Related Topics: Bioidentical Hormones, Hormones, Menopause

Why Hormones Can Sometimes Initially Make Symptoms Worse

Dr Tony Coope answers a question that some women ask after starting bioidentical progesterone treatment.

Dr Tony Coope

The women that this phenomenon usually affects are those with a degree of oestrogen dominance, which may have manifested as PMS, bloating, breast tenderness or cysts, lethargy, a tendency to gain weight, headaches/migraines, infertility, polycystic ovaries, insomnia, depression and altered mood – symptoms of excess oestrogen in relation to progesterone.

In these cases the progesterone has been prescribed to ‘oppose’ the excess oestrogen. In a balanced system the two hormones work together to regulate a woman’s menstrual cycle and fertility, and to encourage the normal growth of the foetus in the womb after fertilisation.

There are no direct side effects from progesterone in standard doses, and theoretically its use should rectify the imbalance and resolve many of the symptoms. And so it usually does.

How to deal with this

During this transition stage it is easy for a woman to become discouraged and even discontinue the cream or even increase the dose which will not help in this instance.

However this response in related to both the level of oestrogen dominance and the womens own sensitivity, but is normally temporary. It may occur when the bioidentical progesterone begins  waking up and making the estrogen receptor sites more sensitive.

If experienced, reduce dosage to a tiny dot then build up gradually in the following weeks or until the symptoms subside, you may then resume normal application.

It is vital to continue with the progesterone and return to a normal dose as the ‘flare up’ resolves. The temptation often is to increase the dose of progesterone, which may work for a while, but usually only creates more resistance. The answer is to use at a very reduced dose, gradually increasing until you feel in balance, and stopping at the lowest dose that is effective for you.

Lastly supplements such as DIM, indole-3-carbinyl, milk thistle and also cruciferous vegetables, such as broccoli and cauliflower, may improve the metabolism of estrogen in the liver.

This speeds up the process, as does the use of high quality probiotics, which discourage the reabsorption of estrogen by the gut.

Helpful information:


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Please feel free to discuss this article in the comments section below, but note that the author cannot respond to queries made there.
Comments 148
Sorted by:  Date | Recommended
Louise | 5:28 pm, August 28th, 2012

I am 58 and post menopausal. I have had a terrible transition due to chronic stress, low thyroid and adrenal fatigue over the past 8 years. I have been using bio-identical Progesterone cream for 2 years ( 15-20mg a day ) and have recently been advised to up the dose to 50mg. I have had these symptoms all through the menopause, but now they are now much worse – terrible aching muscles/joints, lot of weight gain around abdomen ( I am of small build), craving for carbs ,headache daily, dry/constricted vagina,lethargy, cloudy thinking, poor/slow memory, depression/crying. Am I sensitive to the cream and should I stop it or persevere? I have read so many conflicting reports about the cream. Some say that these are side effects and that it is not safe to use the cream, some say it is due to oestrogen dominance. I literally cannot function and just want to go to bed and rest all the time. What to do?

Diane | 10:28 pm, October 13th, 2012

Dr Coope,

I am 55 years old and have bee on Bio-Indentical Progesterone 20% (200MG/GM) for years. It has helped me to keep calm. My problem is that I have gained so much weight. Can Progesterone cause weight gain? I just had my Lab done and my Estradiol is 19 is this normal? Cortisol – 9.6, TSH 2.45, T4, Free 1.0, T3, Total 125, DHEA, 236, Progesterone 1.5 and Testosterone, Total 204. And no Libido.

What do you suggest?

Karen | 2:06 am, August 8th, 2016

I am estrogen dominant. ..started hrt .last week. Feel horrific. ..anxiety ect. I am 59 an four yrs post… been a nightmare for 15yrs. .tried several drugs most act opposite. ….having severe anxiety, severe sweating, Insomnia.on this muscles hurt bad. Can’t walk without off balance feeling. Will this end help

Karen | 1:53 am, August 8th, 2016

Just started hrt lo dose estrogen patch an progesterone pill, an I feel horrific stiffness,vision trouble disoriented, off balance ,hurting bad sick,….I am 59 sufferin since age 46…4yrs postmenopausal. ..severe anxiety on this. Can barely drive. Tried other stuff ,can’t tolerate most stuff help

Stacey | 10:59 am, November 23rd, 2016

If my Dr has recommended 1ml. Would you apply 0.5ml in the morning 0.5ml at night?

monica roller | 6:04 pm, October 1st, 2012

I applied it on my acne.. is that harmfull or not. Tired of the acne and blemishes.. tears.. i am 41 years old keeps oily skin. I began eating brocclli and coliflower.. please tell me what shall i do or eat to balance this hormone problem.

Beth | 11:47 pm, February 21st, 2016

Hi Doctor,

I had a full hysterectomy and removal of ovaries @ 31yrs old, I am now 38. I’ve never taken HRT but have begun to experience worsening memory problems, fatigue, weight gain, and re-occurring vaginal itch. I have hypothyroidism but stopped taking levothyroxine 3 years ago, I treat with organic vitamin/mineral supplements now instead and have bloods in normal range last 3 years, though sometimes I still struggle and get goiters. I also suffer from migraines, so wonder what you would you suggest I take and in what amounts to tackle the memory/fatigue issues without triggering migraines or worsening my hypothyroid symptoms. Thanks 🙂

mary bryson | 3:08 pm, November 13th, 2012

i have started using the serenity cream today do i stop taking my hrt and prozac right away thanks

lerrin | 3:51 pm, January 11th, 2013

Hi,I am 39 years old,I’ve been for a few laparoscopys for endrometriosis and I’ve been suffering with pcos and type 2 diabetes since I was about 29 and have had several large cysts removed from my ovaries my doctor prescribed birth controll pill and metformin but they both make me feel awful,I’ve recently had a spell of very bad health and have ended up in the er and seen at least 3 doctors all of whom have said its panic attacks and I’ve had to go on a hypoglycemic diet as my sugar has been hiting lows of 2 on the glucometer…I do not have health insurance and I have been unable to see a gynae but after doing some research of my own I’m not sure why my doctors haven’t prescribed naural progesterone cream for me in the past as I fit all the symptoms of estrogen dominance I’m 25kgs overweight,have hair loss,thick black facial hair,brain fog,memory loss etc..I’m not sure if I’ve done the right thing as I bought some and have been using it for 2 days but this afternoon I have a bad headache and am a bit dizzy..should I continue? Sorry for the long post

Gemma johnson | 1:20 am, October 7th, 2011

At 58 I would love to pluck up the courage and try this cream but when I had started my menopause at 32 and blood tests confirmed finished at 42 I was put on hrt and many but they all drove me almost insane and my acne severe.
I came away from all hrt as I felt so shamed and have not had any help since.
Am 58 and would like to try this but will I have all the problems as I did with ?

Angela Sterling | 6:27 pm, November 23rd, 2015

Did the author actually have to leave a contentious comment about women (wives nagging their husbands) and thus not only detour from the biochemical issue at hand, but subsequently, also detract from credibility?

It was unnecessary at best.

Vikki | 1:38 pm, September 23rd, 2012

I had breast cancer 8 years ago and using tomixifen for 5 years has given me abnormal cells in my womb. I have now had a hysterectomy (six weeks ago) my surgeon has recommended HRT. I really do not want to take it as my breast cancer was estrogen based. A friend recommended your cream. I am confused as the cream is progesterone? Can you help before I see my GP and start HRT? Thanks.

Ruth | 6:32 pm, September 22nd, 2012

Hi, I a m 53 and recently was started on Prometrium for excessive bleeding with huge clots that lasted over a month.
I took 200 mg for 7 days and then 100mg daily after that. I am now getting some breakthrough bleeding. Can I take 200 mg again for a few days to get things under control. I am going on vacation in a few days and really don’t want to be dealing with this.

Tammy Bennett | 6:12 pm, January 24th, 2017

Hello; I was wondering; I have be on bi-identical hormones for a few years now, I have had ablation done a few years back. My question is; Do I have to take a break from my progesterone if I don’t have a uterus lining? I do not get periods. I seem to get PMS symptoms when I go off progesterone. I am 54.

michele | 6:19 pm, August 20th, 2016

I am 49 yes old and have been post menopausal for two years. I am on BIH
it has helped with severe hot flashes and night sweats. helped with sleep for awhile but now I wake up through out the night with such severe stiffness in whole body. it gets better once I am up and moving. but lack of sleep and body aches and stiffness, so much inflamation is making good my quality of life terrible
going to go off for a few weeks and see if anything changes
has any one else had this experience as I am becoming very concerned and cannot go on like this

Josephine | 1:49 pm, November 29th, 2015

I am greatly confused,
My doctor says I have hormone imbalance… Put me on the pill 3months ago….. I have been having severe symptoms for a year now and it seems to of got worse …. Really poorly every two weeks most times…… Nausea, heavy head, dizzyness headaches, legs aching and really heavy, no energy at all, feels like I’m getting the flu or a bad cold but never end up with a cold, anxious, cry over anything, hot sweats sometimes chills …… It’s really affecting my life now and not sure if hormones can cause you to be this poorly….
Have been lightly bleeding on the pill for weeks…. dr wants to do an endometrial ablation or a hysterectomy if ablation doesn’t help …
I just want to be well again
But can these procedures help with my symptoms

Kim | 2:56 am, March 6th, 2013

I gained lbs7 over course of a month and my hair loss and hair thining has been getting worse. My Dr. Diagnosed me with hypothyroid and low progestron 5 months ago. I am on T3 and 50mg bio identical progestron pill and my symptoms didn’t improve much. Only slight mood lift and less brain fog. However no matter what I do the weight doesn’t move and my hair texture is getting worse. Recently my period is getting closer and heavier so my Dr. increased my compound progestron to 100 mg. is that change can help with my estrogen dominance symptoms?

georgina glover | 4:26 pm, September 24th, 2012

Dr Bond prescibed me pro -juven natural progesterone cream for osteoporis, I started taking it late July this year and by mid August I was having difficulty sleaping, this has now got servere and makes me quite stress due to being so tired. Dr Bond says stop taking the cream but has given no advise as to how long these side effects may last. Can you advise also what to take to help me sleap. many thanks Gina

Helen | 12:14 pm, March 13th, 2012

I have a long history of natural pregnancies, IVF (due to husband’s low sperm counts), miscarriages etc. Hence my hormonal balance has been through the mill.
I am now going through early menopause at age 42. Periods are irregular or absent and often very long. My doctor prescribed HRT which I only took for 10 days before putting on 5 lb in weight and suffering severe nausea.
Then 5 months ago I tried Wellsprings Serenity cream and after about 5 or 6 weeks the hot flushes disappeared. After another month I started on 20-1 cream in a bid to alleviate vaginal dryness. I was getting on absolutely fine until a few weeks ago and the hot flushes have come back with a vengeance. I am reluctant to go back to my highly sceptical GP but can’t live like this.
What do you suggest?

