Progesterone replacement: When, why, and how to use progesterone at menopause.

PART II: Progesterone replacement: When, why, and how to use progesterone at menopause // Last week's video discussed the nuts and bolts of progesterone, and in this week's video I am breaking down exactly why (and who) needs to take progesterone, the benefits of progesterone, and my preferred types of progesterone replacement in perimenopause and at menopause. Be sure to tune in to be sure that your progesterone regimen is going to help you thrive (not just survive) the menopause transition!
#Progesterone #menopause #heatherhirschMD
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• Progesterone replaceme...

[@heatherhirschMD]

Do you find progesterone to be helpful or to cause side effects? Let me know in the comments below.

[@shawunminor1761]

I haven’t started the medication yet because I thought that mirena iud and depo shots are all associated with progesterone so I was like what’s the point

[@cold_spring_ranch]

I personally have been taking prometrium progesterone since I wa 36. Because my periods were really heavy I was always tired had bad hot flashes right before my period happened. I would wake up drenched in sweat. Not anymore. I personally have lost 12 pounds. Since starting it. My period is back to normal and predicted sex is not painful anymore. I had a hard time getting pregnant in my 20s and I feel that I had to have had low progesterone then. My period stopped completely. I stopped ovulating. I had to take meds to get my body working again. I have had a crazy reproductive history.

[@katebruno9255]

Thank you so much for sharing your valuable knowledge. I’ve had periods every 2 weeks for about 18months now. My functional Med doc gave oral progresterone to help offset high estrogen. Unfortunately that hasn’t helped yet and I’m still bleeding just as often. Not sure what to do next.

[@katebruno9255]

Ps - it’s been incredibly helpful with sleep for me, but she told me to stop taking it when I start bleeding which means I only end up getting to take it 2 weeks out of the month (basically every other week since I’m bleeding on the other 2 weeks)….I would love to use continuously but she hasn’t offered that option yet

[@Dandelion_flight]

@1:59 Why does someone who takes vaginal estrogen not take any progesterone? Doesn't estrogen cause the womb lining to thicken and the thickening of cells can lead to uterine cancer and the vaginal estrogen is literally at the door of the womb. That vaginal estrogen does not travel up to the uterus?? It does not make sense to me. Can you please clarify? x

[@R.N.LosAngeles]

I take estradiol and progesterone together. I don’t have a uterus and was having terrible insomnia. I feel fine. I slept almost 10 hours for the first time in years and lost 6 lbs of water weight in the first week

[@lolasen1206]

What dose combination are you using for both?

[@sousousousou940]

do you use to suffer from insomnia just for some days in the month or the whole month. please answer thank you

[@anagabriellat8281]

I read Suzanne Somers book on progesterone, and transdermal micronized progesterone changed my life for the better in perimenopause. Sleep definitely improves. I find it baffling recommending the Mirena. That IUD wrecked havoc in my system in so many ways, and once I removed it I was able to feel normal again. I definitely prefer bioidentical hormones going through my skin. It is more gentle and I can adjust depending on how I feel.

[@kellymallory9007]

How much do you take

[@anagabriellat8281]

@@kellymallory9007 when I started, I tried my hardest to measure the amount. I started with the smallest measurement. I suggest Dr. John Lee’s book on progesterone. Once I started noticing the changes, I became more comfortable with it, and just followed the guidelines. I believe is one week off during menses.

[@GiGi-fd6om]

For women in late peri-menopause who are presumably low in progesterone, but still cycling regularly, would taking oral 100 mg progesterone be beneficial in the first 12 days of bleeding or the 12 days right after ovulation? Thank you.

[@hayleysmith5077]

53 premenopausal still getting anticonceptional, in my actual case getting also estradiol gel I had to add progesterone pill and equate both hormones to cancel anxiety symptoms for me bioidentical progesterone was a great idea, I am asstested constantly from a serious dedicated doctor Thanks for sharing doctor blessings ❤

[@Hollowmoon007]

There is an estrogen ring that stays inserted. How come there isn’t a progesterone ring if the vaginal progesterone technique works?🤔

[@brandonkaylasmommy]

Compounded progesterone alone is suppose to help with joint pain, weight gain, etc. is it not? I’m 51 with a uterus and peri menopause. TNx

[@nancyadams9598]

My doctor put me on 100 mg prometrium nightly because my uterine lining was 7 mm. Was supposed to stay on that 6 months and repeat. You don't mention using it for that reason (without using estrogen). Is that what I should be using? I see another doctor later this month. Love your videos, book, and all the info! Thanks!

