extreme fatigue follicular phase


I have a history of Graves Disease (hyperthyroidism) and in the last two years have been diagnosed with Adrenal Fatigue and Hashimoto’s Disease. I struggled with infertility for years and failed many IVF attempts, becoming pregnant the old fashioned way with the help of progesterone cream. My pregnancies were supported with IM progesterone injections throughout. And I felt my best (also lost weight) after baby #1 when the doctor allowed me to continue the Progesterone Injections a few months after delivery.

I have a history of abnormal bleeding, including spotting for 3-5 days before AND after a period. I also had an episode of endometrial hyperplasia. It is not unusual for me to ovulate at the very beginning of a cycle (sometimes while I am still bleeding).

I have long had symptoms intermittent debilitating fatigue and brain fog. My motivation drops to zero. I have low energy, may nap once or twice a day and still feel tired. My creativity disappears and I have trouble finding words, have no interest in social contact and difficulty communicating. I have great difficulty losing weight and must go to ridiculous lengths to avoid gaining weight. I often have a migraine before my period begins. I have intermittent extreme thirst and often My breasts get sensitive and enlarged. My libido and sexual response is low. I feel most interested in sex just at the time my period is ready to begin rather than mid-cycle.

I have very low serotonin and many indications (from an OATS urine analysis) of poor Krebs cycle / mitochondrial function. I also have compound hetero mutation on the mthfr gene. I have been taking many supplements to assist with these issues. This includes:
Vitamins C, D, B, M-B12, iron
Naturally dessicated thyroid
Adrenal cortex supplement, Mitochondrial energy optimizer, broad spectrum amino acids, DHEA, Testosterone, 80 mg Progesterone (luteal phase only), Sam-e, Omega 3, 5-Htp, Magnesium, Chromium, Zinc, Selenium, Lithium, Hcl, and digestive enzymes.

Most recently the doctor dropped my DHEA from 25 mg to 10 mg b/c of a high blood test. At the same time he added the progesterone and testosterone. My libido has declined since this change. (my hunch is to blame the lower dose DHEA, tho it is a shock that the progesterone & testosterone wouldn’t help!)

Since beginning the supplementations I am markedly improved and my good days are better than ever. Also, a pattern has become evident that really points at progesterone – that I start to improve a few days into midcycle (after starting progesterone) and then feel my best as my period draws near.

My periods of tiredness return as soon as spotting begins and progressively worsen. My tired feelings are somewhat unpredictable. Some days I may be tired all day, but perk up at night. Some days I feel horrible upon waking, then improve for two hours, then need a nap at lunch time. Other days I feel fine all morning then feel exhausted and flat for several hours in the afternoon. Other days I take a nap both morning and afternoon. I spend about half of the month with days of some degree of poor function and exhaustion and half the days feeling mostly well. The more I am closer to well, the less patient I am with my bad days, and am really at my wit’s end, ready to reclaim my life and feel well EVERY day!

Two months ago I went from taking no progesterone to taking 80 mg during the luteal phase (which I have a very difficult time finding enough places on my body to smear it), along with the testosterone. I’m wondering whether my body is not appropriately absorbing it and have also been researching about pregnenolone – thinking this precursor hormone may be a good option. I think back to when I felt well taking the progesterone as an injection, but my doctor now won’t consider that.

I am desperate to get better and look forward to your advice.

With many thanks in advance, from a woman suffering in Singapore.

Comments for extreme fatigue follicular phase

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Jun 11, 2015
Extreme Fatigue Follicular Phase
by: Joy

Hi there

Well I think that you have just answered your own question. "I felt my best when the doctor allowed me to continue with progesterone". What makes me angry is the word 'allowed'! It's your body, your choice and you have the right to do whatever you want!

You are suffering from Estrogen Dominance symptoms and progesterone is needed to help with this and your abnormal bleeding etc. Have you been tested for Insulin Resistance, it could be the reason for your weight gain, the Ketogenic Diet is excellent for those wanting to lose weight, it is beneficial for other health issues to. Please read Dr Lam’s website on adrenal fatigue.

I don't believe that anyone, men or women need to take extra testosterone, it can cause here amongst other things. Testosterone does not help with libido, progesterone does. DHEA increases testosterone levels, plus you are taking extra! Your are on 'testosterone overload', so I am really not surprised that you are battling.

I suggest that you use nothing less than 100mg/3ml of progesterone every day with no stopping for 2-6 months or until things settle down. More progesterone maybe needed, depending on how severe symptoms are. It is most important to use a cream that has the correct amount of progesterone concentration. How to Use Progesterone Cream will help you.

Do you know what your Vitamin D level is, a deficiency reduces the benefits of progesterone.

Hope this helps you.

Jun 15, 2015
re: extreme fatigue follicular phase
by: Anonymous

Thank you so much for the kind and detailed reply. I will research about insulin resistance, that is a new concept for me.

I have been taking Vitamin D supplements for several years now, though my levels have not been tested recently.

Do you think my exhaustion in the early part of my cycle is due to lacking progesterone in the latter part of the previous cycle?

So your recommendation is taking a minimum of 100 ml Progesterone cream daily, regardless of my menstrual cycle? Should I take more in late cycle and less early cycle, or just a steady dose? What are your thoughts on stronger cream from a compounded pharmacy?

Can you refer me to any other sites or doctors that discuss daily use of progesterone? I am willing to use the OTC cream to dose myself but would prefer that my doctor was on board with the idea.

Can you advise at all about pregnenolone? This is a precursor to progesterone and something I am interested to explore as a possible alternative to the cream. I started looking into pregnenolone after learning that my serotonin levels are terribly low – then switching from using melotonin to using 5-HTP. Taking the precursor to the hormone has been helpful in that case. So I wonder if the same is true with pregnenolone.

Many kind thanks for your help and advice!

May 08, 2019
Low energy in follicular phase
by: Anonymous

Did you manage to find relief for your symptoms? I too feel absolutely exhausted and get very sluggish in the follicular phase and then pick up after I have ovulated.

I am on Levothyroxine for an under active thyroid. I have read that Estrogen produces high levels of thyroid-binding globulin (TBG), a protein that binds to thyroid hormones in the blood and prevents them from being taken up by the cells. So I am wondering if higher levels of estrogen are causing my tiredness. But, as far as I am aware, you can't take progesterone in the follicular phase and so am wondering what can be done about it?

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