When can I expect to see results from using the cream?

Stages of Natural Progesterone?s Action In The Body

First 10 days - Estrogen Dominance Wake-up Crisis

Progesterone seems to work at various stages and at various levels. These changes occur for the majority of women (we have observed) in the first 10 days, 6-8 weeks, then there is a change at 4 months, another at 7 months, a further change around 12 months, and finally another roughly at 18 months, based on the individual and her specific condition. For example, many women suffering chronic fatigue exhibit a delayed response, and their phases may kick in weeks later than the average woman. These stages of natural progesterone?s action in the body have been too consistent to be dismissed.

During these different stages that occur along the journey, slight adjustments are often required to maximise progesterone’s effectiveness. If you are not aware of these stages, you may misinterpret the signs as progesterone losing its effect, when in actual fact it can represent the opposite.

Because we are reintroducing progesterone back into the body thereby sensitising and stimulating the estrogen receptor sites, there are the immediate, intermediate and long term benefits and side effects (estrogen dominance wake-up crisis).

From observation, we have found the immediate benefits which generally occur within the first 10 days of usage range from instant calming, clearer thinking, feeling more grounded, an awareness that you are able to cope with stress better, reduction or elimination of headaches, a deeper, more restorative sleep pattern that draws comments like, “best night’s sleep I’ve had in years!”. You may find you will shift body fluid as a result because progesterone acts as a natural diuretic. Breast tenderness, PMS and other symptoms may reduce dramatically, and many women comment that their face glows and looks healthy.

There have been reports of women feeling very euphoric such that some have experienced orgasms in their sleep, and the return of colourful, happy dreams. These are but some of the many reported benefits that women experience with the reintroduction of their essence hormone - progesterone.

On the other side of the coin, as a consequence of bringing progesterone back into the body and waking up estrogen receptor sites, women can actually go through a roller coaster of symptoms that can be quite frightening and debilitating unless they understand the reasons, and how to overcome these problems. And that’s why we suggest the usage of a very good phytoestrogen formulation during this early phase. There are many premium products on the market (see our section on Phytoestrogens). By using a good phytoestrogen (not in cream form) it helps to tone down and reduce estrogen dominance wake-up and associated symptoms.

Some of the more common symptoms reported can be increased PMS, breakthrough bleeding (spotting) or the onset of a very heavy non-cyclic period, increased tenderness of the breast, headaches ranging from unrelenting dull headaches to severe migraines, uncontrollable hot flushes, fluid retention, anxiety, teariness, aggravation, irritability and aggression, panic attacks, increased joint and muscle pain, exacerbation of thrush, impetigo, acne, weight gain, lethargy, palpitations, heartburn, the list can be endless. These symptoms are intrinsically connected to the waking up of the high levels of estrogen already in the body that have become dulled (toned down) due to the absence of progesterone up until now.

We remind women that estrogen and progesterone are a pigeon pair, each requiring the other to stimulate its activity in the body. That’s why it’s so important to maintain the correct balance between these two hormones.

Because of this severe wake-up in the body where the symptoms of estrogen dominance are exaggerated, we often recommend women double their recommended dose for the first 6-8 weeks in conjunction with a phytoestrogen to over-ride this phase.

For a smaller number of women, estrogen dominance crisis may occur weeks to months down the track. And we believe this is due to a sluggish receptor response.

1-8 Weeks - Reaching Saturation

During this period, double doses are well tolerated because the body is busy soaking up the hormone it has probably been deprived of for years. And being a fat-soluable hormone, whilst the body will get some benefits from progesterone, considerable amounts will find its way to fat cells. Our observation is that around 6-8 weeks the body reaches a saturation level at which point dosage can require adjustment (gradual reduction) depending on the individual and her symptoms.

Because many women have high levels of estrogen dominance wake-up and have not reached saturation, we often suggest they not take a break in the first 8 weeks. This will not interfere with their normal cycle or compromise their health. Note, your normal period will still come on time while you remain estrogen dominant. However, we strongly advocate that only in the first 8 weeks can all rules be broken while the hormone is reaching saturation point but, thereafter, strict adherence to cyclic breaks must be followed, and dosage tailored to where you are asymptomatic.

