HRT and Me: Progesterone Intolerance

Blister pack of pink pills in hand to illustrate progresterone intolerance

Things have not been going well for me lately as far as my HRT is concerned. I’ve been experiencing problems with both my progesterone and testosterone treatment.

Low Testosterone Levels

Despite the fact that I’ve been applying Testim gel very day for over two years now, a recent blood test showed that my testosterone levels are still very low (0.7) and consistent with that of a woman who is perimenopausal and not taking testosterone.

I have no idea why the testosterone is not being absorbed properly and unfortunately, my consultant was unable to offer any suggestions but said it was nothing to worry about. Although it’s obviously not life threatening, I do worry because I’ve been feeling tired and depressed and withdrawn and more like the person I was prior to starting on HRT – which is not a good state to be in. I still have to spend more time with Dr Google to try and get to the bottom of this.

Progesterone Intolerance

A box of Utrogestan 100mg capsules
It’s also become apparent that I am progesterone intolerant. For 12 days of every month I take 200mg of Utrogestan, a micronised form of progesterone that is bioidentical. Even though bioidentical progesterone is meant to produce fewer side-effects in women, on the days I take it I am bloated and feel depressed and antisocial. I get migraines, my libido disappears and when my period starts the real fun begins.

For the past few months I’ve been experiencing heavy and painful periods where the walls of my womb feel as if they’re being scraped with a comb of nails. By the end of my ten day bleed I felt positively anaemic.

In total I have about one week a month where I feel able to do all the things a normal, energised woman likes to do; work, exercise, be creative, sexual and social and have a bit of fun.

Symptoms of Progesterone Intolerance

Fluid retentionAbdominal cramps
Heavy, prolonged periodsRestlessness
Weight gainPanic attacks
BloatingWeakness
Migraine and headachesDepressed mood
Increased insulin resistancePoor concentration
Acne, greasy skin and darkening of facial hairDizziness
AnxietyForgetfulness
IrritabilityBreast tenderness
AggressionLethargy

The symptoms of progesterone intolerance are very similar to those of premenstrual syndrome or PMS. In fact, women who’ve suffered from PMS are more likely to be progesterone intolerant if they take HRT during their menopausal years.

Studies have shown that progesterone intolerance is one of the main reasons why many women discontinue HRT and the way I’m feeling at the moment, I may soon be joining the ranks of the non-compliant.

Unfortunately, if you have a womb and are taking oestrogen HRT it is necessary to include progesterone as well as it prevents endometrial hyperplasia, thickening of the lining of the uterus, which can cause endometrial cancer. Progesterone is responsible for shedding the lining of the uterus in the form of a monthly bleed.

Treatment Options for Progesterone Intolerance

At my appointment with the Consultant last week I was given a few options to try and reduce my heavy, painful periods and other side-effects of progesterone intolerance.

Increase Progesterone

One was to increase the Utrogestan from 12 to 14 days a month and see what impact that has on the bleeding. The problem I have with that is it means two extra days every month of feeling bloated and depressed.

However, reducing the duration of the progesterone to 7 or 10 days a month can reduce the symptoms of intolerance, but may cause heavy and prolonged bleeding to be more of a problem. It will also increase the risk of endometrial hyperplasia.

In other words, I’m caught between a rock and a hard place.

Have the Mirena Coil Fitted

Diagram of Mirena coil in uterus

Image: Courtesy of http://www.mirena-us.com/

 

Another option was to have a Mirena coil inserted and this was the option the Consultant favoured most. The Mirena coil is a long-acting, reversible form of birth control called a hormonal intrauterine device (IUD) and is effective for up to 5 years. It’s also been approved to treat heavy menstrual bleeding in women. It works by releasing progesterone directly into the uterus making the endometrial lining very thin. Less progesterone floating around your system means fewer side-effects and in some women, the end of periods altogether.

This all sounds marvellous, but a bit of research on the internet revealed another story. Forums are full of horror stories from women who’ve experienced side-effects like migraines, ovarian cysts, depression, mood swings, aches and pains and constant bleeding for the first few months. It can take up to six months for your body to get used to it and for the bleeding to settled own.

The Mirena coil is also prone to spontaneous migration and perforation of the uterus. Other side-effects include pelvic inflammatory disease, acne, ectopic pregnancy and weight gain. Of course, I must be clear that there are many women who have had few side-effects and are full of praise for the Mirena coil. We are all different, but it is good to be aware of potential harm before having something implanted in your body.

So, I think I’ll pass on the Mirena coil. Another thing I don’t like about it is the fact that you have less control. Once the device is fitted, you have to wait for an appointment with a health professional to have it removed if you start experiencing side-effects. Some women have had difficulty convincing their doctors to remove it. Also, it contains synthetic progesterone rather than bioidentical and I really prefer to go the bioidentical route after my awful experience of taking Prempak-C, a synthetic HRT.

Different Approaches to Progesterone Treatment

So, where does that leave me? Mostly with a long list of questions for the next time I see the Consultant.

For a start, I am confused by the different approaches various menopause specialists in London take when it comes to progesterone treatment. Professor John Studd, a prominent London gynaecologist and pioneer in the use of bioidentical HRT in the UK, advocates Utrogestan 100 mgs daily for the first 7 days of each calendar month. However, my Consultant at King’s College Hospital Gynae-Endocrine clinic prescribed double that dose for me.

Vaginal Progesterone

I have since discovered that there are vaginal forms of bioidentical progesterone available in the form of Crinone vaginal progesterone gel and Cyclogest vaginal pessaries. I think these are usually prescribed to women undergoing fertility treatment but they can also be used as part of hormone therapy.

Vaginal progesterone has the advantage of bypassing the liver and having direct access to the uterus. It is associated with fewer side-effects. I don’t know why my consultant didn’t mention them and offer them as an alternative, so I’ll have to question him about that at my next appointment.

Next Steps

I am due to have a scan of my uterus next week to check the endometrial lining for any abnormalities which may be causing painful, heavy bleeding and then I’m due to see the Consultant again at the end of May.

In the meantime, I’ll follow the Consultant’s recommendations and up the Utrogestan 200mg to 14 days a month. But I’m not happy about it and unless we can find a solution so that I can cope with the progesterone intolerance, it may be the end of HRT for me.

What about You?

Have you had a similar experience? If you’ve experienced progesterone intolerance, or have been prescribed the Mirena coil or vaginal progesterone I’d love to hear from you. Please share your experience by leaving a comment in the box below.

UPDATE: Read about what happened when I took Cyclogest vaginal pessaries in my post HRT and Me: Utrogestan vs Cyclogest Natural Progesterone

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111 Responses to HRT and Me: Progesterone Intolerance

  1. lynne owen October 10, 2017 at 4:17 pm #

    Hi Angie, I have only just joined this group, I am 48 and have been experiencing horrendous symptoms for the past few years to the point of , irregular periods, terrible migraines which causes visual disturbances, fuzzy head, foggy head, anxiety, hot flushes, insomnia no sleep at all, terrible dry eye so no longer can wear contact lenses, burst blood vessels in eye, eye glasses prescription changes every few months, but the worst has been the suicidal depression, I have never suffered with depression at all but this has to be the worst symptom, I didn’t know what was happening to me, the more anxious I became the worse I felt, after going back and fro to my GP I then worked it out for myself that this must be hormonal, I then seen Carol Voderman on the Lorraine show and realised that this depression was coming on a monthly basis and was hormonal, I booked to see Professor Studd and have been on bio identical hormones since June this year, I have now discovered that when I take the Utrogestan orally or vaginally I am having heart palpitations, fuzzy head , ears feel full, migraine headaches, visual disturbances, slightly down but nothing like before, just feel really awful, my own gynaecologist has suggested that I have a mirena coil fitted which will then replace the utrogestan, what are your thoughts on this. Professor Studd also suggested about having the coil and if this was not successful then to have a full hysterectomy. Has anyone on here had the dry eyes, burst blood vessels in eyes and visual disturbances with this peri menopausal.

    It is so worrying.

    • Angie Macdonald October 10, 2017 at 4:41 pm #

      Hi Lynne. I can sympathise with what you’re going through as I’ve experienced much of it myself. It sounds like you are progesterone intolerant. This is a tough one, as your depression sounds hormonal and oestrogen is normally the solution, but unfortunately if you have a uterus, you have to take the progesterone with it. The Mirena coil is certainly an option and one which my own consultant was very keen on, but I decided it was not for me. However, many women swear by it and so it is certainly worth a try. A full hysterectomy is a very radical solution and one which shouldn’t be taken lightly, so I’d recommend trying different forms of progesterone first. I too suffered with migraines that had an aura (visual disturbance) before my period each month and have had dry eyes for many years. I highly recommend Hypromellose eye drops for dry eyes – they are artificial tears and keep the eyes nice and moist especially when the central heating is on. I could not cope without them. As for me, the suicidal feelings, uncontrollable rage and passing out with period cramps that came with the progesterone each month became too much for me and I came off HRT about 18 months ago. It’s been tough and I’ve gone back to having hot flushes and hardly any sleep, but on the plus side I no longer have monthly migraines or any PMS and my mood is on an even keel. Unfortunately, if you are progesterone intolerant there is no easy solution with HRT.

      • lynne owen October 13, 2017 at 1:18 pm #

        Thanks so much Angie for coming back to me, did you find that at certain times of the month that your eyes were more sensitive to the light, as I am finding this quite often and the migraines have seemed to increase since I have been on the HRT.
        Did the migraines damage your eyes in anyway

        Did you come off the HRT gradually.

        Many thanks

        Lynne

        • Angie Macdonald October 13, 2017 at 1:37 pm #

          Hi Lynne. I didn’t notice any change in light sensitivity at certain times of the month. The migraines didn’t damage my eyes, they’re fine, thank goodness. I gradually reduced my HRT dosage over the course of year, reducing it by a quarter every 3-4 months to allow my body time to adjust to the new dose inbetween. However, despite that, I still suffered horrendously for the first six weeks after stopping completely. I had continuous migraines and headaches for 6 weeks and was so light sensitive I could barely look at my computer and had to keep all the lights off during the day. It sounds like the Utrogestan does not agree with you at all. Try experimenting with another form of progestogen and see if there is any difference.

        • Angie Macdonald October 14, 2017 at 10:51 am #

          Hi Lynne. I have just come across an abstract for a journal article on migraine, menopause and hormones. Unfortunately, I don’t have access to the full article, but here is the abstract:

          Perimenopause marks a period of increased migraine prevalence in women and many women also report troublesome vasomotor symptoms. Migraine is affected by fluctuating estrogen levels with evidence to support estrogen ‘withdrawal’ as a trigger of menstrual attacks of migraine without aura, while high estrogen levels can trigger migraine aura. Maintaining a stable estrogen environment with estrogen replacement can benefit estrogen-withdrawal migraine particularly in women who would also benefit from relief of vasomotor symptoms. In contrast to contraceptive doses of ethinylestradiol, migraine aura does not contraindicate use of physiological doses of natural estrogen. In women with migraine with or without aura, using only the lowest doses of transdermal estrogen necessary to control vasomotor symptoms minimizes the risk of unwanted side effects. Cyclical progestogens can have an adverse effect on migraine so continuous progestogens, as provided by the levonorgestrel intrauterine system or in continuous combined transdermal preparation, are preferred. There are no data on the effect of micronized progesterone on migraine, either cyclical or continuous. Non-hormonal options for both conditions are limited but there is evidence of efficacy for escitalopram and venflaxine.

          Here is the link to the article: http://journals.sagepub.com/doi/abs/10.1177/2053369117731172

          From what I can gather, you might be better off with a lower dose of oestrogen and trying the Mirena coil. I hope this helps.

          • Lynne owen October 17, 2017 at 2:34 pm #

            HI Angie thank you so much for this information, can I just ask how long were you on the Hrt and was it the bio identical hormones, did your migraines intensify when you were on the Hrt mine have became a few times a week many thanks Lynne x

            • Angie Macdonald October 17, 2017 at 5:30 pm #

              Hi Lynne. I was on bioidentical HRT for about three and half years. My migraines got a lot better on the HRT and I had far fewer than before, which is as it should be as the HRT is meant to stop the sudden hormone fluctuations that cause migraines. Something is definitely not right if you’re having migraines a few times a week. I think the sooner you discuss this with Mr Studd and change your progesterone the better, Lynne.

