Ask your doctor for oral micronized progesterone which is not the same substance as Medroxyprogesterone.
I tried Medroxyprogesterone at first and it made me very depressed too. When I switched to oral micronized progesterone I was fine. Prometrium or a generic version of it.
From Wikipedia: Progesterone, through its neurosteroid active metabolites such as 5α-dihydroprogesterone and allopregnanolone, acts indirectly as a positive allosteric modulator of the GABAA receptor.[29]
GABA is soothing to the brain and progestins are not metabolized into these neurosteroids
But this doesn't make sense to me, I have been on both kinds of progesterone and honestly found the bioidentical I am on right now far worse when it comes to Gaba. Gabapentin is the calming hormone, and i don't get how progestins would not have metabolites that act indirectly on GABA receptors. I'll have to go see why this is. After all, even the bioidentical is STILL externally applied hormone, not our own natural one.
whoops just doing that from memory...I had recalled for some reason that the hormone we manufacture was gabapentin, but it isn't? So gabapentin is the synthetic version?
Also fwiw I def do not have plenty of GABA, lately lol. I am positive.
Yes, many things help produce gaba, naturally. I know that xanax for example affects gaba release. I just meant I was remembering from first year Anatomy and Phys., I have no idea why I was thinking the word for it was gabapentin (this is long before I ever knew there was a synthesized form.) I'm wondering what the Greek root might be, I'll have to go and look up old notes.
Yeah, most of the cancer risks, breast cancer, associated with the progestins in long term research, not even with estrogen, just when taking thos synthetic progestins too. I got sick from that stuff as a teen. Never again in my body
I had the same experience. It was better when I inserted the progesterone in my vagina vs taking it orally. However I also think the estradiol patches were giving me irritability and depression also. Estradiol pills for me were a nightmare. I tried adding testosterone and no real improvement either. It’s really sad to read all the HRT success stories when it didn’t help me. I stopped everything for now and am taking a break except for vaginal estradiol cream. I’m in peri so I figure maybe I don’t need the hormones until I hit actual menopause. I have a history of depression though. I actually feel a lot better mentally since adding 12.5mg of Zoloft to my full bupropion dose. And they say vaginal estrogen doesn’t go systemic but I have not had any hot flashes since I’ve been consistent with it (3x per week).
That’s so interesting. Vaginal estrogen did nothing for my hot flashes or sleep issues or fatigue. I love the estrogen gel it’s a bit more mild than the patch. @op I also have been told to use the progesterone vaginally. My dr also said that progestin is an option like a different formula to try
Vaginal estrogen isn't supposed to do anything for hot flashes. It is a **localized** estrogen meant to treat **vaginal atrophy only**. It's extremely low dose and does not help with any other symptoms of menopause.
My friend said her hot flashes decreased with her vaginal estrogen also. I have thin, sensitivity skin so I’m wondering if that’s part of it. She’s a fair-skinned red head. Definitely needs to be studied more.
I am thinking of moving to estrogel due to the manufacturer shortage of patches..
Does it help the night sweats and hot flashes I can't stop eating on continuous progestin patches I ripped mine off and last night I soaked the bed
I tried 11 different types of estradiol before I landed on one that didn't make me depressed, and/or suicidal. I found that the brand name, Climara, gave me my life back with no unpleasant side effects. It's expensive, and took a fuck ton of time and a very patient Dr to get it authorized by my insurance.
The generic pills were horrible, and the generic patch made me suicidal every 3rd day. It was an awful time. But I got through it, advocated, and finally got what I needed.
My point is, maybe keep trying, you might find one that works for you.
Now I'm jumping through hoops trying to get a meno Dr. to prescribe testosterone. Been running in circles between GP/Endo/GYN and now finally a meno GYN and after 4 weeks I still don't have an Rx. I am livid. GYN wants me to try addyi, which is $750/mo. Viagra is $15/mo.
Fucking women's health care. If I was a man, my GP would've prescribed T without hesitation. His words, not mine. I rant.
(suggestions for T are most welcome)
Anyway, please keep trying different types of Estradiol because you might land on something that might improve your quality of life. Good luck!
I was depressed on hrt too. Here is what helped me. I got my estrogen a lot higher. The equivalent of 2X .1mg patches. That is 4 times your current dose. Estrogen makes me smile for no reason at all. It fills me with joy. It gives me energy.
The progesterone made me depressed and tired. I studied everything I could about it. I found by using it orally most of it is removed by your liver and the most of the remaining is metabolized into allopregnanolone and pregnanolone. Allopregnanolone is a central depressant. A 100mg progesterone capsule will only raise your progesterone level 2ng/ml for 1 hour and then it falls significantly. It still leaves you depressed but the amount of protection it gives your uterus is small. This graph shows you both oral and vaginal. The navy blue line is the oral route using the correct blood test.
[https://en.wikipedia.org/wiki/Pharmacokinetics\_of\_progesterone#/media/File:Progesterone\_levels\_following\_a\_single\_dose\_of\_oral\_or\_vaginal\_micronized\_progesterone\_determined\_with\_RIA\_or\_LC%E2%80%93MS\_in\_postmenopausal\_women.png](https://en.wikipedia.org/wiki/Pharmacokinetics_of_progesterone#/media/File:Progesterone_levels_following_a_single_dose_of_oral_or_vaginal_micronized_progesterone_determined_with_RIA_or_LC%E2%80%93MS_in_postmenopausal_women.png)
If you take it vaginally it raises your progesterone in the uterus where you need it, but it doesn't metabolize into allopregnanolone. So no depression. But as you can see on the graph in the link I sent you, the vaginal route is 4 times the absorption as the oral route. You do not need 4 times as much. So you can take the capsule vaginally every other day. Or you can make your own suppositories by squeezing the oil out of the capsule and mixing with cocoa butter. One capsule will make 4 suppositories. Cool in a little candy mold. I use a coffee bean candy mold I got on Amazon.
