Dealing With Progesterone Problems In Your HRT Routine: Tips And Tricks

[@heatherhirschMD]

If you had progesterone intolerance, what alternative worked for you? Tell me in the comments along with any other questions

[@sunnysal3889]

Thank you! I am so sick of being told progesterone intolerance is rare or all in my head. I wanted to love prometrium but it gave me every single side effect. I ran back to my 0.35 mg norethindrone mini pill which gives me no side effects at all. I’ve been on it for years and recently had a uterine scan. Thin lining. It works! PS I think I would be dead without my estradiol. I took oral for years. New doctor is insisting on patch and balking at raising the dose. She wants me off because I’m 65. UGH

[@stephaniesteiner6028]

Ugh. Vomiting. Horrible LE swelling, hand sweats. But sleep was AMAZING on MC PG. Went 2 IUD

[@natashabitter9866]

I started having daily acid reflux/gerd/lpr 3-4 months after starting hrt, .1 e patch and 100mg progesterone. Just started Provera last week to rule out progesterone as the culprit. Would norethindrone be better?

[@drsakshisargam]

I hate the effect 200mg microionized progesterone is having on me. It makes me moody, bitchy, anxious, irritable. It just nullifies all the good things that the estradiol patch gives me in the first half of the cycle. It has zero effect on my sleep and I want a form that helps my insomnia. Any suggestions?

[@dechengyalmo09]

@@drsakshisargamin which form are you taking progesterone?

[@lauren1259]

THANK YOU for bringing light to this issue as it is incredibly real and problematic for a subset of women, myself included. Unfortunately, I am in the more severe category. I was diagnosed with PMDD in my 30s and am now 53 and in perimenopause. I’m on the estradiol patch and cycle progesterone cream as tolerated. It still causes side effects, but not near as bad as Prometrium or compounded progesterone did. Ultrasounds have shown my lining is still OK with cream. I hope in the future women have better solutions. Many doctors seem to lack knowledge that this issue exists, so thank you again for giving this topic some much-needed focus.

[@dodiaydell3649]

Is the cream you are using now usp?

[@agnesjuhasz7715]

I am in early perimenopause, and was just prescribed estradiol gel and the same progestin that was used in the WHI study. Went to two other doctors to see if they would have other option, and they all said that this progestin is perfectly safe. It is so confusing- I straight out asked for micronized progesterone, and the doctors looked at me like I was crazy. So here I am, binge watching youtube for the sake of my sanity and health… should be starting the HRT this week, not sure if I should be terrified or relaxed. Tired- yes No sleep- yes Irritability-ohhh yes Libido- let’s just say I am more interested in gardening😮😅

[@user-ho5ht7mu4s]

What is your take on side effects from Prometrium caused by filler ingredients like titanium dioxide USP, D&C Yellow No. 10, FD&C Red No. 40? Would you go to compounding route with cleaner ingredients when you really want to stay with human bioidentical micronized Progesterone for obvious reasons and at the same time want to avoid side effects of toxic fillers and peanut oil?

[@jessicalittle1802]

I love that Prometrium helps me sleep but the next day I am dizzy, lightheaded, low blood pressure, just weak and sick feeling even on 100mg

[@svetlanaanthony2675]

Same here, I was wondering why my blood pressure is so low, now I know. Thanks for sharing!

[@Sadoge99]

Me too 🥺 I am about to throw the towel. BP drops, no energy, lethargic, sad, angry, depressed…

[@svetlanaanthony2675]

I have been using ProgonB-L 4x by Bezwecken to see if a smaller than 100mg Progesterone dose will make me feel better. Bezwecken claims there is 40 mg per 10 drops of topical solution. So far so good, not as tired in the morning. BP doesn't plummet anymore. The downside of course is not knowing if you are getting the same dose daily.

[@kaitcaputo8514]

@@svetlanaanthony2675 I made the switch to Bezwecken as well and I'm still experiencing all of the symptoms above. :(

[@ozglasscat]

I'm also glad that this being addressed a bit more. People who don't have it don't get it and it's laughable to me how many HRT Dr.s simply lie and say it's not a thing and they've never heard of it. What I would like to know more about is - what if you had this sensitivity to your own progesterone your entire cycling life? That's me and the women I've spoked to who have the most reaction to P with hrt also seemed to have the worst pmdd/pms as well. I've tried P in every dose, form and delivery and it's all the same. I was intolerant to any synthetic p in the pill and it's disappointing that the only alternatives are progestins, which to me aren't worth any of the risks, even if they are slight. I would never stop taking estradiol no matter what and push through cycling p as often as I can. The last alternative is a hysterectomy which I have known some women to do to never have to deal with p again and may consider it myself.

[@dodiaydell3649]

I read an article saying what you just said about women that are intolerant, have been sensitive to it all their lives, meaning their own progesterone that was produced. Progesterone wakes up, estrogen receptors, so I’m wondering if it’s not really the progesterone that causes the intolerance and the symptoms, but maybe making one estrogen dominant? I’ve done so much research on this trying to find a way around it. I’ve tried using less, I’ve tried using more, same symptoms. Also, you will need progesterone, along with your estrogen, for other reasons than the uterus, you need it for the thyroid to convert to T3, VERY IMPORTANT AS WELL , and estrogen dominance is just not good for anything, not just affecting the uterus,make sense? So I think sticking to as much as you can tolerate is your best bet, that’s what I do also, and just try to stick to a low-dose of estrogen .

[@SPower-yl9ww]

Agree with you. I reduced oral progesterone from 100mg to 50mg. May consider further reduction to 25mg. Hopefully thats enough to offset 80mg transderrmal Estradiol. ​@dodiaydell3649

[@annemarieedwards68]

This was very informative. One of the best I've seen on progesterone intolerance. I have just one question. How is it that if you use prometrium vaginally, it goes systemic, but if you have a mirena inserted, it does not go systemic?

[@athenachloewoodrow6356]

The mirena does go systemic, just creates lower blood levels than standard birth control pills

[@Agoodeyestyle]

Yes! My former gyne acted like no one else had issues with progesterone and switched me to bio identicals which didn’t work either. So glad to know I have other options. These were never discussed before

[@ymuc129]

The Gyno that I was seeing did the same thing to me. Notice I said the Gyno "I was seeing".