    • Elizabeth October 13, 2017 at 11:08 am #

      Hi Lynne and Angie,

      Thank you for your help on this page Angie. I have read all posts as I’m on the NHS waiting list for a bilateral oophorectomy and hysterectomy. I expect it will be January 2018.

      I am 39 and have suffered with progesterone intolerance and hence depression since my periods began. I have tried the mini pill, Mirena coil, Utrogestan 100mg orally and now 200mg Utrogestan vaginally but all leave me feeling depressed and completely awful. I was lucky enough to visit Professor Studd who brought all of this to my attention. He has also suggested removal of my womb and ovaries if I could not tolerate the Utrogestan vaginally and after seeing a few very helpful NHS doctors and gynaecologists I’ve made the decision to have the surgery. I have two young children and suffered with sickness, measuring over size in my first pregnancy and post natal depression with my second. I felt ok during pregnancy.

      I felt a different person after starting the oestrogen and testosterone treatment but the progesterone came with migraines and this awful depression I’m feeling today (I’m on day 4 of my 7 day monthly Utrogestan 200mg vaginal dose). I do not want to stop the oestrogen (4 pumps daily) and testosterone (making a tube last 4 days) as I do not want to go back to feeling as awful as I did, so to me surgery is the next step?

      I’ve also been offered a uterine ablation but was informed this would not rectify any hormonal imbalances and I would still have to take progesterone. It would help my heavy periods.

      I feel like I’ve tried all options and to be honest I’m worried about having the surgery and all the other side-effects that might come with it, but an intuitive feeling and respect for the people I have seen is leading me to it. I cannot fault any. All have been so helpful and understanding. My GP also communicated wit Professor Studd on my behalf. She had a real interest in this area of medicine which is promising for the future I feel.

      I would be more than happy to share my story after surgery with this group as it might be helpful to others? I’ve read some women feel great for around 18 months but then symptoms return?

      It sounds as though this area of medicine is becoming more and more talked about which is great as I can’t imagine the amount of women suffering in silence. I’ve always been prescribed anti-depressants and referred to CBT groups and psychologists/psychiatrists over the last 25 years or more, but now I realise it was hormones all along.

      Thanks again.

      • Angie Macdonald October 13, 2017 at 1:26 pm #

        Hi Elizabeth. Thank you for sharing your story. It is becoming more and more clear to me that women who suffer with progesterone intolerance have two choices: avoid hormones altogether or have a hysterectomy so that you can enjoy the benefits of oestrogen and possibly testosterone. It’s far from ideal and I really wish there were more options on the table. It sounds like you have exhausted all avenues available to you. I’m sure you have been counselled by your GP and Mr Studd, but it may be worth your while rethinking having the bilateral oophorectomy. I know the reason is usually to prevent ovarian cancer but from what I’ve read, women who have both ovaries removed usually suffer far more than women who just have the hysterectomy.
        Good luck with your hysterectomy and please let us know how you get on afterwards.

        • Elizabeth October 13, 2017 at 7:03 pm #

          Thank you Angie, I appreciate that and I will ask the question. I understand it’s to prevent the ovaries producing more progesterone but I will check.
          Good luck everyone and I’ll be back in touch.

    • Anne October 22, 2017 at 2:21 am #

      Hi, Lynne,
      I’m 43 and have experienced infertility as well as many of the symptoms you have listed. I had the Mirena inserted as a “last effort” before partial hysterectomy. It was fine for the first 6 months and at month 7 was horrible…terrible anxiety, suicidal ideation, depression, and more. It has been removed now for 5 months and I still am having physical symptoms and many difficulties. I would definitely not do the Mirena knowing what I know now. Although, every person is different it was a colossal mistake for me!! I’m not sure if I’ll every be back to my “normal.”

      Very Frustrated, Friend

  2. Kate October 3, 2017 at 6:27 pm #

    Hi, this page has seen me through a lot on the HRT and progesterone intolerance journey. I have a question. I am on the Prof Studd regimen (3 pumps oestrogel, testim tube lasts 4 days, and utrogestan for a week). I’ve been on this for about a year…The utrogestan makes me exhausted, depressed, fuzzy but all of these in THE EXTREME. Even when using it vaginally.I hate it. I decided to just take it every 2nd month and still got a period on the money I didn’t take it. Then I took it again as have had endometriosis and fibroids so don’t want to tempt fate…Felt horrendous…So for three months I haven’t taken it but still have bled monthly. If I am bleeding without taking the utrogestan does that mean the endometrium is shedding …And I don’t have to take the progesterone part of the HRT??? I still get the usual bleakness/bloat/tiredness every month, and the bleeding! I’m 43 and my reason for seeing Prof Studd was irregular cycle, anxiety, and extreme tiredness. I have hypermobility spectrum disorder and am very sensitive to progesterone. Any thoughts? Please 🙂

    • Angie Macdonald October 4, 2017 at 9:18 am #

      Hi Kate. I can sympathise with your reaction to Utrogestan, I too hated the stuff apart from the fact that it made me sleep well. It sounds to me that because of your relatively young age your own natural hormone cycle has kicked in and produced a monthly period. I am not a doctor, so I don’t know how safe it is to continue not taking the Utrogestan for very long in terms of hormonal balance as well as thickness of your endometrium. You would be shedding the endometrium with your monthly bleed but I don’t know what the quality of your bleed is, how heavy, how long etc. Prof Studd is very used to dealing with women who have progesterone intolerance so I’d suggest you contact him again and discuss your monthly bleeds and trying a different type of progesterone. I’m curious as to why your dose of Testim is so high – the usual dosage for women is to make a tube last 8 – 10 days. Did Prof Studd give you any particular reason for this? Is it because of having hypermobility spectrum disorder?

      • Kate October 4, 2017 at 10:53 am #

        Hi Angie, thank you for the quick reply! The reason for the Testim is that my testosterone levels were ridiculously low, with zero libido, so he put me on 1/4 tube daily and it didn’t have much impact, but he has kept me on it. I tend to adjust it myself during certain times of the month or if my face gets very spotty or hairy (argh!). I STILL have zero libido which is so upsetting, but I think that’s a lot to do with anxiety as we have been through a lot of other fairly horrible major life events (lost a baby, and had a baby very very prematurely).

        When I last saw Prof Studd he was decidedly doddery (sadly) and didn’t do bloods or any other scans etc. How do they scan endometrial thickness? Internal ultrasound? At the previous appointment he was very unsympathetic about how the progesterone made me feel. He did try me on the other bio identical tablet (which I’ve forgotten the name of, annoyingly) but said my other option is hysterectomy which I feel is extreme at 43. He said lots of people suffer with the progesterone phase and didn’t suggest alternatives. Ugh. What I think I’m going to try is to complete the 7 days of utrogestan (started last night), and see how I cope…And if it’s doable I’ll commit to doing this every 2 months. I’ll also try and get an appointment with Dr Panay as he’s had very good reviews too.

        I know that 3 pumps of oestrogen doesn’t suppress my natural cycle, so if I only do progesterone every second month then hopefully I’ll still shed enough to limit the endometrium building up to risky levels.

        It’s crazy how much female hormones and the management of them is an art rather than a science. You can bet if this was affecting men (more directly!) It would be have been researched a whole lot more!

        • Angie Macdonald October 4, 2017 at 3:12 pm #

          Hi Kate. Thanks for getting back to me. The fact that you’re getting spots and unwanted hair growth is a definite sign that your testosterone dosage is too high. At the correct dosage you shouldn’t experience any side-effects. After a while I also had zero libio and had testosterone levels at 0.5 even though I was taking Testim gel daily. There are two possible causes for this; the testosterone is being converted into oestrogen and/or dermal fatigue, where after a while very little testosterone is absorbed through the skin. This is something that is not widely discussed or known. In your case I suspect stress has a lot to answer for and all the testosterone in the world won’t make any difference. However, I suspect that if you were to engage sexually despite not being in the mood, the testosterone would ensure that your sexual response was still very good.
          As far as measuring endometrial thickness is concerned you would need a transvaginal ultrasound for that. I would have thought that Prof Studd might have suggested the Mirena coil to you as that is something he has written about and which my own consultant was extremely enthusiastic about. It’s not something that appealed to me but it works for many women. A hysterectomy sounds very radical and not something to be undertaken lightly. Dr Panay sounds very sensible, I have read a lot of his work, so that may be your best bet. Have you tried to get an appointment at an NHS menopause clinic? You’ll probably have a long wait, unfortunately, but most NHS Gynae-Endocrine consultants prescribe exactly the same HRT as private gynaecologists.
          It’s ridiculous how little most doctors and medical professionals know about menopause and other female hormonal maladies. Their training is sadly lacking in this area. But, as you say, if this was a male issue there would be a research centre on every street corner!

  3. Joanna February 2, 2017 at 12:23 pm #

    Hi Angie

    Just wondering how you are – and where you are with regard to HRT – did you manage to stay off?

    (Still battling here with severe progesterone intolerance when I take the Utrogestan, every six weeks – I dread taking it with every fibre of my being – but I need the estrogen.)

    • Angie Macdonald February 7, 2017 at 10:02 am #

      Hi Joanna. Lovely to hear from you again but sorry to hear you’re still battling with Utrogestan. I have managed to stay off HRT but it hasn’t been easy. Awful for the first six weeks – terrible migraines etc – and since then battling with hot flushes, night sweats, vaginal dryness and weight gain. But mood wise, feeling a lot more stable and apart from one small period, I am loving life without PMS and periods. I just wish I slept better.

      • Joanna February 7, 2017 at 3:10 pm #

        Hi Angie

        It’s always good to hear how others are coping and to share experiences.

        Well … your news is semi-positive! You’re experiencing some good and some bad with no HRT. Hopefully over time your biochemistry will adjust and settle. Are you using vaginal estrogen (eg. Vagifem)?

        It’s so strange how meno changes the metabolism isn’t it – and the whole weight gain thing, eating less but piling it on, so infuriating. My thighs and stomach grew and grew – and my bottom and full breasts flattened and disappeared – and have never returned. Not a good look! It happened quickly too, like a switch being flicked. 9 years on I’ve lost considerable weight and my metabolism seems to have changed again. I never feel hungry, just a vague hollow feeling. I’ve cut out bread, yeast, sugar (as much as one can as it’s hidden in everything) and red meat, only occasionally eat chicken.

        Re: Migraines – these returned with a vengence when my periods stopped at 44. I had migs from age 9 to c.20 years old, realise now this was when estrogen levels were rising. The low dose (Estraderm 25) estrogen patch helps to an extent and I would be scared to stop. For the last six months or so I’ve been taking Vit B2 (Riboflavin), Magnesium Citrate and CoQ10 and the migs seem to have improved signifcantly. Or it may just be that the hideous hormonal fluctuations that create the migraines have settled somewhat. Are you taking any supplements – these could be worth a try, particularly the B2 and Magnesium. I don’t take Triptan anymore as apparently they’re not suitable for post-meno women due to artery narrowing effects, not just in the brain but around the heart too. What do you take for the migraines?

        When I’ve tried to stop HRT, the migraines lack of sleep, anxiety are what drive me back on.

        It’s great that your mood has stabilised – that is a biggie. Maybe your adrenals are kicking in to produce some estrogen.

        Wishing you well on this horrid meno journey – that none of us want to be on!

        • Angie Macdonald February 7, 2017 at 3:20 pm #

          Hi Joanna. Yes, I find it very reassuring hearing how other women are getting on with their menopause. I have been prescribed Vagifem but have to confess to not having used it yet. I got rather fed up with putting things up my vagina so felt the need for a complete medical break for a while. I use coconut oil when necessary. I was prescribed Maxalt Melt wafers for migraines and these work quite well and swiftly most of the time, although I do end up feeling very groggy afterwards. As far as supplements go, I take a daily multivitamin and magnesium, calcium and Vit D3 before bed. Without magnesium I get cramps in calves and feet at night. If you do decide to stop HRT, choose the time carefully, make sure you taper off HRT first, and have a support system in place – supplements, exercise etc. Also, be mentally prepared for some bad times for the first six weeks or so. I wish you well too – I can’t wait for postmenopausal zest to kick in.

          • Joanna February 8, 2017 at 11:16 am #

            Hi Angie et al

            Thanks for the advice – will be attempting to stop HRT again in the summer months. Progesterone turns me into the devil.

