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Post by Karen on Jul 13, 2010 19:22:56 GMT -5
The regulars around here know that I'm into more natural approaches to getting a handle on endo. I've recently started on a prescription dose of bio-identical progesterone. Let's use this thread as a central place to share info about bio-identical hormones and our experiences.
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Post by Karen on Jul 13, 2010 19:36:25 GMT -5
I had been using progesterone cream monthly for several months with mixed results. I've also been temping my cycles to see the effects of progesterone on my cycle. Some months I used the cream from the end of my period until the start of my next period (lower dose from period - ovulation, higher dose from ovulation to period as was suggested for women with endo to keep estrogen in check). Other times, I'd just use it from ovulation to my period (as is suggested for women under normal circumstances). Only once did it lengthen my luteal phase (length between ovluation and period). Most months, it was 7-8 days, which is really, low, but one time I was able to get it up to 12 days on the cream. Because I wasn't seeing drastic results and had a hunch I still wasn't getting enough progesterone based on my luteal phase, I decided to find a doc that knew hormones. And I found one!
A few months ago, I started on 100 mg prometrium orally. 21 days on, 7 days off. When my period came, I was supposed to go off again for 7 days. I was on progesterone cream at the time and started prometrium mid-cycle. It took me forever to ovulate and I ended up having an 87 day cycle! Hey, I'm not complaining, though... My luteal phase jumped to 13 days, which was an indication that I was getting more progesterone! Best part? My daily nagging pain was GONE with a few minor exceptions here and there when I was on it. (When I was off it, I had some cramps that kind of sucked.) My doc did a blood draw after I had ovulated to check my hormone levels - estrogen was kind of low and my progesterone was now up in the normal/near high range on the prometrium.
But, I started having some spotting and my hands were a bit tingly - not bad or anything, just noticeable - so my doc switched me to a compounded formula. The compounded formula doesn't have any other additives, artificial colors, etc. that prometrium does. She also lowered my dose to see if my spotting would go away, thought it might be a slightly higher dose than I needed. So she dropped me down to 75 mg/day orally. Within 2 days the spotting stopped (don't know if that was coincidence or not).
So far, so good! It's really thrown off my cycles, though they were never really regular to begin with. I've read that progesterone suppresses your luetinizing hormone. Anyway, it's raised my basal body temp by a few tenths of a degree so it's a bit harder to tell if I ovulated or not now. But, the impact it's had on my pain has been great! I've gotten a much better control of pain in the last year with diet changes and supplements and physical therapy, but this seems to be what my body needs. I'm looking forward to monitoring it and seeing how much better things can get in the long run!
I also talked to her about my lack of a sex drive, so she put my on 2 mg of testosterone cream. I can tell my face gets a bit flushed after I use it, but so far, no real change there.
then down to 75 mg compounded orally.
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Post by Karen on Jul 13, 2010 19:37:53 GMT -5
Oh, and my cortisol/DHEA levels were low, so I'm on supplementation for that. Why is that significant? DHEA is a precursor for the sex hormones (progesterone, testosterone, and estrogen)!
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Post by Karen on Jul 13, 2010 19:44:51 GMT -5
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Post by redwood on Jul 14, 2010 9:40:48 GMT -5
Thanks for the info Karen! So your compounded progesterone is oral. That's interesting as I wouldn't have thought they compounded oral progesterone (I would have though it would be a cream or gel). I found a Dr. that will prescribe bio-identical hormones (compounded or otherwise). I just did a search on the internet and found someone local. Here's the list I found for drs. in the USA and various states: biomimetic-hormones.com/bioidentical-doctors/ He's not a gyn, but internal medicine, but will test hormone levels and supports the use of bio-identical hormones. There was about 17 pages of info I needed to fill out before the appt! I have an appt. tomorrow morning with him, so we shall see what he recommends for me. I'll update my experience with this on here.
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Post by Karen on Jul 14, 2010 12:33:50 GMT -5
Yeah, I assumed I was getting a cream, too, and was surprised it was pill form!
Good luck with your appointment! If you're going to see results, I'd guess it'd be if you're using a proper dose based on your current levels. I look forward to hearing about you experience! Oh, and my doc is a family practice with a specialty in women's health, also not a gyn!
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Post by redwood on Jul 22, 2010 9:03:28 GMT -5
So I got my results back from the blood test (earlier than I thought)and saw my dr. yesterday. I have slightly high estrogen and slightly low progesterone but not anything extreme. I am also protein deficient and am not absorbing protein well. Additionally he had toxicity tests done and said that I have slightly elevated levels of mercury and petrochemicals (like from plastic). I have avoided plastic for the past 5 years, but it seems I still have that in my system. I'm not sure if it's from before or if I'm still exposed to it somewhere. Of course, I can't avoid ALL plastic as some foods come in plastic containers.
He has put me on a de-tox regimen which is fairly different. For instance, every morning, I empty a capsule of glutathione under my tongue and then put a teaspoon of honey in my mouth and hold it for 5 min, then swallow and drink 1/4 lemon in water with 2000mg of Vit. C. In the evening, there's another drink to take with amino acid powder, selenium, glutathione, l-histidine and selenium, but I have to empty the capsules and put the powder in apple juice and drink that. Interesting.