[@alisonmacfarlane9895]

Thank you for taking the discussion on progesterone intolerance a bit further than I’ve seen before. I’m 59 and have tried Prometrium, Mirena, Tibolone, Norethisterone and currently 10 days in to trying Slinda. I’m now getting a painful bleed on Slinda. I feel like I’m being difficult and I just want to get off the roundabout and not see a doctor ever again. I will persevere for a few more weeks with Slinda as Ihave no other adverse effects from it. I’m tired of pain (have had a clear Propel biopsy). I’d happily agree to have the useless uterus and it’s friends removed so that I can get on with living my life😂

[@serizer9]

@@alisonmacfarlane9895 look up Carol Petersen. She discusses that p intolerance could be from under dosing. She increases the dose until those symptoms go away. If that doesn’t work she looks at yeast overgrowth and blood glucose levels.

[@nicolewisniewski4045]

I’ve had issues with so many progesterones from constipation to bleeding. Last one was the 100mg and caused severe allergic reaction of swollen and itchy hands and feet. I got tested for peanut, soy and gelatin allergies and nothing. So now I have a very small estrogen patch and we’re going to try vaginal ultrasounds every so often or a potential synthetic progesterone every three months for a few days to see if that can work. But the estrogen patch is so helpful for my hot flashes and sleep so I’d hate to lose it due to progesterone problems. I’m nearing menopause and in late peri going now 4 months without a period fyi.

[@Authentistic-ism]

Do I really need to be post menopausal? I'm in peri. I already have a Mirena IUD, and asked for estradiol patches to go with it to smooth the perimenopause ride. The NP prescribing said I could keep using this combo as long as my body allows the IUD to be replaced on schedule.

[@janicewaite9144]

Thank you. This was an extremely helpful video. I loved the multiple options and explanation of the side effects.

[@jessicalittle1802]

Iud was a nightmare for me. 4 months of headaches, bleeding, tiredness, blah until I had the Dr take it out. Aygestin gives me no side effects

[@brianne571]

I did the 100mg micronized one for menopause hrt, and its extremely sedating and droggy. Stopped it couldnt drive. I will say i never been more calm in my entire life, the few days i took it. Even after surgery on drugs lol i wasnt that calm.

[@secilys]

I love it. I cycle it 20 days on and 10 days off. I can tell with my sleep and anxiety when I don't take it for those 10 days

[@user-qw8no5bl5m]

@@secilys Does this cause a period? Trying to avoid… Regarding cycle, which time of the cycle is the 20 days (ie start of new cycle?)

[@debbiethompsongasaway2982]

I had a severe intolerance and tried to take progesterone in many forms and dosages and just could not do it. Also tried estradiol patch. Symptoms got worse. I tried for many years and just take basic supplements and vagifem 3x a week and alternating days a pea size of estradiol cream externally it has helped me tremendously! No side effects and my sleep has improved so much!

[@nancyelmon4544]

What kind of supplements did you take can you please share. Thanks

[@debbiethompsongasaway2982]

@@nancyelmon4544I am on Nordic naturals omega algae, vitamin C chewable, theracurcumin, vitamin D3, alive 50+ multivitamin, osteo biflex, and probiotic from Target ( UP brand)

[@agg23-p7r]

The mirena an iud was a nightmare for me. So was the maxim, visanne and the mini pill ( a progesterone only) daily pills. I had to take them to control my endometriosis but the medicine was so much worse than the problem. I’m not perimenopausal yet, but it gives me hope to know I have other options for when I will need them!

[@sherryw.1466]

Just started estradiol and 100mg of progesterone about 2-3 weeks ago. I feel wonderful!!! However, within 48 hours my tinnitus went from mild and intermittent to severe and constant. I have messaged my gynecologist and I’m waiting for her answer. Sleeping like a baby for the first time in years and less urinating, but the tinnitus is definitely aggravated by one of those hormones.

[@athenachloewoodrow6356]

I started with a couple cycles of estrogen only which had only positive effects. Once I introduced prometrium my tinnitus revved up in a very obvious way. Dizziness, slowed gut, sore breasts , achy joints, and low energy too. Kind of makes sense, since these are the symptoms I've always had the week leading up to my cycle. It does help some people sleep. I've talked to women who have the same effects using the mirena IUD, so there doesn't seem to be a silver bullet for everyone, just have to talk to a specialist and trial different stuff until the positives outweigh the negatives. I'm happy for those who have positive effects from progesterone

[@sherryw.1466]

I chose to not replace my patch. It’s been 24 hours and I don’t notice my tinnitus lessening. I’ll see what happens when I quit the prometrium. I hate that there always has to be a compromise, but I guess that’s life. Thanks for your comment.

[@athenachloewoodrow6356]

Yeah, so sorry, it is a bummer when there isn't just a straightforward answer. We are all so different in how we respond to hormones. I also have endometriosis, so then there's this whole other layer. But don't lose heart, and if you can swing it do try to talk to a menopause specialist and try a few different things before you give up. Going from oral to vaginal improved some symptoms for me. Taking it at a lower dose continuously versus sequential solved some issues. You might get to the point where you can deal with the side effects because overall you're better than before you started 🤞 I'm hoping we eventually have more options. I just know in terms of overall health going forward, I'm convinced that HRT is the best route for me

[@mglarson5936]

I had the same thing happen. Tinnutis was intermittent now it's constant. I've tried stopping everything and restarting and it seems like the tinnitus is sticking with me.

[@sherryw.1466]

⁠@@mglarson5936so sorry to hear that. I think that might be the case for me too. I’ve read a lot of articles about hormone changes and tinnitus, so clearly there’s a correlation. My gynecologist thought it was crazy and asked if I thought I should see an ENT. I saw an ENT when I first developed tinnitus a year ago. He even did an mri. They say don’t use google and be your own doctor, but if I can read research on the internet on medical topics, how do doctors not know about this research? Surely they are required to do continuing education for their field of medicine.

[@kathyblake1275]

100 mg of progesterone at night. I’m using estradiol patch and estradiol vaginal cream. Had a DNC due to bleeding. What a journey. I’m 69 years old.

