Hello and Welcome!!

~Seek first to understand, then be understood~
Moving into the holidays, I am focusing on posts about positive things women with PMDD can do to strengthen our relationships with our loved ones.
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If you're looking for information on a particular topic, just type that word in the search box. You will then pull up all posts that include information on that subject, assuming the search box is working, which occasionally it is not. Sorry about that. I have no clue why that happens.
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I have a "friend" who shows up once a month. She turns my world upside down, over and over again.
I am a good person, caring and sweet, but when she comes to visit, I could rip off your head.
She takes no prisoners, foul words she does spout, I try to keep the words in, she lets them come out.
People don't understand me, or what this is about, to have this creature inside my head.
I despise who I am, half of the time, I feel sorry for my daughter, family and friends.
There's no way to describe it, for those who don't know, it's a living nightmare, she really needs to go.
~Neysia Manor

Wednesday, August 18, 2010

Progesterone Treatment for PMDD -- Is it for you?

Update:  I am working on a new post about progesterone, progestins, and bio-identical progestins, to be posted in December of 2012.  In the meantime, my post, What's Special About Progesterone? is good to read as background material.  Thank you, and have a great day!

A couple of weeks ago I received a comment from a reader, suggesting I look into saliva hormone testing and progesterone creams if I intend to give advice on how to manage PMDD. To that reader I want to say thank you for speaking up, because it gives me a direction to go in today. My blog is still young, only three months old, and with posting only once a week I’ve gotten nowhere near to telling you about all the things I have tried, experienced, researched, and discovered in the past ten years. But questions or comments give me an idea of what people are interested in reading about, so I very much appreciate them.

One thing you’ll notice on my blog is I don’t recommend something unless I’m sure it will be helpful to a lot of women. I know how busy you are, and how desperate you are for relief, so I don’t want to waste your time, or send you on any wild goose chases that will only further demoralize your efforts to be well.

Part of what convinces me something is helpful is when I read about a type of treatment from an unbiased source. In my reading and experience, the proponents of progesterone treatment (both synthetic and bio-identical) are anything but unbiased. This makes me naturally wary of them. In my day job, I edit books, and as an editor, particularly an editor of crime fiction, suspense thrillers, mysteries, and whodunits, it’s almost second nature any more for me to spot inconsistencies in a story. My son goes crazy when we watch NCIS and after the show, I say, “Yes, but what about…?” and I show him how the plot was manipulated to suit the episode.

In general I’m a trusting person, but when it comes to my wealth or my health, I am biased toward the skeptical. Nobody is going to look out for my financial welfare or health and well being better than me. And if I don’t do it, don’t set the example or standard of what I will or won’t go for, no one else will.

Why should they? It’s not their pocketbook or health being depleted. No skin off their nose, right?

So…back to the progesterone question. This week I collected all my books on women’s health and wellness, and hormonal imbalances in particular. Put them all on the same shelf, so that I can easily find what I am looking for. One of these days I’ll print a list of all the books I’ve read, but I won’t recommend them unless I know they can be of specific help to YOU, or whoever is asking a particular question or needs advice. No need to encourage people to run around buying and reading books that won’t do them any good anyway. And I’m not here to impress you with my hormonal library. I’m here to help you if I can.

To that end, I’ve read at least 12-15 books on women’s hormones, and hormonal imbalances alone. Unfortunately, in every one I’ve read that recommends saliva testing and/or progesterone creams, they also happen to have a financial interest in the outcome of your testing and the product they are promoting.

I have yet to find one book-writing or online-type doctor who recommends progesterone treatment for the sake of progesterone treatment alone.

On the other hand, I have yet to read from one unbiased doctor—meaning one who does not also sell supplements and/or progesterone cream—that progesterone treatments work to eliminate PMDD.

The best (meaning unbiased, so I consider it reliable) information I have come across is that progesterone cream relieves some of your PMDD symptoms, while it can and quite often does make other symptoms worse. Why? Progesterone decreases serotonin. What creates the first D in PMDD? A dip in your serotonin levels. Serotonin lifts depression.

