PCO/Heavy Bleeding/Anemia

by Elaine S.
(Ohio, USA)

I am 43 always had PCO and heavy bleeding. I have taken Vitex (chaste berry) to regulate my periods, but did nothing for the heavy periods. From many years of progesterone deficiency, natural progesterone cream and even Prometrium did nothing for my heavy bleeding, which of course, led to anemia. At the recommendation of my ob/gyn, I am having a D&C.

In order to keep the heavy bleeding from returning, how much natural progesterone cream will I need to use?

Thank you.

Comments for PCO/Heavy Bleeding/Anemia

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Jan 02, 2011
PCO/Heavy Bleeding/Anemia
by: Wray

Hi Elaine I'm not in favour of vitex, it has oestrogenic properties. You certainly don't need more oestrogen, this is the cause of the heavy bleeding. Oestrogen is a mitogen, it stimulates cells to grow. Vital in stimulating the endometrium each month to grow and thicken ready for a possible fertilised egg. But in excess it stimulates cells to continue growing. MMP?s are enzymes that break down protein. They play a role in the breakdown of endometrial tissues at the end of the menstrual cycle. If they are over active, as would be the case with excess oestrogen in the body, as oestrogen stimulates their production, the result is a pathological reaction. A high level of MMP's can lead to inflammation and excessive bleeding in the uterus. If a low level of progesterone is present, and a high level of oestrogen, the lining will continue to grow. With a high level of MMP's the lining will also continue to break down. Progesterone suppresses both MMP's and oestrogen.

It is essential to use a high amount of progesterone, between 400-600mg/day. If the bleeding is continual, use it both daily and hourly. Using it hourly keeps the level high throughout the day. If there is a cycle, it?s best to ignore it and use the progesterone daily, hourly too, until the bleeding is under control. The progesterone can be used to regulate the cycle once bleeding has stopped. For more info on this see our page on Peri-menopause. If you should consider following my suggestion, please read our page on Oestrogen Dominance first. The chances are you won't get it if you use such a high amount of progesterone. It's generally only felt if a low level is used, such as 20-40mg/day. Take care Wray

May 21, 2012
Vitex and Progesterone Cream together?
by: Ann

I am so glad i found this site, I have been using Dr. Lee's Progesterone cream for months, after discovering to suffer from Estrogen dominance.
I feel so much better, but I want to continue the therapy and want to switch to Natpro because my cream contains some soy and i have never liked that, I see Natpro does not contain any!!

I wanted to know if I could take Vitex only during the 14 days previous to my period (when I do not use the cream) and then use the cream starting on day 14, but in this way decrease the dose of the cream, so alternating 14 days of Vitex and 14 days of cream, but in lesser amount?

Now I use about 1 tablespoon, I wanted to decrease a bit, and use Vitex in combination,
Would this be good?

I see you are not in favor of Vitex, am I right?
it is so confusing, because many medical sites state that Vitex helps in the Progesterone production, even if it is not as strong as a cream, and other site state that it does not work at all
The doctors I have consulted seem to have very little or no knowledge at all about both progesterone cream or this Vitex and how it works, so it is just a guess

I was hoping that this way I could slowly decrease the dose of the cream as I am feeling better and eventually after 6 more months, switch to Vitex completely and go from there

Would you please kindly give me your advises?

Thankx a lot

May 23, 2012
Vitex and Progesterone Cream together?
by: Wray

Hi Ann I'm so pleased the website has helped you. I do have reservations about vitex, it does have oestrogenic properties. Agnus castus has been used for many problems which women suffer from, PMS, mastalgia, menstrual irregularities, fibrocystic breasts, increasing lactation and more, see here. In days gone by it was used by monks to reduce sexual desire, hence it's name 'chasteberry'. It can also reduce prolactin levels, prolactin can cause tender breasts, see here, and luteal phase dysfunction, with subsequent problems in embryo implantation, see here. But because it has a mild oestrogenic action, levels of 17 beta-oestradiol can increase. One study found mild ovarian hyperstimulation syndrome occurred in the luteal phase, see here. Agnus castus does not contain progesterone, and does not increase it's secretion. In fact progesterone itself stimulates it's own secretion, there's more info about this on our Menstruation page. It's active constituents are the essential oils limonene, cineol, pinene, and sabinene. The iridoid glycosides aucubin, agnuside, and eurostide. The flavonoids casticin, kaempferol, quercetagetin, orientin, and isovitexin. And the diterpenes vitexilactone, rotundifuran, and 6-beta,7 beta-diacetoxy-13-hydroxy-labda-8,14-dien. It also contains several essential fatty acids, including oleic acid, linoleic acid, palmitic acid, and stearic acid. Prolactin can rise in the few days prior to bleeding, this is due to excess oestrogen in ratio to progesterone during these days. Oestrogen increases prolactin secretion by the pituitary, prolactin is an inflammatory hormone and can cause Breast Tenderness, although oestrogen is also an inflammatory hormone, so is often the culprit. Plus low iodine causes sore breasts. If prolactin levels are high, both progesterone and the amino acid tyrosine are very affective at suppressing it. You appear to be using about 240mg/day progesterone, if you use tablespoon. If you do switch creams, you will need to use 7ml of Natpro to get the same amount of progesterone. 5ml is 1 teaspoon. We have more info on our page How to use progesterone cream. Take care Wray

