Overly sensitive to progesterone cream?

by Michelle
(Australia)

I am a 40 yo mum of 4 who had always suffered from shocking pmt from ovulation through to period start. Symptoms included anxiety, anger, hyper, cravings (chocolate and carbs) depression and tearfulness and being overly sensitive, sore breasts, headaches and legs that wanted to run a marathon at night but the rest of me wanted to stay where I was, while I did get cramps they were not that bad.
I got full relief during each of my pregnancies or I was just so distracted with the 24 hr nausea and vomiting for the first 5/6 mths and then the very high Bp kicked in causing pre-eclampsia on first and then attending high risk clinics on other pregnancies and being put on meds and induced early because of this, my Bp remained high after my last one and I am on Bp tablets. I also haeomraged on every pregnancy no matter how much clotting agent I was given.
I could never really settle on the pill and rarely used it but had the more a fitted at 30 after my 4 th baby.
I still got monthly cycle but very light and was fine and most of my symptoms eased dramatically.
It was removed and not replaced when I was 35 and my cycle never regulated. My health issues increased, started suffering tonsillitis regularly, pmt came back with a vengeance, missed periods, heavy periods for 2-3 wks, got glandular fever, quinsy, back surgery, flus panic attacks for the first time ever,etc...these issues were endless. History of early meno in family so asked doc to do tests and he eventually gave in. Blood tests showed: FSH 50 u/l Oestradiol 110 pmol/L and progesterone 2 nmol/l
Was put on the pill as I was told I needed a higher dose due to my age being in peri meno. Within 5 days I was an anxious mess and Bp through the roof so binned the tablets and saw a bio identical doc. Meanwhile I started indolplex, AMAZING relief and take 4 capsules a day. The total and utter fatigue lifted enough to allow to me get through a day, the anger/rage eased along with other pmt symptoms, not perfect but was grateful for the relief.
Saliva test showed these results:
E1 was 11. E2 was 2. E3 was 41 progesterone 576 testosterone 258

I was given 4% progesterone cream in a Mac base 50 ml and told to take .5 ml at night.

I did this and was feeling great but I was not using nearly the amount, I got breakthrough every mth on day 7 and had to stop. I realised without the syringe which I lost, I was not using the prescribed amount. And got a new one but since then I have become very moody and irritable, exhausted,depressed, zero libido, etc almost a full return to the old ways and am finding it really difficult when I had been doing so well and I have only just increased the dose to its correct amount in the last week. I also started using MACA capsules, to aid the indolplex in reducing the bad estrogen but appetite increased as did cravings so I have cut back to one capsule every other day for the moment. I take citracal with vit d supplement (vit d has flagged low occasionally) I use fish oil and also probiotics daily. One thing I have noticed since I increased the cream is that I am going to the bathroom almost daily when I have spent my WHOLE life (since age 2) battling constipation/piles/ thrombosed hemeroids which is really the ONLY benefit since increasing to the correct dosage. Having read through almost all of this, despite the symptoms, I wonder am I using enough or too much given the above info. Apologies for this massive history but I figured it is more helpful to have all details than not enough! I hope my info helps people and that I can also gain some knowledge, this is an incredibly informative site!

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Jan 29, 2012
Overly sensitive to progesterone cream?
by: Wray

Hi Michelle Bless you for the kind words, and the more info I have the better it helps me to help you. Well the first thing that jumps out at me is a lack of vitamin D. No one need get ill, no one. You live in Australia which has the daft policy of covering up when in the sun. Nothing could be more harmful to health, vitamin D is a vital nutrient, without it we all get sick. Even people living in sunny parts of Australia have low levels, see here and here. You say your level flagged low, but what is the 'adequate' level in Australia. I know in the UK it's 20ng/ml (50nmol/L) and in the States it's 30ng/ml (75nmol/L), but even the most conservative vitamin D specialists say it should be 50ng/ml (125nmol/L), please check your results. Others say it should be 70-100ng/ml (175-250nmol/L). For more info on vitamin D levels, testing etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. 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. Pre-eclampsia is directly related to low vitamin D levels, see here, here, here, here here and here. Here are more, some on progesterone, see here, here, here, here, here. Continued below

Jan 29, 2012
Overly sensitive to progesterone cream? Part 2
by: Wray

Hi Michelle And the remainder here, here, here, here, here, here,
here,
here, here and here. Nausea in pregnancy is a sign progesterone is low, I've helped many women who've had it, to recover once on high amounts of progesterone, ie 330mg/day. Your saliva P:E2 ratio is 14, we've found from Saliva Tests a naturopath runs for us, that the ratio should be 600:1 and over to feel well. Interesting you should feel so ill on the Contraceptive pill. It stops all ovarian function, which means of course no progesterone is made, nothing could be worse for you. A 4% progesterone means there's 40mg/ml of oil, so you were getting 20mg/day. No wonder you reacted to this! I recommend 100-200mg/day or more if symptoms are bad, which yours are, so suggest you increase it to 200mg/day, 10 times the amount, and see if this helps. It appears you have been deficient in progesterone your whole life. We have more info on our page How to use progesterone cream. Interestingly maca apparently has no affect on oestrogen or testosterone levels according to this one paper, see here. And yet this paper said it increased oestradiol levels, see here. If this is so it would account for the increased cravings. Continued below.