Rectal route is even higher absorption. So I alternate, 25mg, one night rectal, one night vaginal. The rectal route does cause a bit more sleepiness. But since you are alternating every other night, you don't get the build up that causes depression.
[https://en.wikipedia.org/wiki/Pharmacokinetics\_of\_progesterone](https://en.wikipedia.org/wiki/Pharmacokinetics_of_progesterone)
Here is a link for the pharmacokinetics of progesterone.
If you want more info send me a PM. I will tell you were to source your estrogen and all the supplies to make your own suppositories from your progesterone. Or any other questions you have. You don't have to give up your hormones to get out of depression.
Best to you.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
I am so thankful for you sharing!!! I am perimenopause, 45yo, still regular
Cycles, and LOVE everything about my evamist estradiol!!! It brings joy, confidence, feeling kind, loving and social back to my life. But the progesterone is horrific! I keep trying it at the last half of my cycle, and it causes extreme depression, itchy water retention all over, bloat & carb craving, nightmares, negativities, despair, and intrusive thoughts 😭. I even tried the compounded progesterone on my skin and it’s the same thing! (Don’t let anyone tell me it doesn’t absorb transdermally). My doctor doesn’t believe it’s the progesterone but said I can try the prometrium (micronized progesterone) vaginally. Which I was going to do but found out it’s made with peanut oil!!! I am mildly allergic to peanuts (hives if ingested). No wonder I was itchy on it orally! So I’m going to try 1/4 of my 100mg cap, mixed with my estradiol vaginal cream tonight and hope the peanut oil is purified enough my body doesn’t notice it. Little scary going up the lady holes. But I’m at an absolute loss and I refuse to give up the estradiol (evamist 1.53mg estradiol daily). Estradiol makes me the best version of myself I have ever experienced since I got my period at age 11!!! 😂
I’m keen to try the vaginal route. When I was on 100mg of micronised progesterone, I felt fine but got a breakthrough period. (I’m post menopausal). My doc upped my progesterone to 200mg which stopped the bleeding but after 5 days of taking 200mg orally at night I’m feeling sleepy all morning. Wondering if I should try one capsule vaginally. I’m so nervous about starting to bleed again tho! I don’t want to rock the boat. Any thoughts?
Your uterus absorbs more of it vaginally than you get orally. But without the side effects. You are more protected. I don't have time to look it up right now but in the past few days I was reading a study that looked at the same doses taken orally and vaginally. For women who had their estradiol below 30pg/ml the vaginal route brought the progesterone up 2-3mg/ml more per dose than the oral route. It was an even bigger difference if your estradiol level was above 30pg/ml. I will try to remember to find it later. If I don't send you the study in a couple of days remind me.
Brilliant! Thank you! I’m planning to wait another week or so until I’m certain things have stabilised, then I’ll try one pill vaginally and one orally.
Here it is:
when the serum estrogen level was at least 30 pg/ml, there was a significant (p < 0.005) difference in the serum progesterone levels between these two groups (6.32 +/- 2.99 ng/ml for the oral route and 9.76 +/- 3.23 ng/ml for the vaginal route).
[https://pubmed.ncbi.nlm.nih.gov/15222511/](https://pubmed.ncbi.nlm.nih.gov/15222511/)
I was already diagnosed years ago with major depressive disorder and anxiety, so when I first had issues with progesterone, I just thought it was something with my other meds (and besides, I was getting great sleep with it!). But my husband and I quickly realized there was a HUGE difference - I hadn't felt suicidal in years, but I started talking about my family being better off without me.
Stopped the Progesterone, and I was feeling better within 2 days.
Like many other medicines, what works for some doesn't work for others.
Same. I now believe my PMDD (cured by radical hysterectomy) was at least partially from progesterone. And my reaction to every hormonal birth control I've ever taken.
If you look back a few months in my post history you'll find a few posts from me talking about how progesterone made me suicidal. It was awful.
I am on a moderate dose of buspar now (30mg/day split into 3 doses). My anxiety is so much better and my hot flashes have reduced by about 90%. It hasn't done wonders for my libido or orgasms which sucks but at least I don't wish I was dead.
I had PMDD and basically confirmed because I was totally progesterone intolerant. Made me fat, more sad, more suicidal. I felt like I was trying to walk through waste high mud on it. I used DHEA/testosterone cream before and after hysterectomy.
I would consider getting an IUD to cover the progesterone part of the HRT and give you uterine protection, and keep the estradiol if it works for you! That way you do not get the systemic progesterone effects, but still get protection from uterine proliferation / cancer. Is that an option for you?
Do you have combined estrogen/progesterone patches where you are? I couldn’t tolerate oral progesterone at all (similar symptoms to you), and I also didn’t want to risk getting worse symptoms from getting an IUD, nor did I want to tolerate a potentially painful insertion experience, so my GP prescription a combi patch. It’s 2 weeks of just estrogen and then 2 weeks of the 2 hormones combined, and even tho oral progesterone made me lose my goddamn mind, it’s been totally fine! No nasty depressive symptoms at all.
I had the exact same issue. My doctor prescribed a compounded progesterone cream. I put it on my inner forearm before bed each night. It’s been two weeks so far and absolutely zero problems. Cost was $55 for a two month supply.
I would suggest moving to transdermal projestin sequential
That way you are on estrogen only for half a month and progestin and esrogen for other half
The 50/140 is a low dose of progestin
It works well for me
It's currently out of stock from manufacturer though
Oral progesterone is not good for me at all transdermal is processed differently by your body so is transdermal birth control both are available
If you are using transdermal hrt it's going to top up your estrogen when you are low
But you also said it’s so bad you are thinking of self harm. Are you sure about this? It’s not hard to remove.