Jul 18, 2012
Vitex and Progesterone Cream together?
by: Ann

Hi Wray
I posted the above question some months ago and you were so kind to reply to it, in details. Thank you so much for your time and assistance. So if I understand correctly, Vitex can cure symptoms similar to estrogen dominance, but it does not contain Progesterone and it does not stimulate Progesterone at all, either, plus it contains some estrogen, so it would not be of any help for my case at all. Am I correct?

I wanted to know if you can kindly also shed some light on another type of Pregesterone as well
I have read in this forum somewhere, that some women are also using the Micronized progesterone Prometrium and they find it to be even more effective, so i am a bit confused,
Is this micronized Progesterone Prometrium as good as the cream? What is the difference?

the PubMed research site here recommends it and classifies it as natural or biodentical Progesterone

This site does it too

But I also have seen some sites that think is not natural but synthetic, so it is confusing

It would be easier for me, to use some form of natural Progesterone also by mouth if i could, or at least alternating with the cream, one day by mouth, one day by massaging the skin
Would you please help to shed some light
Thank you

Jul 18, 2012
Vitex and Progesterone Cream together? # 2
by: Ann

also, have seen online several saliva test kit options,(Estrogen-Progesterone) and it is confusing, Do I have to do it several times a day, or is it necessary only once,
and do i chose those that have a 4 days kit, or only one day?
Do you have a preferred website where I can find these kits?
Thanks again, i so much appreciate your insight

Jul 20, 2012
Vitex and Progesterone Cream together?
by: Wray

Hi Ann Vitex can reduce levels of prolactin, as this is an inflammatory hormone as oestrogen is, in can help alleviate some symptoms. It does have some oestrogenic activity. Progesterone is progesterone, it doesn't matter what form it comes in. If it's a progestin the full name is always given after the trade name, i.e. Provera is medoxyprogesterone acetate. There are many Delivery systems, a list is given on this page. So Prometrium is progesterone. But it's oral progesterone, this is the least effective of all the delivery systems. Most is destroyed by the gut and liver. The best forms are injections, suppositories or creams. I prefer the cream as it can be applied anywhere at any time, and doesn't cause any pain or discomfort. I've no idea why those sites said the test should be done over several days. It should be done ±7 days after ovulation or before bleeding, this is when progesterone and oestrogen peak. I.e. in the mid-luteal phase. If in Menopause it matters not when it's done. The best is ZRT Labs. Take care Wray

Jul 23, 2012
Vitex and Progesterone Cream together?
by: Ann

Dear Wray,
Thank you so much for your insights! It clears so much confusion!!!Yes lets forget Vitex then, if you say it has estrogen activities, I want to avoid it.
About the trans-dermal Progesterone versus oral Progesterone. OK I here is my situation, and I am going to be totally honest with you. I had to increase the dose, since I was having some estrogen dom. side effects, Now I am using 2 tsps Natpro! I like it!

