Here's my reasoning for starting on Progesterone:
(micronized or natural USP Progesterone cream, not synthetic progestin)

I've been on Estradiol & Spiro for 10 years (ERT).  I got type 2 diabetes in this time, pretty bad.  I've got that under control now with diet and exercise but would still like to improve the insulin resistance more along with other things like my figure:  used to be a PEAR and now an APPLE but I'd like to be a PEAR again.

I've read some interesting things about all this and would like to share some of it with you:

Definitions for my following comments:
HRT = Estradiol + Progesterone
ERT = Estradiol only

In one study, I read that ERT causes a significant increase in cortisol compared HRT group.  In this same study I also read that progesterone regulates cortisol (makes sense since it often has a calming effect in women).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663529/

Excess cortisol (stress) drives insulin resistance, metabolic syndrome, diabetes, heart disease, cancer etc.  As cortisol causes the already insulin resistant liver to dump out more and more sugar, wearing out the pancreas faster to where the insulin resistant person becomes diabetic, has a heart attack, gets cancer or alzheimer's etc.

Excess cortisol also causes abdominal visceral fat along with tummy fat.  That's where fat usually stores with elevated cortisol and insulin.  I have this problem.  I lost a lot of weight and most of it came off from my hips and thighs.  All the weight I gained was in abdomen region, upper arms and I notice a slight "Cushing's Syndrome-like" hump in upper middle back below neck, although very subtle.  As you know Cushing's SYndrome is caused by excess cortisol.

I also read in another study that HRT (not ERT) actually improves insulin reisstance in post menopausal diabetics.  (which makes sense since most post menopausal women are too low on progesterone and ERT has no progesterone component).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884259/pdf/OAMJMS-4-83.pdf

I also read other studies that showed a shift in central obesity to gluteal femoral with HRT -- this is what I hope for hence switching to HRT from ERT.
https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem.82.2.3735
http://www.metabolismjournal.com/article/0026-0495(91)90037-W/pdf

I've read two books that says progesterone activates LPL , particularly in the gluteal femoral region. I had virtually no progesterone so this explains why I lost all that weight from gluteal femoral region and gained in the abdomen (due to unoposed estrogen, elevated cortisol & insulin).
Gary Taubes' "Good Calories, Bad Calories" page 398: "The female sex hormone progesterone increases the activity of LPL, particularly in the hips and buttocks, but estrogen, another female sex hormone, decreases LPL activity."
Another book:
https://books.google.com/books?id=elJbDAAAQBAJ&pg=PA39&lpg=PA39&dq=progesterone+lpl+gluteal+femoral&source=bl&ots=qm7kAfnk3o&sig=nUjPkku2_XQrKRjDpYe3oLMUVXc&hl=en&sa=X&ved=0ahUKEwi5m5O02sPWAhVDl1QKHdubB_EQ6AEIJzAA#v=onepage&q=progesterone%20lpl%20gluteal%20femoral&f=false

[LPL is Lipoprotein Lipase an enzyme which breaks apart triglycerides in the blood stream into fatty acids, along with glycerol backbone -- from chylomicrons (ingested fats) and VLDL (saturated fats made by liver) which happen to pass by the capillaries the LPL is hanging out in near the fat cell -- the fat cells can only receive the fatty acids and glyceral backbone through the cell membrane, not the whole triglyceride itself.. the fat cells reassemble the backbones and fatty acids into triglycerides within the fat cells.]

I can tell you right now, after two days on this progesterone cream, and having eaten more than I have burned off today, I feel that fat storing in my gluteal femoral region as we speak.  You might think I am odd but I feel a tingle where fat is being stored in my body.  I've observed where I feel these tingles and within two weeks I see visible evidence of fat growing just in that exact region.  Before (about 2 months ago when I was gaining some weight), when I wasn't on any progesterone, I felt these tingles in my abdominal tummy region (and gained fat there).. now, as of past two days, I feel them in my buttocks & hips, as well as posterior, outer & inner thighs.   I expect to see improvement in my figure soon. [If you google "tingle fat" you'll see others claiming they feel the same thing.]

