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Progesterone advice needed

by Lori
(Ashburn, VA)

Hi Wray,
I am obsessed with your website and have found it to be so knowledgeable. Thank you!

I am 39 years old with no children, never been pregnant. My hormonal imbalance symptoms started at the age of 28, after my wedding was cancelled and going off of the bcp, that I had been on for 10 years. My hair became very, very thin, I developed melasma on my face...not to mention headaches, exhaustion, no periods, etc. I assumed it was all from the stress I was under.
For 9 years I suffered from the symptoms, which kept getting worse and worse. I visited many dr's complaining of my symptoms to which they only cared to throw another bcp my way. At this point I realized that the pill was only masking the symptoms, not getting to the real issues.
Two years ago, after my divorce, I thought I was going to have to quit working.I was sleeping 14 hours a day, still exhausted and hardly functioning. At this time my dr. diagnosed me with hypothyroidism. I was very hopeful that the medication would help my symptoms. It didn't, and they became worse than ever. My hair thinned to the point that I had to buy a wig, I was having severe night sweats, fatigue, headaches, still no period...you name it, I had it and was miserable. My GYN kept offering bcp, estrogen patches, etc. (never offered or mentioned progesterone alone)After trying everything estrogen related, bcp's, and none of them helping, I demanded I be referred to a endocrinologist. She did 6 months of tests and concluded that I had hypogonadism at age 37. I was just grateful of a diagnosis.
I took it upon myself to visit a compound pharmacy that my GYN agreed to work with. I did the saliva testing and the results came back as: Estradiol 3.3 (1.3-3.3 premenopausal),Progesterone 210 (75-270 premenopausal),Testosterone 46, DHEAS 3.7, Cortisol 3.9
I believe that my results show that I am not in menopause however peri menopause.

My dr. put me on compounded progesterone/DHEA/Cortisol= 50mgs. per day. I use 25mgs. in the am and 25 mgs. at night before bed. The pharmacist recommended that I take 2-3 days off per month to set the receptor sites.

My questions are:
Should I be using my creams differently? I don't have a cycle at all to go by, but sometimes spot here and there.
Is daily use ok?

I've gained 10 lbs in the 6 months I've been using it and feel bloated all the time. I've always been tiny, so the weight gain is very noticeable and uncomfortable for me. My symptoms are better, however the night sweats are still raging most nights. Besides the weight gain and sweats I have been feeling much better.My hair has come back some, to the point that with a few extensions it looks pretty darn good. I don't have headaches like I used to, and much more energy. After reading your site I am understanding that perhaps I am on too low of a dosage and need to increase up to 400mgs. per day. Correct? Am I stuck in the estrogen dominance phase?

I am on several antidepressants and suffer from major depression. Could this be causing the night sweats? (Pristique, Wellbutrin, Seroquel)

Are there any other recommendations as far as supplements that you feel would be beneficial for me for hair growth, melasma, etc? I take a multivitamin daily.

Thanks so much!
Lori

Comments for Progesterone advice needed

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Feb 25, 2013
 Progesterone advice needed
by: Wray

Hi Lori So delighted the website has helped you! Like so many who write in, you have been through the mill, all so unnecessary too. Although the 50mg/day has helped in a number of areas, I don't feel it's enough. I don't know where the 'hypogonadal' diagnosis came from. And the only way to tell if you are in Peri-menopause would be to check your LH and FSH levels. These rise in an effort to make an egg mature and ovulate. Women in their 20's can still suffer severe symptoms if the ratio of hormones is skewed. Your progesterone is normal for the luteal phase. Your oestradiol shows you are in pre-menopause. But your ratio, which is the all important factor, is only 64:1, we've found from Saliva Tests we run that it should be 600:1 and over to feel well. Your testosterone is at the very high end of normal for women aged >30 16-47 pg/ml. Although your DHEAS is low, the range for ages 30 to 39 is 45 to 270 ug/dL, I don't believe you should have been given this. It follows the male hormone route, i.e. converting to the androgens, and you certainly don't need more testosterone! See here, here, here and here. Testosterone is notorious at increasing visceral fat, see here and here. Excess testosterone also causes severe PMS. 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. SHBG drops if sugars are eaten, even those found in all grains, legumes, processed milk and sweet starchy fruits and vegetables. Fructose, sucrose and glucose, reduce SHBG by 80, 50 and 40% respectively, see here. Thereby allowing testosterone to rise. It's best to avoid all the foods and sugars mentioned. Wine and beers contain carbs, so it's best to avoid those too. Plus alcohol affects hormone levels in women, see here and here. Continued below
Feb 25, 2013
 Progesterone advice needed Part 2
by: Wray

