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Registered Nurse

by Barb
(Mesa, Arizona, US)

Dear Wray
I have had two ultrasounds since. one last July, and one in March, 2012. Each one showed a hyperplasia of the endometrium. I am 62 and post menopausal. I have been taking the micronized progeterone, 100 mg per day, and estratest 1.25/2.5. I assume the high dose is for osteopenia.

In July, my endomtrium measured 6.5 mm, and in March, it was 7.8. My progesterone prescription was doubled to 200 mg per day, back in July my estratest dosage remained the same.

For some time, I have wondered if the estratest dosage was too high.

I have slight vaginal pinkish discharge every few months, mostly when under undue stress. My father passed away recently and I am a disaster responder for my work.

My marriage has been trouble for a long time.

I also have a "seasonal" Spring vasculitis of the lower extremities and treated with a relatively high dose of prednisone, no longer, but on Dapsone and Cholchicine. No autoimmune disorder has been found

In two days, I go in for a D & C and hysteroscopy, and obviously I'm very frightened due to my age and hyperplasia. No fibroids or polyps were seen. I'm not only anxious, I am in a panic state. :(.

I realize now I have to be my own advocate. If the estratest is too high a dose for me, I'm a small person, I wonder what the proper ratio is for progesterone and estrogen.

If the biopsies are okay, what do you propose as a course of treatment?

Please advise.

Thank you,

Barb

Comments for Registered Nurse

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Apr 25, 2012
 Registered Nurse
by: Wray

Hi Barb Hyperplasia is caused by oestrogen! Why on earth they gave you more is beyond me. It's no wonder it increased, and the discharge too. These are a few papers I have on it here, here, here and here. Please don't be frightened, the obvious reason is the added oestrogen. Why they are still so hooked on giving it to women I have no idea. It's very interesting your vasculitis is found in spring. After the winter vitamin D levels drop to their lowest level. They don't start rising again until mid summer when we have more sun. Vitamin D is a potent anti-inflammatory, I would think this is the cause of the vasculitis. Please have a test done. It also prevents the proliferation of cells, all cells, so should help the hyperplasia too. It seems you have a very stressful life, so having a high level of Inflammation doesn't surprise me. Oestrogen too is an excitatory, inflammatory hormone, it won't be helping. You are taking progesterone, this is the least effective Delivery system. Most of it getting destroyed by the gut and liver. I recommend 100-200mg/day progesterone, but in a form which is absorbed well, injections, suppositories or a cream. I prefer a cream, as it can be applied anywhere. We do run Saliva Tests and have found the ratio of P:E2 should be 600:1 and over to feel well. I'm sure the biopsies will be ok, but whether they are or aren't your best course is to get your oestrogen down, and your progesterone and vitamin D level up. Both are protective against Cancer.
Continued below.
Apr 25, 2012
 Registered Nurse Part 2
by: Wray

Hi Barb As you're now in Menopause please read through this page, as it explains how to use progesterone. Please have a vitamin D test done. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. Blood levels should be 70-100ng/ml or 175-250nmol/L and not the 30ng/ml or 75nmol/L most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. Take care Wray
Apr 26, 2012
 Reply to comforting
by: Barb

Hello Wray,

Thank you for your helpful and soothing letter.

I had my procedure yesterday, cervix was negative for anything but a fibroid. The uterus showed a polypoid mass, with large vessels. My understanding of that is those are similar to varicosites, but I am now wondering if it is part of the inflammatory proceess. I won't get my biopsy results back until early next week. I will try not to stress that too much, as it is what it is. The doctor did not say much except to wait on the pathology report.

I did have a Vit D test, was 55 ml about a year ago. I take 1200 mg/day with 600 calcium for my osteopenia. It sounds like I need to increase the Vit D to at least 5,000 mg from your recommendation. I am going to tell my gyn at 62 years of age, I will no longer have menopausal discomfort and want to treat the osteopenia w/o the estrogen. As I am taking Estratest, it sounds like androgens are not very helpful either.

I would much prefer a cream to taking a big pill everyday. When the biopsy results are in, I will write you again for the proper recommendation.

Thank you again. I was able to finally relax yesterday after I read you reply.

I had a good night's sleep, too, thanks to you.

