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Does it matter if I cycle progesterone?

Started by Angélique LaCava, October 11, 2016, 12:40:41 AM

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Angélique LaCava

I've been on progesterone for 5 months and when I started my doctor told me to take 1 pill everyday. Does it matter if I cycle it?
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Wednesday

I don't think so. I take it 2 times a week and it works good for me.
"Witches were a bit like cats" - Terry Pratchett
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Lucie

Do you mean two times a week or two time a day ? Progesterone half life is very short, so I am doubtful about whether two times a week intake might be effective. That said YMMV.
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Mohini

#3
Angélique, you might want to read this:

<Link removed by moderator>

That is what I'm going by on.  Remember that women naturally are not on a constant level of estrogen and progesterone.  Read the file up there and look at google images of women's menstrual cycle charts.  There is a reason for the cycling.  If anything, everything happens in cycles.  Everything in this material world is on cycles, whether it is the cycle of a Universe, the birthing/death of stars, weather cycle over millions of years, a year, a day, etc., the chemistry cycles of living beings and plants/trees, even the electron cycles of seemingly stationary/inanimate objects.  Everything is movement, and movement is life.  Nothing is static, including a woman's cycle.

I will repeat it again.  It is my feeling that the reason women have cycles is for at least two reasons I am aware of.  We all know of the periods that help with periodic preparation of the ovulation and potential pregnancy, but what about the development of secondary characteristics?  I get the feeling from my experience of being on a constant dosage regimen for years that cycling helps estrogen (or testosterone) receptors and the like to get periodic breaks from hormone exposure during the low parts of the cycle, so that when the hormones are released again, the hormone receptors and the like are as sensitive as they were during the first few cycles of a person's life. 

What I notice is that during the growing phase, you have a certain amount of development by the end of a particular cycle, and when you go through the low of the cycle, you may lose a little development (if any), but usually a smaller amount than you gained during the cycle.  For each subsequent cycle you start on, you have a little bit more development than last time.  The issue with constant-dosage regimens is that when your body is exposed to such a level over a long period of time, your body may develop estrogen resistance/insensitivity, and you seem to "max out" too early.  My case has been that I seemed to reach a maximum early on, and even I was starting to regress somewhat noticeably (I'm 50 now).

Now that I'm approaching the primary peak of my third cycle, I can say that the following has abated:

Formication (the sensation of bugs crawling on the skin even though there aren't any).
Hair thinning out.
Being flat-chested.
Dry, rough hands all the time.

The formication has largely gone away, my hair is not thinning out now.  I'm not flat-chested anymore with more development than I've seen in the past, and my hands are not always dry and rough (I still haven't ascertained when it stops being rough during the cycle (sometimes, it stops during the low part of the cycle, sometimes the high part).

It is like exercising.  Is it better to do 5 sets of repetitions all at once, or is it better to do one set at a time with a short recovery break in between?  Most likely, you don't have the strength at the beginning of set 5 as you did at set 1 (if you run through them all at once).  If you do cyclical breaks between the sets in a consistent manner, then you will perform better for each set than all at once (constant-dosage regimen).  If you're going through all five sets at once, you're probably losing strength and performance in the last 2, if not 3 sets.  Only this isn't about strength, but about sensitivity of responses to an input stimuli (don't do coffee all the time, just once in a while, and you feel that zing, or do it all the time, and you can probably go to sleep on coffee at 10 PM at night - I've done the former and the latter with sodas when I was a kid, and I know my body will respond this way).
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Lady_Oracle

Ive been on P for 4.5 years now and like I don't really notice much of a diff if I take it on and off or consistently.
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Mohini

Lady Oracle,

You also have to consider whether you are cycling not only progesterone, but the estradiol - take a look at a woman's menstrual cycle.

The news is that today, I was approved by my doctor to continue with the Wiley Protocol (cycling estradiol AND progesterone, and the progesterone needs to be micronized, not MPA).  I'm very excited about this, as it'll give me the opportunity to determine if cycling is what I need.  I went to the pharmacy to get the estrogen refill/progesterone on the way back home.

Angélique, do you want me to post up my own post with my experience on this protocol?  I am hoping very much that I get back to work soon, because there's a possibility that I may have to change the way the hormones are administered (transdermally through the skin as opposed to sublingually/transbuccally), which is what the protocol advises.
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Lady_Oracle

I'm on weekly injections so I'm constantly going through highs and lows and have been on micronized P since the start and I developed incredibly well. I just dont intentionally cycle my hormones, thats just the way injections are. If I could be on pellets I would so I could avoid pms symptoms which is caused mainly by a sharp drop in E or low E.

