Is it true that USP progesterone use causes high cortisol levels?

by Jo Grant

I have used both Tri-est and USP progesterone for about 4 years now. I have had a hysterectomy as well, within about 2 years. My cortisol level is high and I have heart palpitations all night causing chronic insomnia. I read that USP progesterone can cause rise in cortisol levels. Would like very much to know if this is true or not.

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Aug 28, 2013
Is it true that USP progesterone use causes high cortisol levels?
by: Wray

Hi Jo I've not heard this before, unless using too little. Progesterone actually suppresses excess cortisol, not only that but it's a potent anxiolytic so lessens the stress response. This gives the adrenals a break from having to produce the stress hormones. It doesn't surprise me you have heart palpitations being on the Tri-est. Oestrogen causes prolongation of the QT interval, which results in palpitations, arrhythmia, Torsades de Pointes and sudden death. Whereas progesterone shortens the QT interval, see here, here, here, here, here, here, here, here, here and here. These symptoms occur far more frequently in women who naturally have a long QT interval, rather than men who naturally have a short QT interval. I don't believe testosterone should be given to a woman either, see here, here, here, here here, here, here, here and here. Continued below

Aug 28, 2013
Is it true that USP progesterone use causes high cortisol levels? Part 2
by: Wray

Hi Jo It also causes an increase in visceral fat, see here and here. Testosterone is converted into oestrogen too, so it would add to your oestrogen load. Interestingly zinc reduces cortisol levels, see here and here. Equally interesting progesterone increases zinc. But oestrogen increases copper, which suppresses zinc. Excess copper can cause depression, psychosis etc, which would of course raise cortisol levels. I don't know how much progesterone you're using, but we do have a few pages you could look through, see How to use progesterone cream, HRT, Peri-menopause and Menopause. Take care Wray

Aug 28, 2013
by: Jo

Wray - thank you so much for your repsonse and all the relevant links. I am about to begin reading. Again, thank you.

Sep 02, 2013
Thank you
by: Jo

The papers you suggested for reading are amazing and I have emailed them all to my regular doctor. She'll be very interested!

Sep 08, 2013
Thank you
by: Wray

Hi Jo I'm delighted you found the papers interesting and useful, I hope your doctor does! Take care Wray

Aug 22, 2014
I have the same heart pounding, insomnia issue!!
by: Jen

Hi Jo, I also have the same exact issue whenever I use bioidentical progesterone cream. I used it from Day 10-24 of two cycles with positive results, but then on day 16 of my third cycle using the cream, all of a sudden my heart was racing and I couldn't sleep. When I went back off the cream on day 24 of my 3rd cycle, the symptoms abated over a few days. Then on my 4th cycle, I started the cream again on day 10 and within 3 hours my heart was racing and I was up almost all night that night. When I realized the progesterone cream was triggering the heart pounding, insomnia and general feeling of being totally amped up (like I'd had several cups of coffee), I stopped using it.

It was hard to find info about this on the internet, but I did find a few sites that mentioned excess progesterone leading to increased free cortisol, which may explain your and my unusual symptoms. For instance this quote from one website: "High levels of free (unbound) cortisol—(Progesterone and cortisol compete for the same binding protein. When free progesterone floods the system long enough, it can compete with cortisol for the binding protein and release excessive amounts of cortisol into the system.)High cortisol can cause numerous problems, including high blood sugar, insulin resistance, weight gain, low thyroid function, sleep problems, osteoporosis, immune system dysfunction, GI system problems, and more. An ASI (Adrenal Stress Index saliva test) will properly assess this issue.

I need to do more research before I come to any conclusions, but mostly I wanted to let you know that you are not the only one experiencing these unusual symptoms as a side effect of using USP progesterone.

Apr 02, 2015
Progesterone replacement
by: Anonymous

I don't care if it's a cream that's so-called natural, synthetic progesterone intolerance is a SEVERE issue with me and I refuse to take any progesterone ever again. It stole months and months from myself and my family and my heart rate went up over 100 and my mom died or arrhythmia and heart failure. Be careful to all women with progesterone or addition of any hormone for that matter as we are not robots. Peace.

