Progesterone and the brain

Insights and discussion from the cutting edge with reference to journal articles and other research papers.
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KatieS
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Re: Progesterone and the brain

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Stavia wrote:Julie, I have just started 25mg at night. I'm trying a lower dose because of the sedation. I plan to cycle 21/rest of the month.

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Thanks Stavia for posting the articles. I had been on the ultra-low dose estradiol for years, then three weeks ago, started the low-dose estradiol patch (0.025) with continuous Prometrium 100mg (the lowest available dose here). Perhaps, it's too early to judge, but my anxiety, recall, musical ability, Sudoku solving, etc...has incredibly improved. I almost feel like Dr. Bredesen's case of the woman with too low progesterone (0.4) especially in relationship to her over 200 estradiol level. My sleep seems deeper. I'll need to review Dr. Brinton's 2009 article again, but progesterone seems to modulate my neurohormones, but now the question is whether to cycle. Do you think Dr Brinton has views as to cycling on progesterone? The higher dose (200mg for the 12-day cycle) would seem to likely to make me feel sluggish the next day.
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Julie G
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Re: Progesterone and the brain

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Katie, I'm so happy to hear about your improvements! :D

Stavia, did you recall that Dr. Hathaway had a protocol for women that were sensitive to oral progesterone? rather than lowering the oral dose, I think she recommended that same oral dose to be used intravaginally. I'm pretty sure that's in her talk with our group... somewhere near the end. That said, how are you feeling on your baby dose?
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Re: Progesterone and the brain

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Julie G wrote:Katie, I'm so happy to hear about your improvements! :D

Stavia, did you recall that Dr. Hathaway had a protocol for women that were sensitive to oral progesterone? rather than lowering the oral dose, I think she recommended that same oral dose to be used intravaginally. I'm pretty sure that's in her talk with our group... somewhere near the end. That said, how are you feeling on your baby dose?
she said that she uses intravaginal progesterone - the same capsules that are taken orally but inserted high vaginally. I would personally be checking at minimum blood levels with such a method to make sure the levels were therapeutic. One still needs uterine-protection and a guess isn't good enough in my book, I'd want proof that the levels were sufficient. In addition, one is using a hormone preparation off licence (route of administration) and the safety of the endometrium hasn't been studied with intravaginal progesterone so any doctor would be best to watch the endometrium with serial ultrasounds, say 6 monthly with this route. In addition t o the blood tests.

As to the cycling - she said that there was no proven exact regime, but she favoured some cycling on and off due to the P4 receptor sensitivity issue - possible (or real?) down-regulation of the P4 receptor with continuous therapy. I don't know if this issue is theoretical and only animal model at this stage or if there is any evidence in humans. Ref 1. Is the only recent one I could find of actual science rather than guesswork and theory. Is this a theory with "appeal to nature" gloss or is it a real consideration in therapy? Hmm... dunno...

Then she said if a woman slept better on progesterone she would prioritise sleep over cycling the progesterone and compromising sleep.

I slept very nicely on the 25mg and possibly feel a teensy bit sedated today, but I've come off super high calories and am fasting. So dunno. I am going to take it for 3 weeks then check a blood level. And see how I feel mentally and emotionaly.


ref 1. https://www.ncbi.nlm.nih.gov/pubmed/22393359
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Re: Progesterone and the brain

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Anyone currently cycling progesterone having trouble with vaginal bleeding? If menopausal with vaginal bleeding, does one move forward with an endometrial biopsy to rule out cancer, or simply increase the progesterone? Tricky....
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KatieS
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Re: Progesterone and the brain

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I had an endometrial biopsy, but the bleeding was found to be due to an endometrial cyst detected on the second ultrasound. Since the cyst removal, I have not had any endometrial lining built-up on ultrasound or bleeding. Upon re-starting a higher dose of estradiol and adding progesterone, the GYN warned that any bleeding would required an immediate biopsy. However at 65, I'm years beyond those peri-menopausal spotting periods.

Stavia, I didn't realize that the 25mg dose was vaginally. :oops:
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Re: Progesterone and the brain

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slacker wrote:Anyone currently cycling progesterone having trouble with vaginal bleeding? If menopausal with vaginal bleeding, does one move forward with an endometrial biopsy to rule out cancer, or simply increase the progesterone? Tricky....
If the endometrial lining in thin on ultrasound, a biopsy isn't necessary.
I recently had a bleed which I think was due to my patch sliding sideways and losing its full adhesion. My scan showed an endometrial thickness of 2mm. Didn't need a biopsy
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Re: Progesterone and the brain

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KatieS wrote:.

Stavia, I didn't realize that the 25mg dose was vaginally. :oops:

nope I ate it. If I tolerate 25mg and I get an OK blood level, that's great. If either = false, I will try vaginally.
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Re: Progesterone and the brain

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slacker wrote: Anyone currently cycling progesterone having trouble with vaginal bleeding? If menopausal with vaginal bleeding, does one move forward with an endometrial biopsy to rule out cancer, or simply increase the progesterone? Tricky....
For around 8 years now I've been cycling 200 mg prometrium for 12-14 days every 3 months (with the .05 vivelle patch) and basically have a regular period at the end of each cycle. I don't tolerate progesterone very well and monthly cycling was just not something I could deal with. Taking into account some family history of breast cancer and E4 status, the functional med doctor I was seeing at the time suggested it as an option for me. (Btw, not suggesting this as a possible protocol for others here; just an approach that has worked for me so far given my own risk factors). Awhile back I did have some spotting in between and had an ultrasound to make sure all was well, and it was, although endometrium was in the higher normal thickness range. My gynecologist said if the spotting continued I should have a biopsy, but I've been fine so far. Because I'm not following a standard protocol for progesterone, I'm doing yearly ultrasounds and hoping I've made the right choice...
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KatieS
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Re: Progesterone and the brain

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Lucy, it sounds like you are developing chronic endometrial lining built-up, which could become dysplastic. Have you had estradiol and progesterone blood levels? I'm wondering if you could decrease the Vivellle patch to 0.0375mg and still keep the Prometrium dose low?
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Re: Progesterone and the brain

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Katie, I agree that's something I need to keep a close eye on. Have labs on Friday and planning another visit with my gyn soon afterwards to discuss and see if I need to consider making some adjustments.
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