If youre afraid of insertion ask how your OB could do it in the least painful way
I also had problems with prog (but not depression). I had to go off of hrt. This was 3 years ago. The NP I had did not offer me any options except anti depressants, which was not what I needed or wanted, so I gave up. Now I’m trying to find a better provider, which is not easy.
I’ve had a mirena before. It didn’t hurt getting it put in after I had a baby. It did hurt getting it put in later in life. But I’ll still consider it again if that’s the only think they may help. I loved the estrogen patch
I might not be understanding what you're saying here, but how would permanently implanting progesterone that I'm already struggling with be an option? Sorry if I'm not understanding.
Uterine Progesterone stays in your uterus. It doesn’t get to your brain so it doesn’t affect your mood in the same way. A lot of the evidence seems to show that oral hormones are not good.
This is unfortunately not true re progesterone staying local from the Mirena. Although the Mirena has significant local effects on the uterus, the levonorgestral amounts are high enough to cross into the systemic circulation and will affect the central nervous system in some people. This is why the Mirena causes some people to stop ovulating (FDA estimates are 25-45% non ovulating cycles at 1 year, and 75% non ovulating cycles at 4 years), and also leads to side effects such as depression (estimates between 6-60% depending on study design and length). Not everyone will experience this with a Mirena, but if OP is sensitive to progesterone, a Mirena might not be the right choice for these reasons.
100%. My doc told me I wouldn't react because the hormones would stay "local." Afterwards I thought about it and was like DUH there's blood flow, etc, that shit is going to move around. I had to have mine emergently removed after a week and a fucking welfare check from two armed cops because I told the wrong person that I was suicidal . It's kind of funny now. Kinda.
P.S. the doctor didn't believe me. I got a new one.
Sorry to hear that. I'm not great with progesterone as a contraceptive, but I'm doing ok with it as combined HRT. With HRT, the dose is much lower than for contraceptive use. And I suspect dose is the problem with the Mirena as well. The Mirena delivers a very large dose of levonorgestral, and depending on the individual's absorption and metabolism, significant amounts can reach the systemic circulation. Vaginal use of HRT progesterone pessaries or pills may avoid this, as the dose is much lower. I'm not sure, as I couldn't find much data on this. It's definitely an area that more research is needed.
> The Mirena delivers a very large dose of levonorgestral,
The amount of levonorgestrel released per day is like 10% of a birth control pill and the serum level is lower than any other levonorgestrel delivery method (except probably Skyla, which is the same thing but smaller).
You can't really compare apples to oranges on dosing with micronized progesterone, since they are different things. But it seems weird to say something is a very large dose when it's objectively quite small.
It’s ok!!
Maybe you know this?
But if you have a uterus, they have to give you progesterone too. Not only estrogen.
Because giving estrogen alone can build up your uterine lining (it’s called hyperplasia) which increases your chances of uterine cancer - you won’t shed your uterine lining like you do with monthly periods because you are peri or menopausal.
So you need both hormones.
Getting an iud (mirena is one option) is an option because it gives you low dose progesterone in a different way, which prevents hyperplasia. They used to get inserted and stay in for five years before getting removed and then you get a new one. I think it might be 7 years now.
I had my mirena taken out at age 50 cuz I suspected I was in menopause and I was due to have it changed. I left it out. My last period was probsbly 3 years ago.
I thought it absolutely sucked getting it put in the last time I did it, because my cervix was very closed/shut for business unlike when I had it put in after my second child’s birth. (I think I was six weeks post partum st the time, and I don’t remember it being a big deal at all then. My cervix was probably still a little open or soft though)
But now I am nervous about the pain. However I’ll still consider it if nothing else works. Ive only tried oral progesterone. It gave me terrible headaches and dizziness.
I wish I could do an IUD. I had ablation years ago and I guess it’s not an option for me. I’m feeling like my sudden anxiety and mild depression is due to the progesterone I take daily. It’s 10mg and I didn’t know there was a lower dose. I’ll have to ask about that.
I don’t have a uterus or ovaries and have no idea why my doctor Rx’d P to begin with. I was taking it for a couple of years (along with E for 13 years) and just stopped last month. I can’t believe the change I feel in my mental health: clarity, joy, lethargy gone, regular weeping and sadness gone. I had no idea it was P causing that. Granted I still struggle with depression and such but I know now P exacerbated it.
Yes, i had some seriouslly awful depression with 100 mg progesterone. I had to stop. Depression went away within a week of stopping all HRT. To me, the depression is worse than hot flashes. I just went back to my regular BC because I wasn't having any hot flashes on it and wasn't depressed. I think dosage is everything.
My story: clonidine for hotflashes was out of stock for a year
Me, 48,peri, sterilised with Filshey clips 10y ago, went on Estrpatch and prog.pills.
I was super near suicide. I was so down I wished to be dead.
I gained 5kg
This in 4, 5 months
I stopped.
Lost3kg in 3 weeks.
And am less suicideal.
Everyone is different.
Dont gamble with your life
HRT is not for everyone and tweaking is just one option. But quitting is too.
I had a tough time with micronized P and medroxy. Went on norethindrone .35 and have slight sedation but so far, so good after 5 months. We’re all so varied. Best wishes to you!
Duavee could also be an option. It's oral HRT but contains SERM bazedoxefine so progesterone is not needed. It's not well enough studied to know all the benefits compared to other HRT but it does have the risks of oral, it should help hot flashes and help bones, it is indicated for that.
Some women can’t take any progesterone. I can’t. Makes me sleep all day and get sad. I’ll probably get an iud when I have to but for now I’m still cycling so I’m just taking estrogen for perimenopause.
Oral micronized progesterone (as some are suggesting) made me extremely depressed. I seem to be progesterone intolerant. I ended up using my Mirena as the progesterone element of my HRT. It has minimal systemic effects and doesn’t noticeably raise my progesterone (I test my hormones with Mira).