[@goddessoracles4730]

I was taking continuous progesterone 100mg with estrogen successfully until 3 months ago when l became very anxious and insomnia came back. Now trying to figure out what doses my body needs.

[@giuseppinasanger6410]

Me too…worked for insomnia for the first few months and I was so happy. Now, not so much:-(

[@bigbankyb]

Does taking cream progesterone, suppress natural production, as it does with men and supplement testosterone ? ❤

[@adriapeet3943]

Im 41yrs old and I was prescribed 100mg of prometrium daily cyclically about a month ago and has really helped my symptoms (anxiety, insomnia, bloating,headaches). I feel like I need it in the morning AND at night eventhough my doc told me take it just before bed. I would like to take 100mg in the morning (to help with anxiety) and 200mg (to help more with sleep)at night. Is that too much?

[@AdelaideAndLulu]

I'm estrogen dominant. Starting prometrium 100mg before bed cyclically reduced my symptoms to almost gone. After about 6 months we upped the dose to 200mg and I felt like my problems were fixed. During the pandemic I switched to an OTC progesterone cream, just to see how I would feel without the prometrium. I'm still doing that. It's been helpful but not as good as taking the prometrium. I also started "seed cycling" when I switched to the cream, and do notice a difference if I forget to eat the seeds. My point is, you don't need it twice a day. You may want to try upping the dose for a month or two and see if that helps. I was good on 100mg but not 100% and eventually started getting hormonal cystic acne. Going up to 200mg brought me back to feeling normal again. You can take it whenever you want, it's just suggested to take at night because it "can" make you drowsy. But it's not an instant relief spot treatment for symptoms. You have to go through a monthly hormonal cycle or two to see results. It's a process.

[@louisefraser5328]

Do you give any advie on testosterone treatment for women in peri or menopause?

[@karenlayton6162]

I am post menopausal and on a .1 mg estradiol patch. I have a uterus. First on 200 mg micronized progesterone at night. Break through bleeding. Sleepiness and weight gain. Had a hysterscopy. No cancer or other issues seen. Dr changed me to 5 mg medroxyprogesterone. Horrible bleeding, breast hurt, anxiety and general bad mood. Changed back to micronized because dr will not do iud. I see many people asking if they can use the micronized vaginally and you have not responded. would it be more effective if used that way? Especially for us who seem to have adverse reactions to progesterone and progestins? And my NAMS doctor does not want to do an iud.

[@onewomansjourney760]

I've been told yes, you can use the oral micronized progesterone vaginally.

[@hea7055]

Yes I'd like her to do a video on using it vaginally too. Many women use it this way.

[@ritapaine7752]

Upped mine to 10 mg works great

[@FortheHealthofit.]

Please get licensed in Georgia! 😊

[@pamw3238]

I began using it and slept amazing then about a month in it caused very bad insomnia, unable to sleep at all. It also made me very moody. Do you have any information why it would work great for a while then opposite after a month? Thank you

[@hea7055]

That happened to me too. Using it vaginally reduced these symptoms down.

[@MH-yh8rz]

That happened to me too!

[@sukrijazvizdic]

in perimenopause can i take only progesteron without estrogen?

[@mtntm5628]

After going from a one mg. Estradiol pill to a compounded cream and then a patch, I developed bloating. Both my doctor and compounding pharmacist said I needed the balance of progesterone. It seems to help but it’s not mentioned here. I’m a little confused and wondering if I’m experiencing a placebo effect.

[@Aki-wq6xh]

I recently started HRT with both. Continuous. Dyhydrogestin I learned that I cannot continue with my current dose of Thyroxine and melatonin! I MUST reduce my thyroxine without crazy heart palpitations during the day and I cannot wake up at all if I continue with melatonin…. I may just experiment with a lower dose of those but I guess this is a good thing. Because clearly the lack of estrogen/ progesterone was causing the symptoms that made me need the thyroxine and melatonin in the first place. Hormones are SO powerful. More so than any drugs supplement and placebo…

[@leahahowe]

Hi! Just curious that you said if taking cyclically, to be do so on days 1-12. My understanding is it’s meant to be taken day 12-28 ish and not during menses. I’m curious if the rationale for days 1-12! Thank you!

[@hea7055]

I was thinking that too. I've been told to use it on days 15-26. To mimick my own body's progesterone cycle.

