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[Sage 🍃]

AngelaH, I was just replying to pastie supper  I agree that progesterone is an important hormone for peri and postmenopausal women, including women who had oophorectomy. Even though it is primarily a gestational hormone, it has been around our entire lives, so withdrawal symptoms are bound to occur in some of us, after all progesterone is a powerful neuromodulator 

Regarding Utrogestan... yes, it should be used for what it was designed for, although it was originally designed to be used vaginally in the treatment of fertility disorders and to prevent miscarriages and recurrent spontaneous abortions, the off-label use for menopause has become somewhat 'official' now, it's a fluid reality.   

[Hurdity]

This Topic is not about the role of progesterone in protecting the womb, but about forgotten by NHS the role of progesterone in general in the women body. Just like estrogen, progesterone is important for the brain, bones, muscle…. Some women need estrogen to fix the problems in their bodies, but some need just progesterone.

I did not try to use Utrogestan on skin, really don’t need to do that because it helps to ease my symptoms by taking it in the way it should be taken.

Hi AngelaH

My post was directed at pastiesupper who asked a question about spreading the micronised suspension from the utrogestan capsule on her skin and my comments about absorption still stand ie it is not designed to be spread on the skin and as such won't be absorbed in this way. In addition the comments about endometrial protection are there as a caution for anyone who might pick up on this, like me, without reading the rest of the thread, and be tempted to try this method as the progestogen component of HRT. ( I haven't read the rest of the thread...)

I agree that progesterone is an important hormone for peri and postmenopausal women, including women who had oophorectomy. Even though it is primarily a gestational hormone, it has been around our entire lives, so withdrawal symptoms are bound to occur in some of us, after all progesterone is a powerful neuromodulator 

Sage I don't know what you mean by withdrawal symptoms? Who gets withdrawal symptoms from progesterone? All post-menopausal women? Progesterone is still produced post-menopause in the small quantities that are needed for physiological functioning, but of course not in the amounts needed for pregnancy, but these quantities are only needed for pregnancy as you say.

Hurdity x

[Sage 🍃]

Hurdity,

Progesterone reference ranges:

Follicular: < 5.0nmol/L.
Luteal: 3.5 – 67 nmol/L.
Post-menopause: < 4.4nmol/L.
Pregnancy 1st trimester: 35.62 to 286.20 nmol/L.
Pregnancy 2nd trimester:  81.41 to 284.29 nmol/L.
Pregnancy 3rd trimester: 152.64 to 477 to 954 or more nmol/L.

Oestradiol reference ranges:

Children: Less than 130 pmol/L
Males: Less than 146 pmol/L
Females:
Follicular: 72 – 529 pmol/L
Ovulatory: 235 – 1309 pmol/L
Luteal: 205 – 786 pmol/L
Post-menopause: Less than 118 pmol/L


If low oestradiol levels in menopause, which are measured in pmol/L can cause withdrawal symptoms, why not progesterone levels in the  nmol/L range, which are 1,000 higher than pmol/L?

The highest oestradiol level  is around 1309 pmol/L = 1.31 nmol/L.

We have been exposed to up to 67 nmol/L of progesterone during four decades (or much more if pregnant) and then it drops to < 4.4 nmol/L and this won’t have any effect? I don’t think so, but I stand to be corrected.

[AngelaH]

Even though it is primarily a gestational hormone, it has been around our entire lives, so withdrawal symptoms are bound to occur in some of us, after all progesterone is a powerful neuromodulator 

Regarding Utrogestan... yes, it should be used for what it was designed for, although it was originally designed to be used vaginally in the treatment of fertility disorders and to prevent miscarriages and recurrent spontaneous abortions, the off-label use for menopause has become somewhat 'official' now, it's a fluid reality.   

And estradiol has the main function to mature and then maintain the reproductive system, but it doesn’t prevent us from using it in HRT even if reproductive function is completely stopped - menopause and post. Simply because both sex hormones regulate various non-reproductive functions in the body as well.

And Mirena coil originally was invented for preventing pregnancy, but now it is used for other different proposals (where progesterone is needed) including HRT.

So this is not about name of medication, this is about its active ingredient - progesterone, Utrogestan is progesterone, there is nothing surprising in the fact that it’s used now for HRT.

