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Progesterone and vaginal flora

by Kelly
(Jackson, WY USA)

Dear Wray, Wondering what you know about hormone levels and maintaining healthy vaginal flora?

I experienced early menopause at age 43 - probably due at least in part to working a VERY stressful and somewhat toxic oil field job. That same year I also had several dental surgeries and took several rounds of antibiotics for an infection in my jaw bone. Anyway, about a year into menopause, I started experiencing a constant burning pain in my vagina and labia. Got tested for all STD's - totally clean. Was told it was a yeast infection (though I kept telling the doc this didn't feel or look at all like yeast) and was treated with Nystatin - no change in symptoms. Then was told it was a problem with the nerves and there was really no treatment. I really felt it was something bacterial, but no one would do a culture.

Finally found a nurse practitioner who would do what I asked and checked to see what was growing there and found... nothing! No bacteria of any sort, no yeast, nothing. My vaginal tissues were virtually sterile. She recommended probiotic supplements, orally and vaginally. I was already doing this occasionally, but increased to several times per day for a few months, and symptoms subsided, but found that if I skipped a couple of days, all my vaginal flora would die off again. So went back and was told I probably needed estrogen. Went to a compounding pharmacist who specializes in helping menopausal women, and was given an estriol vaginal suppository. The pharmacist casually mentioned that my progesterone levels were probably near zero, so I asked if I should also be taking a progesterone supplement. She said I didn't need to, as the estriol is safe to take without progesterone.

So, initially, the estrogen helped somewhat. But then after awhile things seemed to get worse, plus I started experiencing severe vaginal dryness, which I had not had before using the estrogen supplements. I also started to develop pretty clear symptoms of estrogen dominance, such as breast tenderness and difficulty sleeping, and hot flashes became worse. So about a month ago I started searching the internet, found your website, and immediately quit the estrogen and began using large amounts of progesterone cream. (In a month I have used two tubes of Natpro, plus a tube of Pro-Gest which had 1000 mg progesterone.)

The progesterone is definitely helping, and the estrogen dominance symptoms are finally beginning to ease up (after getting much worse initially.) But the vaginal flora still seems difficult to maintain. Do you know if I just need to persist with the progesterone and build up higher levels, or if something else might be needed in addition? I can't seem to find much info on this, and feel the medical community here is pretty clueless. I would appreciate any information or suggestions you have. Thank you so much!

Comments for Progesterone and vaginal flora

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Feb 06, 2010
 Progesterone and vaginal flora
by: Wray

Hi Kelly. Apologies for this very late reply, but I can't keep up with questions! It's good you finally found someone who would do a bacterial/fungal test and that it turned out negative. Candida especially can be so troublesome in menopause. It seems it's a clear cut case of inflammation, in which case the progesterone would help. A fungal infection would have caused itching, which you didn't have. I'm glad you quit the oestrogen, although estriol is regarded as a non cancerous oestrogen, I've had a contribution from a woman using it who now has endo cancer. Please see this.

I would continue using the vaginal probiotics periodically, but suggest you use some of the cream in your vagina too, before bed is the best time. It's wonderfully soothing and being an anti-inflammatory it should help calm that down. Progesterone is protective against fungal infections, whereas oestrogen exacerbates them, please see these...
Paper 1
Paper 2
Paper 3
Take care, Wray

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