Should I take progesterone every night and never take time off?
Hi Catherine,
I am 62 and have not had a period since I was 57. When my Naturopath first tested my hormone levels in the summer of 2003, because I was having problems such as frequently crying, dry skin, trouble sleeping, I was found to be Estrogen dominant, with NO progresterone in my body at all. He suggested I try one of the Progesterone products that my local natural foods store sells. I tried it for a few months and didn’t see any difference in the way I felt. He then prescribed a natural Progesterone compound for me in the form of a gel. It is 200 mg. per pump, and he had me to do 4 pumps each night (totalling 800 mg.).
He recently re-tested me using a saliva kit and found that all of my estrogen hormones are back where they should be, but my Progesterone is “off the chart.” He told me to cut back to one pump of Progresterone each night. He said that there is no harm in having this much Progesterone, but I am concerned and would like your opinion.
The directions on the store-bought progesterone cream said to take it for 25 days, then stop for a week. My Naturopath said to take this new Progesterone every night and never to take time off. Do you agree with this? Can it harm me in any way by never taking a break? I have read pros and cons of both.
I still have some of the same symptoms I used to have (pre-progesterone cream), and I know every woman’s body reacts differently to this treatment.
Thank you for taking the time to read this.
Rachel
Dear Rachel,
I’m not surprised your progesterone levels are unnaturally elevated. 800mg transdermally a day is a pretty hefty dose! That’s about twice as much as a pregnant woman would put out [via the placenta].
High doses are generally well tolerated short term when a woman is considerably progesterone deficient. But it doesn’t seem to take very long for stores to build up, particularly if she had a degree of body fat, or if other contributing factors have not been addressed.
Dr John Lee stood by his belief that women use bioidentical hormones only in dosages that provide normal physiologic tissue levels. That would be roughly 20-30 mgs progesterone per day. And I tend to agree with him. Even at these very modest levels, we can still potentially end up with too much progesterone circulating in our body if ‘other’ factors are at play.
We know that, in excess, progesterone can cause lethargy or sleepiness which is often reported when women use oral progesterone. But even in an excessive dose, high progesterone levels tend to cause no particular side effects other than a decrease in potential progesterone benefits. We do know that when cream accumulates, it can contribute to disruptions in the adrenal hormones such as DHEA, cortisol, and testosterone.
Higher pharmacological dose of progesterone are medically indicated in some situations - infertility being a good example - but as a rule women who are still ovulating each month wouldn’t normally manufacture more than 20-30mgs of progesterone a day during the last two weeks of their cycle.
Mother Nature doesn’t bombard our receptor sites with progesterone 24 hours a day, 7 days a week, month after month. Why then would we supplement progesterone in this manner? Wouldn’t it make sense to follow Mother Nature’s template? Cell receptors will, over time, down-regulate if we don’t give them a ‘rest’. Should this occur, we tend to need twice as much cream to get half the result.
Rachel, for all these reasons (and some I haven’t discussed here) I recommend physiologic doses rather than pharmacologic doses (less is best!). Taking a 5-7 day break from cream each month will ensure you continue to get optimal results. And keep in mind, not all progesterone creams are created equal. So if you aren’t getting results try another brand. If you still have unresolved symptoms, as you suggest, well then this would indicate progesterone supplementation is only one piece of the puzzle.
