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What's normal?

by Kris
(Utah)

I am 51 with almost normal periods of 24-27 days and have been on 20 mg of progesterone cream from a compound pharmacy for 2 years due to premenopausal symptoms. I start the cream on day 12 of my cycle and use for 10-12 days. I am 5'4", weigh 120 pounds, run 25-30 miles per week, travel quite frequently for my job which I am stressed about. I did the hormone saliva test on day 19 of my cycle and the results are:

Estradiol. 1.5
Progesterone. 370
Ratio of Pg/E2. 247
Testosterone. 32
DHEAS. 8.2
Cortisol (morning) 10.0

I would like to know if the results are good. I still feel some of the 'bad' symptoms. What can I do about the Cortisol? Should be progesterone be increased?

Thank you,
Kris

Comments for What's normal?

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Mar 10, 2012
 What's normal?
by: Wray

Hi Kris Although your ratio of P:E2 is better than some I've seen, we've found from Saliva Tests we run, that's it's best if it's 600:1 and over. This would probably account for the 'bad' symptoms you feel. I do recommend a much higher amount than 20mg/day, 100-200mg/day in fact. We have more info on our Peri-menopause page. If you should consider increasing it, please see our page on Oestrogen Dominance first. Your testosterone and DHEAS are within normal range, but so is your cortisol according to Medline. In fact it falls within both the am readings and the midnight readings. Are you concerned it's too high or too low? I would suggest you try increasing the progesterone and see if it helps. But please read the oestrogen dominance page, as it can occur when increasing. Take care Wray
Apr 01, 2013
 What's normal
by: Kris

Hi Wray.
I'm now 52 (soon 53)and have missed a couple of periods over the past year. For the last 4 months they've been every 27-29 days. Three weeks ago I increased my progesterone( from a compound pharmacy) to100mg per day. I divide it into two doses in the AM and PM. I was feeling better, but when my period started I stopped the cream and by day five of my cycle I felt bloated, anxious, teary, etc. I started my 100 regimen again on day five but feel anxious, a bit nauseated, have insomnia, cry easily and feel like I'm retaining water.. I am stressed because my husband and I are moving. Even though it's a great opportunity, it's a stressor. Any suggestions are so appreciated.
Kris
Apr 02, 2013
 What's normal
by: Wray

Hi Kris You are in Peri-menopause which is such a difficult time. I don't believe you're using enough progesterone and suggest you increase to 200mg/day. I also suggest you don't take a break. You'll find your cycles become even more erratic and therefore impossible to follow. Each time you stop, progesterone levels drop and oestrogen rises. We also have more info on our page How to use progesterone cream. Moving is very stressful, however good it may be. Stress drops progesterone levels, vitamin D too. A lack of this reduces the benefits of progesterone, plus causing insomnia. 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. Take care Wray
Apr 15, 2013
 What's normal
by: Kris

Hi Wray,
I've increased my progesterone to 150 mg a day. I'm afraid to increase to 200 mg. My healthcare provider wants me to decrease to 75 because of my symptoms of bad insomnia, palpitations, anxiety, extreme fatigue. I won't decrease the dose. I had my vitamin D drawn and will get the results this week. I feel awful!
Thank you for helping all of us who write.
Kris
Apr 15, 2013
 What's normal
by: Wray

Hi Kris Don't be afraid, I'm not sure what of, that progesterone is dangerous or your healthcare provider! Progesterone does help sleep, see here, here and here. So too does vitamin D, see here and here. Oestrogen causes prolongation of the QT interval, which results in palpitations, arrhythmia, Torsades de Pointes and sudden death. Whereas progesterone shortens the QT interval, see here, here, here, here, here, here and here. This is why more women get these problems than men, they have very little oestrogen, whereas we have a great deal more. But using too little progesterone will stimulate oestrogen causing palpitations. We do have a page on Anxiety. If you read the papers you'll see progesterone is a potent anxiolytic. Plus there are a number of nutrients which help too. And the fatigue is caused by excess oestrogen. I had exhaustion which went using progesterone. Let me know your vitamin D results please. Take care Wray
Apr 16, 2013
 What's normal
by: Kris

