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I am not taking the stuff, so I am worthless for first hand.  What you describe is a result of the liver metabolizing the basic progesterone in the prometrium.  Prometrium is "micronized" progesterone and this is not supposed to happen (as much).

You should probably discuss this with your doctor just to be safe.


Erin

It's actually perfectly normal. When taken orally, a important fraction of progesterone in the liver eventually gets metabolized to allopregnanolone which is responsible for making you feel "drunk", euphoric, relaxed, sedated, sleepy. For me, the effect still persists 2 months into taking it but I also take it with food which increases the effect but also the concentrations of progesterone in the blood. It usually last 30-45 minutes at most. The effects were quite strong in the beginning, first couple of weeks but since, are slightly milder but there are still days when it can be pretty intense. I personally enjoy the feeling and have gotten used to it. :)

Be sure that you aren't taking any other drug, supplement that could interact with progesterone, which could potentially increase too much the concentrations of allopregnanolone. Check with your doctor and pharmacists.

Quote from: KayXo on April 20, 2014, 08:18:47 AM
I also take it with food which increases the effect but also the concentrations of progesterone in the blood.

I'm not expert with biology so I really can't grasp this fact: it sounds to me a contradiction that taking it
with food both increases the allopregnanolone effect and P concentration in the blood. Shouldn't it be
the contrary, i.e more enzime/metabolite = less P available and less metabolism = more P available ??
Sorry if that sounds a silly question :)

I started taking my Prometrium after dinner exactly one week ago on the 15th.
I experienced the sedating effect ONLY the first two evenings: it was strong, I couldn't have driven
a car, for example, it lasted about 30-40 minutes but I wasn't scared because I anticipated it
(and I have to thank Kay for that: neither my doctor nor the leaflet would have warned me on this side
effect !)
But already the third day the effect was delayed and less strong.
Now I'm not experiencing it anymore (almost).
And I eat more or less the same foods at dinner.

I'm on my third month of P and the main things that I have noticed are increased irritability starting on about day 4 and I'm hungry all of the time. Minor side effects are occasional queasiness or headache. I can't say that i've noticed the euphoria or sleepiness that ya'll talk about. And I seem to be getting a growth spurt in my butt and a little in my boobs too. I am on the bio-identical version.

Quote from: ♡ Emily ♡ on April 22, 2014, 08:31:51 AM
Oh, that explains it then... And I have to admit having hopes that P would stabilise my metabolism and allow me to drop weight because I seem to be stuck at 70-71 kg and can't get any lower - but with current rate of food extermination... not sure... Maybe I need to put myself into some sort of semi-ketosis state, but last time it happened...it was not a pleasant experience...

I think that one purpose of the progesterone is to make you hungry and help you add curves from what you are eating. I dieted myself down to about 160lbs before I started on progesterone because I had been warned by my therapist that I would eat and gain weight. My butt is getting larger by the day and my boobs are too but at a much slower pace. This only started happening when I started taking progesterone.

Quote from: Mirian on April 21, 2014, 05:44:57 AM
I'm not expert with biology so I really can't grasp this fact: it sounds to me a contradiction that taking it with food both increases the allopregnanolone effect and P concentration in the blood. Shouldn't it be
the contrary, i.e more enzime/metabolite = less P available and less metabolism = more P available ??
Sorry if that sounds a silly question :)

Fertil Steril. 1993 Jul;60(1):26-33.
The absorption of oral micronized progesterone: the effect of food, dose proportionality, and comparison with intramuscular progesterone.

"Concomitant food ingestion increased the area under the serum P concentration versus time curve (AUC0 to 24) and the maximum serum P concentration (Cmax) without affecting time to maximum serum concentration (Tmax) (P < 0.05)."

"Absorption of micronized P was enhanced twofold in the presence of food."

If progesterone levels increase with food intake and if progesterone gets eventually converted to allopregnanolone, then an increase in allopregnanolone levels also naturally follows. This is why in the leaflets that come with progesterone, it is recommended not to take it with food as sedative effects are much stronger.

I tend to always have some fat in my dinner and sedative effects, quite intense at times, seem to persist after more than 2 months on it. :) I like it. 

Quote from: Eva Marie on April 22, 2014, 08:28:37 AM
I'm on my third month of P and the main things that I have noticed are increased irritability starting on about day 4 and I'm hungry all of the time. Minor side effects are occasional queasiness or headache. I can't say that i've noticed the euphoria or sleepiness that ya'll talk about. And I seem to be getting a growth spurt in my butt and a little in my boobs too. I am on the bio-identical version.

We are also all taking the bio-identical version. Have you tried taking it twice daily? Once daily could lead to headaches or irritability as progesterone has a very short half-life, I had the symptoms you speak of when I took it once daily. Or it could just be that progesterone is reducing your estrogen's effectiveness and thus, you get those side-effects.

