Quote from: LittleEmily24 on February 18, 2014, 11:41:40 PMToday was the day I actually started taking the hormones and my Endo prescribed:
Estradiol, medroxyprogesterone And spiro
I strongly advise against the use of medroxyprogesterone acetate (MPA, Provera). For several reasons.
1) It may, in some, increase anxiety, irritability, depression, even make some suicidal. I've read more than at least 100 reports, if not more, of transsexual women, experiencing mood disorders on it. Micronized, bio-identical progesterone, on the other hand, does not have these effects but may cause slight depression if too much is taken relative to estrogen. In general, though, it is anxiolytic and can improve sleep.
J Womens Health Gend Based Med. 2000 May;9(4):381-7
"When compared with the MPA-containing
regimen, women using micronized progesterone-containing HRT
experienced significant improvement in vasomotor symptoms, somatic
complaints, and anxiety and depressive symptoms."
CLIMACTERIC 2005;8(Suppl 1):3–63
Pharmacology of estrogens and progestogens: influence of different routes of administration
""It has been shown that MPA may impair the beneficial effects of CEE on depressive mood and other psychological symptoms in postmenopausal women"
CEE is conjugated equine estrogens (Premarin)
J Clin Endocrinol Metab. 2004 Jun;89(6):2998-3006.
"These findings suggest that MPA antagonizes certain behavioral effects of E2 that may be beneficial to women, and that it does so more profoundly or in ways that endogenous P4 does not. The marked increase in aggression seen during MPA treatment suggests that production of negative affect may be a particularly serious side effect of MPA."
E2 is estradiol and P4 is bio-identical progesterone.
2) It is mildly androgenic whereas progesterone is not. That's why it is never given to pregnant women whereas progesterone is for prevention of miscarriage.
Experimental and Clinical Psychopharmacology Copyright 2007 by the American Psychological Association
2007, Vol. 15, No. 5, 427–444
"Synthetic progestins marketed as Provera, PremPro, and Cycrin are widely used but may produce a number of significant side effects, such as fatigue, fluid retention, lipid level alterations, dysphoria, hypercoagulant states, and
increased androgenicity. Natural progesterones are reported to have milder adverse effects"
CLIMACTERIC 2005;8(Suppl 1):3–63
Pharmacology of estrogens and progestogens: influence of different routes of administration
"MPA has no antiandrogenic effect, but
weak androgenic properties."
Contraception. 1987 Oct;36(4):373-402.
"Progesterone (P), the natural hormone, binds to its specific
receptors to induce specific progestational effects. In addition to
this binding, P is able to interfere with the binding sites of other
steroids. Therefore the natural hormone exhibits an anti-estrogenic
activity, and anti-androgenic activity and also exerts anti-
mineralocorticoid effects. For a long time progesterone could not be
used in clinical applications because of a rapid liver inactivation
after oral administration. An 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 . 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."
3) It increases breast cancer risk vs progesterone that does not. Has been associated with increased risk in the famous 2003 WHI study.
CLIMACTERIC 2005;8(Suppl 1):3–63
Pharmacology of estrogens and progestogens: influence of different routes of administration
"Recent epidemiological studies found an increase in the relative risk by 20–30% during treatment with CEE/MPA" (risk of breast cancer)
"The nearly significant reduction in breast cancer incidence in women treated with CEE alone"
Med Hypotheses. 2001 Feb;56(2):213-6.
"Recent epidemiology indicates that unopposed oral estrogen
replacement therapy has a surprisingly small impact on breast cancer
risk--little if any in overweight women--whereas combined regimens
featuring synthetic progestins are attended by a much larger
increase in this risk."
Int J Cancer. 2005 Apr 10;114(3):448-54.
""(...)Our study shows an increased risk of breast cancer associated
with HRT use. It indicates that the association between HRT use
and breast cancer risk most likely varies according to the type of
progestogen used. There was no or little increase in risk with
estrogens used alone or combined with micronized progesterone,
at least when used for short periods. The increase in risk reached
significance when estrogens were combined with synthetic progestins
and was significantly greater than when combined with
micronized progesterone."
J Steroid Biochem Mol Biol. 2005 Jul;96(2):95-108.
