How Much Cream for Joint Pain/HRT Cold Turkey Withdrawal

by CamperKat
(New York)

Dear Wray, I've been lurking here on and off for a couple of months, reading everything I can find here and also by John Lee, Dr. Dalton and others. I bought NatPro a couple weeks ago and have been using that, along with using up the last of my Progester-All, ProGest, and Serenity.

Here's a question that I haven't seen addressed and which might interest you. How much of any cream--in milligrams--should I take to ease shoulder joint pain?

Background: I just turned 51 in March. From age 42 in 2002 to Dec 2010 I was either on fertility drugs trying to get pregnant, being pregnant, losing pregnancies, recovering from the losses, or on Lexapro for depression after failure to achieve motherhood--and I then suffered from hair loss due to all the fertility drugs and stress.

From 2005 to Dec 2010 I was treated for hair loss by a "top" endocrinologist with Yasmin 28 day continuous and Spironolactone 200mg per day.

Long story short: I had a wake-up call in Oct 2010 when my blood tests (which I requested previously and which were never ordered by my endo--he said they were ?unnecessary? in his experience!!) came back with scary numbers for liver function, cholesterol, A1-C, super-elevated iron, etc. The endo took two weeks to call me back after Emailing the test results, and said, without any interest in my opinion or any discussion: "You have Metabolic Syndrome. I'm putting you on Metformin and Crestor." I knew that meant I was fat and a borderline Type II diabetic. But I was a thin person until 2002 when I began the fertility treatments. So I might have been fat outside, but inside?well, you know the story.

When I asked ?His Nibbs? Dr. Endo how long I had to be on the Metformin, he answered (annoyed that I?d asked) "Probably forever." Well...that pissed me off so much that I did NOT take his drugs, but rather, I began to do research on diet, supplements, Rx side effects, food production, liver function, organics, etc. I just couldn't believe how easily ?Dr. Nibbs? did NOT discuss lifestyle changes, and I was damned if I was going on any drug forever--especially since my research showed that both Yasmin and Spiro CAUSE LIVER PROBLEMS and that Crestor is CONTRAINDICATED for those with liver issues. Get his: just by changing how/what I eat, I went from 188 lbs to 160 lbs in 5 months without much exercise (well, actually?with no exercise) and I'm still losing. As of Tuesday April 5th I was at my regular gyno, and the midwife showed me that I went from a 31 BMI to a 25 BMI, and my blood pressure was recorded last year at 130/82?on Tuesday it was 110/70. My blood tests are all normal. My glucose is 82. So I did not need any of Dr. Nibb?s new drugs.

And?.along with changing my diet, by Dec 2010 I realized that the alopecia drugs I was on were incredibly bad for me, especially since I would be turning 51 in March and I was still taking "young woman" drugs just to keep hair on my head--and these drugs were far more potent than I would get if I were on HRT. So I quit them cold turkey on Dec 20th. Big mistake.

By Dec 26th, I had sudden, sharp, deep, burning, unrelenting shoulder joint pain that was so bad, it was a level 8-9. Still not realizing I had basically quit "super HRT" hormones and that my pain was caused by this sudden stoppage, I started taking supplements meant for arthritis, like magnesium, D, K, curcumin, hyaluronic acid, MSM, etc., but nothing eased the pain.

I suffered this excruciating pain and made due with almost zero sleep--maybe 3-4 hours total a night--none of it consecutive?from Dec 26th until Feb 10th when, through my exhausted/exhaustive research, I came across progesterone cream via Dr. John Lee's book.

I immediately bought ProGest on Amazon and began the "no more than 40mg per day" routine that Dr. Lee and Virginia Hopkins espoused. But it caused even MORE joint pain that now radiated all down my arms and even into my hip joints, plus I NOW got a little bit of night sweats. And sleep--such as it was--got worse, if that was possible (it was.) I kept track of everything I ate, drank and the supplements I took, including progesterone cream--to try to determine what exactly was causing this intractable pain. This pain went on no matter what I took, and Big Idiot that I was, I still hadn't figured out that by quitting cold turkey the drugs I'd been taking for 5 years that I'd put myself into instant menopause?and one of the major complaints of menopausal women is?PAINFUL JOINTS.

I slogged on, and then remembered I'd seen your website back in February and recalled that you said to take large doses of progesterone cream. Although still frightened by Dr. Lee's admonition about not going over 40mg maximum, I bought the NatPro, and of course?continued to use just 40mg per day. The shoulder joint pain continued unabated.

Last week, out of desperation, I started using up to 120mg per day. Then I spent a couple days away and things got a little wacky and I didn't follow my new 102mg plan, and I had deep pain again.

