![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 198 to 222 of 226. Go back in thread:
Posted by sara wish on April 8, 2004, at 21:53:29
In reply to Re: pmdd, posted by Tuck on January 4, 2004, at 12:51:07
I have been seeing a psychiatrist for about a month. At my last appointment I walked in, sat down and said: "I could talk about my family history until the cows come home, but until I address what seems to me to be a serious hormonal imbalance prior to getting my period, life will not improve for me".
He listened while I told him that I am normally a happy, engaged helpful human being, but for the ten days leading up to my period I am argumentative, paranoid, self loathing and suicidal. He immediately pulled out all the information he had on PMDD. We have agreed to embark on an investigation into the best treatment for me.
I have read the posts on this subject and feel really validated by them. I guess I wanted to put in a good word for psychiatrists who are respected and recommended. I feel like it enables a woman to address the multi-limbed monster that is pmdd, and not just the medical side. For example, my partner of ten years is bruised and battered from trying to hang in there with a woman who is perfectly charming half the month and ragefully plotting to leave the other half of the month. I hope our relationship can hang on in time for me to find relief from an illness, which has resulted in so many strained relationships and intermittent job walkouts.
It seems to me that continuing on with SSRI's in combination with some form of anti anxiety medication combined with regular exercise might be the first thing I'll try. Has anyone had success with cutting wheat out of her diet? I'm reluctant to go on the pill, but it seems to have worked for some.
At times I feel like what we know about the world of hormones is just the tip of the iceberg. SSRI's seem like a bit of a blunt instrument. I look forward to the day when treatment is more refined. Hopefully by that time I will still have a job, family and friends to celebrate with!
Lets keep on talking about this.....Remember, many of the people funding and guiding the research don't have ovaries....... They need to be reminded that we are here and struggling.
Sara
Posted by Heather Hall on April 9, 2004, at 8:37:44
In reply to pmdd, posted by sara wish on April 8, 2004, at 21:53:29
This article is long, but I pasted it because I couldn't remember where I found it to put in a link. The information is amazing - about how hormones work in our bodies etc. The PMS info is about half way in, but the whole article is so good! It gave me a lot of hope. I am currently searching for a doctor who will work with me on this approach.
International Journal of Pharmaceutical Compounding September/October 1999 1
Interview: Katharina Dalton, MD:
Progesterone and Related Topics
In the last 50 years Dr. Dalton has become the acknowledged authority on the part played by menstrual dysfunctions in confused and criminal behavior. She also has worked tirelessly in the treatment of postnatal depression and lectures extensively in Great Britain, Europe, North America and Australasia.
Dr. Dalton has a consultant practice in London and was principal of the Premenstrual Syndrome (PMS) Clinic at University College Hospital, established in 1953. It was
the first PMS clinic in the world and operated until 1996. In 1971 she became the first woman president of the general practice section of the Royal Society of Medicine. She
has received numerous awards for her original research, including three from the British Medical Association.
Dalton’s early training was as a chiropodist at the London Foot Hospital, where she wrote Essentials of Chiropody, a basic textbook. Her medical training began at the Royal
Free Hospital and she qualified as an MD in 1948. During her first six months of general practice, she identified and successfully treated six women suffering from
premenstrually related asthma, epilepsy and migraine. In collaboration with Raymond Greene, MD, she published the first paper on PMS in the British medical literature.
Her books and publications include Premenstrual Syndrome, The Menstrual Cycle, The Premenstrual Syndrome and Progesterone Therapy, Once a Month, Depression After Childbirth, Premenstrual Syndrome Goes to Court, and Premenstrual Syndrome Illustrated.
What are some of the latest trends in hormone replacement therapy (HRT)?
What’s happening now that wasn’t happening five years ago?