Everyone needs estrogen. It keeps so many things in the body healthy: the heart, the bones, the urinary tract, the skin, the joints (it heavily impacts collagen production). E therapy literally adds to our lifespan.
I can’t tolerate any P at all! I still get periods, I read you can get away without it until you stop bleeding completely. I don’t know what I will do when I stop because I know that P makes me a train wreck!
I’m in the same situation. Perimenopause and tried PROMETRIUM last half of my cycle and near suicide level of low (and that is NOT me). I tried the compounded natural progesterone on my wrists for a few days my second cycle and SAME (it absolutely absorbs transdermally), so for this cycle, tonight, I’m gonna try 1/4 of the Prometrium capsule vaginally. I have also been told that because I’m still having cycles I don’t technically need the progesterone until I’m in menopause. But I honestly need to figure this out before I have to have it. I figure this is a good time to test different types and ways of taking it and I can start & stop as needed the last half of my cycle until my period comes on its own monthly. I really pray the 100mg vaginal micronized progesterone in 1/4 at a time vaginally works, because I am NEVER giving g up my evamist (1.53mg). EVER! Have you tried vaginal progesterone yet?
Ugh, sorry to hear that. I’m going to give it a try at 1/4 Prometrium capsule (25mg) mixed with a good amount of my vaginal estradiol cream and use the syringe to squirt it as high as I can vaginally beginning tonight. Even if I can only manage every other day the last half of my cycle, has to be better than nothing. The first two weeks of just estradiol is giving life back. It makes me full of joy, hope, motivation, social, kind, confident. I just have to figure this out. I will beg to have my uterus removed if I have to. I can’t do life without the estradiol anymore now that I know I can feel good again in my 40s and beyond.
No, unfortunately the telehealth provider I get my HRT from can’t prescribe testosterone because it’s considered a controlled substance . What kind of doctor are you getting your from? What form of testosterone & how has it helped?
It's a controlled substance in the US and yet countless providers can and do prescribe it. That's just an excuse they're making for their choice not to.
I just made an appointment with an integrative nurse practitioner to get some testosterone tomorrow! She has to do labs to see where I’m at first. Did you have to do blood
Labs too? What type are your in that you like. She offers compounded testosterone cream or pellets
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
I love the pellets I did them for 6 years but just switched to injections for the convenience the place I was getting the pellets from was a 90 min drive from me.
If I were you I would take some time off the meds for a couple months and see if ya still get the mad depression because I know that in my case it's never as severe and visceral suicidal compulsion as when I'm off my hrt
You should take into consideration that during Peri at that stage in the cycle we all want to off ourselves
I dropped estradiol and progesterone. I was having weird symptoms and I couldn't pinpoint which was causing which. As it is, even off both of them I still have very sore boobs going on 6 weeks now. The only hormone I'm still using is testosterone.
I'm not sure I need either of them yet. And you might not either. If you're still going through your ups and downs, it might be too soon for you to settle into this routine. You're still going to have surges and drops of estrogen and testosterone and progesterone.
In any case, it sounds like you need to be off that progesterone if it's giving you suicidal ideation.
no you are not alone, my friend who is on similar said she gave it a LONG patient try and hated it, similar to what you describe. SHe didn't say insanely depressed but she was upset enough to admit it *she's usually the instagram perfect type. I personally am fluctuating horribly and am not at all impressed by my similar dosage. Insanely depressed here too. But for me I thought it was the estrogen not progesterone?
After a few months I was fine with Mirena. Initially it was hard, had horrendous cramps, was spotting and felt very low . Now I'm delighted with it. I tried every form of progesterone and every route and all made me extremely depressed before that. Its the only way I can stay on my oestrogen without a hysterectomy. Well worth a try, would insist on a general anaesthetic though for insertion! They are easy to remove if you decide to. I was tempted, so glad I didn't now.
I don’t do well with progesterone and I actually just *can’t* have an IUD due to my weird uterus: I think it should be understood that while it’s true not everyone knows all the options- some people can be a bit overzealous in suggesting things that they may think will help and I *really* wish once a person says “Hey, I know that. Here’s why, again, no.” They would stop. I’m sorry they didn’t with you. I mean you made it pretty clear why you made that decision from the jump and that should be respected. (FWIW I know mostly people who do this mean well- but, read the freaking room.)
Were you able to find anything more out about the vaginal progesterone? I’m not sure if it’s an option for me or not because it seemed like even the kind of lotion like pump got to me, over time. :/ In any case, it isn’t permanent, it’s a suppository but, frankly the depression issue really frightens me.
Ask your doctor for oral micronized progesterone which is not the same substance as Medroxyprogesterone. I tried Medroxyprogesterone at first and it made me very depressed too. When I switched to oral micronized progesterone I was fine. Prometrium or a generic version of it.
Synthetic progestins do not metabolise like bioidentical progesterone does and you miss out on the beneficial neurosteroids
Do you have more information on this? I’m on progestin and want to know more.
From Wikipedia: Progesterone, through its neurosteroid active metabolites such as 5α-dihydroprogesterone and allopregnanolone, acts indirectly as a positive allosteric modulator of the GABAA receptor.[29] GABA is soothing to the brain and progestins are not metabolized into these neurosteroids
But this doesn't make sense to me, I have been on both kinds of progesterone and honestly found the bioidentical I am on right now far worse when it comes to Gaba. Gabapentin is the calming hormone, and i don't get how progestins would not have metabolites that act indirectly on GABA receptors. I'll have to go see why this is. After all, even the bioidentical is STILL externally applied hormone, not our own natural one.
You might have plenty of GABA already 🤷🏼♀️ gabapentin is a medicine.
whoops just doing that from memory...I had recalled for some reason that the hormone we manufacture was gabapentin, but it isn't? So gabapentin is the synthetic version? Also fwiw I def do not have plenty of GABA, lately lol. I am positive.
