Kate Smith

I was diagnosed with endometriosis 8 years ago, had a laparoscopy on both ovaries to remove it, now 3 years and not pregnant. I still have a small endometrioma in one ovary. I get a positive LH around day 9 and then start spotting at around day 20 for a bout 12 days with then a 3 day period. I used synthetic progestrone for a few cycles which stopped the spotting but I am unhappy taking this again for fear of side effects. Can you please advise me when to take your cream? My gynaecologist wanted me to take the synthetic progesterone as soon as I got a positive LH- does this apply also? Have you had any success with stopping spotting and clearing endometriosis?

Many thanks for your informative site,

Kate Smith

Comments for Kate Smith

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Jul 27, 2012
Kate Smith
by: Kay

Wray will be able to answer your questions, but I wanted to say that I have been on the natural micronized progesterone and as far as I know, it is the only one than can really help your condition and without side effects.

Jul 29, 2012
Kate Smith
by: Wray

Hi Kate I'm relieved you stopped the synthetic progestin, for more info see our page on Contraceptives. We do have a page on Endometriosis too, the amount of progesterone to use and when to use it is really dependant on symptoms. For instance I've found 500mg/day is needed if there is severe pain and bleeding. Endo is caused by oxidative stress, and high amounts of antioxidants are needed to reverse it. It's most important to have a vitamin D test done, it's a potent anti-inflammatory, needed by every cell to function normally. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. Blood levels should be 70-100ng/ml (175-250nmol/L) and not the 30ng/ml (75nmol/L) most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. It's interesting the interval between your LH peak and bleeding is so long, as it's normally shorter in women with endo. Not only that, but the luteal phase in all women is always 12-14 days long. If longer or shorter it's termed a defective luteal phase. I would really suggest you use the progesterone daily, through any bleeding, for at least 2-3 months. This will ensure that it suppresses any excess oestrogen and becomes the dominant hormone. Once you feel stable you can begin to follow your cycle. As you normally ovulate on day 9, you would start the progesterone on day 9 after the previous bleed. It can be started 1-2 days earlier, as progesterone begins rising exponentially about 2 days prior to ovulation. This surge comes from the brain and it's believed to initiate the LH surge. There's more info about this on our Pregnancy page. Continued below.

Jul 29, 2012
Kate Smith Part 2
by: Wray

Hi Kate Plus more about the cycle in general on our Menstruation page. It amazes me how instead of progesterone, the progestins are always used. I'll never understand why. It also amazes me so few doctors seem to know about the progesterone surge prior to ovulation and that in fact it initiates the LH surge. I would hope by giving your ovaries a break by using the progesterone continually, your cycle will settle down. Another thing I suggest you take is NAC (N-acetyl cysteine), at least 2000mg/day. This inhibits the MMPs which cause the lining to breakdown. Please see this page here for encouragement. Thanks for the kind words. Take care Wray

Jul 31, 2012
red spotting two days into starting
by: Anonymous

Hi Wray, you are so lovely not to get tired of our storys and really believe you want to help us. I have started on 1/4 tsp two days ago and have had some red spotting today??! i am day 11, this is really early I usually start spotting day 20 and it is brown and results in no pregnancy. What should I do? Continue on as you said every day for 3 months? Will is shrink the endometrioma do you think by doing that? I am scared to take NAC as it says high does have caused alzheimers in rats! Sounds paranoid but any other suggestions other than Vitamin D

Kindest regards,

Kate Smith

Jul 31, 2012
red spotting two days into starting
by: Wray

Hi Kate Thanks for the kind words, yes I do want to help. But it's difficult, like walking through a maze! There are so many hidden causes, I can only go by the symptoms given. All too often the problem lies with food and drink, stress plays a huge role, and where does the person live, as the sun has a big role too, i.e. lack of vitamin D. Progesterone is but one part of the story. You say you've used 1/4tsp, is that the Natpro? Whichever cream you're on it's giving you far too low an amount. If Natpro it's only giving you about 42mg/day. I recommend 100-200mg/day, dependant on symptoms. You have endo, so you need at least 200mg/day, probably much more. It should be used at least twice a day too, as levels drop after about 13 hours. Progesterone does upset the cycle, but it's nothing to worry about, it settles down given time. I take it you are trying to get pregnant? There is too much inflammation in your uterus for you to fall pregnant. The lining has to be in prime condition for any embryo to embed. It won't if you continue to spot. It's essential to reverse this and take the antioxidants. Please can you give me the reference to the NAC causing Alzheimer's, because it's actually laughable. You might like to see these studies here, here and here, which actually prove the reverse! And please read the endo page, there are plenty of papers on antioxidants, this one in particular, see here. Where they used NAC to reverse the oxidative stress causing the endo. So it's not just NAC and progesterone, but all the other potent antioxidants are needed, for at least 3 to 6 months for any healing to take place. Take care Wray

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