[@arandomchick7510]

I’m doing nearly this exact regimen at 51 and it has been so helpful. I only take the progesterone for 12 days per month.

[@user-qw8no5bl5m]

@@arandomchick7510 I would like to know more about the 12 days per month. Is this continuous or every other night? Does it spark a period, trying to avoid that …

[@russellmania4542]

Alot of friends n family have had hysterectomy and use estradiol patch but dont have to take progesterone and do AMAZING. So we as women should have the choice to have a hysterectomy at perimenopause so we can just use estradiol patch and call it good. I cant get anymore dizzy or low bloodpressure or feel faint. Just give us a hysterectomy so no need for progesterone and just give estradiol and call it good.

[@drsakshisargam]

You nailed it my dear

[@debir4111]

Speaking as a GYN RN who had a hysterectomy. My pelvic floor has been damaged from the surgery. I have pain nearly every day since 2013 when I had my uterus removed. I had 2 years of internal pelvic floor therapy and it did get better, but I wish I’d never gone that route.

[@diplomatgirl171]

How many days a month would you need to take the prometrium to protect the uterine lining, just the last 12 days of the month or last 15 days?

[@drsakshisargam]

12 days is the minimum. Day 15 to 26 of the cycle.

[@LA14185844]

I have been using combipatch for 2.5 months. Many symptoms have improved, but I have tiredness and dizziness and weight gain and swollen feet. Will I adjust to this? Has it not been enough time? So many symptoms are better, so much less body pain, rare hot flashes, no reflux, dry eye improving, better eyesight. I’m just tired of being tired and do not need to gain weight. I was surprised I could tolerate hrt because I couldn’t tolerate birth control pills. I was thinking of trying the bio identical hrt from the holistic doctors that the cream is made at a compounding pharmacy and you put the cream on your forearm daily composed of estrogen, progesterone, and testosterone. Supposed to have no side effects and all the benefits of hrt, but I do not know as much about the bio identical treatment.

[@athenachloewoodrow6356]

The problem with compounding pharmacies is they are not regulated by the FDA, so you don't know for sure what's in them, they tend to use higher concentrations of other estrogens besides estradiol (like estriol and estrone), and there's no guarantee that they absorb well through your skin. They have done studies that showed that the progesterone creams definitely are not being absorbed sufficiently to protect your uterine lining. This is why menopause specialists recommend FDA approved prescriptions. If it's estradiol and micronized progesterone, that is in fact body identical

[@SybilSheltonFord]

One more question: if I want to take progesterone cyclically, do I need to double my dose for those 12-14 days?

[@athenachloewoodrow6356]

The standard dose is either 200 mg for 12 to 14 days, or 100 mg continuously (and that's if you're not on a super high estrogen dose).

[@sallychappell5644]

Im a year into menopause and ive been taking 1 micronised progesterone at night and 75mcg squirt of oestrogel. My gp told me to take progesterone for 25 days then take a 3 day break. I was suffering from severe flushes and night sweats every 2 to 3 hours. Since starting hrt my flushes havent been as intense but are still disruptive at night. Yesterday night i didn't take progesterone and had best nights sleep no sweats no anxiety and very little flushing and i felt like me again today. Do you think i need to lower my progestrone or increase oestrogel? Im confused.

[@jessicalittle1802]

Thank you for this. This is for me

[@smurfette6499]

Very helpful, thank you

[@teriholvey5048]

When I started taking HRT, the LPR reflux that began at menopause kicked up significantly. I've recently seen people say this can be from progesterone. It relaxes the LES, allowing stomach acid to come into the esophagus, but in my case, it's the upper esophagus, affecting the larynx and pharynx ( where the LPR comes from in my diagnosis). I hate being on Omeprazole as it has side effects of its own, and my digestion has suffered with my stomach contents being too alkaline. I'm wondering if using the prometrium vaginally could help. I also think I might be part of the progesterone intolerance group. I was irritable before HRT, but once I started, depression set in, and the anxiety that menopause brought increased significantly. It does make me sleepy, but I've still got insomnia, though some of that is just my hips and back hurting sleeping on my side. I'm on 200 mg of P and 0.1 if estradiol, so I'm wondering if I could get by with 100 mg of P. Ugh. It's all so messed up! Still trying to get my estradiol up (was 29 a month ago before upping the patch), but just trying to find balance. I miss my energetic, joyful self. 😢 Thanks for the video. It's given me a lot to research and think about!

[@rachelteeuws1241]

It took about 6 weeks for my body to get used to micronised progesterone. Made me feel groggy of a morning but fine now.

[@cherrylanemonroe1082]

I just started last Thursday and I do feel groggy and tired . I was hoping someone would say that it goes away or that it gets better. THX!

[@lisalamberton6486]

I tried Compounded progesterone 50mg pills and had horrible mood swings and anxiety, especially when e levels are low

[@mdaze9753]

Taking progesterone vaginally every other night was a game changer. I am post menopausal and am on a relatively low dose of estrogen patch.

[@user-qw8no5bl5m]

Please share dosage and type of progesterone and method vaginally?

[@workhardplayharderx2]

Same - 100mg of Micronized Progesterone every other night vag. My patch is only .25 and I change it twice a week.

[@user-qw8no5bl5m]

@@workhardplayharderx2 thank you

[@dodiaydell3649]

Is there a certain kind to use that way?

[@workhardplayharderx2]

@@dodiaydell3649 mine is just the oval type shape of micronized progesterone that you typically are prescribed for oral.

[@gypsylvia]

Like many women, I didn’t tolerate p at all (gave me severe anxiety) until my e was high enough

[@drsakshisargam]

Really? 200 mg P is giving me a lot of psychological side effects. Estradiol patch is 0.5.......whats your dosage if you don't mind sharing please 😢

[@gypsylvia]

It was when I was on injections - high dosing - also p was better tolerated when I was on 2 .075 patches

[@drsakshisargam]

@@gypsylvia thank you

[@ebonyh9832]

Working through it now. Dr. Hertel ( The Collaborative Team-hoot hoot!) has me taking 100mg Progesterone nightly orally. I have had some spotting and feeling a little sluggish in the mornings but seems to be getting better.

