How to deal with progesterone (prometrium) intolerance when using HRT

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How to deal with progesterone (prometrium) intolerance when using HRT

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Күн бұрын

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@heatherhirschMD 8 ай бұрын

What did you find helped the best with progesterone (prometrium) intolerance or what do you think you will try next?

@janedoe7251 8 ай бұрын

I got a Mirena inserted by my gyno after watching your videos. The menapause expert nurse practitioner told me it wasn't FDA approved for HRT and prescribed me micronized progesterone. 😂😂😂

@user-EinsteinSarge 8 ай бұрын

I'm on Mirena as part of my HRT, but I've learned there are systemic benefits to oral micronized progesterone that I'm missing out on. Specifically bone benefits. Can you confirm that oral mirconized progesterone has bone benefit?

@psheerinhamill1 5 ай бұрын

Hi there, watched several videos by Dr Gersh on cyclical progesterone even post menapause knowing you will have a structured planned bleed. So 14 days You would take progesterone with continous estradiol patch. What are your thoughts, I would like to do this. Is this safe? confusing to know what to do. Love your videos and here is an example of what some or most doctors are saying: 5mo ago Continuous birth control and continuous HRT have always been "better' in the sense of decreasing risk for breast cancer. Unfortunately, most women never learn this. Periods are the enemy for breast cancer risk (ovarian cancer risk, too). I have omitted the Doctors name, she is an Obgyn and quite popular. 1 am going to ask my doctor to change my regimen to cyclical but with all the contradicting info, a bit nervous.

@StrideOrDie71 4 ай бұрын

Duavee only has half the estrogen I need. I can’t do an IUD, so I’m sticking with estrogen-only and getting uterine scans every six months. I’ll probably end up needing a hysterectomy. Not ideal, but that’s literally my only option.

@nancypisani7229 4 ай бұрын

@@StrideOrDie71 is this ok by your doctor.? Sounds interesting. Are you in the United States

@emilyv5366 5 ай бұрын

I am in perimenopause for 8 yrs now. I have had the Mirena for one year now. Within one week I had significant brain symptoms (apathy, sadness) there is a warning on the box for women who have depression. I do NOT have "depression" but I do have PMDD. Once estrogel was added to my perimenopause HRT care, I saw some improvement. The brain symptoms still come and go but are less frightening. Just wanted to share my experience. I've spoken with other women who experienced this too. I suppose what I'm getting at is that menopause care needs to be monitored and flexible ♥️😊

@annemarieedwards68 7 ай бұрын

I've watched many videos about progesterone intolerance and the options, and this was by far the most succinct. Thank you!

@jennifer1424 8 ай бұрын

What about those of us with PMDD? For me, my gaba receptors have an abnormal response to progesterone and it makes me not just “moody”, but full on rage and constant irritability. Before I was diagnosed I was given the progesterone only birth control and I was a raging lunatic. I realized it was the pills and once I stopped things improved. Perimenopause has been a godsend with the lower hormone levels and I’ll never take HRT. It would be great if there was more research into this and it was more widely addressed and accepted.

@gilliandowney5225 4 ай бұрын

Not taking hrt opens you up to alot of problems. I suggest you do more research. It's about your heart bones and brain also.

@GodsChild-128 2 ай бұрын

This is me exactly! Birth control made my pmdd worse, and all month long rage. Now I’m 45 perimenopause and I’m trying the HRT to help the pmdd and the progesterone pill the last half of my cycle is like being on birth control all over again. But I LOVE the estradiol!! I don’t know how to stay on the estradiol if I can’t handle the progesterone part half the month 😢

@OZMAZZ12 25 күн бұрын

@@GodsChild-128if you get an answer to this please share it with me 😊

@user-qm5nq9wg3d 7 ай бұрын

Seems progesterone is the problem when it comes to hrt for many women and why women discontinue hrt. For most whom had a hysterectomy/ooverectomy don't even take progesterone in any form and they get on well without it, and there is some who still need it to relax . l personally think progesterone should be available in lower dosages than the standard lowest dose of 100mg. AS this could be too much progesterone. Some women find relief switching to vaginal. Some find relief with localized IUD progestin. It would be great if progesterone had more lower dosage options. Estrogen comes in increments of dosages and we guage how we feel based on symptoms whether it's too low or to high till we get it just right. It would great if this was also an option for progesterone, as some women can't even tolerate 100mg vaginally. Reply

@user-qz9sd2zf1i 7 ай бұрын

It doesn’t come lower because you need a min of 100 mg daily to protect the uterus for cancer. I have tried lower compounded formulations out of desperation in the past and I can say that even smaller doses have illicited the same reaction. Doesn’ matter if it is 25 mg or 200 mg for me. I have tried, compounded creams, compounded oral, prometrium, used it vaginally and same response every single time.

@r-anne7375 7 ай бұрын

But progesterone taken vaginally doesn't reach the uterus. An IUD placed in the uterus is what will and what I want, but my gyn. won't do that for me until I have a small fibroid removed surgically. I don't want to be put under. The fibroid has never been to much of a problem.

@user-qz9sd2zf1i 5 ай бұрын

I have taken lower amounts of 25 mg and also 50 mg compounded oral for that reason and it results in the same result in any amount for me.

@time_traveller3 4 ай бұрын

@@r-anne7375Yes it definitely does reach the uterus this way - it’s called the vaginal first-pass effect according to a medical journal research paper published on this topic and there are no systemic side effects such as dizziness etc when used this way.

@gilliandowney5225 4 ай бұрын

Is there no good comment at all about progesterone 😢

@ToshAllan 3 ай бұрын

no and for good reason. it's a steroid and causes rage and manic mood swings and more importantly causes cancers with a high rate of breast cancer for an fda approved drug. fair warning

@spaceorbust 8 ай бұрын

after taking prometrium for several months, i started waking up with a big headache and retaining a ton of water. so sad because it helped my sleep!

@Theorist9 4 ай бұрын

Yes, progesterone gives me horrible headaches. I'm going back to my Dr. in a couple of weeks and asking for a different option. They weren't migraines but certainly debilitating.