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Stephenie S

Cycling of the hormones is basically useless.
People convince themselves is does something basing it on what happens with natal females.
So what needs to be understood is that we are not natal females and don't have the history of one.
Neither do we have a few other things in our bodies that are at the same level as natal females.
The interaction of all the parts of the body is part of the equation too.
There is no study nor could there really ever be any study that could tell you cycling works or doesn't.
How would experiments be run to test for that?
When we take something it is to bring that something to a level that is in the female range and to keep it there.
There is no sensible reason for it to rise and fall because of variation of the dose.
One's levels rise and fall throughout any given day naturally anyway, why play around with it any further?
That progesterone does anything at all is considered suspect.
When I asked my doctor for progesterone I had to sign a form consenting and that I was aware of the possibility that there is no effect because none is known for certain. Oh and to acknowledge that the risk of complications increases.
Having said all that, I have been on prometrium for about 5 months also and couldn't say if it does what I am looking for which is help with breast development. My nipples hurt a little again but I can't say my boobs have grown. Even if they do I won't know for sure that it was the progesterone or the estradiol that was the reason.
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JLT1

Hi,

I cycle it in 7 days a month and do not lower estrogen.  It seems to help breast tissue and nipple growth.  There are some studies out there that suggest constantly high progesterone can cause problems with viens.  Not sure if that is correct for nonsmokers.  I don't beleive it hurts...

Hugs.

Jen
To move forward is to leave behind that which has become dear. It is a call into the wild, into becoming someone currently unknown to us. For most, it is a call too frightening and too challenging to heed. For some, it is a call to be more than we were capable of being, both now and in the future.
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JoanneB

Back in the age of dinosaurs, otherwise known as the 70's-80's, trying to mimic a woman's natural cycle seemed like a good idea. This was also an age of a lot of DIY. These days it seems there is still a lot of by the seat of your pants prescribing. I see widely  varying "Target" E levels, if any, just results driven. Same seems to go for P which also seems to be scarcely used or written about.

As an old dinosaur, as well as a sort of scientist, I tend to think Mother Nature tends to know best. So once a month I skip my shot of E and ramp up the P. I do a little P every day and notice a BIG difference for the better in how I am emotionally, as well as little physical things like how alive the girls feel. Given my age I sure cannot complain about gaining an almost B cup. Nor can I say if cycling or not, even P matters as for a lot of my growth happened while just on E and an AA.
.          (Pile Driver)  
                    |
                    |
                    ^
(ROCK) ---> ME <--- (HARD PLACE)
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Mohini

I state that at this time, in the middle of cycle 3 (cycling estradiol only, but starting to cycle progesterone for the first time tomorrow night for the last two weeks of this cycle), I can say that I definitely have had the most breast development of any time in the last 18+ years.  I was surprised at the physical changes as well as mental/emotional changes!  I only wonder what the progesterone has in store for me!
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KayXo

Quote from: Stephenie S on October 14, 2016, 08:52:53 PMWhen I asked my doctor for progesterone I had to sign a form consenting and that I was aware of the possibility that there is no effect because none is known for certain.

J Sex Med. 2014 May;11(5):1240-7.
Clinical review: Breast development in trans women receiving cross-sex hormones.


QuoteOur knowledge concerning the natural history and effects of different cross-sex hormone therapies on breast development in trans women is extremely sparse and based on low quality of evidence. Current evidence does not provide evidence that progestogens enhance breast development in trans women. Neither do they prove the absence of such an effect. This prevents us from drawing any firm conclusion at this moment and demonstrates the need for further research to clarify these important clinical questions.

Volume 18a of Elsevier's New Comprehensive
Biochemistry, Titled 'Hormones and Their Actions, Part I', editors BA
Cooke, RJB King and HJ van der Molen.  Published 1988.  ISBN
0-444-80996-1.  Dewey 612.405.
Chapter 14: Progesterone action and receptors, by
Nancy L Krett, Dean P Edwards and Kathryn B Horwitz, of the University
of Colorado Health Sciences Centre, Denver.


QuoteProgesterone also acts synergistically with estrogen in the normal development of the breast.  Estrogen stimulates cell mitosis and growth of the ductal system, while lobular development and differentiation is dependent on progesterone.  When estrogen is administered in the absence of progesterone, the tubular system proliferates and the ducts dilate resulting in the formation of cysts and fibroses.  These changes are comparable to those observed in fibrocystic disease and are suppressed by progestins, so that normal breast development requires that estrogen and progesterone be administered together.[2-4]

J Steroid Biochem Mol Biol. 2013 May;135:1-6.