Hi Wray,
Today I will increased my progesterone dose to 200mg/day. I'll keep you posted as to how I feel. My vitamin D is 52. What should I increase my daily vitamin D dose to? My night sweats are gone. Does that mean I'm getting an "upper hand" on my estrogen dominance?
I can't thank you enough for your help!
Kris
Apr 17, 2013
 What's normal
by: Wray

Hi Kris Let me know how you get on with that amount, you could get some Oestrogen Dominance, as the rise in progesterone will cause a spike in oestrogen, but it usually calms down quite quickly. Your vitamin D is better than some I've seen. Specialists are now saying the minimum should be 50ng/ml, the less conservative 70-100ng/ml. I tend to err on the side of the less cautious! My level is 92ng/ml. I've found without doubt that high vitamin D levels really does boost the effect of progesterone. I did give you the details of vitamin D doses above, I'm not sure if you are following that? 5000iu raises it very slowly, 10,000iu much quicker. I didn't realise you had night sweats, we do have a page which covers them, see Hot Flushes. I've found it usually takes about 400mg/day for them to go, so I'm surprised a much lower amount has helped you, delighted though. So yes it does mean you are getting the upper hand, long may in last! Thanks for the kind words. Take care Wray
Apr 18, 2013
 What's normal
by: Kris

Hi Wray,
I do have symptoms of estogen dominance. I feel like I'm gaining weight and feel bloated. I don't know if it's water retention or fat. I still work out daily. My stomach is upset which I know happens when I'm stressed; having celiac doesn't help. I have slightly sore, swollen breasts which is new to me. My energy has decreased and not sleeping well has contributed to the problem. The night sweats started when I increased progesterone to 100mg/day (didn't have them before). I have terrible insomnia which I think is worsened by my anxiety with moving and selling our house. I'm reading a book about insomnia because I'm trying to get off of Klonopin that I was given years ago for anxiety and sleep issues. I was on .5 mg and have decreased to .25 mg. Looking back it was probably hormones!! I will increase my Vitamin D to 10,000 IU/day. My healthcare provider wants my level between 80-90. All in all, I feel worse using more progesterone. I know I have to give it time, but I want to feel normal--- don't know what that is right now. Any idea how long before I feel better? Does it normally take days, weeks or months. You have helped me and so many others. Thank you for your dedication to an issue most healthcare providers either don't know about or are living in the past regarding solving the problem. Have a great day! Kris
Apr 19, 2013
 What's normal
by: Wray

Hi Kris At least your health care provider is on your side, I'm delighted he wants your vitamin D between 90-100ng/ml, that is most unusual. I didn't realise you had celiac disease, this indicates your vitamin D is too low, see here, here and here. Maybe you should consider taking 20,000iu per day and having a test in a months time. You would feel worse using more progesterone as it's stimulated oestrogen again. Reducing it does reduce the symptoms, but defeats the purpose. I also feel the low vitamin D is not helping, progesterone needs a high level to have it's full affect, too low and it barely works. It's impossible to say how long it will take to get to normal, I do know if you used 1000mg/day progesterone you would respond quickly. Continued below
Apr 19, 2013
 What's normal Part 2
by: Wray

Hi Kris This is a list of all the things which cause progesterone to drop. Have a look through them and see if there is anything you could do to change things......
lack of or drop in vitamin D.... are you taking it, or missed a dose, or spent lots of time indoors?
dark days, especially winter, probably because vitamin D drops in winter due to lack of sun
high oestrogen.... aromatase, which converts testosterone into oestrogen, is working over time, or SHBG (sex hormone binding globulin) is low, this binds oestrogen making it inactive
high testosterone.... SHBG is low, this binds testosterone making it inactive. Sugars drop SHBG, they also drop progesterone levels
high LH.... the pituitary is working over time trying to make an egg develop, secrete testosterone and oestrogen, and then ovulate
high FSH....the pituitary is working over time trying to make an egg develop, secrete testosterone and oestrogen, and then ovulate
high stress...... this converts most of the available progesterone into cortisol
high adrenaline (comes from Stress or excitement, and a drop in blood glucose)..... this stops progesterone entering the cells
sugars of any kind.... they drop progesterone, plus dropping blood glucose, plus dropping SHBG
large meals..... because of the increased metabolic clearance of progesterone
alcohol.... this reduces progesterone levels and increases the androgens, ie testosterone
insulin.... increase caused by eating large meals, sugars, or meals containing sugar or starchy carbs
high level of phytoestrogens in the diet.... ie grains and legumes, soy milk, tofu etc these all act as oestrogen
oestrogenic herbs.... often given to women to help with symptoms
Thanks for the kind words! Take care Wray
May 21, 2013
 What's normal
by: Kris