Astrid | 3:26 pm, December 22nd, 2017

Hi, How long does it take for the initial estrogen dominance worsening symptoms to subside? I was prescribed bio-identical progesterone cream to deal with my estrogen dominance symptoms. I am 47 and peri-menopausal. I started with a full dose, which made me feel very sleepy and increased my heart rate. Then at night I could not sleep at all.

My naturopath told me to decrease the dose and build back up. I am about 10 days in, on 1/8th of a dose once per day, and I feel like I am gaining tons of water and I feel quite depressed. I also have a “swimmy” feeling in my head some of the time.

Should I persevere in hopes it will improve? Or should I quit? I don’t know what to do. What I am experiencing is actually worse than the initial symptoms I was trying to treat. Please advise.

Cathy Arabanian | 1:05 pm, September 23rd, 2016

Hi there I’m 40 years old and started seeing a bio identical hormone doctor a couple of months ago as I was experiencing irritability at home, extreme tiredness, no sex drive, and just feeling unwell. After my third child who I had a C-section with I found that is when my symptoms felt worse. Couldn’t lose any weight from exercising at least 4 days a week. When I saw the doctor we did blood work and she prescribed me Progesterone 30mg/0.25 ml in Versapro cream which I would rub one pump into my left arm about three weeks out of the month and stop when I get my period. After a couple of months I increased the dose to two pumps. I went in for a follow up visit and told the doctor I didn’t notice that much difference but my husband who was with me told her that he noticed I seemed more happy and smiling more. My sex drive and tiredness levels were not fixed so then she prescribed me testosterone 4mg/0.25ml in versapro cream to apply to the pelvic area. Along with my progesterone I apply this at one pump just below my C-section scar. I have been on this for about 3 weeks but have not noticed anything? I do have extreme bloating. I look like I’m 3 months pregnant at times.

Jay | 9:59 pm, November 29th, 2015

I am 66 years old, I have Hashimotos, Adrenal fatigue. I suffer from hot flashes ,mood swings, depression crying a lot. I am on 3 grains of NDT daily. My thyroid levels are low but my Dr put me on a combination of Bioidentical Progesterone and Oestrogen-17B-Estradiol micro0,1%(1mg/g) Progesterone micro3.5%(35mg/g) and feels that if these hormones improve my thyroid levels will. My problem is when i start this cream my breasts get very tender, and I am wondering how long this should last for. I usually stop the cream as I get worried. I am on it for 25 days of each month. many thanks

A.A.S. | 4:16 am, January 7th, 2014

I’m using Emerita Progest cream. I’m not sure if this cream is making my main symptom is even worse – HAIR LOSS! That is the reason for me even wanting to try this cream.

I thought for sure I had low progesterone so I took a saliva test through ZRT labs, which I ordered through Dr. Lee’s website. I’m not 39 and have had hair shedding for exactly two years. Spotting before periods most times too. Thyroid normal. I just took a saliva test on day 20 of my cycle through ZRT labs. Here are my results:
Estradiol E2 is .7 (normal range is 1.3-3.3)
Progesterone is 127 (normal range is 75-270)
Ratio: PG/E2 is 181 (optimal range 100-500 when E2 1.3-3.3)

I was informed that even though my estradiol is LOW, I’m still estrogen DOMINANT since the ratio is 181:1 and optimal is like 600:1.

Well I’ve been taking this cream for 1 week and my hair seems to be shedding even more so I’m beginning to freak out. Am I just awakening estrogen receptors? I don’t know but it’s still making me wonder if I should stop the cream.

Dr Tony Coope | 8:18 pm, June 30th, 2013

Rachel: You are not having an easy time! Usually when you experience a response to progesterone like this it is because it has re-sensitised estrogen receptors which then respond more strongly to whatever estrogen is there, giving rise to symptoms of ‘oestrogen dominance’. Normally it would take a few weeks of perseverance for the progesterone levels to rise enough to balance this, and the symptoms should then subside. However there are other factors here, in that if your adrenals are flat, this will affect both your thyroid function, your hormone balance, and your sugar metabolism. To put this right, it has to be done in the right order, building up your metabolic balance from the foundation of restored adrenal function. I would also want to question your true thyroid state, as there is often a problem with interpretation of tests, or with their omissions (e.g. for autoimmune problems). I feel your situation is too complex to hope that any worthwhile change can occur with a simple approach, – you really need to develop an accurate overview as to what is actually going on here, and then build from there in stages to a state of better health. This will need guidance. If you cannot find this, I would be happy to talk with you in consultation to see if I can be of any help.

Cally | 7:09 pm, November 29th, 2012

I started taking Emerita pro-gest progesterone cream days 12-26, 1/4 tsp day and night. I stopped taking it yesterday after I confirmed that I was not pregnant, for menses to start. Now I am very bloated, constipated, tired, and moody. I have endometriosis, cysts, and celiac disease. I was very consistent with the symptoms of estrogen dominance. I stopped eating gluten and dairy, started taking probiotics, and started eating more cauliflower and broccoli on a daily basis. I’d like to get pregnant, but I’d also like to just not feel so horrible during this time of the month. It almost feels like bipolar some months. Will it get better on progesterone and soon I hope?

Lalabel | 10:58 pm, April 26th, 2017

Well clearly Dr Coope would be the very last person that I would ever consider to consult about women’s experience of the menopause if he finds it necessary to compare certain bio receptors’ inability to receive messages to
“husbands when persistently nagged by their wives!….In this case the message from oestrogen is too strong and the receptors ‘down-regulate’ in an attempt to lower the volume and maintain balance.”
Dr Coope, this is the 21st century. Please keep up.

AnnA Rushton | 1:42 pm, January 27th, 2017

Depends on what you are using Tammy. Bioidentical creams that are applied to the skin are recommended to have a break to avoid saturating the receptor sites and so absorbing less hormone. Progesterone is still necessary for hormone balance even after an ablation and your symptoms would indicate that. If you do not wish to take a break then use internal vaginal application instead.

Kris | 8:22 pm, June 5th, 2016

I have not had a period since July 2016. My doctor referred me to a doctor who works with weight loss. This doctor did blood work and said my hormone levels were a little low. Estrogen was 49, Testosterone was 14 and Progesterone was .4ng. I was prescribed 100 mg of Progesterone and .05 Estradiol patch. I started both on May 19, 2016. I was having headaches, nausea, fatigue – was told to add another patch, and I did. I have now had very heavy bleeding for 3 days, in pain and not feeling right. I do not dare leave the house. I emailed my doctor and waiting to hear back. Is this normal? I went to her for weight loss and was put on hormones – I had no problem before this. No night sweats, no hot flashes, nothing. I am confused why I was put on hormones and stated this in my email. Any advice is appreciated.

AnnA Rushton | 9:30 am, November 30th, 2015

You need to speak to your doctor Jacey as the tender breasts show oestrogen dominance so you may want to ask to have that reduced to see if this helps. Progesterone certainly will help your thyroid, see the article below, but your dosage of the hormones may need adjusting to eliminate the soreness.

AnnA Rushton | 11:09 am, January 24th, 2014

It will depend on the form of progesterone Lacey oral forms are always much higher than transdermal creams but as you consulting an obgyn please discuss it with them.

AnnA Rushton | 10:58 am, January 21st, 2014

Oral progesterone is processed by the liver and so its action is different from that of a bioidentical cream. Certainly progesterone helps with water retention and weight loss but progesterone can awaken oestrogen receptors and the advice with cream use is to reduce the dosage to a small amount until the body adjusts. However as you are seeing a consultant you need to discuss this with them.

Sarah | 1:25 pm, August 3rd, 2013

Hi there I have been on serenity since march and my flushes have now completely subsided .so I stopped the cream about a month ago .since then I have 2 shows .. The one last week was nothing more than brown discharge and it stopped quick , however I came on again 3 days ago and last night was admitted to A@ E with heavy vaginal Bleedin g … I am on tranxemic acid now but wondered what you think this bleeding may be caused by ? I am going for a ultrasound to check everything’s ok … But I was jolly scared. The blood was pouring out very fresh red colour with big dark clots .. My blood count amazingly is completely normal .. Any thoughts?

AnnA Rushton | 9:06 am, July 16th, 2013

Weight gain is common at perimenopause to compensate for the declining levels of oestrogen so it is then produced in the fat cells and adrenals. You seem to be doing all the right things but the stress will certainly impact your hormone levels so that would be the area to tackle plus strengthening your adrenal system. This article by Dr Andrew WEil explains it in more detail:

ANGIE | 11:02 pm, May 5th, 2013

I am 51 and peri menopausal. I began taking 100 mg oral progesterone after labs revealed low P and T and normal Estrogen levels. The first several weeks I had horrible depression, irritability and anxiety like I have never experienced before so we increased to 200mg. My emotional symptoms improved greatly but I have been spotting daily, sometimes small amount of frank blood and sometimes old dark blood. It is quite annoying but I am reluctant to decrease my progesterone for fear my emotional symptoms will return. My HRT MD doesn’t seem to know what to do. I am also on Testosterone cream twice a day.

