Serious depression after increased Estrogen and adding Progesterone

[novumdiex9]

So about a month or so ago my doctor increased my estrogen, spiro, and added progesterone. After all that I started to get really depressed and now am in one of the darkest depressions I've had ever. However, this isn't totally uncommon as I suffer from chronic depression and bipolar disorder. I wondered if these increases/addition of progesterone can cause really bad depression or if maybe it's just a typical cycle for me again.

Thanks for any help! <3

[Ms Grace]

These medications can have an effect on mood - especially estrogen and progesterone. It is usually cyclical or temporary. You should talk to your doctor if it doesn't improve or worsens.

[Laura_7]

So about a month or so ago my doctor increased my estrogen, spiro, and added progesterone. After all that I started to get really depressed and now am in one of the darkest depressions I've had ever. However, this isn't totally uncommon as I suffer from chronic depression and bipolar disorder. I wondered if these increases/addition of progesterone can cause really bad depression or if maybe it's just a typical cycle for me again.

Thanks for any help! <3

What kind of progesterone ? Bioidentical progesterone, in the form of capsules, or synthetic progestin in the form of pills ?

The side effects are different.

https://www.susans.org/forums/index.php/topic,187678.msg1669564.html#msg1669564
Please discuss this all with your doctor...
concerning costs, there are hints further below in the thread.


hugs

[Rachel]

Talk to your doctor about the issue. If you re on other meds you should make sure the doctor is aware.

My depression was helped from E and the addition of P did not make an impact I can remember.

[Mariah]

I would definitely contact your doctor as the others said. Even though it's possible side affect as they cycle through our bodies it's still one you need to let your doctor know about even more so if you dislike the side affect. I assume that is the case  because I know when my levels were getting to low between cycles it caused that issue and the endo made changes right away as a result. Good luck and Hugs
Mariah

[Eva Marie]

I am taking prometrium on a cycle and some months it has no effect whatsoever, some months I am extremely emotional and weepy, and some months I am very short tempered. I don't want to stop taking it because I am loving what it's doing for me and I tend to look forward to starting each cycle, but on the last day of my cycle I am usually glad to be coming off of it.

With that said - your emotions do sound a little outside the box. It might be worth having a chat with your endo and maybe getting an adjustment made to your dosages.

[HughE]

I am taking prometrium on a cycle and some months it has no effect whatsoever, some months I am extremely emotional and weepy, and some months I am very short tempered. I don't want to stop taking it because I am loving what it's doing for me and I tend to look forward to starting each cycle, but on the last day of my cycle I am usually glad to be coming off of it.

Maybe you should try taking the prometrium continuously rather than cycling it, and see if you get better results that way? Maybe lower the dose somewhat if you're getting excessive side effects from it.

What people tend to forget is that, historically, natal women would be pregnant or nursing for most of their reproductive lives. The situation we have now, where women menstruate month after month for years on end, is a very recent development, and not the natural state women should be in at all.

Also, as Laura_7 says, the OP should make sure she's been given bioidentical progesterone and not Provera. Provera has a reputation for causing emotional instability, severe depression and suicides in trans women.

[KayXo]

If estrogen is too low, not enough to compensate for loss of androgens due to Spiro and progesterone, and is combined with progesterone that further reduces effectiveness of estrogen, this might be one reason for your depression.

If you are taking Provera, then some girls report severe depression from it and perhaps asking your doctor to be switched to bio-identical progesterone could reduce severity of symptoms.

Maybe, you just aren't ready for transition or are reacting to all the changes which, with time, could improve as you adapt.

The first two explanations, in my humble opinion, are most plausible.

Please bring this up ASAP with your doctor.

[mfox]

I wondered if these increases/addition of progesterone can cause really bad depression or if maybe it's just a typical cycle for me again.

For me, I take the lowest dose of bioidentical aka micronized progesterone, and even one dose can leave me unsettled (especially the following day).   I added it 5 months into HRT, and it's definitely responsible for some depressive moments.  It's more like it causes drastic mood swings than depression though; it makes me much more sensitive to whatever is happening around me (good and bad).