THe progesterone is activating LPL in the gluteal femoral region, while calming down my cortisol (I feel more calm). [So, it's literally slowing down abominal fat storage (due to less cortisol) and increasing gluteal femoral storage.. beautiful how that single hormone works.] The unopposed estradiol always made me feel I have been in fight or flight mode and really caused a lot of bad insulin resistance over the years. I've also had a lot of poor sleep / insomnia due to the cortisol.  I feel so calm now.. did the first couple hours of my first application of the progesterone cream.   I'll let you know how it all affects my blood sugar over time, to let you know if I am an improvement in insulin sensitivity... because again HRT (instead of ERT) is supposed to improve it.  I'll let you know if I can shift back into a PEAR from an APPLE.  I was a PEAR early on in transition.

Interesting indeed. The only thought i have and i have been on progesterone for a year and a half and HRT for about 2 yrs total. is that progesterone does seem to increase the appetite substantially, so that could cancel out some of the cortisol effect.

My weight has distributed a lot - i have much larger booty than before HRT

Sure one can resist it and i have done well in doing so, but it is hard. I watch everything i eat and keep track of it on a phone app.

Quote from: RobynD on October 02, 2017, 12:30:13 AM
Interesting indeed. The only thought i have and i have been on progesterone for a year and a half and HRT for about 2 yrs total. is that progesterone does seem to increase the appetite substantially, so that could cancel out some of the cortisol effect.

Sure one can resist it and i have done well in doing so, but it is hard. I watch everything i eat and keep track of it on a phone app.

Yeah Gary Taubes' mentioned in the same book (above) that Progesterone is more of a fat storing hormone and estradiol actually helps you burn fat.. but in the case of excessive unopposed estrogen in presence of insulin resistance, elevates cortisol and actually causes central abdominal visceral apple obesity.  So it makes sense that Progesterone makes you hungry.  I am also gaining a bit of water weight as expected.. just started out and my body needs to sort things out to get estradiol and progesterone in balance.  Not worried about it.. I know I'll pee out all the water at some point later on .  Are you taking a one to two week break each month on the Progesterone, to mimic a more normal female cycle?  Maybe at least a one week break each month would help you with the weight and potentially other metabolic things as well?  John R. Lee in his "What your Doctor May NOt Tell you About Menopause" recommends taking a week break each month from progesterone if one has had a "total hystorectomy".  Actually I don't see any case where he recommends progesterone every single day of the cycle.  THere is always at least a week break, and in many cases with women that still have ovaries, it's usually a break from the cream 1/2 the cycle.

Quote from: JennJenn on October 01, 2017, 11:53:51 PMIn one study, I read that ERT causes a significant increase in cortisol compared HRT group.  In this same study I also read that progesterone regulates cortisol (makes sense since it often has a calming effect in women).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663529/

The total cortisol level was measured and likely, the free cortisol level remained the same. This is because oral estrogen increases CBG (cortisol binding globulin) and as a result, more cortisol is bound (made unavailable) so cortisol production is increased to bring free cortisol back up.

Also, progesterone is not taken in this study but rather medroxyprogesterone acetate which is anything but calming, it can actually make some more anxious.

QuoteExcess cortisol (stress) drives insulin resistance, metabolic syndrome, diabetes, heart disease, cancer etc.  As cortisol causes the already insulin resistant liver to dump out more and more sugar, wearing out the pancreas faster to where the insulin resistant person becomes diabetic, has a heart attack, gets cancer or alzheimer's etc.

The major factor behind insulin resistance, diabetes and metabolic syndrome seems to be chronically high levels of insulin, not cortisol. But, chronically high levels of cortisol surely does not help either.

