Started progesterone cream - terrible headache

by Sam

Hi! I've been on bio-identical progesterone capsules for about 3 years. Never saw much change in my low progesterone levels (blood serum tests). My doctor changed me to bio-identical cream about a week ago. The starting dose was 100mg, applied at bed time. The first night, I slept well and felt good. The second night, I tossed and turned with bad night sweats. The doctor told me to increase to 150mg at night. Same thing. First night was good, second night rough with sweating. I also developed a bad headache in the afternoon. So, we upped it to 200mg. All was good, but digestive system slowed down. Now, she wants me to go back to 150mg tonight and see. Ugh!

I still have a terrible headache this evening. Like the back of my head is in a vice grip and my neck and shoulders are super tight.

To complicate matters, I am also withdrawing from Xanax. Stopped cold turkey 65 days ago. I was on a low dose for about 3 months. Withdrawals haven't been fun, but manageable. I'm worried that the up and down with the progesterone cream is exacerbating the withdrawal process a bit. The good news is I'm not feeling anxious.

So, I'm looking for advice on how to bear to take the progesterone cream - dosage and timing.

Here are my latest labs, taken just last week:

Progesterone - 2.05 ng/ml
Estradiol - 37.3 pg/ml
Testosterone - 41
Free testosterone- 3.5

In March my FSH was 53.7 and LH was 42.4. We did not test for those this time.

I do take testosterone cream (low dose), which is reflected in my labs. Without it, I basically have NO testosterone.

Oh, I am 52. While FSH would suggest menopause, I am still cycling.

Any help would be greatly appreciated!

Comments for Started progesterone cream - terrible headache

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May 28, 2018
Started progesterone cream - terrible headache
by: Joy

Hi Sam

Any form or oral progesterone is not the best Delivery Method as 96% gets destroyed by the liver. A good progesterone cream is so much better. Using anything less than 100mg will aggravate estrogen receptors and make your Estrogen Dominance symptoms worse. Headaches are one of many estrogen dominance symptoms. You haven't been advised on How to use Progesterone Cream correctly. It should be used no less than twice a day, half in the morning and the other half at night, this will keep progesterone levels stable. It also takes between 2-6 months before positive results are felt. I suggest that you continue with 200mg and give it time.

Your progesterone:estrogen ratio is 60:1, it should be around 600:1. Please read the Hormone Testing page. Your are also in Peri-Menopause.

Vitamin D3 is 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
Mainstream thinking on progesterone
by: Sam

Thanks! I’ll give that a try.

If 100-200 mg is what we truly need now, why does "conventional wisdom" recommend only 25-40mg per day? Is the thinking seriously outdated? Why are more doctors not changing their thinking?

May 29, 2018
Progesterone during period
by: Sam

One additional question, my doctor has advised that I should stop progesterone during my menses.

My concern is the effect it may have on my Xanax withdrawal symptoms. Progesterone can affect GABA receptors in much the same way as a benzo drug. Not exactly the same, but there is a calming effect. If I stop the progesterone suddenly during menses, I risk putting myself into a bad withdrawal state again. Not interesting.

Can you take progesterone cream straight through a cycle?

My cycles are erratic for sure. I had one at 60 days and one at 23 day recently. I am deep into a menopause transition. Fun times!


May 30, 2018
Progesterone during period
by: Joy

Hi Sam

Using less than 100mg progesterone cream merely aggravates estrogen receptors. Many professionals do not seem to understand this.

Progesterone is safe to use no matter what drug one is taking and it does have a calming effect if used correctly.

Many women use progesterone daily with no breaks at all especially if cycles are erratic. As you are in peri-menopause I suggest that you use it every day as it becomes difficult to use if periods are not regular.

Nov 22, 2020
Progesterone cream
by: Anonymous

Hi Sam, I’m wondering what your update is concerning the progesterone cream dose?

I’m 42 and experiencing bad headaches as well. I’ve taken the advice on this site and increased my dose by a lot but I’m still experiencing bad headaches. This is the only place on the internet that says the progesterone to estrogen ratio should be 600 to 1 to feel good.

I need to know if this is true and if your symptoms improved after increasing your dose to 200mg a day.

Please give us an update.

Nov 23, 2020
Response on progesterone
by: Anonymous

I actually take both estrogen and progesterone now and am feeling tons better. The high doses of progesterone made me miserable for a long time. Super bloated and I cried every day. Just couldn’t do it. I feel we need both, in proper balance, to feel good. I’ve never seen a 600:1 ratio before and that is counter to everything I’ve read. We don’t have those rations when we are younger. We have progesterone in out luteal phase only. We have very small amounts in our follicular phase. Many doctors have told me that too much statically doses progesterone can cause a lot of issues, such as insulting resistance.

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