So while studies have shown progesterone has a Valium-like effect on the brain and some women will feel relief from pre-menstrual anxiety and tension--you know, that fear, that panic, that wanting to jump out-of-your-skin edginess, that feeling that makes you want to hit somebody--anybody--that irritibility that has you snapping for no logical reason at all at your co-workers and loved ones--increased progesterone can also have negative effects, including

headaches
mood swings
irritability
breast tenderness
bloating
increased appetite
food cravings
feeing fat
and no sex drive

In other words, PMS symptoms. But isn’t that part of what we’re trying to get away from to start with?

The bottom line is this: If you’re using progesterone cream and any or all of these things are happening to you, that may be why. Ditto if you’re taking progesterone orally, be it alone or as part of a birth control pill or some other form of hormone replacement therapy.

But beware: if progesterone treatment is stopped abruptly, it can produce withdrawal symptoms similar to that of benzodiazepines, barbituates, and alcohol.

So if you’re taking it orally, and want to stop, you need to withdraw slowly, and under your doctor’s supervision.

Note: Studies show that synthetic progestins in birth control or hormone therapy regimens can increase the frequency and severity of headaches in women, including migraines. Progestin-only types of contraceptives, like Norplant and Depo-Provera, you especially need to watch out for.
But back to the question of progesterone cream. I myself tried progesterone cream, looking for that magic bullet. I tried it for four months. Any and all of the programs that promote it say you should notice a discernable change within three months, even if you have severe PMDD. I noticed a lessening of some symptoms, a pleasant steadiness in my mood, but it did not seem to have any overall effect on my PMDD. It still comes around like clockwork, and when it comes, it hits hard.

Part of the problem with the creams is that they are not regulated. So you never know how much you are getting in a dose. Or even if you’re getting what you’re supposed to be getting, depending on what brand you use. Never get one that is not pharmaceutical grade micronized progesterone, and those easily run $30 to $50 a tube or bottle.

Some on-line doctors have gotten around this uneven dosage problem by providing pumps that supposedly pump out the exact dose you need, or by providing pre-packaged doses guaranteed to contain 50 mg of micronized progesterone in them. If one packet or squirt doesn’t work—try two that day, or more.

Seems rather hit or miss to me. And one doctor I recently read (I wish I could remember which one right now) said you’d have to practically bathe in the progesterone cream to make any difference if the real underlying problem was a progesterone deficiency.

So that’s why I don’t recommend it. I won’t recommend anything here that I am not absolutely, positively sure will help women. We’ve been led astray too many times already by people more concerned with their bottom line than the state of our pocketbook or health and well being. When I read the blog comments on other blogs by women suffering from PMDD I can see right away things that are contributing to their PMDD that their doctors refuse to acknowledge or simply don’t know or care about.

I won’t do that to you here. Here you will be listened to, and I will answer you to the best of my ability. If I don’t know something, I will tell you I don’t know anything about that, and then I will stay up nights looking it up in order to provide an answer at a later date. If there’s a need, I will do what I can to fill it. We’re all in this boat together, and what I learn while researching your question, may in the end help me or others as well.

So it’s all good.

Thank you again for your question, and anyone else who has a question, please either leave it in the comment section, or email me privately at info(at)livingwithpmdd.com. Your privacy will always be protected. Even if you give me your name, I won’t use it here in my blog.

Until next week, be informed, and be well :).

26 comments:

  1. Thank you for your diligent hard work, it is so appreciated.

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    1. You just stated in your above comments that ...."I myself tried progesterone cream, looking for that magic bullet. I tried it for four months. Any and all of the programs that promote it say you should notice a discernable change within three months, even if you have severe PMDD. I noticed a lessening of some symptoms, a pleasant steadiness in my mood, but it did not seem to have any overall effect on my PMDD". You said your self you noticed a lessening of some of the symptoms. Have you ever had your progesterone levels checked? My body will not maintain the proper level of progesterone. I take the natural progesterone, nothing else and have experienced little or no symptoms for the past 20 years. Yes I wanted to scream at everyone, drive off cliffs, and often just curl up in the fetal position. I have gone thru menapause and attempted to stop the progesterone, but was told by my woman physician to continue on the hormone. I keep my weight healthy , work out and have an excellent diet. Not all that easy, but well worth the end result.
      Go to an all Woman's clinic if you have one near by, get your hormone levels tested. Living with PMDD is not only hell on us, but the worst for our loved ones. And maybe if you find a good physician they can help you and maybe if they sell the product you need, it is just because they know it works.