            Coconut oil is a good suggestion. Carlson Labs Natural Vitamin E Suppositories are pretty effective too – although it was only the Vagifem that stopped the UTIs and cactus-like discomfort.

            Reading again about PMDD – Symptoms of Premenstrual Dysphoric Disorder mirror exactly those when taking HRT progesterone:

            Marked lability
            Marked irritability or anger
            Markedly depressed mood
            Marked anxiety and tension
            Decreased interest in usual activities
            Difficulty in concentration
            Lethargy and marked lack of energy
            Marked change in appetite
            Hypersomnia or insomnia
            Feeling overwhelmed or out of control
            Marked affective lability.
            Marked irritability or anger or increased interpersonal conflicts.
            Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
            Marked anxiety, tension, and/or feelings of being keyed up or on edge
            Decreased interest in usual activities
            Subjective difficulty in concentration.
            Lethargy, easy fatigability, or marked lack of energy.
            Marked change in appetite; overeating; or specific food cravings.
            Hypersomnia or insomnia.
            A sense of being overwhelmed or out of control.

            So if you’re highly/severely progesterone intolerant, it can turn you psycho!

            The Menopause Clinic told me that all of the women who take HRT, roughly 20% will be progesterone intolerant and within that group, roughly 10% will be “highly progesterone intolerant”. Those women are intolerant to their own progesterone.

            However … here’s the contradiction:

            one can ALSO experience all of the above symptoms when NOT on progesterone. Also when the periods stop. Also when on estrogen only. I guess, though, to a lesser extent.

            The point is: one can feel just as crap ON or OFF progesterone!

            Maybe the small amount of progesterone that the body still produces is enough to create the intolerance symptoms.

            Beyond confusing. Fluctuations? Who knows.

            Postmenopausal zest – now there’s a thought … if only …

            Think I’ll add Calcium Carbonate to my list of supplements.

            Best wishes.

            • Angie Macdonald February 8, 2017 at 6:14 pm #

              Interesting reading! Thanks, Joanna and good luck for when you decide to come off HRT.

    • MJ July 25, 2017 at 7:31 pm #

      I’ve felt so desperate teary / Bloaty and fat , I’ve actually gained weight on this break and so tired ! Does it go away when you stop ? So down

  4. Bianca January 26, 2017 at 1:04 pm #

    I am an RN with 5 years of premature menopause from hell. Standard pill which contains artificial progestin has destroyed my eyes and my life. I find that bioidentical estrogen is weak and doesnt last long do i use transdermal e2 patch and top up a little with bipidentical e2 cream daily. Progesterone will cause you issues you described if your estrogen is too low in relation. The idea is to mimic day 14 not tje last day before your period but the good doctors dont seem to understand impor5ance of fine tuning. P4 pessaries will cause direct hit and pain cramping etc. Try a good compounding pharmacy and try the troches. 100mg morning and night they seem to work the best. Good luck

    • Angie Macdonald February 7, 2017 at 10:05 am #

      Thanks for this, Bianca. I was unaware that progesterone was available in the form of troches.

    • Caroline March 10, 2017 at 8:36 am #

      Excuse my ignorance but what is a troche?

      • Angie Macdonald March 19, 2017 at 11:28 am #

        Hi Caroline. A troche is similar to a lozenge, so it melts on the tongue.

    • lynne owen October 10, 2017 at 12:38 pm #

      Hi Bianca, I am new to this site I am on the bio-identical hormones prescribed by John Studd and have been terrible with the utrogestan intolerance, when you say that progestin destroyed your eyes and your life could you tell me in what way, only i have been having terrible vision problems (distorted vision ) i would really appreciate any help on this.

      Many thanks

      Lynne owen

  5. Felicia January 17, 2017 at 6:26 pm #

    I found this post in my search to find out why I feel awful on progesterone. You helped me answer that question. For women with very very heavy periods, one extreme option might be a _very_ low sugar diet. I don’t mind it, but some people might be unhappy about it. That being said, a diet of less than 100 g of carbohydrates (not counting fiber) a day seems to result in less bleeding for some women. I eat 60 g of non-fiber carbs, and my period has _significantly_ decreased. Watch out for eating less than 50 grams, as that can send you into ketosis, which comes with a lot of strange health problems. However, with 60 grams, it doesn’t seem so bad. Of course, that means no bread, no sugar, no potatoes, etc, but I have managed to avoid getting sick since I started this diet, which is impressive in itself. Hope my experience is useful to someone.

    • Angie Macdonald January 23, 2017 at 11:39 am #

      Hi Felicia. Thank you for sharing your experience of a low sugar diet. Very interesting! Could you clarify exactly what 60g of non-fibre carbs consists of so that readers can know what carbs you eat and in what amounts.

  6. Kerry Milton January 10, 2017 at 12:01 pm #

    Hi
    I suffered with severe and debilitating PMDD and progesterone intolerance for 20 years. No treatment helped and the only option was a total hysterectomy. The first 18months was great, I was on oestrogen only patches and had no symptoms. After this I began to feel the PMDD symptoms returning. I was told this could be due to my body trying to produce more and more progesterone which would explain my symptoms but then on a PMDD forum I was told this cannot happen and now I am confused and scared as the symptoms are quite bad.

    Could you tell me if the body will produce enough progesterone after a total hysterectomy to cause the same progesterone intolerant symptoms I had before? Thank you. Kerry

    • Angie Macdonald January 10, 2017 at 7:15 pm #

      Hi Kerry. Sorry to hear that your PMDD symptoms have returned. Most progesterone is produced in the ovaries and a small amount in the adrenal glands, but if you had a total hysterectomy your ovaries would have been removed. I don’t know much about PMDD at all but I believe there is a connection between PMDD and low levels of serotonin so you might want to discuss this with your doctor. I don’t know what your symptoms are but another factor to consider is that your oestrogen levels could be too high leading to symptoms of oestrogen dominance. Does anyone else have any ideas on this issue? Warm wishes, Angie

      • Bianca January 26, 2017 at 1:13 pm #

        Estrogen alone therapy will cause some issues and the body needs some small amount of progesterone i.e for immune system, thyroid function, to reduce bloating and get rid of excess fluid and mood balance. Try a small amount of compounded natural progesterone in troche. 25mg am and 25mg pm (you may need to adjust this for you). This will replicate first half of a normal cycle and you should feel better. You dont need more if the uterus is no longer an issue.

  7. Inge June 19, 2016 at 12:25 pm #

    Hi, I had been to see Professor Studd a few years ago and I felt extremely unwell when starting his regime which included testim (I got acne, bloated and extreme weight gain). So I stopped. I have recently gone to Dr Nick Panay and he has started me on Sandrena (estradiol) 1.0mg gel daily and then on day 15 Utrogestan 100 for 12 days. Only just started this month and am sleeping better than I have for years. But I am feel very tired, lethargic and mentally foggy during the day. Is this because of the Utrogestan? Anyone else been to Nick Panay – he was highly recommended to me and is meant to be one of the best in London.

    • Angie Macdonald June 19, 2016 at 12:46 pm #

      Hi Inge. What time of day do you take the Utrogestan? It has a very calming effect which is why it makes you sleep better, so it’s best to take it before bed. Nick Panay has an excellent reputation so I have no doubt you are in good hands.

    • Bianca January 26, 2017 at 1:23 pm #

      What your describing may be the progesterone but if its happening on days you dont take it id look at the sandrena as these symptoms are listed side effects which you can find in the drug information. It seems to be dose dependant..i.e less tired on 0.5mg day but then other symptoms come back. Seems odd that in this day and age they havent come up with estrogen that doesnt exacerbate the issues were trying to fix..The only way to know if it is the gel is to reduce or stop for a bit and monitor your symptoms but check with the doc first

  8. Helen Felleen May 22, 2016 at 6:10 pm #

    I saw Professor John Studd in April 2015. At that stage I was 53 and still perimenopausal. I had suffered with bouts of depression since the age of 12/13. Pregnancy was wonderful but the depression after my first born was unbearable. Many antidepressants and 10 years of excruciating flooding 12 day periods with a one week break then another 12 days and so on left me anaemic, exhausted, even more depressed. I had been put on Prempak C to alleviate the bleeding and menopausal symptoms of hot flushes and insomnia but instead I added breast lumps, migraines and 3 stones of weight gain over 4 years to the list.

    Prof Studd put me on 3 pumps Oestrogel, a smudge of Testim gel and 7 days per month of 100mg Utrogestan. I was a new woman. In 48 hours the hot flushes stopped, I slept uninterrupted for 10 hours several nights in a row. After 6 months it was clear that the utrogestan was the only tricky bit as I became depressed and dizzy whenever it took it. I was switched to Provera but warned it may be no better. Was now out of funds to go back to Prof Studd. Decided to experiment relatively safely (I am not medically trained). Used the Utrogestan vaginally, as they are a soft form of capsule rather than a hard tablet. Has worked a treat. I now get a light and predictable bleed of about 5 days, no pain and also significantly less depression whilst taking it! My hints are
    1. Insert the capsule at bedtime as it makes you a bit drowsy.
    2. Lie on your back and shove the capsule as far up as you can. Body heat will sort of dissolve it
    3. Don’t worry about seeing some white material come out on your underwear or when you urinate. It is still doing its job! But wear panty liners if you don’t already!
    4. From what I have read, progesterone would normally be released in this area of the body anyway, so it’s going along with your body’s preferred route which is totally in tune with the whole bioidentical concept anyway!
    5. Guaranteed your GP will not agree with this. I haven’t told my GP this is what I’m doing as he’s been no bloody help for the last 10 years anyway and I have shelled out 2 years of hard earned holiday money getting sorted out. I don’t feel any particular loyalty any longer, especially when they can’t even be bothered to read a single Article that might suggest there is a different way! bOth Utrogestan and Oestrogel are available on the NHS in principal but your GP practice may say differently. This is only because of price and nothing else. Don’t be fobbed off. It isn’t much more expensive but Prempak and the other horse hormones are very cheap. Offer to pay the difference or for a private prescription and see if that helps.

    Hope this helps someone out there.

    • Angie Macdonald May 23, 2016 at 5:37 pm #

      Hi Helen. Thank you so much for sharing your story. It sounds like you have suffered from hormonal depression which the HRT solved. Very interesting to read about your success with using Utrogestan vaginally and I hope you continue to thrive.

      • MJ July 25, 2017 at 7:49 pm #

        Thank you I Tried it transdermally and that was the same it’s not fun is it

    • Eve Campbell April 6, 2017 at 3:05 pm #

      This is exactly what I use but use just a tiny amount progesterone from a pierced utrogestan capsule. Literally a drop or I get tired grumpy feel awful. I Do it for a few days stop and I have a bleed. I take it prob 3 days max as it will cause a bleed when I stop which is what I want.

    • Deborah April 23, 2017 at 8:24 pm #

      Hi Helen, I too went to Proffesor Studd last May. I was on exactly the same prescription as you. I don’t know why but I’ve gradually reduced my estrogel from 3 to 2 pumps a day. Just wary of being so dependent on it I suppose. Anyway I wasn’t feeling great on ustrogestin either and the Proffesor suggested taking every other month. This has resulted in very heavy periods. I’m so pleased to read that the tablets come in pessarie form. I’m now seeing a gyny through gp as I too cant afford the private treatment. I’m definitely going to try and get them. Thanks so much for sharing x

    • MJ July 25, 2017 at 7:47 pm #

      Thank you I feel so bloaty and fat ! Did it stop this – I feel like I’m inflating ! I tried it transdermally too and still felt same . Really appreciate your help ,it’s awful isn’t it

  9. Mimi February 16, 2016 at 3:46 pm #

    Has anyone out there taken synthetic oral progesterone tablets 10 mg norethisterone along with the estradot 50 or 75 and testim ?
    I am menopausal and just switched off the utrogestin 100 due to brain fog. My Dr recommended the synthetic progesterone as an alternative but o feel so tired I am in bed today and reading the website !!!! It’s scary as the Dr said there were ‘no’ side effects.
    But sure if I should go back to utrogestin or give it more time on the synthetic 10mg tablets –I have a lot of mentally demanding work coming up and can’t even contemplate it I feel so ghastly and incapable!!!
    Any feedback welcome
    Mimi

  10. Barbara February 12, 2016 at 5:36 pm #

    Hi,
    I’m 50 and since 3 years on HRT. Firts I started with Estrogel plus Utrogest vaginally ( here in Germany vaginal route is mostly recommended). Still progesterone gave me worst PMS symptoms like depression, anxiety, deradful thoughts,crying spells, zero libido, feeling of deep despair, even suicidal thoughts, so that I was every months scared of getting crazy when I’m those 12 days on Progesterone. It really wasn’t fun. I was also having strong and painful bleedings every 2-3 sweeksVaginal route didn’t help, actually the capsules are absorbed much better then orally and the 100 mg were just too strong for me. I had bad PMS since my middle 30’s and I had horrible sickness during my pregnancies, for at least 6 months. Obviously progesterone intolerant.
    So no matter how I wanted to use only bioidentical hormones, I changed from progesterpone to synthetic progestins. I’v tried few of them, they were all not much better the the bio progesterone. Now I’m on patches called Fem7 Combi, with synthetical gestagen. And it works for me. The PMS is much less ( still there), libido good and since I’m on this patch ( 6 months) I had a bleeding only once, not strong and absolutely painless. My lining was one months ago fine, only 0.6 cm.
    So I think I willstay on this gestagen patch and my consolation is, that used transdermally it’s way less risky then used orally.
    If I would have any other alternative, I would stick to bio P. But the side effects were unbearable.

