by Stephanie

Hello Wray, I'm 43 and began having perimenopause symptoms in February of this year. The symptoms were subtle at first then exploded in June. Some of my symptoms before February were weight gain and inability to lose weight. I had hair loss body aches and was diagnosed by a naturopath as having sluggish thyroid a year and a half ago.

In June I began having electrical shock sensations, extreme hot flashes then cold flashes along with heart palps anxiety IBS and a lump in my throat. I had also experienced heavy menstrual bleeding. Before June I had been taking Naturethroid, DIM, fish oil and in May had experimented with red raspberry extract to see if it helped with weight loss. (I think this contributed to my symptoms in June).

In early July my symptoms seemed to subside but by my next period I felt like they had intensified. I ended up in the ER 3x over the summer. Finally a friend recommended a progesterone cream called Kokorro. I used it for only a week and my last hot flash was August third. I made myself an appointment with an OB who specializes in menopause. She did blood serum levels which were on day 2 of my cycle FSH 5.9,estradiol 23.1 on day 20 of my cycle progesterone was 10.47, and estradiol was 88.3, she said I could keep using the cream but that if I felt worse I could try estroven. I feel ok, much better than before and still have not had any hot flashes but I still have stomach issues and the lump feeling in my throat which I know is related to my hormones.

What would be your recommendation for progesterone? Also I have tried eating soy as my dr suggested but I found myself in tears just an hour after eating it and this was on two seperate occasions.

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Sep 19, 2011
by: Wray

Hi Stephanie Peri-menopause can start 5 to 10 years before Menopause. My symptoms started 10 years before, and thought it was all due to getting older! It wasn't until I was 47 that I discovered progesterone, and all my 'old age' symptoms gradually went. Your symptoms, like all of us, are caused by excess oestrogen, including the heart palps. Oestrogen causes prolongation of the QT interval, which results in palpitations, arrhythmia and Torsades de Pointes. Whereas progesterone shortens the QT interval, see here, here, here, here and here. Was this why you ended in the ER 3x? Progesterone does have a beneficial effect on the gut, the following papers might seem obscure, but I'm sure you'll see what I mean, see here, here and here. Interestingly the 'lump' in the throat could also be caused by excess oestrogen. Oestrogen increases smooth muscle tone, leading to constriction, progesterone relaxes muscle. In fact two of the drugs commonly used for oesophageal spasms do just that. One is a calcium channel blocker which prevents the contractions of the muscle, by decreasing intracellular calcium, which leads to a reduction in muscle contraction. Progesterone also blocks calcium channels. Extracellular Ca2+ is normally required for cells to contract, ie to go into spasm if there's an excess, see here and here. I've run out of space so will start a new comment below. Take care Wray

Sep 19, 2011
by: Wray

Hi Stephanie I've no idea why you had tests done on day 2, as they should be done ±7 days after ovulation, or ±7 days before bleeding. So day 20 would be the norm. This shows your ratio of progesterone to oestrogen as 119:1, compared to some not bad, but we've found from Saliva Tests we run, that the ratio should be 600:1 and over to feel well. I don't believe any women needs more oestrogen, so wouldn't advise the estroven as it contains soy isoflavones and black cohosh which are oestrogenic. Soy in any form, unless fermented, has adverse effects, see here, here, here, here and here. So it doesn't surprise you the reaction you had, although I've not heard of one so severe. I recommend 100-200mg/day progesterone, more if symptoms are severe. We have more info on our page How to use progesterone cream. Please have a vitamin D test done, a lack of it impacts hugely on our health, not least the thyroid, see here, here and here. For more info on testing etc see the Vitamin D Council, GrassrootsHealth Birmingham Hospital and Vitamin D Links websites. Interestingly a lack of vitamin D reduces the benefits of progesterone. Take care Wray

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