How did my Progesterone levels get so HIGH!

by Leigh
(Texas, USA)

I am a 54 y/o postmenopausal female, 5'7", 150lbs with all organs intact.

4 years ago I began missing my period fro 3-4 mo in the fall of the year. I had my Vit D tested and it was 19 so I was treated with 50000units by an endocrinologist and it came up to 55. Since then I was taking 2000u a day, but my vitamin D dropped back down to 25, so now I am taking 5000u and my Vit D now stays around 45. I am taking D3 form.

During the times of missing periods I would have tremendous hot flashes, 30/day, insomnia, night sweats, and most bothersome of all...urogenital pain which was almost constant. When my periods resumed, these symptoms all went away. My Gyn refused giving me any hormones as I was still having occasional periods.

1 1/2 year ago I had my last period and these symptoms came back to stay. At first I was just given vaginal hormones which did not stop the urogenital symptoms but made them a little less intense, but did nothing for the other symptoms. My Gyn died, so I had to get a new one, and this one doesn't believe in systemic hormone therapy. So....I found an internal medicine doctor who works with a compounding pharmacy and PHARM D program through a university health system.

My baseline hormones (serum)
fsh 55.5
lh 30.6
total estrogen 96 (E1+E2+E3) pg/ml
prog less than .5ng/ml
total testosterone 28ng/ml
dhea 159ng/dl

All of these were in normal range for post menopausal female but I felt terrible.

The pharmacist calculated doses for me and I was put on a SL (sublingual) dosage as follows (splitting dose in am and pm) troche...

BIEST .5mg (70% estriol and 30% estradiol)
PROG 150mg
TEST 0.25mg

Still having urogenital problems 5 months later, although I had more energy and was sleeping better with great decrease in hot flashes. Still using vaginal hormone twice weekly for at least 8 months (supposed to stay local).

Got some more bloodwork:

estradiol 26pg/ml
progesteron 13.7 ng/ml
testosterone 29ng/dl free test 1.9pg/ml bioavail test 4.1ng/dl
dheasulfate 135 mcg/dl
Vit D 45

All of these were in normal range for postmenopausal female except progesterone, but it was an acceptable level for treatment, but I was still having symptoms.

New dosage: Sublingual dose (split am and pm)...

BIEST .75mg (70%estradiol and 30%estrogen)
PROG 175mg
TEST 0.25mg(same dose)

After 3 months, I began having more hot flashes, night sweats, insomnia, urogenital symptoms were better at first but starting coming back. PLUS....I began to lose weight, had continual headaches, hangover type feeling in am, muscle and joint aches, foggy thinking. The headaches get a little better if I eat a small snack.

Got some more bloodwork (5 mo after dosage change)...

estradiol 22 pg/ml
Progesterone 52 ng/ml********equal to 3rd trimester pregnancy
Testosterone 75ng/dl********
dhea 374ng/dl
Vit D 45

I have never taken any dhea. Are my adrenals now starting to pump out hormones themselves, if so, why not more estrogen? If these are my serum levels, I can only imagine that my salivary levels are way high. What is going on? It appears that my adrenals are now making more dhea than they were baseline (dhea has increased 3X over baseline although still in the normal serum range)and this is now being converted to excess progesterone and testosterone????? Why is my estrogen still low in comparison....not making any? The pharm D has no idea and my doctor has no idea. Now the doctor wants to put me on a conventional HRT called Femhrt with synthetic estrogen/progestogen but I am scared to take it.

I have decreased the sublingual troche dosage by 1/2 on my own and feeling a little better. Since all 3 hormones are in it, I have no way to take individual dosages of estrogen or progesterone. I tried to go down to 1/4 dose, but the urogenital symptoms were really bothering me (still taking vaginal estrogen though), so went back up to 1/2 dose. I will try to wean off more slowing, but I don't know what to do next.

Any advice would be helpful!

Comments for How did my Progesterone levels get so HIGH!

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Nov 14, 2011
small correction
by: Anonymous

just wanted to make a correction

The second dose I was on was BIEST .75 with 70% estriol and 30% estradiol, percentages just like the first dose.

Nov 14, 2011
Topical hormones
by: Anonymous

I used to do sublingual hormones also until I started feeling so tired during the day. Sign of too much progesterone. From all my research I concluded the best way to do hormones is topically. You can find over the counter Estriol/Estradiol cream without a prescription. I believe topically is the correct way to do bio-identical hormones. I get an Rx for my testosterone and fill it at a compounding pharmacy in a cream. I feel so much better on the topical than on the oral sublingual form.

Nov 14, 2011
check adrenal functioning
by: Rosanne

You might want to get a 4 pt. cortisol saliva test. Losing weight is associated with low cortisol. Under functioning adrenals reek havoc on our bodies. I know this first hand. A good supplement program can correct this. Search dr. wilson adrenal fatigue or better yet read his book. Very interesting.

Nov 17, 2011
How did my Progesterone levels get so HIGH!
by: Wray

Hi Leigh Your progesterone is not that high, the luteal phase can range from 5-40ng/ml, third trimester ranges from 48.4 - 425 ng/ml. It's evident some is getting through your system, but not much. The amount of progesterone is good, but it should be in a from which is absorbed well. Troches are not the best Delivery system. I've found 400mg/day progesterone is needed to stop hot flushes. I'm not surprised you have all those symptoms with the added oestrogen and testosterone. I never recommend them, particularly testosterone, see here, here, here, here, here here, here, here, here and here. Plus the menopausal ovary is an androgen producing organ, see here. I would avoid the HRT, too many risks, and rather use another form of progesterone only. Your vitamin D is too low, so was the 2000iu's per day, as you saw. 5000iu's is the minimum dose, although the latest research indicates it should be 10,000iu's per day, see here. For more info on testing etc see the Vitamin D Council, GrassrootsHealth Birmingham Hospital and Vitamin D Links websites. Blood levels should be 70-100ng/ml. Take care Wray

Nov 19, 2013
Need help!
by: Wray

Hi Jen Yes your ratio does fall within the range, although I feel a range so large is meaningless. We’ve found from Saliva Tests we run on our cream that it goes to 600:1 and over. Your oestradiol also falls within range which is 1.3-3.3 pg/ml according to ZRT. Oral progesterone is the least effective Delivery system, "The liver and gut region removed a mean of 96 per cent of the progesterone entering these tissues", see here. So the 50mg you’re taking is giving you so little as to be worthless. 40mg/day does not raise levels to that of the luteal phase, it’s still only giving you follicular phase levels, see Progesterone Misconceptions. You are now approaching Peri-menopause which could explain your symptoms. I would suggest you increase the amount you’re using. Take care Wray

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