    • Angie Macdonald February 13, 2016 at 2:01 pm #

      Hi Barbara. Thank you so much for sharing this very interesting information about the FemSeven Conti patch. I’m so glad that you’ve finally found something that works for you. I will bear this in mind if I decide to opt for a synthetic progestin in the future but for now I am in the process of coming off HRT altogether as I’m so fed up with the PMS symptoms and periods. I looked up information on the FemSeven Conti patch and I see that it contains oestradiol (bioidentical) and the synthetic progestin is levonorgestrel, which is the same kind of progestin found in the Mirena coil that my consultant was so enthusiastic about. I wonder why he didn’t suggest this patch? I would much rather have a patch than a permanent device inside my uterus. Interesting!

      • Barbara February 18, 2016 at 6:09 pm #

        Hi Angie,
        my gyno also suggested Mirana coil, but I wasn’t really enthusiastic to have this thing inside my uterus. Transdermal gestagen patch is even more soft to the body and mind, but fulfilling its purpose. This month I again didn’t get the bleeding, so I would like to know if my lining was too thin due to gestagen to get a bleeding, or the gestagen is too weak for my increased does of estrogen and that’s why I’m not getting the period. I would be so happy only on estrogen, but this problem with P/gestagens is really annoying. If you now come off HRT it would be confusing for the body to re-start some day. MAybe you should give this patch a chance before you quit the estrogen? If you take Fem7 Conti you won’t get any period at all. Fem7 Combi is giving you a withdrawal bleeding every month.

        • Angie Macdonald February 18, 2016 at 7:02 pm #

          Hi Barbara. I see I have been getting confused betwen Fem7 Conti and Fem7 Combi. It seems the Fem7 Conti is for postmenopausal women. It is strange that you haven’t had your monthly bleed, have you asked your doctor about it? I can’t find anything about Fem7 Combi in the UK. Most of the information on Google seems to be in German or Polish. I wonder if it is available here?

          • Barbara November 7, 2016 at 5:44 pm #

            Hi Angie,
            sorry, I wasn’t around for a while 🙂 Fem7 Conti is the method, when you are using a pa´tch with estradiol and gestagen continuosly, so the bleeding won’t appear. It’s a good alternative for women with strong and exhausting bleedings. On patch Fem7 Combi you will probably get a withdrawal bleeding after the removal of the gestagen patch ( aster 2 weeks(, but not necessary,l if the lining isn’t build up too strong.
            I’m now using Fem7 Conti, but only for 2 weeks in the cycle, since unfortunately I developed again the PMS symptoms and depressive moods on the gestagen 🙁 So now I’m on the patch Fem7 Conti which is having weaker dose of gestagen then the Fem7 Combi and I’m using it only for 2 weeks in the cycle. On the other weeks I’m using estrogen only, to avoid PMS and depressions. I didn’t have any bleed since then ( 6 months) and my lining was fine ( 0.6 mm).

            • Angie Macdonald November 10, 2016 at 6:30 pm #

              Hi Barbara. Thanks for this. I hope the Fem7 Conti works well for you. Having PMS and depression with progesterone is horrible, especially as 2 weeks every month is half your life!

      • Caroline April 16, 2016 at 8:46 am #

        Dear Angie

        I just wondered how you were doing? Have you come off HRT altogether? I have now been put on a long cycle whereby I only take the Utrogestan every two months. I am just dreading taking it again, but don’t have any other options having had a such a dreadful time with the Mirena coil. I feel lousy without any oesgrogen. How are you feeling? Best wishes Caroline

        • Angie Macdonald April 17, 2016 at 10:40 am #

          Hi Caroline. Great to hear from you again. I stopped taking HRT 3 weeks ago today. My hot flushes and night sweats returned within a couple of days but I’m trying not to allow myself to be too troubled by them. The worst thing has been the frequent headaches and migraines, about every second day or so. I wasn’t expecting that. Also, my libido has gone awol again. Emotionally I feel the same as when I was on the low dose of HRT, a bit flat but I have been coping okay with stress. So, all in all not a brilliant picture, but not a terrible one either. The thing that is keeping me going is the hope that I will never have a period again but only time will tell.

  11. Kristi Stevens January 25, 2016 at 9:59 pm #

    Hello Ladies,

    Here is my story, briefly(ish!). I’m 34yrs old and have one daughter, Amalie (4yrs old).

    Over the years since early teens, I’ve always suffered badly with PMT (both physical and emotional symptoms). I’ve tried all sorts to alleviate them because not only were they affecting me but also my respective partners/ boyfriends at the time. I’ve tried the pill, the mini pill, the mirena coil, the injection, vitamins, counselling, and anti-depressants (various doses and lengths of time). I even tried NOT having anything. Nothing really worked. Being a women and obviously couldn’t get away from these things, I kind of became resigned to it each month and just pre-warned the boyfriend of it all building up and allowed myself the first day of each period (which was usually the worst for physical symptoms, intense irritability and tears) to ‘step out of life’ for 24hrs and only focus on what I needed… Lots of baths, slouchy clothes on after work, junk foody dinners, hot water bottle, chocolate galore etc etc.

    After Amalie, my 4yr daughter, was born on NY day 2012, I seem to have got stuck in the ‘baby brain’ stage of post-pregnancy. I just couldn’t shake off those feelings of being empty-headed. Of fuzziness and fogginess, terribly poor memory, a lack of concentration and just a general feeling of being left with half a brain working. In the months that followed Amalie’s birth, I put it down to lack of sleep, hormones, the stress of losing my dad etc. However, as the years progressed, I’ve felt these symptoms worsening, like I’m on a slippery slide. Thought processes went out the window, I’d stop speaking mid-sentence because I had no idea what I was going to say or what the conversation was about. Trying to concentrate on any one thing knackered my brain out. I kept saying to my partner, my mum, friends…. Anyone that would listen really……how thick-headed I felt for most of the time. I probably had 7-10days a month when I felt a reasonable improvement but then I’d be plunged back into this dark empty space for another 3weeks. Period bleeds were lighter than I’d ever experienced before which I revelled in, sometimes only bleeding lightly for 2.5days each cycle.

    However, the emotional symptoms were worsening. My stress threshold was so low I seemed to be in a permanent stressy state, constantly snapping at Amalie to ‘hurry up’ or don’t do that, losing my cool so quickly that rows erupted in a second with Paul (my partner). I booked an appt with my doctor early last year, sat in her surgery sobbing my heart out, begging her to help me because I truly felt like I was losing the plot. She looked forlorn and apologetically said there was no where she could refer me to- to come back in 3mths and see how I felt!!! I felt like I was going insane. During the worse days I felt like I was on a knife edge with myself. That I could so easily just flip and do something that I was going to regret because this fog and red mist could so easily descend.

    One day in October, I was having a particularly up and down morning. I rang my mum in floods of tears, inconsolable as solutions to how I was feeling were absent and I felt resigned to this being my life. I felt, that in order to survive in my head space (which really didn’t feel very big and couldn’t cope with much going on in life) that I had to close the doors slightly on life out in the bigger world. I didn’t push my new nail business, just let it chug along quietly as a sudden influx of enquiries caused anxiety to overwhelm me. I saw friends but wasn’t ‘social’ like how I used to be. Even fitting the food shopping in to my non-working life was hard! In truth I was having to close off from the world because I couldn’t mentally cope with information overload.

    So having cried down the phone to my mum, I refocused for the day and carried on with what had become my life. My mum rang me later, saying she had found a private PMT Clinic in London and she thought I should enquire on cost/ meeting them. It wasn’t going to be cheap but I started to feel a little glimmer of hope. The professor was world renowned Prof. Studd.

    I visited him on 16/11/2015…. A day I think I will come to recognise as a turning point in life! It brings tears to my eyes now, just thinking about it. He offered me HRT after doing some tests and asking me lots of monthly cycle questions. I now have oestrogel and testim gel to administer each day on my skin. At the beginning of each month I take a progesterone pill for 7days to kick start a monthly bleed.

    And OMG is it all working or what?!?! In 6short weeks I feel like a different person…. Like the curtains have been drawn back and the light is finally able to get in. The difference in my head space is phenomenal… I honestly cannot explain how I feel! Just ALIVE again I guess. The act of thinking isn’t a job in itself anymore! I can partake in life once more. As if my partly burnt out batteries have been zapped with a hundred thousand volts!

    But do you know what the funny thing is in all of this, both blood tests I’ve had over the passed year for hormone imbalance have both come back as ‘normal’!!!! Crazy, absolutely crazy!

    I’m apparently progesterone intolerant and was heading for an early (peri)menopause hence all the symptoms

    I’m so relieved and excited for my future again. After years of living like this it’s finally lifting.

    Since I first saw Prof. Studd I’ve had one bleed which lasted for a full 7days! Felt like a hundred years after my 2-3days periods the last few years. It may have been longer because he said he wanted me to wait 6weeks from first applying the estrogel before taking Utrogestan so my womb lining was probably thicker.

    I return to see Prof. Studd this coming Monday, 1st Feb for a 3mth review. It’s obviously very early days but I’m hopeful that things are turning around for the better. ☺️

    • Angie Macdonald January 26, 2016 at 11:35 am #

      Thanks for sharing your story, Kristi. I’m so glad you have finally found the help you so obviously needed. I suspect your young age probably confounded doctors and seeing a hormone specialist was the best thing you could have done.

    • Sarah March 25, 2017 at 11:53 pm #

      Hello. Can you tell me the names of the hrt you are on as your story is very similar to mine.
      Thanku

      • Angie Macdonald April 4, 2017 at 7:20 pm #

        Hi Sarah. From what Kristi says, I believe she was prescribed EstroGel (oestrogen), Testim gel (testosterone) and Utrogestan (progesterone). This is commonly prescribed bioidentical HRT and is available on the NHS. Some GPs will prescribe it but you will normally have to see a Gynaecologist-Endocrine consultant in order to be prescribed this particular, effective combination.

  12. Lori January 24, 2016 at 3:50 pm #

    I have not read through every single response, so I hope I’m not repeating what someone else has said. I am 62, and using bioidentical hormones for the last 10 years. I also had 2 very large uterine fibroids… and breast cysts… and I was anemic. That aside, I started using estradiol gel transdermally, progesterone suppositories 14 days of the month, and 1 mg. of testosterone daily. What I didn’t know was how important that testosterone was! Not only did it hugely increase my sense of well being and energy, but my fibroids disappeared. I do not know why that happened, but they are absolutely gone, as are the breast lumps. So far, every doctor of mine but one has completely ignored the testosterone piece of my hormone replacement treatment… I now have to insist upon having it. Women make twice the testosterone that they do estrogen… so maybe that’s a big piece of why things sometimes go wrong. We need all 3 hormones to be balanced.

    • Angie Macdonald January 26, 2016 at 11:43 am #

      Hi Lori. That is amazing that your fibroids have gone! I suspect your original problems with anaemia, fibroids and breast cysts were as a result of having too much oestrogen in relation to progesterone and testosterone so it’s wonderful that your hormones are now balanced. And you’re right, most of the time testosterone is overlooked but it’s an integral part of the hormonal system and so vital for wellbeing.

  13. Skyler January 20, 2016 at 9:47 pm #

    Hello Angie

    I’ve found reading the comments so helpful, thank you for this blog and for the time you take to curate it all.