Hi Lori It decreases progesterone levels and increases androgen levels, both the total testosterone and free testosterone become higher. The lowered progesterone, higher testosterone probably accounts for the increased risk in breast cancer risk among women, see here and here. Higher testosterone is also associated with an increased risk for Insulin Resistance and heart disease, see here. Sugars and large meals also drop progesterone levels, see here. Plus insulin drops levels too, see here. This means SHBG also drops, testosterone rises, another vicious cycle. Excess testosterone can also cause Hair Loss. Hot Flushes and night sweats respond to 400mg/day and over, so if you still have those I suggest increasing the amount. You are on a cocktail of AD's! There are natural alternatives, please see our page on Anxiety. They all come with a huge list of adverse side affects, see Seroquel, Pristiq and Wellbutrin.
I suspect your vitamin D is very low, this causes major mood disturbances, see here, here, here, here, here and here. Continued below
Feb 25, 2013
 Progesterone advice needed part 3
by: Wray

Hi Lori Please have a test done, a lack also reduces the benefits of progesterone. 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. Take care Wray
Feb 25, 2013
 Progesterone Advice
by: Lori

Thanks for your response Wray. Yes I had a vitamin D test and it was low at a 28. The compound pharmacist recommended 5000 iu per day. I have been doing that for the past few weeks. However, after reading your site it looks like I need more like 10,000 iu per day? I'm using vitamin d serum that you drop under your tongue. Would you recommend the serum verses taking the pill form?
I accidentally left out a couple more details that I thought about after writing to you before. At the time of the saliva test my dr had prescribed testosterone cream to increase my lack of labido that I was experiencing. I stopped the cream in August 2012.

With all of that said, can you tell me what supplements you recommend for me? Anything for hair groth or melasma? I will raise my progesterone dosage immediately and hope it can help with my foggy thinking. I have cream form and vaginal suppositories of progesterone. If I used the vaginal form that is 100mg per pill, would you still recommend I use it 2x per day=200mg or 2 suppositiories before bed=200mg? The suppositories can be messy so during the day may not be ideal.

Thanks again!!
Thank you!
Feb 25, 2013
 Progesterone advice needed
by: Lori

Hi Wray,
In Dec 2011 when I was seeing the endocrinologist my LH level was 10.2, FSH was 5.4
Thanks!
Lori
Mar 01, 2013
 Progesterone Advice
by: Wray

Hi Lori Well your vitamin D was very low, I did suspect it. 5000iu is a good amount, but only a maintenance dose, to get it up high you need to take at least 10,000iu if not 20,000iu. Then have another test about 3 months later. If your level has gone up taking the serum then continue with it. If not switch to the capsules. Now I see why your testosterone was so high! I'm relieved you've stopped it. High testosterone is generally the reason women loose scalp hair, and get facial hair. And if it's Libido you're worried about, then progesterone plays a far greater role than testosterone in both sexes. It's typical for men to think it's testosterone which increases libido, as if they are the only ones with high libido! I know many women with very high libidos, and men with very little. In fact one study found hypogonadal men with very high libidos, and those with high testosterone with low, interesting. We also have many men using progesterone to get theirs up. It appears dopamine is the main substance that increases libido. But dopamine drops with stress, which then causes prolactin to rise. This hormone kills libido, oestrogen also increase prolactin levels. I would always recommend using progesterone twice a day. And to always use the suppositories at night only, because of the mess. I use the cream in my vagina every night. Did the endo not say anything about your LH to FSH ratio? They should be approximately the same, a high LH indicates you have PCOS. This would account for the lack of periods, and your symptoms too. Also the high testosterone, if it hadn't been for the cream you were using. Please look through the page I've given you and see if there is anything which ring bells for you. I'm also puzzled why you had to have saliva tests via your pharmacist, when the endo had done 6 months worth of tests! Take care Wray
Mar 02, 2013
 Progesterone advice
by: Lori

Hi Wray! I just want to say thank you for getting back to me. When I didn't hear anything I thought you were at a loss for words with my case...thanks for not giving up.
My compounding pharmacist tells me 50 mgs. a day is enough progesterone and my gyn tells me I need to add estrogen to the mix, which is why I'm gaining weight.You mentioned my luteal phase level of 210 is in normal range...do you think increasing my dose is a good idea for the night sweats, foggy thinking, lack of libido, and now 11 lb. weight gain? I don't have a cycle to go by but I can tell you I feel "out of my mind and ridiculously dumb" the 1st half of each month for the most part. I am not happy about the weight gain. I started natural progesterone in Aug 12' but didn't see the weight gain until about 3 months ago. So far 11 pounds and counting. Ugh!! Once I increase my dosage to 200mgs. per day , what is the average time frame of becoming progesterone dominant and shedding the pounds? I'm so afraid I'll just keep gaining and gaining.

