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I need help deciding dosage for excessive menstruation.

by Faith

Hi, I was wondering if you could please help me figure this out. I am 25, have PCOS, and have been on my period for 3 months straight now. I'm in desperate need of relief and I just want the bleeding to stop. I've used Pro-Gest before to stop the bleeding, about 2 years ago when this same thing happened. I've tried to use it this time but it's not stopping the bleeding. So right now I'm comparing my options and I'm thinking of either using NatPro or the medication Prometrium. I came across an article by a dr and she advised 600 mg of Prometrium for 3 months straight, every day, and then lower the dosage and use it on cycle days 12-27 for 6 months. I'd like to follow her advise and I'm wondering if I could do it using Natpro. As I understand it, Prometrium is natural progesterone, but passes through the liver and all of it doesn't get absorbed. And NatPro's absortion is faster and more efficient, have I understood that correctly? So if I want to compare it to 600 mg of prometrium, how much NatPro would I need? I hope I'm writing this clearly and you're able to understand me. Also, do you have any measuring tips to make sure you're applying the exact dosage you're intending to. I've always had trouble judging how much Progesterone cream I'm applying. I'm desperate to stop this excessive, and at times painful and heavy bleeding.

Thanks for the help!

Comments for I need help deciding dosage for excessive menstruation.

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Apr 13, 2012
 I need help deciding dosage for excessive menstruation.
by: Wray

Hi Faith I understood exactly what you meant! We do have a page on PCOS. It's caused by oxidative stress, and high doses of antioxidants are needed to reverse it. Although I don't normally recommend an amount as high as 600mg/day, no one would believe me if I did, I fully endorse high amounts. But I have found 400mg/day works for most women. And she's quite correct too, I always suggest using it daily for 2-3 months if there's a problem. Longer if it's PCOS. You are right, oral progesterone is the least effective Delivery system, as much of it gets destroyed in the gut and the rest metabolised by the liver. Please consider taking 2000mg/day N-acetyl cysteine, this inhibits the MMPs which are causing the excessive bleeding. This is explained on our Menstruation page. Your might like to see this comment here for encouragement. We do have a chart on measuring right at the bottom of our page on How to use progesterone cream. But don't be too worried about accurate measures, it's not that important. When you have any pain, rub the cream over the area, it works far faster. Before you start the progesterone please read our page on Oestrogen Dominance. Take care Wray
Apr 21, 2012
 Thanks for the help
by: Faith

Hi Wray,

Thanks for the help, sorry it's taken me so long to reply back. I've been using 400 mg of NatPro daily for 8 days now. It did stop the bleeding 2 days after I started it and everything was looking great until 2 days ago. I started spotting a little bit and yesterday I pretty much started bleeding again. I did take your advice and was able to find N Acetyl Cysteine yesterday, I've taken 2 days of 2,000 mg so far. I'm hoping this is just my body getting used to the progesterone or something, and the bleeding will stop again soon.

again, thanks for the help.
Apr 23, 2012
 Thanks for the help
by: Wray

Hi Faith I'm delighted it did stop it, but not that it started again! Should you have been bleeding now, ie is it the normal time for a period? The progesterone can upset the cycle when first using it, although on that amount it should control it. I do hope the NAC helps, it's helped others. I wish it wasn't such a bumpy ride for some. You probably noticed Annie is having difficulties, I asked her to have a check for fibroids as that can cause it. Please don't forget the other antioxidants you need to control the PCOS, vitamin D is the most important. There is info about it on the link I gave you, please have a test done. And let me know how you get on. Take care Wray
Apr 23, 2012
 I'm very sensitive to stress too...
by: Faith

Hi Wray,

I just finished reading Annie's full thread, and I see so many similarities in her story and mine. I've noticed for a while now, I am extremely sensitive to stress. For months now, I've had to go without regularly exercising because I would start cramping and bleeding heavily after my workouts. I've tried to exercise every now and then, more specifically since I started taking NatPro, I thought since I was on a high dose of progesterone the exercise wouldn't effect me too much. But sadly, it has. I so wanna exercise and lose weight though, I'm not extremely overweight, but can stand to lose 20-25 lbs to be at my ideal weight for my height and body build. I try not to live a stressful life, but with any little bit of stress my body just seems to bug out, it's very annoying. I do have low thyroid function, and have ordered a supplement that will hopefully get here soon. I had my thyroid levels tested just a few weeks ago and they are still low. I have not had my Vitamin D Level tested, I will do that soon hopefully, but I am taking 10,000 IU of Vitamin D3 a day, along with a high quality fish oil. I've also come across your PCO formula, and I plan on buying that as soon as I can.

