Prolactinoma and progesterone - does it supress the already low estrogen levels? or help?

I am a 39 year old woman. I have a small prolactinoma causing my estrogen levels to be very low (high prolactin levels suppresses the estrogen levels). I have chosen not to treat with Cabergoline (the normal medicine to shrink the tumor) as it has terrible side effects, and my prolactinoma does not grow.
I was suffering a lot from the effects of low estrogen: foggy brain, depression, anxiety, very stiff aching muscles, tendon inflammations, hairloss (it took a couple of years before I found out about the prolactinoma.
In my country there is no practioners of treating with bio identical hormones. I was offered a standard HRT combination pill with estradiol + a synthetic gestagen.
My doctor and endocrinologist will not test for progesterone deficiancy, they say it is not important.
The HRT i am taking has helped some, depression and foggy brain is much better, but my body don't feel normal yet. I still suffer a lot from muscle and tendon pain/inflamation + hair loss.
My question for you is do you think it would be beneficial for me to use the progesterone cream? (I have 26 points in your progesterone defficiancy test)
I have read elsewhere here that progesterone suppresses estrogen, so maybe it is not for me?
Can I use progesterone cream now that I am taking the HRT pill with estradiol + synthetic gestagen?
I have read elsewhere here that you recommend Tyrosine against elevated prolactin. Is L-tyrosine good? and what daily doses do you recommend? I really appreciate your help, you are the source of the best knowledge on this subject I have found yet, and I have researched a lot! Thank you!

Comments for Prolactinoma and progesterone - does it supress the already low estrogen levels? or help?

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Jan 16, 2015
Prolactinoma and progesterone - does it supress the already low estrogen levels? or help?
by: Wray

Hi there I'm not sure what country you are writing from, but all those symptoms you list are caused by low progesterone, not low oestrogen. See Anxiety, Hair Loss and HRT. Oestrogen is an inflammatory hormone. It stimulates glutamate, our most excitatory neurotransmitter, see here. Oestrogen also destroys beta-endorphin neurons in the brain, these produce endorphins which promote a feeling of well being and relaxation. And it increases free radicals, see here. The paper says "This loss of opioid neurons is prevented by treatment with antioxidants indicating that it results from estradiol-induced formation of free radicals". Whereas progesterone protects against glutamate toxicity, it also increases BDNF (brain-derived neuroptrophic factor) in itself protective, see here and here. If glutamate is too high, it allows calcium, an excitatory mineral, to enter the cells. This only makes matters worse. Progesterone also protects against calcium induced excitotoxicity, see here. Substance P is a nociceptive, neuropeptide involved in causing pain and nausea. Substance P inhibits progesterone, see here, but if enough is used, progesterone suppresses substance P, see here. "Accumulating evidence indicates that the neuropeptide substance P is predominantly involved in neurogenic inflammation and pain perception...... Intriguingly, decreased pain sensitivity is found to be associated with high plasma progesterone levels. We hypothesize that progesterone may attenuate nociception and associated inflammatory response." Oestrogen stimulates substance P, see here. So it's essential to use enough progesterone to inhibit oestrogen. A lack of magnesium causes substance P to rise, see here and here. Check magnesium levels. And please check your Vitamin D levels too. Tyrosine does help lower Prolactin levels, so too does progesterone. Oestrogen increases prolactin. You might find more info on this page here. Take care Wray

Jan 16, 2015
Natural progesterone and HRT
by: Anonymous

Hi Wray thank you so much for all of that information, there is a lot to read up on! My big question is now will it be harmfull to start using progesterone cream now that I am taking the HRT with the synthetic gestagen?

I have read somewhere that it is not the best combination, but I am thinking that it will only be while I am trying out if the natural progesterone will make the symptoms better, then I can slowly get of the HRT.

With all the knowledge you have will it be harmfull for the body to have both natural progesterone and the synthetic gestagen? Thank you!

Jan 17, 2015
Natural progesterone and HRT
by: Wray

Hi there There's no harm in combining the two. In fact I suggest it if someone wants to reduce the HRT. It's best to give the body support. If you do use progesterone please, please use enough! But read our page on Oestrogen Dominance first. It can cause very unpleasant symptoms which are put down to progesterone when it's not. Take care Wray

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