Should I follow my cycle or use every day?

by Amy
(Santa Cruz, CA)

I am a 31-year-old woman with two young daughters, ages 3.5 years and 15 months. Over ten years ago, I was diagnosed with fibromyalgia (chronic pain and fatigue), which I think very closely matches the symptoms of progesterone-deficiency/estrogen dominance. (I also took the progesterone deficiency questionnaire which confirmed my suspicion). This would also explain to me why my fibromyalgia went into nearly complete "remission" during my pregnancies. I know of other people who have experienced total healing of this syndrome through use of progesterone cream, so naturally I am very excited to get started with treatment!

But... I don't really have a period to speak of right now; not sure if this is because I'm still nursing my youngest (only at night now though), or because of my IUD (they say some women have no period with the Mirena), but it makes it tricky to get the timing right. And from what I've read, it DOES in fact matter when one supplements progesterone, since a woman's body naturally produces it at certain times in her cycle, and if one supplements then, the natural progesterone isn't produced when it should be AND there's still a deficit (in the case of progesterone-deficiency/estrogen dominance) the rest of the cycle.

I read two things that I *think* indicate that I should use the cream daily in an ongoing manner right now, despite the benefits of following one's cycle - can you tell me if I'm correct?

"If a woman still has a cycle to follow, then its advisable to follow it, otherwise it can be disrupted. Having said that, if symptoms are severe, the cream can be used every day to get rid of them first and then revert to following the cycle."

"For other forms of contraception or HRT, ie. progestin only, injections, implants, IUD?s, etc., progesterone should be used every day."

I appreciate your help! Thank you!

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Sep 23, 2009
Natural Progesterone
by: Anonymous

The Mirena IUD has a synthetic progestin. You could still use natural progesterone in small amounts for the fibromyalgia. Use 20 mg. per day, divided in AM and PM doses. Use it 5-6 days per week, stay off 1-2 days. Will keep your periods light, that's all.

Sep 25, 2009
Should I follow my cycle or use every day?
by: Wray

Hi Amy. Your lack of periods is caused by the IUD. The Mirena is impregnated with a synthetic progestin which leaks slowly into the system. This stops ovarian function, ie stops you ovulating. By doing so it stops all progesterone production in your body, not what you need!

A far safer option is the copper T IUD, which leaks nothing but a small amount of copper. For further info on the risks of contraceptives please see this web page.

Progesterone can help with fibromyalgia as it raises levels of serotonin, a lack of which is regarded by some to be the cause. It also stimulates the production of IL10 and IL4, anti-inflammatory cytokines the body makes. But it will have an uphill battle against the progestin! You will have to use at least 200mg/day of progesterone to help.

It does matter when you use progesterone in your cycle. It should only be used from ovulation and for the ±14 days of the luteal phase. This won't stop ovarian function. As the IUD is preventing ovulation and leaking the progestin daily, you should use the progesterone daily too. Unless you choose to have it removed, a safer option! Please have a vitamin D test done. There is increasing evidence a lack of vitamin D is behind fibromyalgia and other unspecified pain. Although you live in Santa Cruz and should be getting enough sun and therefore vitamin D, it doesn't mean you are. A recent study done in Honolulu which is 21 degrees north found 51% of the participants had a deficiency. Santa Cruz is 31 degrees north, the further north of the equator the greater the deficiency. Please see this paper.

And please have a vitamin D test done! Take care.

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