Painful Periods, PMS, and Progesterone

Question

I am currently on Prometrium and have been for about a year (give or take). It has been incredible in helping with my physical symptoms. Prior to this drug, I would get menstrual cramps so awful I can’t describe them, but can only really express they were, at least, a 12 on a 1-10 pain factor. They were debilitating, and I’d find myself curled up in a ball at home, praying for relief. Midol barely took the most minute edge off of it. They tested for endometriosis, but it was inconclusive (and then they told me there’s no real test for that condition).
Thankfully, I switched doctors, and my current one prescribed Prometrium. I get some cramping now, but nothing compared to what I use to have; however, my PMS (emotionally) can still get pretty awful. I am wondering if Prometrium is supposed to help with that. My moods sway all over the map from overly angry over absolutely nothing to insanely depressed and sad that I cry and don’t know why (which I’m not much of a crier to begin with). It is tough to handle, at times. I’m wondering if the medication is supposed to aid with this issue, as well, or if it was merely to assist with the pain (which I’m grateful for beyond words).

If Prometrium doesn’t assist with the moods associated with PMS, do you have any advice or tips? It is difficult to carry out day to day life never knowing what mood will rear its ugly head at the most inconvenient time.

I don’t know if you need/want the additional information, but I have tried birth control pills, anti depressants, Prometrium (currently on), Travacor (currently on), and even some natural medications from the health food store geared towards PMS.

Riley

Answer

Last Updated: August 15, 2023
Dear Riley,

Prometrium is a form of progesterone that is identical to what your body produces, and that is a good thing. The key, if taking progesterone, is to take it in a dose and at the time that supports normal hormonal function.

Progesterone is not at the consistently same level throughout the cycle, but rises following ovulation, and should stay risen until right before the next period. If a woman’s own progesterone level is inadequate, this can contribute to the pms symptoms you are enduring, and restoring levels to normal by supplementing levels with progesterone can provide relief—but the key is to supplement with the correct dose, at the correct time.

To do this, a woman must have accurate and precise knowledge of her cycle, to identify ovulation and know when to begin the progesterone.

I suspect you may not be timing the prometrium you are taking in this cooperative fashion. When taken too early, prior to ovulation, or throughout the cycle, it can negatively impact normal ovarian function, even suppressing ovulation. I would speculate this might provide some relief from your painful periods, but not by addressing or curing the cause, but by suppressing ovulation.

Endometriosis is a reasonable suspicion as the cause of your painful periods, and cannot be diagnosed by imaging studies. The next step to diagnose and treat is a laparoscopy. If you have endometriosis, the only actual treatment that directly addresses the cause of your painful periods is to remove it, surgically.

The best way to diagnose and treat your pms is a thorough hormone evaluation, also timed by precise knowledge of your cycle.

I recommend you do two things. I recommend you contact an NFP teacher to help you learn to observe and chart the details of your cycle. I also recommend you contact a physician trained in a specialty called NaProTechnology to diagnose and treat the cause of your painful periods and pms. The chart of your cycles you provide this physician will be the key in timing the tests, and the treatment.

Relief is possible! These are treatable conditions. Professionals that can assist you are on our website at www.canfp.org.

Sheila St. John

Answered By:

Sheila St. John
Sheila St. John is the Executive Director of the California Association of Natural Family Planning, coordinating the non-profit’s education and advocacy efforts throughout the state. Initially attracted to NFP as a healthy, effective method for planning families, drug, device and surgery free, her passion for NFP has grown over the last 42 years as she has journeyed with the over 900 couples she has personally instructed in its use, and been privileged to witness its role in overcoming infertility, women’s health, and the transformation that occurs in lives of men, women, and families, when we embrace God’s design for love and life.

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