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Spotting and irregular periods

Hi Wray,

First off, thank you so much for your website and all of the research and advice you have given! This site has seriously helped me so much with everything.

I am 25 years old. When I went off birth control three years ago, I was a mess. I would go months without a period. In addition, a slew of other issues popped up like bad cystic acne (something I've had since age 12 but was almost completely treated), ovarian cysts that would come and go, painful sex, decreased libido, and severe constipation (that even prescriptions from doctors could not fix.)

Since starting natural progesterone cream, my period has returned! Also, every symptom above except acne has vanished after just a month using the cream.

I was on spironolactone for the last 2 years for acne, and although it cleared my skin, I had even more bad side effects, so I am almost weaned off of it now. Consequently, the acne returned when I lowered my dose (before starting cream.) I am seeing some improvement from the cream, though. I have also started your recommended dose of vitamin D.

However, my main concern writing you is my period is completely random. I am spotting every week or two, or bleeding a bit heavier (more like an actual period.) I honestly have no idea when my real period is supposed to be, or which spotting occurrence is the real deal and the one I should be starting the breaks on.

I've read on your website that you sometimes recommend using cream daily instead of taking a break for a few cycles. I am willing to try this; however, I am really really scared that my period will stop again. Any advice would be appreciated! Thank you so much again.

Comments for Spotting and irregular periods

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Nov 05, 2012
 Spotting and irregular periods
by: Wray

Hi there Thanks so much for the kind words and I'm so delighted you have responded so quickly! I have found younger women do, it's those in Peri-menopause that have such problems. I'm also very happy you've come off the Contraceptive, all the drug based ones have the potential to harm. All the symptoms you've given indicate low progesterone, high oestrogen and testosterone. I'm pleased you've almost weaned off the spironolactone. Although touted as an anti-androgen, it does have androgenic properties, see here, here, here and here. And pleased that you're taking a good dose of vitamin D too, that really pleases me, as it's such a vital nutrient. Please could you let me know how much progesterone you're using. It could be it's not enough, although progesterone can upset the cycle when first using it, so it could be this. It does settle down given time. I do recommend using the progesterone daily if symptoms are severe. The bleeding only stops if amounts of 400mg/day or more are used. As your symptoms seem well under control, I don't see any reason for you to use it daily. But I suspect you're not using enough, and that your testosterone is too high. High testosterone initiates acne, see here. This paper also explains why your acne started at puberty. We do have a page on Acne too. 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. Continued below.
Nov 05, 2012
 Spotting and irregular periods Part 2
by: Wray

Hi there You'll notice the amounts of progesterone used in the above study went up to 1200mg/day, a huge amount. The reason being they used oral progesterone, it's the least effective Delivery system. SHBG also drops if sugars are eaten, even those found in all grains, legumes, dairy 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. When you apply the cream, please rub some on your face too, I've found it seems to work quicker if applied to the problem area, be it acne, piles, burns, period cramps etc. It's also good for the face too, see here. Take care Wray
Nov 06, 2012
 Thank you!
by: Anonymous

Wow! Thank you for such a quick response, Wray. Your advice is invaluable, as doctors don't seem to listen to me anyway, not to mention when I try "outside the box" methods.

I am so pleased with the results I've gotten so far too! I also have had anxiety most of my life and I finally feel content and calm.

I am taking less than 20mg a day (probably 10-20mg nightly.) I know that you recommend more like 100mg-200mg, but I wanted to start off slow, especially since I am still weaning off spiro. I am pleasantly surprised that this little has been working so well, but am wary to use too much too fast. I gained weight and my hair thinned on spiro, and now that I'm back to normal I don't want anything like that to happen again. Do you think I risk negative side effects if I use too much?

I think I understand what you said about my initial question. To clarify, should I just take a break at the day after day 28 like traditionally recommended? Even if it's not that time of month for me for sure? Or take a break when I start heavier bleeding? Like I said before, I have no clue where my cycle is at.

Thanks for the suggestion on avoiding sugars. I am gluten intolerant so I avoid wheat grain but I'll try to avoid sweets more. It's healthier anyway! :) Also, I put the cream on my face the past few days and it has helped a bunch! I hope it continues this way.