With the progesterone, I'm taking 400 mg a day and split it up into an hourly application, for about 12 hours straight at 1 ml an hour. For the past 3 days I've noticed that once I get past my last dose is when I see a difference in the bleeding. It doesn't stop, but it's down to just spotting an hour or so after my last application of the day. However, I go the full night sleeping, without applying any progesterone of course, and the next morning i wake up to slight cramping and bleeding. So should I try increasing to say 450-500 mg a day, or try to apply more than 1 ml an application to get to my 400 mg? We are kind of tight on money, as everyone is these days, so I want to find the most affordable option of course.

thank you for creating this wonderful website and being of such help. I'm 25, and desperately want to have kids, I'm just ready to get on the road to healing so I can have babies.
Apr 23, 2012
 I'm very sensitive to stress too...
by: Wray

Hi Faith I'm glad reading Annie's thread helped, it does make us feel less alone in our journey, to realise others are in the same or similar boat. And please don't forget you have been using progesterone for only 10 days, it can take 3 or more months before things settle. I'm thinking more of your exercising and cramping, not the heavy bleeding, which I hope settles soon. Particularly as you're taking the NAC too. Very pleased you're taking 10,000iu's vitamin D, it's so important. I didn't realise you were slightly overweight, insulin resistance can of course cause this, and it's often found in PCOS. Excess oestrogen and testosterone can cause IR, a lack of vitamin D can too, it's so important for weight loss, see here, here, here, here, here, here and here. Testosterone is notorious at causing an increase in visceral fat, see here and here. But if bound to SHBG (sex hormone binding globulin) testosterone becomes inactive. Progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone. SHBG drops if sugars are eaten, even those found in all grains, legumes, dairy and sweet starchy fruits and vegetables. Fructose, sucrose and glucose (all carbs are converted into glucose), reduce SHBG by 80, 50 and 40% respectively, see here. It's best to avoid all the foods and sugars mentioned. Please persevere with the 400mg/day, as you're applying it too. Although you could try skipping a ml or two during the day and use that at night, to see if it will tide you over till morning. Continued below.
Apr 23, 2012
 I'm very sensitive to stress too... Part 2
by: Wray

Hi Faith I would hope the NAC kicks in soon, it is a very powerful antioxidant, so should help the inflammation in your uterus. I'm pleased you're going to try the complex, it has helped others, so I hope you too. But as with all these things it does take time. If you read the studies on the page, you might have seen they all took 3-6 months before any result was found. I didn't realise you wanted to start a family, although I should have guessed! We do have a page on Pregnancy, and another here too. It is essential you heal first, but if you should fall pregnant, it was obviously meant. One further thing, you say stress bothers you greatly, this increases cortisol, excess cortisol has an adverse affect on us. Please would you consider going to an EFT practitioner, its remarkable how it lowers cortisol, and helps stress too. It could possibly help the PCOS too. Bless you for the kind words! Take care Wray
May 16, 2012
 Update on my situation
by: Faith

Hi Wray,
Again, thanks for the reply and help, and sorry I've taken so long to reply back. I have stuck with the 400 mg a day since my last post. About a week and a half ago I started splitting it up into 3 nigger doses to get to the 400 mg instead of the 12 hourly doses. Unfortunately the bleeding hasn't stopped, though at times it did get down to barely anything and just spotting. Last week I started cramping really bad and the flow got quite heavier, so I thought maybe that was a period. It stayed like that for about 5 1/2 days and slowed back down quite a bit. however, now I'm actually noticing I'm having the opposite problem than i was having since my last post. now the bleeding slows down quite a bit about 3 hours after my last dose of the day, at times the bleeding stops completely overnight, but once I take my first dose the next morning, I start bleeding and cramping about 2 hours later. I've noticed this pattern for about 4 days. I'm really trying to persevere and stick to the 400 mg a day, I really want to finish at least 3 months of progesterone therapy and see how it helps. I'm just really confused. I just hit the 1 month mark last weekend, and I know there's still plenty of time for things to happen. Do you have any advice or input on anything? Should I keep the 3 doses to get to the 400 mg, or go back to hourly, or something in between? Thanks for all of your help!
May 18, 2012
 Update on my situation
by: Wray

Hi Faith I'm very disappointed you have't stopped bleeding yet. I hesitate to ask you to use more, as I know finances are tight, and I have no idea if more will work. It will be a question of trying it and see, maybe you could consider this just for a month perhaps? At 500mg/day. Another thing you could try, is not applying it in the morning. You say it sometimes stops overnight, let's see if by not applying it, the bleeding doesn't start up again. It might be you go the whole day without applying any, which would be a good thing. Because maybe you could then begin following a cycle again. And are you still taking the NAC? If you are I suggest increasing that too, to maybe 3000mg/day. There are a number of natural MMP inhibitors, including an endogenous one called TIMP. I have no idea if this is available, or even been extracted. A few others are epigallocatechin-3-gallate, catechins, sesamol, curcumin, cranberry proanthocyanidins, see here, here, here and here. Although sesamol inhibits them, it does appear to increase the risk of stomach cancer. But sesamol is extracted from sesame oil, which is safe to take. A delicious oil, but with a remarkably strong taste. Whether the concentration of sesamol is sufficient is another matter. You are taking a good dose of vitamin D, once you've had your test you'll have a better idea of whether you need to increase this or not. I wish I could suggest more, or wave a magic wand, but I'm baffled why the NAC and progesterone are not helping you yet. It could be you need more time, it could be you need more of each. I wish I knew, but we're all so different it's impossible to tell. Take care Wray

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