Bar
Apr 27, 2012
 Reply to comforting
by: Wray

Hi Barb I'm so happy it helped you. The Fibroid doesn't surprise me, most of us have them! I must confess I never go to a doctor, never have check ups or tests, so I've no idea if I do. And if I do, they certainly don't bother me. Fibroids are caused by oxidative stress, which ultimately leads to inflammation, so yes you are right. Because oestrogen is a mitogen and an inflammatory hormone, it exacerbates them, and causes them to enlarge. And don't stress about the results, stress only causes more oxidative stress! There is a wonderful and very quick way to help you relax and take your mind off it, and that's EFT, please look into it. Your vitamin D level at 55ng/ml is not as bad as most I've seen, but is it that now? Stress drops levels, as it does progesterone, so please have another test done. It reduces fibroids too, see here, here, here, here and here. I would suggest you consider taking 10,000iu's per day for a month or two to get your level up, but please have the test done beforehand. The dose can be adjusted accordingly. Continued below.
Apr 27, 2012
 Reply to comforting Part 2
by: Wray

Hi Barb And I've been very dim, I didn't register that the Estratest contained testosterone too, it should have hit me in the eyes! You are so right about the androgens, they are not something that should ever be given to a woman. These papers are not intended to worry you, but to assure you that you're on the right path, see here, here, here, here, here, here, here, here and here. Plus these here and here on visceral fat. I see you're taking calcium, please rather consider taking magnesium. This is the most important co-factor for vitamin D. Besides which vitamin D draws calcium from the gut, and our food normally contains far more than it does magnesium. This is low in our soils and therefore our food. Please let me know the biopsy results, which I'm sure will be fine. Take care Wray
Apr 27, 2012
 NEGATIVE!!!
by: Barb

Hi Wray,

Thank you for all the good information. The biopsy came back negative. All the worry was wasted energy.

I appreciate the interesting articles. Funny, didn't know what EFT was, but downloaded an application on my phone for sleep, and I listen to it, and have a sound sleep, each night. I will look into and get some of the literature. This is all very exciting.

I believe I can get a Vit D test here at a lab without a Dr's. order, so yes, will check it again, and add magnesium. Do you think then, not to take the calcium, but include lots of dairy into my diet?

The testosterone was prescribed for low libido. It really hasn't worked. I believe that comes with how close you feel to your partner. I do have an increased waist line, and I would love to see it get smaller. I do work out, so I'm already on a path. Luckily my blood sugar levels are fine for now as well as my lipids, HDL,LDL, etc. I will call the office, as this was about a month ago, and I think he does run a Vit D test.

I am very excited now about a fresh start and maybe even examing my marriage at this point. I suppose we are never to old to start over. :).

Thank you again for all your support during this scary time.

Barb
Apr 27, 2012
 NEGATIVE!!!
by: Wray

Hi Barb I can feel your excitement in your subject line! Yes the worry was for nothing, and even if it had been a bad result, the worry wouldn't have helped that either! That sleep app sounds excellent, I must remember to tell others to look for one. Yes it is exciting, there are many wondrous things occurring on earth, but most of us don't know what to look for. I find the more I learn about EFT the more remarkable it is. I'm more in favour of the magnesium, as calcium is often high, particularly if dairy is eaten/drunk. There's very little magnesium in milk. Too much calcium, particularly if it's out of ratio with magnesium can lead to upset blood glucose, depression, see here. CVD, see here and here. We're always encouraged to take calcium for our bones, but this study throws doubt on it, see here. I think the problem lies in not realising magnesium is low in soil, therefore in food, that dairy has high levels of Ca with low Mg, that vitamin D does draw Ca from the gut, provided of course there's enough vitamin D! It's always 'take Ca for your bones', very rarely do they give vitamin D a thought. And never magnesium, the most important co-factor for vitamin D. Yes Ca is needed, is vital, but so are the other two. Ca is an excitatory mineral, causes muscle contractions amongst many things, whereas Mg relaxes muscles. I do wonder if all of us who get 'uptight' aren't undernourished in Mg. As for testosterone for libido, you must have a male doctor! There's strong evidence it's progesterone which increases it and the sexual response, in both sexes, see here here for men. Unfortunately the full paper gives far more detail and is much more exciting that the dry abstract. But I can't give it to you as I had to buy it. And here for women. Dopamine is essential for a normal sexual response, increased prolactin causes a drop in libido. Excess oestrogen causes a rise in prolactin, circles within circles! Hopefully with a drop in testosterone levels your increased waistline will diminish. And no we are never to old to start healing, emotionally or physically. Take care Wray
Apr 29, 2012
 Thank you!
by: Barb

Hi Wray,

I have had a chance to read the excellent articles that you have provided the links for. I find myself a little ashamed, being in the medical profession, I did not look up those prescribed meds. I usually do, when given a prescription, but HRT just seems so cut and dry, and no alternatives given.

I have started increasing the Vit D, by 1000 iu/ml per day until I get the results from my test. I will try to work up to the 70 to 90 range, which means more outdoor time too, here in the Southwest, and so less depression.

