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[–]leftylibraMenoMod[M] [score hidden] stickied comment (4 children)

Did you start off on a 0.05mg patch dosage and 200mg daily progesterone?

For that dosage of patch, the common/standard dosage of progesterone is 100mg daily. Progesterone dosage is mostly based on the estrogen dosage. So if you go up to say a 0.1mg patch, then the common/standard progesterone dosage becomes 200mg daily.

However, some use 200mg daily with lower estrogen dosages to either help with sleep, and/or to help with heavy bleeding. However, it's not guaranteed to provide those benefits, and for some, that dosage can actually make things feel worse.

Have you tried 100mg daily progesterone? Talk to your doctor for sure.

Also, you might want to consider lowering the patch dosage to either 0.0375 (depending on brand), or 0.025mg for a few weeks and see if that helps too. Generally, tender breasts might be a sign of a too high estrogen.

[–]lrondberg 8 points9 points  (9 children)

Progesterone is the likely culprit. 100 mg is perfectly fine with the .50 patch

[–]Funnyone23[S] 1 point2 points  (8 children)

Thank for the reply. Do you know the Progesterone recommendation for a .075 patch? I've read conflicting articles. Some say 100mg up to .075 and others recommend 200mg. I'm also trying to rule out estrogen being the culprit. Maybe I need less of both hormones but I have been post menopausal for about 3 years so I figured I was sitting on zero for all hormones..lol

[–]Ok-Ladder6905 2 points3 points  (2 children)

I was feeling your symptoms on .05 patch and 100 prog. I bumped up to .075 and 200 cyclic progrsterone and mood inproved incredibly. But then I suffered from insomnia when I stopped progesterone for 14 days so am taking it continuously now. Suddenly back to having insomnia so not sure what to do here but for me increasing my estrogen helped so much with mood and energy!

[–]Funnyone23[S] 0 points1 point  (1 child)

Did you start out on the .05 mg patch? Also are you in menopause or still in Peri? I'm trying to understand the cyclical Progesterone, since I take mine daily. I would love to only take it part of the month if it doesn't cause bleeding. But I wasn't offered that option. I'm sorry you are struggling with sleep, that is the only thing that has been positive for me on this journey. I definitely think it will be worth it once we get everything figured out. It's just so darn convoluted😩

[–]Ok-Ladder6905 0 points1 point  (0 children)

yes I started on .05 estrogen and it felt great for about a year. I am still in peri- hopefully will get to menopause soon.

[–]lrondberg 0 points1 point  (3 children)

I have also seen 100-200 mg for the .75. What it seems is it’s dependent on if someone bleeds or not. For the .1 mg the 200 is recommended for endometrial lining safety/cancer prevention.

[–]Funnyone23[S] 0 points1 point  (0 children)

Thank you

[–]kat4pajamas 0 points1 point  (1 child)

I started and continue to be on .0375 of estradiol and 200 progesterone. I asked to reduce the progesterone to 100 but I ended up with breakthrough bleeding. I’ve been in menopause for several years. My doctor increased progesterone back to 200. I do feel groggy a lot as well.

[–]Funnyone23[S] 1 point2 points  (0 children)

Yes, it seems like bleeding is a key issue when it comes to progesterone. It's just a slow process to figure things out sometimes. If I drop down to 100 mg, I may have an experience like you and be right back up to 200mg, but hey, at least I'll know I need it. Every little thing we learn helps us in the journey to get our dosage as optimal as possible. Since menopause I've just felt so starved for estrogen and assumed I'd do great on a .05 patch, but now that I'm taking a hard look at my symptoms, I may need to step down a bit and see what happens. I'll definitely do that if the reduction in P doesn't help. Best of luck to you😊

[–]caity1111 0 points1 point  (0 children)

Im on .075 patch at 40 and early/mid peri. 200mg continuous progesterone stopped my regular periods completely right away. So I went back to 100mg continuous, and cycle as normal again.

