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Progesterone cream after endometrial ablation?

by Susan Merritt
(Muskegon, MI)

I'm 43 years old and had an endometrial ablation 3 years ago. I have not had any vaginal bleeding since then, but I have PMS symptoms sporadically monthly.

I have headaches, breast tenderness, vaginal dryness, virtually no libido, bloating, ot flashes, night sweats, insomnia etc. I would like to try progesterone cream for these symptoms, but I'm afraid it will induce vaginal bleeding. Does anyone know how progesterone cream affects a person after having an endometrial ablation and how often should I use it?

Comments for Progesterone cream after endometrial ablation?

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Feb 04, 2011
 Ablation
by: Anonymous

I am thinking of having the ablation myself. Did you end up having all of these symptoms as a result of the ablation?

Thanks :)
Feb 14, 2011
 Progesterone cream after endometrial ablation?
by: Wray

Hi Susan We have many women using progesterone who've had the ablation, and it doesn't cause bleeding, as the ablation has destroyed the lining. Incidentally supplemental progesterone in high amounts of 400-600mg/day stops heavy bleeding. It should help with all the symptoms you've mentioned. The ablation doesn't stop the ovaries making testosterone and oestrogen. And it doesn't prevent ovulation, with subsequent progesterone production. Judging by your symptoms you are now in Peri-menopause, please read this page as it explains how to use progesterone. But before using it please see this page on Oestrogen Dominance. Hot flushes are reduced or eliminated by using 400mg/day progesterone for 4-5 days, then reducing the amount slowly. Consider using some of the cream in your vagina at night for the dryness, and rubbing it on your breasts to help the pain. Take care Wray
Feb 14, 2011
 Ablation
by: Wray

Hi there An ablation doesn't normally cause any adverse symptoms, apart from the usual risks of having a surgical procedure. But if you have heavy bleeding, please consider using progesterone as this does stop it. 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, see here and here. 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. I'm not sure of your age, but please read these two pages on How to use progesterone and Peri-menopause. Before considering progesterone please read our page on Oestrogen Dominance too. Take care Wray
Nov 26, 2012
 Progesterone cream after uterine ablation
by: Jenn

I am 41 yrs old and had a uterine ablation 2 years ago. Recently I found out that I am progesterone deficient. I started using a progesterone cream. It says I should use 2 weeks a month prior to my cycle, but I don't know when my cycle is anymore. Also, I have been experiencing uterine cramping since I started it. I was wondering if I should cut the amount down or maybe use it every other day of the month versus 2 weeks in a row. Any suggestions? Thank you
Nov 27, 2012
 Progesterone cream after uterine ablation
by: Wray

Hi Jenn It appears you are using about 20mg/day, possibly 40mg/day? If you had an ablation I imagine you must have had heavy bleeding? If this is so you would have had excess oestrogen, and still have it, as the ablation wouldn't affect it. Oestrogen causes the lining to build up, it also stimulates the MMPs which cause the lining to break down. Progesterone inhibits both, there is more info on our Menstruation page. I normally recommend 100-200mg/day progesterone, but feel you would need at least 200mg/day, possibly more. Progesterone is effective at stopping heavy bleeding, but I've found amounts of 400mg/day and over are needed. So you might need as much as this to reduce your oestrogen levels. The uterine cramping is in part caused by oestrogen, prostaglandins also play a role, plus cytokines and chemokines, progesterone inhibits these. The cramping is the same as labour pains. One paper says "Central to the onset ..... will be a mechanism for progesterone withdrawal and estrogen activation in human". Unfortunately using small amounts of progesterone merely stimulates the oestrogen, hence the cramping. There's info about this on our Oestrogen Dominance page. We also have more info on our page How to use progesterone cream. I would suggest you increase the amount of progesterone substantially, and use it daily. Please confirm the amount of progesterone you use, and whether you had heavy bleeding. Take care Wray
Nov 27, 2012
 more details..
by: Jenn

Thanks for your response Wray. I did have the uterine ablation due to heavy bleeding. I had my saliva tested which is how I found out my Progesterone level was low at 15 (75-270). My Estradiol was also low at 1.1 (1.3-3.3). Testosterone level was normal. My MD feels I have adrenal fatigue. Cortisol levels are normal until bedtime when they dip below normal. I am on 20mg of Progesterone cream. I also have a multi-nodule thyroid wich will be biopsied next week. I have depression and no libido which is why I initiated the saliva test in the first place.
Nov 27, 2012
 more details..
by: Wray

Hi Jenn Thanks for coming back to me. I did suspect you would be using a very low amount, too low to have any affect, beyond making things worse. Your P:E2 ratio is very low at 14:1, we've found from Saliva Tests we run that it's best if it's over 600:1. I had a feeling you would still have a high oestrogen ratio. Adrenal fatigue is quite possible, any stress causes it. Stress also drops progesterone levels, vitamin D drops too. Please have a test done. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Blood levels should be 70-100ng/ml (175-250nmol/L) and not the 30ng/ml (75nmol/L) most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although recent research indicates it should be 10,000iu's per day, see here. It's the most vital nutrient above all others, cells malfunction without it. Plus a low level reduces the benefits of progesterone. Women have found by getting it high, persistent symptoms have resolved, in spite of high amounts of progesterone, see here. Please increase the amount of progesterone you're using, and it should be used a minimum of twice a day too. Levels begin dropping after about 13 hours. We do have a page on Libido, progesterone and dopamine play a big role, so too does vitamin D. I suggest rubbing the cream all over the area that's painful, hourly if needs be. Both Progesterone and Vitamin D help depression. So do a number of nutrients listed on our Anxiety page. Vitamin D is also vital for the thyroid, see here, here and here. Take care Wray
Jan 27, 2015
 When to use cream?
by: Anonymous

Since I had a uterine ablation, I don't bleed anymore; but my ovaries are intact.