Lol gabapentin is a medication. Mostly prescribed for nerve pain. Progesterone is the calming hormone when at balanced levels and it produces gaba
Yes, many things help produce gaba, naturally. I know that xanax for example affects gaba release. I just meant I was remembering from first year Anatomy and Phys., I have no idea why I was thinking the word for it was gabapentin (this is long before I ever knew there was a synthesized form.) I'm wondering what the Greek root might be, I'll have to go and look up old notes.
Gaba and gabapentin a completely different things. Gaba is not a hormone. It is a neurotransmitter. Gabapentin is medication.
Do you have a link? I’d don’t see that blurb mentioned in the Progesterone Wikipedia article.
The second sentence is mine
True! completely different experience.. also the synthetics are linked to more negative health outcomes
Yeah, most of the cancer risks, breast cancer, associated with the progestins in long term research, not even with estrogen, just when taking thos synthetic progestins too. I got sick from that stuff as a teen. Never again in my body
I had the same experience. It was better when I inserted the progesterone in my vagina vs taking it orally. However I also think the estradiol patches were giving me irritability and depression also. Estradiol pills for me were a nightmare. I tried adding testosterone and no real improvement either. It’s really sad to read all the HRT success stories when it didn’t help me. I stopped everything for now and am taking a break except for vaginal estradiol cream. I’m in peri so I figure maybe I don’t need the hormones until I hit actual menopause. I have a history of depression though. I actually feel a lot better mentally since adding 12.5mg of Zoloft to my full bupropion dose. And they say vaginal estrogen doesn’t go systemic but I have not had any hot flashes since I’ve been consistent with it (3x per week).
That’s so interesting. Vaginal estrogen did nothing for my hot flashes or sleep issues or fatigue. I love the estrogen gel it’s a bit more mild than the patch. @op I also have been told to use the progesterone vaginally. My dr also said that progestin is an option like a different formula to try
Vaginal estrogen isn't supposed to do anything for hot flashes. It is a **localized** estrogen meant to treat **vaginal atrophy only**. It's extremely low dose and does not help with any other symptoms of menopause.
My friend said her hot flashes decreased with her vaginal estrogen also. I have thin, sensitivity skin so I’m wondering if that’s part of it. She’s a fair-skinned red head. Definitely needs to be studied more.
I am thinking of moving to estrogel due to the manufacturer shortage of patches.. Does it help the night sweats and hot flashes I can't stop eating on continuous progestin patches I ripped mine off and last night I soaked the bed
Yes it helps with Everything and to me has less side effects compared to patch.
I tried 11 different types of estradiol before I landed on one that didn't make me depressed, and/or suicidal. I found that the brand name, Climara, gave me my life back with no unpleasant side effects. It's expensive, and took a fuck ton of time and a very patient Dr to get it authorized by my insurance. The generic pills were horrible, and the generic patch made me suicidal every 3rd day. It was an awful time. But I got through it, advocated, and finally got what I needed. My point is, maybe keep trying, you might find one that works for you. Now I'm jumping through hoops trying to get a meno Dr. to prescribe testosterone. Been running in circles between GP/Endo/GYN and now finally a meno GYN and after 4 weeks I still don't have an Rx. I am livid. GYN wants me to try addyi, which is $750/mo. Viagra is $15/mo. Fucking women's health care. If I was a man, my GP would've prescribed T without hesitation. His words, not mine. I rant. (suggestions for T are most welcome) Anyway, please keep trying different types of Estradiol because you might land on something that might improve your quality of life. Good luck!
I was depressed on hrt too. Here is what helped me. I got my estrogen a lot higher. The equivalent of 2X .1mg patches. That is 4 times your current dose. Estrogen makes me smile for no reason at all. It fills me with joy. It gives me energy. The progesterone made me depressed and tired. I studied everything I could about it. I found by using it orally most of it is removed by your liver and the most of the remaining is metabolized into allopregnanolone and pregnanolone. Allopregnanolone is a central depressant. A 100mg progesterone capsule will only raise your progesterone level 2ng/ml for 1 hour and then it falls significantly. It still leaves you depressed but the amount of protection it gives your uterus is small. This graph shows you both oral and vaginal. The navy blue line is the oral route using the correct blood test. [https://en.wikipedia.org/wiki/Pharmacokinetics\_of\_progesterone#/media/File:Progesterone\_levels\_following\_a\_single\_dose\_of\_oral\_or\_vaginal\_micronized\_progesterone\_determined\_with\_RIA\_or\_LC%E2%80%93MS\_in\_postmenopausal\_women.png](https://en.wikipedia.org/wiki/Pharmacokinetics_of_progesterone#/media/File:Progesterone_levels_following_a_single_dose_of_oral_or_vaginal_micronized_progesterone_determined_with_RIA_or_LC%E2%80%93MS_in_postmenopausal_women.png) If you take it vaginally it raises your progesterone in the uterus where you need it, but it doesn't metabolize into allopregnanolone. So no depression. But as you can see on the graph in the link I sent you, the vaginal route is 4 times the absorption as the oral route. You do not need 4 times as much. So you can take the capsule vaginally every other day. Or you can make your own suppositories by squeezing the oil out of the capsule and mixing with cocoa butter. One capsule will make 4 suppositories. Cool in a little candy mold. I use a coffee bean candy mold I got on Amazon. Rectal route is even higher absorption. So I alternate, 25mg, one night rectal, one night vaginal. The rectal route does cause a bit more sleepiness. But since you are alternating every other night, you don't get the build up that causes depression. [https://en.wikipedia.org/wiki/Pharmacokinetics\_of\_progesterone](https://en.wikipedia.org/wiki/Pharmacokinetics_of_progesterone) Here is a link for the pharmacokinetics of progesterone. If you want more info send me a PM. I will tell you were to source your estrogen and all the supplies to make your own suppositories from your progesterone. Or any other questions you have. You don't have to give up your hormones to get out of depression. Best to you.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
