Dosage, tapering, withdrawal etc.

by BoysMom


I am really hoping someone can offer some insight as I am in a really rough place at the moment. I am 42 and have been suffering what I now know are perimenopausal symptoms since I had my second child at 38 (though doctors seem to brush it off).

I have very regular periods, normal length about 5 days, but with several days of very light spotting before every period and 2 days of very heavy bleeding/clotting. Extreme PMS for 7-10 days before.

I had a saliva test (done on my own through ZRT) which showed a ratio of 49 (P/E), with "normal" estradiol and borderline low progesterone. As I am not able to find a doctor that shows any interest in looking into this (aside from offering anti-depressants and ablation, neither of which I am interested in), I started progesterone cream (Natpro when available) on my own about 10 months ago. Honestly, I have not seen much relief, I assume due to insufficient dosage.

Last month I learned that my Ferritin is ONLY 6 (!!) due to my heavy periods. I am now on Iron supplements and finally bit the bullet and did 400mg daily of progesterone cream last month to try and lessen the bleeding. I got my period and it worked like a charm, bleeding was at least 50% reduced.

However, as I stopped the progesterone cream once the period started (to follow my cycle), within a day I developed a headache that will not stop, extreme brain fog, feeling like my head weighs 50 lbs and, extremely lethargic and very nauseous. Are these withdrawal symptoms from stopping the progesterone cream? Otherwise I am very worried that something serious might be wrong with me. If these are withdrawal symptoms, then how does one stop the cream every month at the time of the period, as recommended if you have regular periods, which I do?? These symptoms did not happen when I was using lower dosage 100-150mg daily.

Please help, I really appreciate it!

Comments for Dosage, tapering, withdrawal etc.

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May 25, 2017
Success story--apply it everyday!
by: Laura

The simple answer to your situation is don't stop the progesterone. Apply it every single day as stopping brings on oestrogen dominance symptoms. I had my second child at 39 and nothing was the same after that. I wish I knew then what I know now because it would have saved me so much agony.

My ferritin eventually went down to 8 due to heavy periods and clotting. I also had fibroids and an ablation. I had to have iron infusions because the iron pills weren't working. I didn't understand then what was going on and doctors were not helpful.

Your progesterone is very low and you are having peri-menopause symptoms like I did. At 42 (and especially if you are done having children) you should apply progesterone every single day, twice a day. I apply 3 pumps in the AM and 3 pumps in the PM every single day. I carry it in my purse, I keep one at work and I keep a supply at home. I have alarms set on my phone to remind me when to apply it. I don't miss my dose.

I also take a lot of supporting supplements for my particular needs, vitamin D3 and magnesium being the most important co-factors to progesterone. I arrived at this dose by trial and error but I now do not experience any more awful menopausal symptoms and I would not have gotten where I am now without this website. I still come here often to search and read up on all that I can to keep myself motivated and healthy.

Me and my second child (mentioned above), now 15, joined a kickboxing gym together a few months back and to think I was a curled up, fatigued and a bloody mess who couldn't get out of bed before I found progesterone.

I really hope you get better soon.

May 26, 2017
Re: dosage
by: JW

Hi there,

Stopping cold turkey on a therapeutic dose (over 200mg/day) is dangerous and all symptoms will return. You need to taper off when you're that high (400mg) at no more than 15mg per week. If symptoms return, hold the dose you're at and stay until they go away, then continue tapering.

Hope this helps. Best regards.

May 27, 2017
Don't stop!
by: Kiki

I agree with Laura, don't stop using it. There's no need. 100mg a day is a good daily dose for maintenance if all is well.

Higher dosages, like your 400mg, don't have to continue for a long time, but surely you can't just drop off like that.

Try like JW said, and get back up around 300-400, then taper off.

Hope you're feeling better soon!

May 28, 2017
by: BoysMom

Thank you both so much for your responses.

I felt so incredibly awful for 4 days, it really freaked me out. Yesterday was the first day without extreme nausea, today I feel semi-normal :).

Anyway, 400mg every day is simply not financially sustainable. I will have to reduce the dosage in order to apply it daily and hope that I get some results.

Laura - I am taking Mg and D3/K2 drops from Thorne. Also DIM Detox from Pure Encapsulations. This perimenopause is costing me a fortune :).

I am curious if anyone could explain why we shouldn't follow the natural curve of progesterone levels throughout the cycle and apply different amounts - less the first couple of weeks and more during the two weeks before the period?

Thank you again, just still trying to figure out all this stuff!

May 30, 2017
by: Laura

I'm over 50 and don't cycle anymore so there's no need for me to try and cycle progesterone throughout the month. Once in menopause, we don't produce progesterone but still produce oestrogen so I just apply everyday to keep the oestrogen down. I do remember reading here that progesterone should be applied daily for a few months if you are having issues with your cycle and once things settle down, you can go back to cycling.