@1177margot 8 күн бұрын

Same here, 2nd week and ankles are swelled. I rarely ever have headaches, but I feel more more head pressure. I also get bloated.

@MyFaith2012 28 күн бұрын

currently taking Prometrium w/estrogen patch, still lack energy, take nightly (progesterone) used to help me sleep but lately has affected my sleep. Good tips to look into thank you.

@stargazerbird 8 ай бұрын

Makes me miserable, dizzy and gives me joint pain and makes me so sleepy. I hate it. I used transdermal. I don’t understand why some of us get this. Do we produce enough progesterone and are so overdosing? Frankly I stopped it and now just use transdermal estrogen in low dose. I have done this for twenty years and I am fine.

@user-qz9sd2zf1i 7 ай бұрын

Do you still have a uterus though? You can use estrogen with no progesterone is you have no uterus. It is so frustrating. I was happy to get through life without a hysterectomy only to find that I am pg intolerant and estrogen makes me feel amazing but I can’t take it.

@r-anne7375 7 ай бұрын

@@user-qz9sd2zf1i That's exactly how I feel. I love how I feel on estrogen, but when I take the progesterone because I still have my uterus,( I take it cyclically) I feel like crap. Bloated, weight gain, bad attitude , and groggy.

@natasha09179 5 ай бұрын

My joints are hurting so bad from the birth control I am on. Just wondering if you were able to resolve yours? It helps me sleep and feel calmer but it makes my joints hurt.

@ReasonablySpeaking9808 4 ай бұрын

I have a question: did you have hamstring pain too, along with the joint pain from progesterone? What kind did you use and what was the dosage? I’m having joint pain, but I’m not sure if it from 200mcg of progesterone

@mercedeseulitt223 12 күн бұрын

I get really dizzy and have nightmares on progesterone. Tried pills, inserts and do a cream and just use a dap. But had a hysterectomy so I don’t really take it until I have sleeping issues. Is it ok to continue taking small doses without a uterus?

@user-EinsteinSarge 8 ай бұрын

While on my estradiol patch, I had bleeding using oral progesterone, so switched to Mirena IUD a few years ago and have had zero bleeding since.

@heatherhirschMD 8 ай бұрын

Great! So many patients have benefited from this!

@JS-pq9uh 3 ай бұрын

Can anyone explain what causes the bleeding for some?

@kidges3132 3 ай бұрын

I was 59 when I made my appointment for a mirena iud. She didn’t even get started hardly and the pain was so much that I chickened out. My heart was racing and I went into a full blown panic attack. She prescribed me some meds to help soften my cervix but I was so traumatized that I never went back to get it.

@nancypisani7229 4 ай бұрын

Dr. Hirsch. You didnt mention Provera (medroxyprogesterone). any reasoning?

@workhardplayharderx2 3 ай бұрын

My Dr gave me Micronized P 100mg, my heart raced, anxiety, SEVERE Insomnia and going on 4 night with zero sleep. She upped it to 200mg and within 25 minutes I was wired and full of anxiety and rage and could not sleep. She keeps telling me it works for everyone it must be something else. No, it's for sure the P, I feel it within 25min of taking it. The insominia is horrid and I cannot hold my FT job and not sleep / drive to work. I can't afford out of pocket so I have to stick to a Dr that takes my insurance. I would love to hear suggestions. Someone suggested taking T and E only and it helped her sleep. But, my Dr will not prescribe T and I know I need P since I have a uterus.

@lisaanderson7322 2 ай бұрын

I have the exact same issue with anxiety when taking progesterone orally. I use the progesterone capsule vaginally (it's approved that way in Europe) and it has been a total game changer. My doctor was fine with it and it's allowed me to be on HRT which is life-changing and now I'm able to sleep!

@workhardplayharderx2 2 ай бұрын

@@lisaanderson7322 Thank you for sharing, I'll give this a try!

@GodsChild-128 2 ай бұрын

@@lisaanderson7322thank you for sharing! Do you take the micronized progesterone only the last half of your cycle? Do you break it open first? I am 45yo perimenopause and still cycling but NEED the estrodial. Can’t tolerate the progesterone lag half of my cycle. Hoping vaginally might help😢. (Taking P orally puts me in a very dark place).

@elleherzog 2 ай бұрын

You can use the micronised progesterone as a pessary (vaginally). Dr. Louise Newson has some really good videos on this.

@triciab2354 25 күн бұрын

Same exact issue - still looking for a solution...

@SzazaM077 8 ай бұрын

I swapped taking Utrogestan pills from oral to vaginal for 14 days only - then I get my period. I feel better doing it like that. It's not licenced for vaginal use but my menopause specialist approved it.

@GodsChild-128 2 ай бұрын

Thank you for sharing! Just curious, what were your symptoms taking progesterone orally? I am perimenopause 45 year-old and thrive on the estrogen but taking oral progesterone. The last half of my cycle puts me in a very dark place. I might try the micro nice progesterone vaginally this cycle🙏. I really hope it works because if it doesn’t, I might have to stop my HRT which sucks because I love the estrodial for the hot flashes and night sweats.

@becky6598 9 күн бұрын

Progesterone me serious dizziness and lightheadedness, right after taking it, so much that I had to go to the ER.

@TC-mf1cq Ай бұрын

My daughter took Norethindrone to pause her period when she went to a music festival. She had beautiful thick hair and half of it fell out. It still hasn't grown back after a year. No one ever broaches the negative side effects of hormones.

@OZMAZZ12 25 күн бұрын

My progesterone is 1 and I sleep well. I hardly ever had progesterone all my life. My body doesn’t make it and if I take it I get panic and anxiety. Yuck. Is it a PCOS thing ?

@carmensmith4681 6 ай бұрын

Great Video. I want to stop HRT because of the progesterone. My life is SO much better since being on HRT for 6 months now EXCEPT I hate the progesterone, mostly because I have gained 15 lbs. but also because it make me so dizzy it wakes me up, I have acid reflux, I zonk out on it but am wide awake at 3 am and still have groggy mood issues. The weight is the big one. I think 200 is too much to be on but my Dr says I have to be. I think I am giving up on HRT because I can’t live with weight gain. HELP.

