I?ve started using progesterone after using conventional HRT for some time.

I?ve started using progesterone after using conventional HRT for some time, . When I started natural progesteroneI wasn?t getting any hot flushes and my periods were regulated but now they have returned with a vengeance. Why?

The estrogen and progestogen combination in HRT up until now have carried you over but as they move off the receptors and the levels of synthetic HRT drop, the effects of HRT also wear off.

This is when women suddenly realise they haven’t passed through menopause at all. Regular periods have been controlled synthetically.

Furthermore, the introduction of natural progesterone sensitises the estrogen receptors creating estrogen dominance wake-up crisis. Much of the progesterone sites are still occupied by stubborn progestogens, thus natural progesterone cannot provide full benefits for some months.

The transition period from HRT to natural progesterone can be very discomforting.

Women coming off HRT find themselves in ‘natural menopausal territory’, facing symptoms that HRT has perhaps treated but may not have totally resolved, preventing women from making that ‘rite of passage’. This is the dilemma a good many women face. They cannot cope with HRT side effects, but then they have to deal with the problems of menopause once they stop using HRT.

It’s very hard for long-term users of HRT to make that switch to natural progesterone. Their body has grown accustomed to strong, synthetic analogues.

Maybe their body is overloaded with the remnants of HRT, taken over many years. Basically, for some women, detoxing from HRT, getting the liver function going again, allowing time for receptors to be available for natural progesterone, then allowing for saturation and response to natural progesterone … takes personal commitment and an understanding of how the body needs to adjust.

Many women have returned to HRT only to find the need to forever increase dosage to abate symptoms with side effects and breakthrough bleeding worsening. And menopausal symptoms resurfacing despite HRT.

In other words, after 10-15 years, HRT was no longer effective for them, leaving them with little choice but to return to progesterone therapy. To continue with HRT was to put further work on their liver and aggravate weight and metabolic problems (blood pressure, cholesterol, thyroid, insulin resistance).

It’s a difficult process, and we do understand.