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USP Progesterone cream and Mirena

by Tigrib
(New Mexico)

I am 45 and after no success with birth control pills to stop heavy bleeding my doctor put me on Mirena. Ablation would be the next option. I have been on Mirena for 6 mo and have seen some improvement with the heavy bleeding but the last 3 mo I have been spotting almost constantly and my PMS, water retention, bloating, swollen breast, and irritability two weeks before my period are really bad. I am ready to start my USP Progesterone cream (17 mg in one pump) in 6 days, according to the directions. I still have the Mirena and need it for birth control and wanted to see if my symptoms would be alleviated with the cream but if I could keep the Mirena for birth control. Does anyone have any experience using the two together?

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Jun 18, 2012
 USP Progesterone cream and Mirena
by: Wray

Hi Tigrib All drug based Contraceptives have the potential to harm. The Mirena does not release progesterone but a progestin called levonorgestrel. This has been shown to lower progesterone levels, plus impeding the blood flow in the uterine arteries, see here and here. Levonorgestrel is derived from testosterone, so has androgenic properties. This is the prescribing information here, and please see here too. You might like to read these comments here from women who've used the Mirena. Your PMS symptoms will not improve with it either, and it will be an uphill battle for the progesterone to help. I have found 400mg/day progesterone is needed to stop heavy and/or continual bleeding. Plus taking 2000mg/day NAC (N-acetyl cysteine), this inhibits the MMPs which cause the lining to breakdown. There's more info on our page on Menstruation. The 17mg progesterone you are going to use will do nothing to help the bleeding, or counter the adverse effects of the levonorgestrel. Even 40mg/day does not raise progesterone levels to that found in the luteal phase, see our page on Progesterone Misconceptions for more info. Take care Wray
Jun 18, 2012
 USP Progesterone cream and Mirena
by: Tigris

Wray, thank you for your comments and for the links you provided. I might add that I also have fibroids and a 13 1/2 cm uterus instead of the normal 8cm. PMS and 2 days of very heavy bleeding are my chief complaints. In my research I came across many articles saying 20-40 mg/day of progesterone cream was adequate. You suggest 10x that amount. I guess it just causes a little confusion for me.
I am so tempted to just pull out the Mirena myself but am afraid I will go back to dealing with the heavy bleeding without it and stuck in the bathroom for 2 days again. Not that constant spotting is very pleasant. I guess my question is why a larger dose than I have read in other articles?
Jun 20, 2012
 USP Progesterone cream and Mirena
by: Wray

Hi Tigris Fibroids are caused by oxidative stress, and exacerbated by oestrogen. Large amounts of antioxidants are needed to reverse it, plus suppressing the oestrogen. The thicker lining is also caused by oestrogen. Oestrogen is a mitogen causing cells to proliferate, plus it's an excitatory, inflammatory hormone. Progesterone inhibits mitosis, plus it's an anti-inflammatory hormone with antioxidant and anxiolytic properties. But enough has to be used. If 40mg/day does not raise levels to that in the luteal phase, it will most certainly not stop PMS or heavy bleeding. If it did you would not have PMS, fibroids or heavy bleeding, as we produce 5-40ng/ml per day during the luteal phase. Please see our page on Hormone Testing. Did the articles you read supply studies showing 20-40mg/day worked? If so I would appreciate you sending me the links, I only suggest the amounts I do because of the hundreds of studies I've read. The levonorgestrel you are now getting, is causing progesterone levels to drop, hence your worsening PMS. If you've read those comments I gave you from women who've used it, you'll notice they also suffered too. Hair loss being the symptom which caused a great deal of concern. This is understandable as levonorgestrel is derived from testosterone which causes hair loss. You might like to read these comments here on heavy bleeding. I have found from experience and reading studies, the worse the symptoms the more progesterone is needed. If you want to read about really high amounts, please look through our page on Traumatic Brain Injury. Over 1200mg/day is given via IV transfusion, plus over 70% of the patients were men too. Or read about Dr Dalton's doses of 2400mg/day on this page here. If you don't want to read the whole page, scroll down to 'Progesterone Contraception'. You are now in Peri-menopause which comes with a host of it's own symptoms, not least are cycles with heavy bleeding to very erratic cycles too. Take care Wray
Jun 20, 2012
 Used both Mirena and progesterone cream
by: Paula

