Does anyone here take progesterone only

[RoseAddict]

I’m mid 40s and have had perimenopausal symptoms for a few years now. They are getting harder to cope with. I’ve spoken the GP and am getting blood tests done. I think the blood tests are to rule out other problems rather than to prove or disprove that I need HRT. Once the results come back I think I’ll be offered HRT if I want to try it.

From what I’ve read it seems in peri oestrogen fluctuates wildly and progesterone decreases. It seems to me from what I’ve read that my symptoms are mostly from lack of progesterone rather than lack of oestrogen.

On another forum I read about people taking natural progesterone only. I think in some countries you can just buy it as a supplement. Does anyone on mumsnet do this? Why is oestrogen always prescribed here? I’m in the UK so will discuss with the Dr as I’ll need a prescription but just wondered.

Thanks

You are usually prescribed cyclical oestrogen with progestogen preparations here.

Mirena gives you progestogen only where it is needed and you can add oestrogen when you need it.

A lot of peri cycles are anovulatory, so you will have missing periods and build up of lining, and then heavy periods. Progestogen and natural progesterone will help with this. Using it with oestrogen will also give feedback to the hypothalamus to reduce FSH and thus the oestrogen fluctuations but you do need to give it time to settle.

Ok thanks that’s interesting. I don’t get any of the symptoms I used to get of ovulation any more but I do still have regular short cycles and very light short periods. I was under the impression I wasn’t ovulating but still v regular

Currently a 23 day cycle approx with a 2-3 day period. I’ve not missed any.

I used to get loads of periods - I used to track them by taking my temperature every morning to see if I ovulated, but there was no temp rise. Ironically, the only proper cycle I tracked was the one before I started taking MHRT.

I found out that if you do not ovulate so the progesterone part of your cycle is absent, the can lining build up, you get 'oestrogen withdrawal' bleeding when you stop trying to ovulate and the oestrogen drops. This can be a bit bleedier and more painful and it certainly the way it went with me.

If you want mhrt that is like your own hormones, the thing to ask for is utrogestan (or micronised progesterone) and estrogel (flexible dosing) or patches (these give a more even dose). You will need to understand how to use them in case your GP is not used to it - Louise Newson uses this combination a lot www.menopausedoctor.co.uk/

A lot of GPs go for the tablets first because they are simpler to use and prescribe and cheaper.

I'd like to know that too. I have tried hrt 4 times, different type, mode of delivery etc.. during the peri stage and meno and each time, it made me feel worse. Ironically, I've never suffered much from hot flushes, but they are horrendous with oestrogen. I've tried to stick to it, increased the dose, reduced it, and it made no difference. It also got worse the longer I took it. After 4 months, I just gave up and sure enough, no more sweats day or night since I've stopped.

I am convinced that for some women, oestrogen is the problem, not the solution. I am indeed much better since being in the full menopause than I was during the peri phase.

My issue though is sleep and for that progesterone is helping, so I would indeed like to know if I can take it, if so in which form, without the oestrogen.

larabriden.com/what-estrogen-does-perimenopause-how-progesterone-can-help/ this was posted on another thread that got me wondering if progesterone only was what I need. She isn’t a doctor but the site seems fairly credible I think 🤔

No, in the UK @RoseAddict it's very unlikely a dr would prescribe progesterone only as HRT unless it was for something like bleeding between periods, when it's used to sort out early bleeding as a result of no ovulation, but the lining still building up and bleeding.

The link is from a naturopath. That's someone who calls themselves that and has an opinion :)

Meno symptoms are caused by lower estrogen. I know there are sites saying otherwise, but they are usually not mainstream.

If it DID work, meno specialists would a) know and b) give it to women.

Also, if you read the posts here, you will see that in 99.9% of posts, where women are not happy with their HRT regime, it's the progesterone in the 2nd half of the cycle that is the cause of their depression, tiredness, moods, etc.

If you just want the progesterone you could always take the mini pill which is literally just progesterone. The mini pill- like the mirena coil - is often given as part of the progesterone part of HRT (mirena doesn’t need additional progesterone in HRT, the mini pill usually required additional progesterone in the form of utrogestan taken as well). However, generally it’s thought to be important and beneficial to take both oestrogen and progesterone- and even testosterone gel as part of the whole HRT process. (I take the mini pill, oestrogel 4 pumps daily and utrogestan 100mg every night).

