Perimenopause and menopause.
These hormonal transitions are a natural part of life, but the experience isn’t always a breeze. Hot flashes, night sweats, sleep problems, insomnia, weight gain, fatigue, and mood swings – these symptoms can leave you feeling like a stranger in your own body. Hormone replacement therapy (HRT) is a common option to manage these issues, but navigating the world of hormones can be confusing, especially when it comes to bioidentical progesterone use after hysterectomy.
What is Bioidentical Progesterone?
Progesterone is a natural hormone produced by the ovaries. During perimenopause, progesterone levels drop significantly, contributing to many uncomfortable symptoms. Bioidentical progesterone is a hormone that mimics the structure of your body’s natural progesterone. It’s different from progestins, which are synthetic hormones with a slightly different chemical structure, and often used in traditional HRT medications. ALL birth control pills and IUDs also contain synthetic progestins.
Uterus or No Uterus?
Whether you still have a uterus plays a significant role in considering bioidentical progesterone. Here’s a breakdown:
- Women with a Uterus: When combined with estrogen therapy, progesterone helps prevent endometrial hyperplasia (thickening of the uterine lining) which reduces the risk of uterine cancer. This is a crucial benefit of progesterone for women with a uterus.
- Women Who Have Had a Hysterectomy (no uterus): Since uterine cancer isn’t a concern, the reasons for using progesterone become more specific to individual needs. It is still helpful for managing sleep, mood, and bone health.
Benefits Beyond the Uterus
Progesterone offers a range of benefits beyond uterine protection:
- Improved Sleep: Oral progesterone can promote deeper, more restful sleep, a much-needed relief during menopause.
- Mood Regulation: It may help alleviate anxiety, irritability, and depression sometimes experienced during menopause.
- Cognitive Function: Some studies suggest a possible link between progesterone use and improved cognitive function, but more research is needed.
The Possible Downsides of Progesterone
Overall, bioidentical progesterone is safe and well-tolerated by most women. However, there can be side effects for some. Here are some things to consider:
- Progesterone may cause some women to become dizzy, drowsy, or experience fatigue. Make sure you know how you react to it before you drive, use machines, or do anything that could be dangerous if you are not alert. You should take progesterone at bedtime to avoid this. A hangover effect in the morning may mean your dose is too high.
- May Worsen PMDD. If you try progesterone and your PMDD symptoms worsen, you may be intolerant to it. If this happens, SSRIs are the treatment of choice.
- High progesterone symptoms include breast swelling and tenderness, bloating, and other symptoms like anxiety, agitation, or depression.
When Your Doctor Says No
If your doctor is hesitant to prescribe bioidentical progesterone, here are some tips for a productive conversation:
- Do your research: Gather information from reputable medical sources about bioidentical progesterone and its potential benefits for your specific situation. A great place to start is by reading my book, Perimenopause: The Savvy Sister’s Guide to Hormone Harmony.
- Be clear about your symptoms: Explain the menopause symptoms that are most bothersome to you and how you’d like to manage them.
- Ask questions: Inquire about your doctor’s concerns regarding bioidentical progesterone and explore alternative options they might recommend.
- Seek a second opinion: If you feel unheard, consider consulting another healthcare professional with bioidentical hormones experience.
- Check out over-the-counter alternatives. Only oral progesterone requires a prescription, and many creams are available over the counter. If you’d like more insight into this and your personal situation, let’s talk.
Additional Considerations:
- If you are allergic to peanuts, avoid the brand name progesterone (Prometrium and its generics)
- If you are taking oral progesterone, the sustained-release form will last longer into the night. Progesterone is quickly eliminated from the body.
- The effectiveness of bioidentical progesterone can vary depending on the dosage form (cream, gel, pill, etc.) and how it’s delivered (orally, vaginally). The selection of your dosage form should match the symptoms you’re having (e.g., oral for sleep)
The Bottom Line
Bioidentical progesterone can be a valuable tool for managing menopause symptoms after hysterectomy, but it’s not a one-size-fits-all solution. Discuss the potential benefits and drawbacks with your healthcare provider to determine if it’s the right choice for you. By advocating for yourself and working collaboratively with your healthcare provider, you can navigate menopause with confidence and find relief from your symptoms.
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Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at www.perimenopausebook.com.
Dr. Anna is available for 1-1 consultations. Find out more at www.drannagarrett.com/lets-