@stefaniasigurdard 5 ай бұрын

I have similar issues. Have you tried skipping progesterone for a at least one cycle and allow the body to find balance with only Estrogen before introducing the progesterone again? I am on that kind of adjustment period by my Doctor´s orders and am curious if others have tried those kinds of adjustment periods?

@carynf5922 7 ай бұрын

My understanding is oral progesterone (prometrium) passes through the liver) and then converts to metabolites. These metabolites cause the grogginess and can cause depressive symptoms. With vaginal delivery or using a transdermal cream metabolites are no longer an issue and progesterone is better tolerated.

@user-qz9sd2zf1i 7 ай бұрын

This is actually not true. I have tried prometrium vaginally with the same side effects of extreme sedation, depression, vivid nightmares etc. I have also used cream with the same reactions.

@onewomansjourney760 7 ай бұрын

@@user-qz9sd2zf1ievery woman responds differently though. I vaginally insert micronized progesterone capsule at bedtime each night & also use Estradiol patch & it's been the best combination for me & works!

@onewomansjourney760 7 ай бұрын

Yes, this is what I do! At bedtime every night I vaginally insert the micronized progesterone capsule & I do that in combination with Estradiol patch & it's been fantastic!! Works great for me. I've been on this combination 7 months & I've had excellent results!

@r-anne7375 5 ай бұрын

I'm pretty sure it still goes thru your system . the only way it doesn't is planting an IUD in your uterus.

@sheilazerby4144 4 ай бұрын

⁠@@onewomansjourney760 Have you had any weight gain or water retention from it? Thx! 😎

@straykittsco.950 Ай бұрын

I think I have progesterone intolerance. I started with an estradiol patch at 0.05 mg and oral progesterone 100mg and i was doing alright but still having hot flashes just fewer so they went up on my estrogen patch and also increased my progesterone to 200mg. I was ok the first week then suddenly it was giving me vertigo and within an hour of taking it i would black out. I would get really dizzy, light headed and feel high and knock out and then wake up but 2am or 3am feeling like i got hit by a bus then go back to sleep until 7 am when i had to get up for work but then feel off and groggy all day. They decreased my progesterone back to 100mg which helped a little but I'm still dealing with very bad grogginess and mild depression.

@sarahhills4572 28 күн бұрын

I'm very much the same.im on 200mgs daily and have been feeling really depressed 😔

@onewomansjourney760 7 ай бұрын

I uae Estradiol patch & vaginally insert the micronized progesterone capsule every night at bedtime. Works fantastic & no horrible side effects. They do it this was in the UK & it's a common way to get the progesterone. This combination works great for me & I've had fantastic results & feel great!

@kathyhandler5254 6 ай бұрын

interesting. my side effect is acne, which i never had before. might have to try that.

@shawnhammond5426 5 ай бұрын

Do you poke a hole in the capsule before inserting?

@StrideOrDie71 4 ай бұрын

Just curious, how much estrogen are you taking and how much progesterone? I’ve read that sometimes the problem is the estrogen being too low relative to progesterone.

@time_traveller3 4 ай бұрын

@@shawnhammond5426No just insert it as it is. Don’t poke any hole in the capsule.

@sue3519 4 ай бұрын

i started great with estrogen patch and micronised progesterone vaginally but lately the progesterone is causing me severe digestive issues it sedates my entire system. i am now experimenting with 1/2 patch estrogen and 1/4 peace of the cyclogest progesterone vaginal. if it is not going to work will have to give up HRT altogether because i cant risk problems with my digestion. i started HRT to solve this problem mainly

@melisnl 8 ай бұрын

Progesterone gave me heart palpitations, elevated cortisol

@amberwest9478 6 ай бұрын

Try taking it with food/carbs. It won't convert to cortisol that way.

@SunnyBunney 5 ай бұрын

Me too, even if I took it with food

@Butterflylovely5 3 ай бұрын

How do you know about the cortisol? Did you test for it?

@stefaniasigurdard 7 ай бұрын

So helpful! Just started HRT and began with only estrogel because of bleeding, began taking progesterone later in my cycle and soon felt intense side effects. Really responded well to the estrogen but not handling progesterone well. Really fast weight gain, really tired and foggy, bad nightmares (had no problems with sleep before), intense mood changes and terrible headaches. Stopped yesterday and already feel a small relief. Will stay off for 2 weeks and talk to my doctor about how to move forward. Thank you

@feminineheart 6 ай бұрын

Sounds like me. Prometrium gave me intense headaches, moodiness, etc.

@stefaniasigurdard 6 ай бұрын

@@feminineheart sorry to hear that.Did you find an alternative way? I am still struggling. Tried to do it vaginally but the same effects. Not worth it imo but I still resist going off estrogel since it has helped me so much.

@feminineheart 6 ай бұрын

@@stefaniasigurdard I’ve been on HRT for 25 years, and I haven’t found an alternative way to get the progesterone I have to have because I have a uterus. I just have to suck it up for 10 days a month 😞. Some people have success wit an IUD, but I’m not a candidate. Some people do better with the synthetics like provera. I wish I had some answers for you. I’m not giving up my estrogen for 10 bad days on prometrium though!

@stefaniasigurdard 6 ай бұрын

@@feminineheart oh gosh, having these hormonal changes is such a challenge. Truly didnt expect it. I am sorry that you are not one of those that get the instant relief and everything changes. Would also like to be a part of that group. Thank you so much for your answer ♥

@user-qz9sd2zf1i 5 ай бұрын

So glad to hear someone else say this. I too have tried to take it in multiple forms, compounded on skin and oral and also prometrium and it is a horrible. Vivid nightmares and the list goes on lol. I have never heard anyone say they had bad dreams on it but myself. I too, have had zero issues with sleep at all through my peri/post journey. I am going to try a progestin next because I really like my Evamist.