[@pamw3238]

I had severe side affects from it so went very slow....one 100mg every 3rd day for a while then every 2nd day for a while and gradually my body got used to it every night.

[@GodsChild-128]

Please share more! I would love to know what your side effects from progesterone were! I can only barely tolerate it vaginally 50mg the last 5-10 days of my cycle which isn’t enough for uterine protection (46perimeno). 100mg was just too much after 3 days in a row. I considered doing alternate days continuous vs cycling the last 12 days of cycle. Curious how severe your sensitivity was. I can’t even put it on my skin. Severe low mood, apathy, intrusive thoughts, migrain with aura. It’s toxic. But I have often Wondered if I just go very low And slow, and maybe alternate days could I ever get used to it?

[@pamw3238]

@@GodsChild-128 I also had severe mood issues, crying lots, terrible anxiety....and I am a very Happy person! I tried the iud and that was actually worse. To be honest I think when I first started oral progesterone I was so low on estrogen that it took over. Once my estrogen became higher due to my dosing I was able to slowly tolerate progesterone. I have since had my uterus removed as we couldn't get the bleeding under control which I attribute to progesterone. Feel sooo much better now without it but I did adjust to it...just took time

[@KellyJarvis-cn6fb]

I have the same problem. I'm like a zombie on it. Super sedating. I had genetic testing done and it showed that I have a variant that my liver does not metabolize medications very fast, therefore medication takes longer to go out of my system. I wonder if I space out my dosage to every other day, it will help?

[@pamw3238]

@@KellyJarvis-cn6fb I have done every 2nd day and tolerated better...my gynecologist said that's fine

[@GodsChild-128]

@@KellyJarvis-cn6fbtry 50mg with a dash of vaginal estradiol cream, vaginal. I have grown to like it the last 10-12 days of my cycle vaginally. Also, check for low ferritin! I discovered I was iron deficient and also got on testosterone a few months ago. And getting iron levels up and T levels up…I am no longer progesterone intolerant. I could probably even do 100mg vaginally…but I’m doing so well on 50mg, if it ain’t broke don’t fix it. I’m on P right now, and love it.

[@tinamariemartusus5665]

I couldn't tolerate 100 mg so had 50 mg compounded and only needed to take is one week per month. Even that was a struggle for a while. I found I tolerated it better if I drank more water with it in the evening. I did find that the longer I took it the more I started to tolerate it but still on a low dose. Later on I tried to go up to 75mg and it was like starting all over with side effects. It also puts me to sleep but then I wake up after midnight and have difficulty falling back asleep. The compounding pharmacy recommended doing extended release so we ordered that and they suggested I stay on it daily vs. cycling it so my body didn't have to readjust each month. For now my doctor is fine with have me stay at 50mg.

[@r-anne7375]

I'm a nice person, but not while taking progesterone, just like I used to be before my monthly period. I really hated everyone ! I used to say to my friends that I have no right to be with anyone during this time of the month. Now in menopause for 6 yr's, I went off my estrogen0.05/progesterone(100mg) almost 3 months ago and Its' weird because I'm sleeping better! I have a few hot flashes but nothing too bothersome. I did try the Combi patch but made me extremely dizzy. I think I'm fine doing nothing for now ?

[@kb4640]

Maybe it was the estrogen. I put on a patch and thought id end up inpatient psych.

[@tonyalewis3806]

Thank you!

[@damecuchifrita1321]

Im 52, 16 months after my last period, my perimenopause was about 6 years , mostly insomnia, terrible migraines ( passed out and injured head on a sidewalk after 9 days of migraines) , gained 10 lbs, havents slept more than average of 5 hrs per night for the last 6 years . Im on prometrium, and estradiol patch . its been 8 days , i slept like a baby and dreamt vivid dreams . So far i love it , minor nausea and slight cramping . A lil bloating . 200 mg every night . My question, if i stop after 12 days, will I bleed? So far i think i love it !

[@serizer9]

Yes you will

[@arandomchick7510]

I only take it 12 days per month and I do not bleed when I stop. I’m 51 and this is my 4th month taking progesterone. Last cycle was March 2024.

[@athenachloewoodrow6356]

Since you are fully menopausal, you could also take 100 mg continuously and see how you feel. Some people prefer the lower dose, they get fewer side effects, and doing it continuously mitigates ups and downs. And if at some point you have breakthrough bleeding, they often will up the progesterone dose, or have you go back to sequential. It's really helpful to have an actual chat with a menopause specialist and have a game plan for all the things you can safely try

[@r-anne7375]

Yes you will bleed. Its like having your monthly period again.

[@cherrylanemonroe1082]

@@arandomchick7510 hi, my last period was in June. I just started estrogen patch and progesterone, but my doctor didn't say anything about stopping the progesterone. Do we have to stop it on our periods? Like, if I get my period again will I have to stop taking the Progesterone?? I am clueless and so confused now. THX

[@isipags6567]

I couldn’t take 200 mg of progesterone at bedtime. I would wake up feeling tired, nauseous and dizzy. I started taking 100 mg at night and 100 mg in the morning. This fixed my problem.

[@jessicalittle1802]

I can't even take the 100mg

[@sunnysal3889]

@@jessicalittle1802 Same. I switched to Norethindrone, like the Doctor talked about. No side effects.

[@dodiaydell3649]

@@jessicalittle1802me either !

[@dodiaydell3649]

@@sunnysal3889 so you switched from the bioidentical, to the synthetic? I’ve always been afraid of that because of them saying it was harmful for a while, but has research changed that you know?

[@sunnysal3889]

@@dodiaydell3649 Yes. I take the 0.35mg norethindrone mini-pill she talked about. The risks are still minimal. And I have horrible hot flashes without estradiol. So I have to take something to protect my uterus. My doctor approves.

