepressant as last resort as that is what the doctors I was seeing kept telling me to do. I felt better but it did absolutely nothing for me 2 weeks before my period. That is when I starting realizing that there is a hormonal component to the worsening of my symptoms. I am now 3 months postpartum with my son and things are better than they were 3 years ago after my daughters birth thanks to natural supplements I have been taking for my anxiety and to boost my serotonin levels. However, I am still having anxiety and now that my period has resumed, I am back to having very bad anxiety, racing heart, insomnia, and irritability/nervousness 2 weeks before my period. I have been researching a lot about progesterone and I am hoping it will help me. After going to 3 different docs, I have finally found one that believes progesterone deficiency is likely causing my symptoms. I just sent off my hormone test (testing on day 21) and I am almost scared to get the results. What if my hormones show everything is normal? My doc said thought that even if my values are within what is normal, she treats people based on symptoms, not lab results. While we are waiting for the results, she did give me a prescription for some progesterone so that I would not have to suffer. I tried it just today and my anxiety is bad today. My prescription cream is 80gm progesterone 3% gel and I am to use 1/8 tsp on days 7-14, and then that dose twice daily on days 15-28 then stop for 7 days during period. I know that if the dose is not right, it could worsen symptoms. I am just so done with dealing with this. It has caused me so my pain as I am sure it has with others that are suffering with hormonal issues. My questions are: what dose is typically used to treat PMS? Also, does this mean my menopause will be horrific?

Comments for PND and Anxiety and severe PMS

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Nov 19, 2012
 anxiety
by: Julie

Hi,
I am sure Wray will be along with wonderful advise but until then I can tell you a little of what I have learned by reading on this site. I am also dealing with PDD and just got my hormones tested last month and found out I am very low in all my hormones. I just started the cream a week ago and I am doing 400mg. a day. I think in your case Wray would suggest at least 200mg but 400mg would better if symptoms are very severe. Also for the first 2-3 months Wray suggests using the cream daily with no breaks. This helps get your levels get way up there.

HTH

Julie
Nov 20, 2012
 PND
by: Anonymous

Hi Julie,
Thank you for responding. I am sorry that you are also dealing with Postpartum issues. Is this your first child? Has your period resumed yet? I wish I would of had all of this hormonal knowledge three years ago. I really feel like I missed out on a lot with my baby because of the panic I was experiencing. I have long suspected that my hormones were all low since I have symptoms of low estrogen as well. But, I guess what stumps me is that if all my hormones are low, then how come my cycles are normal and I have no problems getting pregnant? Gosh, I am only 31! I never in a million years though I would be dealing with this stuff so early!
Nov 21, 2012
 PND and severe PMS
by: Anonymous

Hi Julie,

Thanks for your comments. I will ask my doctor about upping my dose. I also suspect all my hormone levels are low because I have symptoms of low estrogen as well, and I know estrogen has a big effect on your serotonin levels. Have you had a period yet since the baby? I hope that you start to feel better soon...please post to keep us updated.
Ashley
Nov 22, 2012
 to Ashley
by: Julie

Hi Ashley,

This is my 5th baby. You can read my story under the title 37 year old mother of five. It is just a few post down in the FAQ section of the forum.

My baby is already 15 months old and I have not started my cycle back yet since I am still nursing him a lot. I am trying to cut back with all this going on. Things really started to kick up a notch for me when he was about 8-9 months old.

I also have always had very regular cycles and had no trouble getting pregnant. From what I understand the body goes through major changes after giving birth. The placenta makes 400mg of progesterone a day during the last trimester and after the birth the body makes very little or maybe not at all if you are not ovulating ( while nursing ). If you are nursing you might still not be ovulating even if you are having a cycle. I know Wray will have much more to add to this.

Anxiety has always been an issue for me and something that has really help me A LOT is magnesium citrate. When I was feeling really bad I would take at least 400mg every 2-3 hours. I know Wray also has some helpful things to suggest. Have you started the cream yet? Keep me posted! Julie
Nov 22, 2012
 PND and Anxiety and severe PMS
by: Wray

Hi there I'm very pleased your doctor said she treats based on symptoms, they are the best guide. All too often the doctor will ask for tests, and you are right, will say everything is normal. What they rarely look for are the ratios. Some labs are excellent at giving them, as they know the importance. So both hormones could be within range, but a low progesterone to high oestrogen will still cause adverse symptoms, in spite of both being 'normal'. I'm a bit confused when you say you have an 80gm progesterone 'cream', then say it's a gel? 80g is a huge amount for one container, it means it has 8000mg progesterone. But if it's a 3% gel, it means each gram or ml contains 30mg progesterone. I'm going to assume it's this, and that it is a gel. So each day you are getting about 19mg progesterone on days 7-14, followed by 37.5mg/day on days 15-28. Well as Julie so rightly says!, I am going to say this is no where near enough. Not with your symptoms, which I would put down to post natal depression, as with your previous child. Large amounts are needed for this, 400mg/day is a good start point. Dr Dalton would use amounts ranging from 400-2400mg/day, dependant on the severity, see here. We also have a page on Pregnancy which touches on this briefly. I would also suggest as Julie says, to use it daily, for at least 2-3 months. This usually ensures progesterone becomes dominant and suppresses any excess oestrogen. But progesterone alone won't be enough, you do need the calming amino acids, the B vitamins and vitamin D. Please see our page on Anxiety which gives a list of all those that can help. A gel based progesterone is not as effective as an emulsion or cream, see here. I would suggest changing. And please have a vitamin D test done, a lack of this reduces the benefits of progesterone. Continued below
Nov 22, 2012
 PND and Anxiety and severe PMS Part 2
by: Wray

