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[jasper]

thanks everyone for your thoughts here - the experiences of post menopausal women doing better with some progesterone certainly raises some questions.  I know the estrogen dominance theory was originally about adding in progesterone only but I am still wondering if the reason I am having so many side effects from the patch is due to needing more progesterone (I am in not yet in full peri yet so need it anyway but was trying estrogen first alone and am still having regular periods on it). I am exasperated as better initially (migraines) on patch and then when I raised dose but the effect doesn't last.

[CLKD]

I think one has to remember what 'dominance' means  .  Because certain hormones drop off or rise doesn't mean there's a dominance …….

[Hurdity]

Well this question often raises its head. Not sure what all the talk is about optimum ratios - I can't believe any site seriously asks us to consider this. I mean during our periods for example - we start off as "oestrogen dominant" and the ratio of O to P peaks at mid cycle when we are feeling at our best usually - ie when we are the most "oestrogen dominant". The progesterone begins to rise, oestrogen crashes, and then rises again as progesterone also rises. About at week 21 progesterone is at its peak and oestrogen is low - I suppose we are then relatively "progesterone dominant" until they both fall to a low level at the start of the bleed - presumably neither is then "dominant" according to the theory. The last week of the cycle and the first few days of the new cycle are the times when most women feel at their worst so nothing to do with oestrogen dominance!

The point I'm trying to make is 1) that the ratio changes all the time and 2) women usually feel at their best in the phase of their cycle when they are "oestrogen dominant".

There is a lot of nonsense put out on the web about all of this - and yes in an attempt to get women to buy the dreaded progesterone cream!

In post-menopause progesterone levels are similar to those in the follicular phase ( first half) of the menstrual cycle. Naturally if women start to have anovulatory cycles - additional progesterone is not produced - but there is always the background prog needed for physiological functions still being produced - just not in the large amounts needed to maintain a pregnancy.

"Balancing" hormones is complex because the endocrine system is also very complex and involves a lot of different hormones and feedback mechanisms. Adding oestrogen back through HRT is the easiest (and generally effective) way of restoring our deficient hormone - but can't hope to replicate the natural process.

There is no need (as far as I know) for to balance oestrogen with progesterone except to protect the uterus lining. In pharmaceutical quantities progestogens do exert other effects - mostly negative, but some women find the sedative effects calming. I don't think this has anything to do with balancing oestrogen though - it just acts as a depressant and dampens down emotions etc? Testosterone though is a different matter - and from what I understand the balance between O and T is more crucial to our well-being and what makes us female.

Dawncam - the "sweet spot" I (and others) refer to - is getting the right level of oestrogen.

Btw I have read nothing about ratios so the above is based only on my (limited) knowledge of the menstrual cycle. If anyone can point me to some academic study of this ( not a US site that's selling stuff!) I would be interested

Hurdity x

[dangermouse]

In perimenopause an unusual situation can arise as levels of progesterone have been gradually falling over many years and oestrogen can be at its highest level in a woman's life, due to the surges.

For me right now I feel better in the 2nd half of my cycle so I guess they could call this an oestrogen-dominant phase. Oestrogen does not make me feel good right now unless I use it to override my cycle and dampen my own too high levels.

Post meno is a whole different story though as both oestrogen and progesterone are low.

Oh and just to add that I think the 'dominance' language comes from the pill, as my 30 year old book on the pill puts different pills in the category of oestrogen or progesterone dominant. It has a mathematical formula where you would times the progesterone by the set strength of it (Norethisterine would have one figure and Levonorgestrel would have another etc.) and then you'd apply that to the oestrogen amount to find out which was which. It worked, as an endocrinologist told me I had to have an oestrogen dominant pill (she used that wording too) and it made me feel the complete opposite of the prog dominant pills which had been making me feel bad at the time.

[jasper]

Since being on patch, I am feeling better in 2nd half of my cycle too and pretty awful in first half. Isn't first half more estrogen dominant and 2nd half more progesterone dominant, rather than the other way round?

[Hurdity]

Yes jasper - that's correct! Oestrogen dominance mainly during first half of cycle not second half (although I don't like to use the term!). I should really have said women feel at their best during the first part of their cycle usually when the bleed has finished. When the bleed starts, apart from the period pains etc, oestrogen is at its lowest and starts to rise - by about Day 5 it should have risen to a decent level to feel better. I know that I used to feel the oestrogen rising at some point after my period started - I used to feel terribly tense with pms, headache, irritability etc - usual thing - which continued for a few days - and suddenly it would be like a cloud lifting. Unfortunately for women who do not like progesterone this good feeling is short-lived because progesterone is at its peak by about Day 21 when oestrogen is low, about a week before the period.

Hurdity x

[Annie0710]

That's interesting, I never suffered pmt etc, I only knew my period was due by dates

But My sex drive was always at its highest before and during a period, I used to think I was abnormal as it's usually a no no during period time with women

Annie X

[CLKD]

I had dreadful PMT in my 30s    .  As well as a higher sex drive pre-bleed.  So that's 2 of us so completely normal then 

[jasper]

thanks Hurdity - so what is confusing me is that I feel best in 2nd half of my cycle and pretty awful from day 1-12!! This is making no sense to me :-(