Last night, I took 240mg and had a 6-7 level night...but I slept 4 hours straight, which hasn't happened since December. And after looking at my log today, I realized--my pain had gone down to a level 4-5 about two days after having raised the dosage from 40mg to 120mg. This proved to me that larger doses will most likely abate my shoulder joint pain.

So here's my question...Since I?ve been taking progesterone cream since Feb 10th at the lower dosages and now at 100+mg since March 27th?how much more progesterone cream should I take to completely get rid of this horrible joint pain? Have you heard of this shoulder joint problem before being caused by sudden HRT withdrawal? How long do I have to take larger doses to stop the pain, and then how do I start to gently tapper off to get the dose down into the 100--200 range? Do I need to be worried about taking larger doses?

If you would kindly give suggested doses in milligrams that would be much appreciated, because I would prefer to use up my other progesterone creams in addition to the NatPro that I purchased...and thereafter I am only going to buy NatPro in bulk!

Thank you so much for your time, Wray...you hear versions of this all the time, but...you are ?Goddess-Sent"

Hugs from CamperKat!

Comments for How Much Cream for Joint Pain/HRT Cold Turkey Withdrawal

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Apr 18, 2011
How Much Cream for Joint Pain/HRT Cold Turkey Withdrawal
by: Wray

Hi CamperKat Bless you for the kind words! But what a horror story, I'm glad you gave it in full though, as it helps me help you. I do love your humour, I would be pissed off too! The fertility drugs do cause weight gain, you were lucky not to get cancer too, see here, here and here. And the hair loss, I've found 2000mg/day N-acetyl cysteine, 2000mg/day inositol, 5000iu's/day vitamin D, 2-3mg/day biotin and 100mg/day thiamine (B1) all help hair growth. Progesterone too, as it inhibits 5 alpha-reductase activity by 97 +/- 5.3%. This enzyme converts testosterone into dihydrotestosterone (DHT). DHT is implicated in alopecia, see here and here. And Yasmin? See here. You'll notice it's contraindicated for atorvastatin too. Spironolactone? It has androgenic properties, as do most progestins, see here and here. It doesn't surprise me the endo diagnosed Met syndrome, as Contraceptives cause it, oestrogen alone causes it too. You might like to see our page on HRT too. Insulin Resistance, Met syndrome etc are possible to reverse without drugs, as you found out, this delights me. The 40mg/day progesterone would have caused the pain to get worse, as it's merely stimulating oestrogen, and will continue to do so. As you found out, it really does have to be higher to help. Please don't be concerned by this, you might have noticed reading Dr Dalton's books that she used up to 2400mg/day for her patients with post natal psychosis. They needed it, I believe you do too, although not that much! You found even the 120mg gave you some relief, the 240mg gave you some too, plus more sleep. I still use ±170mg/day, and have a few women using up to 600mg/day for severe symptoms. I?ve run out of space, so will open a new comment below. Take care Wray

Apr 18, 2011
How Much Cream for Joint Pain/HRT Cold Turkey Withdrawal
by: Wray

Hi again CamperKat Progesterone's safety is without question, it's been used for over 60 years in many disciplines. For instance they give over 1200mg via IV transfusion to brain trauma victims, over 70% of the victims are men, see here, here. I wish I could tell you how long it will take, and give you the amount you need, but I can't. Pain for one thing is subjective, you are also full of drugs as you say, these have to be eliminated. Your liver is stressed too, so the detox will take longer. Please consider taking 420mg/day silymarin from milk thistle for a month or two. This is a high dose, but will assist the liver. N-acetyl cysteine also helps detox the liver. I suggest you try the 240mg progesterone you have used and see if that helps, if not increase it. I feel you'll need more to overcome the pain quickly. The more oestrogen present the longer it takes, but if the amount of progesterone used is high, the quicker it passes. I also suggest rubbing the cream all over the painful area. Although progesterone travels quickly round the body, I've found putting it directly on the afflicted area it's quicker. Use it hourly if need be, many women find that very helpful, but certainly no less than twice a day. Once you have been helped with the high amount, start reducing it very slowly. You'll soon notice if it's too fast! So just increase it again. Going cold turkey off HRT or contraceptives can cause severe Oestrogen Dominance. I've not heard of just shoulder pain though, usually it's all joints and muscle pain too, but not the severity you describe. You say you are now in Menopause, so you might like to see this page we have. Please consider having a vitamin D test done, it's a potent anti-inflammatory, plus a lack of it reduces the benefits of progesterone. For more info see the Vitamin D council and GrassrootsHealth websites. If you use Natpro you will need 7.4ml cream to get 240mg progesterone. If using ProGest you will need 16ml cream. If Progester-All you will need 15ml cream, and if Serenity you will need 11.4ml cream. I do hope the pain reduces soon. Take care Wray

