I don't know if it' OK to discuss other things than thyroid disease and treatment here but, since all hormone imbalances are related, I hope it's at least all right to ask the question (hoping that, if it's not OK to discuss it here, at least those who have some answers would be willing to PM me):
Lately, I have been thinking a lot about peri- and menopause and the symptoms linked to each condition. For the past four or five months, I've had terrible symptoms such as hot flashes, profuse sweating (both day and night), and poor sleep quality, leaving me exhausted every morning. I think the sweating is even worse at night and, some mornings, I wake up finding the whole bed drenched in sweat.
I have been on both estrogen (cream) and progesterone (Utrogestan) for the past five years; the first I use day 5-25 of cycle, the second day 15-25.
I have felt OK all along; no more and no less.
However, given my severe symptoms lately (and I'd do anything not to sweat profusely at work, suddenly feeling sweat pouring down my spine and dripping into my eyes...), I have been wondering why I am displaying symptoms for which both estrogen and progesterone are normally prescribed...
What I have learned, by visiting webpages of US hormone doctors, is that peri-menopausal women are progesterone deficient, without exception, which also means estrogen dominant. They should NOT use any kind of estrogen, only bio-identical progesterone. And that you can be E dominant and still have low E levels; the important thing is how low your P levels are in relation to your E levels.
I have not used either P or E for the past two days since it's now 27 of what is nowadays my pretty irregular cycle...in that time alone, I've lost more than 2 kilograms. I have also been peeing like crazy these past two days. This tells me that I am retaining fluid (another symptom of E dominance).
My doctor is a so called hormone expert trained by Thierry Hertoghe and, back when I was put on both E and P, I did not know anything about hormone replacement (except thyroid hormone replacement, which is the reason I went to see a H doctor in the first place, when T4 only drugs turned out not to work optimally for me). Now, however, after having read about how peri-menopausal women (and you are peri-menopausal until it's been 12 months since your last period, and I had a period last month) should never use E, only P, I am beginning to wonder if it was a terrible mistake to use estrogen for the past five years, even if I used Utrogestan along with it...all this time, I have been fighting fluid retention, puffiness, especially around the eyes, difficulty losing weight...and maybe it's all been caused - or at least made worse - by using Estrogel when I was in fact estrogen dominant, rather than deficient, all along...?
It seems E levels will drop approximately 60% after menopause (and I'm not even there yet), whereas P will stop being produced altogether, plus E can also be made from fat tissue, so you never seem to run out of E completely...only P.
I'd really appreciate any input on this from others having used both E and P.
It's so easy to think that just because your doctor prescribes bio-identical E and P everything is fine, but I doubt that is the case...because, if you don't need a hormone, you don't need it, period, whether it's bio-identical or synthetic.
I got the impression, when my doctor put me on E and P five years ago, that it was because I had been diagnosed with adrenal fatigue, meaning my adrenal glands were unable to produce enough quantities of any hormone. And, for the past five years, I cannot say I've been feeling bad; although, looking back, probably not as great as I could have. But, since the beginning of the year, the hot flashes and profuse sweating have been really bad, and Estrogel does not seem to help at all...quite the contrary. Which is why I wonder if it's time to go off it completely, and use progesterone alone...?
Hi hrt was offered to me as I was perimenopausel with bad symptoms at 46 ,I was taking e n p even though I was still having periods...I tried lots of different types including patches but didnt feel any better so weaned off and stopped.At this time I was taking levothyroxine. I just cracked on and am now post menopause having gone 2yr without a period (1 yr is confirmed menopause )last year I started taking NDT but was still havng distressing menopause symptoms. (.some women are never free of them even in their 70s and 80s!) Blood tests showed that my cortisol levels were on low side.I have recently started taking a glandular for adrenals and now my hot flushes have stopped and I sleep better and don't feel as anxious.....at menopause your adrenals take over the production of hormones rather than ovaries although not to same degree so adrenals need to be good ,and when we suffer with thyroid (especially if we have been under medicated for a long time)/hashimotos /menopause they are defined going to be out of whack!hope you find some answers it's a very distressing time and those who "sail through it" just think we are making an issue about nothing..!..they really have no idea!!
cc120 ...I take adrenavive ll ..it is bovine ...it is not the whole gland ..just the cortex (the whole gland includes adrenaline )It contains hormones just like ndt does as it contains porcine or bovine.You need your adrenals to be right for hormone production.Thyroid disease and stress and menopause really take its toll on our adrenal function.Ihave been taking it for a few weeks now...I started on 1a day and at same time I reduced my thyroid medication (as once adrenals kick in you could be overdosed on thyroid medication) but I'm now up to 4a day.You monitor through your temperature.First on waking (before getting out of bed) then afternoon then bedtime...if these temperatures are up and down all over the place then you have an adrenal problem.Once you get these levels more on an even keel but is still low then you start to add more thyroid meds back in til your temperature rises to where it should be (Hypo=low temperature ).So right now my temperature levels are evening out but still a bit low so I will be raising my NDT soon (half at a time)so it is optional.I sleep better,my mood is better,hot flushes have gone! I am not a health practitoner but i am trying to get better like the rest of us and I believe this is definitely the way forward for me.