[@ibop9514]

I have Progesterone intolerance and the worst. This month I tried Norathindron. I was supposed to take for 10 days. After 6 days I felt so bad, I had to stop. What about Progesterone Cream? 🙏

[@heatherhirschMD]

Progesterone cream is NOT safe because it does not readily absorb though the skin. It's also why its better tolerated (you are not really getting anything)

[@SarahFieldsenpointe]

@@heatherhirschMD I still notice side effects when I take even 30 mg progesterone cream-grogginess, low physical & mental energy (probably low bp, at least it feels like it but I haven’t thought before to check). Worse when I take the 100 mg pill. A naturopath allowed me to try 50 mg and then 25 mg of oral progesterone & I still had these symptoms with the 50 mg pill. Only the 25mg gave me no symptoms. After 2 years of .1 - .3 daily estrogen cream & a nightly 25 mg progesterone pill, an ultrasound of my uterine lining showed it’s normal (they didn’t tell me the measurement). Is it possible that I just need less progesterone? Thank you!! 🙏🏻🙏🏻🙏🏻

[@malindalee1]

​​@@heatherhirschMDWhich is better Norethindrone or Levonorgestrel? I took low ogestrel birth control for years with no problem. It has norgestrel, so which would be closer to that one? The oral progesterone has me so afraid to take because of side effects I prev had.

[@malindalee1]

​@@SarahFieldsenpointe I wonder that myself. My progesterone was always naturally low so maybe this is just too much for me.

[@consulttheskywithtracyq]

I just started HRT 8 days ago- weekly estrogen patch, twice weekly vaginal cream and daily progesterone. About 4 days into the therapy my moods started to drastically shift, very emotional and highly reactive, until day 6 when I started crying and have been crying off and on for 3 days, plus anxiety, racing thoughts and depressive moments. Would this be considered medium to severe, and is there any chance I'll get past it if I stick with the therapy? Thanks for all the information.

[@jolandascot6937]

Hi Heather, I’ve been on Prometrium for the last 4 months with my Estradiol. It’s like day and night. I now sleep -deep- through the night [after 15 years of insomnia ] I feel great and instead of putting on weight, I feel my general muscle tone has improved. My breast have become slightly bigger and denser. My specialist and I are keeping an eye on this. All in all I am over the moon with the change in myself [mind] and my body. I have a quick question for you though. My breast do feel very tender and bit painful of a morning when I get out of bed. Is this normal, will this clear up or should I adjust the medication. Im on estradiol 75 2 x per week with 100mg Progesteron gelcap at night. Many thanks for all your guidance and advice. Videos are sooo helpful! Grateful, Jo Scott x

[@dodiaydell3649]

So are you on the Prometrium right now, or the gel you spoke of? Kind of confused thanks.!

[@daphnee-souffledor]

Wath about over the counter "usp progesterone" creams like "Emerita Pro-Gest Cream" could that be a safe way to get 40 to 80 mg daily enough to protect uterus lining ? thank you.

[@workhardplayharderx2]

I asked my menopause specialist this since I do GREAT with the ProGest cream and she told me NO it will not protect the uterus if you are taking estrogen.

[@daphnee-souffledor]

@@workhardplayharderx2 Thank you :-) , that's to bad... I wonder what if whe used the cream with applicator vaginally ?,,I will do some research...

[@triciab2354]

@@workhardplayharderx2 right, I've read the topical progesterone is not protective of the uterus due to the size of the molecule...you can't get enough to absorb to be protective.

[@emilyv5366]

I have endometriosis and diagnosis of PMDD. While pregnant prometrium for first three months was great. Now in peri and have Mirena which causes major mood problems and it seems my endo lesion under my right ribs is getting worse. I am on Estradiol and wondering if I should also take low dose prometrium for Endo lesions outside the uterus, since I have more pain now and since everyone says the Mirena is not systemic. Please advise. My obgyn doesn't seem to know

[@athenachloewoodrow6356]

Pain in that area can also indicate gallbladder issues, which can definitely be exacerbated by both estrogen and progesterone. I had a major gallbladder attack after starting continuous prometrium, never had that before. Now I have to maintain a lower fat diet, not eat too much at one time, continue with hi fiber, and I add things like ginger and magnesium to keep motility happening. I also have endometriosis, but this particular problem didn't start until I initiated HRT

[@monachetty5040]

How would you advise taking 200mg of progesterone. If it makes you feel tired and drowsy in the morning after taking it at night. I see in the comment advising on dosing 100mg in morning and 100mg in evening.

[@mollasima3251]

If you use prometrium vaginally, then it won't have the first pass effect of being metabolized by the liver - which causes only 20% of it to be absorbed. Since that is the case, would it be wise to reduce the dose of the progesterone since more of it will be absorbed? Because there is not first pass thru the liver?

[@farrahgoff557]

What about inserting it rectally? Vaginally gave me a yeast infection.

[@athenachloewoodrow6356]

They have done studies on this that you can find online, blood levels from vaginal and rectal are very similar and can be double the oral dose because it does not get processed through the digestive tract. Other menopause specialists like Dr Louise Newsom in England talk about this in terms of vaginal administration. Vaginal administration also has the benefit of uterine first pass effect, so even though the blood level will be similar to rectal and greater than oral, the endometrial progesterone levels are much higher because it gets absorbed right through the cervix. I have done it rectally and I definitely feel the same whole body effects as I do from vaginal administration. Also, if I'm taking it vaginally and I start to feel a little off in terms of my vaginal flora, I switch back to rectal, and a boric acid vaginal suppository takes care of it before it becomes anything full blown. I was grateful to my gynecologist for that tip, it's nice to be able to easily and immediately self-treat and not have to constantly take antibiotics. But, it has worked for me because I don't wait until I have something full-blown, and even if I don't have anything going on, my gynecologist was fine with me using one suppository a week just to keep everything balanced. I also notice that it has a cleaning out effect, any of the undissolved capsules or remnants of the creams and capsules come out with the boric acid. But unlike douches and soaps, it supports the acid environment of your vagina and therefore the flora benefits. I also use vaginal estrogen cream several times a week

[@kkr5595]

Those IUD's wouldn't help with histamine issues of using estrogens for post menopause would it?