I would say avoid Progesterone if you already have dark moods, but only a doctor can say for sure.

[KayXo]

I would say avoid Progesterone if you already have dark moods, but only a doctor can say for sure.

And yet some transwomen have reported relief from dark moods after taking progesterone while ciswomen going through postpartum depression are sometimes prescribed bio-progesterone to help improve their condition. I think it depends.

The thing is, also, that bio-progesterone has a short half-life so that levels can fluctuate quite a bit, perhaps causing mood swings, from high to low. This is why I take it twice daily. I can tell when progesterone affects me less and this causes withdrawal symptoms such as nervousness, irritability, anger, depression, numb feeling, etc. Metabolism of progesterone also varies from one individual to another. From my own research, it seems progesterone taken rectally, is most effective at producing stable levels and this can be prepared by compounding pharmacies. I still take mine orally though because I can't afford rectal. And, on the whole, the benefits of progesterone outweigh the negatives for me. It's also reduced my anxiety and helped improve my sleep.

[Lady_Oracle]

I experienced depression with medroxy but as soon as I made the switch to prometrium, the depression went away. I've taken P daily since I started hrt, no cycling at all. P also really helps a bunch with the pms I get right before my next shot too.  It definitely acts as a mood stabilizer in my case. So yeah like with everything else ymmv

[Steph34]

I too have struggled with depression ever since puberty occurred in the wrong body, sometimes going several months without functioning in life and considering suicide as well. Aside from food, estrogen is the only thing that has ever been able to stop me from falling back into the darkness. When I tried to add progesterone (at the recommendation of my doctor to block testosterone, since I could not handle the side effects of spironolactone), I became awfully calm. All of the emotionality I had gained from the estrogen, so essential to being my true self, was gone, and I felt really sad. Fortunately, I got off the progesterone before it became full-blown depression, and my mood returned to normal within a day after stopping the progesterone. The bio-identical progesterone was what brought my mood down. MPA had a somewhat different effect on my mood, causing moderate anxiety and mild aggression rather than the depressive effect of progesterone. Both of them also interfered with the estrogen to the point at which my body (face and measurements) actually masculinized while taking them. Both of my doctors admitted that depression can be a side effect of progesterone, and my first doctor was so worried that he did not want to prescribe it; he had seen it happen in other trans women.

[KayXo]

I had the total opposite reaction. I'm happier, calmer and more sociable on P whereas on E alone, I tend to be more aggressive and anxious. Also made my skin so much softer and overall shape more feminine. I love it! 

I also must mention that I take large doses of P and E. Perhaps this is why, who knows?!

To each their own...

[judithlynn]

Interesting topic that I just came across, although some 3 years ld.  It sounded to me reading these posts that the ordinal poster was on something like Provera, rather than the newer Prometrium (Micronised Progesterone).  I have had both. When I first transitioned in my 30's I was proverb and yes I had big mood swings and depression. This time around, my endo added Prometrium (micronised Progesterone) to my HRT regime after 3 years on Estrogen only. It is so much better and I take it on a 12 day cycle.  I do find that before the cycle time comes I get a little moody and somewhat irrational, but as soon as I am into my cycle after 1-2 days all that feeling goes away and I feel really absolutely great again, but by the end of the cycle. like Jill & Eva mentioned i find it quite cloying. One example of my irrationality prior to the cycle was that just prior to this cycle I was travelling on the freeway in an outside lane, overtaking someone and a "P" plater (in Australia people that have just passed their driving test have 2 years as a P-Probationary driver), was literally tailgating me, probably no more than 50cms off my rear bumper. I was travelling at the speed limit 100kms per hour) and I drive a big Grand Cherokee Jeep, yet this idiot (actually a young girl) was driving a small Honda. I got so annoyed, I touched the brake twice. Needless to say she got the message pretty damn quick. This is not something I would do normally. I put it down to my pre cycle "PMS".
Judith