@EmpressLestat 8 ай бұрын

I ended up punctering my micronized progesterone pill with a pin, and then squeezing out the contents onto my skin. It's peanut oil based, so it comes out like an off-white liquid. I just rub it into my arms or inner thighs. I'm going for an ultrasound soon to measure my uterine lining to make sure that application type is having the intended effect. But so far, no spotting. EDIT: Developed VERY SORE breasts, cramping and finally bleeding dark blood today. Stopped my HRT and still waiting for my uterine lining ultrasound. These syptoms suggest that putting the micronized progesterone on the skin is not enough to balance the estrogen patch effectively.

@user-zd1rb6hn7d 8 ай бұрын

This is a great idea! Any side like breakthrough bleeding?

@janedoe7251 8 ай бұрын

Oral and transdermal medications are formulated differently. You should get the cream version. I'm using Mirena.

@EmpressLestat 8 ай бұрын

@@user-zd1rb6hn7d Not so far!

@EmpressLestat 8 ай бұрын

@@janedoe7251 Yes, technically the 100mg dosage translates to a much higher dose since I'm using it through the skin, but i don't put it on every night. If the ultrasound checks out, I'll keep going. I can't get any other hormones thru my regular doc since she wouldn't perscribe HRT, so i get mine online and they don't have alternate progesterone formulations. I tried one from Amazon, but id rather just go with using the pill contents.

@ivalani 8 ай бұрын

For how long have you been doing this?

@user-ju3xc4fi6e 4 ай бұрын

Thank you so much. You truly are my go to for all things peri related. I think I may have a Prometrium intolerance. I’ve been on 200mg for about 3 months added due to my complaints about sleep. This was in addition to my Dotti patch (.075) AND a Mirena IUD. I think my clinician was adding the oral progesterone to address my sleep issues but due to moodiness I think it could be too much with the IUD progesterone. I’m going to try the 2 weeks without the oral Progesterone to see if some of the symptoms reduce. It sounds like my uterus is gtg thanks to the Mirena.

@nazeeniranfar2616 5 ай бұрын

Great and very informative video thank you so much 🙌

@kimhogan4625 7 ай бұрын

This is all so discouraging. I started last week on estradiol patch .50 and prometrium 200mg. I’ve been so sick from the prometrium. Dizzy, nauseous, bloated, depressed, brain fog and very high heart rate. I’ve been back and forth emailing my Gyn. She wanted me to try provera but I don’t want to for fear of worse side effects. She said no to the cream so I have to stop completely. I really wanted this to work for all of the benefits. So upset

@annemarieedwards68 7 ай бұрын

From what I've learned, with your dose patch, you should only need 100mg of prometrium daily. I would ask your Gyn about that.

@kimhogan4625 7 ай бұрын

Thank you! I have a telemed with her in 2 weeks. I'll definitely ask.@@annemarieedwards68

@onewomansjourney760 7 ай бұрын

I'd see another provider. There's absolutely no reason why you can't try the cream.

@echase416 6 ай бұрын

Prometrium is supposed to be started at 100 mg. Only take at Bedtime.

@MiaSonoma 6 ай бұрын

I tried otc prof crm and my heart rate went super high too. It was much lower dose than 100mg a day - it was most popular one sold on Amazon..I think 20mg/2x’s a day...

@lauraschrock3637 4 ай бұрын

I absolutely can not sleep! I’m on 0.005 Estradiol transdermal patch & 100mg Progesterone. Tried taking 200mg Progesterone & didn’t help. If I forget to take my Progesterone at night-I can sleep for at least 4 hours before waking up. I need help 😢

@triciab2354 25 күн бұрын

Similar reaction! to the 100 mg P and .0375 E patch. I think more needs to be discussed by providers on this issue as I hear and read about it ALL the time!

@aspegel5281 5 ай бұрын

Just a thought... make sure you're not at the tail end of perimenopause before you conclude that it's due to progesterone intolerance. When your estrogen drops to low levels (at the end), it can induce feelings of sadness, depression, and anxiety, which could be mistaken for progesterone intolerance. This can be determined by your bloodwork. I'm mentioning this, because I thought I had progesterone intolerance, but then my doctor told me my estrogen levels are low, and that I will probably enter menopause in the following months. That's when I looked into the symptoms of the peri ending into menopause, and sure enough they matched what I was experiencing.

@jaymarx8927 3 ай бұрын

The norethendrone was almost fatal to me. My joints were so out of whack that my knees and shoulder kept dislocating and causing me endless pain.

@GodsChild-128 2 ай бұрын

Thank you for sharing! This is what my doc is recommending since I can’t tolerate the micronized progesterone orally for my HRT 😢. Did you find a progesterone type that worked for you?

@jaymarx8927 2 ай бұрын

@@GodsChild-128 Just micronized progesterone. It seems to be ok so far, but the progesterin seemed to build up causing worse and worse effects over time. I hope I can tolerate something because they won't let you just take the estrogen.

@GodsChild-128 2 ай бұрын

@@jaymarx8927 curious, did you try the prometrium (micronized progesterone) vaginally yet? That is what I am going to try at the end of my next cycle. I will already have pms due to my own progesterone (which is unavoidable) but I’m curious if doing the P vaginally will not ADD to the issue to the point of near mental breakdown like it’s been each cycle since I started HRT. I am still perimeno and cycling so have to take it last half for 14days. I’m hopeful the vaginal way works, because i really love & thrive on the estrodiol evamist.

@madeleine83 4 ай бұрын

Question Dr H ? Do you also get complaints of Prometrium causing acne? That is my issue along with grogginess and brain fog.

@questioneverything1776 4 ай бұрын

Me too!

@madeleine83 4 ай бұрын

@@questioneverything1776 I am thinking that an IUD is the solution.

@robsh7301 8 ай бұрын

If the oral options cause side effects and no internal device is wanted would you ever consider a cream option? If not, please explain why not. I know you have mentioned that the compounded options are not FDA approved but certainly blood tests and symptoms would give some valuable information as to effectiveness. Thank you

@courtneyblue15 8 ай бұрын

From what understand, the creams are not readily absorbed by the body, therefore they are pretty much pointless.

