Quote from: ItsMarissa on April 26, 2016, 07:00:53 AM
Well I hate to bring down the tone, but I have experienced constipation since hormones. Anyone else had to unpleasant side effect.
Spironolactone and progesterone can cause this.
Quote from: RobynD on April 26, 2016, 11:25:18 AM
I'm not sure that bio identical progesterone has any significantly greater risk of blood clots. I am over 40 and my doc prescribed it.
Indeed.
Climacteric. 2003 Dec;6(4):293-301."In both peripheral and cerebral vasculature,
synthetic progestins caused endothelial disruption, accumulation of
monocytes in the vessel wall, platelet activation and clot
formation, which are early events in atherosclerosis, inflammation
and thrombosis.
Natural progesterone or estrogens did not show such
toxicity."
Contraception. 1987 Oct;36(4):373-402.
Oral micronized progesterone. Bioavailability pharmacokinetics, pharmacological and therapeutic implications--a review."No side effects have been reported as far as lipids profile, coagulation factors and blood pressure are concerned.
PLoS One. 2014 Jan 21;9(1):e84698."Results indicate that progesterone has short-term cardiovascular safety. Endothelial function, weight, bloodpressure, waist circumference, inflammation and coagulation were unchanged"
Menopause. 2010 Nov-Dec;17(6):1122-7"recent data have shown that norpregnane derivatives but not micronized progesterone increase venous thromboembolism risk among transdermal estrogens users."
"there was no significant change in APC sensitivity among women who used transdermal estrogens combined with micronized progesterone compared with nonusers."
Climacteric. 2013 Aug;16 Suppl 1:69-78."it appears that transdermal
estradiol alone or combined with natural progesterone
does not increase thrombotic risk."
Journal of the Gay and Lesbian Medical Association, Vol. 4, No. 4, 2000"progesterone does not carry the risk of thromboembolism, prolactinoma, and myocardial infarction."
Rev Prat. 1993 Dec 15;43(20):2631-7."This favourable effect of estrogens is completed by other mechanisms which modify platelet aggregation, prostacyclin/thromboxane equilibrium, endothelin, etc., and which improve arterial wall morphology and vasoactive reactions. Some synthetic progestogens, given with oestrogens for endometrium control, may compromise these spectacular vascular benefits, but
this is not the case with natural progesterone."
Maturitas. 2015 Mar 9."When taken with oral or transdermal estrogens, no significant association of venous thromboembolism (VTE) with concomitant micronized progesterone"
"Similar results had been previously reported for the ESTHER study in which micronized progesterone and pregnane derivatives did not increase risk for VTE"
Maturitas. 2011 Dec;70(4):354-60."With respect to the different pharmacological classes of progestogens, there is evidence for a deleterious effect of medroxyprogesterone acetate on VTE risk. In addition, observational studies showed that norpregnane derivatives were significantly associated with an increased VTE risk whereas micronized progesterone could be safe with respect to thrombotic risk."
Circulation. 2007 Feb 20;115(7):840-5."In addition, our data suggest that norpregnane derivatives may be thrombogenic, whereas micronized progesterone and pregnane derivatives appear safe with respect to thrombotic risk."
Fertil Steril. 2014 Apr;101(4):898-904. "Prempro has been associated with numerous side effects, including heart disease, adverse changes in lipid metabolism, and thrombo-embolic processes (59).
By contrast, micronized progestin (MP), bioidentical to the progesterone produced in the ovaries, has not been associated with such side effects."
J Pharm Pract. 2014 Apr 17;27(3):243-252."Pregnancy is associated with an increased risk of venous thromboembolism (VTE), with a reported incidence ranging from 0.49 to 2 events per 1000 deliveries"
Risk of VTE is at 0.05-0.2 %. Pregnancy is marked by VERY high levels of progesterone, up to 100-200 ng/ml.
Ann Intern Med. 2005 Nov 15;143(10):697-706.« The relative risk (standardized incidence ratio) for venous thromboembolism among pregnant or postpartum women was 4.29 (95% CI, 3.49 to 5.22;P < 0.001), and the overall incidence of venous thromboembolism (absolute risk) was 199.7 per 100,000 woman-years. The annual incidence was 5 times higher among postpartum women than pregnant women (511.2 vs. 95.8 per 100,000), and the incidence of deep venous thrombosis was 3 times higher than that of pulmonary embolism (151.8 vs. 47.9 per 100,000). Pulmonary embolism was relatively uncommon during pregnancy versus the postpartum period (10.6 vs. 159.7 per 100,000). "
Hence, most cases of DVT and PE, already quite low, are present post-partum when progesterone levels drop, not during pregnancy when levels are high
In clinical trials and randomized controlled trials evaluating micronized progesterone, mentioned in Prometrium's product monograph , not one single case of thrombosis or altered coagulation factors is mentioned.
I take a high dose of oral progesterone. My clotting times are normal.
