Progesterone and Simple Hyperplasia w/ no atypia

by Sharon
(Sydney, Australia)

Hi Wray, back in 2003 I had an endometrial polyp. It was removed. No big deal. In 2006, I knew from the symptoms of heavy clotting and bleeding that I had another one, but upon ultrasound, the lab couldn't find anything.

Flash forward to 2010. Period that continued for 2 weeks and got so heavy that I was filling a super tampon every 45 minutes. I ended up in emergency, where they prescribed ridiculous doses of norethisterone to control the bleeding until they could get in to do an ultrasound.

Sure enough, the ultrasound revealed a 2cm polyp, which I'm sure had been in there since 2006. When they went to take it out, they found behind it a "polyp wall" with 10 smaller polyps. Biopsy revealed endometrial hyperplasia without atypia. For this, they leave you on synthetic progesterone for 3 months and then go back in to see if the hyperplasia has cleared.

In the interim, I have consulted with a GP involved in natural therapies and a women's health naturopath. Testing has revealed estrogen dominance, insulin resistance, vit D deficiency and iodine deficiency. I assume I am a bit hypothyroid, even though the tests for that came back normal. All these causes made sense when I stopped to consider that both my mother and her mother have now had post menopausal breast cancer that was estrogen positive, probably brought on by estrogen dominance. My whole family also suffers from one form or another of high blood sugar: some having type 2 diabetes.

I have cut out refined sugar and bad carbs and have been loosely following the rules of leptin resistance dieting and have lost about 16 lbs. As a result, I wasn't fat to begin with, but all the weight has come off my mid section. Of course, I'm also taking vit d sups, iodine sups and iron for the anemia from all the bleeding. I'm feeling much better.

I have the follow up biopsy today (nervous), and my surgeon is trying to tell me that if they find hyperplasia again, it will require either hysterectomy or mirena iud. Of course, I disagree. It has taken a full 15mg /day of norethisterone to control bleeding/spotting over the past 3 months, which is quite a lot.

Over the next few days, I will be stopping the synthetic progestin and starting on a natural cream, despite my surgeon's insistence that I need the iud.

I am just a little confused by the info out there as to what dose and frequency I should be on to control endometrial overgrowth. My doc wanted to put me on 75mg troche which I rejected in favor of cream. I live in Australia, and it's a little harder here to get reliable, accurate info from the medical community. Even harder to get any support in regard to natural progesterone.

I have observed that over the past 3 months on the progestogen I have been getting spotting/bleeding the first week of each month, which matches with my cycles prior to all this happening. I am 42, but given evidence of cycles, my guess is that I'm not actually particularly perimenopausal.

So I'm trying to figure out if I should only be taking the progesterone cream from days 14 to 28 or some other method. Also, I had a bad adjustment period when going on the norethisterone. When I change dosage abruptly I tend to get very bad estrogen dominance symptoms, so I am trying to figure the best way to transition from synthetic to natural.

I read somewhere that starting with large doses of progesterone will get you over the estrogen receptor stimulation faster, so I am planning 100mg / day, but now wondering if that's too much?

If you or anyone has any thoughts on the matter I'd love to hear them. My docs are good but I can't help feeling their info is a bit out of date.

Comments for Progesterone and Simple Hyperplasia w/ no atypia

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Dec 01, 2010
by: Anonymous

I can tell you that I use 100 mg of natural progesterone cream per day and have been using that amount for over a year now. If I lower the amount I still have hot flashes.

I know that Wray always suggests 100 - 200 mg of progesterone daily.

I wish you great luck in your journey.

Dec 04, 2010
Progesterone and Simple Hyperplasia w/ no atypia
by: Wray

Hi Sharon Progesterone does stop heavy, continual bleeding, but the amount needed is 400-600mg/day. Oestrogen is a mitogen, it stimulates cells to grow. Vital in stimulating the endometrium each month to grow and thicken ready for a possible fertilised egg. But in excess it stimulates cells to continue growing. MMP?s are enzymes that break down protein. They play a role in the breakdown of endometrial tissues at the end of the menstrual cycle. If they are over active, as would be the case with excess oestrogen in the body, as oestrogen stimulates their production, the result is a pathological reaction. A high level of MMP's can lead to inflammation and excessive bleeding in the uterus. If a low level of progesterone is present, and a high level of oestrogen, the lining will continue to grow. With a high level of MMP's the lining will also continue to break down. Progesterone suppresses both MMP's and oestrogen. It also prevents hyperplasia and cancer, please see our page on Cancer and progesterone. It is essential to use a high amount of progesterone, between 400-600mg/day. If the bleeding is continual, use it both daily and hourly. Using it hourly keeps the level high throughout the day. If there is a cycle, it?s best to ignore it and use the progesterone daily, hourly too, until the bleeding is under control. The progesterone can be used to regulate the cycle once bleeding has stopped, see How to use progesterone cream. It doesn't surprise me you have low vitamin D levels, over 50% of us have. But particularly in Australia with their daft recommendation to cover up when in the sun and use suncreens. The sun is vital for making vitamin D, a low level reduces the benefits of progesterone, parathyroid hormone increases, slowing the thyroid down, both insulin resistance and diabetes occur. It seems your whole family need to get tested, please see the Vitamin D council website for more info. We should be taking a minimum of 5000iu's per day, more if severely deficient. The IUD will fill you full of progestins, suppressing ovulation, so no progesterone will be made. I'm pleased you're resisting it! I don't believe troches are a good delivery system, it seems they are used extensively in Australia. See this page we have for more info on Progesterone application methods. Please read our page on Oestrogen Dominance too. Take care Wray

Dec 06, 2010
by: Wray

Hi there Thanks for the words of encouragement! It's not an easy journey, especially if you can't find a health practitioner to help you. Take care Wray

Sep 16, 2013
Natural progesterone thoughts
by: Debbie

Hi Sharon , I too live in oz and have just been diagnosed with hyperplasia . I am wondering if natural progesterone has been successfully for you . Thank you

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