Progesterone

[anjaq]

I just found out I need to get a new set of bras. I was out of them today and tried one from 3 years ago and they do not fit at all anymore. The ones from half a year ago still work so la la. So I am living proof now tha tit works. I had oral Estrogen only therapy for 14 years and started 8 Months ago on transdermal estradiol plus progesterone (gel and capsules). I have not gained circumference but a lot in fullness and shape. Oh how it could have been different in my late 20ies if I had known this before. Well, better late than never.
What I have tried to increase efficiency so far: Use the gel directly at the places it is supposed to act. Breasts and hairline; If you have trouble sleeping, taking the capsules orally will make you sleep well but less Progesterone is reaching the blood. If you want more progesterone to reach the blood and act, take the capsule sublingually or vaginally. I presently take 1 capsule sublingually in the evening as it makes me a bit sleepy and one capsule in the morning vaginally for the day. I have not yet experimented with cyclic progesterone. When I tried, I had PMS for 2 of the 4 days I skipped it.

Overall my mood has improved, I have no longer high blood pressure. My hand and feet are numb less often, my skin has improved, I have hair regowth. All of that mind you after 14 years of estrogen therapy.

Its unbelievable that there are still docs out there, gender specialists, who claim that it will not do anything.

[KayXo]

taking the capsules orally will make you sleep well but less Progesterone is reaching the blood. If you want more progesterone to reach the blood and act, take the capsule sublingually or vaginally. I presently take 1 capsule sublingually in the evening as it makes me a bit sleepy and one capsule in the morning vaginally for the day.

I'm post-op since 2005. I take one capsule in the morning with my breakfast and one capsule at night at dinner. Taking it with food increases its bio-availability and I find that adding some grapefruit daily also increases it, since when I don't, I feel the effects much less...sedative effects kick in less and skin/hair is less soft.

It's interesting that you take it sublingually AND vaginally. Sublingually, isn't it inconvenient? How long does it take before it fully dissolves and you can just forget about it and swallow normally? And vaginally, does it really absorb for us since the lining of our vaginas is somewhat different but perhaps after some time, changes to to the same (i..e. mucosal)? Did you check your progesterone levels? This would be a good indication that progesterone works vaginally. I've taken them rectally in the past but I'm really not sure if it was effective and worked. I'd be perhaps interested in taking them vaginally as well because that way more P could get into my blood without having all the extra sedative effect and levels would be more stable during the day. But, I also do like the sedative effects as it helps me to sleep better at night and just relaxes me in general. So, perhaps take some orally and some vaginally. Sublingually, I'm not too interested in personally because levels tend to peak and fall too quickly that way and it seems impractical unless you can convince me otherwise.

[anjaq]

Well - sublingually is a bit of a mess. It tastes odd and I usually do it just before sleeping, so that I am not bugged too much by it. Some of it definitely also takes the oral route, thats why I do that in the evenings. I read that the peaks are happening at the beginning of a therapy , but that with time there are depots building up in the body that can buffer it a bit. Orally it also creates quite definitely some large peaks. Orally, only 1/4 or even less of the Progesterone is taken up as progesterone, that is why I take them sublingually - otherwise I would need to take 3 or more of them. The substance Progesterone is converted to in the liver, which makes it less effective orally, is Allopreganolone and it is what makes tired, but it also has some beneficial effects, so I do not mind some of it going down orally.
If it will work vaginally, I am not sure. I wanted to test it, but my Doc did not analyze it. They are kind of stupid. Usually they take what THEY think is important for them, and not what I write on a note and give them. I will try again though, taking them 2x vaginally a day only and then see what the levels are. I believe it does work though - maybe not as perfect as with a vagina that is completely mucous, but it clearly is sitting there for a long time then - and since it is also taken up through the skin in a cream, I think it will be resorbed eventually throughout the day. I wish, doctors would be more interested in this and get it analyzed. I considered actually buying some colorimetic kits myself and do a 4 hour interval testing of my own blood for E2, E1 and P4 under different regimens. Its not cheap (roughly $1400 for all three hormones), a bit of work and I need access to an instrument that I have to ask some friends at a fellow lab for, but it is doable, I believe

[KayXo]

Thanks for the information. Let us know when you have more definite info re:vaginal absorption. I could always add one at night vaginally and if I see a difference in how I feel or physically, I will know it works. Sublingual seems still inconvenient to me. Taking progesterone with food, with grapefruit seems to do the trick. I can definitely see a difference! Would be interesting though to measure P levels in the hours that follow sublingual administration and say, 6 and 12 hours later compared to oral. I know progesterone is effective taken vaginally in genetic women, studies have confirmed it.

[anjaq]

Yes - in women with an uterus, vaginal application is great. The question is, how much the uterus really plays a role in it - it seems to do so quite significantly. The benefit there is that it is a buffer, a storage. No studies were done on women without uterus, as they usually are not given progesterone (a grave mistake, I must say!). I am not much a fan of grapefruit, but in what way do you think it does help? Do you feel a more intense effect and how so (what do you feel?)