Try taking after a meal, a fatty meal especially and I think you might get that sleepy effect. ;)

As always, follow your doctor's directions, first and foremost. You can discuss what you read here with him/her and then decide together what to do. :)

Quote from: Eva Marie on April 22, 2014, 10:50:50 AM
I think that one purpose of the progesterone is to make you hungry and help you add curves from what you are eating. I dieted myself down to about 160lbs before I started on progesterone because I had been warned by my therapist that I would eat and gain weight. My butt is getting larger by the day and my boobs are too but at a much slower pace. This only started happening when I started taking progesterone.

Yes, it apparently helps some girls with increased fat distribution. Still too early for me to say but i think it may have soften, rounded me out a bit which I was hoping for. I've found I'm actually less hungry on progesterone vs estrogen alone and that the bloating has gone down.

Quote from: ♡ Emily ♡ on April 22, 2014, 08:31:51 AMMaybe I need to put myself into some sort of semi-ketosis state, but last time it happened...it was not a pleasant experience...

I know one thing or two re: ketosis because I was really into that some time ago and I remained in that state for months at a time. You have to allow a few weeks for adaptation and if you cheat during that time, adaptation will never take place so you will always feel crappy. You also have to be sure that you eat enough fat to replace carbs and that you are digesting fat well or else it will be a disaster.

Could I ask how the best way to take Progesterone might be?

I've heard things like it being metabolized into something else other than progesterone if it's taken orally and goes through the liver, yet that's how my Endocrinologist suggested I take it if indeed we decide to add it to my current regimen.

And of course there's the subject of it not being substantially present for half of the month in females anyway?

Progesterone rises in the second half of a woman's cycle to prepare for pregnancy (implantation of fetus and other reasons) as an ovum has just been released for fecundation. That's the only reason why it increases. Nature intended it to be that way as naturally, a woman would most likely become pregnant around that time. Progesterone would then continue to rise just as estrogen would until she gives birth after which prolactin levels (and oxytocin, I think which helps solidify bond between infant and mother) remain high until breastfeeding ceases. Then, estrogen rises again, ovulation, and then progesterone rises to prepare for pregnancy again. In my opinion and I'm not a doctor, just an interested reader of the subject, this is the natural cycle of human females, not the highs and low of progesterone and estrogen every month which according to some, could be the contributing factor to breast cancer but this is not fact, just speculation, at this point.

Progesterone taken orally goes through extensive metabolism but how much varies according from one individual to another, depending on age, metabolism, health, genetics, other drugs/supplements, foods, beverages taken concomitantly. The advantage of taking it orally is its sedative effects as there is a higher level of its sedative metabolite orally than any other route. It will help if you are anxious to begin with, have problems with sleep. I personally like it this way.

Progesterone can be taken rectally (Cyclogest suppositories), capsules like Utrogestan, Prometrium can be even taken vaginally/rectally as genetic women have reported its effectiveness that way and doctors do allow for them to be taken that way in certain circumstances. It can also be taken in pellets or by injection but the latter may be inconvenient as injections have to be done every 1-2 days because levels drop quite rapidly. All these routes allow for much less metabolization and higher levels of P at lower doses, except perhaps for rectal where there still could be some P going through liver depending on where the suppository is placed (how far up).

There are alternatives to bio-identical progesterone, still apparently quite safe and free of androgenic effects. Dydrogesterone (Duphaston) oral tablets, 17-alpha hydroxyprogesterone caproate (Proluton Depot) injectables and even dienogest found in some pills with Estradiol Valerate.

Discuss those with your doctor, and hopefully you will find what is most suitable and effective for you. 

Does this then mean Progesterone should be cycled or taken regularly?

Quote from: ♡ Emily ♡ on April 19, 2014, 05:01:20 PM
Hey :)

Is anybody else having weird side-effects by Prometrium? I am following directions and take it before bedtime but this stuff has an effect of tranquiliser drugs - like having a bit of Xanax overdose. My head is quite clear but at the same time I would totally refrain from driving and I am really euphoric every time I take my pills...

I would love that to happen so my dumb brain would shut up and let me go to sleep..

Quote from: teeg on April 22, 2014, 12:53:02 PM
Does this then mean Progesterone should be cycled or taken regularly?

I would prefer taking it constantly as I don't believe cycling it would reproduce the "natural" cycle of natal women. In my opinion, hundreds of menstrual cycles are not natural and the way nature intended it to be. I explained this earlier. If anything, it will produce highs and lows in hormone levels increasing the likelihood of PMS symptoms EVERY MONTH which is quite undesirable. And it could possibly increase risks of breast cancer although this is pure speculation at this point.

I don't see ANY benefit at all in cycling it, only drawbacks and no scientific ground on which to take it that way. But that's just me.

In the end, follow your doctor's directions and discuss with him/her what you've read. See what they think and find a schedule that is acceptable to both of you. :)

Quote from: KayXo on April 22, 2014, 01:24:32 PM
I don't see ANY benefit at all in cycling it, only drawbacks and no scientific ground on which to take it that way. But that's just me.

I'd tend to agree with this.  In natal women the P cycles aid in the protection of the uterus.  No uterus means no need to cycle P, though the doctors opinion may be more prudent to listen to than the crazy red headed lady on the internet...