Women are very reluctant to take a break from cream for fear of symptoms returning. But they fail to realise that if they don’t start taking their breaks, estrogen dominance may eventually return either because their receptors have down-regulated and render progesterone ineffective or progesterone goes on enthusiastically making more estrogen down the steroid pathway.

Further, the failure to take breaks and fluctuate hormone levels from month to month, mimicking nature, may possibly throw cycles out of sync.

In simplistic terms, once you have topped up your progesterone reserves it then settles, and progesterone can be used more effectively for other roles now that the body is no longer depleted of this hormone. And this represents the baseline for woman to establish their physiological dose. You can test your own level of reserves during breaks from cream by testing how long you can go without feeling deprived?

When your reserves are maximised, your body will comfortably tolerate up to a two week break before you start missing progesterone. At this point, don’t be too anxious if you can only tolerate small breaks each month within the first year because reserve levels can fluctuate depending on how you are utilising progesterone. The body is going to be busy taking advantage of the renewed levels of progesterone to perform multi-factorial jobs within the body.

It is important at this stage, that you start having regular breaks (no less than 3 days) from the cream to prevent down-regulation of cell receptors. If you do not rest the sites and allow them to freshen up, progesterone will become ineffective. Once the initial saturation process has taken place, subsequent re-saturation, which can vary from month to month, is quickly achieved. Some women saturate very quickly and can maintain their reserves, while others use their progesterone very rapidly and don’t appear to have the ability to maintain saturation levels. Whilst other women have extremely high saturation levels (in saliva readings) but appear not to be assimilating progesterone or deriving any benefits.

To comfortably maintain balance, it’s really a case of learning to read your body, understanding when your stores are depleted, and comprehending how your body uses progesterone in relation to things that are happening in your life, and the internal/external demands (see our section on Charting).

4 months - Stabilising & Settling

It appears a four month period/cycle is required before the body really falls into synchronisation. Up until now progesterone has performed numerous jobs that result in many benefits throughout the body. But the greater results are evident around the fourth month or fourth period where women actually feel the deeper benefits of treating long standing, hormone-related conditions.

Women report they are no longer clotting or bleeding as heavily, periods are showing signs of regulating, ovulation is often re-established, PMS is well under control, fibrocystic breasts diminished, the pain and trauma associated with endometriosis is dramatically reduced, and migraines become, for the first time, manageable.

At this point, the body appears to have well and truly settled and is very relaxed. Often women are not consciously feeling the benefits of progesterone because levels have been restored and homeostasis has been achieved. Progesterone, like any of the steroid hormones, works its magic silently in the body, and only when it is absent do we realise it’s not providing the balance which we often take for granted.

This hormonal balance (as nature intended) can be very foreign to some women. And because their body has plateaued and they are asymptomatic without the euphoric highs and sense of wellbeing they reached when using progesterone for the first time, they often interpret this absense of intensity as a sign that progesterone is no longer working. And in an effort to revisit these wonderful early ‘highs’, they begin to slap on high doses which can perpetuate estrogen dominance (because progesterone will go into making more estrogen along the steroid pathway). A vicious cycle is then established, of which women are none the wiser.

On the other hand, many women fall into the trap of believing they no longer need progesterone supplementation and/or adopt a careless approach to their dosage and usage. We’ve seen extremes where women have stopped progesterone cream altogether because their symptoms have disappeared. Or applied progesterone only when they remember, which can bring about a re-emergence of symptoms and/or irregular periods which usually won’t show up immediately - perhaps four to six weeks later or on the second period (thus the connection isn’t made).

We caution women to respect that progesterone IS a hormone. That once you reach the plateau between 4-7 months you adhere to physiological doses, regular application, and appropriate breaks if you want to reap the long term benefits that come with hormonal balance.

7-12 months - Estrogen Dominance Wake-up Revisited

Estrogen dominance wake-up can recur or unusual symptoms appear between 7-12 months but not in the case of every woman. Symptoms can range from increased muscle and joint pain, periods can become erratic and may be associated with heavy bleeding and clotting, polycystic ovarian disease exacerbated, depression may occur, often libido may flag, and unexplained weight gain is commonly reported.