@JinglingHellsBells thanks I have been reading through the threads here but a lot of them are short and not a lot of answers. It’s the second half of my cycle that I am struggling with, to the point that I am trying to steer anything stressful at work towards the first half of my cycle if I can.

[quote RoseAddict]@JinglingHellsBells thanks I have been reading through the threads here but a lot of them are short and not a lot of answers. It’s the second half of my cycle that I am struggling with, to the point that I am trying to steer anything stressful at work towards the first half of my cycle if I can.[/quote]
PMS tends to get worse for most women in peri.
You don't need progesterone, but you may feel a lot better on more estrogen which with hrt is used every day and will help balance your cycles more. You can't 'get' just progesterone, as it's prescribed alongside estrogen, unless it's given for bleeding or fertility reasons.

Yes, you can have the mini pill or the Mirena but these are synthetic progestins, not natural micronised progesterone and my in fact give you worse symptoms.

@Bagelsandbrie I’d love to take the mini pill as that would solve my contraceptive issues too but when I looked up the side effects they were all things I have a lot of problems with anyway. My acne is particularly bad and I don’t want to make it worse. So logically knowing that those were the mini pill side effects I would presume that I already have too much progesterone however

1. One of the main arguments in favour of the new body identical hrt is that it doesn’t use the same progesterone that’s in the mini pill and doesn’t therefore have such bad side effects

1. When I looked at graphs of what normal hormones in a normal cycle should do compared with a likely perimenopausal cycle (bigger oestrogen fluctuations, lower progesterone in the luteal phase) it seemed to me that the problem in the second half that I’m experiencing might be due to lower progesterone. But I’m obviously @JinglingHellsBells is right and some women benefit from both.

I’m trying to figure it all out because I’m lucky enough to have a sympathetic GP but he asked me to research what approach I want to take myself. So that’s what I’m doing.

@JinglingHellsBells my last post got interrupted by warring DC so wasn’t that coherent and I hadn’t seen your last post before I posted mine. Thanks anyway. I guess I’ve just got to try it. I’ll ask for the gel and the body identical progesterone

@RoseAddict Bear in mind that from the middle of a cycle, estrogen plummets. It increases from Day 1 and in an average 28-30 day cycle, falls sharply after ovulation round about Day 15, when progesterone kicks in.

The way you feel in the 2nd half of your cycle can be down to low estrogen, not necessarily low progesterone.

I'm not sure where you have read about estrogen fluctuations. I don't think they are as noticeable perhaps as you think.
What happens is that as cycles get further apart, or without any ovulation, FSH rises and this kick starts the ovaries to work harder to try to produce an egg. It's one reason some women find their sex drive increases in peri meno.

When I first started looking at menopause sites on the internet, there was a research place in Canada that came up high on searches, that advocated the use of natural progesterone for menopause, citing higher than expected oestrogen as the reason for on including it. I think this is the source for this way of thinking. However, I have not heard of it being advocated by any doctors in this country, and we have had a lot of good doctors working on the issues around menopause and hrt over the last 10 years or so.

Despite the highs and lows in perimenopause, oestrogen levels are on an overall downward trajectory. So even if progesterone works out for a few months, it it likely oestrogen would have to be added quite soon.

I have always found that hormone medication takes at least 6-12 months before you can be sure that it has settled (unless there is a definite problem with it) and needs to be taken very consistently and at the same time each day.

It is also worth taking a look at diet and exercise at the same time as these also have a strong effect - I found I was deficient in vit D which apparently is not unusual, and have cholesterol problems which I can control with diet. It all seems to come at once.

@Melroses

When I first started looking at menopause sites on the internet, there was a research place in Canada that came up high on searches, that advocated the use of natural progesterone for menopause, citing higher than expected oestrogen as the reason for on including it. I think this is the source for this way of thinking. However, I have not heard of it being advocated by any doctors in this country, and we have had a lot of good doctors working on the issues around menopause and hrt over the last 10 years or so.