Hopefully, someone can help with your cycling question. I wanted to chime in about my experience with DIM. I too ordered the DIM Detox from Pure Encapulations. I've taken it two different times and both times I was so nauseated and sick, I vomited for hours both times and had to miss work. It is very strange but I just cannot take it. I take calcium d glucarate instead to help clear out any oestrogen and that seems to work fine for me.

Sep 22, 2017
Withdrawal and Depression
by: AnnaD


You posted a very good question.

My periods are regular which means I should only use Natpro cream during the luteal phase.

I have been applying 150 mg for two days now and feel like I need more to combat the estrogen dominance symptoms.

But if I increase my dose now and then stop using the cream on the first day of bleeding my progesterone levels will drop abruptly. Wouldn't I be giving myself something similar to postpartum depression women get after labor when placenta that produces high levels of progesterone is gone?

Thank you,

Sep 25, 2017
Withdrawal and Depression
by: Joy

Hi AnnaD

Your depressed feeling doesn't surprise me.
Usually progesterone should be used every day for 2-6 months in order for progesterone to become the dominant hormone. A longer period of time maybe needed if adverse symptoms are severe. However, if you have a regular monthly cycle and NO Estrogen Dominance symptoms which you appear to have, then Natpro can be used by following a regular cycle as follows and as advised on the How to use Progesterone Cream, page.

FOLICULAR PHASE - starts on the 1st day of bleeding and ends at ovulation. NO progesterone is used during this time.
LUTEAL PHASE - starts from ovulation until bleeding. It is always, in all women, 12-14 days long. Progesterone is used during this luteal phase.

When first using Natpro, it does disrupt things. Two days use is not going to improve anything, your body needs to adjust.

Something that so many people are unaware of is Vitamin D3. Do you know what your level is? A deficiency reduces the benefits of progesterone, it is connected to every single functioning cell in our bodies make it vital. Co-Factors are needed especially Magnesium and Vitamin K2 with NO soy.

Please read these pages and the references provided as they will help you to understand what is needed.

How to use Progesterone Cream
Estrogen Dominance
Vitamin D3

Nov 22, 2017
Dosage of Profeme 10
by: RobynAR

Hi Joy.

I am 45 soon and have been using Profeme 10 for about 5 years to balance my Estrogen Dominance.
Slowly over the last 6-12 mths my periods have become more frequent, painful and heavy.
While I wait to get to see my specialist (which could be a few months) I decided to try upping my dosage to once daily 1.0ml per day in the luteal phase which I did for 2 months. With no change - I then decided this month to use 1.0ml per day everyday from end of last period until my period arrived. My period has not arrived and is 9days late so I freaked out stopped.
I have been very bloated , have cramps and feel quite moody and on edge which is not me.
Why am I not bleeding? Do I just keep putting the cream on even if my period doesn't arrive?
Am at a loss big time as I've never been late or missed my menses!

Nov 22, 2017
Dosage of Profeme 10
by: Joy

Hi RobynAR

Profeme 10 is not a progesterone cream that I would put on my skin! Take a look at the EWG site to check for ingredients, they have a rating score of 1-10, 1 being of no concern. May I suggest that you consider using a good quality organic cream such as Natpro.

You are in Peri-Menopause. It can be a dreadful time for most women but it need not be with the correct use of progesterone. It should be used every day from now on with no breaks at all as your monthly periods will soon become difficult to follow. The following protocol is excellent for heavy bleeding. Painful periods could also mean Fibroids or Endometriosis, have you been tested? The protocol will help if you are suffering from either. It has helped so many women before and must be used exactly as stated. If you do suffer, then I suggest trying 200mg progesterone per day and see how you get on.

Protocol ...

* 400-500mg Natpro Progesterone Cream per day
* 2000mg N-Acetyl-Cysteine (NAC) per day
* 2000mg Taurine per day
* 5000iu's Vitamin D per day
* 1000mg Bioflavanoids per day

By changing the amount and then stopping it's use has caused an upset and would explain why you have not had your period this month.

Please read these pages on how to use progesterone correctly.

Estrogen Dominance

How to use Progesterone Cream




Vitamin D3



Nov 23, 2017
Progesterone usage
by: RobynAR

Hi Joy
Thanks for you response. That's a big help!
I only stopped the cream for 2 days and that was because I didn't get my period. I wasn't aware I should just keep taking it if my period comes or not!
Yes I was diagnosed with small fibroids 5 yrs ago but will get another scan I think.
I have managed an appointment with my doctor in 2 weeks so will discuss things further with her then.
I will see if I can access Natpro.
In the meantime is the daily dosage of 1.0ml of the Profeme 10 sufficient to be helpful do you think?

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