@robsh7301 8 ай бұрын

@@courtneyblue15 Thanks for your response. I know that is what many are saying and again I dont understand why as a blood test could show otherwise. If a woman starts with zero or near zero of whichever hormone and uses a cream and that number goes up, then its being absorbed.

@beatacz7662 8 ай бұрын

I’m using progesteron cream , I see different right away ! My PMS symptoms are almost gone , my period is regular and much lighter, no more hot flashes!

@stargazerbird 8 ай бұрын

I used the cream and it definitely has an effect. I can’t tolerate it.

@user-qz9sd2zf1i 7 ай бұрын

Creams had the same effect on me and so I find it kind of funny when they say they don’t work. They might not have enough efficacy to protect the uterus but they made me almost suicidal at 20 mg on my skin….same effect oral has had.

@user-qm5nq9wg3d 8 ай бұрын

Is 100mg the lowest dose available to prescribe? Is there a reason it can't be less than 100mg?....maybe 100mg is too much for some ?!?!?

@ivalani 8 ай бұрын

I haven’t seen lower dose than 100 mg.

@user-qz9sd2zf1i 7 ай бұрын

It is the lowest dose to take to protect the uterine lining. I am progesterone intolerant and I have even tried compounded smaller amounts out of desperation and even smaller doses have the same effect of vivid nightmares, lethargy, hungover, sadness, anxiety.

@ruthx2614 2 ай бұрын

Thank you SO MUCH for this! I’ve have spoken numerous times to my doctor about HRT in the light of me being progesterone intolerant and he just doesn’t get it. I want the protective benefits of Estrogen without the nightmare side effects of Progesterone. Duavee (Duavive here in the UK) could be the answer. I don’t know why my doc didn’t suggest it?!

@K-E2019 8 ай бұрын

I took the micronized and I felt sedated , angry and dizzy . It was terrible . I knew it was not for me .

@melodielumley6450 8 ай бұрын

Same. Thank you for writing that.

@mcclk1 8 ай бұрын

Me too! On the 4th day of micronized I felt drunk. The 5th day I got so intensely dizzy I almost had my husband take me to the ER. Norethindrone doesn’t make me dizzy, but I gained 10 lbs of water weight on it. Ugh

@tkdickhens 8 ай бұрын

Same here took it for 4 days and felt lethargic, angry and almost suicidal

@ms.t8313 8 ай бұрын

@@mcclk1hello there! Did you feel drunk and dizzy even when you took progesterone at night before going to bed, or did you take it in the daytime? Thanks !

@melodielumley6450 8 ай бұрын

@@ms.t8313 night time. And the effect lasted all the next day. I was so foggy and groggy and cranky. I couldn’t do anything. 2 days after stopping, it all went away. Back to normal.

@rachelteeuws1241 8 ай бұрын

The combi patch was great at the beginning then the cramps started and spotting

@jennybadl7840 4 ай бұрын

I'm wondering if ovarian animal extracts (Beef) could be a treatment for menopause when you can't tolerate HRT? I'm thinking of that because thyroïd extracts could be given in hypothyroïdism and adrenal cortex extracts for "adrenal" fatigue. Did someone try the ovarian extracts?

@JesusSaves7012 3 ай бұрын

Equine estrogen is so cruel to the horses and their babies 😢

@melodielumley6450 8 ай бұрын

Thank you so much! I actually asked for this video last week on one of your fabulous TikTok's. I still have a question: If you've had a complete hysterectomy and have severe progesterone intolerance - can we do without it? Again, so many thanks for this video. Incredibly helpful.

@heatherhirschMD 8 ай бұрын

Yes you can! no need for progesterone if you don't have a uterus

@cleanqueen75 21 күн бұрын

Regarding the Combipatch, the WHI estrogen plus progestin substudy reported increased risks of DVT, pulmonary embolism (PE), stroke and myocardial infarction (MI). The WHI estrogen plus progestin substudy reported increased risks of invasive breast cancer and the WHIMS estrogen plus progestin ancillary study of WHI reported an increased risk of developing probable dementia in postmenopausal women 65 years of age or older

@wearelegion1163 13 күн бұрын

WHI has been debunked for years. Why are you still quoting it?

@cleanqueen75 13 күн бұрын

@@wearelegion1163 Can you provide that data?

@cleanqueen75 13 күн бұрын

@@wearelegion1163 can you provide the data?

@vectorair1 4 ай бұрын

Found this video- every time I try starting my progesterone I have terrible nightmares. (And seem to break out..?)

@athenachloewoodrow6356 3 ай бұрын

I experienced the nightmares initially, but that did get better with time

@r-anne7375 8 ай бұрын

UGGG, you described me. I don't do well on progesterone. I recently started with a new gyno because I moved to a different state, and asked for an IUD. She did an ultrasound and found a polyp in my uterus and I have a fibroid that I've had for years with no problems. She immediately did a hysterscope and told me I need to go to OR to remove the fibroid and polyp and at the same time she would put in an IUD. I don't want surgery but would love an IUD. I'm on hold putting it off and don't know what to do.

@user-zd1rb6hn7d 8 ай бұрын

Omg my story exactly! I'm scheduled for the surgery late January . I don't have any symptoms of these polyp and cyst . I might opt out to surgery

@heatherhirschMD 8 ай бұрын

while scary, it can get three things done at once!

@user-EinsteinSarge 8 ай бұрын

I had a polyp removed in 2019 and all went smooth. I didn't realize at the time how common they apparently are. My next gyn visit I had an IUD put in - wish my gyn would have offered to have it put in during the polyp removal; would have been much easier.

@revil2011 6 ай бұрын

@@user-EinsteinSargeIt is hard to find an obgyne who will make it easy and simplify everything for us. Obgyne wants the most expensive treatment and wants us to keep going back to them!

@patriciapyper4617 8 ай бұрын

I take evorol Conti patches l get neausa vertigo and sore muscle pain😂

@PatB415 7 ай бұрын

Question: Considering that I'm 73 with a Uterine, & taking Bio-Identical Estradiol, do I need to take Progesterone? Thanks!