Kate | 12:18 am, December 3rd, 2012

I have been given everol conti patches. You will probably know that the absorption rate of each patch is around 50mcg of estradiol and 170mcg of norethisterone acetate in 24 hours. Is this not a lot of progesterone in relation to estrogen. I was going to half the patches. Also can i get bio progersterone cream on the NHS.

sally | 9:31 am, October 25th, 2012

Hi, i am only 23years old ive had PCOS since i was 16 had terrible hair loss and acne since then. Now at this age ive developed Hashimotos. im only on Armour 1.5 grain and gaining weight, still with hair loss (noticeable) and i find it hard to focus on studies. Can this cream help? i see most of the reviews are from women 40years and above with menopause.

Neeta | 2:35 pm, January 31st, 2012

I have been on a low dose combination patch HRT (bio-identical estrogen, but synthetic progesterone , Climara Pro) for 6 weeks to address severe hot flashes lack of sleep crashing fatigue, severe vaginal dryness, hair loss and terrible joint pains and aches. it has helped tremendously but I find now the aches/pains and fatigue are coming back. and I feel like I am in slow motion, and have gained 4 inches around my waist, although only 5 lbs bodyweight overall, this is very disconcerning, as I have lost over 100 lbs 2 years ago and now I’m struggling to keep it off, when I had no problems until menopause hit! . all my blood tests were normal. I am age 51 and no periods for 2 years. my biggest fear is that I will feel like this forever and I will not be able to gain my energy back. a few months ago I was running 3 x a week, doing high intensity interval training, walking daily, weight training, felt like a million bucks and looked slim and much younger than my age. . It seems suddently I now look old, I feel tired and weak and have to push myself to do anything. it takes me 3 hours to get myself in gear in the mornings. please tell me there is hope and that bio-identical hormones will help me.

wellsprings | 10:01 am, November 30th, 2011

Karine – your symptoms have been present for quite some time and two months may not be enough to completely rebalance your hormones. So your instinct is right and if you keep on with the regime and monitor your progress you should see results. However, seeing a doctor experienced in natural hormone usage would also be helpful for more individual advice.

Dr Tony Coope | 10:05 am, October 14th, 2011

Gemma: I’m not sure what you mean by ‘the body does not need to convert it’, as progesterone has its own very important effects, but can also converted as needed into the stress hormone cortisol, estrogen, aldosterone which controls fluid balance in the body, and testosterone.
I think we need to have a conversation about all this, so I’ll e-mail you direct and if you like we can discuss it and I’ll hope to answer your questions.

Gemma johnson | 4:24 pm, October 13th, 2011

Dr Coope

Can you tell me where I can get natural Progesterone ,pro-juven cream or Progrest 1.5 Emeritas 1.5 as am told the body does not need to convert it and maybe better for me

Gemma johnson | 10:08 pm, October 8th, 2011

Dr Coope

Thank you for your reply , I have purchased a pot of natural progesterone
From wellsprings who also sent me an email saying that for the first month I should double the dose for the first month is this necessary would it not be too much considering the awful side effects from the hrt which were suppose to help when infact made the symptoms worse and this is what am worrying me.

Kind regards

Dr Tony Coope | 5:25 am, October 7th, 2011

Gemma: I don’t think you really need to find courage, just trust, – there is absolutely nothing to fear. It is likely that you had a low progesterone level for some time before your menopause. The estrogen in the HRT would then have not been ‘opposed’, giving rise to estrogen excess and further hormonal imbalance, and the symptoms you describe. In addition, any synthetic progestin in the HRT has the potential to exacerbate symptoms both of depression and those similar to PMS.
Bio-identical progesterone in action is a very different compound to the synthetic progestins, is very safe, and has opposite effects, so I really recommend that you try it. If you need any help with this, please let me know.

AnnA Rushton | 4:17 pm, November 22nd, 2016

Stacey you need to speak to whoever prescribed the cream for you, as normally progesterone applied correctly helps with weight loss and specifically water retention so it sounds as if you are simply not either absorbing or applying to the right areas. We don’t know what your doctor has suggested but below is the routine recommended for Wellsprings bioidentical creams:

AnnA Rushton | 8:58 am, August 8th, 2016

If you require more detailed help Karen please email for individual help with your symptoms.

AnnA Rushton | 9:21 am, July 8th, 2016

Felicia we can’t deal properly with such queries as they don’t relate to bioidentical hormones so please consult your doctor about your dosage and symptoms.

AnnA Rushton | 8:16 pm, June 18th, 2016

Anna certainly some sensitive women may experience sensitising of the oestrogen receptors but we suggest you do need to speak to your doctor again to discuss these symptoms.

AnnA Rushton | 10:24 am, June 6th, 2016

We cannot comment on your doctor’s actions Kris and your hormone levels did indicate low levels but 100mg of progesterone is a very high dose and we would have suggested 20-1, which is a combination cream containing both progesterone and oestrogen, as being more suitable as that delivers only 30mg of progesterone daily to rebalance hormones. You may want to stop all the hormones and see your regular doctor to discuss this with them as your reaction is severe.

Dr Coope | 5:12 pm, August 9th, 2014

Lisa: different tissues respond differently to the same hormones dependent on the number and receptivity/sensitivity of cell receptors of the particular tissue. It sounds to me that your ovaries and endometrium (lining tissue of the womb) are responding well to progesterone, but that this has also increased the sensitivity of estrogen receptors in your breast tissue, so you are experiencing an increased ‘estrogen effect’, – tender (swollen?) breasts. This usually settles after 2 – 3 cycles, but there may be a hidden factor here, related to your prolonged period of stress. This has probably depleted your adrenals, and the hormone DHEA as well as progesterone, causing an imbalance which may be difficult to resolve without restoring your adrenals to full function. Let me know if you wish at any time to discuss this further.

Joy | 6:11 pm, July 14th, 2014

I am now 51 years old and last year and was diagnosed 7 years ago with PCOS. Last year I first started with a bad bout of anxiety which came totally of the blue as I have always been so level headed and calm in how I dealt with things. This lasted two weeks but only came when I had missed my first period. This happen to me twice after this and both times was only associated when I was either late or missed again.
Last Aug I found serenity cream and started using it and found that I was loads better until the end of Oct when I started up with my anxiety blips again (not as bad but still noticeable). Sadly in Mar decided to start a 1mg dose of Elleste Duvet to try and get my old life back. This particular HRT gives you a monthly bleed.
Each strip of Elleste Duet 1 mg Tablets contains the active substances:
•16 white tablets containing 1 milligram estradiol (as hemihydrate)
•12 pale green tablets containing 1 milligram estradiol (as hemihydrate) and 1 milligram norethisterone acetate.
First month was bad whilst taking the white tablets but fine on the green ones. The next month was really good and my digestive problems also seem to improve aswell. Third month I started feeling flat from day 6 – 12/13 and then improved towards the end of the white ones and whilst on the green ones felt really good again. Forth month, fine with white ones until(day 11) started to feel stressed and flat again. My anxiety has just started to kick in again.
How would I know if this HRT is not doing it job, as yes I getting a monthly bleed but still getting flat times. During the white tablets I was able to use my serenity cream to help with these effects but use anything extra whilst on the green tablets. I feel really confused as I would much rather take the natural route but held onto the fact of hearing others saying that their lives have turned around for the better.

My main problems I guess is I lead a very stressful life and having to now deal with these changes in my life aswell.

Can you help with anything that may help me get my life back to the calm and happy person I used to be.

My main issues really is the feeling flat and low and full of anxiety which in turns effects my digestive symptom.

I believe my natural hormones are still be produced at the same time of me taking the HRT do think this could be where these blips arise and will it eventually balance out and how long should I give the HRT to help me with time before I give up and think of another route?

Many thanks in advance for reading this and for helping me make the correct decision. Joy

chelsea | 5:45 am, July 3rd, 2014

My name is Chelsea Sidaway and I live in Perth, Australia. I have just stumbled across this forum whilst browsing the net for information and advice regarding oestrogen dominance.
I have, after 5 years of issues, specialist appointments and incorrect treatments, finally found an incredible doctor who has diagnosed me as having oestrogen dominance, as well as hypoglycaemia and hypo pituitary.
I feel relieved to have a diagnosis, especially one that feels correct. I have been put on bio identical progesterone troches twice a day. I have been on these for three weeks now and am worried about progress. I am well aware hormone balancing takes a long time, but I am wondering how long it will be before I see some improvement in my symptoms? I have gone from 51kgs to 63kg. I am a small girl, ranging between size 8 and 10 and am struggling with breast swelling and size, as well as weight around the middle. I am both gluten and lactose intolerant and have a very strict diet. My diet and exercise regimes suggest I SHOULD be loosing weight, however this has never been the case. My body has been messed around with by hormones such as the pill and a pure oestrogen pill called progynova, as well as a weight loss drug called duromine. Although I am not overly large, I am struggling with my weight and the breast size of DD is really getting to me. They are also very sore and heavy, and since starting the progesterone this seems to be worse. I have read that this is normal and supposed to happen when first combatting oestrogen dominance, but I am looking for some reassurance or advice from someone who actually knows. I start DIM therapy next month for oestrogen detoxification, but just want to know how long I will need to keep being strong and staying positive before I notice any changes in breast swelling, size and overall weight gain.
Kindest regards,
Chelsea Sidaway

Dr Tony Coope | 5:19 pm, March 17th, 2014

Kim: if your progesterone and oestrogen have been low for a long time, then exposure to those hormones may have ‘woken’ up cell receptors which are now responding more strongly, creating a variety of symptoms until your hormones come into better balance. Usually the thing to do is to cut down the dose but continue until the symptoms stabilise, which may take from 2-6 weeks. If they don’t do this, then you need to be re-assessed.

