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Post by Karen on Aug 8, 2010 19:35:36 GMT -5
Yeah, I'd likely give it a cycle or two to see what happens and how your body reacts. And the dosage may have to be played with a bit, too. Progesterone has a drowsy effect, so if you're taking it at any other time than before bed, you're going to feel it. I got the loopy feeling a bit at first, but that went away, either because my dosage was lowered or I got used to it.
The troches don't sound fun! I'm not quite sure how those get absorbed into your system you'd best defer to your doc on how that all works. And as for the cream, they can MAKE it strong enough! It gets absorbed into your skin and gets stored into the fatty tissue just below it and is released throughout the day. I know the dosages can be a bit different than ingested dosages just because of the delivery method.
I believe the pharmacy I use has info for practitioners - it's Women's International Pharmacy if you want to google it.
As for me and my experience? It's FANTASTIC! I still had a tiny bit of spotting mid-cycle this month, though very, very minor and only for 3 days. Much less than last month. My pain is still mostly non-existent most days, though poor eating habits while on vacation the last few days have awoken the pain a tiny bit. But, still, all in all, this is by far the best treatment I've tried so far!
BTW - am reading a book on anti-aging medicine "Life Extension Revolution" by Miller (don't let the name fool you - it's all about getting your body into balance and working optimally so there's less chance for disease) and they have an entire chapter devoted to hormones. There's no mention of endo, but it's all about getting the right ratio of hormones. The best part? They explain it all and - the best part - give ranges for what your test results and ratios should be for optimal function. It's worth reading even if for just that chapter alone! That chapter is quickly becoming my bio-identical bible.
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Post by redwood on Aug 9, 2010 11:31:44 GMT -5
Thanks for the book recommendation.
The troches are absorbed into your bloodstream directly like if you use cream or oil on your skin (or like a suppository). Which is why I don't want to swallow the saliva right away, as then it would go through my digestive system instead of being absorbed into the skin and gums in your mouth. Apparently this type of absorption is very quick, but I still don't want to swallow the saliva right away as I feel that maybe less will be absorbed that way. I guess I should ask the pharmacist or dr. about that. The dosage for the cream was to be the same - 100mg/day. (using twice per day).
Do you just take one capsule a day?
I take the progesterone 12 hours apart, so at 11pm or 12 at bedtime and then noon during the day. I don't feel the tiredness during the day anymore. That only happened the first few days.
the troches will run out before my next cycle, so I'll have to make the decision as whether to reorder or switch to another form (cream or oral).
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Post by Karen on Aug 25, 2010 20:08:32 GMT -5
Just wanted to post an update. I'm on my 4th (I think?) cycle on bio-identicals and had another period that really wasn't bad at all, quite tolerable and mostly how I remember them in the past before they got godawful. My bloating wasn't nearly as bad, and bleeding wasn't so bad. Mostly cramping, very little of the burning and pulling pain. After day 3 or so, no pain at all, even though I was taking my week long break from the progesterone.
Best part? The weight keeps falling off! I'm down 10 pounds since I started progesterone/testosterone, and I'm down 22 pound overall since my highest last year. Mind you, I've had excellent eating habits for the last year+. The first 12 pounds were a complete b*tch to get off and fluctuated back and forth, but after starting bio-identicals, the last 10 came off without a thought. I haven't even been exercising more than once or twice a week. Amazing what some hormones can do! I know I need to up my workouts and keep my eating in close check, but I'm feeling good and loving life these days for the most part. It's great to get some energy back and feel like my personality is back most days, and for me, that was only possible by getting that awful daily pain under control!
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Post by redwood on Aug 30, 2010 19:19:11 GMT -5
This is my update on my experience with taking bio-identical progesterone. So, it's been one full month now and finally I've noticed a difference in my period (as compared to when I was using progesterone cream or oil OTC). I am taking the progesterone continuously as that is what my Dr. recommended. My period came two days early at day 24 and was much, much lighter, but it has lasted 8 days total. Most of those days are just spotting with a very small amount of bleeding on day 3 and 4, then on 5 it stopped, but then came back on day 5 with spotting and I am still spotting on day 8 (just a little).