Is 600 mg of Ca too much? It always comes with D3. I've noticed that now they are selling supplements that include Vit K with the CA and D3. I don't understand the benefit to adding Vit K. I have also switched my nutritional supplements to a liquid form with some super-fruit as hoping it was more absorbable. I hope other readers don't find this digusting, but I have read that pills sometimes come out whole in stool.

I will continue to learn about EFT, proper supplements and of course, HRT. I had the same problem one of your readers posted about the peeling lips. I thought it was the estrogen when I stopped, now I realize it must be the progesterone.

As the the saliva testing, do they do that here in the States?

All in all, the "change" or menopause, can mean change for the better, as you realize your suddenly a grandma, not a mother, marriages revisited, diet, and how we must tenderly treat our bodies and minds. We lose our parents, ( I just recently lost my father, a wonderful man), and we become the matriarchs of the family. So many things change, no only are body chemistry, but relearning life, which can be exciting and for sure something to feel positive about.

Thank you again for all your excellent suggestions. I will follow-up with the Natpro after my post-op visit to my physician.

I will keep in touch and let you know my progress and if other women are facing menopause, I hope they get on the right course.

I really appreciate all you've helped me with,

Barb
Apr 29, 2012
 Thank you!
by: Wray

Hi Barb Pleased you found the info of help. I'm a bit of a fanatic when it comes to drugs, so very against them. In fact I don't take them at all or go to a doctor! Never had a mammogram and never will, had two pap smears while having IUD's put in, the doctor said he had to do it, but I didn't bother to collect the results, as I certainly hadn't requested it! It's such a pity no alternative is suggested to HRT, when progesterone is so readily available and relatively cheap too. I think you can safely increase your vitamin D to 5000iu's/day, the 1000iu's is not doing anything to help. Would like to hear your test results when they come out. 600mg is not too much Ca, but you can get vitamin D without it. In fact Dr Cannell recommends two brands, one comes with 5000iu's vitamin D3, plus vitamin K, magnesium, boron and zinc. These are all co-factors for vitamin D, see here. You'll find them in the right hand menu, at the bottom. Have a look at both, but I favour this one here, it comes in a gelatine capsule which dissolves easily. The other brand has other actives added, plus a number of excipients. A friend of mine was taking slow K, and found it so slow it came out whole! And yes, saliva testing is done in the States, the best lab is ZRT, Dr Cannell recommends them too. You'll see a link on his site for vitamin D testing, above the vitamin brands. But for saliva test kits, you'll have to go to the ZRT site here. Yes menopause can mean a change for the better, I just wish I'd found progesterone earlier though! I found peri-menopause the pits. So many huge changes occur, not just in our bodies, as you say loosing loved parents, children leaving home and grandchildren coming along etc. Although I still have to wait for one, my daughter of 30 seems to be following me, none to eager to get married and fall pregnant! Take care Wray
May 04, 2012
 Follow up, recovering D&C
by: Barb

Hi Wray,

Just wanted to keep in touch and let you know my progress. I feel fine, still some bleeding. I see my gyn in about 10 days.

I have been paying special attention to my diet. Restricting meat, although my husband raises cattle.:), upped the green leafy vegetables, and fruits. going easy on dairy.

Without Dr. orders, which I know I shouldn't be doing, I have cut the Estratest by half, which would be a normal dosage.

My only problem now is trouble sleeping, but that is only occasionally, and days I feel a little disjointed. I hope that is not early Alzheimers. It may be just beinng tired, relieved, and some altering the dose of the androgen and estrogen. I am now taking 5,000 mg of Vit D and have added magnesium to my supplements.

I was wonderding if the Prometrium capsules can be opened and applied to the skin. I never checked to see if it is a liquid form, but it appears that way from the round capsule. This is the micronized progesterone. If a powder, can I mix with coconut oil for a vehicle to apply it?M

After I see the Dr. I will certainly try the Natpro, and try to age gracefully. :)

Upon feeling better, I have really had the energy to work on my marriage. I had a male friend who was sucking the life out if it and my marriage, and now I am rid of him.

I feel stronger now, and like life is falling into place.

It is very amazing to get some clarity and be able to move on. I have subscribed to some EFT newsletters and find it very interesting. I will ask my counselor if he knows about it.

My grandbabies are very young, 2 yrs, and one a few months, and live about 2,000 miles away. It is hard to see them.

Like you, my kids waited until over 30 and got their life in order, so they were ready. I'm sure your daughter might do the same, although I know a lot of independent women who are very satisfied.

