April 4, 2012

Progesterone: A New Post

After my experience with low progesterone during my pregnancy and after the birth of our second daughter, I realized that I needed progesterone support.  I was on progesterone support between summer 2010 and spring 2011, but April 2011 marked a new phase of therapies for me.

Through the guidance of  Dr. Thomas Hilgers of Pope Paul VI Institute in Omaha, NE (see About Me) and his Nurse Practitioner, Theresa, I began regular, cyclical progesterone support; an ibuprofen regiment from the beginning of my period through the heavy flow days; and Low-Dose Naltrexone.


A relatively new therapy is Low-Dose Naltrexone, or LDN.  Unlike traditional higher doses of Naltrexone, LDN has been found to be therapeutic in extremely low doses.   

Unlike more common LDN prescriptions, Pope Paul VI Institute utilizes LDN by starting at a low dose and gradually increasing to the pharmaceutical dose.  In this manner, Naltrexone users experience fewer side effects but, due to the eventual high pharmaceutical dose, find relief of their symptoms for the following issues:
  1. Premenstrual symptoms lasting for 4 or more days each cycle
  2. Endometriosis or PCOD
  3. Persistent Brown menstrual bleeding
  4. Persistent fatigue
  5. Sleep disturbance
  6. Low mood
  7. Excessive Anxiety
  8. Personal or Family history of
  9. Autoimmunity – MS, Rheumatoid
  10. Arthritis, Insulin dependent Diabetes,
  11. Underactive Thyroid, etc…
See here.  


Pope Paul VI Institute has informed me that all-natural, bio-identical progesterone is the ideal form.  It is available in intra-muscular shots, vaginal capsules, oral capsules, and cream - which are most effective in the order listed.  PPVI prescribes these various forms through a compounding pharmacy. 

In my experience, the capsules were not nearly as effective as the IM shots.  I highly suspect that I have a digestive issue, which is extremely common with thyroid dysfunction sufferers, so that may have been part of my issue.

I took the oral capsules for quite a while.  I switched to a combination of oral capsules as well as vaginal suppository capsules while pregnant from July 2011 to September 2011.

After my miscarriage, I suffered from post-partum depression, just as I did with daughter #2, and switched to IM shots which, in agreement with PPVI, I found to be much more effective.


As I mentioned above and in previous posts on this blog, I miscarried at the end of September 2011.  My progesterone had plummeted.  PPVI and I had been regularly monitoring my levels and even put me on their very strict protocol the weekend I miscarried, but baby had already died.  While I was getting my levels tested before the baby actually died, my lab here kept having mix-ups.  Instead of shipping the actual blood to Hilgers' National Hormone Lab according to their specifications, with their specific equipment, they ran the labs here.  One time they even lost my blood and to this day no one has ever informed me of what happened.  It would be easy to blame them for losing my baby, but honestly, there's no use.

After the post-partum depression dissipated, I dealt with plain old depression.  (There is a difference!)  By January, I had hit rock-bottom.  I knew that something was wrong.  I remember laying awake in bed at night (because I had insomnia) thinking, I'm dying.  There must be something terribly wrong with me to make me feel this bad, and I'm dying.

One Sunday after Mass, a friend and I got to talking.  She said, "You've got to get on dessicated thyroid."  The next day, I called the doctor's office and got an appointment for the following day.  Wednesday morning, I took my first dose of natural dessicated thyroid.  It all went from there.

Finding Relief

I now realize that my diabetes, thyroid, adrenals and reproductive issues are all related, and I'm hoping that by chipping away at each area, a bit at a time, they will all eventually come to a point where they are easily manageable.

For my endometriosis, PPVI recommended high doses of ibuprofen from the beginning of my period through the heavy days, and that has helped. They said it would cut the heaviness of my periods by 1/3, and I believe that it has certainly helped.  However, I also believe that my endometriosis has worsened and despite lighter periods, I have more pain..

Another source that has been extremely helpful to me has been Couple to Couple League's book "Fertility, Cycles and Nutrition" by Marilyn Shannon. From it, I learned about vitamins and supplements that can help. I hadn't been ovulating since my miscarriage in September, but I read in there about taking high doses of omega-3.  (PPVI had recommended that I start taking omega-3) I started taking 10-1,000 mg capsules a day right before I was supposed to ovulate, and I did ovulate. I've kept taking it and it's definitely helped my cycles and my quality of mucus.

She also talks about caffeine and synthetic sweeteners.  I had been relaying on caffeine heavily due to my adrenal fatigue.

UPDATE on 6/18/2012: Since I went on NDT in January and since I've been using CT3M to heal my adrenals, most of the reproductive issues I've been facing have started to diminish.  My periods are no longer heavy; my periods are not 14 days long anymore, but rather 5-7.  This past period, I had only about 1 hour of stomach pain and some slight back aches - as opposed to the intense endometriosis pain I had been having for months; and I had no PMS which I used to have before ovulation AND before menstruation. I feel very strongly that my reproductive issues have been directly related to my hypothyroidism and adrenal fatigue.