cc120 I couldn't comment on what you should be doing as I have no knowledge of taking the 2 together. .I know some people need cortisol prescribed if you have a serious adrenal disfunction and that could be enough in itself ...and some do better on the whole glandular which includes the adrenalin. I don't know what's in the Thorne one but in the one I take there is just bovine adrenal cortex 125 mg(I'm taking 4at the present) and just the capsule made from organic rice flour and bovine gelatin. Perhaps you could post your question on this forum and find the answer ,good luck
Ahh I see ...I really don't know what you should do...I guess you will have to search Google and youtube ...I hope you get sorted it's a difficult time...I had my last period at 48...the flushes came after they stopped but since ive been taking adrenavive ll I haven't had one....but I also reduced ndt at same time. ..you said you are on a large dose of ndt...?how much are you taking?
Thank you for writing this post Anna69. My GP was today trying to get me on HRT (because I have fatigue but no other menopausal symptoms) and she said I need oestrogen supplementing, I am peri-menopausal and still having periods and don't want HRT, just want my thyroid medication sorting!!
She asked me to think about it and see her again in 2 weeks, your post has really helped
This article and other articles by the same doctor have helped me a lot and I have now made the decision not to use Estrogel anymore, but only take progesterone:
I was told, six years ago, that since I was over 40 and suffered from adrenal fatigue, I needed to replace all sex hormones (along with cortisol for which I was prescribed Medrol). I think that one problem, even with so called hormone experts, is that they only look at the levels of each individual hormone, compare it to so called "optimal levels" at a given age, and then decide whether or not you are deficient...instead of comparing for instance estrogen and progesterone levels to each other. The latter is important as they counterbalance each other.
I was told that, as long as I was using bio-identical estrogen (as opposed to synthetic), there would be no problems. Now, given all symptoms I've not been able to understand because they seemed un-related, but all of which are mentioned in the list in the article linked to above), I am not so sure that is really the case...
I have managed to wean off Medrol for adrenal fatigue, and now take a supplement called Adrenavive III. I feel good on it (I have tried adrenal glandular in the past but seem to do better on adrenal cortex only).
I have come to believe that more is not always better...although I find it annoying that I have to pay a fortune for labs and doctor's fees only to have to do a lot of research myself and self-treat in some areas where I believe my doctor is prescribing too many meds...
I'm still having (more or less regular)periods. It's only in the past few months that they have been acting up a little; they have been either a little shorter than usual (21-23 days) or a little longer than usual (40-45 days), but they still come.
Yes, I had my E and P levels measured along with cortisol levels. I will see if I still have the lab results; they are from late 2011 when I first went to see this doctor, before I started treatment. I was diagnosed with adrenal fatigue but told I could not take hydrocortisone since I tended to retain fluid, making Medrol the only option...I took it for about three years before successfully weaning off it (first, 6 mg daily and then 4 mg daily for about a year and a half), and I'd rather not go back on it. I have read that methylprednisolone is not the same as bio-identical cortisone, and should preferably be used to treat inflammatory diseases and not adrenal fatigue.
Ok, I found my lab results from October 2011, a month before I turned 43. Following the doctor's instructions I went to the lab on day 21 of cycle (ref ranges within brackets refer to luteal phase; blood test):
oestradiol 101 pg/mL (21-312)
progesterone 3.9 ng/mL (1.2-15.9)
I cannot find my cortisol test result right now, but I remember it was measured in a 24 h urine sample and was 30 when it should be at least 50.
It's all about balance and finding the right levels for you.
I'm estrogen dominant and was tested last Fall (for sex hormones) and determined I was in menopause (had been peri for probably 7- 9 years). Was placed on a biodentical estrodial patch (0.05mg, twice weekly), oral progesterone (200mg days 1-12) and a transdermal cream (with testosterone and a bit of progesterone).
Initually, night sweats and hot flashes resolved and sleep became more restful BUT I then experienced some "breakthrough bleeding" and blood tests showed an imbalance between prog/estrogen levels and my testosterone level was now very high. If I were younger, the goal would be to have a slight menstrual cycle each month. I prefer to have no bleeding as I am older.
So, I now take 200mg oral prog daily (sometimes 400mg) and my testosterone cream % is greatly reduced.
It was determined that I must metabolize progesterone very quickly. Estrogen sheds uterine lining while progesterone keeps it. It's all about proper balance. Testosterone is important too for sex drive but too much can cause mood swings, anger and irritability. (Been there!)
Also, when sex hormones are properly balanced, I find that my thyroid hormone levels are better since thyroid meds are absorbed better. (This has been my experience. I'm hypoT).
Progesterone creams are tricky since absorption isn't measureable and most contain insufficient % progesterone to be effective once in menopause. Prior to being tested last fall, I had been on a compounded progesterone cream, 100mg/ml, 1ml applied nightly, for many many years and it worked well until my sex hormones took a nosedive and I started menopause symptoms despite still applying the cream. Oral prog and and my estradiol patch are working very well for me.