Apr 25, 2011
Loading Dose,Taking Breaks, Skin Rash
by: CamperKat

Dear Wray:

I didn't know you had responded to my post of April 9th, so I'm so glad to read that you did, and in such detail. RE: supplements, I have been taking a ton of the things you mention since October, and my liver is definitely detoxed. RE: alopecia it's actually not that noticeable, and I have believe my hair will grow better after 4-6 months of cream usage.

Because I didn't know you had responded to my posting, I immediately continued with 100mg of cream per day (NatPro, ProGest and ProgestaCare) per day, split over 4-5 doses which for some reason my body liked.

By April 16 I had several hours of ZERO shoulder joint pain, and then over the next couple of days, the pain ranged from 3-7. I was able to get some OK sleep for several nights, so I definitely felt the 100mg was the dose that was working. But the other day we had thunderstorms and my shoulder joint pain has been at a level 7-8-9 ever since. I've been unable to get more than 2-3 hours of nightly sleep. I don't know why this happened, I had no new stress?is anticipated bad weather enough to suggest a higher dose? But I'm so worried that 240mg per day is far too high. (MORE NEXT PAGE)


Apr 25, 2011
Part 2 Loading Dose, Breaks, Skin Rash
by: CamperKat

Part Deux!

To Take a Break or Not to Take a Break...and High Dose vs. Low Dose. Why do so many MDs and groups like the Natural Progesterone Advisory Network keep hammering that one MUST take breaks otherwise the cream stops working?

In his much-lauded book, Dr. Uzzi Reiss recommends 200mg cream BID for his patients, saying nothing about monthly breaks. (I also bought the book by Michael Platt but I did not find it terribly informative vs. my other studies. Also, I am made wary by his postings on Amazon which contain inaccurate info and which are very defensive.)

Catherine Rollins of the NPAN says when you go off HRT you need a larger "loading dose" of no more than 100mg for many months to overcome estrogen dominance and to start stimulating receptors that had been inactive, but that at about 8 weeks a person most definitely should take a break for at least 3 days, preferably longer, even though it might be hard. Rollins says that "with all due respect" to Dr. John Lee that few in her experience can sit on his recommended 16-20mg per day with any benefit.

Rollins says you can tell if you are "saturated" or not by how long you can go without cream--that it could take over a year to manage the recommended 2-week break without symptoms. She says that the goal after reaching your saturation level should be to try to lower the dose to physiological levels of around 32-40mg per day. She says that one MUST take breaks otherwise the receptor sites will no longer function and you risk losing all benefit of cream usage. This makes sense to me, that you should use loading doses first and then try to taper down. What are your thoughts on this?

My latest problem: I have some sort of an allergic reaction to the creams. For many weeks I mostly I applied cream to my shoulder joints where it hurt, as well as the usual recommended places. By April 16 I began to have minor bumps, so I stopped applying it there and only use other locations. But the bumps continue to get worse and I now have a diffuse, painful bumpy rash on my back and shoulders and a little bit on my chest. I have gotten this reaction from all creams, so I'm wondering if I just continue to apply to "lower areas" that this would stop the spreading? I know you are very busy and I really appreciate you taking the time to answer my neurotic questions! I DID read through every single other posting to see if you'd already answered any of my concerns. I'm trying to be a CONSIDERATE pest!