[KayXo]

I am not much a fan of grapefruit, but in what way do you think it does help? Do you feel a more intense effect and how so (what do you feel?)

I can tell by a few things actually. I get more drowsy, "loopy" in the hours that follow intake of P which honestly, I love the sensation, totally mellow and happy!...my breasts become more prominent, ESPECIALLY the areola, larger, and just more "out there" and areola is SOOOOO soft to the touch...warmth all over body, hungry...it's honestly an amazing feeling for those few hours. and skin/hair also becomes softer within hours. In addition, I do notice, I think, less bloating...always was on the fence about whether P bloats me or not...but, at least in the first few hours, I think bloating decreases.

Without grapefruit, these effects are much less or nearly absent even.

Ceska Gynekol. 2003 Mar;68(2):117-21.
[Does grapefruit juice increase the bioavailability of orally administered sex steroids?].

"Though grapefruit juice on average slightly increased serum levels of estradiol (E2) and progesterone, this increase reached statistical significance only for the E2 level 24 hours after application of tablets. The mean area under curve (AUC) of estradiol rose significantly to 117%. The even greater increase in the mean AUC of progesterone (to 125%) was not statistically significant because of marked individual variability of response."

"Our results suggest that grapefruit juice may increase bioavailability of orally administered estradiol and progesterone. The response varies markedly between individuals."

[Hikari]

makes me almost wonder, perhaps things are going so well on a fairly small dose of E because grapefruit juice is my favorite juice. Like I also only buy the 100% juice no sugar added stuff, something about that flavor just makes me like addicted. I have some almost everyday.

[Joanna Dark]

Grapefruit juice won't have much of an effect if any, you'd be much better off taking cimetidine than grapefruit juice as both as CP450 inhibitors, whereas something like phenobarbital is an inducer. CP450 gets rid of drugs, so by inhibiting it, blood levels remain high.

My question is this: would Prometrium be effective as an AA, much like Androcour. The latter being a progestin, prometrium being actual bioidetical P. I know it lowers T, but by how much. I hate spiro. Really, really hate it.

[Hikari]

I think the consensus is that micronized progesterone (prometrium) isn't an effective AA, but that estrogen itself can be. I hated spiro too, so I went with bicalutamide and I am happy with it. Since I am on sublingual E for a variety of reasons and that doesn't seem to suppress T enough to do with an AA.

[Joanna Dark]

See my T was already very low from 1.5 years of HRT and now I feel with the high dose of E I'm on and the P that it will be enough. Maybe not. I talk to my endo Thursday, so Ill see what he says. Though, I believe you're right...was hoping someone would say "yeah, it's great" lol but thanks!

[TessaMarie]

For some odd reason, the depression I lived with for over 30 years completely evaporated 5 days after I started Prometrium.

I take Prometrium orally once per day with my PM meds.  I do also take Finasteride, but in the AM.  They do not appear to be counteracting one another.

I tried sublingual once.  The taste was not pleasant.  I only take my Estradiol tablets sublingually.

One further curiosity:  I have noticed that if I stop taking Prometrium for a few days (5-7 days), when I restart the capsules my breasts become tender & seem to become fuller a week or two later.  This has happened 3 times since I started Prometrium at the end of Jan 2014.

I habitually take all my meds (apart from the sublingual E) with a few fluid ounces of full pulp orange juice.

My depression has been gone for 5 months now.  Apart from the occasional mini-breaks, I will not be stopping the only medication (of many tried) that has successfully cleared away my depression.

[Sammy]

Speaking of interesting side-effects when taking Prometrium... Prometrium plus Red Grapefruit juice = getting high, seriously.

[anjaq]

Hi.

Definitely taking the Progesterone sublingual is not a pleasant taste but it is about 4-10 time smore effective, it seems. I prefer the vaginal approach, but need to find out if it really works well in the serum levels.

Progesterone as an AA - YES it does have some effect. Progesterone P4 and Estradiol E2 both have an effect on the hypothalamus which then lowers LH which then lowers testosterone T production. More importantly, P4 is a 5-alpha reductase inhibitor, meaning the production of dihydrotestosterone DHT is lowered. DHT is created for example in the skin from T and is what causes hair loss, body hair and such. I recommend everyone to first try a therapy with E2 and P4 only (E2 should not be given as tablets as the Estrone E1 production then will be high and E1 inhibits E2!; P4 should be given at a high dosage - either sublingual/rectal/vaginal or several 100 mg a day orally). Only if this does not improve testosterone levels wven if the dosages are adjusted a bit, then I guess Spiro is needed. P4 can also act directly on the gonads by lowering T production directly.

My hairline finally is growing back with P4 gel applied to it and I found out this week that I cannot really push away my breasts anymore when I try to lay flat on the belly during sports gymnastics. They have gained mass and volume  which makes me very happy

[KayXo]

Speaking of interesting side-effects when taking Prometrium... Prometrium plus Red Grapefruit juice = getting high, seriously.

hahahaha! I always take it with grapefruit except I eat it. Half or one entire grapefruit daily. I love the taste of it.

