I have been sick since stopping progesterone

Hi Catherine,

I was using natural progesterone cream for 7 months with good results - tho I still had some symptoms (tho minor) of imbalance.

I decided to do a saliva test of my hormone levels, and foolishly decided to stop the progesterone supplementation for 6 weeks prior to doing the test - thinking I would then know what I “truly” was producing on my own.

I have been sick since stopping the progesterone. The saliva test came back indicating normal levels of estrogen but deficient levels of progesterone.

• progesterone = 20 pg/ml (luteal), estradiol = 2.7 pg/ml (luteal):
  a ratio of P/E2 = 7

When I stopped the progesterone cream I experienced major breast pain and tenderness, headaches, aching in my joints, extreme fatigue and very heavy periods.

I have been back on the cream for 2.5 weeks and tho my breasts aren’t as tender, I still have excessive fatigue, terrible headaches and just feel crappy. I have slight cramping and just don’t feel like I am experiencing any real relief …

My question is - will my body ever get back to normal? Have I somehow desensitized my receptors or whatever and will be stuck this way? Should I be using more than normal progesterone at first or stick with 1/8 to 1/4 tsp 2x a day? I can’t remember when I felt so ill - it is almost like morning sickness - smells make me nauseous, and I am just so tired!! (I am DEFINITELY not pregnant - tubes tied, no sexual activity)

Thank you so very much for any guidance you can give me…….I realize you are not a Dr. and will not hold you liable for any advice you can give me.

Again, thank you.
Pam

Dear Pam

A baseline hormone panel really ought to be undertaken BEFORE a woman commences hormone replacement therapy (if possible), because it’s at this point she and her GP can accurately capture, as you put it, “what I truly was producing on my own.”

You [and your GP] can assess your baseline hormone levels to monitor and, if necessary, adjust your hormone replacement therapy.

Having said that, I fully appreciate some women just don’t have the funds available to purchase pre-paid saliva testing kits on top of the cost of their cream (and doctor’s bill). We do what we can afford.

In your case, Pam, a snapshot of your hormones at the point where you were realising some benefit from your progesterone cream would have been most beneficial.

The half-life of progesterone in the body is measured in hours, usually 8-12 hour coverage. In a woman carrying little or no body fat, progesterone can wash from her body within weeks, sometimes within days.

It’s no wonder, therefore, you began to feel unwell as you withdrew progesterone.

Your progesterone (P) to estradiol (E2) levels are less than 200 to 1, which is far from a healthy P/E2 ratio. This might explain why, when you supplement progesterone, your estrogen dominance symptoms abate and you tend to feel better.

If you multipy your estradiol levels of 2.7 pg/ml by 200, then your progesterone levels ought to be at least 540 pg/ml … not 20 pg/ml (luteal). By all accounts, you’re progesterone levels are insufficient to adequately ‘oppose’ the action of estrogen in your body.

The Johns Hopkins University conducted a 20 year study, published in 1983 in the American Journal of Epidemiology, showing that women who had good progesterone levels had less than a fifth of the amount of breast cancer, and less than a tenth of all the cancers that occurred in women who were low in progesterone. These outcomes suggest that having a normal level of progesterone protected women from nine-tenths of all cancers that might otherwise have occurred.

Pam, it’s likely that prior to discontinuing progesterone, you required a marginally larger dose to off-set niggling symptoms that your current daily dose was not rectifying. Remember, each woman is different. The dose that works for you may not work for me. We really need to move away from this “one size fits all” mindset.

As I’ve discussed many times over in my ‘Hormone Harmony‘ newsletters, there is a significant safety margin with progesterone creams because they contain the hormone identical to that produced by the human ovary. During pregnancy, a young woman’s body will produce up to 400mg progesterone per day. Given that the toxicity of progesterone is extremely low, we have room to safely individualized our dosage against symptom relief.

I urge you to chart your monthly progress to assess the reduction or flare-up of symptoms against dosage. This takes the guesswork out of progesterone treatment.

Progesterone cream applied at pharmacological doses ranging from 100mg-200mg per day may be considered as a short-term measure (ie., 2-3 months) if estrogen dominance symptoms are quite severe and need to be brought under control fairly quickly, or are not improving at physiological doses. This approach appears to be well tolerated while you boost your progesterone level to a healthy ratio. However, long term, extremely high doses of progesterone can lead to suppression of natural hormone production and can promote abnormal actions in the body.

You need to keep in mind that optimal metabolic health is not regulated merely by progesterone treatment. Based on what you’ve written here, Pam, you may want to discuss with your doctor more comprensive testing to rule out chronic health problems.

In light, love & laughter,

Catherine P. Rollins
CEO, Making Plans Pty Ltd
Natural-Progesterone-Advisory-Network.com

“Supporting Women in their Choice of Bioidentical Hormone Replacement Therapy (BHRT)”