Hi jedigirl
There is a lot of confusion about this not helped by, as Freda says, most of the info advocating progesterone supplementation as a way of relieving symptoms - coming from companies that want to sell it to you! Properly conducted placebo controlled trials do not seem to provide the same evidence - I gather results are mixed, and not consistent.
Yes it is the case that once peri-menopause becomes established and you skip periods - then progesterone is missing due to anovulatory cycles. In this case, in the early stages, if there are no symptoms of oestrogen deficiency, then progesterone supplementation ( not cream!) eg through utrogestan (in the second half of the cycle) may well help regulate cycles. Very soon though the oestrogen deficiency symptoms will appear so this needs supplementation too.
Lack of progesterone due to lack of ovulation is only thought to be a problem due to bleeding and lack of it should not give rise to any symptoms. This is where the prog cream companies will have you believe it does!
The pmt symptoms from the prog crashes are due to a reversal of the physiological changes in the body that occur when progesterone reaches high levels in the second half of the menstural cycle, to prepare the body for pregnancy. The most important point about this, is that the negative symptoms are not sustained for more than two or three days once the body has adjusted - so it can't be argued that the body needs progesterone just to stop these symptoms (although I know some women who tolerate it well prefer to take it all the time because of this - ie prevent the pmt), because they disappear quickly!
I can understand the difficulty of any form of HRT during early peri-menopause or the late reproductive phase (when periods are still regular and before peri-menopause properly starts) - because oestrogen levels are still rising and falling normally - and from what I have read, can rise to extreme levels. Because your cycle is still going on, then I can see that sometimes at the pre-ovulatory peak especially, this might be too much - briefly, while your cycle is strong and give rise to symptoms. Two pumps is medium dose and many post-menopausal women have this dose.
Sounds like a good idea to try to supplement with 1 pump for a while and see how you get on. Any oestrogen supplementation requires progesterone if you have a uterus to prevent thicking of the womb lining.
Not sure about the idea of the body trying to expel it? What is "it"? During pregnancy women feel sick when oestrgoen ( and progesterone) levels are increasing rapidly - but these are essential hormones!
The bottom line is - it is unlikely that you would "feel" that you are low on progesterone, (except through increased bleeding) but you do still need it!
Anyway do hope you feel better soon.
Hurdity x
