This is sort of a spin-off of davinci's great survey, about which please go here:

http://www.power-surge.com/php/forums/inde...c=22058&hl=

I'm one of the many who really have a hard time tolerating progesterone (P) and am trying to figure out if there is a common denominator. So, if you do well on P, can you please jot a quick response to the following*:
* if you've had to try many types/doses to get along with P, please just answer wrt to the P you tolerate

When in peri or post-meno did you start taking it with success?

Are you now still in peri or post?

Do you cycle P or use continually?

Do you supplement with estradiol or estriol in any form?

What form (prescription or OTC cream/pill etc) agrees with you most?

What dose (mgs and frequency) do you use?

During your pre-peri, peri and/or post-meno years, have you been subjected to prolonged stress to the point where you have been literally disabled with fatigue. I ask this one, because I wonder about an adrenal link to this.

Thank you for your input, everyone. Depending on what comes along, I might ask the same of the non-tolerant among us.
GK

I have added my unusual tx because it works! I still feel very good. I have not had one bad day, nor any migraines since staring on bios.

I think that your estrogen has to be high enough to balance out the progesterone. I am beginning to think that without the right amount of Estrogen coursing through your body, that many have trouble handling the Progest., and thus, not able to receive its benefits. ???? Still thinking...
Shebee

Yep, I can't agree more, Progesterone works only when you have plenty of estrogen, this is why it works for some women and not for others, depending what is your estradiool level, endogenous or supplemental, how good you absorb estradiol from HRT, etc.
The only way to prevent progesterone to drive you nuts is to have plenty of estrodiol, i think it should be not less than 2 mg transdermal at least.
JMHO

When in peri or post-meno did you start taking it with success?
Peri started in February I believe.

Are you now still in peri or post?
Peri

Do you cycle P or use continually?
Continuous but I don't have a uterus and was given the okay for this by my BHRT Doc and Gyno.

Do you supplement with estradiol or estriol in any form?
No

What form (prescription or OTC cream/pill etc) agrees with you most?
I have only used oil caps from Bellevue.

What dose (mgs and frequency) do you use?
I started at 150 which got me into the normal ranges. My doctor wanted optimal ranges so upped me to 220, I struggled with that amount for about three weeks and have since been backed down to 175mg. Just got them today so can't comment. I have actually leveled out this past week by only taking the 220 every other day. When on the 150mg I took one capsules right at bedtime.


During your pre-peri, peri and/or post-meno years, have you been subjected to prolonged stress to the point where you have been literally disabled with fatigue. I ask this one, because I wonder about an adrenal link to this. I would have to take naps when I came in from work before I started taking P. My doctor has not been concerned with my adrenals so far.

Makes sense, but is not always so. I know 2 women, who are many years post, who take no estrogen and are on substantial doses of progesterone. One takes 60mgs of the cream continuously and has been happily using it for 3 years. The other one takes 300 mgs of prometrium continuously (although she hasn't been on it for as long) with no ill effects. It could be that a high E level helps to make the P tolerable for those who are sensitive to it but for those who are not it may not matter.

I have recently read an interesting theory that progesterone could have a biphasic effect in that it may cause more problems at moderate doses than at higher ones. Seems counterintuitive I know.

Here is an abstract.

Psychoneuroendocrinology. 2009 Sep;34(8):1121-32. Epub 2009 Mar 9.Click here to read Links
Sex steroid induced negative mood may be explained by the paradoxical effect mediated by GABAA modulators.
Andréen L, Nyberg S, Turkmen S, van Wingen G, Fernández G, Bäckström T.
Umeå Neurosteroid Research Center, Umeå University Department of Clinical Science, Obstetrics and Gynaecology, Norrlands University Hospital, Umeå SE-901 85, Sweden.

