When do I have a break from my cream?
In the first 2 months a woman can actually go through without a break as the body is usually very deprived of progesterone, and a majority of the hormone is being soaked up into fat tissue. This is also the reason why a higher dose is well tolerated.
Not breaking from cream in the first 6-8 weeks will not, in our experience, adversely affect your periods. You will continue to get your period. And it’s likely, during this time, you will still be estrogen dominant. In fact, double doses help negate the estrogen wake-up promoted by the introduction of progesterone back into the body which stimulates the estrogen already present in your body and may exacerbate your symptoms.
After 8 weeks, it is advisable to establish a rhythmic pattern in your body. So it’s important you begin taking a break from cream (as saturation has most likely been achieved around this time). This is also the time when weaning back to physiological doses can be initiated, as determined by symptom relief and charting.
A break from cream must now be taken to fall into line with your menstrual cycles, i.e., menopausal woman would follow a calendar pattern of 3 weeks on, 1 week off; a cycling woman would follow a program of 2 weeks on cream, 2 weeks off according to her period.
This is the aim - to achieve balance using progesterone on physiological doses (’least is best’ principle) such that symptoms are relieved. However, be mindful of the fact you could take many months to a year to achieve hormone balance and maintain the appropriate breaks from cream without feeling the absence and/or deprivation of progesterone.
We remind women that it is so important to have at least a 3 day break in order to restore receptor sensitivity. To do otherwise is to risk losing the full effectiveness of your progesterone cream (down-regulates).
If you cannot achieve lengthy breaks when you first start progesterone therapy, work towards increasing the breaks each month. We always know when a woman is ‘progesterone balanced’ when she can take 2 weeks break without discomfort.
Carol Puopolo | Jan 13, 2005 | Reply
do post menopausal women have to take a break off the progesterone cream when they are on a low dose of estradiiol .5 once a day and 200mg. progesterone
Catherine Rollins | Jan 28, 2005 | Reply
Dear Carol,
I do know that some doctor’s instruct their patients to stay on cream indefinitely.
However, research suggests receptor sites ‘down-regulate’ when there is no ‘on’ and ‘off’ signal triggered by the body’s natural fluctuation of hormone levels.
Post menopausal women would, therefore, follow a calendar month of 3 weeks progesterone supplementation, 1 week break from cream.
Certainly, women can continue without taking breaks, but they can also expect that as their receptor cells eventually down-regulate, they’ll require more and more cream to sustain balance.
Breaking from cream periodically allows us to derive optimal benefit from the lowest possible dose.
In light & love,
Catherine
Laura | Mar 9, 2005 | Reply
I am 49 and was on premarin since 36 at pretty high does due to a a complete hysterectomy. I have been on the progesterone bandwagon for about a year now, using the cream 3 weeks out of the month. Along with that I took DHEA daily, testostorone daily, and used the viville patch daily as well. My skin was getting oily and I was breaking out so he suggested I quit the DHEA and he changed my meds.
He put me on a compounded progesterone capsule (200 mg) with instructions to take them 15 days of the month. I am also on the vivelle patch every day, as well as 1 mg testostorone creme every day.
Should I be taking progesterone 3 weeks a month, and what about the pills versus the creme?
Thanks,
Catherine Rollins | Mar 10, 2005 | Reply
Dear Laura,
May I direct you back to this more recent articles around individualizing HRT:
* Should women post menopause break from cream each month?
Link: http://www.natural-progesterone-advisory-network.com/guide/000401.php
And this one around oral versus transdermal delivery systems:
* What is the difference between natural progesterone in capsules to be taken orally and the transdermal cream?
Link: http://www.natural-progesterone-advisory-network.com/guide/000256.php
In light & love,
Catherine Rollins
Director, Making Plans Pty Ltd
www.natural-progesterone-advisory-network.com
“Advocating & Supporting Women’s Right to a Safer Form of HRT.”
Sam | Apr 13, 2005 | Reply
Hi Catherine,
I am 39, have a Dr who has prescribed NP as progersterone levels were very low(blood tests). Oestrogen was also on low side but was told to eat more phytoestrogens. Apparrently have a few years left before menopause.
Initial dose was 2% 1cm from day 7 -26 (Dec and Jan) now I am on 4% 1.5cm from day 7 - 26(from feb).
Having just read this article it looks like I should be having a 2 week rest! However, I find even one week rest hard to tolerate. Please could you advise what I should be doing. I have also not experienced this euphoric feeling, but I do know the cream has been helping. I feel stress is a huge contributing factor. I already practise yoga nearly every day (which is my lifeline) and eat what I consider a healthy diet.
Look forward to hearing your comments
Thanking you
Catherine Rollins | Apr 28, 2005 | Reply
Hi Sam,
As a rule, if you haven’t realised any improvement to your health within 3 months, then you may have ‘other’ contributing factors which progesterone alone cannot resolve. Ask your GP to check your overal metabolic health (thyroid & adrenal hormones) via salivary assays that tend to be more representative of what’s happening at the cellular level.
Evidence suggests that women can stay on cream without breaks until they become progesterone replete. Beyond that, I would strongly recommend you apply cream according to your menstrual cycle.
There are mixed opinions amongst the medical community around this whole ‘breaking from cream’ debate (as it relates to WOMEN). Can a hormone that protects us become a carcinogen if given continuously? While we await the clinical evidence, I urge menstruating women to map & follow their monthly cycle. See my article below:
http://www.natural-progesterone-advisory-network.com/article050301-1.php
In love & light,
Catherine Rollins
Heidi | Jul 7, 2005 | Reply
How many days per month should a nursing mother use the cream? I have a 4 month old and have not began my menstral cycle yet.
Catherine Rollins | Jul 24, 2005 | Reply
Dear Heidi,
Under our ‘Post Natal Depression’ we’ve outlined some usage suggestions depending on where you’re at.
Our observation has been that progesterone has provided women with a ‘happy’ and safe solution for mum and her baby, and has not interfered with her milk production.
Some women have even commented that they’ve been able to relax, cope better and enjoy the experience of motherhood for the first time, where their previous accounts battling depression and their refusal to resort to medication, or the side effects of the medication they were encouraged to take may have left them feeling quite cheated of the whole mothering experience.
For mild to moderate depression, natural progesterone has proven quite adequate in small doses (15-20mg) for approximately 4 months uninterrupted. We suggest you start at lower doses and assess to see if your depression is lifting, and only increase if you feel you are not responding at that dosage. Give yourself a week to feel the benefits.
Unlike women who have to wait 6-8 weeks to reach saturation level in the body to feel the benefits of progesterone, new mothers don’t need to go through this process because their body, being familiar with this hormone, will response very quickly with the reintroduction of natural progesterone.
We strongly recommend that women DO begin taking at least a one-week break from progesterone cream once they feel on ‘top’ of things.
http://www.natural-progesterone-advisory-network.com/guide/000242.php
In light & love,
Catherine Rollins