in this episode, we answered a listener’s question. We love questions from listeners. If you have a question, please visit our website and click Ask the Doctor a question.
Here is the listener’s question:
I have been perimenopause for at least 4 years now
I am 47 and after completing a Dutch test with a holistic chiropractor she told me to ask
my doctor about Prometrium. I was scared to take it and then 6 months ago my sleep got really bad and three months ago I got very ill with gi issues and gallbladder issues. I had to have gallbladder surgey and developed full blown insomnia. I was sleeping 0 to 3 hours.
Two weeks ago I got two very contradicting solutions for my low progesterone. The functional medicine/ gyno prescribed Promterium at 400mg and told me to go down to 200 mg if too sedating.
A few days before that I saw an integrative doctor. She told me to take 25mg of sr bioidentical progesterone and bump it up by 25mg every week. I was also put on ashwagnhda 700mg at night and 100 mg of L-theanine at night to help lower cortisol and for stress and anxiety. I also take 200mg of magnesium glycinate at night.
I am working with a sleep coach for my insomnia/anxiety. I have calmed down significantly and do not care or panick if I dont sleep
The 25mg dose did nothing. I tried 200mg of Prometrium and it upset my stomach. I felt dizzy until like 3 and then was wide awake and then maybe fell asleep around 5am for 3 hours.
After reading everything on here. I asked gyno to prescribe compounded sr bioidentical in 100mg. She still insisted I take 200mg. The integrative doc thinks it is dangerous to try various doses. I tried 100mg sr and it did not help me sleep. I tried 150mg for 3 nights and it helped me sleep some. I now increased to 200mg two nights ago and my sleep is still horrible but am sleeping a some.
The integrative doc told me it is dangerous to do what I am doing with the doses and told me to stay on 75mg until I see her (that is in a month).
The gyno/functional medicine doctor told me to take 200-400mg and will follow up here in a month.
I am 110 pounds and the integrative doctor told me that 200 mg is way too high for me. She said progesterone will not be a quick fix for my insomnia. I don’t expect it to be but I keep on reading how sedating it is.
How long do you need to be on a dose until you know if it is the right dose and what are the side effects of too a high of a dose? The bioidentical compounded dose does not hurt my stomach like the Prometrium. I feel slightly dizzy at night but not at all sedated. I am very confuse with advice but I would like to follow the gyno/functional medicine doctor.
This listener had a few issues happening here. As that is the case with everyone. There is no clear ‘one size fits all’ when balancing hormones.
In this episode, we broke down her question into:
● How progesterone relates to perimenopause.
● Forms of progesterone such as orals, creams, troches, and gels.
● Dosing of progesterone. There are multiple potencies and dosing of
progesterone.
● The difference between Prometrium and micronized progesterone.
● Appropriate doses and forms of progesterone for a perimenopausal female.
● How sleep is affected in perimenopause.
● Consider gastrointestinal, liver, and gallbladder implications in perimenopause.
● Weight gain in perimenopause.
● Side effects and safety of progesterone therapy.
● How long does it take for progesterone therapy to work?
Again, if you liked this episode, or have your own hormone concerns, please reach out and Ask The Doctor a question.
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