Hi Wray,
For the last 2 months I've been on a continual dose of progesterone (with the exception of a 5 day break during my period in March). I started with 100 mg/day and on April 16 started on 200 mg/day. My period was a couple of days late in April and I continued to spot for a few days after. I feel my period will be starting again soon. I feel bloated and have a few other symptoms. My question is: Should I follow my period with the progesterone? If so, what day do I restart it? Is it OK to continue throughout my period on progesterone? I'm afraid to stop it because of the way I feel without it. Actually, I'm wondering if I would feel better with a higher dose, but I know my care provider won't prescribe it. Would it be wise to get another saliva test to see where my levels are?
As always, thank you for taking care of all of us!
Kris
May 28, 2013
 What's normal
by: Wray

Hi Kris I did suggest previously that you ignore your cycle and use the progesterone daily. Each time you stop it allows oestrogen to rise. Peri-menopause is a difficult time, symptoms are always worse during this phase of our lives. A higher amount would achieve quicker results, although the 200mg/day is a good amount. The only solution if you want to use more, would be to buy it yourself, there are plenty of creams on the market. A saliva test would only show your ratio is still too low, so I don't think it's worth the cost. Thanks for the kind words! Take care Wray
May 31, 2013
 What's normal
by: Kris

Hi Wray,
Thank you for responding.

My symptoms were awful before my period which came on day 36 this month. If I increase my progesterone dose, will my estrogen dominance be horrible?

I thought it was safe to use continual progesterone for two or three cycles only. If I'll feel better, I'll use it continually.

I spend $37 for a 30ml tube. Can you suggest a cream? I don't know where to look and what is safe. I've read a bit about Natpro and wouldn't mind trying it.
Again, thank you so much.
Jun 01, 2013
 What's normal
by: Wray

Hi Kris I do understand what you're going through, as I went through it too. Peri-menopause is an awful time. I see your cycles are now becoming very erratic, as a year ago they were 24-27 days, and now this last cycle was 36 days. Progesterone can be used safely with no break for as long as you like. But as you're in P-M it's essential, as not only are cycles impossible to follow, symptoms are much worse. Increasing progesterone can initially make symptoms worse, but they should pass quickly, although that's also impossible to predict. The cream you are currently using is very costly, I don't know the strength of it either. If you'd like to try the Natpro you can look at the ingredients we use, which are all safe, and the cost here. Take care Wray
Jun 01, 2013
 What's normal
by: Kris

Hi,
I know my period should become more irregular with age, but I thought it could be related to the continual use of progesterone. Yes? No? So much to learn.
My prescription strength is 100mg/ml. I'm going through it fast.
If I order Natpro, is there a certain strength I should order?
Again, I can't thank you enough.
Kris
Jun 01, 2013
 What's normal
by: Wray

Hi Kris No, irregular cycles are nothing to do with using progesterone, continual or not. The ovaries are slowing down, and no amount of progesterone will cause a regular cycle again. Natpro only has one strength, i.e. it's a 3.3% cream. Take care Wray
Jul 17, 2013
 What's normal
by: Anonymous

Hi Wray,
I ordered and received my Natpro cream, but am not sure how much to use or how to measure it. I've been using 200-300 mg per day or my compound progesterone. Thanks much.
Kris
Jul 18, 2013
 What's normal
by: Wray

Hi Kris It's best to stick to the same amount of progesterone, so use the 200-300mg/day. Although you should use only one of those amounts, jumping around 100mg/day can cause havoc! It's best to get a measuring spoon, this site sells them here. Or maybe you have one in your kitchen? Health shops also stock them. Let me know how you get on. Take care Wray
Aug 25, 2013
 What's normal
by: Kris