He also prescribed 100mg of progesterone and suggested the cream or troche and I decided on the troche. The cream would have been much stronger than the OTC stuff, so I could use less of it than before, but I decided to try the troche (which you dissolve under the tongue) instead. I don't have it yet as the pharmacy will call me today and get my credit card payment, etc. He faxes the order in to a pharmacy in Texas (which is certified). Apparently the compounding pharmacies in Colorado are not certified and he recommended this one in Texas over the local one (not that the local one is bad). He said shipping should take one day, so maybe I'll get it tomorrow. Would be nice to start it soon as I'm already on day 16 of my cycle. If it's really expensive to get from Texas, I may just start using the local pharmacy though.
So I'll keep you all posted on how the new stuff works out.
Karen, I told my Dr. about you getting a pill from a compounding pharmacy and he was surprised as he hadn't heard of that. He had only heard of using troches (like a lozenge).
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Post by redwood on Jul 22, 2010 11:47:46 GMT -5
hmm. I just looked more carefully at the blood test results that the Dr. gave me and now I'm confused. It appears that my estradiol is not high - it's 83 on day 12. Apparently levels below 100 indicate perimenopause (I'm 45) and could cause hot flashes (don't have those). My progesterone is 18.2 which is actually actually high for the first part of the cycle (less than 1.4 is normal). For the luteal phase (after ovulation) the range is 3.3-26. I was using the progesterone oil, so maybe that is why. So I'm not sure why he said what he said, but maybe my progesterone is low when I'm not using the oil/cream. But for sure my estradiol is not high.
Karen, do you know what your levels were when you were tested? I'm just wondering now why the Dr. said I had high estrogen. Also my LH and FSH are on the very low end of the normal range. Not sure what that means. Does that mean I'm close to menopause? I have a friend who started approaching menopause at 46 (she didn't have periods for 5 months and but they came back again after that periodically).
Plus I don't see any results of the toxicity tests he referred to (about having mercury and petrochemicals in my system). I wonder if he didn't give me those. But why not? Or maybe he tells all patients to detox. Not that it's bad thing to detox, but I just spent a whole lot of money on the supplements he recommended and feel maybe I was taken advantage of - that maybe it's not necessary. I just felt desperate for a way to resolve this and did as he suggested even though it was expensive.
is it possible to have endo yet have low estrogen? or maybe just the estradiol is low and not the others? estradiol was the only one measured.
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Post by Karen on Jul 22, 2010 12:59:53 GMT -5
I'll write more when I get home, but it's my understanding that sometimes the *ratio* of hormones might be more important. Remember, it's all about getting them balanced, which is a lot different than within 'normal'ranges. I still have a lot more reading to do to understand it all, but just got a good book that I'm hoping will shed some light. stay tuned! Oh, and I'm all about a good detox!
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Post by redwood on Jul 22, 2010 14:19:18 GMT -5
dr. didn't say anything about the fsh and lh so I guess it's not a problem. It is in the normal range, but on the very low end of the scale. I was backwards though - apparently they go way up in menopause, not down. Also, the vitex I take might influence those. This is supposed to affect the pituitary and hypothalamus. Well, the Dr. is really into bio-chemistry (he gives me chemistry lectures), so I'm sure he knows more about this than me.
yeah, a detox isn't bad at all but the supplements cost a few hundred dollars (one bottle was $74 by itself)! AND most of those only will last a month. So I guess I'm doing detox for a month only. can't do that again and I already spend a bunch on the other supplements I take.
Also, my prescription is different from the usual 21 days on, 7 off. he said to take it every day. Maybe I won't get my period. I won't get them until next tuesday, so I'll do another update after I take them and get my period (or not!) which would be due aug. 1.
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Post by hellsbells on Jul 22, 2010 15:22:59 GMT -5
Good luck!
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Post by Karen on Jul 23, 2010 6:21:49 GMT -5
Again, I don't know the details of hormones yet and what's a normal level vs. what isn't, but keep this in mind: you're going to see this guy because you're not feeling right. So even though your hormone levels might be normal for someone your age doesn't mean that's what level you should be at. Think about all these menopausal women going on bio-identical hormones. They aren't taking them to bring their hormone levels to where they should be for someone their age, they are taking them to bring them up to levels that are optimal to feel well. There can be quite a difference!
Also keep in mind that slightly high or slightly low levels can still make a huge impact on how you feel. Your entire body is connected, and there are lots of things going on that have a domino effect. Small imbalances can still cause big problems, but we're so trained with traditional medicine that small deviations from normal are still ok. But people don't go from being perfectly healthy one day to not healthy the next - it's a gradual shift - and identifying and correcting some of those smaller deviations can start to make a difference in how you feel!
As for toxins, I've read those can stay in your system for a long, long time... They are everywhere, so I'm always a fan of a detox! Give it a shot for a month, see if you start to feel any better.
