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Catamenial Progesterone Therapy Trials and Errors

Hello

My now 18 year old daughter has had catamenial seizures since she hit puberty. We have traveled many roads and gone every route you can think of to get to the understanding and realization that her seizure activity is definitely related to her menstrual cycle.

After much research, we began using natural progesterone therapy about a year ago, but we are still in the process of figuring out the best way to administer it along with the correct dosing.

Originally beginning with topical progest creme, beginning at 20mg 2/day, she ended up having to work up to almost 180mg day. We finally realized that her body was no longer absorbing the creme effectively, only storing the creme in her fat cells, as she gained a lot of weight over that first year with nothing else changing in her activity/diet .... when we realized that the urine hormone testing that was being done for her every year to track her estrogen/progesterone did not adequately measure her progesterone, we sought out her blood serum progesterone levels to find out that she was not registering any progesterone despite the creme!

We then discovered natural progesterone that her doctor recommended she take like a suppository -- within the first month her blood serum went up to 26 ng/ml..... whereas before this it was at .05 ng/ml! Talk about miraculous!!!

The thing that we are having the most difficulty with is understanding the dosage and days of the month to take the progesterone. What is the best recommendation for dosing (she just recently had a terrible day of seizures on the day before her latest cycle started after no menstruation for 3 months once starting the suppositories). We got her blood serum tested the next day, which was on day one of her first menstruation in 3 months and it was at 4.0 ng/ml (two weeks prior her blood serum was at 12.0 ng/ml).... during the seizure activity we upped her progesterone, but it must not have been enough because we were unable to stop them. We will continue to check her blood serum each week just to try and get a picture of what her body is doing with the progesterone.

Is there a recommendation as to whether or not she should be taking progesterone every day of the month, or only on days 13-28? Are suppositories more effective than oral progesterone? (I've got conflicting opinions from reliable doctors) If it is every day, and we are at 200mg 2/day on the second half of the cycle, what should it be on days 1-13? Or should the dosage be higher?

So many questions still to be answered, I know! We want to avoid any more terrible days like we just had. I realize that it can take time to figure out this for each individual person, so our hope is that someone else out there who has gone down this road before us has something they have learned that has worked for them that they could share. Thank you for reading this and we pray we can all get some answers!

Comments for Catamenial Progesterone Therapy Trials and Errors

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Apr 04, 2014
 Seizures and progesterone
by: Diane

What ever you do for your daughter, do not let her use orals. The absorption is very poor. On a 200mg dose, maybe 20% is absorbed. Is your daughter truly a 28 day cycle? If her cycle is shorter, then she needs to start sooner. I'm a 24 day cycle so therefore I start on day 10 with my progesterone. Ask her dr If she is seizing during her period if she should continue the progesterone on a reduced dose for the first couple of days. It's tough because it is difficult to find the optimum time and dose with your daughters condition. You could ask the doctor if it would be okay to try having her just stay on the progesterone every day for a few months to see if that helps. Btw.. Dr Michael Platt, Md is an expert on treating with BHRT. He has a book titled The Miracle Of BioIdentical Hormones. He is retired but still sees patients in Palm Springs, Ca in person or if you live too far, he can consult with her via Skype. His website is Plattwellness.com There you will find his office number and you can arrange appointment, where to send her labs so that he has all the information. He charges $800 for first visit including follow ups for one year. It may be worth a try. He may be able to help.
Keep us posted.
I will pray for her.
Diane
Apr 04, 2014
 Seizures and progesterone
by: Diane

What ever you do for your daughter, do not let her use orals. The absorption is very poor. On a 200mg dose, maybe 20% is absorbed. Is your daughter truly a 28 day cycle? If her cycle is shorter, then she needs to start sooner. I'm a 24 day cycle so therefore I start on day 10 with my progesterone. Ask her dr If she is seizing during her period if she should continue the progesterone on a reduced dose for the first couple of days. It's tough because it is difficult to find the optimum time and dose with your daughters condition. You could ask the doctor if it would be okay to try having her just stay on the progesterone every day for a few months to see if that helps. Btw.. Dr Michael Platt, Md is an expert on treating with BHRT. He has a book titled The Miracle Of BioIdentical Hormones. He is retired but still sees patients in Palm Springs, Ca in person or if you live too far, he can consult with her via Skype. His website is Plattwellness.com There you will find his office number and you can arrange appointment, where to send her labs so that he has all the information. He charges $800 for first visit including follow ups for one year. It may be worth a try. He may be able to help.
Keep us posted.
I will pray for her.
Diane
Apr 05, 2014
 Oral vs. Suppository Progesterone
by: R.

Hi Diane --

Thanks so much for getting back to me so quickly with all of your helpful information! Now I don't feel so alone!

My family is basically pioneering this treatment plan for ourselves, as we have done all of the research ourselves and are bringing what we have learned to the only doctor available to us who is willing to walk along side of us in these uncharted waters in the area where we live. The doctor is fairly 'textbook', however is willing to work with us along the line of the natural progesterone treatment plan. She checks in with us to see how it's going and what progress we've made, so it is almost as if we are leading the way in our little part of the world in finding some answers!