Hi Wray.
I've been sticking to 200 mg of progesterone cream per day. I've used Natpro which I love, but when I went to re-order it was out of stock so I got my prescription from a compound pharmacy. Last month my period came on day 31 and this month day 27. It is a dark red/brown and scant. I'm still under a lot of stress, but running and going to yoga. My biggest complaint is bloating in my stomach and my hips feel bigger. I think I can do better with my diet. I'm confused because I've read women can have too much progesterone from long-time use and have the same symptoms I have. I just turned 53 and wonder if this all seems normal. Thanks!
Aug 26, 2013
 What's normal
by: Wray

Hi Kris I'm so sorry about the stock outs. It's supply and demand, cash flow too, plus an internet scam in which we lost 1000 tubes. We're still recovering from that. I'm so pleased you love the Natpro, when you can get it! Bloating is a problem, it could be from food, oestrogen causes it too, or you don't have enough good bacteria, or you mix your foods. We do have a page on Nutrition you could look through, or try the Ketogenic Diet. There are many Progesterone Misconceptions doing the rounds. I use about 170mg/day, so slightly less than you, and have done for 17 years. Apart from the first 6 months when I knew no better and was using 20mg/day. I've not found any problems, nor do the women I know who've used it for the same length of time. Being under a lot of stress doesn't help either. When stressed I use more, so easily get to 200mg/day and over. Have you considered taking the calming amino acids and vitamins? These do help, see our page on Anxiety for more info. Take care Wray
Feb 01, 2014
 Acne
by: Kris

Hi Wray,
I'm 53 and haven't had a normal period since September. I had a small smount of spotting in November, but nothing since. I use 200 mg of progesterone cream which is either from my compound pharmacy or Natpro. I use the same amount with either. I started getting more acne (not normal for me) and the Natpro seems more difficult to rub in. Could I be using too much progesterone? Also, now that my periods are almost non-existent, is my estrogen decreasing, too?
Thanks much.
Feb 03, 2014
 Acne
by: Joy

Hi Kris

I am puzzled that you find Natpro difficult to rub in, I find the opposite in fact. It only takes a few minutes before it is absorbed. Are you perhaps rubbing it on top of other body cream or moisturiser perhaps? Inserting Natpro in the vagina at night is another good area as it absorbs extremely well, a bit messing in the mornings though.

At 53 you are in Peri-Menopause heading towards Menopause. Generally if monthly periods are missed for 12 months, then that would be considered as being in Menopause. It is a difficult time for women and it is also a time when doctors like to suggest a hysterectomy. Please do not succumb to this, it is not necessary.

Most compounded creams from the pharmacies are mixed with estrogen and testosterone, no women needs to take extra and it could be the reason for your acne. Please stick to using Natpro and the 200mg that you are using daily is a good amount too. A diet high in carbs also contributes to this, if you are eating a lot of sweet things etc please either stop or cut back. Please read Wray's page on Acne it may help you to understand a little more.

No your estrogen is not decreasing you would probably have excess. Please read Estrogen Dominance.

Another very important thing to think about is vitamin D. Do you know what your level is as a deficiency reduces the benefits of progesterone, it is connected to every single cell in our bodies making it vital. Please read this page of vitamin D.

Hope this helps you.
Feb 05, 2014
 Ance
by: Kris

Hi Joy,

Thank you for getting back to me.

I've used Natpro before and loved it because it was so smooth and rubbed in easily. The current tube isn't like that at all. It feels sticky and has a consistency like thick, white paste. I just received it within the last 3 months.

I know I eat more carbs than I should and will cut down, but it isn't different than what I've ever done (probably less) and surely isn't an over abundance.

My vitamin D is 82.

I'll stay on my current dose of Natpro. The reason for using progesterone from a compound pharmacy and Natpro is my NP won't agree to a higher dose which means I substitute with Natpro. I try to take the same mg amount every day.

Thanks much.
Kris

Feb 05, 2014
 Acne
by: Kris

Hi Joy,

Thank you for getting back to me.

I've used Natpro before and loved it because it was so smooth and rubbed in easily. The current tube isn't like that at all. It feels sticky and has a consistency like thick, white paste. I just received it within the last 3 months.

I know I eat more carbs than I should and will cut down, but it isn't different than what I've ever done (probably less) and surely isn't an over abundance.

My vitamin D is 82.