And as for the pill form, I've read that since it goes through the digestive system, not as much progesterone makes it into the bloodstream as opposed to creams, suppositories, or drops, but yes, it does exist! Tell your doc about Women's International Pharmacy. They ship all across the country and have offices in Arizona and Wisconsin. Their website is incredibly helpful! Their prices were very reasonable, too.
Good luck with things! Keep in mind that it's best to monitor your hormone levels with your doc and it may take some adjustment. Fingers crossed that you start to feel a difference, though!
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Post by Karen on Jul 23, 2010 6:23:43 GMT -5
Oh, and I should add that I'm on the tail end of 1 week off. Had a period, first time I've had a 31 day cycle in a loooong time (they are usually longer, sometimes much longer!). And, it's the first time I've taken a week-long break from progesterone and actually still felt pretty good, almost no pain! Had some cramping with my period, but it wasn't awful by any means. Yay!! Now if only I don't get any spotting this month, I'll feel like I'm on the right dose.
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Post by redwood on Jul 23, 2010 11:04:08 GMT -5
Thanks for the info Karen! I know I still want to take the progesterone, even if my levels don't seem to show high estrogen and low progesterone (to me at least - but I'm no expert, that's for sure!). I still have endo symptoms anyway, so something needs to be done. I think the progesterone is elevated because of the progesterone oil I am using, so who knows what it would be if I hadn't been taking that. The Dr. didn't say to stop it for the blood test. Well, he didn't seem to think that any of the OTC stuff is effective.
Yeah, the detox is good for sure and my boyfriend said that maybe the Dr. can read information that I can't in the test results that isn't obvious to me (well, I'm sure that's true!). I think that toxins have a lot to do with endo (just my theory).
I was just surprised that I should take the progesterone every day (not stop for my period) and called his office and they confirmed it. But then, that is how I took the synthetic progesterone too (mini pill) and it lightened my period but I had bleeding every two weeks. So we shall see what happens with this.
I was just curious about the pill you are getting. I prefer to not take a pill though, as I don't want the hormones to go through my liver. So I will try the troches and if that doesn't work out well (not sure if it will be difficult to let it dissolve under the tongue without swallowing), then I will switch to a cream instead (or maybe troches can also be used as suppositories??).
If I remember correctly, you normally have irregular cycles don't you (even before taking the progesterone)? Mine are normally very regular - every 26 days - almost without fail. Except when I took the mini pill, but then I guess that was regularly every 2 weeks! lol
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Post by redwood on Aug 6, 2010 21:43:08 GMT -5
So here's an update on my experience with the progesterone troches. I've been taking them for about 11 days now. I started on day 21 of my period and I have been taking it ever since. I take 1/2 during the day and the other half before bed. At first it seems that it made me a bit drowsy when I took it. Although when I take it during the day, I don't seem to notice that anymore (I do still before bed, but maybe I'm just tired anyway). I also felt a bit distracted, somewhat loopy (a tiny, tiny bit). But now that has worn off too. No side effects that I can see at all.
Although progesterone seems to affect other people's periods, it seems mine just has a mind of its own and I got it on day 26 like clockwork, as usual. It wasn't lighter, but then I didn't start the troches until day 21, but I was using the progesterone oil from day 6, so I guess that it's just not strong enough to affect my period much. The troches should be stronger at 100mg, so maybe they'll be an effect next month.
The troches are ok, although I'm not so sure I would like to take them long term. The reason is that they take a LONG time to dissolve, like 20 minutes. I'm supposed to put them in between my gum and cheek and let dissolve. But as you can imagine the saliva starts to form, and because I don't want to waste it going into my digestive system, I hold that in my mouth, so I have a mouth full of saliva when the troche is finally dissolved. And the I swallow that, but then I'm wonder if most of it is going through my digestive system then, although 20 min next to my gums and cheek seem like there would at least be some absorbed. I'm going to ask my doctor about this. I could spit that out, but then maybe I'd be wasting even more of it? Not sure.
The only other option he gave me was the cream, and I just wasn't sure if that could be strong enough. I guess the pharmacies can make it much stronger than the OTC ones, so I could try that instead. I would need to use much less for 100mg than I was using for 50mg OTC.
Although, Karen, it seems like your compounded oral ones are interesting. Maybe I can tell my Dr. about the pharmacy you use and I could get a prescription there if the troches and cream aren't working well for me.
But I think I should wait and see what my next cycle is like before I change from troches. Since he is having me take them constantly and not breaking for my period, maybe my period won't come at all? Or maybe I'll have the spotting every two weeks like I did with the oral progestins I took before. We shall see!
the pain this period wasn't much different from before. There was some the first day or two and then a bit on days 3-6, but only when I was doing aerial dance (I'm participating in an aerial dance workshop this week and next, so I was doing it every day). It's very ab intensive, and that is where my pain is, so I would have minor pain afterward for about 2 hours or so and then it would pass. So that is an improvement from the previous two months. Hopefully there will less of the pain next month (or even NO PAIN at all, wouldn't that be nice?!).
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