So, I would think that a lighter period is better as that must mean that my endo would bleed less too, right? BUT, I had more pain than usual. I had pain for 7 days while it's usually only 3 or 4. I had pain from the first spotting until yesterday. The worst of it was days 1-3. This is different in that the worst of it is usually after my period is done (days 4 or 5). In June, I had 5 days of pain that was worse than normal and that was after I had started the progesterone oil (instead of cream) and then following two months were a bit better.
So, I'm not sure what this means, but I do know that I have to wait and see if it changes in the next few months. I can't decide after just one month. In a way, this is similar to what I experienced on the progestin-only pill that I took a few years ago. The first period was lighter but longer (10 days), and then after that I had a light period (or spotting) every two weeks but lasting only a few days. That pill I also took every day without a break.
Karen, is your period much lighter than normal? Is it just more like spotting?
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Post by Karen on Aug 30, 2010 19:44:59 GMT -5
My periods are typically heavier for a few days, then taper off to just a trickle for the rest of the 7 days. At first when I started the progesterone, my first period was super, super heavy. It was a super long cycle, though, so I suspect that. Second period was still heavy the first few days, but my last one was what I remember them being like when I was on BC, they were lighter. More than spotting the first few days, but lighter. Oh, and I had mid-cycle spotting (8 days of it...) when I first started. I'm taking it 21 days on/7 days off, though (although now I'm sneaking in an extra day or two until my period actually comes).
Keep in mind that your dosage might need some adjusting. That's the beauty of compounded meds - small tweaks can be made! I was on a higher dose at first, but with the spotting and a few other things (was it pain? I don't remember now), she dropped my dose (from 100 mg/day to 75 mg/day) and voila - that seemed to do the trick. Still had a tiny tiny bit of mid-cycle spotting, but only lasted for 3 days and it was barely there. Fingers crossed I don't have any this month.
Do you have a follow-up planned with your doc? If you're having more pain and longer period, your doc might suggest another blood test to see where your levels are at.
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Post by redwood on Aug 31, 2010 14:47:05 GMT -5
Hmm, interesting that you had a totally different experience on it than me (at 100mg). Although you are taking it orally, so I'm not sure what the difference would be with that). So I just went to my gyn today and had a follow-up ultrasound (from feb) and the "thing" - the likely endo implant - has grown 3mm. So, I told her what was going on these past 6 months and told her about my troches that I'm taking and she seemed to think that 100mg wasn't even to treat endo. It did affect my period (making it much lighter), but then the endo implant hurt longer than usual). She said she could prescribe me 200mg of prometrium taken vaginally (you actually insert the capsule) if I didn't want to take it orally (I read of more side effects with taking it orally vs. vaginally). Although she knows my other Dr. that prescribed the troches works with compounding pharmacies so she said see him to see if there's another suppository that could be made that might be better than using a capsule. He had offered me only troches or cream, but maybe that is because of the pharmacy he uses. I'm going to call the local one to see what they have available (or maybe that one in wisconsin that you use, Karen). I think I'd prefer a suppository rather than having to hold my saliva in my mouth. Or I could try it orally. She wasn't opposed to treating endo with bio-identical progesterone but seemed to think orally or vaginally was the better option over cream (which she just said that it was controversial about whether that is very effective or not). She didn't have any opinion on the troches. She seemed to think that those could be used vaginally also, but maybe not with the flavors in them (esp. the mint). They actually put artificial flavors in them to make them taste better. first batch was mint and then I asked what else they had and they ALL have artificial flavors, so decided to switch to orange and found out that with orange, there is also color so they are bright orange too (first ones were white), so that looks rather 'toxic' to me. But I paid $50 for them so I guess I'm using them until they are gone. I have an appointment with my other Dr. tomorrow, so we'll see what he says about the dosage. (if I should have a higher dosage or not). Or maybe I should do 150mg - in between what the two drs. say. But what if he says stay on 100mg? Then I have to decide who to follow. I don't know and there's another problem in that I'm moving in 6 weeks and I'll be in Canada. So I won't be able to follow up with these drs. anymore. My health insurance will cover travel in Canada but I need to be a resident of Colorado and I think I can only swing that through the end of the year and then I'll need to look for travel insurance which I doubt will cover regular dr. visits (not an emergency or acute illness). You see, I'm applying for a permanent resident visa through family sponsorship, but I am waiting during the process (could take 6-12 months) as a visitor in canada, so I wouldn't be eligible for their health care system until I get a permanent resident card. So I'd just be a visitor traveling in Canada until then. So this makes me want to sort this out quickly, and I know I should wait and see, but I will need to take my meds with me as I don't think I can fill a prescription in Canada from a US Dr. Does anyone know if this is possible? And maybe it's better for me to use prometrium instead of the compounded stuff if that might be harder to fill in canada (or maybe both are impossible unless I go to a canadian dr.). My gyn did say she would be willing to take calls from me if I felt I needed some advice or new prescription, etc. when I first went up there. Or can medications be shipped internationally? Anyone know if that's possible? It must be as there might be people traveling who need their meds. Or maybe there are laws against that if the drug is not used in the country you are sending it to.