Dr Tony Coope | 5:04 pm, March 17th, 2014

Janice: there is a lot of ‘info’ out there about progesterone that is very wide of the mark. Progesterone is a hormone made of proteins, but cannot be considered a food, even for candida, which in the body does do very well on sugar. The only connection between them that I can think of is that of Chronic Stress syndromes, where progesterone is often depleted due to the excess production of cortisol, which is made via a metabolic pathway which includes progesterone. At the same time, sugar levels are often raised through ‘comfort’ eating and the release into the blood of sugars stored as glycogen in the liver as a normal response to stress. Combine this with an inevitable reduction of immune system efficiency, and you have the ideal environment for candida overgrowth!

Lacey Rose | 3:03 pm, January 21st, 2014

Thank you Anna. . Again great info! However I am a bit concerned as my obgyn prescribed a higher dose of progesterone. .. not lower.

Lacey Rose | 6:26 am, January 21st, 2014

Dr. , your information is both helpful and reassuring! I recently started a regimen of 100 mcg of bio identical oral progesterone once a day. Over a period of a month and a half I’ve gained 7 pm lbs. My on gun swears it’s not the progesterone but water weight associated to the awakening of the estrogen receptors. So my question is what can I do to help this water retention and not aggravate my pre-existing hypothyroidism? Also this means I cannot take your advice of supplementing with indol 3-carbinyl. Cruciferous veggies are a big no no. So what then? Maybe just the milk thistle?

rachel | 7:53 pm, June 29th, 2013

Hi Dr. I had a question about progesterone cream. I am extremely obese and have Pcos and hypothyroidism. I do not ovulate . i have not been able to tolerate my thyroid medication as well. my age is 42. My saliva progesterone and estrogen results are that both hormones are extremely low. My saliva results for my cortisol are low across the board. What dose of progesterone cream do you recommend so I can build up my adrenals / cortisol and ovulate again? Whenever I use progesterone cream I quit the first week because the symptoms are so bad. The symptoms are migraines with aura and irritability. Thank you for your help.

Kelly | 3:49 pm, May 9th, 2013

I am 45 and having night sweats and weight gain mostly. I have tried some things with no luck. My physicians assistant put me on a mid dose of just estrogen as I have no uterus. I feel worse than before. I still have horrible sweats and can’t sleep worse than before. I also dream every night all night. I am achy and weak which I did not have before. I am on no other medications and otherwise very healthy. Any suggestions?

Dr Tony Coope | 8:35 pm, May 6th, 2013

Angie: I think the likely explanation here is that the initial dose of available progesterone was too low for you (you lose a significant proportion of the original dose through breakdown in the liver after absorption when you take it orally). This was therefore not enough to raise your progesterone to effective levels, but enough to re-sensitise your estrogen receptors to the (normal) levels of estrogen in your body. Hence the ‘excess estrogen’ symptoms of depression, irritability and anxiety. Doubling the dose of progesterone then restored balance, and the emotional symptoms improved. Restoring your hormonal balance to a ‘younger’ version often seems to result in a functional spring-clean, and it is likely that the spotting, especially of the old dark blood, is a sign of this happening. It may take a month or two to settle to normal, but I doubt that you will have to do anything more that wait, as this is, in my opinion, all good.

AnnA Rushton | 10:10 am, March 27th, 2013

Women take longer to rebalance their hormones depending on their previous conditions and level of oestrogen dominance and we cannot comment on your pill Kiki as oral progesterone (if it is progesterone and not a progestogen) is processed by the liver and absorbed differently by the body from the cream so you will not get the same results as you would from a cream. There will be no change in your thinning hair for some time as it takes around 6 months usually for hair growth to be apparent and you need to discuss this with your Doctor who prescribed it for you.

Kiki | 11:38 pm, March 26th, 2013

Hi. I have been on T3 thyroid medication and bio identical progestron pill for last 5 months. My fatigue brain fog and depression was lifted immediately but weight gain and hair loss has not resolved maybe even worsen. My doctor increased my progestron to 100 mg from 50 mg. it’s been 3 weeks but no change in my thinning hair and weight gain. What is going on? I am on some natural supplements for Adrenal support as well and my last blood work showed normal thyroid levels. How long does it take to have symptoms resolves completely?

AnnA Rushton | 11:09 am, March 20th, 2013

Rebeca we have asked Dr Coope about this and it is not clear if you are on progesterone cream as well as the ‘pills’, (Utrogestan?), or is it an estrogen cream or gel? His belief is that blood results are much more fluctuating and unreliable than saliva readings, and your symptoms after the first month could be due to estrogen receptors waking up under the influence of progesterone. If you are on two forms of progesterone, oral and cream, this is likely too much, and could be causing the problem.

We think your doctor is actually doing the right thing, by reducing your dosage, but to be clearer would need more specific information but doubt if stopping everything is the right answer. If you wish to have a second opinion or need more specialised advice on this please contact Dr Coope for a consultation, and you will find information on how to do that at this link 

pregnancy information | 8:45 pm, August 24th, 2012

I will right away grasp your rss feed as I can not find your email subscription link or e-newsletter service. Do you’ve any? Please permit me know in order that I may subscribe. Thanks.

Dr Tony Coope | 5:58 pm, May 11th, 2012

Catz: as an addendum to the above, the standard dose of the progesterone cream is calibrated to supply the body’s average premenopausal needs, which theoretically should be enough to slow or stop further growth of your fibroids. In practice it can be more complicated than this, but as progesterone is so safe, there is no problem in increasing the dose in the hope of shrinking them. Any concern about an ‘imprecise’ dosage doesn’t really stand up, partly because of the safety aspect and also because progesterone is an ‘intermediate’ substance and can be converted in the body to other vital hormones as well as the stress hormone cortisol.
So I am also sure that progesterone can be of benefit to you in this situation, and could also help reduce your tendency to migraines.

Catz | 3:07 pm, May 11th, 2012

I have fibroids, simple hyper-plasia, hormonal migraine and had an ovarian cyst (which led to an oopherectomy). All symptomatic of estrogen dominance. My Gyne wants to do a full hysterectomy and put me on hrt. I am following a more conservative route for the moment and will shortly start a bolus of progesterone tablets to hopefully kick start my ovary into producing progesterone again.

My gyn dismissed my using a natural progesterone as the dose would be too low and imprecise.

Would it be worth using progesterone cream after this? I’m not yet menopausal (46yrs).

Dr Tony Coope | 10:58 pm, January 31st, 2012

Neeta: it’s not easy to work out exactly what is going on here without knowing something of your past history. Your initial symptoms are characteristic of classical menopause, usually attributed to the decline in estrogen levels, but often the picture is more complicated than this, and the previous (and present) levels of progesterone can play a significant part in how you feel.
Your initial improvement is almost certainly due to the estrogen you are using, but the dose may not be high enough. The synthetic progestogen is limited in its ability to fully ‘balance’ the negative effects of estrogen, and in your case may well be part of the problem.
If possible, I like to know progesterone and estrogen levels before starting any form of HRT, and usually find saliva testing is much more helpful, but it would take at least two months off HRT for your hormones to return to their original levels, which with your symptoms would not be either practical or sustainable.
But I think you may well have a much better result using an estrogen-only patch or another form of estrogen, plus (separately) bioidentical progesterone, the dosage of each being adjustable according to your symptoms.
Do let me know if you need further help with this.

Dr Tony Coope | 10:18 pm, November 30th, 2011

Karine: just to say I agree with the advice given above to continue with your present regime, and to give it time. What stands out for me in your story is the link between significantly stressful events and the subsequent appearance of symptoms, – firstly the PID and uterine perforation, then your move back to the UK. If you have the same sensitivity that your mother had as regards stress or shock impacting the reproductive system, this could also be important. A possibility here is of borderline low levels of progesterone being further reduced by the knock-on physiological effects of stress, – most of your symptoms are suggestive of a ‘dominance’ of estrogen in relation to progesterone. This is why it is important to continue the progesterone, and I’m glad you are doing that.
It’s less clear what your estrogen levels might be, – it is possible to be estrogen dominant even with reduced estrogen, if your progesterone is lower still. If your blood tests were ‘fine’ this should mean that your FSH and LH were normal, ruling out premature ovarian failure and early menopause. I think you are very wise to turn down antidepressants and the pill, and I would hope that you will now gradually come back into balance.
If progress proves disappointing, then it would be important to have a saliva hormone screen, and also consider the possible role here of your adrenals, taking into consideration the stress you have experienced more recently, and also back in the past.

Karine | 10:08 am, November 30th, 2011

Thank you for your quick reply. I’ve actually ordered more progesterone from your company last night (and some for my mum!) and will keep at it another few months. I have confidence it works, I just want to make sure I do it properly. Thanks again!

Karine | 9:09 pm, November 29th, 2011

I am not sure if in my case things are getting worse before getting better: it’s hard for me to tell with my history and symptoms. After an operation following a severe case of PID after a doctor pierced my uterine membrane while installing an IUD, I started suffering from nightsweats until I discovered natural progesterone at age 33 (am now 35). I did have cysts removed during operation but doctors tell me even today that I don’t have PCOS, yet cysts remain in my abdomen and occasionally burst at ovulation. Before starting a little dose of 1 dab/day, I had monthly headaches, bloating, extreme depression during pms, insomnia and nightsweats. I also took many vitamins/supplements recommended in Dr Lee’s book which really helped. Everything went away very quickly and my cycle became very regular, and I stopped natural progesterone for a few months after and all was fine. After a stressful move back to the UK it appears my symptoms came back about 5 months ago (especially PMS and its 3 days of extreme depression – I am not normally depressed!) and so I have doubled the dose of natural progesterone as recommended in Dr Lee’s book and taking supplements again for 2 months now. I have been feeling wonderful and the extreme depression has magically vanished as soon as I started again. However, the nightsweats and insomnia seem worse, libido is non-existent, and although my periods are always fairly regular, the last one was rather weak and dragging on for 10 days. I have not had children yet, am rather thin and my mother started menopause early at 34 (although after an emotional shock), but doctors seem to ignore my concern as they say I still have a fairly regular period. My gyne here in the UK took blood tests and said my hormones were fine, and offered antidepressants and the pill, which I both refuse to take as I feel fine except those 3 days of monthly depression and the nightsweats… and surely that would not help my libido! Could these symptoms be a temporary effect – things getting worse before getting better? Could these be symptoms of estrogen deficiency as well, as Dr Bond mentions in another article where she mentions “groups” of symptoms? Or am I just clearly heading towards an early menopause? I’m just afraid of stopping the progesterone cream yet as it only just got rid of my extreme depression but at the same time… perhaps stopping a while would help? Any help is appreciated, I must have missed information somewhere…! Kind regards, Karine.