May 04, 2011
Loading Dose,Taking Breaks, Skin Rash
by: Wray

Hi CamperKat I'm glad you found my answer, I was concerned you said it was a rehash! But gather that must have been another answer. I'm pleased the alopecia is getting better, and that you are taking the supps too. I'm also pleased you're using the cream 4-5 times a day. Twice a day is the minimum, as levels drop after about 13 hours. I'm happy you've had some hours without pain, shows the progesterone is working. Thunderstorms are known to cause arthritis sufferers worse pain, so I can only assume your body responded in a similar fashion. I can see no other reason for it, but why they should do so is another matter! Maybe the drop in pressure causes it, I've not looked into it. To take a break or not, high versus low......well I don't believe we need to take a break if we have no cycle. Obviously if one is present it's best to follow it. Unless symptoms are severe, when I suggest using it daily for 2-3 months, before reverting. And a low amount, well I've found that worse than useless in most cases, it merely prolongs the agony. As I mentioned, the safety of progesterone, even at very high amounts of 2400mg/day is without question. The amount needed is entirely dependant on the symptoms. You found the 240mg/day gave you 6-7 hours sleep, I've often used that much when stressed. I also give myself a top up every so often, I have yet to find the cells become saturated. I've used it for 15 years now, at round about 170mg/day and I can still feel the level dropping when stressed. I become far more emotional! Last year my nails became weak, and were flaking off, it took me 3 months to realise I had been under more stress than usual. Nothing serious, just more of the normal daily stressors. So I covered myself from top to bottom for two weeks, using 2tsp/day, giving me 330mg/day progesterone. I went into bad oestrogen dominance, all my muscles ached, my joints, I had a slight, persistent headache. Plus I was not good to be around! I felt so old too. At the end of the two weeks, my nails were strong again, and all the aches etc had gone. So I reduced back down to my normal daily amount. My receptors are working fine, in spite of daily use for 15 years! And I obviously don't have a fatty build up. I'm starting another answer below. Take care Wray

May 04, 2011
Loading Dose,Taking Breaks, Skin Rash
by: Wray

Hi CamperKat I've just answered another query on this. The woman had stopped the progesterone as she'd read about this build up, well she is now back in severe depression, to the point she doesn't want to get out of bed. I think one could safely say her receptors are working well too. It's pointless using more than needed, as it becomes costly. Another query I've just answered, a woman told me her naturopath had put her on 600mg/day suppositories, to be used twice daily. That's giving her 1200mg/day. This is the amount a coma patient benefits from, I suggested she reduced the amount as she wasn't yet in a coma! I don't believe there is a 'normal' amount, it can vary daily, hourly if stress is high. It should always be used as and when needed, and the amount varied too. As for applying it only on the recommended 'areas', I don't believe that's necessary either. The skin comprises 95% kerotinocytes, these have ample progesterone receptors, so it can be absorbed anywhere. In fact hair follicles absorb it well too, it has been used for alopecia by rubbing it directly on the head. It's excellent in the vagina too, helps with dryness and inflammation. Plus the vagina has a plentiful supply of blood vessels carrying red blood cells which take up the progesterone. Have you looked at the ingredients of the creams you're using, as it could be something other than progesterone that is causing the allergic reaction. There is also a condition known as oestrogen dermatitis, which results in a rash. By applying the creams continually on your shoulder, it could be the progesterone is locally stimulating oestrogen. Although I've never found daily applications on the same spot a problem. I've used it morning and evening all those years on my face, neck and breasts, and never once had a rash. Please look into the other ingredients. So, I do believe you would benefit from more progesterone, you tried it once, try it again and see what happens. It's so easy to reduce the amount. It's so easy to take a break too if you find you want to. There's no hard and fast rule for using it. And thanks for being a considerate pest! Take care Wray

May 08, 2011
re: shoulder pain
by: Natasha (UK)

Dear CamperKat,

Your shoulder pain sounded very much like my frozen shoulder problem which I suffered from a few years ago & I think there is a connection with too much blood sugar and/or insulin resistance. The doctor at my hospital kept asking me if I was diabetic as this condition is common amongst diabetics. Well I'm not from the tests my GP carried out but I do have blood sugar problems.

My body corrected itself by rest and taking a break from a stressful job but I'm now wondering if this was also another symptom of the oestrogen dominance that I'm currently dealing with. If I'd known about NPC then, it could have really helped me.

Dear Wray - I've read in with great interest your response and feel partially relieved that there is not a receptor build up/fat tissue build up problem. I will post my story in full above.

May 09, 2011
Finally Feeling Real Pain Relief
by: CamperKat

Dear Natasha:

Thank you for your remarks...interesting that docs believed your condition might be insulin resistance/diabetes. My problem started exactly 6 days after I quit synthetic drug HRT meds. As of today, May 9th, I am delighted to say that my 3 months of progesterone cream has rendered me virtually pain-free with most days now at 2-4 with occasional flares from working in the garden, etc. I'm sleeping up to 7 hours now--not in a straight shot--but I only get up 2x to pee, and I fall asleep quicly again--first time in years. It took until April 16th (exactly 2 months) for the shoulder joint pain to start to reduce slightly...and I was at my wit's end with how long the process took. I mean...there was virtually NO symptom reduction until April 16th. So it can take up to 3 months to start to feel genuine relief. I advise everyone to hang in there.

Thanks to Wray for her tireless patience about giving feedback.

