Progesterone and following the directions

by L.K.
(California)

I had my first hot flash in December of 2006 at the age of 48. As far as I was concerned the hot flashes were NOT acceptable! Nor would any of the other symptoms I understood could be following in the near future. I had heard about progesterone cream and within two weeks of the first hot flash I started using it (I purchased Emerita's Pro-Gest). The directions said to use it twice a day, but I only applied it once a day in the morning. In about a week the hot flashes were gone.

I continued using the cream daily only discontinuing it while I was on my period but starting right back up when my period ended. All was going well until I ran out of the cream about two to three months from originally starting the "program". I just hadn't gotten into the mindset that this perimenopausal stage was “semi-permanent" and would be here for a while and I didn't have a new tube on hand when the old tube went empty. Well, you guessed it... the hot flashes started about two weeks after I ran out of the cream. When those hot flashes started again I was at that store faster then you could say "Is it hot in here or is it just me?" I have never run out since and never experienced any of the perimenopausal symptoms one hears about.

That is until... I decided to follow the directions. Silly me. As the months turned into years my periods slowly started to change as is expected at this stage in life. I just kept using the cream when I wasn't menstruating and stopped when I was. I really didn't pay attention to the number of days that I was using the cream continually until April of 2009. I realized that I had gone about two months without a period and started wondering if I should still be using the cream. I pulled the box out and read the directions that I hadn't looked at since December of 2006. The directions said "If your period is late, use the cream for up to 3 weeks (day 28 of your cycle), then take a week off. If your period has not started by the end of the week off, resume use of the cream as described below for 8-28 or until your period starts. STOP the cream when your period begins" etc... So I stopped using the cream for the 7 days and my period didn't start, so I was going to resume use of the cream on the 8th day. And you guessed it, my period started on the 8th day and so I didn't use the cream per the directions for another 7 days.

What it comes down to, is that I was off the progesterone for two weeks and those hot flashes came back with a pent-up fury. Far worse then I had experienced the two years prior. It didn't matter that I had started using the cream on the 8th day after my period had started and was using it exactly as I had done in the past, the hot flashes weren't going away and because they were plaguing me at night I wasn't getting a good night's sleep. As one would assume, I was miserable. About mid-June I started using it twice a day and here it is the beginning of July and the hot flashes have subsided to about 5 or 6 light ones in a 24 hour period. I'm hoping with the twice-a-day application that they will disappear altogether in the near future. But here is my dilemma...

As I get older and my periods grow further and further apart, the situation that I noted above may and probably will happen more frequently. What happens if I just keep using the cream for longer and longer periods of time only going off it when I actually do have a period?

Also, what would happen if, as in the example above, I was off the cream for the 8 days when I wasn't bleeding and started using the cream on the 8th day when my period did actually start and I continued to use it during my period?

And finally on the box it says that Progesterone is known to the state of California to cause cancer. Should I be worried or is this one of those "you'd have to use the stuff in quadruple quantities while standing on your head drinking mushroom juice for 40 years" to have a remote chance of getting cancer? I think given the alternative of a lousy and uncomfortable existence or a remote chance of cancer I'll take the remote chance of cancer for a better quality of life, but I'd still like to know the odds.