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Post by Karen on Aug 31, 2010 17:19:18 GMT -5
When it comes to a question of doses, it should be based either on 1. symptoms or 2. blood tests or 3. BOTH! Traditional medicine is such a guessing game, but why not ask your new doc for a blood test if he's not sure what to do? Remember, the goal isn't to overwhelm your body with progesterone, it's to supplement it enough to counter-balance the effects of estrogen, but no more than that.
As for the troches, $50? I think I've been running about $20 for a 21 day supply of the pills. I've heard of the suppositories, though I haven't tried them. I read so much about the cream that I was hell bent on getting it, but in the end, the compounded ones have very, very little effect. With the prometrium, there was the pill coating, artificial colors, etc...
As for meds and travel, I'd have to default to someone else on that. Good luck!!
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Post by redwood on Sept 1, 2010 16:23:58 GMT -5
yeah, the gyn is coming from a traditional bent and seems to think that you need a certain level of progesterone, but it really depends on each person. My bio-identical doc today suggested to go to 150mg. I'm not sure what he based his decision on, but I did have more pain this month, so I'm not sure if it's because of that or what. But I will try it and see. I could always go back to 100mg the following month. He also said he'd work with me over the phone after I leave if I need a different prescription strength. I'm staying with the troches for now but will get them from the local compounding pharmacy that can make them with natural flavorings and no artificial colors. They also make the capsules, but for some reason my dr. doesn't seem to like the oral ones and says that 80-90% of it gets destroyed by your digestive system. He also said that prometrium doesn't have good quality progesterone, so prefers the compounded ones. Because the oral progesterone is in oil, doesn't that help it go through your digestive system? He also seems to like the cream and had suggested that in the beginning, but I had asked about the troches instead. You just said that the creams don't seem as good and I felt that too, although it was based on the OTC stuff. And also on stuff I've read. I"m also not sure how much is absorbed through the troches. He didn't seem to think that I needed to hold my saliva in my mouth while it melts, although he said I could check with the pharmacist about that.
Everyone just seems to have a different opinion, but I guess I'll just have to experiment and see what works for me.
He did also want to do another blood test before I leave.
I wonder, since you can use the prometrium as a vaginal suppository if you can also use the compounded capsules like that. I wouldn't see why not, but probably best to ask a pharmacist. I may have to switch when i go to Canada. I found a compounding pharmacy in Vancouver online that will take a prescription from a US dr. but they only do creams and capsules. Although I'm sure there are more compounding pharmacies in Canada. My doc also said he thinks they could ship it to me from here too.
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Post by Karen on Sept 1, 2010 17:28:47 GMT -5
Ah, well that sounds like good news, like you'll have someone to work with at least until you get settled in up there! I don't quite understand the debate between cream / oral / suppositories... If you think about BC, though, that's taken orally, so why isn't there the same complaint? From The Life Extension Revolution (page 55): "While progesterone creams are extremely popular (in part because of their availability over the counter), I prefer an oral form of progesterone that has been micronized (broken down into tiny particles) and suspended in oil. This allows steady, gradual absorption of progesterone from the intestinal tract. I find the oral form of progesterone to be more potent in raising progesterone levels. This can be helpful in cases where the effects of progesterone cream are too subtle to relieve symptoms. The dosing for the oral form is also far more precise than the progesterone creams, which are simply measured out by the patient with a small spoon. IN my experience, woman tend to get a more accurate dose with the oral form and therefor have more predictable results." And interesting comment about Prometrium... My lips tingled a bit when I was on it, totally strange... I'd much rather take something with as few ingredients as possible! As for the suppository question, if you talk to a pharmacist, please let me know the answer. I'm curious! And if you're looking for a new health care provider up there, see if this link is any good: www.lef.org/Health-Wellness/InnovativeDoctors/ It's a branch of medicine that should be knowledgeable about inflammation, hormones, etc. Might be a starting point if there's one in the area?
