Unsure if I am using the correct dose in troche form

by Alexandra
(New York, USA )

Hi All,

I am 29 and have suffered from painful periods, awful pms, along with cystic hormonal acne for as long as I can remember. I got my hormonal panel done through a saliva test. It showed that I was estrogen dominant and extremely low in progesterone.

My natural pharmacy started me on this plan:
Beginning on day 8 after the 1st day of my period
45 mg troche
Day 8-15 = 1/2 lozenge 2x daily (total of 45mg)
Day 16-22 = 1 loz 2x daily (90mg)
Day 23-28 = 1 loz 3x daily (135mg)
Day 29-31 = 1 loz 2x daily (90mg)
Then stop.

The first month I tolerated the dosage fine. I felt better. The 2nd month was ehh. The 3rd month is awful. My breasts are so tender, I'm bloated, my skin is breaking out like crazy, and I am moodier than ever. My pharmacist said that I should cut the above doses in half. From what I've read on here I'm suppose to be taking close to 100 mg to make progesterone the dominant hormone. He told me not to do that because my body is not used to the progesterone yet? I'm so confused on if this dosage is right for me or not, I would greatly appreciate any input.

Thank you!!

Comments for Unsure if I am using the correct dose in troche form

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Jan 05, 2016
by: Diane

Oh my gosh, it is so frustrating to hear what the pharmacist said to you. You definitely need to up your dosage. You should be at a minimum of 200 mg daily from day 14 until your period if you are tracking your cycle. I am perimenopausal and therefore am using between 200 mg and 300 mg daily even through bleed. My daughter had terrible cystic acne prior to starting progesterone and her skin cleared up beautifully by using a minimum of 200 mg daily from days 14 through when she gets her period. It did take at least 3 to 4 months for her cycle to regulate her skin to improve. Her PMS symptoms improved immensely as well. You should be seeing a functional medicine gynecologist who can help you regulate your hormones.
I wish you well:)

Jan 05, 2016
by: Diane

BTW... You should consider switching to creams rather than troche because troches don't have the best absorption whereas creams do. Troches and orals have to pass through the gut and therefore what is picked up by the progesterone receptors is far less then creams.
Good luck.

Jan 12, 2016
Dosage vs cream vs troche
by: Alexandra

Thanks Diane. With all the mixed reviews online I'm having a hard time figuring out what's best, cream or troche. As far as the doses, I guess I need to play with them and see what works best. I appreciate your input!!

Jan 19, 2016
Dosage - Cream vs troche (oral)
by: Joy

Hi Alexandra

As Diane explained, any form of oral progesterone is not the best delivery method as 96% of it gets destroyed by the gut and liver, 50% gets destroyed when using troches, a real waste of time and money, not to mentioned the havoc it will play on your estrogen receptors. Please read DELIVERY METHODS on the website, do a Google search on the search bar. Please consider switching to a cream.

Nothing less that 100-200mg per day is needed, but using a cream containing the correct progesterone concentration.

Hope this helps.

Jan 20, 2016
Cream vs Troche
by: Alex

Thanks so much Joy. This hormonal imbalance is really frustrating because there is so much conflicting information online. When I got my hormone panel done it read:

My cycle is 33 days.
Estrogen priming is normal (what does this mean??)
Ovulation between day 21 and 23.
Luteal phase starts with ovulation.
Progesterone released in second half of my cycle was on the low side.
Estrogen production is normal. Moderate estrogen dominance is apparent in this cycle.
DHEA is normal. (5 ng/ml)
Testosterone is normal. (22pg/ml)
Luteal surge of progesterone around day 22
Luteal phase deficit, shortened phase, less than 12 days
Progesterone output is 74%
90% of progesterone output by day 28 of period or by day 6 luteal phase
Estradiol output was normal
The average ratio of luteal phase output of progesterone to estradiol is 15. P/E ratio favors estrogen dominance

This is all so confusing!!! I am really at a loss here, I cannot find a happy medium. I am scared to up the dose. My doctor won't let me, so should I do it anyway?

Jan 20, 2016
Cream vs Troche
by: Joy

Hi Alex

One really has to be very careful when reading info on websites and blogs, this is when all the progesterone misconceptions come in

Nothing annoys me more, when doctors say your test result is normal. What exactly is normal? Never accept that please. Also what is all this ‘output’, ‘priming to normal’ talk, almost like you are trying to start up an engine of some sorts? Sorry but I can’t read this tests results. Could you please find out what your progesterone and estradiol (E2) level is in order to work out a ratio. I really am not surprised that you are confused by this, so am I! Perhaps Wray can make some sense of this, I certainly can’t.

Your doctor will not let you up your dose! Really, whose body are we talking about, yours or his? It’s your right. Why don’t you take matters into your own hands, and do what you feel is correct and best for you. It’s what I did and so many others who visit this website.

Jan 21, 2016
estradiol levels
by: Alex

Thanks so much for your reply Joy. The link you provided to the misconceptions did not work :( Sorry for the confusion, as you said its very confusing to me too!!!

My saliva test was measured every few days over the course of 1 cycle.

Follicular e2 = 2.2
total cycle estradiol = 82 pg
preovulatory phase estradiol = 58 pg
luteal phase estradiol = 24 pg
relative luteal phase estradiol = 29%
estrogen exposure = 3140 (reference 1018-5090)

(period begins day 1)
day 1 - estradiol 4 pg/ml ; progesterone 42 pg/ml
day 5 - estradiol 4 pg/ml ; progesterone 19 pg/ml
day 8 - estradiol 6 pg/ml ; progesterone 40 pg/ml
day 10 - estradiol 6 pg/ml ; progesterone 28 pg/ml
day 13 - estradiol 7 pg/ml ; progesterone 20 pg/ml
day 15 - estradiol 8 pg/ml ; progesterone 32 pg/ml
day 17 - estradiol 9 pg/ml ; progesterone 26 pg/ml
day 20 - estradiol 14 pg/ml ; progesterone 42 pg/ml
day 23 - estradiol 8 pg/ml ; progesterone 136 pg/ml
day 26 - estradiol 9 pg/ml ; progesterone 148 pg/ml
day 32 - estradiol 7 pg/ml ; progesterone 72pg/ml

Usually, I get awful PMS for 2 weeks prior to my period. At the end of my period is when I start to feel better, heading into the following week thereafter. My periods usually last a week or a little more. I am scared to stop taking the hormones or just to up them. I am feeling really lost in regards of what to do!

Hope this is less confusing!!!

Jan 21, 2016
Cream vs Troche
by: Joy

Hi Alex

I had a quick word with Wray about this and she agrees with what I advised. Your doctor is trying to pull the wool over your eyes, perhaps his own for that matter. He is trying to force you into doing something that you are not happy with.

Take matters into your own hands, you will then feel less frustrated and get results.

Take care.

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