""Controlled studies and most observational studies published over
the last 5 years suggest that the addition of synthetic progestins
to estrogen in hormone replacement therapy (HRT), particularly in
continuous-combined regimen, increases the breast cancer (BC) risk
compared to estrogen alone. By contrast, a recent study suggests
that the addition of natural progesterone in cyclic regimens does
not affect BC risk. This finding is consistent with in vivo data
suggesting that progesterone does not have a detrimental effect on
breast tissue."
4) It has negative effects on the cardiovascular system whereas progesterone does not. It increases clotting risks.
Climacteric. 2003 Dec;6(4):293-301
"Recent report, particularly the Women's Health
Initiative, demonstrated that hormone therapy with combined estrogen
plus progestin increased the incidence of heart attacks, stroke,
blood clots, breast cancer and dementia in women over 65 years old.
We investigated the role of synthetic progestins in initiating the
adverse events associated with estrogen therapy"
"The acute peripheral and cerebrovascular responses were measured following intraperitoneal or intravenous administration of progesterone, synthetic progestins (medroxyprogesterone acetate and
norethindrone) or estrogens (conjugated equine estrogens and 17 beta-
estradiol). "
"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."
CLINICAL THERAPEUTICWVOL. 21, NO. 1, 1999
Oral Micronized Progesterone
""the most commonly used synthetic progestins, norethisterone and medroxyprogesterone acetate, have been associated with metabolic and vascular side effects (eg, suppression of the vasodilating effect of estrogens) in both experimental and human controlled studies.All 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."
"The progestins do, however, have a number of potential negative effects, particularly metabolic and vascular effects."
"all randomized, controlled studies in animals and humans have consistently shown that the most popular synthetic progestins, including those with only weak androgenic activity (eg, medroxyprogesterone acetate [MPAJ), induce significant disturbances in lipid levels, glucose metabolism, vasomotility, and histologic appearance of the artery walls."
"In controlled animal studies and short-term human trials, however, no side effects were observed when circulating levels of natural progesterone were kept within the range seen during the normal luteal phase.Therefore, natural progesterone may have a better risk-benefit profile than that of the synthetic progestins."
"The 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"
"Only 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 at bedtime. 29 Oral micronized progesterone is therefore an effective and well-tolerated form of progestogen replacement in premenopausal and postmenopausal women"
Experimental and Clinical Psychopharmacology Copyright 2007 by the American Psychological Association
2007, Vol. 15, No. 5, 427–444
"It is important to note that although progesterone and synthetic progestins are used for similar purposes, these may not exert similar modulatory effects on target organs, and each progestin molecule may have specific effects on neuroendocrine action (Bernardi et al., 2006). For example, a commonly used progestin, MPA, was shown to induce more negative somatic effects, more reports of breast tenderness, and increased magnitude and duration of vaginal bleeding in comparison with natural (micronized, oil-suspended) progesterone in early menopausal women (Cummings & Brizendine, 2002). MPA and natural progesterone also were found to differ with respect to molecular signaling in human endothelial cells, suggesting that there may be differential cardiovascular effects (Simoncini et al., 2004)."
Biol Psychol. 2005 Apr;69(1):39-56. Epub 2005 Jan 4.
"89 healthy postmenopausal women were tested twice, before
and after exposure for about 8 weeks to one of the five conditions:
placebo, Estratab (primarily estrone), Estratab plus Prometrium
(micronized progesterone), Estratab plus Provera (synthetic
progestin), and Estratest (same estrogen as in Estratab plus
methyltestosterone)."
"Women assigned to Estratab plus Prometrium had diminished diastolic blood pressure responses
during a speech stressor upon retesting, whereas women assigned to Estratab plus Provera increased."
Also, an anecdotal report from a transsexual woman
"
Medroxyprogesterone was bad for affecting blood clotting too but I couldn't stand it for more than I think it was 5 days before I had to stop it. It did temporarily alter my blood clotting test though."
"Also
the worst clotting offender for me was Androcur. During that time I needed * to * warfarin. Once I stopped using that, not even my usual (...) estrogel could put me that high, nor use of prometrium." Prometrium is bio-identical progesterone.