Quoteallopregnanolone converted from progesterone in hippocampal slices could protect neurons from TBT-induced neurotoxicity due to a GABAA receptor-dependent mechanism. One of the physiological roles of neuroactive steroids might be neuroprotection from environmental chemicals.

Experimental and Clinical Psychopharmacology 2007, Vol. 15, No. 5, 427–444

Quotein a placebo-controlled study, patients with premenstrual mood disorder did report drowsiness but reported improvements in anxiety, depression, and stress when given (...) oral micronized progesterone in the morning and (...) oral micronized progesterone at bedtime (Dennerstein et al., 1985). These positive improvements in mood have also been seen in postmenopausal women given (...) oral micronized progesterone at bedtime (de Lignieres, 1999).

Maturitas. 2003 Dec 10;46 Suppl 1:S71-5.

QuoteProgesterone substitution in perimenopausal women promotes length and quality of sleep.

QuoteWomen who suffer from menstrual migraine triggered by premenstrual progesterone loss often benefit from cyclic progesterone administration. This may be because progesterone and allopregnenolone reduce meningeal release of substance P and inhibit the development of neurogenic oedema.

QuoteProgesterone, generated from pregnenolone by Schwann cells, also enhances myelin synthesis. Myelination of axons is promoted when progesterone is added to cultures of rat dorsal root ganglia.

Climacteric, 8 (Suppl. 1) (2005), pp. 3–63

QuoteOral treatment (...) led to a dose-dependent decrease in blood pressure221.

Endocrine Reviews, April 2013, 34(2):171–208

Quoteno changes were observed in blood pressure with progesterone administration
to normotensive postmenopausal women, although a slight reduction in blood pressure was observed in hypertensive women (198).

Br Med J (Clin Res Ed). 1985 Jan 5;290(6461):13-4.

QuoteIn a placebo controlled, double blind crossover study natural progesterone was given by mouth, in increasing doses, to six men and four postmenopausal women with mild to moderate hypertension who were not receiving any other antihypertensive drugs. When compared with values recorded before treatment and during administration of placebo progesterone caused a significant reduction in blood pressure

Climacteric. 2011 Feb;14(1):92-9

QuoteWhen micronized progesterone was added to the CEE treatment, the increase in daytime blood pressure in the group with normal blood pressure was abolished, and the decrease in systolic blood pressure throughout the day in the group with high blood pressure was potentiated.

QuoteMicronized progesterone may provide beneficial effects on blood pressure

Br J Dermatol. 2005 Sep;153(3):626-34.

Quotetopical (...) progesterone acts primarily in increasing elasticity and firmness in the skin of peri- and postmenopausal women. These effects in combination with good tolerability make progesterone a possible treatment agent for slowing down the ageing process of female skin after onset of the menopause.

Maturitas. 2012 Mar;71(3):248-56.

Quotein the presence of estrogen, progesterone does stimulate appetite and promote weight gain [19].

This, by increasing lipoprotein lipase in adipose tissue. Confirmed by several studies. Important for those wanting more curves and fat deposition.

Geburtshilfe Frauenheilkd. 1991 Apr;51(4):257-61.

QuoteDue to the competitive blocking of aldosterone the effect of progesterone is sodium-diuretic and diuretic, being as important as the therapy of climacteric complaints, as well as the consequence, which is the result of the physiological connection between progesterone and encephalics. Moreover, the effect of the progestogens is to tonicise the vascular system and is linked to a number of intestinal hormones in order to adjust their function. Therefore, progesterone seems to perform a great variety of extragenital functions. Menopausal women should not be deprived of the benefits of these functions within the framework of a replacement therapy.

Obstet Gynecol Surv. 2009 Jan;64(1):58-72.

QuoteVasodilation increases steadily in the follicular phase, reaching a peak about 1 week before the onset of menses (45). In the luteal (premenstrual) phase, progesterone reaches its highest level but estrogen concentration is high as well. Vasodilation may be due to the combined effect of the 2 hormones.

Steroids. 2003 Nov;68(10-13):831-6.

QuoteRecent work looking at the additional effects of natural progesterone or MPA on coronary blood flow and myocardial ischemia in postmenopausal women shows that progesterone has synergistic vasodilatory effects when added to estrogens [26].