[@oddlilbird]

What if your cycle is no longer regular? I’m so confused😩

[@beatacz7662]

Hello Dr Hirsch! I would like to now your opinion about natural progesterone cream like progonol cream , thank u

[@larajohnson8174]

Can I take oral progesterone for insomnia if I have a Mirena? (Also have Estradot patch)

[@heatherhirschMD]

Yes you absolutely can

[@pb9905]

why is there no talk about slow released progrestrone?

[@surfnyolly]

Thank you for part II! I’m 44 and spot after my period ends, I had DCIS, so I can only take progesterone. My GYN has me on a 10-day 3 month cycle of 200mg progesterone - but I’m confused on what it’s supposed to do. Stop the spotting or like you said, I’ll still spot, but it will be more predicable? This month I’m way less anxious due to your Part I. Thank you!

[@jimluvweng]

Dr, I am about to start on oral progesterone 100 mg prior to starting estrogen as my doctor wants to see if i would have any adverse effects from it. I have developed anxiety years ago which I believe is due to perimenopause, now I am menopausal at 51. After listening here I am afraid that it could worsen my anxiety 😟

[@hea7055]

You could ask your doctor about using it vaginally instead of orally, if using it orally causes anxiety. Many women report it's more tolerable vaginally, if they get side effects by taking it orally.

[@denisep6450]

Is taking 200mg progesterone 12 days every 3 months going to protect uterus? Patch is 0.06 estrogen

[@Patricia-cd3sr]

When I attempt to taper off progesterone cream I unfortunately, experience tachycardia,become diaphoretic and experience severe insomnia. Any advice on how to slowly taper off? I read this may be something related to adrenal fatigue.

[@ceeceenocap]

Why would you want to taper off if it’s giving you all of those benefits?

[@user-xs9835]

I take 1.1mg of estrogen(patch) and 200mg of micronized progesteron vaginally.Do you think this ratio is good for me?

[@kellymallory9007]

What dose of cream do you use if someone does not want the oral ?

[@kellygmann]

Do you ever recommend a patient use the oral micronized capsules (Prometrium) vaginally or rectally to avoid side effects?

[@ILfarmgirl1970]

Or topical? I have been opening the capsules and applying to inner thighs.

[@onewomansjourney760]

​@@ILfarmgirl1970 great idea!!

[@MS-sr1fe]

I use vaginally

[@hea7055]

@@ILfarmgirl1970 apparently it isn't effective in protecting the womb when using it transdermally.

[@johannabernardy5923]

I was on .50 estradiol and 300mg progesterone. Was feeling amazing then all of a sudden horrible breast tenderness. Dropped estradiol to .25 then 200 progesterone and still unbearable breast tenderness. I’m thinking of dropping to 100 progesterone as maybe that’s why I’m having tenderness. So weird how I was doing well and now not. Otherwise feeling fine but not sleeping as well

[@marlarangeloff5163]

Im on 2mg of estradiol oral and 100 mg prometrium. Is that a good ratio for menopause?

[@gilliandowney5225]

How you know is your symptoms are gone.

[@amy-dj3jx]

Hi Doctor Hirsch and thank you for all of your videos. I just started on a.025 mg estradiol patch and 200 mg continuous micronized progesterone. Do you think the progesterone dosage is too high?

[@R.N.LosAngeles]

I’m not a doc, but I have a 0.05mg estradiol patch and 100mg progesterone every night and I feel pretty good. I don’t have a uterus

[@ceeceenocap]

Usually folks try 100 mg first, you might ask your doc to lower your dose to see how it goes. I was on 100 mg for a couple years and just upped to 200 when symptoms started creeping back. All fixed!

[@Nellie7777777]

Does day 1-12 mean the day you start your period is day 1?

[@nicolerogers5859]

I am post menopausal with a uterus. I have tired prometrium capsules and also compounded P cream…. They have both really wound me up…. Insomnia, anxiety, and I can not relax…. I always feel like I cud run a marathon! What are my other options? I was offered a progestin, Provera, but my goal is to use progesterone not a synthetic progestin. Any suggestions of progesterone options I can talk to my doctor abt.? Thanks

[@onewomansjourney760]

Maybe compounded cream instead, not as strong as oral capsule.

[@hea7055]

You could try using the capsules vaginally instead or orally. Many women find this works better for reducing side effects.