I think there are two important things. First of all, we have to send a message: we now have suddenly appreciated the difference between the levels of estrogen, which we
measure in picograms, and the level of progesterone, which we measure in nanograms, a thousand times bigger. People imagine that the dosage should be almost the same
but, of course, it isn’t. I think that’s one of the most important things. The other thing is an appreciation of progesterone receptors. When I was here in 1982, progesterone receptors had not yet been discovered in a single human cell; now we realize there are
progesterone receptors in practically every system of the body, and progesterone receptors are present in all vertebrates. The early vertebrates have progesterone for
glucose metabolism; but, of course, in mammals progesterone is there essentially for reproduction. So there is a tremendous advance and, as a result of that, the treatment of PMS has changed.We’re hearing a lot more about doing blood levels and saliva levels.
What we really want to do is progesterone receptor function tests, because it is one thing to have a lot of progesterone receptors; but if you’re not going to use them, they’re no good. We now know the characteristics of the progesterone receptors; among them, first of all, they won’t pick up progestogen - progestins, I think you call them. The artificial ones, forget those. They will only pick up progesterone. They will not pick up progesterone if adrenalin is present, if there’s been a lot of stress, and they
will not pick up progesterone when the blood sugar is low. So we’ve got to look after the progesterone receptors. It’s not a case of necessarily increasing the progesterone.
And the progesterone blood levels are irrelevant.
What do you think is going to happen in the future in terms of progesterone dosing and monitoring of receptor function tests?
First of all, I think we’ve got to appreciate that progesterone receptors are present in men and women equally at all ages, from the fetal stage until death at 100. We have progesterone receptors; we all need systemic progesterone, which is essentially adrenal progesterone. Women have ovarian progesterone, which is colossal, 1000 times bigger than the systemic progesterone that men and children have.
What is the role of progesterone in men?
Yes, I think we’ve forgotten men altogether. But men need progesterone. Men have systemic progesterone and progesterone receptors, and we find those progesterone
receptors particularly in the endothelial lining of blood vessels. And it’s those that keep it nice and smooth. With estrogen (estradiol), the exact opposite happens; they
make it lumpy and bumpy; and, therefore, with estradiol you’re liable to have clotting diseases, strokes and angina. The interesting thing is that men who do not have a high
amount of progesterone tend to get cardiovascular diseases in their 40s, whereas women are protected until after their 50s. Men also need progesterone for their
bones, and they get osteoporosis earlier than women do; because women are protected to a certain extent, particularly with their pregnancies, when they have a lovely high level of progesterone for nine solid months. We all need progesterone for the brain, for the myelin sheaths. Trauma in women heals quicker than in men because women have progesterone, particularly menstruating women; they do very well because they have progesterone protecting them; and it minimizes water retention in the body.
Is there a relationship in men between progesterone and atherosclerosis?
Yes, because the narrowing of the blood vessels is related to the presence of progesterone receptors. The average man has adequate progesterone from the adrenals; it
doesn’t matter, but there is a proportion of men who do not have sufficient adrenal progesterone, and that may show up one way or other in the many systems of the
body and it can show up in the blood vessels. With adrenal stress, do you decrease the amount of progesterone produced? Yes, and, of course, you end up with progesterone deficiency at one or other sites of the body. And it might be in the blood vessels.
Young women who are having cardiac symptoms are those who are the high-pitched, type A, pushing so much adrenaline out that they are neutralizing the effect of the
progesterone.
International Journal of Pharmaceutical Compounding September/October 1999 3
Do you think that might be one of the reasons why there seems to be a higher proportion of type-A personalities with heart attacks at early ages?
Yes.
How do you test receptor sensitivity?
Most of the work has been done on animals; but there’s a tremendous amount of work worldwide on progesterone, which is not really monitored at all. There are hundreds
of peer-reviewed articles in medical and scientific journals covering about 38 different vertebrates, including humans.
In terms of the dosages you use in men, do you still advocate using transdermal progesterone, like creams?
My work has been essentially on women; I don’t treat men. But with the new realization of the vast differences between ovarian and systemic progesterone that men and women have, it is now appreciated that men may need very small doses of progesterone.
Will men experience feminization while using progesterone?
Why should they experience feminization? Estrogen is a feminizing hormone; progesterone is not and is present in men and women.
The reason that I asked the question is that the lay public thinks there’s going to be feminization.