Please point me to a resource that can help me determine when to use the cream, since without bleeding I can't tell what part of my cycle I'm in.
Jan 30, 2015
 When to use cream?
by: Wray

Hi there I suggest you use it daily as you now no longer have a cycle. There's no way of telling when it would occur. So please read our page on How to use Progesterone Cream. But I feel the page you'd find more useful is the one on Peri-menopause, it explains how to use the cream without a cycle. Take care Wray
Sep 12, 2015
 ablation: estrogen or progesterone cream
by: Pink

I'm 37 and have just had an ablation two days ago due to heavy menstrual bleeding. I've tried progesterone cream to try and stop the bleeding but it made me feel so fatigued and irritable. I then used estrogen cream and I felt energy and calm. Neither cream stopped the bleeding hence the ablation but now I'm not sure what to do to get my hormones balanced and back to feeling better.
Sep 27, 2017
 Ablation
by: Anonymous

Hello,
I envy all the women on here who say they have had an ablation and have had no periods since! I recently underwent endometrial ablation (2 months ago) and unfortunately my periods seem heavier, same amount of days with the same pain. I am desperate! I am 46 years old and am debating progesterone cream or trying birth control once again. I even had an IUD for 2 years before ablation to try to control my periods but it did not work at all !
Oct 02, 2017
 Ablation
by: Joy

I understand exactly how you are feeling. At the age of 47, I also had the ablation for the same reason as you. Had I known about progesterone therapy then, I would never have had it done only because it is so evasive. I am now 62. I can tell you from personal experience though, that it was not until my 3rd month of having the ablation that my bleeding eventually stopped altogether.
For some women the ablation seems to take longer to become effective. Perhaps this will be the case with you. Should it go beyond 4 months I would suspect that the procedure failed and you need to take this up with your doctor.

The last thing that you want to do is to take birth control, all drug based contraceptives have a potential to cause harm. Heavy/continual bleeding and clotting is a classic Peri-Menopause symptom which progesterone, together with other nutrients helps to clear. I started to use progesterone very soon after my ablation as I started to experience hot flushes and estrogen dominance symptoms. If I had known about progesterone therapy all those years ago I would most definitely had gone that route. IUD's usually make bleeding worse too.

May I suggest that you give it a little longer as your body is adjusting to that procedure.

Take care.
Mar 16, 2018
 ablation and premenopause
by: Anonymous

I had an ablation done over a year ago 2017, I was having periods for months at a time, it didn't help that my daughter had recently also started having a period.

After my ablation, I no longer had a period which is great, but it's like the week I'm supposed to be on my period I get hot flashes so bad I vomit for an entire day. This also happens on the first day of my daughters period, and it causes me to be sick.

I am 44 years of age. I don't regret the ablation, but it did throw me into pre-menopause. Just sharing what I know and I take an over the counter now that does help or seems to help, it's just the Estroven pill, but it is all natural.
May 27, 2018
 Weight gain after ablation.
by: Anonymous

I had the ablation around 8 months ago. It has been wonderful as far as no periods but I have gained 10 lbs in 8 months with no change to my diet or exercise. I now even work out more than I did because I no longer have the fatigue the excess bleeding used to cause. It all is concentrated in my belly as well.

My question is, would progesterone help me shift this weight? The lbs won’t budge. My body is acting like it does when I am pregnant. The only time I get cellulite on my upper thighs is when I have been pregnant. My thighs are now covered in cellulite. For someone who works hard at being fit this is pretty disheartening.
May 28, 2018
 Weight gain after ablation
by: Joy

You body seems to still be adjusting to the ablation. Progesterone can cause slight weight gain when first using it in some women if progesterone cream is not used correctly. Between 100-200mg progesterone is needed. Please read the How to use Progesterone Cream and Estrogen Dominance pages.

Have you been tested for Insulin Resistance as this can also cause weight gain as well as thyroid issues.

Vitamin D3 is also important as a deficiency reduces the benefits of progesterone. Optimal levels should be between 70-100ng/mL and nothing less than 5'000iu's is needed per day.
May 29, 2018
 Insulin resistance
by: Anonymous

Joy- Yes, I think I have been tested for insulin resistance.

Do you mean for diabetes? My A1C is normal and my fasting glucose is also normal at 93. I will say diabetes runs in my family but I eat right and exercise to keep it at bay. I will say that I have put on weight over the last 5 years about 25 lbs. I am 42 for what it is worth and probably Perimenopausal. This recent gain of nearly ten lbs in the 6 months since my ablation just added insult to injury.

Forgot to add my vitamin D is normal as well.
Thanks for your reply!
Nov 05, 2018
 Ablation and progesterone
by: Anonymous

I've had an ablation several years ago and I would like to take progesterone, is that okay to do?
Nov 08, 2018
 Ablation and progesterone
by: Joy

Hi there. Yes you can use progesterone. I also had an ablation 16 years ago and have used Natpro progesterone cream ever since. Between 100-200mg progesterone is needed, more if symptoms are severe. Please read the How to use Progesterone Cream and Estrogen Dominance pages.

Vitamin D3 is important as a deficiency reduces the benefits of progesterone. Optimal range is between 70-100ng/mL. Nothing less than 5,000iu's is needed daily. Co-factors are needed when taking D3, magnesium and vitamin K2 with no soy are the important ones.

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