Progesterone and Simple Hyperplasia w/ no atypia
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.