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    2. Hi there! Yes, I have had my progesterone levels tested, several times, and they have always fallen within the normal range. As part of my perimenopause regimen, I am now taking 100 mg of micronized progesterone 7 days a month, just before my menses. It still doesn't seem to have any effect on my PMDD. But it helps to keep my cycles regular, so that they don't sneak up on me. So that helps with event planning and such. I can tell by looking at the calendar whether specific appointments or social commitments are more likely to fall during my "good" or "bad" days.

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    3. P.S. I can see that in my previous comments, such as in August of 2012, I have stated that the micronized progesterone "was" helping my PMDD. Well, that is no longer true in my case--I am still taking the progesterone, and my PMDD has returned, as strong as ever. So as much as I would like to, I can't recommend treating PMDD with progesterone alone. Or with progesterone creams. But I am happy if you find it works for you.

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  2. At first when I was told i have PMDD I was put on low dose prozac to help even out the swings. But I wanted to get off of it because I would rather cure it reather than appease the symptoms. I have been using the bioidentical Progesterone cream for years instead...I don't see much of a difference but my man does. I still have those jump out my skin-get the-heck-out of my way feelings. And man it is like clockwork too. Glad to know I am not alone out there...thanks for the blog. I have not seen anything that worked now and my current OBGYN fills my script for cream but I don't think she even believes PMDD is for real.My previous nurse practitioner is one who recommended the cream to me (she described PMDD as a progesterone crash). I am just grateful that my husband understands when I wig out sometimes... BUt he says he really does notice a difference of when I use the cream as opposed to not. I will go check out your links because they all look interesting

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  3. I just got progest cream and haven't used it yet. Im currently on birth control to help with pmdd. It helps extremely well but when I get close to my period and even during and a couple of days after I hit rock bottom again. Dr's will not listen. My husband can tell them what I go threw! Lol I guess question is can I only use it while im in my period?

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    1. I think this site has the information you need. http://www.progesteronetherapy.com/how-to-use-progesterone-cream.html#axzz20QEd92aU

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  4. Great article, I have been following you for awhile.

    The depo shot is one giant dose of progesterone, and that completely cured my PMDD--but it also made me lazy and killed my creativity, which are both vital in my day to day life.

    I am going to try the cream, but will keep in mind everything you have mentioned.

    Thanks again!

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    1. I've read that, that too much progesterone can make you lethargic, which is why I have been reluctant to recommend it, especially with not knowing a good, safe source to recommend. I think I may have hit on something though with the Prometrium 100 mg. It's a prescription that also comes in 200 mg, but I wanted to start out slow, and knew I could always double it if the need arose. Thanks for following me and stay tuned :)

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    2. I had taken the depo provera shot, exactly the next day is when my pmdd sky-rocketed out of control and it has been hell since that shot. I had it for a year before then, but it was not as severe as wanting to throw things or screaming until my voice gives out. I only got the one shot in January of last year, and it feels as though I have not stabilized yet. 1 year of this severe pmdd right before my period and I am feeling like everything I try is not working. Healthy diet, exercise, vitamins, even birth control does not tend to work. Just to say, I would try the cream if it was my only option, but I am leery of progesterone in general because of my shot with depo and how it surged the effects monthly. Thanks for your comments, I will look into this also,

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  5. I am doing more research into progesterone now and hope to write a new post soon. I now have a prescription for 100mg of micronized progesterone and it seems to be working, but only time will tell!

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    1. How has it been going with the 100mg of progesterone? Id really like to know!

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    2. It's not hurting, put it that way. I still have episodes of PMDD, but they seem to be milder, and I seem to be able to handle them better. Much better. Is it because of the progesterone alone?...I don't know. Would a larger dose help?...I don't know, as I haven't tried it yet. (It's not covered by my health insurance.) I do know it has helped immensely with my menopause symptoms, mainly that of breakthrough bleeding, and for that alone it has been worth it to me.

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    3. Thank you for your quick reply and for all of your excellent writing on this blog :)

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  6. Looking at getting a partial hysterectomy to alleviate the problem.... Confused and concerned...

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  7. Deo-Provera is NOT progesterone. The birth control is a synthetic version called progestin and actually blocks progesterone makers in the body. This is why people who already are estrogen dominant have so many side effects on Depo-Provera...they're progesterone levels are very deficient.