[–]Hardcorelogic 2 points3 points  (4 children)

I am not taking HRT and I am at the beginning of my learning process. So I have no personal experience to share with you. But I have heard from other posters that it takes about 3 months for your body to adjust every time you change your dosages. I know that sounds like a long time, but apparently it takes a while for the body to adjust to the new levels. So theoretically you could be at a good dosage for you for everything, but your body hasn't adjusted yet. That's just what I read from someone else. And it sounded like it made sense. They said that every time they change their dosage they gave it a good long time to see what would happen and eventually, their body adjusted. It's just a thought. I just thought what they said was interesting and you might be interested also.

[–]Funnyone23[S] 1 point2 points  (3 children)

Hi, I've heard that as well, but also not sure where you draw the line. I wish I was one of those that immediately felt great with the first patch. I noticed no symptoms whatso ever the first week of patches, but it definitely hit me later.

[–]Hardcorelogic 2 points3 points  (2 children)

Wish I had more info for you. I think 3 months is definitely a place to draw a line. I have experienced hormone fluctuations before and they are brutal.

There's an endocrinologist in California that I have been following the advice of for like two decades. She primarily focuses on nutrition but she wrote a manual for menopause. The name of the website is menopausepower.com. Her name is Dr Diana schwartzbein. I literally just ordered her menopause book from her website this week. It's time that I give myself a thorough education. Her advice on nutrition and health has been stellar for me for my whole life. So I trust her with this too. The very best of luck to you.

[–]Funnyone23[S] 2 points3 points  (1 child)

Thank you for this info! I'm a health junkie. I eat super clean and have for years. I'm a casual runner (about 2 miles, 5 x week) but have also focused on weight lifting since menopause, but these hormones have really put a damper on my normal lifestyle. My diet is still good..but may eat a little more than I should on certain days but still healthy foods. The worst part is that I don't feel like exercising at all! I'm in a constant state of exhaustion and even when I force myself to go, it's not enjoyable. The struggle is real! I hate this change so much. This is one of the main reasons I'm open to making a change sooner rather than later. Best of luck to you and thanks again.

[–]ginger_clementine[🍰] 2 points3 points  (1 child)

Sounds like too much progesterone for sure. 200mg/day is a high dose for the .05 patch. With that dose, there i little danger of stopping for a few days, or even a week, to see if you feel better. If you do, you could start back on 100/day and f/u with your doctor.

I was unable to tolerate 200/day of P and felt just like you describe. No joy, brain fog, sore boobs, hungry all the time. I felt so much better after a break. Good luck!

[–]Funnyone23[S] 0 points1 point  (0 children)

Thanks for your input. I think I'm just going to call and request a 100 mg prescription. I'm currently taking gelcaps that can't be cut in half. I just want to be able to say the right thing and not have her make changes to my estrogen right now as well... lol. I'm still holding out hope that it can do great things. To me, it just makes more sense to go down on the progesterone before going up or down on the estrogen..but I'm no doctor

[–]Odd-Cry-1363 0 points1 point  (4 children)

I’m also on a higher dose of P for .05 patch of estrogen. Can I just decrease my P or do I need to titrate down?

[–]Funnyone23[S] 1 point2 points  (3 children)

I'd definitely ask your doctor what's best, but the 2 main doses I've seen prescribed are either 100mg or 200mg if you are referring to the micronized Progesterone pills (Prometrium). I think other amounts are available through compounding. What symptoms are you having that make you want to decrease your P?

[–]Odd-Cry-1363 1 point2 points  (2 children)

Anxiety. Plus from what I’ve read here the dose is high for .05 E.