Thanks so much again for your response!
Nov 07, 2012
 Thank you!
by: Wray

Hi there Pleased it helped you! You have responded to a low amount. See how you get on, as I've generally found increasing slowly only worsens symptoms. But you are young, it's the older women who suffer if doing that. No negative side effects if using high amounts, a very high amount causes a sense of euphoria, what a way to go! Sorry, I didn't really make it clear about when to use the progesterone. As you don't have a cycle to speak of, use the 28 day cycle to begin with, your own will show itself in time. Although it could be 28 days. So use the progesterone from ovulation to bleeding. Ovulation occurs in all women, 12-14 days before bleeding. So in a 28 day cycle it will occur ± day 14, start using the progesterone then for the next 14 days, then stop. Bleeding should occur within a day or two. But you might find it's still erratic, in which case you'll need a much higher level to correct this. And if your acne doesn't clear up, you will need more. Please use it a minimum of twice daily too, progesterone levels begin dropping after about 13 hours. Delighted that it's helped your face! Let me know how you get on. Take care Wray
Nov 08, 2012
 Update
by:

An update since my last comment... I tried taking a break the day before last, and I felt incredibly anxious yesterday.

My bet is on my body not being completely adjusted yet, since it's only been a month. I used the cream again last night since I was feeling so crappy and the anxiety vanished within hours. I feel great again today.

I guess I'll have to work up to a normal 7 day break!
Nov 10, 2012
 Update
by: Wray

Hi there Thanks for the update. You say you tried taking a break, presumably that was trying to follow a 28 day cycle? i.e. you had used the progesterone for 14 days, and then stopped? A normal break for a 28 day cycle is 14 days, not 7. I'm beginning to feel the tiny amount you're using is not enough, as under normal circumstances you shouldn't feel anxious. So this means you are now not following your cycle, and are using the progesterone daily? I suspect you will have to use more, and use it daily for 2-3 months to suppress the excess testosterone and boost your progesterone levels. But see how you get on, and please keep in touch. Take care Wray
Nov 11, 2012
 Confused!
by: Anonymous

Hi again, I am super confused now! I scanned in the suggested use instructions from my cream. Here's the link: http://i48.tinypic.com/33mubmg.jpg

It says to use it on days 8-28, taking a 7 day break. I see now that you recommend differently. Why would the suggested uses differ so much?

Yes, I only took a day off after the other 21 days and have been using it daily. I will try using a little more cream and will try to take another break when I start bleeding again or at the appropriate time. I haven't been following a cycle because I don't know what my cycle is -- so that last break was forced based on how long I was taking it. Thanks so much for your replies, this is all new and a little confusing to me!
Nov 12, 2012
 Confused!
by: Wray

Hi there Thanks for the link, I can see now why you're confused! There are so many Progesterone Misconceptions I did this page on some of them. The whole idea about supplementing with progesterone is to boost too low a level. So if a woman has a cycle, it should be used when our own progesterone is made, i.e. after we ovulate, for the 12-14 days of the luteal phase. This occurs in all women 12-14 days before we bleed. So no matter how long the cycle is, and some women have 35 day cycles, ovulation only occurs 12-14 days before bleeding. This is when progesterone should be used. We make none in the follicular phase. But to confuse you further! There is a surge in progesterone about 50 hours prior to ovulation. This surge comes from the brain, see here, here, here and here. Oestrogen also surges 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. If any of these symptoms occur, I do recommend starting the progesterone during those 50 hours. I also suggest this to women wanting to fall Pregnant, as an early luteal phase surge is essential for implantation to be successful. Although the amount you are using won't affect it, using 100mg/day or more progesterone 5 to 8 days prior to ovulation can stop this. In other words it acts as a contraceptive. I thought initially that the amount you were using was enough, hence my suggestion to try following an average cycle to begin with. I'm beginning to think you should use it daily, through any bleeding, for 2-3 months. This will ensure any excess testosterone and oestrogen are suppressed, and progesterone becomes dominant. Take care Wray
Jan 07, 2013
 An Update
by: Anonymous

Hi again Wray, I wanted to update you with my progress. Maybe it will be useful in some way. There is good and bad news.

The good news is my periods are regular and predictable now. When I stop the cream, they come, last a normal amount of time and are the normal amount of bleeding for me. No spotting between. I am so so happy about this!

The other not so good news is that my skin is the same... kind of. In my follicular phase, my skin clears almost completely and looks fantastic. My mood reacts in the same way -- I feel wonderful and have little to no anxiety. It's like two weeks in heaven.

My luteal phase, however; is like hell. My skin breaks out in those two weeks. Also, my moods drop drastically... this is what is concerning me the most.

I started the cream at the beginning of Oct so this would be the beginning of month 4. I have still been using the cream for three weeks, and taking a week off. I would love to only use it in my luteal phase, but it just doesn't feel possible right now. I feel like if I didn't use it before ovulation the drop would be even worse. The progesterone acting as a contraceptive is not an issue for me at this point, as I don't want to fall pregnant.