QuoteI also read in another study that HRT (not ERT) actually improves insulin reisstance in post menopausal diabetics.  (which makes sense since most post menopausal women are too low on progesterone and ERT has no progesterone component).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884259/pdf/OAMJMS-4-83.pdf

I also read other studies that showed a shift in central obesity to gluteal femoral with HRT -- this is what I hope for hence switching to HRT from ERT.
https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem.82.2.3735
http://www.metabolismjournal.com/article/0026-0495(91)90037-W/pdf

In all these studies, HRT is compared to placebo, not to ERT and progestogens taken are anything but progesterone which have different effects on the body and the glucocorticoid receptor.

QuoteI've read two books that says progesterone activates LPL , particularly in the gluteal femoral region. I had virtually no progesterone so this explains why I lost all that weight from gluteal femoral region and gained in the abdomen (due to unoposed estrogen, elevated cortisol & insulin).

Estrogen also promotes gluteo-femoral fat deposits and actually inhibits abdominal obesity.

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

"Estradiol stimulates the activity of lipoprotein lipase (LPL) in femoral adipocytes and lipolysis in abdominal adipocytes
[35], thereby promoting accumulation of gluteo-femoral fat. On the other hand, estrogen deficiency is associated with enhanced accumulation of abdominal fat [35]."

"treatment of postmenopausal women with estrogen enhances LPL activity in the femoral region and at the same time lipolysis in the abdominal region, which might promote fat accumulation in the former region and fat loss from the abdomen [84]."

I suspect your problem may lie in the fact that your eating habits, stress and/or lack of estrogen contributed to your situation. Certainly not excess estrogen.

QuoteI can tell you right now, after two days on this progesterone cream, and having eaten more than I have burned off today, I feel that fat storing in my gluteal femoral region as we speak.  You might think I am odd but I feel a tingle where fat is being stored in my body.  I've observed where I feel these tingles and within two weeks I see visible evidence of fat growing just in that exact region.

Anecdotal and tainted with emotions. Not scientific nor objective. Fat accumulation/redistribution takes far longer to occur.

QuoteTHe progesterone is activating LPL in the gluteal femoral region, while calming down my cortisol (I feel more calm). [So, it's literally slowing down abominal fat storage (due to less cortisol) and increasing gluteal femoral storage.. beautiful how that single hormone works.]

I actually feel calmer and more STABLE, mood is improved since stopping progesterone which I took at a high dose orally for several years. On estrogen alone, I also developed plenty of fat in the female areas while on progesterone, I became even "fatter" and bloated, this is one of the reasons I stopped it.

QuoteI've also had a lot of poor sleep / insomnia due to the cortisol.

I fell asleep on progesterone and slept a good 2-4 hours but tended to wake up in the middle of the night and then have trouble falling back asleep. Now on just estrogen, I usually sleep right through the night.

QuoteI'll let you know how it all affects my blood sugar over time, to let you know if I am an improvement in insulin sensitivity... because again HRT (instead of ERT) is supposed to improve it.  I'll let you know if I can shift back into a PEAR from an APPLE.  I was a PEAR early on in transition.

Studies have shown estrogen alone actually IMPROVES INSULIN SENSITIVITY.

Diabetologia. June 1997, Volume 40, Issue 7, pp 843-849

"Oestrogen replacement therapy improves insulin sensitivity in liver, glycaemic control, lipoprotein profile and fibrinolysis in postmenopausal women"

CLIMACTERIC 2005;8(Suppl 1):3–63

"In women with supraphysiological estradiol levels during treatment with implants, no adverse effects on lipid metabolism, but a reduction in LDL cholesterol and fasting insulin were observed."

Int J Oncol. 2011 Dec;39(6):1443-53.

"Estrogen treatment triggered the loss of body fat, induced insulin sensitivity, suppressed tumor growth, reduced growth factors and improved hepatic steatosis."

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

"supra-normal circulating concentrations of estradiol, delivered subcutaneously, may beneficially influence insulin metabolism."

Int J Pharm Compd. 2015 Jul-Aug;19(4):289-93.