I find what you say about balancing sex hormones affecting thyroid hormone absorption interesting, as I need a very high dose of NDT in order to get my FT4 levels to climb above the lower normal range (barely) and my FT3 levels midrange...
According to Dr. Bergman and Raypeat.com - you should use the progesterone only - and especially if you have Hashimoto's or some other thyroid disorder. Dr. Bergman has a lot of YouTube presentations and is a chiropractor in California. He speaks highly of Dr. Ray Peat, PhD. Dr. Ray Peat recommends that even men take progesterone - to counteract all the estrogen's that we get through our environment and our food that's contaminated so much with pesticides (many times estrogen-based) - and he goes on to name all the ways estrogen enters our bodies it's everywhere. And there's great dangerous with being estrogen overloaded. I suspect The sweating that you're describing is as a result of too much estrogen. Another remedy that I've heard of his black cohosh / red clover tea. I'm on the other side of menopause and did not know about the progesterone and I'm going to start taking progesterone naturally. I'm going to use wild yams / turmeric. I learned of the natural sources of progesterone from Dr. Bergman. I suffered through perimenopause without any medications but I didn't have the symptoms that you describe. I still have occasional hot flashes but again nothing like you describe. I asked my friend who is 80 "when do these things end?" Her reply? "Mine never have."
It would be worth an experiment to taper off and end the estrogen supplement and keep up with the progesterone. You are probably getting enough estrogen from everywhere else.
I think one thing we (the patients of so called Hertoghe or hormone doctors) tend to forget is that they are first and foremost anti-ageing doctors, which means their primary goal is to restore your hormones to youthful levels (=the levels you had in your early 20s). That has never been my goal, but I went to see such a doctor simply because they are the only ones (at least in Belgium) who work with natural desiccated thyroid...not that it did me much good in the end, as Armour had already been reformulated and worked less well as a result, and Erfa ended up being problematic not long after...so now I order NDT myself from Thailand at a fraction of the cost and much less trouble.
Even if those doctors work with natural or bio-identical hormones only, that does not mean these drugs are good for you if you don't need them to begin with...
Yes, I have had so many strange symptoms and it was impossible to find one common denominator...then, I saw that one symptom of E dominance is brittle nails. My nails break as soon as they grew a millimeter, forcing me to wear false nails (I hate it). High blood pressure is another symptom of E dominance; I was put on blood pressure medication two years after starting estrogen. Hair loss is a third symptom; I have been losing lots of hair lately. There is hair on my pillow when I wake up, in the shower, on the kitchen floor...just like before I was diagnosed with hypo 17 years ago.
I have been attributing the brittle nails and the hair loss to vitamin/mineral deficiencies, and taking lots of supplements without much success. I have not been able to explain the hypertension, though...
I have read about wild yams which has been getting glowing reviews. Might be well worth a try!
Thanks a lot, I will check out Dr. Bergman for sure...I have already read some articles by R. Peat and like his ideas.
I am beginning to realise that it's not so simple as to go to a so called "top doctor", at least not in Europe, and just take all the drugs s/he prescribes...because some of them can mess you up pretty badly, not to mention wreak havoc on an already unstable endocrine system (and I was diagnosed with Hashimoto's at age 32 and told it was probably the result of mononucleosis which I was diagnosed with at age 27, so 21 years ago, five years before I was diagnosed with hypothyroidism). I cannot blame estrogen dominance for all my strange symptoms, as I have not tried being without E for the past five and a half years, but I do recognise many if not all of the symptoms of E dominance listed on US top doctors websites...and, come to think of it, it makes sense; i.e., a woman's estrogen levels won't drop significantly until she's post-menopausal. That means: without a period for a consecutive period of twelve months. That is far from being my case, as I'm still having (pretty) regular periods. Also, even in post-menopause, a woman's body can still make estrogen by using fat, plus it seems the adrenals make small amounts of E as well...so, while progesterone levels drop by virtually 100% once postmenopausal, E levels will only drop ca 60%...knowing that, I can understand that the E-P imbalance starts pretty early in a woman's life, and is only exacerbated by well-meaning but clueless doctors prescribing all female hormones as soon as she turns 40...I can only hope the 5.5 years I've spent on E have not done irreparable damage to my organism. Thank God at least I combined it with bio-identical progesterone...!
I just got most recent lab results back. My OB-Gyn sent me to the lab and wanted to have estrogen levels but not progesterone levels measured...no idea why, and having estrogen measured was not the main reason I went to the lab, so I did not pay attention to the day of testing. It was day three of my period, and estrogen levels came back below range. However, I think they don't start peaking until during the follicular phase which I think starts around day five of cycle (the first day of cycle being the first day you're bleeding...), meaning it's normal to have below range estrogen levels during the first days of your period...?
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Estrogen/progesterone ratio: go off estrogen or increase progesterone?
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