Progesterone as an AA - YES it does have some effect. Progesterone P4 and Estradiol E2 both have an effect on the hypothalamus which then lowers LH which then lowers testosterone T production

But, if you are post-op, this is a non-issue and usually, the levels of progesterone are not high enough, on average, unless you take it intramuscularly, to really have a significant effect on LH.

More importantly, P4 is a 5-alpha reductase inhibitor, meaning the production of dihydrotestosterone DHT is lowered.

This has only been found in a study with extremely high levels of progesterone that we cannot ever possibly replicate at the doses we typically take. So, personally, I very much doubt it's effective for that purpose. 

E1 inhibits E2!

My suspicion as well, that estrone may act as some sort of an anti-estrogen to estradiol if there is too much of it, saturating receptors and preventing estradiol (the strongest estrogen) from binding to receptors BUT this is only a suspicion and has not been confirmed, as far as I know by doctors or studies. Who knows if this is indeed the case?! I personally have done better on injectables vs. oral where ratio of estradiol to estrone was more favorable but it could be due to other reasons as well.

P4 should be given at a high dosage - either sublingual/rectal/vaginal or several 100 mg a day orally).

I personally find it quite impractical to let it dissolve there and wait...and I'm also not sure I like the quick peaks and lows on it. I also do enjoy the sedative effects I get from it when I take it orally which I think on sublingual is much less.

Rectal could work but whether the capsule really dissolves there and gets effectively absorbed, I'm really not sure although some doctors do tell ciswomen it's ok to take them that way if they find the vaginal route inconvenient due to leakage.

Vaginal, I'm also not sure due to the fact that our vaginas, for the most part, are not mucosal as ciswomens' are. Perhaps, with time, they become similar as some have postulated but who really knows?? I really can't tell with mine, I'm post-op 8 yrs.

I also find that the progesterone levels obtained through that route (i.e. vaginal/rectal) don't really amount to that much but they do seem better than oral on average with.

For me, I still choose oral. More convenient, I know it works and I take just enough so to have the desirable effects from them.  

They have gained mass and volume which makes me very happy

Same for me!

[anjaq]

Well just a quick reply on the issue with P4 inhibiting DHT, as I am about to go to sleep and want to reply more later. But what I need to say is that if you apply P4 locally on the skin, the concentrations within the skin are much much higher than what is done systemically by taking P4 orally. I think you can really reach the levels used in the study. For me, it worked. I am on Estradiol for 16 years now. And NOW that I use P4 locally and orally/vaginally, I get hair regrowth.

(see all those short hair there? all my other hair is at least 20-60 cm long. Its all newly grown hair within half a year now sinc eI changed hormones.

[KayXo]

So what exactly do you apply to your scalp? The content in the capsules or a progesterone gel? And perhaps, there is something else about progesterone that helps like the fact that it has anxiolytic and anti-depressant properties, dilates blood vessels, thus improving blood circulation and allowing more scalp hair to grow. But, I guess who really cares if the end result is more hair growth, right??!

[Shantel]

So what exactly do you apply to your scalp? The content in the capsules or a progesterone gel? And perhaps, there is something else about progesterone that helps like the fact that it has anxiolytic and anti-depressant properties, dilates blood vessels, thus improving blood circulation and allowing more scalp hair to grow. But, I guess who really cares if the end result is more hair growth, right??!

I need to dump a bucket full on my head! 

[anjaq]

I am not quite sure as to why the replies have disappeared, maybe it was too specific?
My reply to what I apply to the scalp was: progesterone gel

But, if you are post-op, this is a non-issue and usually, the levels of progesterone are not high enough, on average, unless you take it intramuscularly, to really have a significant effect on LH.

I was talking pre-op. If you take P4 sublingually or rectal, levels can go up significantly and inhibit Androgens.

My suspicion as well, that estrone may act as some sort of an anti-estrogen to estradiol if there is too much of it, saturating receptors and preventing estradiol (the strongest estrogen) from binding to receptors BUT this is only a suspicion and has not been confirmed, as far as I know by doctors or studies. Who knows if this is indeed the case?! I personally have done better on injectables vs. oral where ratio of estradiol to estrone was more favorable but it could be due to other reasons as well.

With a RBA ratio of 100:60 between estradiol and estrone, I think it is quite fair to conclude that significantly higher emounts of estrone can compete with estradiol for the receptors.

Of course studies with humans using medical products would be favourable but I think the evidence is pretty clear already

Vaginal, I'm also not sure due to the fact that our vaginas, for the most part, are not mucosal as ciswomens' are. Perhaps, with time, they become similar as some have postulated but who really knows?? I really can't tell with mine, I'm post-op 8 yrs.

In the worst case vaginal is like using it transdermally but keeping it from drying out - essentially allowing all of the contents to be absorbed by the vaginal lining.

[Rachel]

Posts may have been lost because the back-up last night was not 100%.

[Rachel]

I take progesterone  sublingual in the morning. So, can I put it on my scalp at night instead and get the same effect from the P internally and also get hair benefit?