@gillianmillington7735 6 ай бұрын

yes

@linyfelix4846 2 ай бұрын

Definitely

@ubstill 4 ай бұрын

I was moved over from 2mg estradiol/10mg? Medroxyprogesterone days 10-19 to same 1 mg estradiol/100mcg prometrium, had miserable hot flashes so bumped estrogen back to 2mg/100mcg prometrium, and I hate it. I strongly prefer the prior Rx combo - was functioning well, had libido, workouts progressing and getting the best sleep of my life, all blood tests were best of adult life, too. Now having floppy arms, less energy, no libido, etc, etc… no weight gain, but body composition on the skids and I just don’t feel great. Why shouldn’t I go back to the original combo with medroxyprogesterone, on which I was so good? No family history of breast cancer, high cholesterol controlled by statin (since my 20s), osteoporosis. I need help discussing with my gyno.

@tibisayhuerta 3 ай бұрын

I don't feel sedated or gruggy, but the bloating and gastroparesis. I'm positive it's the prometrium, because I goes away when I stop taking it... It's HORRIBLE!!! 😩

@athenachloewoodrow6356 3 ай бұрын

It did this to me too. What works for me is taking an extra fiber supplement every morning, Ginger regularly, and magnesium with dinner encourages gut motility

@athenachloewoodrow6356 3 ай бұрын

I also take it vaginally which improved the gut issues, but I still need the above

@kidges3132 3 ай бұрын

Casgara sagrada is hands down the best supplement for constipation. I follow a KZfaqr that has given me great recommendations over the years and she suggested that supplement.

@rannerobin2787 2 ай бұрын

Severe, severe depression

@beatacz7662 6 ай бұрын

Dr Hirsch , what do u think about progesterone cream from wild yam ?

@questioneverything1776 4 ай бұрын

It’s actually an estrogen despite what the marketing is. Also, topical progesterone has shown not to absorb well to have the beneficial affects needed for the uterus

@user-zd1rb6hn7d 8 ай бұрын

I was on the combi patch had break through bleeding so Dr prescribed the progesterone pill and estrogen patch. I'm afraid to take the progesterone pill now because I will be traveling and I'm afraid I will have a breakthrough bleed ugh What's a girl to do 😊

@K-E2019 8 ай бұрын

This is my story exactly. I took the Combi low progesterone for eight months with no problem, then started bleeding. Switch to the higher progesterone, Combi patch, and that lasted about the same until I started bleeding. Now I’m doing the estradiol patch with a Madroxy progesterone pill because that’s really all that I can tolerate. No bleeding !

@kaiulanisallas9005 7 ай бұрын

@@K-E2019thanks for sharing! I can’t take this break through bleeding - SUPER HEAVY ruining my clothes and just a nuisance. Thanks for sharing about the iud!

@jenniferallred9367 4 ай бұрын

Progesterone knocked me out. I slept all day and night. Medroxyprogesterone put me in the ER!

@Butterflylovely5 3 ай бұрын

Why what happed to you to end in the ER

@jenniferallred9367 3 ай бұрын

@@Butterflylovely5 severe migraine ( never had a migraine in my life), high blood pressure, chest pains, vision disturbances

@agnesjuhasz7715 24 күн бұрын

I am presribed Provera as for progesterone along side Estrogen gel, a little worriwd - any thoghts ?

@jen-lo13 Ай бұрын

Hello! Question? I just started HRT for menopause and I think I have progesterone intolerance (I take it orally at night every night ) 125 mg from a compounding pharmacy and I feel so much worse. Worse insomnia , worse hot flashes, depression and bloating Would a progesterone cream or topical be better? I need to talk to my provider but it’s the weekend and I’ve been miserable so I was thinking of stopping the progesterone until I can get this figured out. I heard you could buy the topical creams over the counter but I’m just not sure what to do. 😞

@aliciawalters4132 7 ай бұрын

What time of the cycle should I take my progesterone?

@gilliandowney5225 4 ай бұрын

The second half

@ketolowcarbsharimac Ай бұрын

I'm on HRT. The progesterone is causing me to have hair loss. A lot of hair loss. Will this stop?

@sophiemeulemans2353 3 ай бұрын

Please, I need help; my life is become nighmate!!!! after total hysterectomy and bilateral oophrectomy last november, I have HUGE difficulties with HRT... i use estradiol patches with bio identical estradiol; i try utrogestan (micronised progesteron) vaginally and even this way I has severe anxiety, I tried several dosages, and also I have severe abdominal pain. I don't have womb anymore BUT I am not well with estradiol alone nevertheless. The problem is sometimes I experienced GOOD effets on the muscles, etc, but the rest of the time, I have various problems, digestive, hepatic, etc. I tried also natural creams that are better but not enough (dosage, only 0,5 or 1 of progesterone)

@user-nr3wl9bu1q 2 ай бұрын

Can I stop cold turkey from taking my prescription hormones? Prometrium 100mg estradiol 1 mg I don’t see no Benefits. I got on them to help with sleep but I keep waking up early and can’t go back. Is there any over the counter supplements that can with hormones besides prescription?

@southernsass7624 7 ай бұрын

Isn’t Duavee a bisphosphonate? This class of drugs can cause osteonecrosis of the jaw if you have currently or previously been treated with this class of drugs.They lead to an exposed bone or bone that can be probe through a fistula and the maxillofacial region that does not heal,especially when having a tooth extracted. I have seen this with patients. Can you clarify if this falls in that class of drugs? Thank you

@midlifewellnessnp 6 ай бұрын

No Duavee is a combination of a SERM and a conjugated estrogen. For those who need a progestin, but can’t tolerate it, Duavee is a good option.