Dr Tony Coope | 9:08 am, October 9th, 2011

Gemma: the symptoms you experienced previously were side-effects from the HRT itself, excess estrogen and synthetic progestin, and would have likely continued as long as you were on it. Any symptoms you may experience when first using the progesterone cream will be nothing to do with the progesterone itself, but short-lived and temporary due to a re-sensitisation of estrogen receptors, as I have explained in the article. On standard doses, If this were to happen at all for you (it’s not necessarily to be expected), it should only last a week or two, disappearing once your progesterone levels have been restored to normal.
This is why it is sometimes recommended to double the dose initially, – it builds up the progesterone levels more quickly, and shortens the duration of any temporary symptoms if they occur. I usually start with a standard dose, and change it if these do occur.
The important thing to remember is that you will continue to have problems until your progesterone levels are restored, and this can’t happen until you actually use it. I repeat, it’s not the same as the HRT you had before.

AnnA Rushton | 10:23 pm, August 6th, 2018

Billee we are sorry but you need to discuss this with your doctor as you are under his care.

Billee83 | 12:58 am, July 23rd, 2018

Well I’m a bit confused, I am to use the progesterone only days 14 to my period beginning. This is month one. I am 34. My prog. was low, I had all the fun symptoms, and facial hair…I pray that goes away and doesn’t continue to increase. Anyway, my symptoms then came back after a few days of feeling great. I was told to double and possibly triple my dosage. Then do it again this month. My period showed up earlier than my apps predicted (it was irregular-ish for a few months so that may not matter) but I haven’t had cramps in about 4 years, and here they were. Sluggish, cravings, spacey. I usually get all clear headed, happy, motivated after a new cycle starts…not this month. The crazy/irritable etc. is hanging on. It’s like it waited for me to not have the progesterone. Not like it was awesome while using it last cycle. My doctor is well known for this therapy (not just locally, but nationally and internationally), so I’m confused why I’m reading a different approach here with the dosage. My husband and I would like more children, but now idk when we should start trying and if we did now if it would be successful, or if I should even be trying to balance these hormones until after we are done with children. So confused here.

AnnA Rushton | 10:57 am, December 23rd, 2017

Astrid we are very sorry to hear this but you must speak to your naturopath who prescribed this for you. Generally we advise staying on a vey small dab and very gradually building up – the symptoms you describe other than the bloating – which is related to oestrogen dominance – do not relate to progesterone so do speak to your therapist.

AnnA Rushton | 10:42 am, December 20th, 2017

Ami we can’t reply in detail here and have already corresponded with you by email about this so hope you have now received this.

Ami | 6:51 am, December 19th, 2017

Good morning

I started using natural biodentical progesterone cream about a week ago to try and help with my very irregular ovulation and luteal phase defect.

I’ve been getting a lot of PMS like symptoms (anger, anxiety) and also fan fog and tiredness. Yesterday I started bleeding to an amount that I would consider to be a medium flow but I know I haven’t ovulated so this isn’t a period.

Is this what is called a breakthrough bleed and if so what is that?

And my symptoms seem to be signs of an estrogen response to the progesterone. Is that right? And if so approximately how long will it take for things to level out and how much cream should I take in order to ensure my estrogen levels don’t remain dominant? I’ve read varying things so I’m a bit confused!

I’m also concerned about weight gain. Is it a common side effect or more of a secondary effect from some of the primary side effects? I.e. Lethargy, anxiety, depression etc wanting to make you eat more?

Thank you and I really appreciate any advice you have – I’m quite worried I’m going to end up making the situation worse.

AnnA Rushton | 5:34 pm, May 14th, 2017

This 2012 site refers to progestogens with HRT, not progesterone, and certainly the effect of bioidentical hormones is very different from that of the synthetic equivalents.

daniel1986 | 2:05 pm, May 14th, 2017
AnnA Rushton | 4:17 pm, November 24th, 2016

Stacey if your Doctor has made this recommendation you must speak to them about they wish you to use it.

Stacey | 10:39 am, November 23rd, 2016

Thank you soo much for this. Ive been using my wrists to apply 1ml of cream to the insides of my thighs at night only. I havent been ulternating.

Stacey | 1:03 pm, November 20th, 2016

Hi There, I am currently 27 and was diagnosed approximately a year and a half ago with turners syndrome. This has put me into early menopause (with every possible side effect). I have been given bioidentcle progesterone cream which I have been using for about a month and a half now. Symptoms haven’t yet improved which I think is a time thing. What I have noticed is i have started to put on quite alot of weight and retaining alot of water (which has me feeling uncomfortable and really down). I’m wondering if this is a normal response? Will it subside and balance out allowing my weight to even back out and fluid retention to disapate? My doctor was talking about an oestrogen, progesterone and testosterone bio identical blend and I am really unsure what is the best option for me. Any help you are able to provide me I would be very greatfull. Thank you so much.

AnnA Rushton | 4:01 pm, November 16th, 2016

Katy oral progesterone is completely different from a bioidentical progesterone cream as it is normally in a very high dosage and they work differently in the body as the oral form has to pass through the liver. We cannot advise you as you need to consult with your own naturopath as to these symptoms based on her recommended dosage. As you have signs of oestrogen dominance stopping progesterone won’t help you but may be time to consider another form.

Katy | 1:06 pm, November 16th, 2016

Hello. I am a 43-yr-old with endometriosis, PMDD and recently had uterine polyps removed for the second time. My naturopath put me on 200 mg of oral progesterone with a goal of suppressing ovulation and controlling endo symptoms, and then reducing the number of days and dosage after 6-9 months. I’ve been doing this for three months, and though my mentrual pain is getting better, my mood symptoms have never been worse. On the day of my ovulation I’m consumed by fury and for the next two weeks I’m overwhelmed, hopeless, can’t stop crying. Based on your article, can I expect these symptoms to pass as the progesterone starts to override the estrogen? Or should I discontinue the progesterone? Thank you for your thoughts.

AnnA Rushton | 9:50 am, September 24th, 2016

Cathy you need to speak directly to your doctor about this as we cannot advise on your medication, but generally hormone creams are best applied in rotation otherwise the receptor sites become saturated. Dr Mercola in the USA advises internal vaginal application so you may wish to discuss this with your doctor.

Dee | 5:42 am, September 7th, 2016

Sounds like you may be deficient in magnesium and vitamin b12.

AnnA Rushton | 9:32 am, August 21st, 2016

Michele you would be best speaking to the doctor who prescribed your BIH s you may need the dosage adjusting and some of these symptoms may not be related to your hormones but other causes.

AnnA Rushton | 4:57 pm, August 13th, 2016

You may need to consult with a bioidentical doctor for individual help Karen with these reactions and symptoms.

Karen | 9:18 pm, August 9th, 2016

I tried bio.identical.progesterone cream .I had severe hypotension. ….I couldn’t sit up without blacking out. .I felt same pms stuff bad. I tried diff. Dosages sick .took a course of antibiotics to help me …I am feeling so pms it’s awful. It’s been 15yrs
Not just yesterday.. tried so many things nothing works I need help.

AnnA Rushton | 8:57 am, August 8th, 2016

You are on a synthetic progestin with your HRT Karen, not progesterone. If you wish to come off it please see the article below but you should consult your doctor about these very severe symptoms.

demetrice1984 | 9:49 am, July 26th, 2016

I don’t agree
Best regards, Demetrice

Felicia | 5:37 pm, July 7th, 2016

I also did stop taking the birth control May 2, so I realize things are still out of whack.

Felicia | 5:32 pm, July 7th, 2016

Hello! I am a 29 year old mom of two. I had my second baby (a boy) in September and went back on Ortho tricyclene lo in February. About a month later I had awful anxiety, insomnia and palpitations. After no luck with my primary dr I found a holistic dr who tested all of my hormone levels and she found that my pregnenolone was low (29) progesterone is .4 and my cortisol was high. I am now taking a new multi-vitamin, DHEA, Pregnenolone, L-Phenelalanine (not sure if I am spelling correctly) and was supposed to take 100 mg of Prometrium at night for the first 13 days of my cycle and then days 14-28 take two. I noticed an improvement last week but then when I went to take two, I noticed I was up all night. I then went back to only taking one. I have only been taking it for 16 days. I just wonder what is a normal time frame to see improvements with my sleep? Also, should I give the 2 doses a shot like she told me to or stick with one for a while? Looking for advice as far as a time frame of when improvements should stick around for good. Thank you!

AnnA Rushton | 9:38 am, June 29th, 2016

Which link Felicia?

Felisia | 5:13 am, June 24th, 2016

Nothing found for the link you provided.

Anna gough | 11:15 am, June 18th, 2016

I feel the same and have the same questions X I’m a chronic headache sufferer anyway and I have just restarted bio identical hormones again. Initially it was a cream with a little of everything but my body heat and headaches were still bad. When I went back to see the doctor she suggested as my progesterone was v low and not in ratio with esteogen that we add some of that at night time. I can say I have felt worse my head is worse the panic the fear and I hate it. I have read though that initially this can happen as the esteogen almost reignites when you add progesterone to balance things so I’m praying this is the reason. I can almost Cope with the daily headaches but not the panics and fear and mood X

AnnA Rushton | 8:16 am, May 29th, 2016

Katie please email for individual help with your symptoms.

