Progesterone

[AnnaCannibal]

Honestly I would like to try P to see the effects myself, but as you said my endo doesn't think its necessary.  How do you say something to an otherwise polite person without insulting their intelligence that I'd like to try it?

[Hikari]

Honestly I would like to try P to see the effects myself, but as you said my endo doesn't think its necessary.  How do you say something to an otherwise polite person without insulting their intelligence that I'd like to try it?

Simple: this is my life and my transition and while I respect your opinion I would like to try this.

Anyone can be wrong.

[JessicaH]

Progesterone for Symptomatic Perimenopause Treatment – Progesterone politics, physiology and potential for perimenopause
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987489/

[JessicaH]

Int J Pharm Compd.
2013 Jan-Feb;17(1):74-85.

The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors;
cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women.

http://www.ncbi.nlm.nih.gov/pubmed/23627249

[Jessika Lin]

I told my Doctor that I wanted to add Progesterone to my Rx, I also told her flat out that I won't touch Medroxy with a 10 foot pole, mainly because her literature (sourced from the only endo in my area who deals with trans* people) listed Medroxy as the only Progestin. I also explained my reasoning to her and let her know that I've done my own research. It sucks that Medroxy would be covered for me, but I have to pay for my Prometrium out of pocket, but it is what it is.

[Shantel]

I told my Doctor that I wanted to add Progesterone to my Rx, I also told her flat out that I won't touch Medroxy with a 10 foot pole, mainly because her literature (sourced from the only endo in my area who deals with trans* people) listed Medroxy as the only Progestin. I also explained my reasoning to her and let her know that I've done my own research. It sucks that Medroxy would be covered for me, but I have to pay for my Prometrium out of pocket, but it is what it is.

Better to have to pay to be smart than to get paid for being ignorant, way to go sis!

[KayXo]

Hmmmm, well that information was from the GIC, though it was from the psychiatrists. From what you are saying though, it is still true, even if it is possibly negligible.

It is also my understanding from what they said that gnrh would reduce progesterone levels. I would like to hear whether you know anything about that, as I am currently hoping not to be put on one. My levels are quite good without - my T level is at 0.3 ng/ml

I really don't think it will negatively impact your P. If you don't want to be put on it, then just have a discussion with them and explain your reasons why.

[KayXo]

After thoroughly reading through every post and some links, Im still not convinced P is as miraculous as some are making it out to be.  Not to discredit the effects you believe to be happening, but they are truly just testimonials.  Not to say that it couldn't be that P in harmony with E are causing better results, could it also not be the prolonged use of E giving the results?  Or perhaps it is the placebo effect.  What I'm getting at is it seems there is some anti anti-andogen and some pro-progesterin attitude when aa is perfectly acceptable for many MtF.  It is only my suggestion to take the tried route of aa first and see how you react to that before delving into P from the get go.  At least until further scientific data presents itself.

I agree with you. I'm still taking some continuously and honestly, I'm still on the fence about it despite having seen clear signs of some benefits (breasts, mood) because I've also seen other symptoms creep up (bloating, slight depression/numbness, tiredness, irritability) that may indicate that taking E alone could prove to be more beneficial to me (I'm post-op). Like I said, I'm really not sure. Some girls claim it has given them positives, better skin/hair, stronger nails, better mood and breast and I've seen all of those but especially when I switched to injectable E so was it the E or the fact that P worked better with more E since E increases progesterone sensitivity?

Scientific data tells us this and that and yet girls who take it report stuff that contradicts their findings so really, it is not that clear at all. For example, studies have shown progesterone to be a potent diuretic despite increases in deoxycorticosterone, especially orally which increases water retention and YET, plenty of women report feeling increasingly bloated on it and that it disappears soon after stopping P. I also get the feeling that many women have PMS symptoms while on it it while others feel better...and studies suggest it is the drop in progesterone (with the drop in E) that leads to PMS symptoms. Trust me, I spent countless hours reading about it, full studies, actual feedback from genetic, trans women on various forums and it still not 100% clear. I will read on...and use my own experience on it to finally decide on what is truly going on...and will report hopefully, when things clear up.

[KayXo]

P itself is actually a bit AA without the side effects of AAs.

Not really. Very high doses of oral P need to be taken to reduce testis' production of androgens OR high enough non-orally and post-op, it really does nothing. To effectively inhibit T to DHT formation, super high doses need to be taken which is impossible in our case.

[KayXo]

I told my Doctor that I wanted to add Progesterone to my Rx, I also told her flat out that I won't touch Medroxy with a 10 foot pole, mainly because her literature (sourced from the only endo in my area who deals with trans* people) listed Medroxy as the only Progestin. I also explained my reasoning to her and let her know that I've done my own research. It sucks that Medroxy would be covered for me, but I have to pay for my Prometrium out of pocket, but it is what it is.

My doctor sent a letter so that my Prometrium could be covered just like the Medroxy would. He explained that the reason he prescribed Prometrium instead was because of depression associated with Medroxy...that's all it took! I'm saving more than 100$ every month.

[KayXo]

Better to have to pay to be smart than to get paid for being ignorant, way to go sis!

Well said, LOL!

[JessicaH]

Wait until I start the thread explaining why finasteride and spiro are bad. lol

[KayXo]

Finasteride because it reduces 5 alpha-reductase activity and hence allopregnanolone concentrations, responsible for making us feel relaxed and helping us to cope with stress??

Spiro, well, I don't like it already. Messes up electrolytes, can reduce blood pressure too much, have negative effects on the heart, leads to dehydration making one look tired/unhealthy (dry skin too), etc...while taking quite high doses to have significant anti-androgenic activity.