    Hoped you might find my experiences with the Mirena useful to you. I am 51. Had Mirena put in 2011, taken out 2015. I had fibroids, a v. large ovarian cyst (>5cm) and flooding– periods that nothing would contain. I was told my options were Mirena or hysterectomy. That was untrue, I had two discrete fibroids, one large one small, they could have removed these. I could have had ablation, they could have taken out the cyst and arguably should have, etc. If I had my time again, I would do all that first.

    The insertion of Mirena by a consultant gynae was so painful I fainted. A few weeks later, my cyst ruptured and I was in A&E. At the removal, 4 years later, I screamed as it had “embedded a little bit”…they said I must have a low pain threshold. Oh really…

    I put on two stones in weight in 18 months after the Mirena was put in. I was miserable and my libido, that was already knocked, dwindled to zero. BUT, I didn’t have the awful periods, a couple of months in and I had stopped bleeding altogether, and all the painful period rubbish and the feeling tired and PMS and the awful stuff just disappeared. I did have slightly sore boobs, but I had those before. So, I put up with the weight gain and tried to keep a sex life going. What I didn’t realise was that the progestogen in the Mirena was slowly driving me nuts. It got much worse when I started to have hot flashes 12 times a day, nights sweats 3-5 times a night and I was put on estrogen plus Mirena early last year. From that point, I just couldnt cope with stress, I was breaking down, I thought it was work, the family, I blamed everything around me. I took voluntary redundancy as I couldnt cope with my job. I couldn’t cope with the house either and told my husband we had to sell up and move into a flat! Lucky he ignored me.

    When I had it taken out, I had a blissful month of normality and then the hot flashes and night sweats just took over. Back to the GP, was prescribed Kliovance, a norethisterone continuous combined. 12 weeks later and I was basically bedridden with symptoms of diabetes, a temperature that had plummeted to hypothermic levels, a stomach ulcer and all sorts of other symptoms that I cannot believe (though I do) came from one pill. The reason I know it was the Kliovance is that when I finally twigged and read the info sheet and stopped taking it, my symptoms just melted away, starting from day one and I was pretty much back to myself in a fortnight. I was so ill I thought I had a brain tumour or something.

    I have now ditched the NHS for all HRT related stuff and am being treated privately, it is a few hundred quid that I can’t really afford but I cannot risk being prescribed some cheap old fashioned product with such bad known side effects and a GP that doesn’t really know anything about HRT and thus doesn’t recognise side effects. She also says I have to be on something for 3 months before she will even talk to me about changing it. And she’s actually really nice lady, its tragic.

    I can read people’s experiences all over the internet and I think what I am seeing is that as we age, our hormones are all in flux. The ingredients in pills are fixed in quantity and seem to build in our systems and yet our need for the ingredients changes and we have no way to measure and respond to that relative change, you know, up a bit estrogen, down a bit progesterone, up the testosterone or hold it back and so on. I dont know what the answer is but am trying again now with gels rather than pills to see if I can be or at any rate feel that I am more in control of the dosages.

    Good luck to you & best wishes.

    • Angie Macdonald January 21, 2016 at 5:29 pm #

      Oh Skyler! What you have been through sounds absolutely awful. I was going to say ‘unbelievable’ but unfortunately it is all too believable. Thank you for sharing your story here as I’m sure it will help other women who are experiencing something similar. The last few years read like a complete nightmare and I really hope you have found what works for you now that you’ve gone private. Your horror story about the Mirena coil is exactly what I feared and makes me glad I stuck to my guns and refused it. I would love to know more about the treatment you are receiving now and whether or not you are feeling better. Please feel free to comment below or write to me privately via the contact form.

  14. Kelly January 3, 2016 at 4:54 am #

    Hi Angie – I am progesterone intolerant also, and am having trouble finding much information on this problem. My doctor prescribed (and highly recommended) bioidentical progesterone in a troche for me this summer and I had a pretty bad reaction after just 2.5 weeks of taking it, and had not even worked up to a full dosage yet. I became very, very depressed, anxious, and lethargic. I had trouble focusing at work and doing much of anything except sleeping when I was at home. I suspected it was the progesterone, so I talked to my doctor and she said that a small percentage of women are not able to tolerate progesterone, so I quit. I decided to give it one more try this winter, when I was in better health and less stressed going into it, to see if I could tolerate it better. I started seeing a therapist so she could monitor me weekly during the process, and I set up weekly vitamin B injections to help counteract any problems, since the injections always help me feel so good. But no luck. Just a little over two weeks into it this time, my therapist made me promise to stop taking it and made me sign a release so she could talk to my doctor. So now I know for sure it was the progesterone. It makes me crazy! Depressed (almost suicidal), anxious, paranoid, and completely unfocused. Not to mention the acne, skin breakouts, itchy scalp, etc. My doctor also shared something I found interesting. She said that women my age (I am 46) who are intolerant of progesterone are usually those who were sick as dogs when they were pregnant. I was never pregnant, so I don’t know if that would have been true for me or not. But moving forward, she has recommended that I take calcium d-glucarate, which helps fight off the estrogen dominance. She also wants me to take a supplement called femguard, which she loves, but it also gives me very painful acne, so I’m not sure i will be able to tolerate it either. I’m also taking iron for my anemia and heavy doses of vitamin D, so I’m hopeful that these supplements can help me since I will never take progesterone again.

    • Angie Macdonald January 3, 2016 at 1:20 pm #

      Hi Kelly. Thank you for sharing your fascinating story of progesterone intolerance. Your doctor sounds brilliant. I’m sorry that you haven’t managed to find a solution to your progesterone intolerance and I do hope the supplements help with your symptoms.

  15. Caroline November 8, 2015 at 12:27 pm #

    Dear Angie

    I’m so pleased I stumbled across this website! I am perimenopausal and am still having heavy periods every three weeks! I was put on Evorel 50 patches by my GP and felt so much better – just human again! It then turned out that because I still had a uterus, he had put me on the wrong HRT. It was oestrogen only! I tried Evorel Conti which was an absolute disaster. I felt absolutely dreadful so ripped off the patches asap. LIke you, I am now between a rock and a hard place. I had a Mirena coil fitted years ago which had to be removed after two days – it was so uncomfortable. A GP friend told me that she had Evorel patches and used the cyclogest pessaries every month because, like me, she reacted so badly to so many tablets and was oestrogen intolerant. I told my own GP who said she hadn’t heard of this combination but would refer me onto a specialist GP who is more clued up on the Menopause. I have spoken at length to a friend who is a gynaecologist who told me that it would be possible to go on the longer term oestrogen with a short burst of progesterone every two months or so. Is this what the lady in a previous comment was talking about? What are the main side effects of the cyclogest pessaries? I have Vagifem pessaries to try in the short term, but don’t know if they will provide me with enough oestrogen. I haven’t tried them yet.

    • Caroline November 8, 2015 at 12:28 pm #

      Sorry, that should read progesterone intolerant!

      • Caroline December 12, 2015 at 12:14 pm #

        Dear Angie

        I just wondered how you were getting on with the cyclogest pessaries? I went to see a specialist menopause GP who put me on the Utrogestan orally combined with the Evorel 50 patches. I felt SO much better on the Evorel, then started taking the Utrogestan…. oh dear. They have given me such severe stomach cramps that I can’t get to sleep. What with all the other symptoms I have (back pain, neck pain, arm pain), I just can’t function properly. Like you, I seem to be stuck between a rock and a hard place. My only remaining hope is the cyclogest or to use the Utrogestan vaginally – if it is possible to get them in that form in this country. I know that I feel absolutely lousy without the oestrogen so can’t come off HRT altogether. Did your period pain settle down with the cyclogest after a month or so?

        • Angie Macdonald December 12, 2015 at 12:34 pm #

          Hi Caroline. Sorry to hear about your stomach cramps. I’m afraid it hasn’t been good news with the Cyclogest pessaries. I am still taking them but they make me very bloated and extremely irritable each month. Also, I have had such bad period cramps that I have passed out from the pain. Since I reduced my Evorel patches from 75 to 50 a couple of months ago the cramps have not been as bad, so my impression is that the higher the oestrogen dose, the more endometrial lining you have to shed each month and the worse the cramps. I get cramps whenever I am about to pass a huge clot. I have decided to gradually come off HRT and take my chances just so that I can be free of periods for a while. My gynaecologist thinks I am doing the wrong thing. He says my next step should be to try the Mirena coil or to try a synthetic form of progesterone such as Provera. I didn’t get on well with the synthetic progestogen in Prempak-C, so I’m not keen. Also, research shows that synthetic progestogens in combination with oestrogen is more likely to cause breast cancer, but my gynaecologist says the chance is very slim. Still, at this stage I’m not keen to experiment, but who knows, after a few months without HRT I may be.
          My gynae said there’s no difference between using Utrogestan or Cyclogest vaginally, they are both natural progesterone, so the same thing. I don’t know if you can get Utrogestan in pessary form in this country, from what I’ve been able to deduce, women are using the tablet as a pessary.

    • Angie Macdonald November 9, 2015 at 12:45 pm #

      Hi Caroline. Sorry to read about your HRT disasters and perimenopausal woes. Another case to prove that doctors need more education when it comes to the menopause! Evorel Conti contains bioidentical oestrogen but a synthetic progesterone, so that may be why you reacted so badly to it. I have tried both the Utrogestan tablets and Cyclogest pessaries, both of which are bioidentical progesterone. The Utrogestan made me feel very depressed, sometimes suicidal, with periods that lasted 10 days and the Cyclogest makes me pass out with period pains every month and makes me so irritable I could kill, but the periods only last 5 days. I’ve stuck with Cyclogest because I just can’t bear feeling depressed and suicidal. But I hate the side-effects of progesterone intolerance so much that I am in the process of weaning myself off HRT altogether and fantasise about a life without periods. However, just because I feel this way, doesn’t mean that it will be the same for you. We all have a different reaction.

      As far as I’m aware, taking progesterone for 12 – 14 days a month is the safest route. There are some doctors who prescribe progesterone for only 7 days a month or every couple of months, but this is more risky, especially as you are perimenopausal as opposed to postmenopausal, and you would probably have to be regularly monitored for thickening of your endometrial lining and growths as a result of too much oestrogen and not shedding the uterine lining each month. Vagifem pessaries are good if your only symptoms are vaginal, like lack of lubrication, painful sex, frequent urinary tract infections and urinary incontinence. But because their effect is localised the oestrogen will not be strong enough to treat any other symptoms you may be having like hot flushes or mood swings and so on. The good thing is that if you take Vagifem you don’t have to take progesterone as well. I hope that helps.

      • Caroline November 10, 2015 at 8:01 pm #

        That’s incredibly helpful, thank you! I don’t have hot flushes as yet although I am constantly tearful because I have real problems with my neck. I’m convinced that lack of oestrogen is making my neck worse. (I’ve always been told by physiotherapists that everything “softens” just before a period and muscular or joint weaknesses can become much worse. Since I’m having heavy periods every three weeks, there are very few days in the month when something is not hurting!)
        I’ve only just started the Vagifem and feel a bit “crampy”, but I will have to give it time. I’d like to wave a wand and wake up at 75! It’s just so good to be able to share stories with someone!

        • Angie Macdonald November 11, 2015 at 10:16 am #

          Hi Caroline. Another thought, because you’re having frequent heavy periods there’s a very real chance you could be suffering from iron deficiency anaemia which can make one feel close to death; depressed, tired, out of breath, unable to cope etc. Also, many people are Vitamin D deficient and this can result in muscle aches and weaknesses that just don’t heal. I was treated for knee pain by an osteopath once and nothing she did helped. Eventually she suggested I ask my GP for a blood test to test my Vitamin D levels. They were extremely low and once I supplemented Vitamin D3 the knee was cured and all my muscle aches went away. Magnesium is also fantastic for muscle pain and many perimenopausal women are very low in this important mineral. Obviously, I don’t know the nature of your neck problem, but I can sympathise. Sometimes these things may be aggravated by hormone imbalances, but very often they are due to vitamin and mineral deficiencies brought about by the stress of perimenopause. If you are experiencing muscle weakness this could be a symptom of hypothyroidism (underactive thyroid) another common occurrence during perimenopause. So, it may be worth asking your GP for further blood tests to rule out any other causes of your pain.

