Progesterone for PMS
Question
Hi!
I am writing to you from Germany.
Your website is very interesting and helpful.
I have suffered from PMS since puberty. Now I am 39 years old. The PMS symptoms are stronger now and I have noticed some new symptoms as well.
My Gyn prescribed Cerazette, (Gestagen) but I wanted to try bioidentical progesterone.
There are progesterone capsules in Germany. The name is: Utrogest. I am taking three capsules vaginally (each 100 mg) one in the morning, one in the afternoon and one in the evening, which means 300 mgs daily, from the 7th – 26th day of my cycle.
I first took the capsules from the tenth day of my cycle, but in the ovulation phase I felt very bad. I do not know why, so I read in the information leaflet of the capsules, that in the premenopause, one can take progesterone from the 7th day – 26th of the cycle.
I feel not so good, when I swallow the capsules, because my body gets only 10% of a 100 mg capsule of progesterone. When I insert the capsule in the vagina, my body gets about 70% of 100 mg.
I feel better with Progesterone…what do you think? It is right what I am doing? Can the vaginal use, make problems with time? Before I started with the capsules, I used a progesterone Creme 3%. It did not help me. With the capsules I feel better.
I have been using the progesterone capsules for three cycles now–this is my 4th cycle with it.
In Germany progesterone pessars like Cyclogest are not known.
Thanks a lot for your help…
Kind regards, Bessy
Answer
Last Updated: December 28, 2014
I am so glad you found our website educational. Some of the confusion may be just the different terms and medication names between what is available in Germany, and in the United States.
I think you are questioning a few things; the type of progesterone you are taking; the timing of it in your cycle; and the method of delivery (oral vs vaginal vs creme).
Being unfamiliar myself with what is available in Germany, I cannot comment specifically on the types available to you, except to emphasize the difference between progestins and progesterone. It sounds however like you are taking a progesterone, not a progestin, and that is good. Bio-identical progesterone is what we recommend for the treatment of pms sypmptoms, not progestins.
It is fine to take vaginal forms of progesterone, and many find it more effective than the cremes or oral forms, as you have.
Your timing of the progesterone in your cycle does concern me. I assume at 39 you are still cycling. If you take the progesterone prior to your ovulation, you are not taking it in a cooperative fashion. We recommend taking progesterone cooperatively, supplementing the progesterone levels when needed during the time they normally rise, after ovulation. Typically, it is prescribed for peak plus 3 through peak plus 12 in your cycle, with peak being identified by observing and charting the signs your body produces that indicate ovulation has occurred. If you are taking the progesterone beginning on day seven in your cycle, it is prior to ovulation, and you are unnaturally raising progesterone levels at a time in your cycle that would normally be low, and possibly interfering with normal ovulation.
The best way to evaluate what is going on with you is to have your hormones evaluated, and the best way to obtain a complete evaluation is to chart your cycles, so the hormone testing can be timed in your cycle. If this evaluation is not available to you, then I suggest you learn to identify when you ovulate, and use the progesterone for about ten days after ovulation in each cycle to see if that helps you.
I hope this clarifies a bit how progesterone can be used in treating your pms, and gives you some points to discuss with your physician. If there are NFP services in your area, they will be able to assist you in charting your cycles, and referring you to a physician that might offer these evaluations.
Sheila St. John
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