I have had major anxiety in this last luteal phase. Last night (two days before the "scheduled" follicular phase when I start the cream again) I had horrible panic attacks that lasted most of the night. In the middle of the night when I just couldn't take it anymore, I rubbed 40mg of cream on my stomach and legs. I felt IMMEDIATE relief. I started to be able to breath and felt calmer within minutes.

I decided to up my dose a little like you've suggested today. I am now taking 60mg (20mg in the morning and 40mg at night) and I plan to take 80mg-100mg in the luteal phase to see if that helps. Would using it daily instead of a break make any difference to the luteal phase? Do you ever recommend using more during this time? Do you think it would help the Dr. Jekyll / Ms. Hyde occurrence? Sorry for all the questions! You have helped me so much already.
Jan 09, 2013
 An Update
by: Wray

Hi there I'm delighted your cycle is regular now, but not with the other problems you've been having. All pointing to far too little progesterone. I did wonder if the low level you were using would in fact be too little. I really feel you should use it daily, through any bleeding for at least 2-3 months, until you feel stable, then you can try to follow your cycle. I feel it's more important to get rid of symptoms first. I know you were anxious to get a cycle going again, but it's really not important. As you can see the progesterone can help with that if it should get disrupted. You're only 25 so there's ample time to get it going again once feeling better. This passage of yours has me really confused..... "I have had major anxiety in this last luteal phase. Last night (two days before the "scheduled" follicular phase when I start the cream again) I had horrible panic attacks that lasted most of the night." The follicular phase begins when bleeding occurs, so why would you use the progesterone immediately after bleeding? The "two days before the "scheduled" follicular phase when I start the cream again" would place you 2 days before bleeding which is precisely the time when PMS hits. Although progesterone should be the dominant hormone during the luteal phase, oestrogen also rises. If the corpus luteum is making insufficient progesterone, or if none at all is made due to anovulation, then oestrogen will be the dominant hormone making you feel awful. In which case you will need far more progesterone than you are currently using. So please try using 200mg/day, and using it daily through any bleeding, for at least 2-3 months. And have you had your vitamin D levels checked, as a lack of this reduces the benefits of progesterone. Take care Wray
Jan 11, 2013
 sorry!
by: Anonymous

Sorry about the confusion... it's really me getting all mixed up in my head.

Here's what I have been doing:

7 days off for bleeding
3 weeks of progesterone
7 days off for bleeding
3 weeks of progesterone

And so on. During the seven days off, I am usually fine. I am also feeling great in the week after bleeding, when I am using it again. It is the two weeks after that where I start to feel bad. If I understand correctly (which I probably don't) ovulation happens around 14 days before bleeding. This is about when I start feeling crappy each month.

That's why I was saying in my luteal phase I've been feeling badly... is that correct? My apologies if I am misunderstanding again.

In addition to the hard phases, I had that panic attack episode on the last day of the 7 day break. I think you are correct suggesting it be used daily. I had panic attacks before starting progesterone, just not since starting it, so it was quite upsetting.

I will try to use it daily and see how it goes. I am taking a lot of vitamin D already (6000iu's) since I am in a high-altitude colder climate. I started taking around 30mg zinc in addition yesterday, as I am hoping it might help the remaining acne. I am also considering trying Natpro to see if it affects me differently than this other cream. Do you offer samples?

Thanks again for your help, and sorry about all the misunderstandings I've been having! This is all new and confusing to me.
Jan 14, 2013
 sorry!
by: Wray

Hi there Well now I understand, thanks for clearing it up for me. It appears you are either not ovulating, or if you are, your corpus luteum is not making sufficient progesterone. This would make you feel awful. It's when the ratio of progesterone to oestrogen gets out of sync, with higher oestrogen to progesterone, that things really go awry. During the follicular phase, progesterone is at it's lowest. Oestrogen begins rising slowly during this phase, so the ratio is not too disturbed. It's only when oestrogen rises exponentially in the 50 hours prior to ovulation, when progesterone should too, but doesn't, that things come apart. After the 50 hour rise, oestrogen takes a dip, but progesterone should continue rising if ovulation has taken place. Oestrogen also makes another peak mid-luteal phase. If the 50 hour surge of progesterone doesn't take place, or if ovulation has failed, or the corpus luteum is making insufficient, there's nothing to counter this rise in oestrogen, so things fall apart. I didn't realise you had panic attacks prior to using progesterone, we do have info about them on our Anxiety page. You are taking a good amount of vitamin D but please have a test done. It's winter now and levels drop, so more is normally needed. Only by having the test will you know if you are taking enough. Unfortunately we don't offer samples of the Natpro, but it is one of the cheapest creams on the market. And if you did our questionnaire, the link is found top right of this and every page, you can get any amount for a 30% discount. It's a once off offer, although we do give discounts for 20 tubes or more. Take a look at this page here to check the ingredients we use, all as natural as possible. Take care Wray
May 03, 2013
 another update - switched to natpro
by: Anonymous

Hello again Wray, Long time no talk! I want to thank you again for your advice. I took it to heart and am so pleased with how things are going.