@questioneverything1776 4 ай бұрын

@@midlifewellnessnpbut the oral CEE increases risk of stroke and clots and doesn’t seem a heart protective vs transdermal application

@midlifewellnessnp 4 ай бұрын

@@questioneverything1776 that is debatable, some research says oral more protective of heart. I personally do transdermal estradiol and oral micronized progesterone first and if all possible to avoid any unnecessary risks. I have had tremendous success with this. I know everyone is unique though. Just as a prescriber, that is my go to! Yes, oral estrogens are higher risk of clots due to first pass in the liver where clotting factors are made. Risks are rare according to The Menopause Society, but as we age, our risks of blood clots increase. Anyway, that is my favorite way and no issues reported.

@jovicrazed 5 ай бұрын

Progesterone gives me dermatitis. The mini pill (norethindrone/progestin) did it - a horrific case of perioral dermatitis that took FOREVER to get rid of. Now Prometrium has caused dermatitis in my ears. UGH.

@tammycampbell6742 3 ай бұрын

I have watched so many of your videos over and over and been through several doctors' gynecologists .. I would love to have a one on one or make a appointment with you I don't care about that drive.. I am recalling struggling and need some help... please please reach out to me

@Manaldeeb711 8 ай бұрын

What about progesterone creams , do they protect the uterus

@gillianmillington7735 6 ай бұрын

@cleanqueen75 13 күн бұрын

@@Manaldeeb711 I was told they do.

@monikapacko2731 3 ай бұрын

I am sleepy after taking progesterone what is great as I sleep well, but unfortunately I have a headache everyday because of that. Need to contact my GP and hopefully something else can be suggested to me

@nikilyn 3 ай бұрын

Me too, I take it at night before bed and I feel like I have a hangover in the morning, even though I didn’t drink

@lotus6544 3 ай бұрын

Why is the Mirena iud is the last thing to try?

@haniosman9891 6 ай бұрын

I am not on Menopause, but I was given Provera and natural progesterone to 'regulate' my long cycles. I stopped using Provera after using it for 2 months, I felt so emotional so I stopped and was given natural progesterone. After 6 months of using bioidentical progesterone, I stopped in August and have not been bleeding since. Is this normal :(

@jennyb360 4 ай бұрын

Is it safe to take a 2 week break from oral bio progesterone if you are also on an estradiol patch?

@nicolebeavers2684 4 ай бұрын

I am wondering the same thing. I’m definitely retaining fluid but don’t know if it’s from the oral progesterone or the estradiol patch.

@lucianacampos356 3 ай бұрын

What about having progesterone vagibally?

@user-qm5nq9wg3d 8 ай бұрын

Question for viewers, did progesterone improve or worsen your sleep in peri doing cycled progesterone? Same question for those in post menopause but on continous progesterone?

@ivalani 8 ай бұрын

It improved my ability to fall asleep, but not to stay asleep. I often still wake up around 3 am and have trouble falling asleep again. (I am on continuous micronized oral progesterone).

@EmpressLestat 8 ай бұрын

When I was initially taking it orally, it helped me sleep as i was having insomnia. At first, it zonked me out and i had headaches for 3 mornings, like a hangover. It evened out after that. I don't take it orally anymore because it slows large intestine motility and I already have issues with constipation.

@r-anne7375 7 ай бұрын

@user-qm5nq9wg3d Progesterone definitely helps me sleep. I'm on cycled progesterone but I don't tolerate it at all. I'm so bloated and moody and emotional when taking it. Hate it, but I'm afraid to go off of it.

@nancypisani7229 4 ай бұрын

@@EmpressLestat how do you take it now? combi patch?

@EmpressLestat 4 ай бұрын

@@nancypisani7229 I had a IUD inserted in February of this year. So now i just use an Estrogen patch.

@user-fb3qk8pb8y 8 ай бұрын

Took prometrium 200 mg for 6 m with .075 estrogen patch. Progesterone just made me groggy and sleepy. Had a mirena placed 2 weeks ago and now having severe reflux. Can’t win 😢

@jenl2771 8 ай бұрын

At night. Within 30 min it knocked me out. Which isn’t terrible except for the groggy feeling which lasted through the day. I’m pretty sensitive to meds.

@echase416 6 ай бұрын

Only take Prometrium at bedtime. 200 mg is a higher dose to start on. Why this high?

@swet-lengpang2077 5 ай бұрын

I had reflux after IUD coil and I wonder why. Omit everything link to reflux but it does goes away after few months just bear with it.

@natasha09179 5 ай бұрын

Dr. Hirsch, can progesterone make your joints hurt if estrogen is too low? I am on lo lo estrin for perimenopause symptoms (light periods, hot flashes), but my joints are hurting so bad. I’m wondering if you have a video about this or any answers?

@nancypisani7229 4 ай бұрын

once i upped my estrogen my joint pain was so much better after a few weeks

@questioneverything1776 4 ай бұрын

Sounds like you need to increase your estrogen

@paulawilkinson6341 3 ай бұрын

I can so relate to this am getting very light periods too ! Even when I used utrogeston vaginaly . But lately am getting terrible aching joints , my knees , shoulders a. Down my arms . I take 3 pumps of estrogel and 200mg utrogeston

@paulawilkinson6341 3 ай бұрын

@@nancypisani7229do u think r diet has anything to do with joint pain ? I find when am not eating healthy my joints get worse

@nancypisani7229 3 ай бұрын

@@paulawilkinson6341 I’m sure it can only help to have a better diet but I do know some of it’s definitely from declining estrogen bc the patches do help w the joint pains and body aches

@valerie4912 2 ай бұрын

Is compounded no good?

@time_traveller3 4 ай бұрын

And what about the lawsuit with the Mirena coil in the USA & Australia and the horrific things it did to some women…🤔?? I would not be wanting to have that implanted!

@questioneverything1776 4 ай бұрын

Please explain. Haven’t heard of this! Menopause Drs recommending Mirena for progesterone intolerance

@danajones6659 3 ай бұрын

I had the Mirena IUD removed a week ago. It was part of my HRT. It didn’t even last 2 months inside me. It caused horrible horrible depression, I was tired all of the time. I thought I was having a mental breakdown. There are a small percentage of women who have these side effects. I’m really upset I wasn’t told this as my out of pocket cost was 1,000.