So a new chapter begins.. I will let you know what the doc says, and after that, stay away from them, unless obvious health issues.

Thanks again for all your support. It is what saved me from total panic.

Take care,

Barb
May 05, 2012
 Self Medicating
by: Barb

Hi Wray,

I recently wrote to you saying I was cutting my Estratest in half withought and thought to withdrawal symptoms. I felt awful, was the reason I got on it in the first place, feeling spacey, not remembering things, among others. It was not for hot flashes or the usual symtoms, but my old ones returned. So I will wait until I see my doc in about a week and just tell him I want off and how to properly wean. I sure made a mistake there.

Do you know, other than the Vit D, what might help the cutaneus vasculitis. It is just a hypersentivity vasculitis. I was in remission prior to surgery, and not it's reappeard. I imagine it was the stress and wondering if it was an assault on my body, causing it to come back. I will keep up with the Vit D, and have added more dark greens and fruits to my diet.
Hope all is well with you.

Thanks again.
Barb
May 07, 2012
 Self Medicating
by: Wray

Hi Barb It never occurred to me to give you our page on Coming off HRT, the Pill etc, so sorry. You reduced it far too quickly. I think you'll find your doctor will just tell you to stop it, they never give a thought to the effects of cold turkey! I'd be interested to hear. Plus you're taking progesterone, so you will be getting very little to counter the withdrawal. Please open the caps and add the contents to a small amount of natural skin cream and rub this on. I think you'll find this helps greatly, but do watch for Oestrogen Dominance, which are the symptoms you describe above cutting down on the estratest. If it should occur please increase the amount. And please have a vitamin D test done again, and increase the amount to at least 5000iu's per day. You could try taking about 2000mg/day N-acetyl cysteine, it's also a potent anti-inflammatory/antioxidant. Wonderful for the skin hair and nails, ageing too, see here, here and here. I take about this much every day now. Take care Wray
May 07, 2012
 Follow up, recovering D&C
by: Wray

Hi Barb Well I'm delighted I saved you from total panic! It's appalling how easily the medical profession can put us in this space, and what for?! If you're interested in diet, please see our Nutrition page. I try to follow the Paleo Diet, it makes so much sense to me. But one thing they do advocate is meat. So unless your husband uses growth hormone on his cattle, please don't avoid it. Doctors orders are not something you have to stick to, don't be fearful of them. You must do what you feel is best for you, which is often the opposite of what they think! And no you do not have Alzheimer's! You are suffering from an overdose of oestrogen and testosterone, neither of which we need. Besides progesterone is protective of Alzheimer's, oestrogen is not, see here, here, here, here and here. In fact you'll see in one paper that low allopregnanolone is being regarded as a potential marker for Alzheimer's. They call it 3α,5α-THP in the paper. Allopregnanolone is a potent natural metabolite of progesterone, so if it's low, progesterone will be too. You are right about opening the caps, I made this suggestion in my previous reply. Very pleased you've upped the vitamin D and now taking magnesium, don't forget to have the test done. I'm so happy you are resolving the issues around your marriage, and that you find the EFT interesting, it is! 2000 miles is very far away, I hope they move closer for you. Let me know how things progress. Take care Wray
May 16, 2012
 Post-op MD vist
by: Barb

Hi Wray,

Again thank you for the interesting articles and your support.

I saw my gyn yesterday, all is fine, he said it was a benign large polyp in the cervix. I find this all interesting as polyps and fibroids were never a problem before.

The doc wants me to stay on the high Estratest dose for awhile and see how I do. He is concerned about more bleeding from withdrawal. I suppose it takes a while for all to heal. It made me curious, as I breastfed both my children for 16 months each, and didn't have periods for about a year. I wonder if there is come healing to be done and our bodies do it naturally when we breasfeed. I did read your withdrawal articles as well as the other articles as well.

Yes, my husband raises growth hormone free cattle, and I am not much of a vegetarian. A naturapath has just started me on increasing my fish oil to 4000 mg, and a supplement that contains turmeric and ginger for inflammation, plus quercitin. The vasculitis seems to almost magically be improving. I suppose at my age, a lot of our systems suffer from inflammation, including heart blood vessels, so I think this is great prophylactilly. She thought the recurrance of the skin vasculitis was the assault on the uterus from the procedure, as I am prone to that. In addition to some food elimination such as wheat, soy, corn, dairy, we might be on track. My reproductive system seems fine and my libido is back:). I know soy is an estrogenic food. Are there others? I will follow your suggestions on sleep, and feel once I reduce the Rx, will be better.

The N-acetyl cysteine sounds interesting. I will let my body adjust to all the new regimens slowly, so I know which are working the best.

