How much progesterone is helpful in preventing menstrual migraines?

by Eileen
(Mapleton, UT)

I have chronic migraines that have not responded to preventatives. They are much worse on days 1-14 of my cycle, and better on days 14-28.

My doctor started me on a progesterone troche (100 mg) that seemed to help lessen the headaches this last cycle, but now I am having break-through bleeding (starting on day 13) and my bleeding just increased quite a bit, even though it is still 3 days before my period is supposed to start.

My doctor suggested I go off the progesterone because of the bleeding, but I am reluctant to give up the benefits I felt last month. Do you have any suggestions?

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Jul 03, 2011
don't quit
by: Annette Canada

Hi there don't quit the progesterone for sure! The irregular period and bleeding is due to the excess estrogen being cleaned out of the uterine lining, you will get clots as well. That's a good thing. I don't know the amount of progesterone in your cream but if it's Natpro, Wray recommends 200 milligrams a day when first starting, using it once in the morning and at night. If symptoms worsen just up the cream throughout the day. Also don't cycle the cream for the first few months, you can try that after you have no more symptoms. You can rub the cream right on your head for migraines. Wray will also recommend vitamin d, minimum 3000 iu's a day. Hope this helps until Wray gets to respond.

Jul 06, 2011
How much progesterone is helpful in preventing menstrual migraines?
by: Wray

Hi Eileen Progesterone does help migraines, see here, here, here, here, here and here. It's interesting that yours are worse during the follicular phase, as they are generally worse the few days before a period. Progesterone is very low in the first half of the cycle, but oestrogen rises, culminating in a peak a day or two before ovulation. Troches are not the best Delivery system, as much of it gets swallowed. This means the amount you are getting is far lower than the 100-200mg/day I recommend. It's essential to use a system which allows full absorption of the progesterone. I've found that a cream is the best system, as it can be rubbed all over the neck, under the ears and face too, when a migraine starts. This usually reduces the pain, or stops it. When first using progesterone, it can cause either early or late bleeding, but it does settle down within a cycle or two. I've found if bleeding is continual, heavy too, 400-600mg/day is needed to stop it. Reducing the amount slowly once this has occurred. You might find you need to use this amount to stop the migraines, it is a question of experimenting. We do have more info on our page How to use progesterone cream. But if you change delivery systems, and increase the amount, please read our page on Oestrogen Dominance first, as this can occur and is disconcerting if it does. Please have a vitamin D test done, low levels cause migraines, see here, here and here. For more info on testing etc, see the Vitamin D Council and GrassrootsHealth websites. And if you live in the UK see here. Take care Wray

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