My gyn mentioned pcos 2 years ago but it was hard for me to accept without a test to determine it for sure. Really, the lack of a cycle and possible infertility (I've never been preganant), are the only symptoms I've had related to pcos. I've had a glucose intolerance test, my prolactin levels checked etc. All were normal. The LH and FSH levels are off though. ?? Could that be from a progesterone deficiency? I chose to have the saliva tests done because after 6 months of tests by the endo, the diagnosis was hypogonadism. Again, I wasn't convinced.
I also forgot to mention that I had dysplasia for over 5 years. My last pap in Nov was finally normal!! Thank you progesterone! Could all of my symptoms and years of torment have been from lack of progesterone?
Thank you!!
Lori
Mar 03, 2013
 Progesterone advice
by: Wray

Hi Lori No not at a loss for words! I took 2 days off to finish a page I'd started 6 months ago on memory loss. This sets me back hugely, problem is I need to update the site, and I never have the time to do it. I answers queries about 12 hours a day, 7 days a week. I downloaded 37 last night, heaven knows when they'll all get their answers. It's very evident 50mg/day is not enough, and the last thing we all need is more oestrogen! And yes I do think you should increase the amount. I can't tell you how long it will take to get progesterone dominant, there are so many imponderables. One woman with asthma found she had to use 500mg/day before she stopped gaining weight. She needed a large amount to stop the asthma, before it could help in other areas. It could be the same with you, I simply don't know. I do believe the high level of LH could be due to a lack of progesterone, as the pituitary is trying to get an egg to ovulate and then the corpus luteum to make it. There's a feedback system between the ovaries, uterus and hypothalamus. It does appear you're not ovulating. Unfortunately high LH increases testosterone levels, and if these hormones are high there's no chance of ovulating. I take it the dysplasia was in the cervix? Progesterone does stop this. I think you're problems could well be due to low progesterone, and low vitamin D too. A lack of this reduces the benefits of progesterone, are you taking the high amount I suggested? Take care Wray
Mar 07, 2013
 Progesterone advice needed
by: Lori

Hi Wray,
As always thank you for writing back. Yes, I have increased my Vitamin D dosage to 10,000iu per day. 5,000 iu in the am and 5,000 iu in the pm. I have also increased my progesterone to 400 mgs. per day. Started the increase about 3 days ago. I am using (2) 100 mg suppositories before bed and 200 mgs. of cream in the morning. The last 2 nights the night sweats are much lighter. How long should I wait to increase the dosage again? Does my body need time to catch up to this new dose or is the progesterone effective right away and still isn't enough?
I just purchased Natpro for the first time. I'm real anxious to get it. My compound pharmacist and GYN will not prescribe the increased dosage that you and I both feel I need from the compound pharmacy, so we are on our own.
I ran across my progesterone labs from 2011 before I started using bio-identicals. My level was a 2.34. I have no idea what the normal range is but I know I was real miserable at this point in my life.
Thanks again for your kind words and wealth of knowledge. I've found hope!!
Lori
Mar 09, 2013
 Progesterone advice needed
by: Wray

Hi Lori Very pleased you've increased your vitamin D dose. I don't think you need to increase the progesterone yet, you've said the night sweats are much lighter which is a sign it's working. It does take time to have an affect. We are only conscious of the symptoms we feel, but progesterone has so many roles we have no idea what else is being put right. I also feel once your vitamin D levels are up, this will help too, as a lack reduces the benefits of progesterone. You might like to read these few comments on using both, see here, here and here, scroll to 'Having a Hard Time' or 'Information on Hidden Copper Toxicity'. Such a pity about the pharmacist and gyn, this is so often the case. Thanks for considering the Natpro, let me know what you think of it. If by 2.34 you mean your progesterone level, then it was low. We do have a page on Hormone Testing you can look through. I'm so pleased the info on the site has given you hope. That in itself raises levels of the anti-inflammatory cytokines we make. In fact it raises levels of all the beneficial bio-chemicals we make, and reduces those that harm us. Nothing could be better for healing! Please keep in touch. Take care Wray
Nov 18, 2015
 FSH
by: Pam

Hi Wray,
I hope you can shade some light on this question. I had a FSH level done because of symptoms of fatigue, depressed mood, irritability, night sweats and anxiety. I am 47 years old with one ovary after having a hysterectomy 4 years ago. My FSH came back a 18.8 and my doctor said I am not in peri menopause yet but suggested an antidepressant instead. After reading about symptoms and menopause I thought for sure I was entering this phase of my life. Can you help? Thanks-Pam

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