[@cynthiaphillips9373]

Taking oral microniozed progesterone, 100mg for 5 weeks and instead of helping me sleep, it has the opposite efect. My sleep is worse! When i take a day off the pill, i sleep so much better! Any suggestions? Should i take it every other day? Will it provide the same uterine benefots? (Note- i also take 0.05mg estradiol patch 2x per week and 4mg testosterone cream daily)

[@athenachloewoodrow6356]

I had the same problem trying to take it orally, I felt awful and sleep was terrible. I take it vaginally and rectally, and it does seem to help me with sleep, maybe because the blood levels are higher, I don't know. Our bodies are so different

[@workhardplayharderx2]

@@athenachloewoodrow6356 SAME - I could not take oral, after 100mg I was up for two straight nights, it had opposite effect on me, then my menopuase specialist said "you need more" so she told me to take 200mg the next night - OMG why don't I listen to my body instead of doctors?! Epic fail. Info. online directed me to vag or rectal and I can now tolerate it. I only use every other night. My patch is only .25 and I change it twice a week.

[@triciab2354]

same with the worse sleep, I wish this was talked about more as a side effect... my provider wouldn't approve it be used via other methods vs. oral so I just gave it up altogether.

[@drsakshisargam]

It made my sleep worse too.

[@sallychappell5644]

Me too, im on 100 p and o.75 e and i sleep a lot lighter since taking them .Yesterday i stopped the p and had best sleep ever and felt great and all other symptoms reduced drastically.My gp wants me to leave p off from day 25 for 3 days. Not sure what to do tbh . Ill see how day 2 goes p free .

[@jbicondoa]

Is there a thing such as estrogen dominance? Does it mean the progesterone is too low for the Estrogen?

[@karenjensen6774]

200 mg of Progesterone and it’s so great! Only positive for me. Take at bedtime. Generic prometrium

[@heatherhirschMD]

wonderful!

[@madeleine83]

I am so jealous 😊but Glad for you .

[@Katepwe]

Progesterone was the only thing that helped me with sleep but lately I’ve had sore, heavy, swollen breasts. I really need to sleep, what other choice do I have?

[@antonellamasella2300]

Can prometrium taken by mouth at night cause headaches

[@dominikatanianis7132]

that's what I'm trying to figure out too. I've had a continuous tension headache for a month now.

[@marondijkslag]

Hi, I’m from Europe and the knowledge on progesteron intolerance is not so good unfortunately 😢 I tried bio-identical progesteron in different doses & different ways (oral, vaginally), but I really couldnt handle the depression (200 mg) or the extreme bleedings (100 mg). I also tried Duphaston and Primolut, but I get really depressed from it. I also suffered from PMS after my pregnancies and it feels like that, but even more extreme. Now I will try Mirena and hopefully that works for me. I know that also Mirena can cause problems for some women, I just hope I’m not one of them. Alsobtaking oestrogel 3 pumps a day, which really helps me. It’s the progesteron that is not working for me 😢

[@CMonsteronutube]

Good luck. Mirena worked well for me when other progesterone and progestins made me very mentally unwell.

[@marondijkslag]

@@CMonsteronutube thanks! Three days in now and it feels ok 🤞

[@GodsChild-128]

Please keep us updated on your experience with Merina! I hear such mixed reviews. It would be my choice if I thought it would resolve P Intolerance 😢

[@CMonsteronutube]

Oral MP... totally sedated. Vag MP 2 types, experienced dark intrusive thoughts , nearly cost me my marriage, maybe my life. Synthetic progestin in patch , not quite as bad but still felt very negative mood. For me the changing dose or off/on cyclical dosing of Mp/progestin was even worse than the static stable dose. I felt I was losing my mind. And soooo much bleeding, I didn't exercise for 2 years. Now have Mirena and I am a new person. Fortunately I can tolerate Mirena insertion as an outpatient with mild painkillers and a lot of meditation practice to relax. Only problem now is that my GP says no more Mirena or HRT after 60. So 4 years to go to find another doctor. Sigh. Would you continue Mirenas into 60's? 70's?

[@sunnysal3889]

@@CMonsteronutube The arbitrary cutoff of 60 or 65 is such a lie!

[@GodsChild-128]

Thank you for this! I have had ALL your negative experimece with P, but scared to try the merina for initial pain, but mostly being stuck with all the symptoms you spoke of unless pulled.

[@natashabitter9866]

Any suggestions for onset of daily acid reflux/gerd/lpr 3-4 months after starting HRT?

[@teriholvey5048]

This is my problem, too. Menopause brought LPR (upper esophagus reflux) into my life. I got it under control with digestive enzymes with betaine HCl in them. But when I began HRT, it kicked up and I had to start taking a PPI, which has side effects of its own. My GI doc said HRT can relax the lower esophageal sphincter, causing the acid to be able to come up. I'm now learning this could be due to progesterone, so I'm wondering if another delivery method (rectal or vaginal) might fix that issue. Being on the PPI has slowed my digestion down so much that I'm constipated all the time. Miserable. I've never had reflux in my life, even after tearing my esophagus in 2007. So this was one of many bizarre symptoms that menopause brought. I chased them for 3 years, but only recently found, through Dr. Haver's The New Menopause, that they can ALL be tied to low estrogen. 😢

[@Stevielynnofficial]

I took 100 mg of micronkzed and it gave me awful side effects!! Like taking steroids!!! I was super anxious 😢didn’t sleep for days and was really moody and angry! I’m scared to try even a lower dose now.

[@Karikk72]

The first 8 weeks on it and I was super anxious. Helped me sleep but so anxious. It still makes me nervous and anxious and I am considering stopping it. I don’t have a uterus so I don’t have to be on it. 100mg. They told me it would help with anxiety but I find that I am shaky and nervous till about mid day after taking it at bedtime 😢

[@jennybadl7840]

Mirena is know in France to increase the risk of meningiome.

[@robinlawson3574]

Not true. I just read the study and it shows that other oral progestins can cause them, but IUDs do not.

[@whiteemic]

I struggled with nearly constant tremors, swollen hands, numbness in hands/forearms, and shaky/wobbly legs while walking on progesterone for 5 months. I have since tried vaginally for 1 month with not much change. We tried 2 weeks off and my symptoms nearly vanished. But we need to protect the uterus since I’m on .05 estradiol patch. We are trying norethindrone acetate (I’m trying the morning) and i have felt good during the day but the tremors have crept back in which is really hard at night. I had an ablation so i am not a candidate for the Mirena. I can try using a smaller compounded amount to see if with smaller doses i can start tolerating it. My patch dose might need to decrease. 😢 I need to ask about Duavee. Or go completely off HRT but I’m scared to do that. I can also consider a hysterectomy but I’d like to try these other options first.