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Post by Karen on Sept 2, 2010 18:06:11 GMT -5
By the way, the same book offers this as the target values and ratios for women under 50 (keep in mind that different labs may have different measurements, but the ratios should be the same).
Progesterone: 2000-14000 pg/mL Estrogen: 180-200 pg/mL Total Estrogen/Estradiol Ratio: 2.5 or lower Progesterone/Total Estrogen Ratio: 10-20
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Post by Karen on Sept 16, 2010 6:26:28 GMT -5
Well, my current cycle is off... The only thing that's changed this month is that my doc upped my dose of DHEA to 10 mg/day (which is a small dose, but my previous dose was 5 mg). DHEA is the precursor of estrogen and testosterone and can be converted to either into the body. I suspect that might be why this cycle is off. I don't believe I ovulated this month, and if I did, I only had a 2-3 day luteal phase. My period is light but the pain has been awful. Perhaps I need a higher dose of progesterone to balance it out, or perhaps I need to lower my dose of DHEA? I have a follow up with my doc next week and hope she has more insight!
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Post by amber84 on Sept 16, 2010 18:07:58 GMT -5
Sorry you are in pain Karen! I know you have been feeling a lot better so that really stinks. I'm just curious: Since the DHEA can become either estrogen or testosterone in your body, after they change your dose wouldn't it make sense for them to re-test your hormone levels?? So they can see how your body is processing the DHEA. Can you remind me why your doctor decided to increase the DHEA? I'm pretty sure you already said why but I can't remember. Was the change in your cycle only after they changed the DHEA?? Sounds like you need to cuddle up with a heating pad and a nice movie tonight!
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Post by Karen on Sept 16, 2010 18:31:00 GMT -5
I've only been on a higher dose of the DHEA for a few weeks, so yes, I'd suspect she'd either re-test my hormone levels or, at a minimum, adjust my dose based on symptoms for now.
She put me on DHEA because she found my cortisol levels were really low (which explained why I was tired all the time) and she put me on an adrenal gland supplement and she's been slowing increasing the dose. The ratio between cortisol and DHEA is really important, and my DHEA level was borderline low and my ratio between the two was a bit low, so since she increased my adrenal supplement a few times bit by bit, she finally upped my DHEA as well. So, yup, the change in cycle was only after that adjustment. Some women are really sensitive to fluctuations in DHEA so for now, that's my assumption. Perhaps she'll be able to shed more light on this next week.
The pain is much better today but I'm still kind of out of it and swollen. A lot of the bloat is going down, though. I'm hoping that I'll be back to normal by the weekend!
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Post by KSA on Sept 16, 2010 20:17:27 GMT -5
Glad you are feeling better today Karen. Something is going on with all of us. All of us got hit at once with the pain this month.
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Post by redwood on Sept 17, 2010 12:53:26 GMT -5
I'm wondering if higher progesterone would make the pain lesson or increase. I was going to increase my progesterone because I had worse pain (but light period) last month. I actually didn't increase it as when I tried to take 100mg at bedtime it made me feel drunk and woozy and I still felt that a little when I woke up the next day and felt a bit queasy too. So then I was afraid to try 75mg twice daily, so I stuck with the 100mg this month instead and am waiting to see how my next cycle is (it should start today as it's day 26). Well, it didn't come early like last month. So far I am not noticing any pain in the usual area from the endo, just a few cramps that come and go in the normal areas (pelvis) for menstrual cramps.
Karen, if you were feeling fine before you upped the DHEA, then maybe you should go back to what you had before, rather than increase the progesterone, although you could try that too. It seems like it's a guessing game, doesn't it? But then at the same time, you need to wait and see, which is frustrating. I'm not sure whether to increase or stay the same. Maybe if I do increase, then it should be to 125 only and not 150. I am hoping to stick to 100 and have it work though.
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