In late 2023 I started HRT because my perimenopause symptoms had become so severe - anxiety, depression and lack of sleep. I checked with my liver specialist at the time as to whether it’s ok with PBC and he said to just keep monitoring liver results. I improved dramatically straight away. But after about 3 months I started to get strong histamine intolerance in response to increased oestradiol. I persevered until October when I had to stop as histamine reactions were extreme - constant post nasal drip, cough, retching and unable to keep food down. Gradually the perimenopause symptoms have come back. Out of desperation I’ve just started progesterone on its own again as it helps with sleep and is calming. But my naturopath has correctly identified it can slow bile flow and motility in the gallbladder and lead to gallstones and may not be ideal with PBC. I did get significant gallbladder pain mid last year. Does anyone know anything about this and have you had any related experiences? My liver specialist doesn’t really engage in these questions and I don’t know how much of a problem I may be causing with bile flow while taking progesterone and how much this may affect PBC. I’m taking 100mg micronised body identical progesterone daily which I only just restarted last night. It already feels like it’s helping me.
progesterone and bile flow: In late 2023 I... - PBC Foundation
progesterone and bile flow
The only thing I can say regarding progesterone i this. When i had my hysterectomy 29 years ago, my ob/GYN put me on estradiol patch. He did not like prescribing a pill for the fact it filters through the liver. And that was many years before I had PBC. Another thing is he would not put me progesterone because it would put me at a higher risk of breast cancer. That’s all I know. Hope you find some answers. 🙏🏻
Thank you. What has occurred to me is I know the progesterone capsule thing can be taken vaginally instead of orally. It just dissolves/absorbs. So that might be better in terms of bile flow and the gallbladder and liver. Both the progesterone and oestradiol prescribed these days are body identical which are different from what used to be prescribed. The progestins in birth control, for example, are something different. From what I’ve read it’s the synthetic progestins that are thought to have potentially some link with breast cancer. I’m going to keep reading on it. When I was taking oestradiol it was through a gel transdermally rather than orally which, along with patches, is considered the safest way with oestrogen these days. Thank you 🙏
I’m glad you’re doing your patient research. We can learn a lot by doing that. I wish you the best.
Thank you kindly 🙏
You’re welcome 😊
How frustrating for you! This happens so often when one doctor doesn't coordinate care with the other doctors involved. Seems simple, doesn't it? I find it almost appalling that your liver doc won't even engage in these discussions. Bile ducts and possible gallbladder problems should certainly be part of his expertise - he is, afterall, knowledgeable in the entire GI tract. Do you have Dr. Jones' book? The Definitive Guide for Patients with Primary Biliary Cholangitis? On page 210 he speaks extensively on taking HRT with PBC. You might also reach out to The PBC Foundation and see if they can be of some help for another resource. pbcfoundation.org.uk I hope you can get some answers.
Thank you Donna. Yes, my gastroenterologist just doesn’t discuss details with me. I asked him about HRT and PBC over a year ago and he just changed the subject. The naturopath has been far more engaged and discusses the effects in the body. He was concerned about the bile flow issue. Thank you, I’m going to get Dr Jones’ book. I’ve read that oestrogen receptors and progesterone receptors behave in certain ways in PBC that are specific to the disease. I’m reading various things and trying to get my head around it all. Many thanks 🙏
hi have you thought about haveing the iud coil that way no pill have to go through the liver!!! I’ve got one and no problems so far!!!
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