September 9, 2012

Progesterone and Other Reproductive Hormones

Background on me and progesterone

I have PCOS and endometriosis.  If I don't take natural progesterone to create that rise and fall that progesterone should be undergoing (see the second graph here), I have really long cycles because my body is so low on progesterone. 

Before starting on natural progesterone, I was having 90-190 day cycles, at my worst.  I get lovely PMS-associated depression from my low progesterone, and also I get post-partum depression.  I even got PPD when I miscarried last fall - and I was taking progesterone during pregnancy.  So, the progesterone replacement is a lifesaver for me. 

I take three 100 mg intramuscular shots on the 4th, 7th and 10th days after ovulation.  The oral capsules were 200 mg.  But even with the shots being a lower dosage, they're soo much more effective.  It was like night and day when I switched.  They are a literal pain in the butt, but worth it.

The first time I ever started on progesterone was as treatment for post-partum depression after my second child was born.  I was a zombie; completely losing my mind, literally rocking myself in a corner.  I took a single dose of Prometrium (prescription natural progesterone) and it was all GONE.  It was unbelievable.

Progesterone Mishap

In early August, I had a mishap with my natural progesterone shots.  My husband's business trip was coinciding when when I needed my second shot (out of three).

Instead of having someone else give me the shot, I thought I would just take a progesterone capsule that I had left from before I switched to the shots. 

Sounds like it would work, right?  Wrong!

Those capsules aren't nearly as effective, so my progesterone dropped and signaled the onset of menstruation, so I couldn't do shot #3 or it would have stalled menstruation.

In the end, I had shot #1, but not the second or third shots.

The day after I should have had shot #2, I saw a shocking return of adrenal fatigue symptoms that I hadn't seen in months.  I was depressed, anxious, and suicidal.  My blood pressure dropped; I was dizzy and light-headed. 

So, in short, not having that progesterone in my body wreaked havoc! 

I increased my 5-HTP and it really helped, but it's no replacement for progesterone.

Piecing it all together

Dr. John Lee writes in this book that cortisol (and aldosterone) are made from progesterone.  I had heard from my friends' on the STTM Facebook Discussion Groups that progesterone and cortisol share a pathway, and I have known for some time that progesterone is vital for me, so I've begun piecing things together about my past.  

I think that I'm beginning to understand why I miscarried one year ago:

  • My thyroid was deficient in its hormones (I was on 175 mcg Levothyroxine),  
  • plus my adrenals were fatigued from compensating for the lack of thyroid hormones and from other stressors.
  • To make more cortisol, my adrenals were "stealing" progesterone--progesterone which I needed to maintain pregnancy.
So despite the fact that I was taking extra progesterone to maintain my pregnancy, my levels dropped too much because my body was using high amounts of progesterone to make more cortisol for my low cortisol levels which were due to adrenal fatigue . . . which was in large part due to deficient thyroid hormones. 

That's my theory at this point.  I can't change the past, but I can learn from it and use it for the future.

Reproductive Hormone Labs

I got the results back from my reproductive hormone blood panel.  My progesterone, estradiol and testosterone (drawn on peak+7) are all low. 

Per Dr. Hilgers' staff recommendations, I'm taking chasteberry/vitex, plus a small amount of DHEA supplements each day.  I'm also adding progesterone capsules to my IM shot regimen. 

I am really eager to do that next cycle!

It is my hope that with more adequate progesterone replacement as well as the continued use of the Circadian T3 Method, continued iron supplementation and eventual optimization of my natural thyroid hormone replacement, I will see an even better improvement in my symptoms and gain better quality of life.