[@madeleine83]

On Prometrium causes Bloating and acne for me , still sticking with it though .

[@sunnysal3889]

Same but I also had all the other side effects. I switched to norethindrone.

[@drsakshisargam]

​@@sunnysal3889how are you doing on norethindrone?

[@sward0606]

Love it!!!!!

[@TameraShoemaker]

Trialing vaginal route … experienced the water retention and bloating, so uncomfortable!! The frustration is that I’m having to figure this all out even with a “menopause specialist”. I have a prescriber but the knowledge, not so much.

[@leoniehenderson547]

I went back to a progestin. Prometrium gives me mega constipation despite adequate water and fibre.

[@agnesjuhasz7715]

Which progestin are you on? I am just starting HRT, and have been prescribed Provera, the medroxyprogesterone acetate…

[@leoniehenderson547]

@@agnesjuhasz7715 Primolut which is noriesthistone.

[@tonyalewis3806]

How long can the Mirena IUD be left in for menopause?

[@athenachloewoodrow6356]

I think in the US menopause specialists are now okay with the IUD being used for 6 to 7 years. And one specialist said that that may even be extended to 10 years at some point in the future because they are seeing good endometrial suppression

[@we4utube2]

I’m on 100mg of progesterone for sleep (which has stopped working) and I’ve noticed constipation. I have ulcerative colitis so I may need to come off it and I’ll discuss with my NP next week.

[@yanetladron6736]

I have the Mirena and i put estradiol spray, i feel pretty good now, i hate progesterone

[@ripps999p]

I am perimenopausal and experience severe depression on days 14 to 28 of my cycle after taking prometrium

[@feminineheart]

Me too, along with extreme moodiness and irritation, anxiety.

[@dd-fy2mh]

M​e too ! Im on combined pill and wondering what ti do next

[@heatherhirschMD]

Interesting - could be the progesterone - try going without out it for 1 -2 cycles and see if that goes away (tell your doctor and this is okay to do)

[@drsakshisargam]

I m in the exact same boat

[@drsakshisargam]

​@@heatherhirschMDthanks Heather! This is what I wanted to hear from you. I want to be off microionized progesterone. It is making me a rage full person to say the leastl. Estradiol patch is a godsend for me.

[@dodiaydell3649]

I definitely have intolerance to progesterone, I take .5 mg of estrogen by injection, which I think is a low-dose correct me if I’m wrong, so I just tried to take as much progesterone as I can, which is not a lot, after a few nights of it, I start to feel the negative effects, severe bloating, irritability, and just overall not feeling well. If I knew the synthetic form was not dangerous I would try it, but not sure on that, any suggestions?

[@kristiethompson7185]

I must be the odd ball. Progesterone gave me anxiety, kept me up all night with crazy thoughts going through my head and I just did not feel well at all. Sometimes the next morning my chest felt tight. Started on 200mg pill went to 100mg pill then 50mg cream then all the way down to 25mg cream still had same side effects. Had to stop my estradiol patches which I love because they stopped my hot flashes and made me feel normal again but I could not take progesterone so I had to stop it all😢

[@drsakshisargam]

I get absolutely the same side effects on 200mg oral microionized progesterone that I took in the second half of the cycle. I love how estradiol made me feel normal again. I will never quit that but I m making up my mind to get the uterus out to get rid of Pr forever. It makes me extremely anxious, irritated, moody, no effect on sleep at all. I still have insomnia. So you are not alone my dear.

[@hollypaladino2651]

Hi. You are not the odd ball. I had the same experience with oral progesterone. I want to be on HRT and spoke with my doctor. I currently take 200 vaginally at bed time and I have no bad reaction to it. I think because it skips the gut I am able to tolerate it. Ask your doctor for vaginal progesterone

[@drsakshisargam]

@@hollypaladino2651 are you using the same capsule vaginally or is it a different preparation?

[@kristiethompson7185]

@@hollypaladino2651thanks for the information

[@kristiethompson7185]

@@drsakshisargamI wish my uterus was gone so I could just use my estradiol patches.

[@MNP208]

I was only prescribed 100 mg prometrium nightly. No problems.

[@marimiranda999]

Is progesterone always prescribed with estrogen if your levels are high? My progesterone was high but estrogen very low

[@ericaaldin6611]

I cannot take more than 100mg. Not sure if it is having any positive effects, but more than 100mg gives me severe breast tenderness.

[@mmags]

What about skin hives-like angry eruptions? Just started HRT at 57.

[@athenachloewoodrow6356]

Unfortunately, I have experienced the same thing with micronized progesterone. I get intermittent hives on my neck, and now perioral dermatitis on my face. Some women have these effects during the high progesterone times in their cycle, and some are downright allergic to it. Progesterone slows gut motility, and can have a loosening effect on connective tissue/ joints, so I guess I can see how it might affect skin as well. So weird

[@mmags]

@@athenachloewoodrow6356 thank you for your feedback. Sorry you go through the reaction. Have you tried other methods of administration aka vaginally? I’m waiting to hear from my endocrinologist who is my hormone doctor.

[@sunnysal3889]

@@mmags Progesterone caused cystic acne on my back.

[@jennybadl7840]

I do have huge side effects of progesterone. I take now dydrogestérone (I'm not sure it is available in US). I have to cut the (small) tablet in 8 and take it only twice a week. If I take more or more often, my bowel movement stops. Even twice a week, I have to take a laxative the day after because of the slowing effect. I also have to drink a strong coffee not to be sleepy all day long. I had to stopped my oestrogens cream for one month because of this very poor tolerance of progesterone. I feel stuck.

[@serizer9]

She speaks of alternatives in this video. Also Carol Petersen suggests increasing progesterone (increasing until symptoms subside) for those who have intolerance.

[@robynm2037]

i was fine with 100mg progesterone orally but at 200 mg, i had painful abdominal bloating, inability to pass gas, constipation and diarrhea. switching to vaginal delivery resolved the symptoms.