Jan 29, 2012
Overly sensitive to progesterone cream? Part 3
by: Wray

Hi Michelle It does appear to increase diastolic blood pressure slightly too, see here. DIM is excellent, oestrogen is broken down into 2 principle metabolites, 2-hydroxyestrone (2-OHE1) and 16-alpha hydroxyestrone (16alpha-OHE1). 16alpha-OHE1 is regarded as a potent oestrogen, whereas 2-OHE1 is a weak oestrogen. DIM increases levels of 2-OHE1, by doing so it also increases the ratio of 2-OHE1:16alpha-OHE1. This increased ratio is associated with a lower risk for breast cancer, see here. Other studies have found a protective role too. Another supplement you could consider is Calcium D-glucarate. Oestrogen is metabolised in the liver by glucuronic acid, the process is known as glucuronidation. The process also removes other substances, including toxins, drugs, bilirubin, androgens, mineralocorticoids and glucocorticoids. It's then excreted in the bile, but an enzyme in the intestine called beta-glucuronidase breaks the oestrogen/glucuronide bond, which allows oestrogen to be reabsorbed. There's evidence beta-glucuronidase activity is increased in breast and prostate cancer. Calcium D-glucarate inhibits beta-glucuronidase, see here, here, here and here. Incidentally this enzyme is produced by undesirable gut bacteria, so supplementing with probiotics as you are, suppresses the bacteria, and subsequently the beta-glucuronidase. Finally, progesterone is an excellent diuretic, so good it's now given to TBI victims to prevent oedema forming, see here. This explains why you no longer have problems going to the bathroom, it's replacing the water from the gut which has been removed by excess oestrogen, this causes water retention in the tissues, robbing the gut of water. Rubbing progesterone on the piles is excellent too, it's a potent anti-inflammatory. I do have more papers on progesterone and headaches, sore breasts, anger and more, but feel I will give you indigestion, I've already given so much! But you could look at our page on Anxiety. Take care Wray

Jan 29, 2012
Contd from above!
by: Michelle

Hi Wray, thank you so much for all of this info. One of the links in relation to vit d did not work but I certainly got the gist of what it all meant. I had low vit d when I had mono but it hasn't come up since and I lived in between oz and Ireland in my first pregnancy and was an avid sun worshipper it was I think the last decent summer Ireland has ever had 1995 for any length of time, I think other factors may have aided the per eclampsia. Having had 2 cancerous moles removed in later years I do avoid the sun, I am fair and freckled but take vit d caltrate. I will look into your recommendation when I have finished this round! My fear with your recommendation on increasing the dose so dramatically is this: when I was on the indolplex with various supplements I felt great, so good in fact I was considering not doing the bio identical appt. but out of curiousity and a belief in saliva tests over bloods for accurate results I went ahead. I was given the cream before the results came back and the amount was not changed on follow up. I was only using about .2mgs in error and felt this is why I was getting a heavy period on day 7 on this 14 day routine but I still felt good, very good actually. To stop the breakthrough period I increased to the .5mg which you said was 20 mls if I recall? And you also said this needs to be dramatically increased, YET when I took the .5ml dose, I could not move the next day, it was like having mono. All over again without the throat aspect! All i could do was sleep and when i was awake eat massive amounts of carbs which i normally dont do or avoid!! With 4 kids and my other half in another country, I fear increasing this dose even further would put me in a coma!! And I cannot risk this type of reaction with that sort of responsibility. Can you confirm if this would happen if I increase the dose further? Is this the oestrogenic dominance kicking into high gear with the additional use of progesterone now and that it WILL go away. When I used the progesterone in the morning I felt quite jittery and anxious and resorted to using it at night only, should I go back to morning and evening, splitting your recommended dosage as per your link using progesterone cream and I think I am more peri meno than per meno as my cycle was all over the place originally? I am sorry to pester you but I do have great faith in this treatment and I want to get it right without risking my ability to drive, concentrate and get through the day which I am currently finding hard to do on .5 ! Thank you for considering all of my fears and also for your amazingly detailed and informative response! My testosterone is also quite high for a female which suggests stress yet I do not feel overly stressed, think this could be down to playing father and mother most of the time mind you!