I switched to Natpro and am glad I did... as you said the price is better for the amount of progesterone. I had a question about this... do you offer an autoshipment program? I looked and I'm guessing that you don't. :( I try to buy a couple tubes every month but sometimes it says you're out of stock. I would love it if I could be billed and shipped a certain amount automatically every month! :)

Everything is going great. I did stop taking Zinc. It seemed to help the acne at first but then I started getting tons clogged pores in places I never had before. I read somewhere that zinc affects testosterone so maybe that's why?

The progesterone keeps most of my acne at bay but not all, at least at the amount I can afford to use. I do take it everyday like you suggested, regardless of my cycle and that has helped the most with all of my symptoms.

Anyway, along with Natpro I started taking DIM. It seemed to somehow "boost" the effects of the progesterone and the acne is finally going away completely. I have only been on DIM for a little over a month but I feel that in another month or two I will be completely clear.

All of my other estrogen dominance symptoms have vanished since using progesterone and have not returned. I wish I had discovered it so much sooner as it has improved so many areas in my health and happiness. Thank you again.
May 03, 2013
 another update - switched to natpro
by: Wray

Hi there I'm so delighted you're doing well, and thanks for trying the Natpro. I know we were looking into an auto shipment program, and in fact thought we had it set up. I will ask about it as it is a good idea. I can be very absentminded and I know I would forget to order it till too late. I'm puzzled about the zinc, I will have to look into that, as I've not heard it before. Well if you put testosterone into PubMed you will of course only get studies done on males! As if females don't make it. I did find one on PCOS though, which indicated calcium is high and magnesium is low, see here. This might sound obtuse to you, but women with PCOS are generally plagued by high testosterone and acne. I know you take vitamin D, but are you taking magnesium, it is the most important co-factor for vitamin D. If not please consider taking it, who knows it might help. I also found a paper which found that testosterone increases zinc levels in male rats, if you can relate to that! See here. Progesterone also raises levels, so maybe you don't need as much now. Please keep a check on your vitamin D levels by having a test every six months, they do fluctuate and it's best to keep on top of it. I do appreciate feedback, even if negative, as I learn from others experience. So thank you! Take care Wray
May 08, 2013
 that would be great!
by: Anonymous

Thanks for your reply again, Wray. I would love it if auto-shipment was possible... it would really simplify things. I am the same way, I forget until I'm already out.

I don't understand the zinc thing either. It's supposed to inhibit DHT. http://www.ncbi.nlm.nih.gov/pubmed/3207614 Maybe it had to do with the type that I was taking (Zinc Gluconate). Perhaps a higher quality zinc would have helped. I can tell you that it was working on some level, because I had very vivid dreams every night while taking it. However, I'm not that worried about it since I've found progesterone and DIM.

PCOS could be a possibility, as I had a few of the symptoms. I'm thin and very healthy though, so no one has ever brought it up. Doctors are always VERY short with me. That or they try to prescribe lots of medication that I don't want to take. That has lead me to taking care of myself which has lead me to start taking progesterone.

Interesting thoughts about Magnesium. I will look into it more! Thanks for the suggestion and have a great day! :)
May 09, 2013
 that would be great!
by: Wray

Hi there I have made enquiries about having the auto shipment option, waiting to hear back. Thanks for the paper, it's one I didn't have. It was on using topical zinc, not oral. So it could be you took too much, zinc gluconate is a good choice. It's so interesting you had vivid dreams, as a lack of zinc and B6 stops people dreaming. Or I should say remembering them, which is the case with me, I never remember them. I have experimented by taking high amounts and found it worked, but am back to the 15mg/day. There's a limit to how much I'm prepared to rattle with supplements! We do have a page on PCOS you could look through, you don't have to be overweight to have it. Doctors and drugs go hand in hand, a great pity, as they only do us a disservice, causing many to turn to their own research and treatment. Maybe one day when we are all self medicating naturally they might join us! Take care Wray
May 09, 2013
 Auto-shipping
by: Wray

Hi there I've had a reply about the auto-shipping and it's not good news. This is the reply I had back from the department handling it...... "We tried it about 3 years ago and it proved major uphill as people set it up then cancelled after shipment, and we had to refund and get the cream back. And others forgot they'd set it up and we got irate emails accusing us of abusing credit cards etc etc." Such a pity. Take care Wray

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