Teeg - If your Dr is suggesting oral then there is a good chance that you are not on progesterone but medroxyprogesterone acetate. If that is so, please tell your Dr that you want micronised progesterone. It is soooooo much better for you. I have a load of studies that show this, as will KayXO. Seriously. I would not take MPA at all.

Quote from: kira21 ♡♡♡ on April 23, 2014, 10:50:23 AM
Teeg - If your Dr is suggesting oral then there is a good chance that you are not on progesterone but medroxyprogesterone acetate. If that is so, please tell your Dr that you want micronised progesterone. It is soooooo much better for you. I have a load of studies that show this, as will KayXO. Seriously. I would not take MPA at all.

there is only one Kay, stop trying to be her.

Just to clear up things, I didn't take offence in the least bit from Kira's post. I don't think she is trying to be me. We all have something to bring to the table and that's why forums like these are so valuable. :)

Quote from: ♡ Emily ♡ on April 26, 2014, 02:47:28 PM
And your point topic-wise was...? (apart from trolling, ofc).

LOL

Ok because with the exception of Kay everyone with the internet is not a doctor.

Kay has shown time and time again an understanding of a multitude of different medical questions.

I have actually been on this forum for a while on and off, I have seen Kira's old posts on subjects like this and you could clearly tell she had no idea what she was talking about. Right when Kay became active on this forum is when I totally dropped off onto another, which is much much much better than this one.

I remember an interaction between kira and kay and kira was almost shocked at the evidence and studies kay has always been known for posting and backing up almost all of her claims.

It is just annoying and very dangerous to see her mimic someone who knows what they are talking about while at the same time acting as though they have all of this knowledge and all of these studies underneath their belt as if she is a real doctor.

@Kay sorry for being a butt kisser but it's true. It wasn't about you being offended it was about me being concerned about anyone with an internet connection and a website that publishes studies all of the sudden having an all knowing understand of all things transgender.

On a lighter note though, Kay I was prescribed this yesterday [removed dosage] at night. Do you think it will help my hip fat storage as well?

Thanks for that. I am not trying to be anyone.  I thought that person would benefit from knowing what I had to say.  As Kayxo hadn't commented on that at that point and would no doubt have said the same thing, I believe it was useful.

And I never claimed to have a knowledge of all things transgender.

Kayxo is also not a dr. She is someone who has learnt a lot about the subject.  I am not as knowledgeable as her about her about her but that does not mean I should not be allowed to say anything. I have read a lot of studies recently on progesterone and being a uni lecturer myself with university qualifications in a variety of subjects,  including biology,  I am quite capable of distinguishing between Internet tripe and proper research.

I think you should try and be more friendly and try and raise any points in a more discursive way rather than attacking people.  You have quite upset me quite needlessly. 

Kira is right, I'm not a doctor, just a regular transsexual woman (layperson) who's taken the time to educate myself about female hormones. I never stop learning, I'm far from knowing everything on the subject. I will make mistakes quite often and this is part of the learning process. Knowledge is never absolute, we must always remain open to the possibility that what we know now may someday prove to be wrong.

I will share with others what I learn but it's everyone's responsibility to double check the information, consult with their doctor, etc.

I don't see anything wrong with what Kira is doing. If anything, she is trying to be helpful and has provided useful comments.

Now, let's get back to the topic at hand...progesterone! :)

Ok, progesterone.

When I go to my PA in June I will be 12 1/2 months HRT. I to want so much for the best possible physical outcome; however, I will be 52 at that point. I have heard there are risks to the positive side and there is the potential weight gain :( .

So, are the positives worth the risks? Do the risks go up with age? 

I am not sure about the risks going up with age,  but the befits I consider would.  The older we become, the more neuro degeneration becomes an issue and there are several studies that link progesterone to protection against general neurodegeration and more specific neurodegeranerative diseases such as parkinsonism.  Natal women have lower levels of such diseases and it is thought that progesterone could play a part in that.

The risks often cited with progesterone are actually side-effects only noted with progestins, analogues of progesterone. It appears from several studies that progesterone is quite devoid of side-effects and may have several benefits. It does not appear to be associated with increased breast cancer/cardiovascular risk, improves well-being in some (anti-depressant and anti-anxiety), helps some actually lose weight and reduces bloating, has a synergistic action with estrogen (complements it by increasing vasodilation and increasing breast volume), helps some sleep better, increases body temperature, enhances libido, makes skin and hair less dry (more soft), makes nails stronger, is rejuvenating. Too much may make you lethargic. It will make you sleepy/drowsy, so best to take before you go to bed until you body gets used to it.

The occurrence of headaches and bloating and other pms symptoms with progesterone could, i think be avoided if taken twice or three times daily to keep levels steady. But, this is speculation, not sure at all.

Progesterone is NOT androgenic, either has no effect or reduces blood pressure, much like estradiol. Tends to actually reduce water retention.

So, overall, I think, wayyyyyyyy more benefits than drawbacks. Not to be confused with other progestins like medroxyprogesterone acetate or those in birth control pills. You could always try for awhile and see what happens. Ask your doctor about it and see what he/she says. Could prove worthwhile. ;)

I like it. :)