As to the Alzheimers, thanks. Once I restarted the usual dose of the Estratest, I was back to normal, so if any older readers are reading this, I thought that a fog or confusion might be a factor in recognizing estrogen dominance. It actually was my first clue when I was perimenopausal as well. I had a tubal when 35, so was not on the Pill when started perimenopause.

Interstingly enough, some old medical material indicated that vasculitis, ( not sure about auto-immune disoders) could possible burn out after menopause. It makes me wonder if HRT has contributed to the chronic problem this has become as my body is aging and probably cannot produce the body chemistry needs to combat the estrogen/testorone as it did initially.

Thanks again for your responses and the reading sites. I will follow your suggestion for applying the micronized prometrium topically, and soon take my estrogen intake into account. When I use up my bottle, will the Nat-pro be preferable to the precription?

Keep in touch, and thanks again,

Barb
PS, I found an EFT practitioner here in Arizona, but a distance away. I think she will do phone consults.
May 18, 2012
 Post-op MD vist
by: Wray

Hi Barb I'm concerned your doc wants you to stay on the estratest, I can't get my head around that. It was obviously causing the thickened endometrium, plus the pinkish tinge. And the fibroids too. Bleeding is a good thing, as it does mean your lining is being cleaned out. It will happen once using the progesterone, rarely have I found it occurs again. You're on a high dose fish oil, I do hope it is, and not cod liver oil. This contains too high an amount of vitamin A, which inhibits vitamin D. Very pleased your vasculitis has been helped, those are potent anti-inflammatories. Pleased too you're eliminating those foods, and yes there are other oestrogenic foods, although wheat and soy have the highest, see here, and here here. I'm sure the HRT has contributed to the inflammation, oestrogen is an inflammatory hormone. Whether the Natpro will be preferable really boils down to cost! The pills you have are 100mg, applied to the skin will make a big difference. Although I believe you'll need about 200mg/day to combat the estratest. So you could compare the cost of the two and see what you think. We also have a list of the ingredients in the cream here. So happy you found an EFT practitioner, do let me know how you get on. Take care Wray
Jun 10, 2012
 Feeling better
by: Barb

Hi Wray,

Again, I wanted to thank you for all the information and for "virtually" holding my hand while having the D&C, and for all the interesting links you've sent.

I don't know why the doc wanted to keep me on the Estratest, but the Naturopath voiced her opinion, but told me to make up my own mind. So I did. :).It is not the first time I have not followed doctor's orders to a T. Doing it slowly this time, but already I feel so much better and stronger, less depressed, and getting more done. The fish oil I'm taking is the Krill Oil, not cod liver oil. :). Yuck...guess it was mostly what we had when I was a kid.

I know this must be a strange question, but have had a few vasculitic lesions after the procedure. I have a few theories of my own, but all in all, a great improvement. My question is since I am opening the capsules and applying the progesterone topically, would there be any contradiction to applying it to where it looks like there is some inflammation beneath the skin? I thought I read somewhere on your posts that it could be applied anywhere, especially if there is a troublesome area. What comes out of the capsule is a creamy substance already.

I did read to take the Prometrium at night, as it helps with sleep, or drowsiness on the label of the bottle. If so, it might calm things down in general. I will also remember that with the Nat-pro when my Rx bottle is done.

Thanks again.

Take care,

Barb
PS, You are providing a wonderful service to females of all ages.
Jun 10, 2012
 PPS, Vit D
by: Barb

I forgot to mention, I did have the blood work for the Vit D, and it was 45, not acceptable to the Naturopath, so she upped my dosage.

A year ago it was 55, but have given up dairy. I certainly get enough sun here.

I hope all these treatments will complement each other and such very interesting research lately on the importance of Vit D!!!!
Jun 13, 2012
 Feeling better
by: Wray

Hi Barb I'm so delighted you are gradually feeling better, it does take time. And I'm really pleased you are coming off the oestrogen slowly, there's no need to give the body a shock. Pleased it's the krill oil you're taking too, and not cod liver oil. I think the cod liver oil we had as kids was better quality than that now available. Progesterone is an excellent anti-inflammatory, please try rubbing it on the vasculitis, you could try a small patch first if you're concerned. Oral progesterone does make one sleepy, so if you have problems with sleeping, please try it at night. I'm so pleased your naturopath agreed about upping your vitamin D, I feel 45ng/ml is too low, I like to see it above 70ng/ml. The research on vitamin D is extraordinary, so many studies come out now, covering many disciplines. I find the synergism between Progesterone and Vitamin D fascinating, you might like to read through this page. Thanks for the kind words! Take care Wray

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