Not sure what to do about progesterone

by ally

Hi-
I am a 41 year old mother of 3. I began having some trouble sleeping in March. This led to several tries with different benzodiazapines over a few months and then finally to remeron which I am now trying to taper off of. I recently had my hormone levels checked. My progesterone was 0.5 and my estradiol was 41.1--I had a uterine ablation done about five years ago so I have no idea where I was in my cycle when this blood test was done. I have a history of endometriosis and have recently been having low level cramping everyday but no spotting. Anxiety levels have been pretty bad over the last few months mainly due to wanting off the meds and being able to sleep normally again. Bioidentical progesterone cream was suggested to me and I actually have some but have been afraid to use it due to some things I have heard that claim it is like benzo withdrawal when coming off of it (which scares me to death). I have actually used a tiny bit here and there (maybe 15mg or something) on nights when I was having trouble sleeping...which it did seem to calm me--but then the next day I would worry about whether or not I messed things up more by using it.....I'm lost as to what to do. If this could help me I really want to use it--but I'm not sure how to know for sure what my hormone levels are or when to use it since I had the ablation and I cramp everyday it seems. Also--my last vitamin D level was low at 26 so I'm working on bringing that up. previous to this last blood test, I had FSH and LH checked (in June) and those levels were 14.8 and 5.19--but again, I don't know where I was in my cycle for that blood draw either.....so confused....any advice would be appreciated.

Ally

Comments for Not sure what to do about progesterone

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Sep 01, 2013
Not sure what to do about progesterone
by: Wray

Hi Ally I can't believe they would give you a benzo for sleep! You must have had Anxiety too, maybe that's why? This page gives a list of nutrients which help anxiety. The Remeron of course is given for it too. You might like to see this comment here by a user of progesterone. Especially the web sites she gives, written by doctors. We also have a page on Endometriosis you could look through. I'm not sure why you're worried about coming off progesterone when you have't started it. Do you mean when you take the customary break? I would not recommend you take a break as you have no cycle. It's not harmful in any way. A friend of mine had an ablation and she uses it daily. I take it you had heavy bleeding if they did the procedure? This shows your progesterone was far too low, as it still is. Your ratio of P:E2 is only 12:1 very low. We run Saliva Tests on our cream. You'll notice the ratios are 600:1 and over. Progesterone can help heavy bleeding, see our page on Menstruation for more info. Your vitamin D was low, it was probably this which caused the sleep and anxiety problems, although progesterone helps both these, and your level of that was very low, see here and here. I suggest you take at least 20,000iu per day of vitamin D for a month or two to get it up fast, then have another test done. Continued below

Sep 01, 2013
Not sure what to do about progesterone Part 2
by: Wray

For more info on vitamin D levels, test kits etc see the following websites, Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Blood levels should be 70-100ng/ml or 175-250nmol/L, and not the 30ng/ml or 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. If you're so worried about the progesterone, why not get your vitamin D levels up high first. Plus take some of the calming nutrients listed on the anxiety page. Then see how you feel. Take care Wray

Sep 02, 2013
response
by: ally

Hi Wray! Thanks for your response!
Yes- I know I need to work on the vitamin D and I'm already doing that now. I'm not really "scared" of the progesterone--I actually would love for it to be the answer--just still have some questions about it. Even though I did have an ablation, it was my understanding that I would still cycle just wouldn't bleed like I used to. I can usually tell when I ovulate (or at least when I think I do) based on cervical mucus/discharge being the "egg white" stuff (sorry didn't know how else to put that, lol). So--if I'm having that, wouldn't that indicate that I'm cycling? One thing that really concerns me is the constant low level cramping I experience everyday....is this a symptom of low progesterone? left over endometriosis? If I still cycle--how would I use the cream and would there be symptoms for me during the 14 days I don't use it? Hope this makes sense. Thanks so much for your help! I would love for this to be the answer to my current situation.

Sep 04, 2013
progesterone levels
by: Anonymous

Hi Wray-
I went back to the doctor today and reviewed my latest blood work with him. I had more done a week after my original labs (which showed progesterone to be 0.5 and estradiol to be 41.1). This time my progesterone was 0.55 and I think estradiol was 45. He also stated that my testosterone level was practically non-existent but I don't remember the number. He recommended I take 100mg bioidentical progesterone by mouth at bedtime (since sleep has been such an issue for me, he says the oral progesterone helps with sleep more...?). Also--he wants me to start a bioidentical cream for testosterone. I am very nervous about doing this--but I want to feel better. Here is my biggest question: This past Saturday, I had one sign of ovulation (cervical mucus)--so, since the ablation this is usually a hint as to where I am in my cycle. I would really like to know what my progesterone levels were after ovulation since that is when the are supposed to rise anyway as I understand it (correct?). Even though the two progesterone levels I have had drawn are low, if they were both before ovulation, aren't they still within normal range? I want to take this and for it to help and allow me to come off the remeron--but the last thing I want to do is start this if I don't truly need it. What are your thoughts if you don't mind? Also--in my previous post, I asked about low grade cramping everyday, which I am still experiencing. Do you think that has any significance? Thanks
Ally

