Up to 264 mg of progesterone/day and still having symptoms

by Shelli

I have somewhat slowly increased my dose of progesterone cream to 264 mg/day every day with no breaks. I just turned 47 and was having fairly regular periods approximately every 25 days. I started using it due to spotting before and after periods and shortened time between them as well as a few other symptoms of perimenopause such as poor sleep and swelling legs. I have written here before and was encouraged to up my dose from the 40 mg prescribed by pharmacist. I'm still having symptoms though and now am having almost non-stop spotting, slight breast tenderness, some breakouts, swelling again in legs at times (this seemed to get better for a short period of time after one increase), and sleep is still poor (waking too early). I don't know what to do next. Do I increase more? Do I need to take a break and see if I have a period? During the last couple months I can't tell what was supposed to be a period and what is spotting. I don't know if some of it was a light period or not. Thanks for any advise.

Comments for Up to 264 mg of progesterone/day and still having symptoms

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Jan 07, 2015
E dominance
by: Diane

Hi there, Shelli~~
It appears you are still E dominant, breat tenderness, edema, insomnia...I personally would up your dose and possibly try DIM which is a supplement to help metabolize E in your system...I'm posting info on DIM below..I know it's a lot of information, but it is important to understand what may be going on in your system.
Good luck to you.

(Di-Indoly Methane) For Natural Protection from Estrogen's Effects

Frequently Asked Questions

Compiled by Thomas Stearns Lee, NMD

What do perimenopause, premenstrual syndrome, enlarged prostate glands, and early heart attacks have in common? Estrogen. A new understanding of healthy estrogen metabolism is providing a natural treatments for these and other important conditions confronting both women and men.

Fortunately, phytonutrients discovered in cruciferous vegetables offer a natural approach to resolving estrogen imbalance. Dietary supplementation with an absorbable form of one of these phytonutrients, called Di-Indol Methane (DIM), helps promote healthier estrogen metabolism. DIM's hormonal balancing effects have revealed these midlife problems are not due to estrogen itself alone, but rather, to estrogen metabolism imbalances.

Q. What is DIM, and how can it help hormones?

A. DIM is a phytonutrient (plant nutrient) found in cruciferous vegetables. These include cabbage, broccoli, bok choy, Brussels sprouts, cauliflower, kale, kohlrabi, mustard, rutabaga, and turnip. These plants have been cultivated for thousands of years and were initially used for their medicinal benefits. The connection between DIM and hormones like estrogen has to do with similar characteristics between them at the molecular level. DIM is not an estrogen or a hormone, but like estrogen it shares the common characteristic of being poorly soluble in water. Like estrogen, DIM can be metabolized only by a special class of cytochrome enzymes that reside in cell membranes in the non-water part of cells. It turns out that DIM, when consumed in food or in absorbable formulations, encourages its own metabolism. This special metabolic pathway for DIM, and the enzymes involvemd, precisely overlap with the pathway needed for healthy estrogen metabolism.

Stated simply, supplementing the diet with DIM speicifically promotes beneficial estrogen metabolism and helps restore a healthy hormonal balance.

Acquired estrogen imbalance. This important form of estrogen dominance has to do with inherited problems in estrogen metabolism and influences of diet and chemicals on beneficial metabolite production. Acquired estrogen imbalance affects both men and women. Almost 20 years ago, H. Leon Bradlow, Ph.D., a renowned breast cancer investigator, discovered women with breast and uterine cancer made too little of the 2-hydroxy or "good" metabolite of estrogen and too much of the 16-hydroxy or "bad" variety.(4)

Since 16-hydroxy is an unregulated form of estrogen prone to behave like "super-estrogen," higher levels create a particularly unhealthy form of estrogen dominance. 16-hydroxy estrogens can result in mutations, abnormal growth (as in cervical dysplasia),(5) and an increased risk of future breast cancer.(6) Overproduction of 16hydroxy estrogen is also seen in obesity,(7) high-fat diets,(8) and exposure to a host of "estrogenic" environmental chemicals.(9) Therefore, this dangerous form of estrogen dominance can result from inheritance, diet, and environmental chemicals.