Feb 10, 2018
High Cortisol, Weight gain, Progesterone
by: Suzy B

I have been on progesterone cream high doses like 300mg approximately 6 years. Last year I had to cut way back to 40mg as my saliva tests for progesterone were off the chart they were extremely high. I was told to cut down which I did. I was on other hormones like DHEA and pregnenolone and they even tried me on some cytomel T3. I was like a walking pharmacy.

I've had chronic fatigue for about 10 years now. None of these things have made me feel any better especially recently. At least when I was on the higher dose progesterone cream I was 56 kilos now I'm 68 and I also have high cortisol. My saliva test also showed high oestrogen levels. All I am on now is 7.5 micrograms of DHEA for my adrenals and I've recently upped my dose to 100mg of progesterone cream. I can't for the life of me lose this weight and I still feel fatigued a lot of the time. I eat gluten-free and try to avoid chemicals and too much sugar. I don't exercise vigorously as I do not have the energy. I'm damned if I do and Damned If I don't. With all due respect to Way, I'm still not convinced of high doses of progesterone cream. I have also had terrible problems with heart palpitations and adrenaline bursts while trying to sleep when on higher dose medications.

Does anyone have any answers or suggestions. I am 58 years old

Feb 21, 2018
Progesterone and high cortisol levels
by: Anonymous

To those of you who mentioned increased heart rate, and severe insomnia with bioidentital P, your experience is the same as mine and, from blogs I have read online, I have learned this reaction is fairly common.

Sep 26, 2018
Heart palpitations from bio identical progesterone
by: Anonymous

I am adding to some comments, that yes when I use natural creams of progesterone in the amount from 100 milligrams to 400 milligrams over the two years, trying different doses all in creams, I get a surge of heart palpitations and severe insomnia.

So I take the cream in the morning because, it does raise my cortisol. My Thyroid is fine from a functional doctor. My D3 is good, my estrogen is less than 20 pg/ng ul. But, I have tried and tried to take progesterone to help with menopause, I can't seem to take anything over 50 milligrams a day. I am addressing my adrenal issues. That will take time too. So just wanted to say not everyone can take large dosages of this cream. It is trail and error, but addressing your adrenals is a first step. Progesterone is just a band aide temporary with your hormones.

Sharon H

Nov 05, 2019
by: Jen

If you are already stressed and have high levels of Cortisol then no matter how much Progesterone cream you use, all of it YES all of it will get converted into Cortisol and you will feel worse, the more Cortisol you have the higher blood sugar, the more insulin, the more estrogen and androgens.

Meat and Dairy, Eggs all contain high levels of estrogen and cortisol, if you drink coffee on a daily basis, it increases cortisol too. If you drink Alcohol, that increases estrogen and your liver can't metabolise hormones properly. If your liver is malfunctioning and you have high blood sugar from eating processed foods that will make everything worse. High blood sugar is toxic to the body and leads to high levels of insulin production, high insulin has a cascading effects on all our hormones and shuts down thyroid function. So, without changing your diet its almost impossible to cure estrogen dominance. This is the vicious cycle.

Educate yourself before you blame Progesterone for all your problems. Most people don't want to change their bad diet and just want a quick fix well that's not really how our hormones work.

Mar 03, 2021
Adrenal crashes
by: Anonymous

I'm so glad I found this thread.

I suffer with low cortisol levels all day, plus below range DHEA etc... I am menopausal.

It was only after taking 125mls of progesterone cream, for a couple of weeks that I discovered that I was having adrenal crashes because of it, it was extremely frightening and took me a month to recover after stopping the cream.
I can now only tolerate 40-50mls a day.

Mar 04, 2021
Adrenal crashes
by: Joy

Hi there. I am assuming that you mean 125mg and not 125mls, which is 1/4 cup!

You only used progesterone cream for a few weeks, it takes time and patience for the body to adjust to progesterone therapy. It usually takes between 2-6 months before benefits are felt, in many cases it takes longer. Between 100-200mg is needed. By using the amount that you were using merely aggravated estrogen receptors and made matters worse. It is such a pity that you stopped. One has to try and preserve with the horrible adverse symptoms, it will pass.

The low cortisol indicates your adrenals are very stressed. If you are stressed or anxious at all then that would explain things. There is a page on Anxiety if you care to read it. Progesterone is very beneficial to the adrenals as it lessens the Stress response. It's a calming hormone.

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