Quote from: Stephenie S on October 14, 2016, 08:52:53 PMOh and to acknowledge that the risk of complications increases.

Contraception. 1987 Oct;36(4):373-402.

QuoteAn oral micronized preparation of progesterone is now available which produces adequate plasma and tissue levels of progesterone. The preparation reproduces the anti-estrogenic effect of the natural hormone on the endometrium at the dose of 200 mg daily. It also reproduces the anti-mineralocorticoid effect and has no androgenic action. No side effects have been reported as far as lipids profile, coagulation factors and blood pressure are concerned. Therefore oral micronized progesterone appears suitable for hormonal replacement therapy in various areas

PLoS One. 2013 Nov 1;8(11)

QuoteWe found that breast cancer risk differed by type of progestagen among current users of EP therapies. No increased risk was apparent among EP therapy users treated with natural micronized progesterone.

QuoteThis study confirms differential effects on breast cancer risk of progestagens and regimens specifically used in France. Formulation of EP therapies containing natural progesterone, frequently prescribed in France, was not associated with increased risk of breast cancer

J Hypertens. 2003 Jun;21(6):1145-9.

QuoteWe conclude that progesterone given without oestrogen does not adversely affect vascular function in postmenopausal women.

Clin Ther. 1999 Jan;21(1):41-60; discussion 1-2.

QuoteThe results of published clinical studies show minimal or no changes in lipid profile, blood pressure, or carbohydrate metabolism during treatment with oral micronized progesterone.28 This safety profile contrasts with the reported negative effects of some synthetic progestins, including adverse effects on lipid metabolism and glucose tolerance. Several studies, including the 3-year prospective PEP1 study, 4, 28 have shown that oral micronized progesterone significantly improves metabolic tolerance compared with such progestins as MPA.52,54,58

QuoteOnly minor adverse events have been reported in association with oral micronized progesterone therapy in clinical trials. Dizziness and sleepiness are the primary adverse reactions reported.33 However, these side effects can be suppressed by administering micronized progesterone once daily at bedtime. 29 Oral micronized progesterone is therefore an effective and well-tolerated form of progestogen replacement in premenopausal and postmenopausal women.

QuoteAll comparative studies to date conclude that the side effects of synthetic progestins can be minimized or eliminated through the use of natural progesterone, which is identical to the steroid produced by the corpus luteum.

Lipids Health Dis. 2012 Oct 9;11:133.

QuoteThe effects of intranasal and percutaneous estradiol were similar, regardless of the addition of progesterone. Similarly, for the overall group of 86 women, micronized progesterone did not alter the response to E2. Blood pressure, glucose, insulin, HDL-c, triglycerides, and usCRP remained constant with or without micronized progesterone. Total cholesterol decreased after E2, and progesterone maintained this reduction. LDL-c levels were similar at baseline and with E2, and lower during E2+P in relation to baseline.

Quote from: Stephenie S on October 14, 2016, 08:52:53 PMHaving said all that, I have been on prometrium for about 5 months also and couldn't say if it does what I am looking for which is help with breast development. My nipples hurt a little again but I can't say my boobs have grown. Even if they do I won't know for sure that it was the progesterone or the estradiol that was the reason.

Progesterone taken orally is poorly bio-available so that sometimes, to see any significant effect, the dose must be increased by the doctor. This needs to be discussed with your physician. If one sees significant breast growth soon after introducing progesterone, that it ceases soon after stopping progesterone, then most likely, the progesterone was responsible.

I've personally benefited from it on many fronts. :)
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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Mohini

I'm in the midst of cycle 4, ending week 1 tonight.  I was finished with the progesterone portion of the cycle at the end of cycle 3, which was a week ago on Saturday night.  I'm finding that on my base dosage of estradiol during this week 1, I'm still experiencing nipple tenderness.  Today is the first day of the increase into the primary peak dosage.  Last night, I was sitting and looking at my phone, and noticing my rib cage rising up and down with my breathing, and I had a GIANT shift into experiencing visually and physically what it is like for a woman to look down and notice her breasts rising up and down with her breathing.  I have not really experienced that before!  And, I'm noticing it getting harder to reach as far with the opposite hand to wash my sides.

I'm finding that since I am taking my progesterone at night, I think that this needs to be taken at the same time as the single-time dosage (taking so many estradiol pills at night and none in the morning) on these days, and maybe shifting the majority number of pills to night-time instead of the morning on split-dosage days (estradiol taken in the morning and evening).
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