  16. Fran October 18, 2015 at 8:51 am #

    Wow… first of all pleased to find all of you here and so many ( from my experience ) accurate reactions to all the different attempts to resolve our awful symptoms. I am not going to go into to much details as i will be here all day but here is my opinion after finally realising i was prog intolerant !I double my size during my first pregnancy( doctors could just not believe what was wrong with me)then i start having PMS, then mood swings, 20 day periods and after my Iron (both levels) fall down to 4… they finally after begging them to see what was wrong with me started more thorough tests. I’ve been diagnosed with prog.intolerance, and PCOS syndrome. I have been prescribed antibiotics back in July to stop the spotting between periods ( it helped!!!) then i started the metforming ( been given wrongly 4000) felt extremely sick but when i got down to maximum but on normal 2000 daily dosage , i stabilised some of the PCOS symptoms. maybe feel sick some times ( if i eat more than usual sugary or fatty foods) but helped my start loosing weight and having less spots on my face. then i had to tolerate mood swings that increased my anxiety levels for no apparent reason. So i gone down the route of admitting that anxiety pills may be the way forward after all ( after at least 10 years of PMS causing anxiety and mood swings). I am against pills just to mention.. So i made the dreadful to me question to my GP and they prescribed 10mg citalopram. I have been taking met forming 2 months now and citalopram 2 weeks and i don’t think i have been better for a long time…. hope this helps !

    • Angie Macdonald October 18, 2015 at 7:55 pm #

      Thanks for this, Fran. Glad to hear you’re feeling better after everything you’ve gone through.

  17. mo August 4, 2015 at 5:58 pm #

    Great site!

    i have been progesterone intolerant all my life with intolerance of the pill and very bad PMS
    I have struggled through menopause but last month started evorel conti patches to stop dreadful flushing every 30 mins and hourly during the night.

    Have GP tomorrow as back being “prickly”,tired,irritable,hungry(when I had fantastic energy) but not sure what would be better

    Any ideas?

    • Angie Macdonald August 4, 2015 at 6:30 pm #

      Hi Mo. I’m afraid I’m in a similar position to you and it appears there is no simple solution. The evorel conti patches contain norethisterone which is a synthetic form of progesterone. Many women who hare progesterone intolerant have worse side-effects from synthetic progesins compared to the natural forms of progesterone. However, even the natural forms have side-effects. With the evorel conti patches you are having a continuous dose of progestin, but the advantage is that you will probably not have a monthly bleed. It may be worth asking your GP to prescribe the the oestradiol separately in the form of Evorel patches and natural progesterone in the form of either Utrogestan capsules or Cyclogest pessaries. The advantage to this way of taking HRT is that you only have the progesterone in your system for 12 – 14 days a month as opposed to all the time. The disadvantage is that you will have a monthly period. The other alternative to the progesterone is the Mirena coil, which my consultant is very keen on, but it really does not appeal to me. However, many women swear by it. You’ll probably have to try a few combinations and see what works best for you. Hope your appointment goes well tomorrow. Let me know what the outcome is.

  18. Maria Chumas-Baker July 4, 2015 at 4:29 pm #

    Hi,
    I have just discovered your site and am pleased to have done so. I have been going through abt 7 months of Helll trying to make myself feel better through HRT. Iwas so against it but succumbed to it in December last year. I have neen on Estradot 50 patches and have just completed my first month of micronor mimi pill. I am paying a fortune for my gynae expert privately and she knows I do not want a mirena coil although she keeps saying that it is “gold standard”. She has put me on micronor and the first 2 weeks were fine until I had a bleed. Since then I have had breast tenderness in one breast, headaches and the most awful anxiety, irritability. I keep wanting to cry. It doesn’t help me that my husband is finding me awful and our marriage is on the rocks. For about 6 weeks during my trial with estradot, I decided to go down the herbal route and came off Estradot. The herbal route did not work either so decided to go back on Estradot. The Estradot made me feel better but was putting off starting my progesterone. I feel desperate now and am not starting my next pack of micronor. I have another appt. with my gynae woman in a couple of weeks. That will be another £160. I feel now that I should come off HRT all together and just face it full on. I am 55 and post menopausal. What can I do xx

    • Angie Macdonald July 5, 2015 at 4:53 pm #

      Hi Maria. Thanks for getting in touch. I’m sorry to hear you’re having such a bad time with your HRT. It sounds like the Micronor mini pill doesn’t agree with you. If you are progesterone intolerant you’re more likely to experience bad side-effects with the synthetic form of progesterone which is what the Micronor contains. Synthetic progesterone also carries a much higher risk of breast cancer and for this reason I think it’s best avoided at all costs. It might be worth talking to your gynaecologist about trying a natural form of progesterone like Utrogestan capsules or Cyclogest pessaries. Although you may still experience side-effects, they may be less intense and they don’t have the breast cancer risk that the synthetic progesterone has. Unfortunately, that will mean changing your contraception method. All of these medications are available on the NHS so it might be worthwhile asking your GP for a referral to a menopause clinic or NHS Gynaecologist. If you are going to come off HRT it would probably be best to do it when your marriage is in a better place or you have other support in place, like a counsellor or a nutritionist – somebody to help you through what might be a difficult time. Stress only makes menopausal symptoms worse. I wish you luck. Please let me know how you get on.

      • Maria Chumas-Baker July 7, 2015 at 11:18 pm #

        Thanks so much Angie. I am 55 and so do not need contraception. I suggested Utrigestan but she was not responding positively to this request. Prof. John Studd recommends Utrogestan and I know ladies who use it without problem although you are experiencing problems yourself. I will see what she says but would also like to investigate the vaginal progesterone that you mentioned. Thank you again and good luck with your next appointment x

        • Angie Macdonald July 10, 2015 at 11:44 am #

          Thank you, Maria. I hope you manage to get what you want from your next appointment too. x

  19. marcia May 28, 2015 at 10:26 am #

    Hi Angie, Marcia here again, I went to see my doctor last night, as I mentioned earlier I came off hrt mainly because of being progesterone intolerant and have been taking just half a sachet of testim gel a week plus estriol in the form of ovestin but the night sweats have been horrendous (and day sweats also), libido has reduced also. I have been excersising swimming twice a week plus 20 minutes on the exercise bike nearly every day, have lost no weight, eating healthily too (apart from 2 or 3 bottles of wine a week.) Anyway, I asked my doctor about crinone gel but she told me you can only get 8% and I can give it a try if I like. I know that the 8% is usually for infertility treatment and 4% for hrt so does anyone know why we cant get 4% in this country? I have decided to give it a go. Instead of doing a cyclical every three months I am going to try 2 applications a week continuous, so I will not get a period(i am pretty sure my periods stopped a while ago (57 now) my pharmacist is looking into the 4% but will let you know how I get on. The reason I stopped the utrogestan is because it was to strong and gave me brain fog and depression. Felt like my normal self since coming off hrt, but am willing to give it another go.

    • Angie Macdonald May 28, 2015 at 4:47 pm #

      Hi Marcia. Thanks for the update. I hope someone can help you out regarding obtaining 4% Crinone gel in the UK. You could try asking your doctor to prescribe Cyclogest 400mg pessaries which is what I’m taking at the moment. I no longer get the depression I got with the Utrogestan, just irritability. It’s not ideal, but at least I keep passing the open windows…

      • kirsti June 11, 2015 at 10:00 pm #

        Hi,

        i live in Germany and the oral utrogestan capsules are here taken as a vaginal tablet. This is very common because of less side effects. One before going to bed it will absorb in short time. Ist the same utrogestan (utrogest in Germany) you can swallow.

        Hope this helps,

        best regards
        kirsti

        • Angie Macdonald June 14, 2015 at 6:48 pm #

          Hi Kirsti. Thanks for this information. It’s interesting to learn that taking Utrogestan vaginally is common in Germany as I think it is very rare here in the UK. I am starting to get used to Cyclogest pessaries now, but I think I might try Utrogestan vaginally. The problem is every time I try a new type of progesterone I have the most awful period pains as my body adapts so that is a bit off-putting.

        • Sue June 19, 2015 at 12:45 pm #

          Hi Kirsti,
          Very interested to hear you take the utrogestan tablets vaginally, what dose, how many days a month?
          It seems a great idea!
          Very best,
          Sue

          • Elizabeth June 8, 2016 at 11:31 pm #

            Hi All

            I was living in Geneva when I started bio-identical HRT four years ago. My highly-regarded Swiss gynaecological surgeon put me on one pump Estrogel and three Utrogestan 100mgs taken vaginally three times a week.

            It is her recommended regime and produces no bleed. So far so good – endometrial lining always thin.

            My problem is the crazy weight gain over the past three years: three stone and so often feel like I’m holding on to an ocean of water. Boobs are huge.

            But after horrid insomnia, sleep comes easily and the terrible vaginal atrophy that killed my sex life is gone. Still feel lethargic and demotivated though but I think that is because I’m unhappy being this porky. Now carb-cutting and keeping up the resistance training in hopes of figuring out how to shift the pounds.

            As well, I’m going to reduce the Utrogestan to twice weekly. That doesn’t mimic a natural cycle but at least it matches the frequency of Dr Studd’s protocol.

            I am attending an NHS menopause clinic but don’t seem to get any real advice. One member of the team pushed the Mirena when I complained about the weight gain and watermelon boobs. No way was I subjecting myself to that. Another rather helpfully agreed that gaining “three stone is a lot of weight” but offered no suggestions / theories.

            I’ll cut back Utrogetan to twice weekly and see if that helps.

            It’s such a shame that many of us feel overwhelmed by all the conflicting advice out there, even when getting the best the NHS has to offer.

            • Angie Macdonald June 15, 2016 at 7:57 pm #

              Hi Elizabeth. I can sympathise with you on the weight gain front, a similar thing has happened to me recently. It sounds like your hormones are still out of balance – difficult to tell if you have too little oestrogen, too much progesterone or the other way round. Could you ask your doctor for a blood test and discuss changing the ratio of your dosage when you get the results? I’m with you when it comes to resisting the Mirena – it fills me with terror every time my Consultant mentions it. It sounds like you’re doing the right thing with carb-cutting and resistance training. I am realising that stress and cortisol also have a big role to play in weight gain, so it’s important to cut back on caffeine and to eat regular small protein-based snacks and meals to sustain energy and blood sugar levels. Another thing you should have checked out is your thyroid. An underactive thyroid will result in weight gain, lethargy and depression. I hope you get it sorted and get your weight back on track.

  20. Shay May 19, 2015 at 7:40 pm #

    I am pretty sure I am somewhere between intolerant and allergic to my own progesterone. Even with the 3 month pill, I knew the rows of pills in which the progesterone kicked up and skipped over those pills. My PMS and periods were HELL. I wasn’t so much moody as flat out sick like I had the flu and absolutely starving. When I used that cream that kicked up my progesterone, I was borderline psychotic. I spent most of my adulthood keep my body fat low and exercising hard to keep my progesterone as low as I could. My prostaglandins were very high, too.

    I finally found the answer–an endometrial ablation. I’ve had my endometrial lining permanently removed, and my life has been wonderful since! The surgery was outpatient, no incisions, and I could have returned to work after two days if I had to do so. I haven’t had so much joy and peace until I did this!!!!! It’s so worth it!!! I can’t believe more women aren’t talking about it!!!

    Obviously, I had to be committed to not having children with this choice, but I am 46 so not a problem for me. I kept my uterus and ovaries, but my #1 progesterone (and prostaglandin) maker has been removed. I can still feel a bit of a cycle, but it has stretched out to 5-6 weeks. Now, when I PMS, I am just tired and some migraines (My pituitary is still making some, I believe), but nothing like the suffering I used to experience.

    I am not at the point of HRT, but wouldn’t the removal of the uterine lining solve the progesterone problem? I hope so! I hope this is an option for some of the women suffering from progesterone. It’s been such a blessing for me!

    • Angie Macdonald May 21, 2015 at 2:40 pm #

      Hi Shay. Thank you so much for your comment and sharing your experience of endometrial ablation. I’m so glad it sorted your progesterone intolerance problem. It is certainly a possible alternative to having the more radical procedure of a hysterectomy and I do wonder why more women aren’t offered this as a first choice. If women reading this would like to find out more about endometrial ablation, here is an article outlining the pros and cons on the Women to Women website: https://www.womentowomen.com/hysterectomy/endometrial-ablation-the-pros-and-cons/
      Shay, I’m not sure what would happen if you were to start taking HRT, would the oestrogen still be able to stimulate the endometrial lining? I have no idea. It would be interesting to find out.