Hi Trigis,
I tried to use both Mirena and natural progesterone, but it didn't work for me. Very bad effects from Mirena (severe depression, hair loss, acne) have led me to remove it. I have this feeling that there's no way a synthetic hormone is going to help balance the endocrine system, it can only make it worse. At least that´s what happened to me. I intent to continue with natural progesterone and maybe begin a traditional Chinese medicine treatment with acupuncture, trying to manage anxiety and also anemia due to fibroids and heavy bleeding during my period.
Hope you get well.
Paula
Jun 20, 2012
 USP Progesterone cream and Mirena
by: Tibrib

Wray, again thanks so much. I think the way I feel most comfortable proceeding is get the NAC that you recommended, remove the Mirena, and begin with a lower dose of progesterone cream and work my way up depending on my symptoms. I start my cream tomorrow. I imagine removing the Mirena will have a few side effect for a bit so it may take awhile to understand the benefits of the progesterone cream. I will make posts as I see things changing. BTW, I think I am noticing my hair falling out more as I brush my hair!
Jun 20, 2012
 Used both Mirena and progesterone cream
by: Tigrib

Paula, thanks so much for your input. I think my next step is to have the Mirena removed. My PMS wasn't as bad before I had Mirena and I had a fairly regular 28 day period cycle except for two horrid heavy days. Nothing like the constant bleeding I'm having now and I think my hair is thinning! I start my progesterone cream tomorrow for the first time. If it benefits me half as much as the research shows I'll be happy.
Jun 20, 2012
 USP Progesterone cream and Mirena
by: Tigrib

Ok, my Mirena just came out, by itself, with three big clots. It came out once before after 3 mo, I had a new one put in a few days later, and now this one came out 3 mo later. Total of 6 mo for both. I think that's an obvious sign so no more Mirena for me. I got NAC today, and think I will start the progesterone cream tonight instead of tomorrow to maybe counteract the crash that I think I experienced after the Mirena came out the first time. I'm thinking of taking vitamin K having read that helps clotting issues. Any thoughts on vitamin K? I was afraid to rely solely on the the natural remedies since I've always thought natural products were not effective enough. I guess now I need to believe they are, since I tried 3 different birth control pills over 9 mo and the Mirena for 6 mo and my Dr said ablation or hysterectomy were next and I don't want that.
Jun 22, 2012
 USP Progesterone cream and Mirena
by: Wray

Hi Tigrib Well your second post couldn't have pleased me more! But I caution against using a small amount of progesterone and working your way up. That doesn't work, and often makes matters worse. Low amounts only stimulate the oestrogen you have, hence a worsening of symptoms. There's more info about this on our Oestrogen Dominance page. I always feel it's best to go really high, then reduce slowly over a few weeks once symptoms have gone. This ensures oestrogen is suppressed and progesterone becomes the dominant hormone. Progesterone is excellent for PMS and Anxiety or depression. I don't think I realised Paula had depression, so I hope she sees the anxiety link too. There are many nutrients which help depression and anxiety besides progesterone. I'm delighted you've got the NAC, it's excellent not only for stopping bleeding, but strengthens hair, nails and skin too. It's a potent antioxidant and one I take daily, and will never stop. Vitamin K is one f the co-factors for vitamin D, recent research has found it doesn't only play a role in preventing clots. But is vital for controlling calcium levels in the blood. It's been found that calcified arteries are due to a lack of vitamin K, and nothing to do with high cholesterol. In fact they found that what was happening in the arteries was the calcifying effect was actually building bone! Vitamin K2 has been found to reduce osteoporosis and cancer too. This is an excellent article here. Vitamin K is one of the cofactors for vitamin D ensuring deposition of calcium in bones, and preventing it's deposition in arterial plaque. Excess free calcium in the blood results in calcified arteries and heart disease, plus depression, see here, here, here, here and here. Dr Cannell recommends all the cofactors for vitamin D should be taken, magnesium, vitamin K2, boron and zinc, see here. The clots you had are nothing to do with a lack of vitamin K though. This is old lining which hasn't been shed during your last period, I've found progestins can do this as they disrupt the reproductive system. Continued below.
Jun 22, 2012
 USP Progesterone cream and Mirena Part 2
by: Wray