I'll stay on my current dose of Natpro. The reason for using progesterone from a compound pharmacy and Natpro is my NP won't agree to a higher dose which means I substitute with Natpro. I try to take the same mg amount every day.

Thanks much.
Kris

Mar 28, 2014
 What's normal
by: Kris

Hi Wray,
I'm seeing a new physician because of moving to a new city. I'm 53 and recently had the following labs drawn. Would you be so kind as to interpret them? Would I benefit from a saliva test?
I'm still using 200 mg/day of progesterone cream and taking 5,000 IU of Vitamin D. I'm feeling bloated, have gained 6 pounds (mostly around my hips, thighs and abdomen),am waking during the middle of the night and feel like I'm retaining fluid. I have a good diet and exercise a lot!! I was having periods (last was September)and they were becoming more irregular.
I was extremely stressed when we moved in October and have not had a period since.

Vitamin D 56.2 ng/mL
Progesterone 6.2 ng/mL
Triiodothyronine, Free, Serum 2.8 pg/mL
TSH+Free T4 2.120 uIU/mL
T4, Free (Direct) 1.09 ng/dL
FSH (Serum) 25.7 mIU/mL
Estradiol 136.1 pg/mL

Thank you so much!
Apr 03, 2014
 What's normal?
by: Joy

Hi Kris

Wray is on sabbatical and will not be replying to any emails or posts until she returns.

Your vitamin D level is excellent, continue with 5 000iu’s per day. My level is currently 130ng/mL and I still take 5 000iu’s per day, I feel so much better for it.

I can’t see any more info that can be added to what Wray and I have already discussed with you. It is most important that you read the information provided, How to Use Progesterone is so important, if progesterone is not used correctly it will not work. Have you tried to Ketogenic Diet as Wray suggested? Diet as you know, plays such a huge part in one’s health.

Now I can see where things are going wrong for you. Firstly, you are using 200mg of progesterone cream, both Natpro and the compounded cream, but the compounded cream usually does not have the same progesterone concentration as Natpro. It must be 200mg of the correct concentration, otherwise you need to double up on the compounded cream or work out what is needed to equate to Natpro. This is the reason for your weight gain etc, estrogen is still the dominant hormone, and progesterone needs to be.

Secondly, stress. It destroys both progesterone and vitamin D and both need to be increased during stressful times.

As Wray mentioned, peri-menopause is a difficult time for most women, please read the page on this, it will explain so much more to you. The Hormone Testing page will help you to work out your levels.
Apr 25, 2014
 Lab results
by: Kris

Hi Wray or Joy,
As you can see from my previous post, I had labs drawn. I went ahead and did a saliva hormone test not long after and the results are:

Estradiol 1.1 pg/ml
Progesterone. 2375 pg/ml
Ratio. 2159
Testosterone. 47 pg/ml
DHEAS. 4.0 ng/ml
Cortisol AM. 9.2 ng/ml

I'm using 200 mg compound progesterone cream per day.
These test results seem dangerously high. Are they? I'm exercising, eating well, gaining weight, feeling tired, sluggish, and over all ----blah!

My doctor wants me to decrease the amount to 50mg only at night. I don't know what to do.

Thanks,
Kris
May 02, 2014
 Lab Results
by: Joy

Hi Kris

Your problem is the use of compounded creams. Please use the correct progesterone concentration as already explained.

A while back we had a lady writing in with a result of 15,000:1, she was concerned but was feeling wonderful. Please look at the results on our saliva tests page, they are approximately 3 000pg/ml. Results can go as high as 100 000:1 – see Dr Zava’s page.

Please do not use less than 100mg/3ml of the correct progesterone concentration, reducing to 50mg per day with a compounded cream especially, will cause terrible estrogen dominance symptoms. You are suffering already because of the compounded cream, hence your weight gain, feeling tired, sluggish, and over all ----blah symptoms as you described.

Take care.
Nov 03, 2014
 Post menopausal labs
by: Anonymous

Wray,
I haven't had a period in a year, am not sleeping well, feel anxious, teary and experience all negative menopause symptoms. I've recently had labs drawn and they are:

Progesterone 1.3
Estradiol 59.5
FSH 33.3

I'm was using 25mg of compound progesterone and have recently increased to 50 mg. what should I do to feel better. I'm constantly battling menopause problems.

Any help would be so much appreciated.

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