@time_traveller3 3 ай бұрын

@@questioneverything1776 Women who had the Mirena IUD implanted increasingly reported experiencing complications with the device. Often the device migrated from its original positions, causing a lot of discomfort and some instances of extreme pain. Once the device migrated, it wreaked havoc on internal organs by perforating some of them. Look it up on google, there are several lawsuits against Bayer, the makers of the product.

@time_traveller3 3 ай бұрын

@@questioneverything1776 Women who had the Mirena IUD implanted increasingly reported experiencing complications with the device. Often the device migrated from its original positions, causing a lot of discomfort and some instances of extreme pain. Once the device migrated, it wreaked havoc on internal organs by perforating some of them. I’ve posted this comment twice but it keeps magically disappearing!??

@time_traveller3 3 ай бұрын

@@questioneverything1776 you need to look it up on google about this as my comments keep disappearing everytime I try to reply to your question…

@jeannejones5449 8 ай бұрын

After a month starting hrt I had spotting with 1 day of blood. So after 4 months I quit the hrt. No spotting since I stopped. I had extreme breast pain that I could not tolerate. I was on a .0375 estradiol patch and 200 mg micro progesterone. Now I’m off hrt all together. The gym wanted me to quit bc I was 65 just starting hrt. Is it normal for a gym to discourage hrt? I have no faith in doctors now. My mom passed at 90 so I feel I have 25 yrs left of life. Why would a gym tell me to stop hrt? Could you suggest a path forward for me? Thank you for all you do to help women. 💐

@echase416 6 ай бұрын

200 mg is a moderate-to-high starting dose for Progesterone.

@questioneverything1776 6 ай бұрын

It was the progesterone that was giving you symptoms

@athenachloewoodrow6356 3 ай бұрын

And your estradiol dose was on the low side, with the prometrium way too high

@lD-us3xd 2 ай бұрын

But will the IUD help long term with bone health??

@kake646 Ай бұрын

No.

@VeganKatieFaye 8 күн бұрын

Its the estrogen that helps prevent osteoporosis

@Artysmarty150 8 ай бұрын

I was put on norethrindone during perimenopause to stop heavy bleeding. It worked for that, but my heart rate shot up to 140 at rest. My doc didn’t think it was related but I decided to stop and my heart rate went back to normal. I’m wondering if the bio-identical one is less likely to cause that. I want to go on hrt but am afraid of a repeat of that scary side effect.

@user-qm5nq9wg3d 8 ай бұрын

Most of the menopause specialist on media platforms recommend bio-identical over synthetic due to more probable side effects with a synthetic progestin. or perhaps it's like us commenting who have a sensitivity/intolerance to progesterone overall.

@MiaSonoma 6 ай бұрын

I bought the most popular progesterone cream on Amazon - it was great for a week the very tired and my heart rate started going way up so I stopped for now. I also got major major irritability. If I go back on I will try 1/2 the dose for a shorter duration....

@nancypisani7229 4 ай бұрын

i had really bad side effects with Prometrium. Provera, less effects but they were more GI effects.

@beachlvr5812 8 ай бұрын

I ordered a progesterone cream online and it seems to help with sleeping however I break out in hives exactly where I put it. It’s the second brand I’ve tried and both have caused this reaction. The hives take about 3 days to subside so I have 3 different areas that I use. It’s getting exhausting but I’m so afraid of going the pill or patch route for fear of getting a worse systemic allergic response. Any suggestions?

@athenachloewoodrow6356 8 ай бұрын

You're having a skin reaction, not progesterone intolerance. Why don't you talk to your doctor about getting FDA approved prometrium and use it orally or vaginally? You have no idea what you're actually getting from a cream you got online.

@beachlvr5812 8 ай бұрын

Interesting! Ok I will do that. Thank you!

@jeannejones5449 8 ай бұрын

Correction: 100 micro progesterone; not 200 mg.

@parkerb1275 7 ай бұрын

I could not handle micronized progesterone. Sleepy, dizzy bloated and weight gain. Using the combi patch is so much easier. I think people are now afraid of progestins after more discussion of the supposed increase risk of cancer could have come from the group in the WHI that took estrogen/ medroxyprogesterone. Now there is a fear of anything but “natural” micronized progesterone. Please know that if you can only tolerate progesTINS like norethrindrone that that is not the kind used in that study. And I still feel like this is just a way to justify and back away from the original message which had a generation afraid of estrogen. I don’t want those who better tolerate progestins to feel like that they are at risk or inferior to the “biodentical” folks who often come off as they have the better option. I don’t feel that way after some further reading and discussion with my dr.

@Amzr1776 3 ай бұрын

Interested are u using Norethindrone? I have been using it and am scared with all the stats…ugh!

@user-qz9sd2zf1i 3 ай бұрын

Are you using norethindrone? How is it working? I am extremely progesterone intolerant. I have a RX sitting here that I need to start of the norethindrone and I am scared to even try it now that I have had such awful experiences with prometrium.

@parkerb1275 3 ай бұрын

@@user-qz9sd2zf1i yes norethindone is the progestin contained in the Combi patch- a patch that combines estrogen and progestin in one patch

@parkerb1275 3 ай бұрын

@@Amzr1776 yes norithedrone is what’s in my Combi patch

@Amzr1776 2 ай бұрын

@@user-qz9sd2zf1i Hi I was using Norethindrone-at first it was great, but it started making me really angry-like almost a different tolerance to people-sounds weird I know...but I went down doseage on the Norethindrone and my Dr actually had it compounded for me.still a looming mood issue. We have then tried 100 mg for compounded micronized progesterone I have NOT been able to tolerate this before, BUT the difference is a SLOW RELEASE...THIS has made the difference for me. I have tried this 20 different ways...I would highly suggest trying this options-the slow release is the key if your Dr will prescribe. This is a game-changer!

@aspegel5281 4 ай бұрын

Oh wow, I thought if you had an ablation, that you didn't need to take progesterone. So you literally need a hysterectomy.

@triciab2354 25 күн бұрын

correct, intact uterus and you always need progesterone if taking estrogen...