Hi Tigrib Re your concerns about natural remedies, remember they are all vital to life, without them we cannot function. Which is precisely what happens to us when we eat processed foods which lack them, or get overly stressed, which uses them up at a rate we cannot replenish fast enough through good food alone. I feel the question to ask ourselves is do we have a progestin deficiency, the answer of course is no, but yes we do have a progesterone deficiency. If depressed do we have a prozac deficiency, of course not, but yes we are lacking many nutrients if depressed. Not least serotonin and dopamine, plus cognisance should be taken of any damage done by depression. For instance the hypothalamus shrivels, this is vital for our emotional health, there are more progesterone receptors in the hypothalamus than anywhere else. If these are depleted it will take many weeks for recovery. Excess oestrogen destroys beta-endorphin neurons in the brain, see here. Beta-endorphin is also vital to our well being. The ramifications are endless if we don't have enough nutrients. You might like to look at this short video clip here. Take care Wray
Jun 26, 2012
 USP Progesterone cream and Mirena
by: Tigrib

Wray, I really appreciate the links you have included for me. I have looked at everything you have sent me. I am on my 6th day of progesterone cream and on my 6th day after having my Mirena come out by itself. It really was a coincidence that my Mirena came out on its own for the second time after exactly 3 months. On this day number 6 I must say that I already feel so much better. I lost 5 pounds in water weight within the first three days, my lumpy breasts are smaller and not sore, my abdomen is not as distended. I took birth control pill for many years, from 18-36. I think that may have contributed to my ovaries not being able to produce progesterone effectively now? From 36 - 41 I had a copper IUD but then heavy bleeding became debilitating so I had it removed. Then at 44 the heavy bleeding became such an issue I looked for a doctors help which of course was birth control pills that didn't work and then Mirena. I'm not sure if I even know what normal feels like, but if it's anything like I'm beginning to feel now I am moving in the right direction. I am currently using 80 mg progesterone cream/day, 1200mg NAC, and 800 mg vitamin D, and iron I was vitamin D deficient and anemic 7 mo ago and biopsy showed no cancer. I will update again in the next week or so.
Jun 28, 2012
 USP Progesterone cream and Mirena
by: Wray

Hi Tigrib I'm pleased the info helped you. I'm really delighted your body rejected the mirena, and wonderful news you're already beginning to feel better. All drug based Contraceptives have the potential to upset the ovaries, particularly when off them. It can take many months for them to begin ovulating again, in the meantime oestrogen and testosterone are being produced. But with no progesterone to counter them, adverse symptoms are often felt. We have one women who writes in regularly who believes they contributed to her own depression and other adverse symptoms. She went up to 1000mg/day progesterone for several months, but still not feeling 100% decided to increase it to 2200mg/day. She says at last she's beginning to come right. See how you get on with the 80mg/day, which I feel is a bit low. It's evidently helping you, but do watch for Oestrogen Dominance, it can come out of the blue. I had a copper T too, and the bleeding did become heavier, the answer of course is to use progesterone too. Which I didn't know about at the time. Delighted you're taking the NAC, but the 800iu's per day vitamin D will keep you deficient. 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. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. Blood levels should be 70-100ng/ml (175-250nmol/L) and not the 30ng/ml (75nmol/L) most labs and doctors regard as adequate. Would love to know how you get on. Take care Wray
Jul 12, 2012
 1 month on progesterone and off Mirena
by: Tigrib

I finished my first month of being on progesterone cream, one month of being free from Mirena, and just finished my first period. I feel great not having the Mirena. My bad reactions from Mirena seem to have subsided after a month, having had it 6 mo. I feel my PMS symptoms reduced about 50% using progesterone the first month. I know the after effects of Mirena still need to be considered. I still had some pretty heavy bleeding for 18 hrs my first period, usually it's easily 24-36 hrs. But the most note worthy is I had no clotting. Usually I have silver dollar sized clots that cause irregular gushes. This was more of a consistent bleed, and I didn't break through and soil the sheets at night. It's not a huge improvement but an improvement none the less. I look forward to seeing how the next month improves. I'm hopeful.
Jul 14, 2012
 1 month on progesterone and off Mirena
by: Wray