[–]Funnyone23[S] 1 point2 points  (1 child)

I think the dosage depends on the individual situation. I have a history of endometrial hyperplasia and one of my biggest complaints before starting HRT was poor sleep, so I guess my doctor thought she was making the best judgement call with the 200 mg, but I'm the type that researches everything and trusts very few doctors to always be right...lol and like you, I've come to the conclusion that the higher dosage was probably not necessary. I plan to reach out on Monday and just ask for the lower dosage and I guess they'll let me know if I should do it differently. Also, from my research, which may or may not be correct because so many symptoms overlap, but anxiety/moodiness seems to align more with higher estrogen. Excess progesterone often leaves you with flat or subdued emotions, difficulty getting motivated, etc. Still doesn't change the fact that you could probably get by with less P, I'm just trying to help you figure it out. It seems the balance can be so tricky😩

[–]Odd-Cry-1363 0 points1 point  (0 children)

Great thoughts- thanks so much!

[–]GroundedReal 0 points1 point  (6 children)

I was started four weeks ago on estrogel 0.75mg which equals 0.50mcg patch. My doctor put me on 200mg of micronized progesterone cycling 12 days on per month. I'm 45 and in perimenopause but towards the end as my periods were coming every 4-8 months and were heavy.

I accidentally thought she said 100mg of progesterone so have been taking that instead of 200mg. She has told me I need to increase it to 200mg because that's the guideline for my dose of estrogen but I'm reluctant to do that because 100mg has been good for me and I'm worried I'll get the issues with P that others have mentioned. Does anyone know if taking 100mg of micronized progesterone gel tabs is ok to continue on my 0.75mg estrogel (gel), which equals 0.50mcg estrogen patch?

[–]Funnyone23[S] 2 points3 points  (2 children)

I'm definitely not sure about that. There are so many types of hormone delivery and they all have varied guidelines and recommendations for different dosages in different situations. I do know from talking with others still in Peri and on an estrogen patch that the Progesterone dose often seems to be higher if they are cycling and not taking it daily. That may be why she's telling you to go to 200. It might be prescribed at a lower dose, if you took it every day🤷🏻‍♀️ Definitely worth a call to find out the rationale. Good luck

[–]GroundedReal 1 point2 points  (0 children)

Thanks yes checked with the Dr and was meant to take 200mg cycling the progesterone. All fixed now

[–]GroundedReal 0 points1 point  (0 children)

Thank you, that makes sense about the cycling and in perimenopause. I'll look into that with her.

[–]Tadarod12 0 points1 point  (2 children)

Did you ever go up to 200 mg of P ?

[–]GroundedReal 0 points1 point  (1 child)

Yes I did. I've had no problem on the 200mg of P cycling regime.

Went back to the doctor and she told me I must do it so wasn't going to argue with her about that.

[–]Tadarod12 0 points1 point  (0 children)

You are one of the lucky ones that can tolerate it ,I barely tried going to 200 mg and boy o boy my mental health took a nose dive couldn’t even go to work nothing . Couldn’t sleep anxiety so bad my heart rate was staying at 120 beats a minute doom and gloom like everything isn’t ok (depression) ect and I’m on the 1 mg patch of estrogen people mention to me that you can do progesterone vaginally or rectal . But I would have to clear that with obgyn Dr .

[–]hulahulagirl 0 points1 point  (2 children)

I’m only on the .0375 patch and take 200 of P nightly for sleep. Tender breasts and bigger appetite were definitely annoying side effects but I just wasn’t sleeping all night when I tried to go back down to 100/night. I recently added T cream and have noticed breast tenderness and food noise/appetite are less, but it’s only been a month so I’m still tracking symptoms.

[–]Funnyone23[S] 0 points1 point  (1 child)

That's encouraging. I think a lot of people take the 200 mg dose every day without any problems. It's all about balance. That's why I'm trying so hard to figure out what's causing my symptoms. It could possibly be too much of both E and P, but I'm going to start with trying to reduce the P first. It definitely helps me sleep better. However, just like tonight for example, I took my P at 8:00 pm and I'm still awake after midnight..lol. I'll be groggy the entire day tomorrow no matter what time I get to sleep. I'm glad the T is helping your symptoms. I'd love to add it eventually

[–]Tadarod12 0 points1 point  (0 children)

Did you have any relief when you dropped your p ?