[@workhardplayharderx2]

@nicolerogers5859 did you find your answer? I am currently go through this.

[@nicolerogers5859]

@@workhardplayharderx2 I started pellets (testosterone and estrogen ), now I can take progesterone without the “hyped up effect” but I don’t get any relaxation or sleep Improvement either

[@workhardplayharderx2]

@@nicolerogers5859 Darn!! And my doctor will not put me on any testosterone until we get this figured out. For now I'm not going to take the progesterone for a couple nights so I can try to get some sleep. Unsure of the plan. I don't think she prescribes pellets

[@shawunminor1761]

Hello Dr I had an ovary removed 2 years ago and the Dr told me that my other ovary would compensate the loss of the other ovary after having an iud I ended up having a panic attack which led to anxiety and a lot of other symptoms starting to believe I am in perimenopause

[@heatherhirschMD]

Yes this could be true, so long as progesterone is helping with that then that is good!

[@denisep6450]

Oops you just answered in the vid...no My doc has ordered it every three months ugh

[@angelagreen2167]

I'm on northindrone and still having issues due to uterine fibroids. Do you have any suggestions to stop fibroids from bleeding?

[@angelagreen2167]

Also, my doctor has me take one in the morning and one in the evening and I'm extremely tired all the time.

[@heatherhirschMD]

Have you discussed an IUD?

[@angelagreen2167]

@@heatherhirschMD We have but I'm not sure if I'm comfortable with it.

[@angelagreen2167]

Do you think it would be better than trying another medication?

[@sharonbrown9721]

Hi Dr. Hirsch, Thanks for the information. I don't have a uterus, I had a hysterectomy. I do have a patch with and without progesterone. I find progesterone helps me with anxiety and sleep but too much I find makes me too emotional. Is it ok to rotate once a week with a estrogen only patch and a estrogen plus a progesterone patch. Is this ok? Will this impact anything?

[@r-anne7375]

Yes, it definitely helps with sleep, but I have to say that I wouldn't take it if it wasn't helping to protect my uterus because of the bloating it causes. My Gynecologist will not do the Mirena IUD so I take a separate 100 mg capsule.

[@heatherhirschMD]

Sorry to hear he/she wont do the IUD. maybe see if there is a NAMS doc near you who would do it on menopause.org

[@lisabrinton2614]

I found that using Progesterone keeps my hot flashes at bay.

[@heatherhirschMD]

For some people yes I absolutely can that’s great!

[@cold_spring_ranch]

Helps me.too

[@chastity5214]

If I had a hysterectomy and oophorectomy, do I need progesterone?

[@funtimefranky]

I had the same and am just starting progesterone. Many docs say you don’t need it but others argue that you do. When you consider that how the body uses it, it seems odd not to take it. Progesterone isn't just for pregnancy. This hormone is crucial during all stages of life. Skin that is dewy, youthful, and glowing is largely thanks to progesterone, which regulates sebum production and reduces inflammation.

[@chastity5214]

@@funtimefranky Idk what to do anymore😥 I hate that I had my ovaries taken out. This dr replied to me on another vlog saying I dont need progesterone, so Idk

[@funtimefranky]

@@chastity5214 There are women that swear by it. I’m staring it tonight.

[@stormyweather2807]

@@funtimefranky can I ask how you've done on the progesterone? I had a hysterectomy years ago, and wonder if the progesterone would help with my insomnia. Appreciate any input.

[@funtimefranky]

@@stormyweather2807Hi there! So strange as I literally just started taking it (I put it off again until speaking to my consultant). I will let you know how I get on. Progesterone is used by many parts of the body, no-one is disputing that but when I ask doctors that say women who have had hysterectomies don’t need it, why this is the case considering the many benefits related to it, none of them have been able to answer. I think the small risks linked to progesterone overshadow its benefits.

[@shawunminor1761]

Oh I have been prescribed progesterone 100 mg but I’m not on estrogen medication

[@ceeceenocap]

Sure wish they made 150 mg!

[@patricianoll1229]

I slept 3.5 hours for two years, now good or not i bought progesteron cream

[@surfnyolly]

Thank you for part II! I’m 44 and spot after my period ends, I had DCIS, so I can only take progesterone. My GYN has me on a 10-day 3 month cycle of 200mg progesterone - but I’m confused on what it’s supposed to do. Stop the spotting or like you said, I’ll still spot, but it will be more predicable? This month I’m way less anxious due to your Part I. Thank you!