[KayXo]

To get back to the main topic, I think perhaps the reason some may experience negative side-effects from progesterone is due to its short half-life so that pretty quickly, progesterone and especially allopregnanolone concentrations drop causing irritability and other symptoms characteristic of PMS symptoms or benzodiapenes (like Xanax, Valium) withdrawal. Even taken twice daily orally, levels fluctuate a little too much and it may be that fluctuation that's causing the problem, not the progesterone. Perhaps, if levels were more steady as is observed during pregnancy where even though levels steadily increase, the change represents an increase (hence, positive) and changes are VERY gradual. But, it appears that even taken vaginally, transdermally or intramuscularly, where levels are more constant and where alloP is much lower, these negative symptoms occur so perhaps not. Maybe it is the P after all.

[teeg]

Is the consensus that if someone wishes to start progesterone, they should request Prometrium from their physician above all other types of progesterone medications out there?

Also what's the best method of taking Prometrium? Orally? Injection?

[KayXo]

I think it's perhaps best to take it in a way where levels are steady over time, not fluctuate too much. Orally, levels aren't very steady according to my own experience and study pharmacokinetics where within hours (3-4), levels already start to drop significantly. Maybe take it orally 3-4 times daily?

The problem with injections is that they have to be administered DAILY as even through this route, levels drop quite quickly but are somewhat more steady over 24 hours than oral and MUCH higher (up to 10 times) at the same dose.

There is vaginal but I don't know how many girls are post-op and if post-op, are our vaginas really as effective in absorbing progesterone as ciswomen? Perhaps as time passes. The other route is transdermal (applied to skin) but I'm not too confident about its absorption capabilities over time. Last route is transmucosal where cream or even content in capsules (powder mixed in with oil) can be applied to either inner labia that is quite mucosal even in transwomen or anal opening. But, are levels really steady that way or do they peak and drop rapidly as is the case with sublingual?

As always, discuss these options with your doctor. See what they think.

[JessicaH]

Is the consensus that if someone wishes to start progesterone, they should request Prometrium from their physician above all other types of progesterone medications out there?

Also what's the best method of taking Prometrium? Orally? Injection?

Injection is always preferable. You will maintain higher and more stable level. One thing you have to watch out for in judging personal experiences or an all out scientific study is the often overlooked "confounding variable". Endocrinology is very complex so if you add something like P4 and have a negative experience, you have to look at ALL the variables. One thing many trans people arent aware of is the negatives of spiro. It may be screwing you up in all sorts of ways that you dont even realize.

[JessicaH]

Spiro works to suppress Testosterone differently than Estradiol does. Spiro intercepts the brain's signalling hormone LH which triggers the testes to produce testosterone by disabling aldosterone production in the testicles. Any wild and crazy excessive spiro long term use will lead to the pituiatry being 'fooled' and producing more and more LH....which doesn't prove effective....so your LH scores will be very high.

When estradiol is used to suppress Testosterone production it does so through action on the brain...with all the good things that come with it as well. By doing so it causes smaller and smaller pulses of LH to be produced by your pituitary so those using Estradiol to lower their T will show LOWER LH rather than super high LH.

Whether having your brain struggle to produce more and more LH is a bad thing or not ought to be of interest to researchers. The elevated LH also acts on your adrenals and this unnatural excess could cause adrenal overproduction of steroids, among the many other bad effects of Spiro. Every one who is undergoing HRT should have their LH monitored by any thoughtul endocrinologist

A NOTE: As we expected: There may be the kind of exaggerated adrenal production of estrone (from DHEA in this case) via adrenal activation by the high LH levels produced by high Spiro Intake

In post menopausal women, the adrenal glands become the primary source of estrogens and that results in estrone rather than estradiol being produced by the adrenal pathway. This is why postmenopausal women show higher levels of estrone and low estradiol, if any.

Here is the link for inquiring minds:

The adrenal gland may be a target of LH action in postmenopausal women.

http://www.ncbi.nlm.nih.gov/pubmed/16728548

OBJECTIVE:
LH receptor expression and function have been demonstrated in the human adrenal cortex, but their involvement in normal adrenalfunction remains elusive.

Because cortisol levels have been reported to be higher in postmenopausal women than in age-matched men, the aim of the present study was to investigate a possible association of adrenal function with the elevated LH levels in postmenopausal women.

.
CONCLUSIONS:
These results indicate that adrenal cortisol and DHEA-S production may be stimulated by the highly elevated postmenopausal levels of LH; the physiological significance of this association and plausible contribution to the metabolic syndrome observed after the menopause remain to be evaluated.

And, yes, what likely happens to the DHEA along the hormonal flow chart pathways that we have posted regularly is that much of the DHEA can get converted to Estrone.

[Ginny]

Not really. Very high doses of oral P need to be taken to reduce testis' production of androgens OR high enough non-orally and post-op, it really does nothing. To effectively inhibit T to DHT formation, super high doses need to be taken which is impossible in our case.

I was just quoting what my endo said.  I swore he gave me the literature back in January, but I lost it.  I could possibly ask for it again in July.  As for oral, no clue.  I take pellets which last 3-4 mo. 1 pellet and testis' production dropped to almost zero in three days.

Also Microgest is the generic form of Prometrium for those worried about cost.

[teeg]

If Progesterone via injection requires injection once per day I think my needle phobia would want me to skip that idea...

Orally I've seen the pills are like liquid filled soft capsules? Are there any tablets of the same Prometrium (or comparable bio-identical progesterone) that can be taken sublingually like estradiol tablets can?