But I want (I think I really need to) to use Progesterone for the whole month, everyday, until I get better, I read your forum a lot, and I assume this seems to be the best option for me, according to your knowledge.
I lost my employment 3 months ago, and I am on a very, very low budget, unfortunately at present, i cannot afford any longer to use the cream everyday. I wish I could
So have to find a different solution
I can afford still to use 2 tsp a day for 14 days a month, if I am careful with my budget. and I could use the oral Prometrium for the other 14 days. I see that this oral progesterone is less effective due to the gut and liver absorption

But I wanted to ask you, if I would take the highest dose (200mg) of capsules, one a day during the 14 days after my period, and then the cream the rest of the month, do you think it would be better than nothing? than only use the cream 14 days a month?
The capsules are very affordable, i could even use 2 a day
Honestly i do not know right now what else to do, i love Natpro, but I can only use it for part of the month, but I need to get some progesterone every day

Also, I read about the troche or buccal drops and vaginal gels
Would they be a bit more effective than the oral?
The prometrium is bioidentical, while it seems these others have chemicals in the ingredients, am I right?
I just need to find an alternative option right now, and my only problem is I am on a very low budget, I wish things were different
Can you please give me some more insights and your honest advises, which I so much appreciate, on this?
Thank you so much

Jul 25, 2012
Vitex and Progesterone Cream together?
by: Wray

Hi Ann It's a difficult choice! I can only suggest you try your idea, i.e. using the oral during your luteal phase and the cream during the follicular phase. Although I feel you might need to reverse this, as oestrogen rises during the luteal phase too. It's low in the follicular phase, only beginning to rise anything from 4 to 10 days prior to ovulation. It rises exponentially the 2 days before ovulation, which is when many women get adverse symptoms. Progesterone should rise then too, and often doesn't. It's when oestrogen is too high, without the countering effect of progesterone that all our troubles start. You'll just have to experiment, and you might find you have to start the higher progesterone the two days before ovulation. When are your worst symptoms, that is when you need the higher amount of progesterone. Both troches and buccal drops are better than oral, but some of the progesterone is still swallowed. Vaginal gels work as a cream does, but according to this paper here, it's not as effective as a cream. What I suggest you do with the promethium is open the caps, add the contents to a small amount of skin cream, and rub it on. That way you will get the full benefit of the progesterone it contains. Let me know which experiment you opt for and how you get on. So pleased you like the Natpro! Take care Wray

Jul 25, 2012
Vitex and Progesterone Cream together?
by: Ann

So nice of you Wray,
Thank you so much, you do not know how much I appreciate your help and advises.
I guess I will have to try and see, and find out which way it really works best,

I want to make sure I understand:
you said it is better if I use Napro from the first day of bleeding, until day 14- correct?

And then use the capsules, from day 14 to day 28 or 30, correct?

yes I might try to open the capsule and mix content in a cream, if i can succeed, they are supposed to be made of hard gel, it may be difficult, but i want to try
Would any organic chemical free cream base good?

I also have organic coconut oil, would that work too? Or too oily?
I also use shea butter as a lotion, would that work? or would that be too thick and hinder absorption?
Any better suggestions? I would appreciate them

Also, I tried to find buccal drops or vaginal gels brands online, could not fins any
Could you suggest of sites you know?
Or are those supposed to be made by pharmacies?

I will experiment and let you know how it goes
Meanwhile, thank you again for all your support and advises!!

Jul 26, 2012
Vitex and Progesterone Cream together?
by: Wray

Hi Ann I feel it would be better to use the higher strength progesterone during your luteal phase as that's when oestrogen is high. It's lowish in the follicular phase, i.e. from bleeding to ovulation. It does begin climbing slowly, rising sharply two days before. See how you get on with using it from ovulation till you bleed again. Any good skin cream is fine, coconut oil is excellent, but as you say it might be a bit greasy. Shea is good too, and as it's thicker the gel might mix better, you could then add it to the coconut oil once mixed, to make it softer. I think the drops and vaginal gels are prescribed. I don't think you should have too much trouble mixing it in, looking at the ingredients….. The inactive ingredients for PROMETRIUM Capsules 100 mg include: peanut oil NF, gelatin NF, glycerin USP, lecithin NF, titanium dioxide USP, D&C Yellow No. 10, and FD&C Red No. 40. Incidentally FD&C and D&C colors are coaltar (bituminous coal) derivatives, see here. Take care Wray

Nov 17, 2017
Progesterone cream side effects
by: Anonymous


I purchased the progesterone cream from Dr. Lees website and was only able to use for a few days because of severe itching (no rash), and headaches. This experience has caused me to not want to try any other progesterone creams because Dr. Lees is a expert in the field of balancing hormones and if his cream did not work for me I have not been confident that any other will.

I'm looking for something to treat fibroid and heavy bleeding.

Any assistance is appreciated.

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