Am I the ONLY woman who feels worse on natural progesterone cream?
Dear Catherine,
Am I the only woman to feel worse on natural progesterone cream? I came off HRT last Aug and have been using a 2000mg natural progesterone since Sept 03 - 4 months. I halved the dose after 2 and a half months because of sweating, hot flashes, terrible weeping fits, aching joints, exhaustion. Was OK for a bit, had my week off it and it all started again the first week back on it. I was advised to increase the dose again at the beginning of my 4th month because I was still feeling awful. Someone else has now told me to just use an amount about the size of a match head and still have my usual week off. I have only done this for the last 2 days and am still feeling terrible.
For interest, I am 49 and have not had a bleed since coming off HRT. My problems with menopause started at about age 44. I found HRT good but had to come off because of bleeding all the time. Should I be taking more or less natural progesterone cream to get rid of these awful symtons?
Thank you
Julia
Dear Julia,
You’re definitely not the only woman out there in cyberspace struggling without success to come to terms with hormone imbalance while incorporating progesterone into your health regime. Does this mean progesterone doesn’t work? Not necessarily.
This bring us back to the fact we ought not to ‘blindly’ embark on a hormone replacement program without some idea of our hormone fluctuation levels each month. I think most prudent doctors these days agree it’s imperative patients collect a salivary hormone profile to establish a baseline before embarking on hormone replacement. In so doing, your healthcare professional may consider there is a need to supplement one or two other hormones to get the balance right for you.
If you do not feel right, then something is wrong. If your hormones are low or out of balance, then you will not feel good. Hormones are needed to keep you happy. Saliva testing will identify hormonal status and hormonal imbalance. Intervention with natural hormones can change a person’s feeling of well being for the better and can substantially reduce the risk of almost all of the diseases of western society.
The risk of prostate cancer, breast cancer, heart disease, diabetes, osteoporosis, weight problems and a host of other less serious health conditions can be determined and often prevented when acting on information provided from a saliva assay. Breast cancer, for example, is extremely rare amongst women who have good levels of progesterone.
As new emerging evidence comes to hand, this Network is discovering that high dose creams / pessaries can inadvertently lead to overdosing. Now, while there appears to be a substantial safety margin in the use of progesterone, we can confirm high progesterone levels result in a decrease in progesterone benefits. Furthermore, this hormone has the potential to accumulate and contribute to disruptions in the adrenal hormones such as DHEA, cortisol, and testosterone. Needless to say, elevated levels of progesterone are not healthy. Lower dose creams (2%) delivering 20mg per application help you avoid this.
What you need to do here, Julia, is restore a progesterone to estrogen ratio of 200~300:1 with the aid of saliva assays.
Keep in mind also, Julia, that moving from artificial HRT to natural progesterone cream doesn’t always deliver immediate results. Stubborn synthetic progestins take time to move off the progesterone receptor sites, freeing them up for natural progesterone activity.
You also need to consider your liver. The liver not only breaks down and eliminates toxins in the body, this process contributes to reducing estrogen dominance by assisting in the removal of excess hormones thereby promoting hormone balance. This facilitates more effective performance of progesterone and possibly provides scope to reduce you dose if the body is functioning optimally. On the flip side, a woman with a fatty, dysfunctional liver will require far greater dosage of progesterone perhaps with minimal benefits. By incorporating nutritional supplements in adjunct with liver work, you will go a long way to restoring hormone balance and fine-tuning your cream dosage to suit your individual profile.
Some women come off HRT “cold turkey” and feel great for 2-3 months, and then fall into a hole. The reason being, they are initially over-riding estrogen dominance symptoms with progesterone and also they have reserves of estrogen in their body fat. The sudden slump occurs once they have used up all their body’s reserve of estrogen. Symptoms such as hot flashes, teariness, anxiety, palpitations, insomnia, bladder infections, cystitis, may surface. If this occurs it is perhaps advisable to re-introduce a small amount of estrogen (estriol cream) to restore equilibrium to the body and to abate symptoms. Then, if inclined, a gentle reduction program using your symptoms and salivary assays as a guide.
With the reduction of estrogens and the introduction of phytoestrogens via diet, and vitamin and minerial supplements, women usually find that estrogen supplementation is no longer required to control hot flashes beyond a very small amount of estrogen cream to maintain vaginal tissue health, and to protect the vagina from atrophy.
If a woman genuinely requires estrogen therapy, then she is advised to use the minimal amount to maintain hormonal health. Particularly thinner women who are at greater risk of osteoporosis and hot flashes. We recommend patches or cream rather than tablet form so the body does not have to break it down via the liver.
If progesterone cream alone does not abate symptoms of hot flashes and vaginal dryness after four to seven months (incorporating phytoestrogens), it’s usually an indication that some form of estrogen is required. Best you get your hormone profile checked out.
Dr John Lee maintained there are 3 rules to using Bioidentical Hormone Replacement Therapy (BHRT):
Rule 1. Give hormones only to those who are truly deficient in them.
Rule 2. Use bioidentical hormones rather than synthetic hormones.
Rule 3. Use only in dosages that provide normal physiologic tissue levels.
Clearly, there’s more to hormone balancing than slapping on a bit of progesterone cream! To that end I look forward to Professor David Zava’s upcoming visit to Melbourne early this year where he’ll be fronting a clinical workshop on Hormone & Thyroid Management.