Sep 07, 2013
response
by: Wray

Hi Ally If you know when you ovulate, then it couldn't be easier, as that's the time you should begin using progesterone. All women should if they want to follow their cycle. There could be symptoms during the follicular phase, if you should get them, then do as my first suggestion. Use it daily, but in this case for 2-3 months until you feel stable, then start following your cycle. You say "would there be symptoms for me during the 14 days I don't use it?" 14 days would only apply if you have a 28 day cycle, do you? If not then use the progesterone from ovulation. Our cycles range from 21 days to 35 days, 28 is only the average. The cramping sounds more like uterine contractions, rather than the inflammatory pain from endo. Assuming it is, then the progesterone should help. One of it's roles is to reduce the levels of inflammatory substances in the uterus, notably oestrogen and the cytokines which cause contractions or 'cramping'. It's particularly important during pregnancy, when it keeps the uterus 'quiet', see here and here. If the tests were done during the follicular phase then progesterone would be low, anything less than 1ng/ml. So yes your level is normal for that phase. The test should only be done mid-luteal which is ±7 days after ovulation or before bleeding. Like I said why not get your vitamin D levels up first by taking very high doses, and then see if you need progesterone. Progesterone does help sleep, but there appears to be a stronger response to oral progesterone. Although once the other forms have settled down, they are also affective.Take care Wray

Sep 08, 2013
progesterone levels
by: Wray

Hi Ally Progesterone does peak mid-luteal phase, so this is when a test should be done. It's meaningless at any other time. For instance your ratio with those figures you gave me was 12:1 which is very low. We have a page on Hormone Testing you could look through. Oral progesterone does help sleep, but so do the other Delivery systems. But oral progesterone is the least effective for other issues, "The liver and gut region removed a mean of 96 per cent of the progesterone entering these tissues", see here. Testosterone can help some women, but I would advise caution. You can read these papers here, here, here, here here, here, here, here and here, and see what you think. These are two more see here and here. I feel you should get your vitamin D level up high and see if that helps. Then you can better judge if you need progesterone. Plus take some of the nutrients listed on the anxiety page. Take care Wray

Sep 09, 2013
New levels
by: Anonymous

Hi Wray!
Thanks for your last response. Just a few more questions for you:) I went again and had my levels of progesterone and estradiol drawn last Friday since I felt I had ovulated the Saturday before. I know that is not quite 7 days post ovulation, but they were going to closed on Saturday--so based on my symptoms it was 6dpo. Anyway, this time the levels were: progesterone:5.4 and Estradoil 55. These seem to be in the normal range to me, but what are your thoughts? Also- I have increased my supplementation of vitamin D---but do you ever recommend a specific brand? I use liquid drops know--but not sure this is best?
Thanks for any advice--you are very helpful!

Sep 11, 2013
New levels
by: Wray

Hi Ally Well that one was better as your ratio is now 98:1. It might have been slightly higher a day later, but not that much to make a significant difference. Yes the two hormones are in the normal range, although your progesterone is at the lowest end. The range Medline give is 5 to 20 ng/ml. So if your progesterone had been at the higher end the ratio would have been 364:1. Some women secrete up to 40ng/ml, so their ratio would be 727:1. The paper says "The ephemeral nature of the corpus luteum makes it even more remarkable that this tissue is able to synthesise upwards of 40 mg of progesterone in the human on a daily basis.", see here. The bottom line of course is how do you feel with that ratio of 98:1.... good? Not when I re-read your first query. Very pleased you've upped your vitamin D, but don't forget to have a test done. If I'm asked about a brand I always recommend the one Dr Cannell formulated. Part of the proceeds go towards supporting his Vitamin D Council, a non profit organisation. He's done so much to bring awareness about vitamin D and how important it is. The brand itself is here. It contains all the co-factors for vitamin D which are so important. Take care Wray

Sep 18, 2013
Inositol
by: Anonymous

Hi Wray-

I'm feeling a little better after a few weeks of increasing Vitamin D and also added Magnesium. I'm still kind of "waiting" to decide about the progesterone (and testosterone). One thing, I wanted to ask you about was Inositol. I have read a lot about how it can help with anxiety/OCD and I saw it listed on your anxiety page. I am especially interested since I read it can increase progesterone levels--however, read that it can decrease testosterone--so I was hesitant as I am already at the low end of that....what are your thoughts on this? Would it be safe to try?

Thanks-
Ally

Sep 22, 2013
Inositol
by: Wray

Hi Ally I pleased the vitamin D and magnesium have helped. Inositol is one of my standbys, it's an amazing nutrient. It helps stabilise blood glucose which is often behind many of our problems. It does cure OCD, but amounts of 12 to 18g per day are needed, see here, here, here and here. Excess blood glucose can cause hair loss, inositol can correct the loss, hence it's name of the anti-alopecia vitamin. It also initiates ovulation in PCOS, another blood glucose problem. I've not heard of it increasing progesterone levels. But if blood glucose is high, it means SHBG (sex hormone binding globulin) is low. SHBG drops if sugars are eaten, even those found in all grains, legumes, processed milk and sweet starchy fruits and vegetables. Fructose, sucrose and glucose, reduce SHBG by 80, 50 and 40% respectively, see here. If SHBG is low it means testosterone and oestrogen will be high. These two hormones will reduce progesterone levels. If bound to SHBG testosterone becomes inactive, progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone and severe PMS. You say you have low testosterone, did they check your active or free testosterone? It's the active hormone which causes us problems, see here, here, here, here here, here, here, here and here. Take care Wray

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