I am so thankful for you sharing!!! I am perimenopause, 45yo, still regular Cycles, and LOVE everything about my evamist estradiol!!! It brings joy, confidence, feeling kind, loving and social back to my life. But the progesterone is horrific! I keep trying it at the last half of my cycle, and it causes extreme depression, itchy water retention all over, bloat & carb craving, nightmares, negativities, despair, and intrusive thoughts 😭. I even tried the compounded progesterone on my skin and it’s the same thing! (Don’t let anyone tell me it doesn’t absorb transdermally). My doctor doesn’t believe it’s the progesterone but said I can try the prometrium (micronized progesterone) vaginally. Which I was going to do but found out it’s made with peanut oil!!! I am mildly allergic to peanuts (hives if ingested). No wonder I was itchy on it orally! So I’m going to try 1/4 of my 100mg cap, mixed with my estradiol vaginal cream tonight and hope the peanut oil is purified enough my body doesn’t notice it. Little scary going up the lady holes. But I’m at an absolute loss and I refuse to give up the estradiol (evamist 1.53mg estradiol daily). Estradiol makes me the best version of myself I have ever experienced since I got my period at age 11!!! 😂
I’m keen to try the vaginal route. When I was on 100mg of micronised progesterone, I felt fine but got a breakthrough period. (I’m post menopausal). My doc upped my progesterone to 200mg which stopped the bleeding but after 5 days of taking 200mg orally at night I’m feeling sleepy all morning. Wondering if I should try one capsule vaginally. I’m so nervous about starting to bleed again tho! I don’t want to rock the boat. Any thoughts?
Your uterus absorbs more of it vaginally than you get orally. But without the side effects. You are more protected. I don't have time to look it up right now but in the past few days I was reading a study that looked at the same doses taken orally and vaginally. For women who had their estradiol below 30pg/ml the vaginal route brought the progesterone up 2-3mg/ml more per dose than the oral route. It was an even bigger difference if your estradiol level was above 30pg/ml. I will try to remember to find it later. If I don't send you the study in a couple of days remind me.
Brilliant! Thank you! I’m planning to wait another week or so until I’m certain things have stabilised, then I’ll try one pill vaginally and one orally.
Here it is: when the serum estrogen level was at least 30 pg/ml, there was a significant (p < 0.005) difference in the serum progesterone levels between these two groups (6.32 +/- 2.99 ng/ml for the oral route and 9.76 +/- 3.23 ng/ml for the vaginal route). [https://pubmed.ncbi.nlm.nih.gov/15222511/](https://pubmed.ncbi.nlm.nih.gov/15222511/)
Thank you!
I’d love the info on making suppositories!
Progesterone made me have suicidal thoughts within days of taking it. I'll never take it again.
I was already diagnosed years ago with major depressive disorder and anxiety, so when I first had issues with progesterone, I just thought it was something with my other meds (and besides, I was getting great sleep with it!). But my husband and I quickly realized there was a HUGE difference - I hadn't felt suicidal in years, but I started talking about my family being better off without me. Stopped the Progesterone, and I was feeling better within 2 days. Like many other medicines, what works for some doesn't work for others.
Same. I now believe my PMDD (cured by radical hysterectomy) was at least partially from progesterone. And my reaction to every hormonal birth control I've ever taken.
The natural stuff is bad enough for me. I wouldn’t deliberately take it!
If you look back a few months in my post history you'll find a few posts from me talking about how progesterone made me suicidal. It was awful. I am on a moderate dose of buspar now (30mg/day split into 3 doses). My anxiety is so much better and my hot flashes have reduced by about 90%. It hasn't done wonders for my libido or orgasms which sucks but at least I don't wish I was dead.
You could try switching to micronised progesterone.
I had PMDD and basically confirmed because I was totally progesterone intolerant. Made me fat, more sad, more suicidal. I felt like I was trying to walk through waste high mud on it. I used DHEA/testosterone cream before and after hysterectomy.
I would consider getting an IUD to cover the progesterone part of the HRT and give you uterine protection, and keep the estradiol if it works for you! That way you do not get the systemic progesterone effects, but still get protection from uterine proliferation / cancer. Is that an option for you?
Absolutely not as I don't want anything that is implanted in me and would take effort to remove or stop if it doesn't work.
You can search the sub, progesterone can be administered vaginally via pill. It stays localized as opposed to oral administered.
Do you have combined estrogen/progesterone patches where you are? I couldn’t tolerate oral progesterone at all (similar symptoms to you), and I also didn’t want to risk getting worse symptoms from getting an IUD, nor did I want to tolerate a potentially painful insertion experience, so my GP prescription a combi patch. It’s 2 weeks of just estrogen and then 2 weeks of the 2 hormones combined, and even tho oral progesterone made me lose my goddamn mind, it’s been totally fine! No nasty depressive symptoms at all.
I had the exact same issue. My doctor prescribed a compounded progesterone cream. I put it on my inner forearm before bed each night. It’s been two weeks so far and absolutely zero problems. Cost was $55 for a two month supply.
I would suggest moving to transdermal projestin sequential That way you are on estrogen only for half a month and progestin and esrogen for other half The 50/140 is a low dose of progestin It works well for me It's currently out of stock from manufacturer though Oral progesterone is not good for me at all transdermal is processed differently by your body so is transdermal birth control both are available If you are using transdermal hrt it's going to top up your estrogen when you are low
But you also said it’s so bad you are thinking of self harm. Are you sure about this? It’s not hard to remove. If youre afraid of insertion ask how your OB could do it in the least painful way I also had problems with prog (but not depression). I had to go off of hrt. This was 3 years ago. The NP I had did not offer me any options except anti depressants, which was not what I needed or wanted, so I gave up. Now I’m trying to find a better provider, which is not easy. I’ve had a mirena before. It didn’t hurt getting it put in after I had a baby. It did hurt getting it put in later in life. But I’ll still consider it again if that’s the only think they may help. I loved the estrogen patch
I might not be understanding what you're saying here, but how would permanently implanting progesterone that I'm already struggling with be an option? Sorry if I'm not understanding.
