Estrogen dominance: Does/did natural progesterone help you?

After suspecting I'm in an estrogen-dominant state, my latest saliva hormone lab tests showed I have high normal estrogen but below normal progesterone. Which indeed translates to a rather extreme estrogen dominance (recommended ratio: 1:200-300, mine: 1:10).

And I'm not even nearing menopause yet, being in my early thirties.

I have all the symptoms, premenstrual migraines, cramps, PMS, water retention and about 50 more.

I've read Dr. Lee's and Michael Platt's hormone books and they recommend natural progesterone for this situation. What makes me cautious: My ME is severe and from what I hear progesterone makes some patients worse.

About 2 years ago I gave it a try and after a couple of months I deteriorated a lot. But how could I know if that was from the progesterone or just natural disease progression or something else entirely?

If anyone has tried natural progesterone, I'd love to hear about your experience with it and whether it helped you, if you had documented estrogen dominance and how severe your ME is.

Thanks,
Nina

Hi Nina, i have thought i have estrogen dominance for years from symptoms etc. My herbalist that i see also thinks so - although i havent had any testing for it - i am a typical estrogen dominance woman. I havent ever tried natural progesterone as i am so sensitive to things and hormones particularly can mess me up. My M.E has been moderate/severe for the past 3 years but now just moderate and improving.
What i tried was a herbal tincture of Vitex Agnus castus which was miraculous in its effects. My PMS cleared up immediately and only returned after id stopped the course of drops for a year. Ive recently gone back on it and it really does help to balance my hromones. I havent had any side effects from taking it at all. My herbalist recommends i take it for a while and then have a break from it - although menopausal women do take it for longer periods.
I hope this info helps.
Justy.

Hi Nina--

I have used compounded progesterone for over a decade (since my late 30's) without a problem. In fact, initially it was a fantastic sleep aid, but then my body acclimated to it and the magic of its sedative qualities wore off. I still use it, but now because I am approaching menopause, I also use compounded estrogen as well.

If you are going to use hormones, it's best to be monitored regularly with the saliva tests. I see a naturopath who has a lot of experience working with them. I find the hormones very helpful, and have never had a problem with them.

Good luck with finding what works for you.

Thanks for your replies, Justy and Dreambirdie.

I've been taking agnus castus for over a year now and it helped to get my cycle up to 26/27 days again, which is good. But it didn't do anything for the other problems and obviously didn't help my body make enough progesterone. I'm reluctant to mess with hormones too but the potential benefit is too seductive. The monthly disaster is a big barrier for progress for me. On the other hand I don't want to risk getting worse!

It's good to hear you've had a positive experience, Dreambirdie. May I ask if you are on the mild, moderate or severe end? It often seems to me that mild or moderate patients can tolerate a lot more meds/supplements etc than us severer "cases". Of course at the end of the day only trying it again will show how I tolerate it myself but if there are many others who were made worse then maybe I'm not ready to take my chances. I don't want to jeopardize the little progress I've made during the past 3 months.

Hi Nina--

I am not sure how to classify my ME right now, as I all over the place. I was up to walking 30 minutes/day just a month ago, even better back in October, and then I had several smack downs caused by: food poisoning, a flu-like cold, and pollen allergies resulting in worsened insomnia. So lately I have been mostly in bed.

IN MY CASE, it makes little difference how ill I am as to the effectiveness, or lack thereof, from the bio-identical hormones.

Everybody (and every body) is different. So there is no predicting how the hormones will work for you. I wish there was some way to know IN ADVANCE, but unfortunately there is not. I would advise you find someone who has A LOT of experience with the hormones--MD or ND--and have them monitor you through it.

Good luck.

Possibly silly question but did you do the test on the recommended day of your cycle (usually day 19-21)?

I have used progesterone successfully for years starting in my late 20s (now in mid 30s). I wish I had known when I started though that estrogen dominance is often a result of low cortisol. Estrogen levels can rise when cortisol falls as a result of inflammation. And progesterone can be used to prop up flagging cortisol levels (through steroid conversion) though this method is NOT recommended because conversion is imperfect at best. Many people with CFS/ME also have endocrine issues with adrenals and addressing these can be an important part of symptom relief.