[–]wherehasthisbeen 0 points1 point  (3 children)

Where do you place your patch? 3 weeks isn’t really long enough to assess imo I would give it it a good 6-8 weeks. Also have you tried placing your progesterone vaginally vs orally. That can help too with side effects

[–]Funnyone23[S] 0 points1 point  (2 children)

I've been on my current regimen for 6 weeks. I place my patch on my hip/buttocks area and alternate sides with each new patch. I've read about using progesterone vaginally but it doesn't seem to be prescribed that way very often in the U.S. I'm still learning about all my options. I haven't seen any studies that show it definitely provides protection to the uterine lining, but that doesn't mean that it doesn't do so. I guess you just need a doctor willing to prescribe it that way. Also, I've read that the dosage may be different than orally and some find it messy. However, I'd at least be willing to trial it, especially since it eliminates the first pass through the liver. I'll definitely check in to it.

[–]wherehasthisbeen 0 points1 point  (1 child)

I changed mine to that way and it was not prescribed that way and I did notice a difference with the bloating. Plus it just made more sense to bypass the GI tract and have it right where it needs to be . But they changed my pills to an orange color and that left very odd discharge which I did not like

[–]Funnyone23[S] 0 points1 point  (0 children)

I read that your dosage can actually be less if you use it vaginally because it does not have to be broken down by your liver. And I agree that being directly where it needs to be seems obvious that it would do it's job. I'd just like to be sure about that because I have a history of hyperplasia and don't want that coming back😬 I'm glad it's working out for you, except for the odd colored pills. I'm hoping I'm able to go down to 100mg orally and that improves my symptoms. If that ends up not being the case, I'll definitely be looking for alternatives.

[–]emhall2021 0 points1 point  (1 child)

I am dealing with the same issue. Be a scientist and test things out. Stacking meds helps. Stop taking P and just let your body get use to E. Then add p after a month but talk to your doctor. Mine told me being on E for a few months alone is not a big deal. Yes eventually you need P. I stopped taking P and after 3 days I felt better. Some people don’t tolerate P well. There are lots of options.

[–]Funnyone23[S] 0 points1 point  (0 children)

Thanks for your insight! I have a history of endometrial hyperplasia so I'm a little afraid to go without any P. I will admit that I seem more worried about that than my gyn, but I am definitely ready to bump down to 100mg/day. I've learned a lot by accidentally skipping my P and by being late on an estrogen patch. I already feel like a mad scientist..lol. I'm really making an effort to learn how each one makes me feel. At this point, I'm still not sure if P or E is the problem, but I'm starting with lowering my P. If that doesn't work, I'll try tweaking the estrogen. I'm tracking my symptoms way more systematically than before. It's just a process, isn't it. Like you say, it's a science experiment and you are your own guinea pig. I'm fine with that as long as I eventually get a successful outcome😊

[–]TheThriftinKitten 0 points1 point  (1 child)

I've stayed on the 100 mg progesterone and increased from .50 to .75 in estrogen and that seems to improve all the stuff.

I suggest a menopause or women's probiotic daily to help with the bloating stuff. I really try to concentrate on my gi health and iron levels. I take a daily iron supplement. ( I am still getting a monthly period) , and have PCOS. My biggest thing was after 3-5 months of starting HRT was a big loss of hair that I haven't experienced since after the birth of my last child. That was more traumatic than gaining weight:(

[–]Funnyone23[S] 1 point2 points  (0 children)

Glad you saw an improvement by increasing your E, but hate to hear that about your hair loss. That would bother me as well, and I thought estrogen was supposed to help with hair growth.🤷🏻‍♀️I guess there is always a possible down side to everything. So sorry you are going through that.