There are several reasons why this phase may surface. A genuine drop in hormone production may be a contributing factor. High estrogen levels as a result of increased weight gain - a by-product of a dysfunctional liver, that has disrupted all hormone levels rendering the existing dosage ineffective. High levels of external /internal stress, such as pain, anxiety or illness, will take progesterone down the corticosteroid pathway to produce cortisol - the survival hormone - which negates the action of progesterone in the body (because progesterone is being converted into another hormone that competes for the same receptor).

Another factor can be the change from HRT to natural progesterone, and the time it takes stubborn synthetic progestogens to move off the progesterone receptor sites thus freeing them up for natural progesterone activity for the first time, or estrogen/progesterone imbalance begins to resurface as stores are now depleted as a result of estrogen therapy ceasing some months before.

We cannot say whether this phase is the result of estrogen sensitivity or progesterone deficiency as a result of progesterone working at a deeper level, affecting perhaps for the first time, receptors that are only now responding to the presence of progesterone.

Many cases require an increase in dosage to facilitate the demand for progesterone to oppose these problems and/or accommodate the body’s need for extra progesterone working on this level. Check on what else might be happening in your life at the moment with family, diet, lifestyle, perhaps personal trauma or stress, all of which can draw on progesterone reserves and contribute to hormone depletion.

Too many women are reporting similar activity at this stage for it to be termed non-specific. We encourage women to maintain their journals, increase their dosage temporarily according to symptom relief supporting the body’s demands for higher levels, and work through this phase, because additional benefits of their progesterone therapy are ultimately achieved.

In most cases, any unusual physiological activity that is not life-threatening, is a good sign that progesterone continues to work in your body. Just remember it took many years for progesterone deficiency to compound in the body and it will take time to reverse. In fixing one problem, it often gives rise to another that will need to be resolved. This is why using progesterone cream over many years can be so beneficial.

18 months - Fine Tuning

Women have found their physiological maintenance dose to be very effective but suddenly may find themselves presenting with estrogen dominance symptoms despite following all the rules and nutritional supplementation. Most women in this category are nearing menopause and experiencing dramatic hormone fluctuations, therefore levels are more difficult to control. This is where we suggest vaginal application, rapidly elevating and sustaining progesterone levels, while offering a more direct absorption route (one that we believe has additional benefits of targeting specifically to the uterine tissue and surrounding organs within the pelvic cavity).

Some women alternate transdermal and vaginal application. This offers the body a cross section of deliverance and has been found to be very effective.Note: Vaginal application daily could build up too high levels and therefore needs to be monitored, that is why we suggest two to three days only vaginally if you are a woman who builds up reserved quickly.

A small number of women have managed to successfully control their fibroids and polycystic ovarian disease with progesterone, and have experienced a remission-like stage. Then, out of nowhere, it appears something has triggered estrogen activity and a flare up. Stress and personal grief, fatty liver and other factors need to be considered here. Nonetheless, our group is beginning to form an opinion from these reports that perhaps no less than a 4% cream level should be used as a baseline dose (40mg). However the average maintenance stable dose appears to be between 5 and 6% (50 - 60mg) for fibroids, endometriosis, and polycystic ovarian diseases.

Whilst 4% may be a maintenance dose for women who have stabilised their condition, observation indicates that this dosage does not allow for any buffer in times of stress, thereby not giving additional backup. It is important to recognise your base level and your additional requirements at these times, as a minute variation can make all the difference. Once re-stabilised, reassess your symptoms and determine whether you need to return to your baseline. We are strongly urging women to undertake regular ultrasounds to monitor the stages of their fibroids and/or endometrial thickening, and to determine the success of their progesterone dosage. Saliva assays would be helpful to draw a baseline of all hormones.

Around the 12-18 month phase, we invariably hear back from women who have gradually moved away from the principles the Natural-Progesterone-Advisory-Network.com website has found to work for women to maximise progesterone usage. These ladies believe they have a handle on progesterone based on the fact they’ve had great results, not yet realising the importance of incorporating the correct diet and nutritional supplements in adjunct to progesterone. They haven’t made the correlation between the two. That progesterone has carried them up to this point, however, in the absence of nutritional support and other principles, symptoms have insidiously crepts up and hormone imbalance has resurfaced. Adopting our principles once again has resolved the issue of imbalance within a couple of months.