perimenopause driving me crazy!

I have been in symtomatic perimenopause for 5 years. It started with spotting between cycles and then a diagnosis of simple endo hyperplasia w/o atipia. I was put on provera for three months to resolve the hyperplasia. After that I came off of all forms of progesterone at the advice of my osteopath. While she wasn't pro bioidenticals, she was also cautious regarding progestins. I had been off of them for over two years, trying to regulate hormones with dietary changes. Then a little over a year ago I got endo hyperplasia again. This time after a bout with an ovarian cyst. I am convinced that the cyst is what caused the hyperplasia. At that time my osteopath put me on prometrium to get rid of the hyperplasia. It did. However, she also reccomended that I stay on prometrium since I had had hyperplasia more than once. I have been on it now for over a year. My problem is that my doctors are not very knowledgeable about prometrium and started me on a dose of 200 mg once daily, to be taken the first 12 days of the month. My cycle has been a 21-25 day cycle for the last few years. They didn't take this into consideration. They just put me on the same regime as a progestin. However, I start getting my cycle on day 9 of the pills most months. I finally convinced them to put me on 300mg which is better but sometimes still start period at day 9 or sometimes day 11 or 12. Is there any information you can give me regarding how to take the prometrium in order to make it hold off cycle until pills are finished. I am now trying to take the pills with an fat based food hoping that the extra fat will help it to absorb better. Any sugestions. I would try cream or herbs, but am scared to since I have had the hyperplasia. Thank you.

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Nov 06, 2013
perimenopause driving me crazy!
by: Wray

Hi there It's typical to give a progestin instead of progesterone, I'm pleased you’ve stopped it. Endo hyperplasia and cysts, either Breast Cysts or Ovarian Cysts, are caused by excess oestrogen. I don't know why you were told to use the prometrium for the first 12 days of the month. If you have a cycle, it should be used from ovulation for the duration of the luteal phase. This is always in all women 12-14 days before we bleed. So in your case you should have started it on days 7 to 11. Or taking the average between 21-25 gives 23 so you would start it on day 9. It doesn’t surprise me your cycle was upset. Progesterone cream is far more effective than oral progesterone, which is the least effective Delivery system, "The liver and gut region removed a mean of 96 per cent of the progesterone entering these tissues", see here. In other words you were getting very little, but it still seemed to help the hyperplasia. You'll find a cream has added benefits. If you do switch, I suggest sticking to the 200mg/day for a few months until stable, then you could begin reducing it. I'm not aware of any herbs that will stop the uterine lining growing. This is due to excess oestrogen, which progesterone effectively suppresses. You say you’ve been in Peri-menopause for 5 years, so you could be around 46 to 49, almost at Menopause. In the last few years of P-M cycles do become extremely erratic, so it’s best to use the progesterone daily, ignoring any bleeding. It's impossible to follow a cycle. Finally please have a Vitamin D test done, a lack of this reduces the benefits of progesterone. Let me know how you get on. Take care Wray

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