Certain women experience negative mood symptoms as a result of progesterone during the luteal phase of the menstrual cycle, progestagens in hormonal contraceptives, or the addition of progesterone or progestagens in sequential hormone therapy (HT). This phenomenon is believed to be mediated via the action of the progesterone metabolites on the GABA(A) system, which is the major inhibitory system in the mammalian CNS. The positive modulators of the GABA(A) receptor include allopregnanolone and pregnanolone, both neuroactive metabolites of progesterone, as well as benzodiazepines, barbiturates, and alcohol. Studies on the effect of GABA(A) receptor modulators have shown contradictory results; although human and animal studies have revealed beneficial properties such as anaesthesia, sedation, anticonvulsant effects, and anxiolytic effects, recent reports have also indicated adverse effects such as anxiety, irritability, and aggression. It has actually been suggested that several GABA(A) receptor modulators, including allopregnanolone, have biphasic effects, in that low concentrations increase an adverse, anxiogenic effect whereas higher concentrations decrease this effect and show beneficial, calming properties. The allopregnanolone increase during the luteal phase in fertile women, as well as during the addition of progesterone in HT, has been shown to induce adverse mood in women. The severity of these mood symptoms is related to the allopregnanolone serum concentrations in a manner similar to an inverted U-shaped curve. Negative mood symptoms occur when the serum concentration of allopregnanolone is similar to endogenous luteal phase levels, while low and high concentrations have less effect on mood. It has also been shown that progesterone/allopregnanolone treatment in women increases the activity in the amygdala (as measured with functional magnetic resonance imaging) in a similar way to the changes seen during anxiety reactions. However, it is evident that only certain women experience adverse mood during progesterone or GABA(A) receptor modulator treatments. Women with premenstrual dysphoric disorder (PMDD) have severe luteal phase related symptoms; in this phase, they show changes in GABA(A) receptor sensitivity and GABA concentrations that are related to the severity of the condition. These findings suggest that negative mood symptoms in women with PMDD are caused by the paradoxical effect of allopregnanolone mediated via the GABA(A) receptor. CONCLUSION: Progesterone and progestagens induce negative mood, most probably via their GABA(A) receptor active metabolites. In postmenopausal women treated with progesterone and animals treated with allopregnanolone, there is a bimodal association between serum allopregnanolone concentration and adverse mood, resembling an inverted U-shaped curve. In humans, the maximal effective concentration of allopregnanolone for producing negative mood is within the range of physiological luteal phase serum concentrations.

Well, thanks for all this info so far. Having read earlier comments here at PS, I have tried the add-more-estrogen gambit to the point I practically drown in it, and it didn't work. I loaded up to the gills with it awhile back and applied a ridiculously tiny dot of a ridiculously low dose. Within seconds, the jolting began along with that sense of being badly started, and nasty restless legs. The wet finger in the light socket routine.

I read somewhere that progestin cannot convert to cortisol and, guess what, that's the only type that doesn't do this to me although it's still a bad deal. I am getting more convinced that, for me at least, there must be some adrenal connection here.
Until I get that sorted out, I guess I'm just stuck.
GK

Have you ever tried the oil caps GillK? If so, at what dose and how did you react?

been using p- cream now 2mo with no ill effects- i use for 30 days then stop for my period.....

forgot to add that dr said my estrogen was fine ( 49 )

Hi gazelle. And yes, if you mean Prometrium. Also tried Prometrium, Crinone, compounded micronized caps and creams in doses as low as 10mg, various OTC, norethidrone and even Vitex. I reacted poorly during peri and now, six years in meno, I just can't use it at all. The Prometrium made gave me a jet black mood, terrible lethargy and migraine. All of it will give me a migraine and lethargy, and now in meno the 24-hour no sleep jolting sensations.
GK

I assume Gazelle you are talking about the BHRT oil caps? I'm wondering about the use of the compounded oil caps too. It seems those that are doing well atm are all mostly using oil caps? What about those that have used compounded oil caps that have had problems with it, anybody?

My progesterone oil caps are a safflower base and come from Pete at Bellevue.

Wow. You've been through a lot. I don't know what to suggest. I have heard of a progestin secreting IUD which may not give much of a systemic effect but I don't know very much about it and don't know anyone who has tried it.

I am wondering, with respect to the article that I posted above on allopregnanalone, if you are also sensitive to the effects of alcohol or benzodiazapines?

Yes. I was talking about prometrium or the compounded caps.

All that progesterone trial and error was long ago when I felt so lousy with peri that it was just one more lousy thing - haven't been through that much really. After one round of each new Rx, I'd chuck it, wait a few months and try again. I just list all that stuff to demonstrate how progesterone-averse my system is. I often wonder if women who start progesterone earlier in peri may do better with it.

As for your other question, I am probably the world's cheapest drunk. I don't like alcohol and have never been a drinker. I am no fun at all . I've used benzo's for many, many years (to my everlasting regret) and with them and just about any medication, I am what my MD calls a 'low doser'. Also, my one and only experience with an IUD will remain just that. I see my OB/GYN tomorrow and will ask for some other progestin option. Maybe there are similar synthetics like norethindrone that I could tolerate with less hassle.
GK