      • Marshmellow66 January 8, 2016 at 6:43 pm #

        I’m 42 and had ablation when I was 38. Scar tissue formed across my cervix which blocked it meaning my periods were trapped inside me. I had to have an emergency operations to remove the blood, and nearly died in the process. I would not recommend as a treatment for heavy periods. I’m at early peri menopause and after a year of horrendous hot flushes started taking hot femoston 1\10. I feel great when on the estrogen tablets for Two wks but then the nxt two wks are progestogen at the end of taking those I have extremely heavy and painful periods which leave me feeling exhausted. I’m going back to my gp to discuss this as it makes life difficult.

        • Angie Macdonald January 11, 2016 at 7:26 pm #

          Oh my goodness Marshmellow66, what a nightmare! Thanks for sharing. If your main problem is hot flushes your doctor may be able to prescribe a low dose SSRI instead of HRT. Because of your heavy periods it might be worth your while having your iron levels checked as they can lead to iron-deficiency anaemia. As you have scar tissue across your cervix I’m not sure if you will be able to tolerate a UDI but the Mirena coil is another option that seems to help women with heavy periods as it can stop periods altogether. I hope your GP is able to help.

  21. MARCIA May 15, 2015 at 1:38 pm #

    hi angie, I think we spoke a while back when you were just embarking on bioidenticals and I tried to warn you about prog intolerance, as I am also prog intolerant. I always thought it was the estrogen that I was intolerant to having spent years suffering from pms but when I hit my menopause I realised the estrogen made me feel better and as soon as I took the prog part I felt horrible. I have recently come off hrt altogether apart from half a sachet of testim gel once a week for low libido and estriol in the form of ovestin up the v route as its the least harmfull of all the estrogens and helps with building muscle. My only problem at the moment is mad hot flushes , being kept awake at night because of them.Also my libido has reduced somewhat, I think the testosterone works best together with the estrogen I was taking two pumps of oestrogel per day in the morning and every three months I would take a progestin for the last 10-12 days or so to bring on a bleed but the progestin was awful, until funnily enough I got prescribed the testosterone which seemed to balance things out for that last month but by which time I was resolved to coming off. I am seeing my doctor again soon who is brilliant and am going to ask her if I can try the crinone 4% every three months with the oestrogel plus testosterone and the odd dose of ovestin (estriol) although I don’t have great hopes for the crinone after what other people have said. The utrogestin I found too strong and had brain fog with it. I am even thinking of asking my doctors opinion about having a total hysterectomy then I can take unopposed estrogen which seems the only viable solution for me. I wish you well with the crinone let me know how you get on and like wise. I am slightly concerened about the amount of testosterone you are taking, if you don’t mind me saying it does seem a lot. I think hrt works for some people if you can find the right balance. I don’t have the money to go private and constantly have my hormone levels checked and pay £35 per month for perscriptions. Incidentally with regard to oestrogel, I started on one pump per day but still got the hot flushes, so 2 was just right for me love Marcia x

    • Angie Macdonald May 18, 2015 at 10:32 am #

      Hi Marcia. Good to hear from you again. Interesting to hear about your experiences. I am thinking about coming off HRT in the next few months, but am feeling very anxious about it. I haven’t tried Crinone, I’ve been using Cyclogest 400mg pessaries for the past 2 months – 14 days each month. My symptoms have included bloating, unbelievable breast tenderness, and irritation. But mercifully, unlike with Utrogestan, no depression. For that I am very grateful. Last month’s period pains put me in bed for a day, we’ll have to see what this month brings later this week. Some women seem to have fewer symptoms taking Utrogestan vaginally, so that is another option.
      A total hysterectomy sounds very radical. I’ve read that it’s best to try and keep your ovaries if possible – that way you can still continue to make some of your own hormones and are not completely HRT dependent. I appreciate your concern about the amount of testosterone I’m taking but I am sticking to the standard recommended dose for women, which is to make one tube of testim gel last for between 8 – 10 days. In the past I had symptoms of excess hair growth when that was too much and so then I made a tube last 12 days and in time the hair disappeared, but I have no symptoms of excess now, in fact I feel no benefit from the testosterone at all, so not sure what’s going on there. I think finding the right balance is difficult and would require more frequent appointments with consultants and blood tests. I hope your doctor’s appointment goes well and keep in touch.

  22. Lisa May 13, 2015 at 12:47 pm #

    Hi, I had an oophorectomy last year for severe pms, however over twelve months later I feel that this operation was a waste of time….
    I have always been progesterone intolerant, unable to tolerate mirena coil, oral contraceptives etc, so I have had horrible pms type symptoms from every hrt treatment I have tried.
    I am so fed up, wish that I had been given a full hysterectomy…I am 44 and am in surgical menopause without any relief from hot flushes and other symptoms…any advice please? x

    • Angie Macdonald May 14, 2015 at 10:07 am #

      Hi Lisa. Oh my goodness, I do find it odd that they decided to remove your ovaries and leave behind your uterus. Without ovaries you’ll need HRT and as long as you have a uterus and are taking HRT you’ll need to take progesterone which causes PMS symptoms which was your original problem. I’m sorry, I know I’m not helping, but the mind boggles! If your other symptoms include vaginal dryness, you could try a vaginal oestrogen cream, which means you won’t have to take progesterone with it. Check out the comments from Joanna. She is on a very low dose of oestrogen which means she can get away with only taking bioidentical progesterone vaginally every 6 weeks. It still means having to put up with the progesterone intolerance for 12 days every 6 weeks, but that’s better than dealing with it for 2 weeks every month. I wish I had an easy solution for you, Lisa, but I’m afraid I’m out of my depth on this one. From the research I’ve done there is absolutely no clinical evidence that herbal remedies like ginseng, black cohosh or red clover have any effect on hot flushes, in fact black cohosh can cause liver damage in some people. The same with acupuncture – often trails show that the placebo effect works just as well. I think Cognitive Behavioural Therapy (CBT) has been effective in helping women with menopausal symptoms. In the end, it often comes down to basic lifestyle changes, not smoking, cutting down on caffeine and alcohol, eating lots of fruit and veg, avoiding sugar, making sure you get enough sleep and exercise and knowing how to effectively deal with stress. It sounds boring because we’ve all heard it so many times before and it’s not as easy as popping a pill, but it’s something to consider. Good luck.

  23. Joanna May 12, 2015 at 12:39 am #

    Hi Angie –

    I do sympathise as I’m highly prog intolerant too and have struggled over the years to find a suitable (it doesn’t exist for me, by the way!) prog as part of my HRT regime – have tried the full spectrum, including the vag ones, Cyclogest (migraines worse) and Crinone gel (not good).

    You probably know this – Utrogestan can be used vag route, the meno clinic prescribed this. I can’t take it orally. I still get hideous side effects with the vag route Utro, however it’s the “least bad” option for me – as I need to take the estrogen patch – without it I’m a jibbering wreck.

    I’m only on a low dose estrogen patch so I can take the Utro 100mg x 12 nights every 6 weeks. The meno clinic only allow this 6 week estrogen only section, as the dose is so low. I only get partial symptom control – more estrogen = more prog, which I can’t stand. I *loathe* taking Utro though – would love to come off HRT but then I wouldn’t be able to function. I do worry about being estrogen dependent – and that one day I’ll have to stop and then what. I find herbs/naturals just don’t work.

    Good luck with whatever you decide as the next step. It’s all trial and error in this HRT game.

    • Angie Macdonald May 12, 2015 at 5:16 pm #

      Hi Joanna. Thanks for getting in touch – it sounds like we have a lot in common when it comes to progesterone. I had read about Utrogestan being used via the vag route on the Menopause Matters website forum, I think. I don’t know why my consultant never mentioned this or Cyclogest as an option, only the Mirena coil. Out of interest, may I ask what dosage of oestrogen you’re currently on. I have recently reduced from the 100mg patch to 75mg to try and make my periods lighter. In April I experienced my first period with Cyclogest and came close to passing out from period pains. I also had to take to bed with a hot water bottle and painkillers for a day so I could hardly describe it as a welcome change from the Utrogestan. I think it makes me more irritable than depressed and my breasts are all swollen and tender, so the good times continue. Like you, I worry about coming off HRT and going back to the state I was in before, but at the same time, I am so fed up with progesterone intolerance that I am seriously considering it. Your six week regimen sounds like a good option though.

      • Joanna May 13, 2015 at 3:44 pm #

        Hi again Angie

        As I’m nearly 53 and 9 years post-meno (had a relatively early meno at 44) I didn’t want to be on an artificially high dose of estrogen, so I’m only on *half* of the lowest dose patch, 25 Estraderm. As the dose is so low, I can take Utro 100, instead of 200 for 12 days every 6 weeks. This regime is by no means ideal, I only have partial symptom control – however I’m much worse when off this tiny dose of estrogen, so it must be doing something.

        In the past I was on patch 100, 75 and 50 – didn’t feel great on any high dose, still had night sweats and migraines. The deal breaker on the higher dose(s) was the hideous withdrawal bleed – and crippling pain, I too used to nearly pass out – after feeling like cr@p on the Cyclogest 400 or Utrogestan 200 for 12 – too much stress on the body and no way to live.

        Over time and with advice from the meno clinic I weaned myself down to a lower dose. I get no pain and only a very slight withdrawal bleed for about 3 days on Utro withdrawal. There is no way I would go back to those hideous painful periods, having to take prog every two weeks, the negatives far out-weighed the positives.

        I’ve been on this mad merry-go-round for years now – and I’m in at a different meno stage to you – so not sure if what I’m saying is of any use to you.

        I just know off the low dose patch I’m much worse, depression, can’t function etc etc. So I have 6 weeks, sort of okay (and can drive long distances etc) then 12 days on Utro which is not good – strangely I feel energised for about 6/7 days on Utro then things take a turn for the worse and I stagger through. On nothing I would feel cr@p every day and not able to function and be hideous to live with.

        The meno clinic have suggested a hyster so I can take estrogen only – but that is too drastic and I want to stay intact as I’ve read that I could be swapping one sort of problems for another. Would not consider Mirena as it’s so far out of my control, can’t just take it out.

        In the past I developed hyperplasia within 6 weeks of going back on the half 25 patch (took a HRT break to see how I would respond as fed up with taking prog) then had to take two courses of Cyclogest to get the lining back down to 4mm, so I know that my body is extremely sensitive to estrogen.

        And that’s the thing – we’re all so different and there are no easy answers for the prog intolerant woman – so hard to tell how the body will respond to any HRT and over time. It all seems so experimental and an area of medicine that will take many years to evolve.

        I hope you find a way forward – please let us know how you get on – I will keep reading your blog.

        Guess you have already read this article:

        http://humupd.oxfordjournals.org/content/3/2/159.full.pdf

        • Angie Macdonald May 14, 2015 at 10:17 am #

          Hi Joanna. Thanks so much for getting back to me. All this information is so interesting and valuable. It sounds like you are attending a good menopause clinic which is prepared to experiment. I agree that a hysterectomy is too drastic a step and I feel exactly as you do about the Mirena coil. It seems to me that there needs to be more research into progesterone intolerance – it feels like we’re all guinea pigs at the moment. Thanks for the link, I’m familiar with the article but it was good to be reminded of it. I’m inspired by the way you’re managing your progesterone intolerance and am going to be discussing further options the next time I seem my consultant.

    • Caroline December 19, 2015 at 2:36 pm #

      Hello Joanna

      I’ve just stated on the Utrogestan and was taking it orally which made me feel extremely sick and “crampy”. The gynae said I could insert the tablets vaginally which sounded like a good idea… until the bleeding started! I was absolutely fine on the Evorel 50mg oestrogen only and felt great. The progesterone is my main problem. I had heard that it was possible to use the Utrogestan every 6 weeks. What side effects do you get with the Utrogestan if you use the vag route?