Katie Starr | 10:37 pm, May 26th, 2016

I’m 51 and started menopause fairly early a few years ago. I haven’t had a period in at least two years. I have been having hot flashes, etc. I started using a progesterone cream (1/4 tsp daily) and a lot of the menopause symptoms have decreased or have been eliminated! However, I have been using the cream for 3 weeks tomorrow, and have been bleeding for about 12 days now. It started out as what might be called breakthrough bleeding for about 6 days. Not super heavy, but I did wear a regular pad. Then it stopped for one day, and then a for real, regular period started and hasn’t yet stopped. Will this go away? Should I just stick it out?

Kate Severinsen | 12:42 am, May 15th, 2016

I cannot thank you enough for this article!!! No advice needed as this article is explanatory enough, but I’m going to share the short version of my story in case it helps someone else. I have been on BHRT for 3 months and have had trouble with the progesterone (bloating & general GI discomfort), but all the other articles I found on the internet said there were no side effects to bioidentical progesterone.

Until I read this article I was unaware of the phenomenon of estrogen dominance. And it completely explains what happened to me. I went off BCPs 7 years ago (at 53) because I had gone a year with no periods. Immediately after getting off the pill I started having regular heavy periods which I found quite shocking since when I was younger I had always had light and irregular periods (one of the reasons I was on the pill). Some further searching on estrogen dominance after reading this article indicated that the new heavy periods were anovulatory cycles which caused my estrogen dominance.

Then finally just after my 59th birthday I started getting the “official” menopause symptoms of hot flashes. Meanwhile my previously well controlled asthma went out of control and no medications helped and I could hardly breathe. Finally a chance internet search on asthma and menopause revealed that the onset menopause with it’s fluctuating hormone levels can severely effect some women with asthma. And the treatment was straightforward: I needed BHRT and some anti-anxiety medication to help me deal with the very tight chest until the BHRT kicked in. Of course my mainstream pulmonary doctor and gynecologist didn’t believe this was a valid treatment, nor could they help me. Although they were very judgmental they did mercifully prescribe some anti-anxiety medication. Then my acupuncturist was able to recommend an Integrative Medicine primary care doctor and they started me on BHRT. Within 3 weeks of the BHRT I was breathing normally and no longer needed the anti-anxiety medication. Then I was also able to decrease the corticosteroid levels needed to control my asthma. Another benefit of BHRT.

However I am still working on the right hormone doses. I did drop the progesterone dose because of bloating and diarrhea but I got that straightened out with probiotics, supplements and acupuncture so I am now gradually increasing my dose of progesterone again. The bloating is increasing again but now I know to be patient while my hormone levels adjust to the higher progesterone.

Again, I can’t thank you enough for this article. Finally having an explanation for my experiences is a wonderful thing!!

Susan Collins | 6:44 am, May 12th, 2016

Had a hysterectomy 16 yrs ago, prescribe p remitting hrt, stop taking 9 months ago, Doctor reintroduced them to me last month, have now started a period, I am 68 years old, is this normal,. Thank you for your advice.

Connor | 2:46 am, December 7th, 2015

I know this article is meant for women, but I’ve started using a low dose(10-20mg) of topical progesterone for gynecomastia.

I’ve noticed huge mood improvements, feeling more relaxed and my libido has improved but the gynecomastia is getting worse.

I wonder if this is just temporary while the progesterone resensitises my estrogen receptors? I’ve been using it for 2 weeks.

I had prolactin levels above normal and progesterone is definitely helping with that.

AnnA Rushton | 9:37 am, November 30th, 2015

Josephine we can’t comment on medical procedures, but you are on synthetic hormones which can have side effects such as you are describing. For hormone imbalance bioidentical hormones do not have side effects so you may want to look at using a more natural form of these essential hormones. You may find the following article helpful:

AnnA Rushton | 9:05 am, November 11th, 2015

Fawn approximately 80% of oral progesterone is intercepted by the liver and conjugated by glucuronic acid for excretion in the bile. Additionally, oral progesterone will produce a sharp rise in serum progesterone levels followed by a rapid drop in serum levels within several hours. None of this applies to cream formulas which are of much lower dosage and have no side effects. It is not the hormone, but the amount and how it is delivered that has caused your problems. Certainly headaches can be linked to oestrogen dominance, and rebalancing with progesterone can help with this, and you may find this article helpful:

Fawn | 1:05 am, November 11th, 2015

My doctor put me on an oral progesterone supplement for headaches and after the 2nd month I woke up in the middle of the night with extreme abdominal pain which turned into constant nausea, indegestion, and bloating with stomach cramps for 3 weeks now. I’m miserable! I have not taken any more for 3 weeks and am getting worried it is something else. I even got a scope of my stomach where gastritis was found. I’ve heard this hormone can cause this but I’m just worried. Is it possible that this could be from the hormone?

AnnA Rushton | 7:57 am, May 30th, 2015

Cathy we have no information on oral progesterone as it is processed through the liver, unlike cream formulas, and in this way some will be lost. You need to speak to your doctor again.

Cathy | 4:52 am, May 28th, 2015

I have adneomyosis and fibroids which have me to have an very large uterus 14 cm. I have had several blood transfusions. I have tried bioidentical progesterone cream and it did not help with my heavy bleeding. I recently went on Megace for a week which stopped the bleeding and then my Dr. switched me to 100 mg. oral bioidentical compounded progesterone. He told me to up it to 200 mg daily if I start bleeding. I did start bleeding after about 5 days on the 100 mg. How long would it take for the 200 mg of the oral progesterone to stop my period? They prefer me to take the bioidentical over Megace but not sure if it will work for me.

AnnA Rushton | 11:44 pm, August 12th, 2014

Joy your HRT does not contain progesterone but a synthetic progestin but this article will help you come off your HRT safely and slowly. It is not a good idea to continue your progestin part of the HRT while using natural progesterone. They both compete for the same receptor sites in the body and will both be less effective.

Joy | 6:02 pm, August 11th, 2014

I have been a continuous combined HRT for 5 months and have now decided to come off and restart back with the serenity cream which I had great results last summer. My periods came back to being regular (28 days) until Oct when I had a 21 day cycle. Before starting with the serenity cream I used to be anything from 21 – 25 days so use to start using the cream on day 11 but when with the 21 day cycle I should have started on day 7. Not knowing anything of this info I decided stop using the cream and start using the HRT in hoping that it would help with my anxiety which I had only started last year on 3 occasions when either my periods were missed or just very late. Before this I was happy go lucky and never sat and worried about my health.

With your help I am hopefully going to get my life back by asking how I can come off the HRT. I am due for a bleed this Friday so will be at the end of the progesterone (14 days) part and on Sat due to start the next 14 days oestrogen. I know that I can use the cream a long side the oestrogen but how do I start to cut these down and then can I stop the progesterone tablets all together and continue to use the cream instead?
Your help and guidance will be much appreciated.
I think I may be oestrogen dominance as I have was diagnosed with PSOC 7 years ago and my sinus have really be badly effected since taking the HRT.
Which cream to suggest that I use the 20-1 or the serenity with this in mind. The main reason for starting the HRT was because of the sudden anxiety which started last year and hoped this would help with that but it hasn’t hence why I want to start back with the serenity cream. Thanks Joy

Lisa | 3:45 am, August 6th, 2014

Dr. Coope~ Thank you for such a wonderful article. I am 29 and have a history of Endometriosis, PCOS and firbrocystic breasts. There was a six year period of my life that I was under almost constant extreme stress – so I think that might have something to do with what brought this all on. I started using bioidential progesterone two cycles ago and it seems to be helping a lot with lighter cycles and my PCOS. The one issue that I’m still having (actually it seems to have gotten worse) is very sore breasts between ovulation and my cycle. How long does the initial adjustment period usually last? I am confused on if I should dial back my progesterone use or step it up to get over this “hump”. Your guidance would be greatly appreciated. Thank you so much for your time.

AnnA Rushton | 12:40 pm, July 30th, 2014

Lisa a combined cream can help with more severe symptoms so would be worth tying.

Lisa | 2:22 pm, July 23rd, 2014

This cream is wonderful … except 4 my night sweats !! It’s literally cured the mood swings – depression – heavy periods etc etc & I wouldn’t say if it wasn’t good as I think it’s misleading & unfair we suffer enough!!! So I was wondering if I purchased the other cream you do with oestrogen would that help the night sweats at all as they are a real issue ??? Many thanks

AnnA Rushton | 10:38 am, July 15th, 2014

We are unable to reply to such detail here Joy, please email this to who will be able to help you.

AnnA Rushton | 12:29 pm, July 3rd, 2014

It is not always the case that symptoms get worse on using progesterone,generally only in women who have had severe oestrogen dominance which given the different forms of oestrogen you have had is likely. You need to reduce the dosage right down to a tiny dot and build up slowly and unfortunately women vary enormously in the time it takes to rebalance their hormones, some respond immediately but others can take several months.

chelsea | 5:46 am, July 3rd, 2014

I should probably also add that I am only 23 years of age and this is severely limiting my daily life.

Christina | 10:25 pm, June 27th, 2014

Thank you so much for this blog!! I have been using bio-identical estradiol 2.4 mg (2x day), progesterone 200mg (1x day) and testosterone 2mg (3x week) for almost three years. After an initial adjustment period the creams worked well to balance hormones, eliminate hot flashes and reduce headaches. I have a history of chronic pain due to a failed hip replacement and osteoarthritis in several joints, so aches and pains were not alleviated. Suddenly, in the past 2 months the hot flashes and severe headaches have returned in vengeance. I am embarrassed at work by profuse sweating at least 7 to 8 times a day. Insomnia is also worsening. There is a history of hypothyroidism in my family and my blood tests show mildly elevated thyroid levels. The g/yob had been trying to regulate things with various supplements (which are purchased through her office) many of which made me feel sick due to them supposedly rising and lowering my cortisol and adrenal levels two times per day, so I have discontinued taking those supplements. To complicate matters, my gy/ob has stopped processing insurance claims which has forced me to find a new gy/ob who does not “seem” to be as knowledgeable as my previous gy/ob. However she has recommended only using the estradiol one time per day instead of twice and is retesting my thyroid levels. She spoke of “taking some time to figure out my “whole picture” but I’m not sure I can wait for her to figure it out. I’m questioning whether I should move on to the next level and find an endocrinologist in my area?

