Progesterone and blood sugar

[tigertummy]

Hi there, I’m looking for some advice and my GP is clueless (not her fault but she just hasn’t had any training on menopause). I’m on evorel sequi and during my 2 conti weeks my blood sugar is all over the place. Could this be progesterone intolerance or not enough progesterone? I’m on a 50 and a 25 patch and during my first 2 weeks I feel almost normal but the difference in my last 2 weeks is so dramatic. I eat a fairly healthy diet and have small children so I am active. Please help xx

Why do you measure your blood sugar? Are you on insulin/a hypoglycaemic drug?

@radio4everyday I am very aware of how my peri symptoms change as logging them was the only way I could be taken seriously by the doctor that I am in peri as I'm quite young. I don't check my levels but I can see the pattern of symptoms depending on what I've eaten and when

What are the symptoms that you're attributing to changes in blood sugar?

@radio4everyday dizzy, faint, funny eyes, numb arms and legs, low heart rate. Always in a pattern with meal times

After meals? before meals? could be a host of things.
why not try a mirena with oestrogen patch to be more steady over the month?

Mirena gave me horrible vertigo. Before meals low heart rate. 4 hours ish after meals all the other symptoms. It's like a sugar crash without me having eaten much sugar at all

Go and see you GP with the symptoms but without a pre conceived idea of what you think the diagnosis is.

I have and they just say it's anxiety. It's been the same story for over a year now. Every new peri symptom, every time my thyroid meds have needed changing I've had to fight to be taken seriously.

Have you tried body identical progesterone at all? Maybe the progestogen in the coil and patch don't suit you. You can also use body identical vaginally.

When you're on the conti do you wear one conti patch and one 25 patch? Because AFAIK if you are on over a 50 patch your progestogen is supposed to be increased too, are you wearing a 50 and another 50 cut in half diagonally?

@Apileofballyhoo this is the only HRT I've tried. I was only prescribed an additional 25 patch so that's really interesting. Thank you

The British Menopause Society has a few pdf docs on progesterone and progestogens. I'm on Duphaston which is another type because body identical didn't really suit me. Duphaston doesn't either but it's a bit better. I suspect I just need higher oestrogen to balance it but I'm on a high dose already and GP and specialist reluctant to go higher. If you google the menstrual cycle you'll see how your hormones rise and fall and when you feel better or worse. I'm considering the coil now but I'm kind of scared to try it too in case it doesn't suit me either!

Try a different GP in the practice or change practices?

I had a really excessive hunger during pregnancy and when I was on the progesterone only pill. It does sound like a reaction to progesterone. It can settle down on its own but if it doesn’t then maybe it’s as simple as getting the levels in patch decreased? Good luck, I know it can be very exhausting with blood sugar all over the place.

@Apileofballyhoo I know a lot of people who have the coil and have had really positive experiences!

@radio4everyday there's only one meno specialist at my surgery so I may have to find somewhere else. It's just a pain being somewhere different to my kids and moving everyone is a lot of faff.

Thanks @vincettenoir that's good to hear it could be a progesterone thing!

I wouldn't assume it's anything to do with your HRT although I understand how you think there is a connection.

It may not even be your blood sugar.

I'd see your GP for a blood glucose test to make sure you dont have diabetes, and take it from there.

Also as a PP says if you are on a patch of 50 and an additional 25 patch of just estrogen, in theory you need more progestin so it would be be a combined patch of 25 as well for half the cycle.

The symptoms @tigertummy can be related to blood pressure.

When I read your posts I thought you must be using Utrogestan. That lowers BP and is why it's taken at bedtime. It can cause dizziness.

Have you ever had your BP tested?
Do you have a home BP monitor?

It might be worth buying one and comparing your readings in the first half of the cycle and the second.

But to be on the safe side, do think about seeing your gp.

@JinglingSpringbells I had my blood pressure checked this time last month and it was low at that time. It definitely seems to come and go with my progesterone patches. Is low blood pressure a progesterone thing?

I will make an appointment although I'm pretty sure they'll say anxiety as always

It's not a thing linked to the type in patches. Not usually.

I'd get yourself a home BP monitor (amazon or Boots) and try taking your BP once or twice a week to monitor it.

You mention thyroid meds. I've recently been through a host of tests due to odd symptoms, which is also how I ended up on hrt. So one of the big things that came out of it was that I have become very gluten intolerant which is common with Hashimotos. After the doc did a coeliac blood test I trialled gluten free and it was amazing. I had been getting numb patches on my chin, anxiety, constantly dehydrated, dizzy, tiredness, feeling cold and just a general feeling something was wrong and it all went away. The intestinal issues were quite mild in comparison to everything else.

@WeedsAndWildflowers that’a interesting. I went on the Fast 800 for 6 weeks and felt really energised and much better overall. It’s low carb so I wonder if it was actually the lack of gluten that made me feel better. I ate bread a couple of days this week and have been feeling ropey.

I was on Evorel Sequi 50mcg, with a top up 25mcg estrogen only patch, I was happy, but GP won't prescribe that dosage now without additional progesterone.
I have wondered if it's possible to cut the 50mcg patches in half and use 1.5 patches, which would give 75mcg of estrogen and proportional progesterone.

Sorry, hat doesn't answer your blood sugar question though.

@vincettenoir It's worth giving it a go just to see. I've been down the low carb route as well, but now I can eat lots of gluten free carbs and feel great! Sometimes I have a big bowl of rice pudding for breakfast and it's all good, I just get on with my day feeling energised.

Maybe gluten free is the way forwards... I'll try anything at this point

@tigertummy youre honestly just playing a guessing game at present and medically your suggested explanation doesn’t make sense.

You need to get a cgm and wear it for the 2 weeks overlapping one week normal and one week where you believe you’re having blood sugar responses.

Im pretty certain there will be no difference, your blood sugar would need to be extremely out of range to explain your physical symptoms and if it was so out of range it wouldn’t come and go every two weeks.

What is possibly happening is your blood sugar is identical but when your body is exposed to different levels of hormones it causes you to experience different sensations.

Also it’s well known that fluctuating blood sugars (ie in the normal range due to diet) do cause night waking if that’s one of your symptoms.