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
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 :).