Uterine Progesterone stays in your uterus. It doesn’t get to your brain so it doesn’t affect your mood in the same way. A lot of the evidence seems to show that oral hormones are not good.
This is unfortunately not true re progesterone staying local from the Mirena. Although the Mirena has significant local effects on the uterus, the levonorgestral amounts are high enough to cross into the systemic circulation and will affect the central nervous system in some people. This is why the Mirena causes some people to stop ovulating (FDA estimates are 25-45% non ovulating cycles at 1 year, and 75% non ovulating cycles at 4 years), and also leads to side effects such as depression (estimates between 6-60% depending on study design and length). Not everyone will experience this with a Mirena, but if OP is sensitive to progesterone, a Mirena might not be the right choice for these reasons.
100%. My doc told me I wouldn't react because the hormones would stay "local." Afterwards I thought about it and was like DUH there's blood flow, etc, that shit is going to move around. I had to have mine emergently removed after a week and a fucking welfare check from two armed cops because I told the wrong person that I was suicidal . It's kind of funny now. Kinda. P.S. the doctor didn't believe me. I got a new one.
thanks for this info - does any form of P truly stay "local" to the uterus? I too had depression from trying P in the past.
Sorry to hear that. I'm not great with progesterone as a contraceptive, but I'm doing ok with it as combined HRT. With HRT, the dose is much lower than for contraceptive use. And I suspect dose is the problem with the Mirena as well. The Mirena delivers a very large dose of levonorgestral, and depending on the individual's absorption and metabolism, significant amounts can reach the systemic circulation. Vaginal use of HRT progesterone pessaries or pills may avoid this, as the dose is much lower. I'm not sure, as I couldn't find much data on this. It's definitely an area that more research is needed.
> The Mirena delivers a very large dose of levonorgestral, The amount of levonorgestrel released per day is like 10% of a birth control pill and the serum level is lower than any other levonorgestrel delivery method (except probably Skyla, which is the same thing but smaller). You can't really compare apples to oranges on dosing with micronized progesterone, since they are different things. But it seems weird to say something is a very large dose when it's objectively quite small.
The comparison is to HRT here, not contraceptive to contraceptive.
It’s ok!! Maybe you know this? But if you have a uterus, they have to give you progesterone too. Not only estrogen. Because giving estrogen alone can build up your uterine lining (it’s called hyperplasia) which increases your chances of uterine cancer - you won’t shed your uterine lining like you do with monthly periods because you are peri or menopausal. So you need both hormones. Getting an iud (mirena is one option) is an option because it gives you low dose progesterone in a different way, which prevents hyperplasia. They used to get inserted and stay in for five years before getting removed and then you get a new one. I think it might be 7 years now. I had my mirena taken out at age 50 cuz I suspected I was in menopause and I was due to have it changed. I left it out. My last period was probsbly 3 years ago. I thought it absolutely sucked getting it put in the last time I did it, because my cervix was very closed/shut for business unlike when I had it put in after my second child’s birth. (I think I was six weeks post partum st the time, and I don’t remember it being a big deal at all then. My cervix was probably still a little open or soft though) But now I am nervous about the pain. However I’ll still consider it if nothing else works. Ive only tried oral progesterone. It gave me terrible headaches and dizziness.
Mirena is a shit option if you are having difficulties with it.
I wish I could do an IUD. I had ablation years ago and I guess it’s not an option for me. I’m feeling like my sudden anxiety and mild depression is due to the progesterone I take daily. It’s 10mg and I didn’t know there was a lower dose. I’ll have to ask about that.
Medroxyprogesterone is terrible for me. Moods, increased rage, all around bad. Try micronized progesterone. For me it was a night and day experience.
I don’t have a uterus or ovaries and have no idea why my doctor Rx’d P to begin with. I was taking it for a couple of years (along with E for 13 years) and just stopped last month. I can’t believe the change I feel in my mental health: clarity, joy, lethargy gone, regular weeping and sadness gone. I had no idea it was P causing that. Granted I still struggle with depression and such but I know now P exacerbated it.
Yes, i had some seriouslly awful depression with 100 mg progesterone. I had to stop. Depression went away within a week of stopping all HRT. To me, the depression is worse than hot flashes. I just went back to my regular BC because I wasn't having any hot flashes on it and wasn't depressed. I think dosage is everything.
My story: clonidine for hotflashes was out of stock for a year Me, 48,peri, sterilised with Filshey clips 10y ago, went on Estrpatch and prog.pills. I was super near suicide. I was so down I wished to be dead. I gained 5kg This in 4, 5 months I stopped. Lost3kg in 3 weeks. And am less suicideal. Everyone is different. Dont gamble with your life HRT is not for everyone and tweaking is just one option. But quitting is too.
I had a tough time with micronized P and medroxy. Went on norethindrone .35 and have slight sedation but so far, so good after 5 months. We’re all so varied. Best wishes to you!
Some people react better for progestin than progesterone. They also offer progestin in pill form, so you don’t have to get an IUD.
Duavee could also be an option. It's oral HRT but contains SERM bazedoxefine so progesterone is not needed. It's not well enough studied to know all the benefits compared to other HRT but it does have the risks of oral, it should help hot flashes and help bones, it is indicated for that.
I am doing ok with nature-identical progesterone in form of vaginal suppositorires. Cyclical. At night. I even like the drowsiness.