As of this point, the only natural progesterone we have access to is one called 'progendo'. I have looked it up to make sure that "chemically" it is natural, and it appears to be so -- we don't want to mess with anything synthetic. I am, however, having trouble finding out what it is 'housed' in ... vitamin E or corn oil, or what?!

The biggest hurdle for us right now is the oral vs. suppository argument (as the progendo is oral at 100mg, or can be taken either way at 200mg). Solely from the standpoint of several papers I have come across explaining the effectiveness of all of the delivery avenues for the progesterone lies my lack of clarity on how best to proceed. I will attach the links at the end for you or anyone else who may want to take a look and tell me what you think about orals after reading this information as well. She was on 300mg suppository during the last episode, and her cycle started the day of the episode while on that high of a dosage ....

Another question that we have (seems like another subject, but for us, very related!) is can a heavy metal detox protocol (natural - cilantro and chlorella) remove progesterone as well? That would tell us a lot as to whether or not the latest catamenial episode was due to added progesterone depletion from the detox protocol.

This website and forum is a God-send to us! We know that ultimately it is all in God's hands, but we cherish any guidance we can get to help our daughter regain her complete health.
Here are the few links about progesterone absorption for anyone who has time:

Lita Lee, progesterone absorption

Ray Peat: Progesterone deceptions

Ray Peat: progesterone & epilepsy


British Medical Journal: Absorption and metabolism of oral progesterone

Thank you for your help and prayers ... I look forward to us all gaining more knowledge through this connection!

Blessings -

R
Apr 05, 2014
 number of days in cycle
by: R

Hello Diane -

I forgot to answer your question about how long my daughters cycle was from your last post ...

On the average, 28-29 days ..... this last period of time while we were trying the suppository route rather than the creme she went 3 months without menstruating, and had 2 catamenial episodes (but less migraines) while we were figuring out dosages (however, they did coincide with the prior week being a heavy metal detox protocol week), thus my prior question of the ability of detox to also deplete progesterone.

Thank you for your questions and concerns on our behalf.

R
Apr 07, 2014
 did my last post go through?
by: R.

I was just wondering if my last post ever went through or not ... I had a few more questions and some links from research regarding the oral progesterone issue based on findings from Ray Peat, Lita Lee and others, and was hoping to find someone who may have thoughts on that .... Diane, I am so grateful for you and your thoughts, advice, prayers and obvious knowledge ... this is not to discount what you have shared with me, just to solidify our decision in which method to use as the creme didn't work for her at all and the progendo that we are using says it is oral 100mg, and oral or suppository 200mg .... i want to get the max absorption for her and be able to balance her as quickly as is possible without playing around with absorption and levels more than is necessary. I appreciate any feedback anyone has to offer and am eternally grateful for this website and all who share.

Sincerely,
R.
Apr 30, 2014
 Catamenial Progesterone Therapy Trials and Errors
by: Joy

Hi R

Please read the page on seizures it will help you to get a better understanding on what is happening to your daughter and what is needed. You are correct in saying that her seizures are related to her menstrual cycle, both progesterone and vitamin D are vital!

It is most important that the correct progesterone method and concentration is used, ProGest does not contain the correct concentration and taking 40mg per day would certainly have caused Estrogen Dominance symptoms, weight gain being one of them. Even though you increased to 180mg per day it is not enough because of the lower concentration. Any form of oral progesterone is not the best delivery method as Diane correctly mentioned, 96% of it gets destroyed by the gut and liver – see here. Progesterone does not cause weight gain nor does it store in fat cells, excess estrogen does. Estrogen is a mitogen, causing cells to proliferate, it causes the cells to divide and multiply.

Nothing less than 200mg/12ml of progesterone per day is needed, possibly more. One of the advantages of a cream is that you can experiment with the amount used for a particular symptom, it is rather difficult do that with a suppository. The seizure page will explain all of this, but How to use Progesterone Cream will also help you, it will explain exactly how to use if you are want your daughter to use the cream by following her cycle. We always suggest that one should use the cream every day if symptoms are severe. Perhaps you could try using the correct progesterone cream by following the cycle and if that does not help, then use it every day until positive signs are felt. If she decides to use the cream every day, please ignore any bleeding/spotting/clotting that may occur, just carry on using it, her body will soon adjust. Please understand that progesterone therapy is not an overnight fix, it takes time, anything from 2 - 6 months, possibly longer depending on how severe symptoms are.

Do you know what your daughter’s Vitamin D level is, as a deficiency reduces the benefits of progesterone, it is also connected to every single cell and its formation in our bodies, including seizures, this makes it vital.

I see that Diane mentioned Dr Platt, he is extremely knowledgeable when it comes to progesterone and he actually uses Natpro. I am shocked at his fee though.

Hope this helps you and your daughter.

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