Progesterone and the brain

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

Post by circular »

Stavia wrote:
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?
[Dr. Hathaway] 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.
I'm just curious if any here have been using the pill vaginally and checking their blood levels, and if so, were your levels in range?
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Julie G
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Re: Progesterone and the brain

Post by Julie G »

Circ, I can't imagine that Dr. Hathaway isn't testing levels. Per her recommendations, my guess is this route yields similar levels. That said, as Stavia pointed out, it's off label usage... but may get the job done without side effects.
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Re: Progesterone and the brain

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Stavia wrote:
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
Not sure what the current "standard of care" is in US for postmenopausal bleeding, but...I've had 2 performed, premenopausal, due to irregular bleeding (approx 1997 and 2009) without US ordered. Just a heads up for those living in US.
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KatieS
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Re: Progesterone and the brain

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In retrospect, I think my biopsy was unnecessary, since the second Gyn discovered the cyst and said the lining was not the problem, doubt she would have biopsied, as she simply removed the cyst. However, since my mom had estrogen-induced endometrial dysplasia, the biopsy (like having an IUD inserted) was reassuring. It there a consensus of ultrasound monitoring if suboptimal progesterone,then biopsy only if endometrial thickness?
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Re: Progesterone and the brain

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That's what we do in my country. But its public health here.

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circular
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Re: Progesterone and the brain

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KatieS wrote:I[s] there a consensus of ultrasound monitoring if suboptimal progesterone,then biopsy only if endometrial thickness?
Hi Katie,

I had an ob/gyn when I first started on BHRT. Since I couldn't take any progesterone at first, and then only a small amount, she monitored my lining and said that if it started to grow all I'd need to do was start taking some progesterone to get it back down :shock: My uterine lining was quite thin, so that might have provided some room for assuming any change would be due to the estradiol without enough progesterone before worrying about something worse? That doesn't really make sense as I think about it, so I'm not sure I'm helping :?
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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KatieS
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Re: Progesterone and the brain

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Cir, how low are going in your progesterone (Prometrium or another)? I sense that these vague headaches are due to the progesterone, so my doctor agreed to up to 10 days off each month, but not 15 like Susan (but she might take the Prometrium 200 mg rather than the lowest dose of 100mg). Also, I think the rat brain benefits of intermittent progesterone might bear out for us.
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SusanJ
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Re: Progesterone and the brain

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Nope, I take 100. I'll be testing in a month to see if this strategy works, and keeps me close to the Hathaway ratio. Otherwise, I might have to try the vaginal approach.
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Re: Progesterone and the brain

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SusanJ wrote:Nope, I take 100. I'll be testing in a month to see if this strategy works, and keeps me close to the Hathaway ratio. Otherwise, I might have to try the vaginal approach.
Oops, you already posted Prometrium 100mg (with the estradiol path of 0.025?). How often do you check blood levels? Apparently your GYN feels comfortable, that as long as you do not have any spotting, you don't need periodic uterine ultrasounds to check lining build-up. Initially, I was told to have the latter annually, but since the last two have been negative, I'm not reminding them.
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Re: Progesterone and the brain

Post by SusanJ »

KatieS wrote:
SusanJ wrote:Nope, I take 100. I'll be testing in a month to see if this strategy works, and keeps me close to the Hathaway ratio. Otherwise, I might have to try the vaginal approach.
Oops, you already posted Prometrium 100mg (with the estradiol path of 0.025?). How often do you check blood levels? Apparently your GYN feels comfortable, that as long as you do not have any spotting, you don't need periodic uterine ultrasounds to check lining build-up. Initially, I was told to have the latter annually, but since the last two have been negative, I'm not reminding them.
Yep, 100 and estradiol at 0.025. I'm checking blood levels every 6 months, and yes, if I'm not spotting, then no ultrasound. Would you recommend a baseline ultrasound? This is all new territory for me because the compounded estrogen I used to use, never really got my levels up to where they are today (from <15 to 50). Since 50 is the low end of Bredesen's recommended range, I feel I can live with that.
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