May 11, 2011
re: shoulder pain
by: Wray

Hi Natasha Thanks for the tip about diabetics and frozen shoulder, something I will definitely look into. I'm never surprised though when I hear about blood glucose involvement, any disturbance can lead to oxidative stress, and thence to inflammation. High levels of blood glucose leads to increased glycation of proteins which causes changes in protein function in the body. Glycation leads to advanced glycation endproducts (AGEs), resulting in oxidative stress. This in turn leads to inflammation. As for the build up, well I've never found it a problem, and have yet to hear so from others too. What does concern me is the advice given to only use the cream on thin skinned areas, ie the inner arms, thighs and wrists. If there was a case for build up, this would be it. There's not much skin in those areas, and applying it twice a day, well you haven't got many places to apply it! I have come across one woman, I'm sure there are more too, who rubbed it only on one small spot each day. Trying to get the cream in and spending an inordinately long time doing so. The skin became inflamed because of this. The skin comprises 95% kerotinocytes, all of which have ample progesterone receptors. I will be interested to hear your full story too. Take care Wray

May 13, 2011
Finally Feeling Real Pain Relief
by: Wray

Hi CamperKat I'm so delighted you persevered, it can take time. As I said it's impossible to tell. It took me 6 months before all my symptoms went, but then I was using the commonly recommended amount of 20-40mg/day, as I knew no better. I had no one to get advice from either, as the doc I went to was ignorant about it, in fact I was his first patient using progesterone. You don't say how much you finally went up to, when you have the time I would love to know. In case I get another similar query, I can then advise accordingly. Take care Wray

May 13, 2011
Daily Dosage
by: CamperKat

Hi, Wray...you asked about what dosage I ended up using...I was afraid to use the 240mg per day, mostly because I was getting strange dreams (still do, and sometimes very scary) so I only did this the one time.

But I now use 100--140mg per day, depending on how I'm feeling. If I'm achey, I use 10mg and within 30--45 minutes the pain is reduced...I guess this is what it's supposed to be doing, and I know that I am not completely balanced yet...Yesterday I had a few hours of 7 pain, which was disheartening, but we are expecting thunder and rainstorms this weekend, so I know this is likely the cause. So I am going higher on the progesterone today (likely up to 120 over 4-5 doses) and I'll also up some supplements like Feverfew which is good for barometric pressure changes that affect chronic pain like fibromyalgia and arthritis and migraine sufferers.

So...short answer: I am using 100mg on good days and up to 140 on bad days. And I am planning on taking my first small monthly break with this coming full moon (May 17th) and I'll see if I can go 1 or 2 days without. I don't think I can, but I'm going to try. I do believe that monthly breaks of 3-5 days is a good thing as it does replicate our cycles--even if we are now in menopause, it is still more "normal" to take break than not, I believe.


Jun 07, 2011
Pain Came Back...Was it Cereal Grain?
by: CamperKat

Well...I'm sorry to report that by May 17th--my intended "break time", my joint pain came back to the point where I haven't been able to sleep and I've been back to taking aspirin at night. It's been bad.

I've been doing everything right, and I couldn't imagine that the progesterone cream just "stopped working".

Long story short, I looked back over my daily food/supplement/pain log...and realized I started eating cereal every morning starting on May 13th. Yes, it was whole grain, high fiber, organic stuff, with flax and oat and wheat germ. And I made sure I had some turkey for protein afterwards.

But I remembered hearing somewhere that grains can cause inflammation in some people. So I stopped the other day. And the pain has gone down from a 6-7 to a 5. And I added a little more cream, so I'm doing about 140 per day.

Your thoughts?

Hugs from CamperKat

Jun 21, 2011
Pain Came Back...Was it Cereal Grain?
by: Wray

i CamperKat Firstly I must thank you for all the support you've been giving me, by reassuring others about progesterone, it's such a blessing! Yes, I do believe it could have been the cereal. One, you've already found the pain going down now that you've stopped it. But two, all grains, legumes, seeds, including flax, contain phytoestrogens. In fact it's an alarming thought, but most of our food does. It's safest to stick to green leaves! You might like to read what Cordain et al think of grains and legumes, dairy too. They don't believe humans should be eating them at all, as we're not designed too. There is a link to his site on our Nutrition page. He also sends out an excellent newsletter, full of references which I like. Do let me know how you get on. As you can see I'm now about 10 days behind answering queries, wish I could get round faster. Hugs to you too! Take care Wray

Feb 08, 2012
Email sent
by: Wray

Hi Camperkat I do hope you get this, but I have sent you an email in reply to your concerns about repeated questions! I'm going to put this message on some of the other pages you made comments on in the hopes you get it. Please look in your junk box, it might be there. Would love your suggestions! Take care Wray

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