Menstrual Cramping & Progesterone Supplementation

Menstrual cycles last about 28 days (cycles of 23 to 35 days are usually considered normal as well). During this cycle, the hormones estrogen and progesterone send messages to the lining of the uterus. About day 5 of the cycle, the estrogen causes the lining of the uterus to grow and thicken. Around day 14, an egg is released from the ovary. After this, progesterone causes the glands to release nutrients and blood vessels swell to prepare for the possibility of pregnancy. If the egg is not fertilized, it moves to the uterus and is absorbed or disintegrates. Estrogen and progesterone levels decrease, and the lining of the uterus breaks up and is shed as menstrual fluid.

The uterus, like other muscles, contracts and relaxes. Most of these contractions are not even noticed, but strong ones can be painful. During menstruation, the uterus contracts more strongly than at other times and produces the uncomfortable feeling we know as menstrual cramps. Prostaglandins, natural substances made by cells in the uterine wall, make the muscles of the uterus contract. Strong contractions cut off blood and oxygen supply temporarily and cause extreme pain. This pain is known as primary dysmenorrhea.

Dysmenorrhea

Menstrual Cramps, otherwise called Dysmenorrhea - a Greek word for painful menstruation - is classified as primary (from the beginning and usually lifelong) or secondary (due to some physical cause and usually of later onset).

Primary dysmenorrhea is not a sign that something is wrong. It frequently begins during adolescence, but could begin later in life. Frequently, it disappears after a full-term pregnancy.

Secondary dysmenorrhea differs from primary dysmenorrhea in that the pain lasts longer than the usual 2-3 days during the monthly flow. It may also occur during other times of the month. This is typically an indication of an underlying cause of the pain, such as endometriosis or pelvic inflammatory disease. The most common causes of infections are endometriosis (tissue from the lining of the uterus implants outside the uterus) and adenomyosis (benign growths in the uterine walls), and adhesions (scarring or adherence of two surfaces).

Abnormal growth of the uterine lining

Premenstrual syndrome (PMS), irregular menstruation, menstrual cramps and a tendency toward miscarriage may be at least partially caused by an imbalance of these two hormones—too much estrogen and too little progesterone.

If a woman begins to experience changes in her menstrual cramps, such as severity, timing, or location, she should consult her physician, especially if the changes are of sudden onset. A pelvic exam can be helpful. An ultrasound of the uterus can tell if the uterine lining is thick or thin. If it is thin, no further action is needed for this. Estrogen dominance can cause abnormal growth of the uterine lining into the uterine muscle. What does this mean? It means that a woman may be getting too much estrogen. This excess estrogen is causing the abnormal growth.

Therefore, checking your hormone levels will provide a snapshot of the major hormone groups — reproductive, adrenal, and thyroid - that will enable your doctor to provide a more comprehensive management of your health.

Parabens

We know that menstrual cramps are provoked by xenoestrogens. Xenoestrogens are endocrine disrupting chemicals found in everyday materials like food, medicines, plastics, clothing, soaps. There is suggested links between exposure to environmental pollutants that mimic estrogen and the developing baby’s tissue. Laboratory experiments, wildlife studies, and the human DES experience link hormone disruption with a variety of male and female reproductive problems that appear to be on the rise in the general human population - problems ranging from endometriosis, testicular cancer, infertility, and in there somewhere is PCOS.

Unless you’re a fetus or an infant, your exposure to any one of these products at any one time (assuming normal use) is unlikely to be toxic; it’s the daily exposure to numerous sources that creates toxicity over time.

The most prominent xenoestrogen (but not the only one) that seems to be associated with menstrual cramping is parabens that are present as preservatives in shampoos, lotions, liquid personal care products, and some progesterone creams. Although parabens are thought to be relatively non-toxic, and not very carcinogenic, parabens are a xenoestrogen. John Sumpter from the Department of Biology & Biochemistry, Brunel University, Uxbridge, Middlesex found subcutaneous administration of butylparaben produced a positive estrogenic response on uterine tissue. If a woman eliminates parabens (along with other xenoestrogens) in her environment much of the menstrual cramping goes away. Natural progesterone gets rid of the remainder of the menstrual cramping.

Endometriosis patients report increased pain from the progesterone cream formulated with parabens as a preservative.

Making sure your cream is free of chemical additives or preservatives

Buying a premium, quality controlled natural progesterone cream that you can trust can be hit or miss. That’s why our Advisory Network has done the homework for you. There are many brands on the market today that are manufactured free of any harmful chemical additives or preservatives. So shop around!

Estrogen ‘wake-up’

If you take estrogen supplements or are regularly exposed to xenoestrogens, after a while your body will become less sensitive to estrogen. In other words, your body will down-regulate its reponse to estrogen, becoming less sensitive to this hormone. When you introduce progesterone cream, however, estrogen receptors are subsequently resensitized. You regain your original sensitivity to estrogen. For some women, this can cause estrogen dominance symptoms to reappear (wake-up). This perceived ’side effect’ of progesterone generally settles once progesterone levels rise to opposes the action of estrogen in the body. So menstrual cramping may worsen (or return) before you see any improvement. Dosage adjustment is required for a good outcome. Unfortunately, some women abandon progesterone at the point of discomfort, not knowing how to get through the debilitating stages of estrogen dominance which can occur at any stage. It is our hope women work through these setbacks so that they can stay with progesterone long enough to enjoy optimal hormonal health and wellbeing.

Applying cream

Try applying progesterone cream just above the pubic area at the onset of uterine cramping. For women who are still menstruating, the most effective time to apply progesterone cream is 12 days after the 1st day of your period, continue use for 14 days then stop. Repeat each month.

Most progesterone creams are for EXTERNAL USE ONLY. Dr Lee recommends topical application as evidence suggests it offers a more sustained delivery. Most women prefer topical application of progesterone cream. Nonetheless, some women do choose to work with bioidentical progesterone cream applied vaginally. Vaginal application of (organic) progesterone cream has ‘evolved’ out of women’s need to find solutions underpinned by good research (Transvaginal administration of progesterone induced normal secretory transformation of the endometrium despite low plasma levels, suggesting a direct transit into the uterus or “first uterine pass effect.”).