Hi there Plus causing anxiety, depression and insomnia, see here and here. And here, here, here, here, here. and here. 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. And no, your Peri-menopause and Menopause doesn't have to be bad! Whenever you feel symptoms returning, just start using the progesterone again. Take care Wray
Mar 08, 2013
 Considering switcing to NATPRO
by: Anonymous

Hi Wray,
I just recently switched from 400mg of oral to 400mg of cream. I am going through my prescribed cream very quickly as one click gives .25gm. The cream is 100mg cream and cost me $63. I am wondering how long a tube of NATPRO would last me at 400mg/day? I might even need to go higher than this as I am dealing with PND and PMS (my original entry is this post) and am considering using the cream every day without a break.
Mar 09, 2013
 Considering switcing to NATPRO
by: Wray

Hi there I'm pleased you've switched to a cream, as oral is not effective, most of it being destroyed....."The liver and gut region removed a mean of 96 per cent of the progesterone entering these tissues" see here. Although you've given me some info on the cream you're using, I can't work out from it how much 1 click is giving you. But 400mg/day of Natpro would require 12ml of cream, so 1 tube would last you 5 days. There's 2000mg progesterone per 60g tube. If one click of the cream you're using gives you 100mg progesterone, then it's a 4% cream. Natpro is 3.3%. So if I'm right the progesterone in the one you're using would cost $52.50 for the same amount as in Natpro, i.e. 2000mg. The Natpro costs $23 per tube if you get 3 tubes. I hope that helps! I always advise using it without a break if symptoms are severe. It's far more important to get rid of those, than upsetting the cycle for a while. Please have a vitamin D test done, it's so important. A lack reduces the benefits of progesterone too, so getting your level up high would mean you should be able to use less progesterone. It will also help with the symptoms you have. And please consider taking the nutrients listed on the anxiety page I gave you. Progesterone alone is going to have an uphill battle, unless you go up to 800mg/day as Dr Dalton would for her patients with PND, see here. Take care Wray
Nov 17, 2013
 My Lovely Girlfriiend has Horrific pms
by: Anonymous

Hello,
I know this might seem weird having a male post on this site but I am at my wits end. My lovely girlfriend is 41 yrs old and has 2 children. One is a male at 17 and a female at 18. She has had horrific PMS ever since I met her and that is 3 years ago. We have no issues in our lives together and we love each other with all our hearts. We always are together and it just seems to get better all the time. We are to be married by the end of 2013 and I am as happy about this as can be. Herein is our problem. Her PMS starts around 3-7 days before cycle starts and sometimes continues 7 days after. She gets very depressed and angry resulting in outbursts that lasts for hours. It makes me sad and I am empathetic but I am growing weary of this every month and am starting to lose my patience which is not like me but we have been to three doctors, two female and the other male. First doc started her on Progesterone cream at .50gm once a day and it actually seemed to work for awhile and then it stopped. We did blood tests and showed low on progesterone and a little on estrogen. She recently had surgery for fibroid tumors and had one of her ovaries removed and her fallopian tubes. I still endure her monthly anger and depression almost regularly and don't know what to do. We are now doing progesterone.25gm twice a day on stomach and I see her getting more agitated and angry every month. I am getting weary and tired of this but I love her and want to help her. I have been to almost ALL of hr Drs appts amd am very proactive. Please give me some advice..Jon
Nov 19, 2013
 My Lovely Girlfriiend has Horrific pms
by: Wray

Hi Jon How lucky your girlfriend is to have you! Incidentally many men write in to this site for help for themselves. You might like to read some of the comments here, here here, here, here, here and here. The site seems overwhelming female because we have a rise and fall of hormones each month, men don’t. This can send some of us into severe symptoms. And this is exactly what’s happening to your partner. But 50mg/day is not going to touch sides if she has bad PMS. I would suggest she tries 400mg/day, this might be enough, possibly not. It’s the withdrawal of progesterone just prior to bleeding which causes the problems, it leaves us with Oestrogen Dominance symptoms. A low level of allopregnanolone is also found in PMS, see here. This is the most important metabolite of progesterone, but if progesterone levels are low, it cannot be made. If she has Fibroids it shows her oestrogen is too high in ratio to progesterone. We’ve found from Saliva Tests we run on our cream that it’s best if the P:E2 ratio is 600:1 and over. Continued below
Nov 19, 2013
 My Lovely Girlfriiend has Horrific pms
by: Wray

Hi Jon She probably has a Vitamin D deficiency too, please ask her to have a test done. Most of us have low levels, this reduces the benefits of progesterone, plus causing untold problems, one being fibroids, see here, here, here, here, here and here. Please ask her to read our page on How to use progesterone cream. And as she’s heading into Peri-menopause, this page too. Take care Wray

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