      I really hate all this, but like you, I feel so dreadful without the oestrogen, I daren’t come off it completely. (I’m 52 by the way and was still having heavy periods every three weeks before I went back on the Evorel patches)

  24. Sam March 25, 2015 at 9:44 pm #

    Hi there , ime Sam , 42 and have been suffering from progestrone intolorents since I was young , the pill made me crazy , marina coil made me crazy , any form of progestrone low dose I carnt take ! When I was in my early 20s doc desides good old prozac well they seemed to work till I hit the age 34 then boom ! Anxiety , night sweats , all premeniporse symtoms , I sufferd skipped hart beats as well as depresion , good old ovulation was the worst time ! Every month blue light becouse of my heart ! Anyway I put up with it till I got to 40 and decided to stop the prozac after being on them for 20 years , I new it was hormonal not depression , I seen every specialist you can think of , then I read Denice Walshes book and found proffersor studd

    • Angie Macdonald March 28, 2015 at 12:53 pm #

      Hi Sam. Thanks for getting in touch and I’m sorry to hear that you’ve had 20+ years of hormonal hell. Please can you finish your story. I feel that you’ve left us on a cliffhanger and I really want to know what happens next. I have so many questions for you. Have you seen Professor Studd? If so, what has he suggested you take instead of progesterone? Are you now on HRT? If you could write back and let us know that would be great.

    • Elizabeth April 5, 2015 at 12:50 pm #

      Hello Sam,

      I’m 23 and have been ‘diagnosed’ by two gynaecologists as being progesterone intolerant (alongside my diagnosis of endometriosis). I was put on antidepressants at 17 and I know hormones are a huge contributing factor to my anxiety and depressive symptoms. I have studied biochemistry, I know a fair bit about human biology so I understand my cycle, I have a keen personal and professional interest in psychological and physical wellbeing but in terms of addressing my progesterone intolerance issues I don’t know where to turn. To manage my endometriosis (before I had surgery) I tried depo provera, the mirena coil and then the qlaira contraceptive pill all of which made me really poorly; crippling anxiety, horrendous palpitations, panic attacks, extreme hair loss, terrible acne break outs on my face, neck and back which I have never suffered from particularly badly, suicidal thoughts and just general malaise. Upon stopping or removing these treatments I gradually returned to my ‘normal’ but still I can not imagine having to manage these issues for the next 30+ years. It affects my entire life. Do you have any advice as to what i should do? What should I say to my GP to make them take me seriously? Who should I talk to? Both gynaecologists have vaguely suggested that if my symptoms don’t improve I shoukd attempt to conceive should I wish to and then consider a hysterectomy and oophorectomy. This will pose further issues of course as I entered a menopause-like hormone withdrawal and seems really drastic to me. I have read about endocrinal desensitisation therapies. I have investigated Professor John Studd’s work which is fantastic. What would your advice be? Thank you.

      • Angie Macdonald April 7, 2015 at 5:59 pm #

        Hi Elizabeth. I’m so sorry to hear about everything you have had to endure as a result of your endometriosis and progesterone intolerance. I’m afraid this is out of my league but I do hope there are other readers out there who may have advice for you.

      • Dorothy-ruth August 16, 2015 at 6:53 pm #

        Hello,
        I have had problems for 20 years, which got a lot worse 6 years aho when doc prescribes metformin to help with periods. After having various pills(all made me horribly unwell) & mirena (which was agony misery and massive joint pain & pain inside right down with very negative moods – all I could do was curl up in a ball anddose up on ibuprofen) my doctor is going to try zoladex (?)
        I was unsure, but desperate to stop the illness i get every month which has ruined my life andcost me my job and partner, a friend said she had this for endometriosis and had no problems at all & that it was good.

        Does anyone have any thoughts on this?

        The next step will be to convince endocrinologist to takeovaries & uteris out. They were not sympathetic, and actually suggested i try and manage this with vitamins and natural remedies & ssri (!!?) the problem is physical – not mental!

      • Mary September 24, 2015 at 6:52 am #

        Hi Elizabeth,

        Hope you still get this despite you posting over a month ago.
        I would suggest asking your GP for a referral to Chelsea and Westminster’s Gynacolgy unit. They are leading with their treatment and may help you find some answers.
        Good luck,
        Mary

  25. Karen March 13, 2015 at 2:05 pm #

    I hope this message gets to you;
    I’ m not a medical professional but did study biochemistry and found it useful in searching for appropriate nat ways of dealing with severe PMS assoc with Polycystic ovaries; I found synth. hormones useless and harmful, lots of side effects etc but nat prog. using cyclogest brilliant!
    Please be assured that bio indents need to be used transdermally or transmucosally, best method, in order to get thru effectively in meaningful amounts in order to counter your own oestrogen HRT oestrogen xenooestrogens and phytooestrogens;

    Katherine dalton uk doctor and john Lee were the pioneers with nat prog 60 yrs ago and wrote some very informative books for the public
    Best of luck

    • Angie Macdonald March 14, 2015 at 1:00 pm #

      Hi Karen. Thank you for all this excellent information, it’s very useful. Also good to know that Cyclogest has worked so well for you; I will definitely be asking my consultant to prescribe that next time I see him. I’ve also dug out my copy of What Your Doctor May Not Tell You About Menopause by John, R. Lee and Virginia Hopkins and will have another read of it. I am aware of oestrogen dominance but because I feel so depressed and awful on the days I take the Utrogestan, my consultant agreed that I’m progesterone intolerant. I am finding this all rather confusing and exhausting at the moment and am grateful for all the help I receive from you and other Write Health readers.

  26. Karen March 13, 2015 at 1:47 pm #

    Dear Angie
    Sorry to hear you are experiencing difficulty with progesterone;
    however I am very baffled that you have been asked to take a bio identical hormone orally; bio identicals are supposed to go straight into your systemic circulation, not thru the digestive system and liver first; human hormones are released directly by the endocrine glands directly into the blood;
    I very much doubt u are getting much prog by the time it has gone thru liver;

    Therefore it is highly likely, almost certain, that u are suffering oestrogen dominance and hence the gynaecological findings u describe in next blog ;
    The symptom list you have posted is OESTROGEN DOMINANCE not prog dominance; unfortunately there is much misinformation on net; I too have seen this list somewhere but it is wrong; however these oestrogen dominant symptoms can occur if u take progestins which are designed to take orally and which cause horrible side effects probably because they suppress your own natural progesterone and becos they are foreign to body and have to be metabolised by liver into other chemicals
    However, do not despair; the utrogestan can be inserted vaginally at night and rapidly absorbed into the blood particularly around the uterus where prog will thin the endometrium;
    it is INSANE taking them orally !
    If you look on the net u will see that the patient leaflet of some of the brands of utrogestan will
    Say that you can take it either orally or vaginally; they are all prog. in the same base;

    The most accurate and comprehensive site is progesteronetherapy.com;

    I

  27. Jane March 10, 2015 at 6:49 pm #

    Angie, thanks for your reply, it sounds like we have very similar problems. There don’t seem to be any easy answers do there? I too am going to try the progesterone via the vaginal route because apparently there are fewer side effects and it is more effective used in that way. I do have regular blood tests together with regular internal uterine and breast ultrasound and everything is completely normal. The specialist told me that the more estrogen you take, the heavier the periods so that is why I cut my dose down from three measures to two. The thing that baffles me the most is the fact that I never had any period or hormonal problems until the menopause – I suppose the artificial ones are no substitute for your own. Good luck, I look forward to hearing how you get on and I will let you know how my natural progesterone trial goes.

    • Angie Macdonald March 11, 2015 at 1:45 pm #

      Thanks, Jane. I also reduced my oestrogen dose recently from a a 100mcg patch to 75mcg. Last month’s period was lighter and less painful so let’s hope that lasts. Good luck with your natural progesterone trial – I can’t wait to hear the outcome.

    • Jane July 18, 2015 at 6:12 pm #

      Angie, how are you getting on? I thought it was time to give you an update on my situation. I have had no luck finding any natural progesterone cream so I decided to run my own trial by taking 100mg of Utrogestan via the vaginal route – I am told Utrogestan is the nearest match to the stuff we used to produce ourselves. Well, for the first month, I took 100gm vaginally for 7 days, felt fine, no breast pain, no problems with a reasonable, albeit fairly painful, period. I thought I had really cracked it so I strung it out for about 5 weeks and then started the next round but this time I decided to take the same amount i.e. 7 x 100mg but every other day instead. I read about using this on Menopause Matters and thought it was worth a try and many women use this method in continuous combined HRT regimes. Sadly, the day after taking the second capsule, I had an attack of the scintillating scotoma (silent migraine without headache) which followed the usual pattern of visual disturbance for 25 minutes and then feeling spaced out for the rest of the day BUT as soon as the migraine started, I slapped on a dose of Estrogel and I didn’t get the 72 hour postdrome that I usually to get. I decided not to take any more but luckily I had a normal period even though I only took two capsules. This is only my guess but I think I hold synthetic progesterones in my system for a very long time (hence the normal period after only taking two capsules) and can only tolerate very low doses. As you can imagine, I am disappointed but I will try it again and see what happens next month. I certainly will not bother with the every other day regime next time.

      I was interested to read Shay’s post about endometrial ablation, this could be an option for all of us with this problem. I did think about it before but was slightly put off by the fact that you still need to use progesterone when taking HRT but I think it’s worth finding out if you can use a much lower dose, it would certainly be a great improvement and of course there is the added bonus of no periods.

      By the way, the RLS has disappeared! I have changed the brand of my Vitamin B complex and they seem to work better so fingers crossed.

      I would be interested to hear from anyone who has tried a natural progesterone skin cream or pessary that they would recommend and also where to get hold of it. Many thanks.

      • Angie Macdonald July 20, 2015 at 4:22 pm #

        Hi Jane. Thanks so much for your update – very interesting to read about your experiment with taking Utrogestan 100mg vaginally. I am getting used to the Cyclogest now, I’ve had two cycles now and am about to have a third. I still have bad period pains for the first day of each period, but the good news is that the period only lasts a maximum of 5 days, as opposed to 10 days on the Utrogestan, so that is something of a relief. However, I am finding it quite stressful trying to plan holidays and important events in my life around my period – I’ve been experimenting with shifting the start date each month so that I can time my period to begin just after an important event. The bloating I’ve been experiencing on the Cyclogest has been awful – nothing fits!

  28. Jane March 9, 2015 at 4:34 pm #

    Angie, I know exactly how you feel, I am in a similar place. This is my story. Firstly, I had a Mirena coil fitted for contraception purposes and did not really get on with it – I felt depressed with swollen breasts and low sex drive. I still had the coil when I hit the menopause and that is when the problems started. I started getting scintillating scotoma without headache (silent migraines) once my hormones started dropping off. Interestingly, I had just one of these episodes when I was 12 (one year before my periods started) then absolutely nothing for 41 years to the month and then then the migraines started again 10 years ago. The migraines were always just before a period (when I still had them) and to cut a long story short, it turns out that I am progesterone intolerant but ONLY with HRT related progesterone, not the one I used to produce myself, I never had any PMT symptoms either.

    I have tried norethisterone (absolutely dreadful and guaranteed to set off a migraine). Angeliq, a continuous combined pill which was OK for about a month and then I had another series of migraines. I also see Professor Studd and I am now on a similar regime to yourself i.e. the Estrogel (two measures) everyday, Testosterone and Utrogestan 100mgs for 7 days per month but I do have a confession to make, I cannot stand having periods or taking progesterone so I stretch my cycles to 6 weeks but it does mean a fairly heavy period. I can just about stand 7 days of Utrogestan but no more. I tried to take 100mgs everyday with the Estrogel to avoid periods altogether but sure enough, after about six weeks, I had a migraine so that was the end of that trial.

    I now have an added problem. I suffer with Restless Leg Syndrome (RLS), a disorder I have inherited from both my parents. This condition is made worse by a LACK of progesterone so I can’t win. Frankly, I am running out of ideas. I thought a hysterectomy would be the answer to all my problems but that will not help the lack of progesterone and RLS. I am now researching natural progesterone creams for the RLS – this is last chance saloon.

    • Angie Macdonald March 10, 2015 at 11:45 am #

      Hi Jane. Oh my goodness, you are in a tough position. Thank you for taking the time to share your story. As someone who also suffers from migraines I can really relate to what you’ve been going through. I had a hysteroscopy last week and am feeling thoroughly fed-up with menopause and hormones and HRT and everything that goes with it. I am waiting for my next appointment to discuss vaginal progesterone options as I feel these are my last resort. I hope you get on well with the natural progesterone for the RLS. Do you have your ferritin levels checked regularly? I ask because I am iron deficient again thanks to my heavy periods and experience RLS as a result of low ferritin levels. Luckily in my case it is resolved when my iron levels return to normal.

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