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    1. I'm assuming this is a reply to PMDD Sufferer from August 12. Absolutely....I agree. Depo Provera is a synthetic progestin, not a progesterone. Sorry I didn't catch that sooner. PMDD Sufferer, if you are still reading, can you update us on how the shot worked for you? Thanks!

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  8. Hi there I am a PMDD sufferer who has been on Sertraline and a birth control pill for years however had to come off the mini pill as it was giving me a headache above my right eye. I have just had the under the skin depo injection. I will let you know how it goes. I have also in the past tried Yasmin which helped with the PMDD but I suffered sleepiness, night sweats and the hormone headaches so that wasn't helpful.

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  9. I just want to say that I bought into the natural progesterone cream cure and tried it out for several months. I noticed no difference in my pmdd symptoms. I've also tried progesterone and progestin pills that threw me right into an extended period of pmdd symptoms. I have read that these fixes can truly help out some women, but I am apparently not one of them. I urge other women to be careful with experimenting with these so-called "cures" because they turn life into a living Hell.

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  10. I have finally found relief from pmdd. I have been on prozac for 6 months. My symptoms decreased to about 3 days while taking that, but those 3 days were bad. I just finished my 3rd month of progesterone cream and did not have any symptoms. It was amazing. I am so hopeful that it wasn't a one time thing. I don't think it was a placebo bc I didn't think it would work, and don't think a placebo could make me not have symptoms.

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  11. I also want to add that I found out I was hypothroid and have been on meds for that for 3 months as well. Don't know if that helped the pmdd or not.

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  12. thank you so much for this blog! ... I just recently learned that PMDD was a thing, and that I have had it since I first got my period. all these years I have thought I was crazy, been convinced by doctors and family that I was crazy and " just being dramatic" ... so glad I know the truth now and can begin finding a solution that works for me! ... I'm on my second month of using gnc brand progesterone cream ( I'm on nuvaring so I just use it the week before I'm scheduled to start) and to be honest, I am not sobbing every day, and I'm able to get out of bed and be productive, and I no longer have suicidal thoughts during that week or so. but I'm not sure if that is because of the cream or because of the epiphany that it's an actual hormonal thing and that I'm not just insane... Either way, your blog has helped me so much in getting my life together and finding solutions for this absolutely debilitating disorder. thank you!

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  13. I started using an SSRI 14 days out of the month to manage PMDD and it has changed my life. But the day of and before ovulation I still experience "crazy." I read that this might be due to the spike in estrogen that happens right around ovulation (see the NYtimes article: All the Rage). Apparently SSRIs only work for dealing with the progesterone crash? So I am wondering if anyone knows any solutions for the hormone shift that happens just before/at ovulation. Cognitive work helps so long as I (and my husband) am prepared for it, but when my cycle is irregular it can catch me off guard and is really destructive. Suggestions?

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    1. Hi, there, Thank you for asking that question -- I am actually working on finding an answer to it (and about 50 other things at the moment, as usual) and do not want to offer an answer until I have double and triple checked my facts/sources, so I thank you again, because you just moved that question to the top of the pile again...and sort of nudged me to hey, get that blog post written. Not what you want to hear right now, but I AM working on an answer, so please check back now and then.

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  14. I was doing some reading on Progesterone and Estrogen yesterday while I was trying to research Maca root (which I find helps keep me in balance a lot!) and started thinking that perhaps the PMDD is an over abundance of estrogen at times - which would make sense... Right now I am not treating it, the birth control doesn't work like it used to, and I am a smoker, and over 30. I am very tempted to try progesterone cream, worse case scenario - I feel crazy... right? Not like that's not already the story of my life. It feels like no Dr will get it, well asides from the one at a specialized women's health clinic who diagnosed me, so I spose you just have to take charge and keep trying. Also, Maca root. It's amazing! Look it up!

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  15. Thank you for the blog. PMDD is terrible. I use progesterone cream and have found it helpful if I start using it at the right time, however this past month I began to feel depressed as soon as my period came/right when I stopped the cream. Usually symptoms lift at the onset of my period which is why I stopped the cream... not sure what happened. I also take 40mg of Celexa because I have been diagnosed with generalized anxiety disorder (I am a mental health professional and agreed with this diagnosis) and also to help with the pmdd. PMDD continues to seriously mess with my life and I have been aware of what it is and trying to treat it for about 3 years now :/

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