AnnA Rushton | 4:11 pm, June 20th, 2014

Kathy we are unable to comment on your product specifically as we have no knowledge of it, but progesterone normally improves sleep so we recommend you contact the manufacturer for their advice. Worsening symptoms are usually a sign you should stop the product or seriously reduce the dosage and yours indicate oestrogen dominance so clearly you need more information from them.

kathy | 6:19 am, June 20th, 2014

I am so desperate for help with dosage. I have been taking an a.m. and p.m. 20 mg recommended dosage of Life-flo Progestacare-care progesterone cream for 1 month for severe hot flashes and insomnia. The first week I had less severe and less frequent hot flashes and improved sleep. But the 2nd week my hot flashes and insomnia worsened and continue to do so. Is it safe and helpful to increase the 2 daily dosages, as I’ve read? How much should I increase or should I stop the cream? I now have dizziness, bloating, xerostomia and abdominal weight gain. The feedback is confusing. Thank you so much for this website and your response. I appreciate it. Kathy

Dr Tony Coope | 2:41 pm, April 14th, 2014

Donna: our ideas of what is happening hormonally in a situation like yours is limited by our training, our insights, and what we have come to believe from our own experience. What is actually happening may be much more complex than we can easily conceive. The relative effects of progesterone and oestrogen can be thought out, but by the time we have added the variable influences of receptor sensitivity, adrenal depletion, continuing stress and emotional factors, the picture is much less clear. Protocols have their uses, but individual variation ensures they will not always be appropriate. It is often helpful to have saliva measurement of hormonal levels (serum values are much less reliable as these hormones tend to be fat-soluble), but in the end your own body is your best laboratory, and you can work out your own best balance by intelligent trial and error, changing dosages gradually, refining according to any improvement or deterioration in symptoms until you have found a satisfactory point. This may take a while; over time, change may happen spontaneously , and re-adjustment may be necessary. But for now, I think your conclusions are reasonable and worth exploring, – you may well notice a difference within a week or two of any changes you make.

Donna Green | 12:38 am, April 14th, 2014

I was on the wiley protocol for seven years with good success. (This is rhythmic dosing, two weeks on progesterone, estrogen all month and then an
induced period)
I went througha long period of stress with lots of anxiety and tremors cuz of a med a doc put me on. My adrenals were already low, btw

My ND decided to put me on
static dosing, because for the most part my anxiety
disappeared during progesterone weeks and came
back on estrogen only weeks.

So now I am on static dosing
(same amount of pro and estrogen everday)

It hasbeen one week and my anxiety has put me in bed with
chest pains.

Your article was written for me. It makes so much sense, esp the exhausted and over-reactive part….thats me. My Nd
cranked up my progesterone and made me worse.

This switch over from rhythmic
to static has put alot more progesterone into my
systemthan I ever had before. So I am thinking of loweringmy
pro, even tho my ND thinks the more progesterone the better.

Is this a reasonble conclusion
and how long do I wait if I should not get relief? A week? Then lower it again? I dont know the balance is.

Thank you so much for this insightful article.

Janice | 9:33 am, March 17th, 2014

Hi, my research tells me that Candida lives on progesterone, and lowers eostogen. This surely is important with all the sugar everywhere in food.

AnnA Rushton | 4:59 pm, March 16th, 2014

We can’t comment on your cream Kim as we do not have any cream with testosterone it it. You need to speak to your gynaecologist about the reaction you have had and it is not dangerous not to take HRT but there are a number of health risks associated with it such as increased cancer, stroke and heart disease risk.

Kim | 3:15 pm, March 16th, 2014

Hi. I have recently been suffering from hot flushes and weekness. I saw my Gyne who tested me to find my Oestradil <44. He put me on Esraphem very low dose but it made me Sick. I then heard of biodentical hormones and saw a doctor on this who tested me and told me all my levels were low and then prescribed cream which has allow dose of est, prog and test. I had a hysterectomy 10 years ago but kept an ovary which is slowly giving up. Why is it when I take this cream my hot flushes are worse and I feel more emotional than when I am not taking anything ?I feel better without hormones. Is it dangerous not to take hrt?

AnnA Rushton | 10:53 am, January 28th, 2014

Progesterone is associated with weight loss Lacey as it acts as a diuretic, see the book ‘From Belly Fat to Belly Flat’ by Dr C W Randolph. Certainly oestrogen is associated with weight gain but speak to your doctor re your progesterone dosage.

Aimee | 8:08 pm, November 25th, 2013

Hello, I am 43 and have been taking bio-identical compounded progesterone and testosterone cream since Aug. I have gained almost 7 pounds, and I have not weighed under 131 lbs since then, whereas for the last 6 years, I have only weighed that after a week of ‘binging on vacation”! I usually weigh between 124-127lbs. My doctor has tested my hormone levels twice, both times said I was too high in estrogen too low in progesterone and testosterone. I started with 20mgs of prog, then 40, now am at 80. Have been on that dose for a week. Testost. has increased from .25 to .5. I feel lethargic, I force myself to lift weights and go running, but I am anxious, stressed and tired. I had an adrenal saliva test done, my rhythm was backwards on cortisol.

I feel like the cream is keeping me from returning to my regular weight. I had a DEXA scan in April and I was 121lbs, 22% BF. In Aug, I scanned at 30% and weighed 133. I want to stop taking it, but am wondering if that’s the right thing to do. I had an ablation in 2008, so I do not have periods anymore. My sex drive is minimal, and I don’t know how they can tell where I’m at in my cycle for the hormone tests. I am worried the cream is the culprit, yet wondering if it’s too little a dose. They also started me on Metformin last week.

Can anyone help?

Dr Tony Coope | 8:56 am, September 6th, 2013

Megan: there have been studies which show that there can be benefit from taking progesterone orally, but it is generally accepted that only up to 25% of the hormone is absorbed, the rest being broken down into metabolites by the liver. Some of these have an effect, but this is variable from person to person. My feeling is that absorption via skin is much more reliable as it goes straight into the bloodstream and fat stores, and so requires a much smaller dose.
Your progesterone levels may be low because the synthetic progestin part of Yasmin, drospirenone, is structurally close to progesterone, (although it lacks many of the beneficial effects of progesterone, as well as having potential side effects of its own). This means your metabolism may have removed much of your progesterone, seeing it as excess. Restoring your progesterone levels could help with the acne, discourage migraines, suppress some of the symptoms of endometriosis, and return you to a ‘younger’ hormonal balance, which may mean the reappearance of your periods. My preferred method would be the cream, which you can use for a 3 month trial period before taking stock, as results can be either startlingly quick, (2-3 weeks) or frustratingly slow (2-3 months). Let me know if you need any guidance.

meg | 11:57 pm, September 5th, 2013

I am a 29 yo with previous hx of endometriosis. I have been on yasmin for a number of years and came off of it in January (suffering migraines) I had ‘periods’ until May and since then, nothing- except acne, insomnia, and pain when i sneeze/cough on my R ovary side! My Dr completed a series of blood tests which showed everything was within normal limits except my progesterone, which was pretty much non existent. He has put me on 50mg progesterone tablets (from a compounding pharmacy) for 5 days, then increase to 100mg for 5, then 150mg for 5 days then break for a week. Will this return my periods and fix my acne? how long until i see results? Or would i be better on a cream? my dr didn’t go into much detail, just handed me a rx….
Thank you

megan | 10:41 pm, September 5th, 2013

I am a 29 yo with previous hx of endometriosis. I have been on yasmin for a number of years and came off of it in January (suffering migraines) I had ‘periods’ until May and since then, nothing- except acne, insomnia, and pain when i sneeze/cough on my R ovary side! My Dr completed a series of blood tests which showed everything was within normal limits except my progesterone, which was pretty much non existent. He has put me on 50mg progesterone tablets (from a compounding pharmacy) for 5 days, then increase to 100mg for 5, then 150mg for 5 days then break for a week. Will this return my periods and fix my acne? how long until i see results? Or would i be better on a cream? my dr didn’t go into much detail, just handed me a rx….
Thank you

Dr Tony Coope | 10:00 am, August 5th, 2013

Sarah: thank you for that. As you come up to menopause, this makes it more likely that this is due to hormonal fluctuations, especially influenced by the stress you have experienced. It is still important to have the ultrasound to exclude endometrial thickening, fibroids, polyps etc, but my feeling is that you don’t have too much to worry about. If you can stay off the Serenity until this is done, and for at least 6 weeks in total, then it would be helpful to have a 1-day progesterone/estrogen saliva test done to establish your hormone balance at this critical moment. It would provide the information required to know what specific steps need to be taken to get you back in balance. If you need help in arranging this, please do not hesitate to contact me.

Sarah | 7:39 am, August 5th, 2013

Hi doctor . My history is I am 49 and my periods up until a year ago became very erratic and heavy and then nothing for a few months when heavy Iean flooding .. I have not had children either .this year from September they have oractically stopped .. But hot flashes started and got worse around march when I started serenity .within 2 months they had gone .

I am extremely healthy , run , surf 5.7 and 9.5 stone .. Eat a healthy diet take menopause natural vis and cod liver oil .. I have joint pain in hips and back quite regularly but mainly the back pain coincides with a period .. The last one being in April snd now again , coinciding with this current bleed .