Despite the highs and lows in perimenopause, oestrogen levels are on an overall downward trajectory. So even if progesterone works out for a few months, it it likely oestrogen would have to be added quite soon.

I have always found that hormone medication takes at least 6-12 months before you can be sure that it has settled (unless there is a definite problem with it) and needs to be taken very consistently and at the same time each day.

It is also worth taking a look at diet and exercise at the same time as these also have a strong effect - I found I was deficient in vit D which apparently is not unusual, and have cholesterol problems which I can control with diet. It all seems to come at once.

It’s all so confusing. You mention diet to help but how do you know what to eat and what to avoid?

The progesterone issue doesn't really add up because we don't have any for 2 weeks per month anyway and post menopause we have none at all. But women do continue to produce some estrogen all their lives, some of it from fat cells.

So long term it would be a bit weird to keep giving women progesterone and no estrogen.

It’s all so confusing. You mention diet to help but how do you know what to eat and what to avoid?

It is a minefield and forever changing.

Mediterranian diet is a good start - Plenty fresh veg, fish, pulses, enough red meat (or other foods with same nutrients) eggs, nuts (if not allergic) and seeds, wholegrains, err towards fats with more omega 3s and less omega 6 (olive oil and canola oil, not sunflower which is all omega 6).

Save naughty stuff for the ever decreasing treats

I aim to get all my vitamins and minerals in and plenty of fibre and avoid things like white bread cheese toasties that always seem a good idea at the time, but do not make me feel good later.

My naughty stuff list for today includes 4 chocolates and 2 bowls of ice cream. I definitely need to cut down on sugar

@JinglingHellsBells what you’re saying makes sense thank you

Meno symptoms are caused by lower estrogen
For the majority of women but not all. I'm now under the care of a private gynae, who herself is going through the menopause an on hrt. She agreed that she has had a number of patients who actually get much worse during the perri phase than menopause and see all their symptoms get worse on hrt, including oestrogen only.

It is absolutely and certainly the case for me. Very few hot flushes and night sweats, almost non existent once periods stopped, but was plagued with it once starting on hrt. Tried 4 different types, and the same happened each time. Each time I stopped, so did the hot flushes.

Not common, but not totally unheard of either.

I’ve been prescribed Norethisterone as I can’t have oestrogen for hot flushes. Anyone have any experience of this? X

Personally not sure if I agree that women report to be worse on HRT. Though sometimes the dose is incorrect. As with anything it's not the same for every woman. When I didn't take progesterone my mood dipped and my symptoms returned quickly. Now I take it vaginally at night and its much better.

I've done a lot of reading as i didn't think I could have hrt as am still breastfeeding my youngest. (Turns out you can 🙄)

Lara briden describes ups and downs of oestrogen due to the way the cycle becomes more irregular and therefore sometimes not ovulating etc.

She sees the main point of a cycle as ovulation = best health. Overall over time it declines but there's ups and downs on the way. As progesterone is what thins the lining, women in early peri often describe heavy bleeding which is where I think she advocates to try progesterone first, favouring body identical. But essentially this is what the mirena is, which is often given to older women who bleed heavily.

Actually, I know a woman who has just been prescribed progesterone for heavy bleeding; Gp won't prescribe full hrt for some bizarre reason despite the facts she's 45.

The problem is that all women are different and over time the lack of oestrogen can be a big problem for bone, brain and heart health.

I then read the XXbrain by Lisa Misconi, who does recommend hrt, but talks a lot about diet, exercise and some vitamins as well. You can hear her discussing basics with Rupy Anjila on his podcast (fascinating stuff, eg post partum brain shrinkage!!)

So it's very possible that in early peri some women are lacking the progesterone, but it gradually moves on.

@RoseAddict you could try the other things that are suggested by Lara briden for now to support progesterone but it's possible you'll need more. I've read that women take ashwanga for this reason but the body gets used to it and the effect wears off. I used taurine a while ago and found it really helped sleep. Doesn't seem to be so effective now. But stress from work etc is much higher.

Ultimately it's a long game of tinkering with doses and methods and waiting 3 months.

I've just started hrt as I simply can't take the symptoms any more!