Hi Tigrib Many thanks for this feedback. I hope it continues to improve. Take care Wray
Aug 04, 2012
 2nd month on progesterone
by: Tigrib

After my 2nd month on progesterone cream I've seen a little more improvement on my heavy flow from my first month and my clots are a little better as well. My PMS seemed a little worse since I applied only 60mg/day instead of 80mg. I need to increase it back to at least 80mg again or even more. I'm still trying to learn how my body is responding. I even applied some middle of the day as I felt I needed more as it got closer to my period. It's a learning process trying to figure out the dose but I'm learning to read my body. I guess that's part of it. I'm still hopeful progesterone cream is going to help my symptoms.
Aug 16, 2012
 2nd month on progesterone
by: Wray

Hi Tigrib It's wonderful you are willing to experiment with the amount needed. All too often women think a single 'dose' should do it, progesterone doesn't work like that. I still use about 170mg/day, any less and I get very emotional. I often top up with more when feeling stressed, and often apply it more than twice a day too. Please continue to let me know how you get on. Take care Wray
Sep 03, 2012
 3 mo using Progesterone Cream
by: Tigrib

Just finished my third cycle using the progesterone cream. Month 3 was about the same as month 2, which is basically a 50 % improvement in PMS symptoms and clotting. My bleeding is still heavier than I want it, but there is probably a 40% improvement there. I have been more aware of cutting out xenoestrogens. I think I may start with a lower dose of Progesterone Cream on days 14-21, and then bump it up 5-7 days before my period. I say this because I think I felt better 5-7 days before my period on the amount I was using, but not as well the first week. I am glad to see some improvement but I hope there is more to come.
Sep 04, 2012
 3 mo using Progesterone Cream
by: Wray

Hi Tigrib I so appreciate your feedback, and I'm sure it helps others starting off using progesterone. I have suggested to some women who suffer from PMS etc to increase the amount they use the few days prior to bleeding, it does seem to help. I'd be interested to hear if it helps you too. You mention the xenoestrogens, you might be interested in looking through this excellent site on them, Our Stolen Future. Plus these papers on the phytoestrogens, see here, here and here. These papers here and here,, show how a high level of phytoestrogens in food can affect the reproductive organs. If you are still using only 80mg/day you might consider increasing to 100mg/day to see if that improves things. Take care Wray
Oct 02, 2013
 Name of natural progesterone cream ?
by: Laura

I. I was wanting to know which brands of natural
Progesterone cream are the best . I have been
reading about Arbonne's and was wondering what
Anyone thought of that brand ?
Oct 05, 2013
 Name of natural progesterone cream ?
by: Wray

Hi Laura I can't tell you anything about Arbonne, as I can't find what ingredients they use. No website gives them, or even how much progesterone it contains. But I do know what our progesterone cream contains, you might like to look at the ingredients. We also run Saliva Tests on the cream, so know the progesterone is absorbed well. Take care Wray
Jan 25, 2014
 just had mirena removed
by: seekingtruth

How effective is natural herbal supplements such as Macafem to remove the side effects of the Mirena.
Nov 10, 2015
 how much
by: ericka

Hi!! I have recently got my mirena removed in may of this year. All my symptoms point towards low progesterone especially knowing what the mirena pumps in the body!! About how much should I be using? I'm also using vitex, evening prim rose, i3c, a phytoestrogen to keep the extra estrogen I have in balance. And probiotics and a good mutlivitamin. I've been putting the progesterone.cream three times a day but wondering exactly how much I should do or if I do too much etc.
Nov 11, 2015
 Your body
by: Anonymous

Erica, I hope you feel better without the Mirena, I know I did. My body did not like the synthetic hormone. Start on a lower dose of the cream and work your way to a dose that makes you feel the best. My previous posts are a little outdated. I had a fibrous uterus and had a laparoscopic supracervicle hysterectomy 2years ago which I dreaded at the time but it was the best decision for me. I have my ovaries and cervix, don't take any hormones or pills beside a multivitamin, and this is the best I've felt in many, many years. All natural is the best for me.i hope you find your best.

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