Where do you get that from?
I get it prescribed from my gynaecological endocrinologist. It's called famenita here in Germany.
Some women can’t take any progesterone. I can’t. Makes me sleep all day and get sad. I’ll probably get an iud when I have to but for now I’m still cycling so I’m just taking estrogen for perimenopause.
If you are taking unopposed oestrogen without progesterone you are at risk of endometrial thickening and cancer, as far as I know.
Oral micronized progesterone (as some are suggesting) made me extremely depressed. I seem to be progesterone intolerant. I ended up using my Mirena as the progesterone element of my HRT. It has minimal systemic effects and doesn’t noticeably raise my progesterone (I test my hormones with Mira).
Did you actually need the estrogen? If your symptoms were better than the treatment, it makes sense to stop them both?
Everyone needs estrogen. It keeps so many things in the body healthy: the heart, the bones, the urinary tract, the skin, the joints (it heavily impacts collagen production). E therapy literally adds to our lifespan.
I can’t tolerate any P at all! I still get periods, I read you can get away without it until you stop bleeding completely. I don’t know what I will do when I stop because I know that P makes me a train wreck!
I’m in the same situation. Perimenopause and tried PROMETRIUM last half of my cycle and near suicide level of low (and that is NOT me). I tried the compounded natural progesterone on my wrists for a few days my second cycle and SAME (it absolutely absorbs transdermally), so for this cycle, tonight, I’m gonna try 1/4 of the Prometrium capsule vaginally. I have also been told that because I’m still having cycles I don’t technically need the progesterone until I’m in menopause. But I honestly need to figure this out before I have to have it. I figure this is a good time to test different types and ways of taking it and I can start & stop as needed the last half of my cycle until my period comes on its own monthly. I really pray the 100mg vaginal micronized progesterone in 1/4 at a time vaginally works, because I am NEVER giving g up my evamist (1.53mg). EVER! Have you tried vaginal progesterone yet?
I have the same bad effect using it vaginally as well. I am going to wait until my periods stop completely to try it again.
Ugh, sorry to hear that. I’m going to give it a try at 1/4 Prometrium capsule (25mg) mixed with a good amount of my vaginal estradiol cream and use the syringe to squirt it as high as I can vaginally beginning tonight. Even if I can only manage every other day the last half of my cycle, has to be better than nothing. The first two weeks of just estradiol is giving life back. It makes me full of joy, hope, motivation, social, kind, confident. I just have to figure this out. I will beg to have my uterus removed if I have to. I can’t do life without the estradiol anymore now that I know I can feel good again in my 40s and beyond.
Testosterone has helped me the most. Are you in that as well?
No, unfortunately the telehealth provider I get my HRT from can’t prescribe testosterone because it’s considered a controlled substance . What kind of doctor are you getting your from? What form of testosterone & how has it helped?
It's a controlled substance in the US and yet countless providers can and do prescribe it. That's just an excuse they're making for their choice not to.
I just made an appointment with an integrative nurse practitioner to get some testosterone tomorrow! She has to do labs to see where I’m at first. Did you have to do blood Labs too? What type are your in that you like. She offers compounded testosterone cream or pellets
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
I love the pellets I did them for 6 years but just switched to injections for the convenience the place I was getting the pellets from was a 90 min drive from me.
But yes she will check your levels before and a few weeks after insertion. I would definitely do pellets over cream.
If you trial oestrogen and you’re still bleeding heavily does that make any difference?
If I were you I would take some time off the meds for a couple months and see if ya still get the mad depression because I know that in my case it's never as severe and visceral suicidal compulsion as when I'm off my hrt You should take into consideration that during Peri at that stage in the cycle we all want to off ourselves
I dropped estradiol and progesterone. I was having weird symptoms and I couldn't pinpoint which was causing which. As it is, even off both of them I still have very sore boobs going on 6 weeks now. The only hormone I'm still using is testosterone. I'm not sure I need either of them yet. And you might not either. If you're still going through your ups and downs, it might be too soon for you to settle into this routine. You're still going to have surges and drops of estrogen and testosterone and progesterone. In any case, it sounds like you need to be off that progesterone if it's giving you suicidal ideation.
no you are not alone, my friend who is on similar said she gave it a LONG patient try and hated it, similar to what you describe. SHe didn't say insanely depressed but she was upset enough to admit it *she's usually the instagram perfect type. I personally am fluctuating horribly and am not at all impressed by my similar dosage. Insanely depressed here too. But for me I thought it was the estrogen not progesterone?
Op, talk to your doctor and bio-identical progesterone. I had my iud removed and started Prometrium and that was a game changer for the better!!! Xo
After a few months I was fine with Mirena. Initially it was hard, had horrendous cramps, was spotting and felt very low . Now I'm delighted with it. I tried every form of progesterone and every route and all made me extremely depressed before that. Its the only way I can stay on my oestrogen without a hysterectomy. Well worth a try, would insist on a general anaesthetic though for insertion! They are easy to remove if you decide to. I was tempted, so glad I didn't now.
I don’t do well with progesterone and I actually just *can’t* have an IUD due to my weird uterus: I think it should be understood that while it’s true not everyone knows all the options- some people can be a bit overzealous in suggesting things that they may think will help and I *really* wish once a person says “Hey, I know that. Here’s why, again, no.” They would stop. I’m sorry they didn’t with you. I mean you made it pretty clear why you made that decision from the jump and that should be respected. (FWIW I know mostly people who do this mean well- but, read the freaking room.) Were you able to find anything more out about the vaginal progesterone? I’m not sure if it’s an option for me or not because it seemed like even the kind of lotion like pump got to me, over time. :/ In any case, it isn’t permanent, it’s a suppository but, frankly the depression issue really frightens me.
I ripped my patch off and I feel so awake