Progesterone pills during HRT

by Patti
(ON, Canada)

I have had problems with my periods since I was about 26 or 27. I finally went to my doctor when I was 33 and was diagnosed with ovarian failure. She put me on estrogen and progesterone pills. I take estrogen everyday and progesterone day 21-30 of my cycle. I have been on these pills for almost a year and a half now.

I have had a couple of times where my period started early without me getting to day 21. That happened to me in May where I had two periods. I did not take the progesterone when I was supposed to then... basiclly I just started counting the first day of my extra period as day one again.

So then when I got to day 21 of my cycle I took the progesterone tabs as I should for the 10 days. I usually always start my period around two to three days after I stop taking the progesterone. But this time I have not started my period and it's been about a week.

I thought that progesterone stimulated my uterus to shed the lining the estrogen helped to build. Am I wrong? Could I be pregnant? That would be hard to believe though as I thought I couldn't get pregnant. I decided to wait until the next time to see if I start then but I don't know if that's a good idea or not. I didn't want to bother my doctor if this is nothing.

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Progesterone pills during HRT

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Jul 08, 2009

Progesterone pills during HRT
by: Wray

Hi Patti. You say you're taking the oestrogen and the progesterone which makes me suspect both are synthetic. Oral progesterone is mostly destroyed as it travels through the gut, the liver metabolises it too, leaving you with only 10-20% to have any effect.

The synthetic progesterone or progestins as they are called, are not destroyed. If this is the case, I suggest you switch to progesterone but not oral progesterone. The best systems of delivery are injections, suppositories or creams. Oral oestrogen also causes more problems than topical oestrogen, so I would switch to that too.

Please see:
oxfordjournals
ahajournals
humrep.oxfordjournals
endojournals

You are correct that progesterone helps shed the lining built by oestrogen. But if you are taking a progestin this might account for it, as it does not turn the endometrium into a fully formed secretory lining. As for falling pregnant, there is a remote chance, or it could be the protocol you're on is upsetting your cycle. Generally women with POF need assisted reproduction to fall pregnant. Take care, Wray

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Jul 08, 2009
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Submitted by: Wray

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Hi Patti. You say you're taking the oestrogen and the progesterone which makes me suspect both are synthetic. Oral progesterone is mostly destroyed as it travels through the gut, the liver metabolises it too, leaving you with only 10-20% to have any effect. The synthetic progesterone or progestins as they are called, are not destroyed. If this is the case, I suggest you switch to progesterone but not oral progesterone. The best systems of delivery are injections, suppositories or creams. Oral oestrogen also causes more problems than topical oestrogen, so I would switch to that too. Please see: <a href="http://humrep.oxfordjournals.org/cgi/content/full/del520v1">oxfordjournals</a> <a href="http://hyper.ahajournals.org/cgi/content/full/53/5/805"> ahajournals </a> <a href="http://humrep.oxfordjournals.org/cgi/content/abstract/5/5/537">humrep.oxfordjournals</a> <a href="http://jcem.endojournals.org/cgi/content/abstract/62/2/419"> endojournals </a> You are correct that progesterone helps shed the lining built by oestrogen. But if you are taking a progestin this might account for it, as it does not turn the endometrium into a fully formed secretory lining. As for falling pregnant, there is a remote chance, or it could be the protocol you're on is upsetting your cycle. Generally women with POF need assisted reproduction to fall pregnant. Take care, Wray

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