[@junebug9348]

So I can use the norethindrine pill I take orally, vaginally?? I have severe side effects usually for a day or 2 but just live through them. I take it the 1-12 monthly.

[@athenachloewoodrow6356]

I think it's just the micronized progesterone capsules that you can use vaginally

[@sunnysal3889]

@@junebug9348 There is more than one dose of norethindrone. I take the 0.35 mg mini pill. And I take it daily to minimize fluctuations. It is unnecessary to have a monthly bleed even if perimenopausal.

[@Karikk72]

Been on micronized 100mg for two months. I don’t have a uterus but they told me it would help me sleep and help anxiety. First six weeks were awful. Nervous and anxious till mid day after taking it at bedtime. Helps me sleep a bit better after about six weeks but the anxious and nervous energy is bad. Can I just stop taking it or do I have to wean off of it? How do I wean off ? Ugh !! Makes my face tingle too . I take it and a few minutes later my face gets tingly 😢

[@athenachloewoodrow6356]

You are not required to take it since you don't have a uterus. But it sounds like they were giving it to you for sleep? Have you tried just using estrogen for a while to see how your sleep and mood are? I wish I could do that, my doctor had me do estrogen alone for a couple cycles before introducing progesterone, I felt great and slept like a baby

[@Karikk72]

@@athenachloewoodrow6356 they thought it might help with sleep and my menopause induced anxiety. But I think it has made my anxiety worse. I started estrogen at 0.025mg then 0.0375mg and now on 0.05mg. Menopause is not nice to me 😅it’s a beast !!!

[@ymuc129]

I get the tingle in my left upper thigh area, and it's painful...

[@Karikk72]

@@ymuc129 ugh all these symptoms

[@bucketlistdestinations4228]

Anyone use their Progesterone rectally instead? If so, how does this route reduce symptoms? I'm on the Estradiol Patch . 75 and Micronized Progesterone 100 mg ORALLY at night. Suddenly DEPRESSED, Dizzy, NO motivation and bloated terribly. Anyone find relief with rectal route??

[@athenachloewoodrow6356]

I tried it both vaginally and rectally. In a lot of ways it was an improvement, but I still got a lot of symptoms because it produces much higher blood levels of progesterone. Orals are processed through the liver so you end up with secondary metabolites that cause some symptoms for people. Some menopause specialists in England are okay doing the non-oral routes every other night because it essentially doubles your dose. Also doing it vaginally has an extra benefit because of the uterine first pass effect

[@susan97701]

I take Prometrium in the evening and it helps me sleep.

[@caracorson2709]

Is constipation a side effect of progesterone?

[@serizer9]

For me I get constipation if I use it rectally but not if orally

[@athenachloewoodrow6356]

If you look it up online you'll see that progesterone is known to slow gut motility, so yes it can worsen constipation. Super important to have a high fiber diet, drink water, exercise. I found that I also had to start adding daily psyllium and ginger, with intermittent magnesium supplements just to get back to my baseline. Never had issues before starting prometrium

[@LesIsMoreTube]

Is a Mirena IUD (with progestin) a good way to get uterus protection during HT?

[@mistywilson6961]

Yes it is

[@Unbound1117]

Started HRT 4 months ago and mammogram shows dense breast this year. Is this normal?

[@Katepwe]

Yes

[@kimw5533]

Did not tolerate 100 mg at all. Could not even stand during the day I was so dizzy. (I had a doctor even tell me this was not normal. A “he”.) tried the combi patch. A pesky polyp developed in my uterus - which lead to a biopsy, D&C, hysterscope - and a progesterone IUD & I apply an estrogen patch. ☺️

[@karenlopez5441]

Just started progesterone 100mg at night and getting very dizzy, like drunk feeling 30 min after taking it. Also a little dizzy during the day where Im wobbly walking/standing. I can’t tolerate this. Does it get better!?

[@kims5476]

how are you feeling now with the iud and estrogen patch?

[@jacquelinefoote8081]

What are they called in the uk?

[@sunnysal3889]

@@jacquelinefoote8081 Progesterone = Utrogestan. Norethindrone = norethisterone I learned these on the Menopause Matters forum, which is out of the UK. So much good information on that website.

[@trishemerald2487]

I get my progesterone via my Mirena. Then oral premarin.

[@trishemerald2487]

Yay! You got to it!

[@SybilSheltonFord]

So for taking the progesterone vaginally, does that mean that you simply place the pill that you are prescribed to take orally and insert it vaginally? And if you take it vaginally, is it every day or every other day? I am on 100 mg of progesterone

[@athenachloewoodrow6356]

Yes, the capsule will dissolve. Best to do it at night while you're lying down and get it as far back in the vagina as possible so it can be absorbed through the cervix. Different menopause specialists have differing views on dose, most in the US want you to take the same daily dose as you would with an oral regimen, some in the UK are okay with every other night because research has shown that vaginal absorption can be more than double oral, and there is a vaginal first pass effect where the endometrium absorbs a much greater amount via the cervix.

[@SybilSheltonFord]

@@athenachloewoodrow6356 wow, thanks!!!

[@jean6460]

❤

[@elizabethbauer9017]

Oral progesterone makes me go bonkers!

[@marquettagunderson8820]

Do u need progesterone if you r using estradiol vaginal cream

[@athenachloewoodrow6356]

No, only if you're taking estrogen systemically

[@kristinl9583]

I bleed on progesterone which is really hard

[@rachelabate2401]

I just got prescribed hrt meds. It's an estrogen patch with progesterone. I read online about progesterone side effects like double vision and buldging eyes. The cure for my menopause symptoms seems worse than menopause itself. Im a little afraid to start the meds.

[@priscillaboatman5682]

Can you speak on progesterone along with Estrogen and dense breasts. Please. I have a breast that has become dense.

[@bestme9341]

My naturopath prescribed me Progonb L4x .I started taking it,I get migraine auras frequently and have dizziness.Has anyone tried this.

[@meganbaldwin1699]

I started progesterone in March. My itchy skin symptoms are gone but I’ve been barricaded in my house since. I am not the same person I was a year ago. I cant stand it!!! Could it be this progesterone pill?? 100mg from the pharmacy. This is all so confusing. 🥲