[AngelaH]

Progesterone is still produced post-menopause in the small quantities that are needed for physiological functioning,
Hurdity x

I am afraid but it’s not the case, the body in post menopause still produces some amount of weak form of estrogen, but not progesterone. In peri progesterone falls quicker than estrogen and this is why usually the low progesterone causes problems. NHS doctors don’t really pay attention to that and this is why so many ladies are suffering for nothing.

[LC1962]

Thanks all for the support and encouragement!    Oooh,   I didn’t even think perhaps could NOT get this gel in the UK on the NHS.   It’s used in France,  available over the counter for breast pain.  2.5cm gel, it comes with a measuring scoop, so one measurement on the inside of each thigh.  I don’t rub it in well as it’s supposed to work better if naturally absorbed.  It’s called Progestogel, and I found it here. 

https://moncoinsante.com/mcs/en/various-medications/11140-progestogel-1-tube-80g-for-targeted-areas-applicator-3400931314127.html

Hi LC1962. I have received my gel, I bought it from the pharmacy you recommended, I’ve had it for a week now but have been putting off using it (no idea why) I am on 100mg Utro daily but feel it’s not enough so wanted to add the gel in too. Anyway I just wanted to ask when you apply the gel, do you at night or morning? Thanks

Sorry for late reply.    I always apply first thing in the morning.   It’s maybe all in my head
/placebo at such a small dose but I really feel it is helping  my crippling morning anxiety.  It is supposed to help with sleep and I know some people prefer applying at night but thankfully I don’t have any problems sleeping. 

I’m still feeling the benefit of this and it definitely works well for me.   

[Hurdity]

"We have been exposed to up to 67 nmol/L of progesterone during four decades (or much more if pregnant) and then it drops to < 4.4 nmol/L and this won’t have any effect? I don’t think so, but I stand to be corrected."

Sage - it doesn't work like that - not as withdrawal as such but looking at the quantities. We have been exposed to progesterone in preparation for and during our pregnancies and as I said it is produced in large quantities for that purpose only. Progesterone withdrawal is a distinct phenomenon which occurs late on in the menstrual cycle just before a period - and is a component of pms - a reversal of the temporary physiological changes that take place in the body when it increases, until the progesterone has been metabolised away and your body returns to its normal state. Some of these processes are described on the web but are quite technical!

Hurdity x

[Hurdity]

Progesterone is still produced post-menopause in the small quantities that are needed for physiological functioning,
Hurdity x

I am afraid but it’s not the case, the body in post menopause still produces some amount of weak form of estrogen, but not progesterone. In peri progesterone falls quicker than estrogen and this is why usually the low progesterone causes problems. NHS doctors don’t really pay attention to that and this is why so many ladies are suffering for nothing.

And I am afraid that what your saying is not the case! The information can be found on the web - eg see the Wikipedia entry for progesterone which gives the levels at various stages (scroll down to levels and ranges which gives you the tables). https://en.wikipedia.org/wiki/Progesterone . Of course, the levels are much lower and the tests used to measure are designed to test for much large amounts so are not accuraate at low levels.

The pro-progesterone lobby will have us believe we have none and therefore need to buy it to restore balance or something, but that is untrue - we continue to make it. A while back I did look into the post-menopausal production of it but can't remember where now, sorry. The biosynthesis of steroid hormones is well-documented and there are several pathways.

If there is conclusive evidence from trials that we benefit from its replacement post-menopause, even for those who don't have a womb, then I would be interested to read it.

Hurdity x

[CrispyChick]

"We have been exposed to up to 67 nmol/L of progesterone during four decades (or much more if pregnant) and then it drops to < 4.4 nmol/L and this won’t have any effect? I don’t think so, but I stand to be corrected."

Sage - it doesn't work like that - not as withdrawal as such but looking at the quantities. We have been exposed to progesterone in preparation for and during our pregnancies and as I said it is produced in large quantities for that purpose only. Progesterone withdrawal is a distinct phenomenon which occurs late on in the menstrual cycle just before a period - and is a component of pms - a reversal of the temporary physiological changes that take place in the body when it increases, until the progesterone has been metabolised away and your body returns to its normal state. Some of these processes are described on the web but are quite technical!