Jan 30, 2012
Contd from above!
by: Wray

Hi Michelle Glad it was of help, a bit of a mouthful! I find it so irritating when the URL's are changed! Anyway this is the new link here. Thanks for telling me, as I don't have the time to check them all now. Ironically the UVB rays that make vitamin D do not cause cancerous moles, the UVA rays do this. They've found people with the lowest vitamin D are more prone to the moles, than those with higher levels. In other words the sun is of great benefit, the higher the vitamin D the less likely to get them, see here, here, here, here, here, here. I can never understand the fuss about calcium, it's not a co-factor for vitamin D either. The most important co-factor is magnesium, in fact without magnesium the calcium will not be deposited in the bones. Often calcium is very high in our diets due to dairy products, which have very low magnesium levels. Plus our soils are low in magnesium now. Far better to take the vitamin D on it's own, at least 5000iu's and add the co-factors if you feel you could be low in them. These are magnesium, vitamin K (found in leafy greens), beta-carotene, zinc and boron. The amount of progesterone you were using was far too low, that would cause huge problems, as evidenced by you not being able to move! Oestrogen causes de-stabilised blood glucose, hence the cravings. That low level of progesterone was just stimulating the oestrogen. The anxious, jittery state too, the jitteriness is caused by excess adrenaline, this calms down, progesterone is excellent for anxiety, see here, here and here. Continued below.

Jan 30, 2012
Contd from above! Part 2
by: Wray

Hi Michelle Testosterone is increased if SHBG is low, it's imperative to get SHBG up. Progesterone does this, see here. Fructose, sucrose and glucose reduce SHBG by 80, 50, and 40% respectively, see here. It's essential to avoid all sugars, and sweet, starchy foods such as grains, legumes, and fruits and veggies which fall into this category. Excess oestrogen doesn't help! As it increases cravings. Quite frankly I don't know how you cope, I had only one daughter, that was enough! Take care Wray

Jan 30, 2012
Info
by: Anonymous

Hello again Wray, just to let you know, 2 of the 3 links for progesterone on anxiety are no longer valid, hope this helps you! I find it ironic that low vit d can be asEqually carcinogenic as too much sun! But like hormones, it really is all about balance. I have increased my cream but am doing this in increments throughout the day, so instead of taking 2.5mg of my 4% base twice a day, I am building it up with approx 1mg 3 times a day (yesterday) and will do this 4 times today I think. I have already noticed a decrease in tiredness and I feel some brain fog starting to lift so the fear of being comatose is also going out the door. I fear my bio Identical doc will have a fit given she prescribed a mere .5mg but if it works, I am all for it and in such a short time, I am definitely feeling something, I also slept much more deeply and did not wake feeling swamped...all good! So can I check with you that this is ok to do and also that 5mg of my cream is the amount you feel appropriate as per your originally response. Also, given my results from saliva/bloods am I pre meno or peri meno and does this change the amount of days I should apply it for, the current mode is day 12-14 of cycle to apply and continue to normal cycle, but I have not had a normal cycle for years and doubt I am even ovulating monthly. Interestingly, I quit MACA and my blood pressure has dropped a couple of points though it differs on both arms (recently heard readings should be taken from both arms as differences can be pointers towards stroke/heart attack issues) left arm was 118/78, right arm was 128/82) so still very good and this is before I take my Bp med for today! I want to look further into this and it is off point but just thought I would mention it as your notes suggested maca can raise the Bp, it does appear to! Am I right in thinking from your notes that using fructose etc might be a good option on the SGHB point of view? I very much appreciate this time and effort your info is really invaluable. I am now considering giving my 16yo DIM but am going off to google that this is safe! She is def showing signs of estrogen dominance! One of us is more than enough and she does not need to go through this if I can help it!! Again, thank you so much!

Jan 31, 2012
Info
by: Wray

Hi Michelle Thanks for telling me about the broken links, no idea what I did! Anyway these should work, as I've tried them all, see here, here, here and here. We also have a page on Anxiety which has more info. It you're using a 4% cream, it means each ml contains 40mg. So 5ml of cream will give you 200mg/day, an excellent amount. This is the reason it's beginning to help. I will never understand why all women are told to use progesterone from day 12 or 14. This would only apply if their cycle was 24 or 28 days long, is/was yours?! Cycle lengths range from 21 to 35 days, making 28 the average only. All women, irrespective of the cycle length, ovulate 12-14 days before bleeding. If there is a cycle, progesterone should be used from ovulation. It's impossible to follow a cycle in Peri-menopause as there isn't one! So I suggest women use it daily, ignoring the bleeding, it will come and go at will. I did, in fact even when my cycle was regular, as symptoms came back when I stopped, something I could do without. Interesting your experiment with maca bears out what the study found, I'm pleased you've stopped it. Fructose is the very worst sugar you could eat! That decreases SHBG by 80%, which in turn increases free testosterone. This increase causes an increase in visceral fat, which is why middle age women get a middle age spread! We make androgens when in P-M and Menopause, see here. Yes DIM is safe for a 16 yr old, so is progesterone. I put my daughter on it when she was 14, and she's still using it and is now 30. I had depression during puberty, and didn't want her to. Take care Wray


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