If I had it to do over again, I would test cortisol with a saliva test prior to starting progesterone. It isn't to say that you might not need progesterone as well but just that it is best to know why it is happening.

You can also get a Metametrix Organic Acids test that has a measure for b-glucuronidase which may help you understand how well you are excreting estrogen as there are herbs and supplements (like the Vitex mentioned or also calcium d-glucarate) which can help increase estrogen metabolism. But again, knowing what to take means knowing a little bit more about why your ratio is off and there is testing that can help suss that out for you.

I have PCOS so have issues with progesterone dominance.

I couldnt take progesterone (before I even had ME). The mini contraceptive pill which is progesterone only pill.. triggered off extreme symptoms (made me feel like I was going crazy and really did affected my mental health, it started affecting me within days of taking it with each day getting worst) and made me end up in a mental hospital for a week, within two weeks of starting it. I was fine again when I stopped taking that pill.

Roll forward 20years later by this time I'd had ME long term. A doctor suggested I trial natural progesterone (previous doctors after my past progesterone experience hadnt wanted me to have it again in any form and I wouldnt have tried it again anyway). I found I was fine with taking the natural form of it, no side effects in my case with that form at all. Unfortunately it thou didnt help any of my symptoms.

Thank you so much, Ema. Yes, I took the test on day 20.

I know that my adrenals are a problem but not as much as they used to. I ordered a cortisol saliva test as well and that came back a lot better than the last time. I was actually within the reference range for the first time over the whole course of the day. So although that has improved, I am still not making enough progesterone. It may very well still contribute to the problem though.

I will look into calcium d-glucarate, thanks, sounds like a sensible approach!

Tania I'm sorry to hear you have PCOS. No doubt progesterone dominance isn't pleasant either! So hard to fiddle with hormones and get the right balance. Natural progesterone seems to be the way to go in any case, I wouldn't touch progestins or gestagens.

Thanks Ema, that's really interesting about the cortisol, i have adrenal issues but have never had the cortisol saliva test...might be worth a go.

Hey Nina - sorry the castus hasnt had more of an effect for you. I find it helps just enough that i can cope - ive always had these hormonal problems so i guess im used to it by now! i wonder what the menopause will bring - not looking forward to that.
Take care, Justyx

I haven't been formally tested, but I do have PMDD and as I do FAM tracking, I know that I have a short luteal phase (9-10 days). The start of the PMDD, when I was 28, coincided with rapid unexplained weight gain. I had several doctors tell me that the extra weight was probably making my hormones worse, as oestrogen is stored in fat cells. I've just finished losing the weight (lost 30% of my body weight). It's too early to tell whether it will help with the PMDD, as hormones tend to go crazy during weight loss, plus I took flax seed oil for a couple of months and that badly exacerbated my breast pain.

At one point I tried "natural" progesterone cream, bought over the internet from what appeared to be a reliable source. It made no difference to the PMDD or the short luteal phase. It did increase the amount of spotting I experience a little. To be honest, I am now very suspicious of all the claims made for progesterone ("natural", for one), and I hear that a lot of the creams have been tested and found to contain no progesterone whatsoever.

It's really important that the rhythm across the day is right too. It should form a nice curve - at the top of the reference range in the AM and at the bottom of the reference range at night for sleep. One can be "in range" for every period and still have a terrible rhythm that can cause symptoms.

DIM is another good one for estrogen metabolism.

You might try progesterone cream from a compounding pharmacy so you would know it actually contained the active ingredient. I've also had good luck with Emerita and NOW brands OTC.

I had good luck alleviating breast pain from fibrocystic breast disease as well as lengthening my short luteal cycle with progesterone cream. I don't know if I would have experienced the same effects without the stronger progesterone cream that was compounded though as it would take a LOT of the OTC cream to get to a reasonable therapeutic dosage for someone who was quite low like I was. I also found it needed to be applied directly to the breasts in order to get a benefit to the soreness. Applying only to my inner arms or thighs did nothing to help with breast pain.

Strangely enough, the other thing that helped with breast pain is spraying the topical magnesium oil for about 20 minutes before a bath. Between the two, my issues have vastly improved.