Hurdity x

Hurdity. Totally correct - the withdrawal of P (or lack of it) is responsible for pms. Cyclogest is licenced to treat severe pms.

So, this being the case, why do you believe P has no role to play, other than endometrial protection? Clearly many woman are deficient in progesterone, especially moving through peri as it declines first.

I am very curious as to why you are so anti progesterone (apart from uterus protection)?

[CrispyChick]

I haven't gog time to sit and look for 'scientific' papers on the need and/or benefits of progesterone in peri and meno.

This is given no thought in the NHS. So perhaps there are no papers, in UK.

However, this is a huge event in the US and Europe.

Take a look at this Canadian website - there are plenty of papers linked https://www.cemcor.ca/resources/progesterone-therapy-menopause. Probably not from UK, but I dont believe science only comes from the UK 🤔. Science only delivers answers on the things that are researched. Often big pharma plays a role in what is researched 

[ToriiJ]

I agree with you CrispyChick. Progesterone during menopause is really not given the attention it deserves. Oestrogen just seems to be pushed all the time and progesterone is seen to be just taken to protect the lining of the womb.

I for one have started to realise that I don’t need hrt oestrogen, or at least tiny amounts and I’m definitely pro progesterone. Oestrogen has never helped me, I’ve tried various doses and different methods and my mental health has just been awful. For almost a week now I have ditched the oestrogel but continue to take utrogestan and I finally feel a bit more stable.

Progesterone plays a huge role in mental health and I know it isn’t for everyone, but as we all know we are all different.

[CrispyChick]

InterestingTori. I assume you are peri?? Keep us updated on how you get on.

No, prog isn't for everyone (especially in NHS doses) and I'm still struggling to find my magic dose. But god, progesterone, or no progesterone, high estrogen can cause carnage in peri. it makes me mad that the only thing offered to me on the NHS through this peri hell has been combined hrt. The estrogen just compounded my problem. If I dont need estrogen, the NHS can offer me nothing.

[katyh75]

I really relate to your difficulties with oestrogen (mind also extend to progesterone but there we are!)

I'm now in chemical menopause due to the severity of my mood symptoms from fluctuating levels in peri - interestingly my worst time was days 4-11 in my cycle when oestrogen is theoretically increasing.

The last time I tried it I felt great for just over a week and then became suicidally depressed. I hung on for three more weeks to see if it passed - it didn't. It persisted even when I stopped the Utrogestan under medical advice and resolved only after I stopped the oestrogen.
M

[LC1962]

Just a wee update.

I am getting on brilliantly with supplemental progesterone.   I ran out of Progestogel, so I have  started on Pro-Gest from iHerb, which does not smell of alcohol and is a cream you can use on your face. It is not my imagination, but I just look so much better!  It makes my face all glowy in the morning.   I don’t think you can overdose on topical prog.  This is the cream the famous Dr Lee recommends.
I am also convinced my brain chemicals were completely screwed up over the years.  Closely tied to hormonal changes.   I  never ever had any motivation or joy….my life was just so miserable for years and years and years.  Utterly depressed and anxious ALL the time.     I read somewhere about B vitamins helping anxiety and increasing dopamine…so I also started taking a supplemental B vitamins. Thyamine, B12, Biotin and Folic.   Honestly, I’m a different person.  At 62, I’m waking up exited about the day, motivated, looking forward to the future.  I’ve stopped drinking wine to escape.  It’s life changing. I’ve no idea what actually helped but I’m not stopping any of it. Still taking the Prozac although it does nothing.


Honestly…my life is so much better.

[AngelaH]

No, prog isn't for everyone (especially in NHS doses) and I'm still struggling to find my magic dose. But god, progesterone, or no progesterone, high estrogen can cause carnage in peri. it makes me mad that the only thing offered to me on the NHS through this peri hell has been combined hrt. The estrogen just compounded my problem. If I dont need estrogen, the NHS can offer me nothing.

It’s all about balance between progesterone and estrogen, both hormones should be properly balanced, so some of us are needed progesterone to be added and some of us estrogen. I just realised how lucky I was in peri, my GP was German and she was educated in Germany, this is why she didn’t prescribe me estrogen in peri, it would simply kill me. I don’t know why NHS rewrites anatomy and makes it different from the rest of the Word. I only can guess it’s all about finances.