Q. What benefits can DIM offer?

A. Supplementing our diets with DIM can shift the production of estrogen metabolites away from dangerous 16-hydroxy in favor of beneficial 2-hydroxy metabolites. Taking DIM in an absorbable formulation encourages active and healthy estrogen metabolism. DIM supports estrogen balance by increasing beneficial 2-hydroxy estrogens and reducing the unwanted 16-hydroxy variety. This improves estrogen metabolism and helps resolve all three forms of estrogen dominance.

NaturoDoc Note: Remember, 2-hydroxy is good; 16-hydroxy is bad.C.

Q. How much DIM is recommended?

A. To replace the DIM from healthy amounts of cruciferous vegetables in the diet, women should take a starting dose of about 15 mg per day of actual DIM in an absorbable formulation. Men should take about 30 mg per day of actual DIM in the same absorbable or bioavailable formulation. These amounts can be increased three to four times on an individual basis to derive needed benefits for hormonal balance and metabolism. Based on testing in men, improved estrogen metabolism, easier weight loss, and prostate health require a higher dose of DIM than in women.

Since pure DIM must be provided in an absorption-enhancing formulation, the dose for DIM sometimes specifies the weight of the absorbable formulation, which is only one-fourth, or 25 percent DIM. In the book, All About DIM, the suggested dose of 100 to 200 mg per day for women and 200 to 400 mg of DIM per day for men refers to milligrams of such an absorbable formulation.(15) This dose range for hormonal balance corresponds to 25 to 50 mg per day of actual DIM for women and 50 to 100 mg of actual DIM for men.

Q. Can DIM help improve the safety of hormone replacement therapy (HRT)?

A. Despite a growing list of benefits attributed to estrogen, which include younger-looking skin, more comfortable sex, and better memory, women often view its potential side effects as unacceptable. Study of postmenopausal women receiving long-term HRT with estrogen and estrogen/progesterone combinations has revealed an unequivocal increase in breast cancer risk.(32)

NaturoDoc Note: These studies were done with Premarin, horse estrogens, and synthetic progestins, NOT progesterone.

Added concerns relate to the increase in the incidence of uterine cancer, and increased risk of life-threatening blood clots, especially after bone fracture.(33) Most recently, the nationwide HERS study reported the concerning finding that women with a history of heart disease had an increased risk of heart attack in the first year after starting estrogen.(34)

Many of estrogen's risks can be related to a lack of its beneficial metabolites. It is now known that a lower risk of future breast cancer is associated with higher 2-hydroxy estrogen levels. Supplementation with bioavailable DIM increases protective 2-hydroxy estrogen and therefore may reduce the risk of HRT-related cancer. Reduction in the risk of abnormal blood clot formation related to HRT estrogen would benefit women who suffer fractures while on HRT, but also may benefit women with early heart disease. It has been known since the Framingham Study in Massachusetts that men with the highest estradiol level had the highest risk of early heart attack.(35) DIM may help normalize the cardiac risk in both men and women related to unhealthy or underactive estrogen metabolism. Also, the beneficial 2-hydroxy metabolites have been shown to be powerful antioxidants,(36) which may contribute to protecting against the early stages of atherosclerosis and subsequent heart attacks.


DIM supplementation is a nutritional approach to achieving a safer and healthier estrogen metabolism, or of protecting it. Many of the benefits traditionally ascribed to estrogen (protection from heart disease, healthy skin, bones, and brain) may actually reside with its beneficial metabolites, the 2-hydroxy estrogens. DIM supplementation is a natural promoter of this specific pathway of healthy estrogen metabolism.

Feb 02, 2015
Did increase
by: Shelli

Thank you Diane. I hadn't seen that someone replied until now. I did up my dose to 352 mg/day. That's how much is in 4 tsp of the cream I'm using. Spotting has pretty much stopped for now and breast tenderness is gone (for now). Still having sleep problems and edema though. Its only been a couple weeks or so that I've been on this dose. I may try the DIM too. The cream is getting awfully expensive. Would be nice to be able to lower the dose.

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