I did have open heart surgery when 4 buy doubt that is anything to do with it . My mother passed away 2 years ago which was stressful and seemed to coincide with earlyish menopausal symptoms

Dr Tony Coope | 9:58 pm, August 4th, 2013

Sarah: I don’t have any past symptoms or history to clarify things here, – your menstrual history, where you are in relation to the menopause etc, but the most likely thing is that this is due in some way to your hormone balance, probably related to achieving that with the progesterone, but undermining it with the stopping of the cream. It suggests that you may have had a low progesterone for some time, culminating in a thickening of the endometrial lining of the womb, or fibroids, which increase its surface area; either of these could explain why you had such a dramatic bleed; but the ultrasound should clarify the diagnosis, which is important here. Once that is clear, you may wish to seek help to establish the next steps.

tc22009 | 6:13 am, July 16th, 2013

I am 28 years old, and own and run 5 businesses, my stress levels peaked last year making my mood swings severe, psychotic and often. i had my hormones checked and it said i was at the level of a premenopausal woman. I then started taking heavy doses of progesterone cream. I gained 12lbs in 2 months (alot for me!) but i was happy again. i got off the heavy cream and switched to a regular dose, it seems like my hormones have leveled out, no more psycho but i cannot shake the weight. anytime i use the cream i bloat so bad i cant wear any of my clothes and its making me depressed.

i am a healthy and active person, workout regularly, but have a lot of stress. my hormone tests also showed high cortisol at night time and now i’m taking rhodiola for that. still no weight loss. do you have any advice for me? thank you so much!

Dr Tony Coope | 6:13 pm, May 15th, 2013

Nancy: straightforward atrophic vaginitis almost always responds to local estrogen, – it definitely shouldn’t get worse. It sounds to me that you have an infection such as thrush (Candida), which is likely to be made worse by estrogen. Progesterone does have an anti-inflammatory effect, so may ease the swelling and discomfort (as in your case?), but it will not cure it. Your best plan is to see your Dr again, have a vaginal swab taken to identify the cause, and then treatment appropriate to what is cultured, whether it is fungal or bacterial.

Lucretia | 10:35 pm, May 14th, 2013

Great article, just what I was looking for.

Here is my web-site: heart disease is 1 killer of apes in captivity

Nancy | 6:53 pm, May 13th, 2013

Dr. Dr. Coupe,
Rencently I have had low grade burning and vaginal soreness. My Dr. increased my estrogen and I got worse for the last several weeks.
I am a 6 plus year user of HRT. Recently I started having severe uterine burning and swelling. This past Friday I choose not to use progesterone and on Saturday I was inflamed and had to lie down with an ice pack to get though the day. The progesterone seems to help. If I am opposite from most women and get burning and swelling from to much estrogen, how long would it take to see relief if I discontinue estrogen for a week or so. Thanks for your advice, my quality of life is terrible.

Kelly | 4:27 pm, May 9th, 2013

Thank you that was interesting. My physicians assistant wasn’t completely knowledgable about it all and just threw me on an estrogen pill. I’m looking at getting the wellsprings cream and trying. I feel like the estrogen is unbalancing me more than anything.

AnnA Rushton | 4:05 pm, May 9th, 2013

You are having unopposed oestrogen Kelly which leads to oestrogen dominance so rebalancing this with some additional bioidentical natural progesterone would help. You might also find this article helpful to read: 

AnnA Rushton | 8:53 am, April 20th, 2013

Progesterone normally helps reduce hormonal weight gain Natalie so this is not usual. If your other symptoms are responding well, then it is not likely the gain relates to our hormones. If they are not please email to with more details of your symptoms and the name of the cream you are using.

natalie | 6:34 pm, April 19th, 2013

Hi, i have been using a natural progesterone cream for 3 months, I have gained about 15 pounds…I was wondering if that is normal, i have read that , sometimes your symptoms get worse before they get better, but i am already over weight, so it is concerning me that i am gaining more weight. Thanks!

dr coope | 11:04 am, April 7th, 2013

If you have had no positive results then clearly it needs a rethink although consistency is important when supplementing with hormones. Your symptoms indicate low levels of progesterone so if you on a combined product you may wish to discuss going on to progesterone only and ask your Doctor to do detailed blood tests to show you exactly what level of both oestrogen and progesterone you currently have. If you still have more oestrogen than progesterone that indicates oestrogen dominance.

seeking help | 6:37 am, April 7th, 2013

I have been on bio identical for 5yrs now and it hasn’t worked at all. The Dr gave it to me when i had to have a complete hysterectomy. I still get really bad hot flashes, weight gain, very tired and have memory loss. I’ve gone off and back on them for yrs. Hoping that they might work. I just don’t want to be tired anymore. They have tried different does but it hasn’t worked. Any ideas?

Dr Tony Coope | 8:27 pm, April 4th, 2013

Brenda: I’m reminded of the old saying: ‘Too many cooks spoil the broth’. This is a very complex picture, and your doctor seems to be unravelling it admirably; but it takes time, with some ups and downs along the way, and it’s really a job for one person, not a committee, because it needs that person to work it through until everything is understood in its right place. At this stage of the process, it is not clear why you are putting on weight to this degree. Your story suggests repressed emotions and much stress, which of course affects the adrenals and your insulin sensitivity, so it may be helpful to ask your doctor about extra adrenal support (the DHEA is part of this), and for you to contemplate your past emotional history with the aim of resolving any major issues and unfinished business there. Good luck!

Brenda | 5:47 pm, April 4th, 2013

Oops just to add, my adrenals are barely functioning after a severe flareup of colitis that took 3+ yrs to control.

My t3-4.9pmol/L, t4-11.7pmol/L, TSH-2.37 mU/L.

In addition, my previous physician had me on 50mg of progesterone cream @HS but it gave me migraines she reduced to 20 mg but migraines continued. My new physician says I am extremely sensitive to progesterone which is why he started at 6.25mg and gradually increased dosage. So what to do??

Brenda | 5:26 pm, April 4th, 2013

Hello Dr. Coope,
I am 51 yrs old and have been in perimenopause for 8+ years. I saw a physician who specializes in HRT. After many blood and saliva tests he found that my estrogen was extremely high and my progesterone extremely low. He prescribed DHEA 5mg as well as bio identical progesterone at a compounding pharmacy. I recieved 6.25 mg progesterone caplets and was to start with one pill at HS and increase by one pill q3days until I felt significant relief. (better sleep, mood, increased energy and mood) I felt relief within a couple days @ 6.25mg(mainly improved sleep) but have increased to 18.75 mg @HS. I feel like a new person!!! However I am steadily gaining weight and I am not happy about it. I am not eating more I am actually eating less but better quality foods(whole foods). I also walk 4-6 times a week. He also prescribed 602mg vit b complex tid, vit c 250mg tid, vit d3 1000mg od,omega 3 oil 1000mg od, magnesium/calcium 167mg/333mg tid all which I have started. He also prescribed indole-3-carbinol 150mg bid and flora care(high quality acidophilus for my colitis(now under control with many medications including injectable immuno suppresive drug) but I havent started these 2 supplements yet. What can I do to decrease this weight gain (15lbs in a month with significant bloating and increase in my mid section)
Thanks for your words of wisdom!!

Rebeca | 12:31 pm, March 20th, 2013

I take both pills and cream, both natural compound for me. But I will contact to Doctor for a consultation. Thanks. Rebeca

Rebeca | 5:21 pm, March 19th, 2013

Hi Dr. I am 42 years old and I started natural hormonal replacement about 4 months ago due to low progesterone. First month I was doing great but by the sencond and third months I started bleeding heavily in the middle of my cycles. I am working with an anti aging doctor who believed that I needed more progesterone until a blood work came back with way too high progesterone and estrogen. We decided to lower my progesterone pills and cream. My question is, should I quit the pills and cream to reset my body and for how long?
Thanks, Rebeca

dr coope | 12:51 pm, March 15th, 2013

Pam please send your query to and we will do our best to help you. If you feel you need more specialised advice on this, then Dr Coope is available for personal or telephone consultations.  If you wish to explore that further, you will find details here: 

Pam | 11:48 am, March 15th, 2013

Im 53 and have been battling hormones for the last 3 years. I’ve taken progesterone 8% on and off for these 3 years. Tried numerous supplements. The end result I gain 5 to 6 in and pounds in the middle, legs get horribly swollen….ending in stopping everything. I know for a fact I’m estrogen dominent, very low progesterone and low testosterone. I’ve tried DIM, I3C but then my body really goes crazy. Did probiotics for awhile too, NOTHING seems to work. I have vaginal dryness they gave me a estrogen cream to apply to vagina, after a time this makes me feel like I have a constent bladder infection, please help me!!

dr coope | 11:32 am, March 7th, 2013

Capsules are processed by the liver so you may find you get better absorption from a progesterone cream like Serenity. may well be that the cream would absorb better,

You do need a full thyroid screen and therefore the diagnosis is incomplete, such as you may have an auto-immune thyroiditis going on. Or there may also be an underlying adrenal exhaustion or insulin resistance which is sabotaging everything. Very tricky to give a specific opinion, so we suggest you put these possibilities to your doctor rather than try anyone new.

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wellsprings | 3:19 pm, May 11th, 2012

Catz – certainly worth trying bioidentical progesterone cream as your fibroids are linked to oestrogen dominance and this may not be resolved just by removing the fibroid.

Progesterone will protect you from breast cancer, heart disease and osteoporosis so certainly worth considering. It would also be worth reading Dr Shirley Bond’s article on oestrogen dominance at this link and also

Karine | 3:39 pm, December 1st, 2011

Dr Coope, thank you so much for your very detailed answer. Strangely enough, although I realised stress played a role in my situation lately, I had not even thought of my operation as a source of stress in the first place (but it was definitely stressful – I am just used to operations as I’ve had a few in my childhood). My stress is now at manageable levels, so I will continue with natural progesterone and hope to see an improvement shortly, and if not I will act as you suggested. I truly believe natural progesterone works, I just need to get the dosage right and… not stress about it in the meantime! Thank you once again for your time.

Karine | 9:17 pm, November 29th, 2011

Oops I now realise how long my previous post was! Apologies! I guess I only want to know if I’m going in the right direction – of course I am considering seeking help from a doctor more inclined to use bio identical hormones for saliva testing, but before doing so thought perhaps I should give this new regimen a bit more time? Thank you and sorry again! Karine

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