"A major function of estradiol involves obesity, insulin resistance, and cardiovascular disease; studies have shown the beneficial effects of estradiol in these areas, and this is somewhat at variance with traditional belief. In recent years, many researchers have studied its protective, beneficial effect, and have arrived at convincing evidence. In females, and, to some extent in males, estradiol is very important in protecting against obesity and lessening the likelihood of insulin resistance and cardiovascular disease."

Also, progesterone may actually have the opposite effect. But, to be fair, those studies were in rats.

The Journal of Clinical Endocrinology & Metabolism, Volume 67, Issue 2, 1 August 1988, Pages 341–347

"Estradiol increased insulin receptor binding, but during pregnancy this effect may be offset by the reduction in insulin binding induced by progesterone and cortisol. The postbinding defect in insulin action during pregnancy is probably related to increasing amounts of progesterone, cortisol, PRL, and placental lactogen."

Nutrition. Volume 13, Issue 9, September 1997, Pages 795-803

"Castrated female rats also become severely insulin resistant, localized now mainly to glucose transport in muscle. Upon substitution with 17-p estradiol, this is normalized, whereas progesterone is followed by insulin resistance.63"

Quote from: JennJenn on October 02, 2017, 12:45:18 AMin the case of excessive unopposed estrogen in presence of insulin resistance, elevates cortisol and actually causes central abdominal visceral apple obesity.

Free cortisol levels seem unaffected by unopposed estrogen and studies in women taking estrogen alone have showed, at least to some extent, a reduction in abdominal obesity.

QuoteAre you taking a one to two week break each month on the Progesterone, to mimic a more normal female cycle?

There is nothing 'natural' about having a monthly cycle all your life. This may actually increase your risk of breast cancer (still speculative) and lead to PMS.

Quote from: KayXo on October 02, 2017, 04:01:17 PM
The major factor behind insulin resistance, diabetes and metabolic syndrome seems to be chronically high levels of insulin, not cortisol. But, chronically high levels of cortisol surely does not help either.

Cortisol, at constant abnormally high levels, tells the liver to keep dumping abnormally high amounts of sugar in the blood stream.  This causes the pancreas to have to produce ever increasing amounts insulin to counter this.  The more insulin there is the more insulin resistance.  As you can see the more cortisol there is, the more insulin resistance.  Do the research, look at people that have Cushing's Syndrome.   Cortisol is a MAJOR factor in insulin resistance and central obesity -- along with heart disease, cancer, alzheimer's etc.  Carbohydrates as well as cortisol drive insulin resistance.  I eat an extremely healthy whole food diet these days low in carbohydrate.  I also am now sleeping 8 hours per day (recent in thanks part to the progesterone creme) getting to be by 10PM -- circadian rhythms.  This helps with stress, cortisol and insulin/blood sugar levels.  Also getting plenty of no-impact interval aerobic cardio.

Quote from: KayXo on October 02, 2017, 04:01:17 PM
I actually feel calmer and more STABLE, mood is improved since stopping progesterone which I took at a high dose orally for several years. On estrogen alone, I also developed plenty of fat in the female areas while on progesterone, I became even "fatter" and bloated, this is one of the reasons I stopped it.

I fell asleep on progesterone and slept a good 2-4 hours but tended to wake up in the middle of the night and then have trouble falling back asleep. Now on just estrogen, I usually sleep right through the night.

I was waking up after 4 hours and couldn't go back to sleep with estrogen alone -- for a good while now.. years. I felt immediate calm after applying progesterone creme and it allowed me to get a good night's sleep.

Btw, I think your bad experience with progesterone might be related to the fact that you "high doses" of it?  Maybe you took too much?  This can cause problems as I've mentioned before in another post , quoting Dr. John R. Lee.  I'll link the relevant studies he cites in his book later on. It's all about balance.  Did you do both blood and saliva tests for progesterone, etc?

Ill get back to your other replies, when I have time.