I think this is one of the things we want to get over. Progesterone is not just a feminine hormone; men also have it.
Dosing for osteoporosis for men, then, is approximately 5 to 10 mg daily?
Yes, you can have a very low dose for men as long as they have it every day.
What about taking the same approach when people have cardiac disease, starting men and women on progesterone just like you would start them on aspirin every day?
Yes, why not? I am not so sure that oral progesterone is what we want, because all progesterone administered orally goes through the portal systems direct to the liver,
where there are numerous progesterone receptors that metabolize the progesterone before it reaches the systemic circulation. Progesterone administered vaginally,
rectally or transdermally goes directly into the systemic circulation.
So you prefer a topical administration?
Topical for men, because men only need a very small amount. They only need a very low amount throughout life.
There are a number of cosmetic products with very, very low levels of progesterone in them. What’s your opinion on those?
I don’t know anything about those. They are not available in the United Kingdom.
International Journal of Pharmaceutical Compounding September/October 1999 4
One way to get progesterone back in men, to have it be widely accepted, is to look at its effect on hair growth, is that correct?
Yes, certainly, it works, in women’s hair growth. Many women lose some hair shortly after pregnancy; they’ve had a lot of progesterone, and suddenly the progesterone
goes down, and they have hair loss, total hair loss sometimes, in some unlucky women. But give them progesterone, and their hair regrows amazingly. I can give you many examples of hair growth in women, but I don’t treat men. And, you know, there is a genetic effect of bald men: they tend to have female offspring with polycystic ovary disease. So if I am querying whether someone’s got polycystic ovary disease, I will certainly ask about male family members, whether they are bald, which would give me another clue, wouldn’t it? For men, should topical progesterone be given once or twice a day? And even for women who are getting their HRT topically, once a day
versus twice a day? Which is, in your opinion, the best?
First of all, I don’t know men at all. But for women, I find once a day is adequate for the group that does not require
it for menstruation, that is, for the nonmenstruating, postmenopausal group.
What is the best topical vehicle for estrogen and progesterone?
That I wouldn’t know. When we do use a cream, we always tell them to use it after a bath when skin pores are open.
You mentioned that, for men, progesterone is good in cardiovascular disease.
Are there any other things for which it might be appropriate? Oh yes - cerebral accidents and trauma in both men and women. If you give women natural progesterone - and menstruating women have natural progesterone within 14 days of a severe accident - they heal up much quicker than a man with severe trauma,
and they have far less water retention in the brain. Therefore, nowadays, some neurosurgeons tend to use progesterone injections prior to neurosurgery to prevent
water retention.
What is the best area of the body for topical application?
The area with the thinnest skin. We’ve got a nice area on the inside of the upper arm with nice, thin skin.
Can a woman ever have too much progesterone?
No, I don’t think she can. A normal menstruating woman can’t have too much because she can’t get up to that “normal” level that she has in pregnancy. Women have a
colossal amount; and there’s a limit to the amount, with our present methods of administration, that we can get into the blood. Vaginally, we can use it. We’ve found 400 mg was the limit, and if you use 500 to 600 mg, it won’t go any higher. You can only put it in every two hours because of the wax in the matrix. So we’re limited by menstruation, after everything else, and the same with progesterone injections, we’re limited by the vehicle.
As a general rule, is it safe to say that it’s better to overdose than underdose?
Oh, definitely. There’s no harm in overdosing. You can’t reach it. Very definitely overdose.
International Journal of Pharmaceutical Compounding September/October 1999 5
When you’re prescribing progesterone for depression, what markers do you use for effectiveness?
The individual patient. We have a full history at the beginning of treatment and a list of all the symptoms. We have answers to questions such as, “Are we clumsy?” “What’s the memory like?” “What’s the sleep like?” “What’s the eating like?” We go all through that, then we come back, and we have them on progesterone, and they’ve
kept a chart, etc. Then we see them next month, and how are they? Have they noticed any difference, what difference have they noted, what difference has their partner
noticed? We do it individually: one is more irritable, the other one is more tired, the other one cries, the other one has hysterical fits, they’re all different. There are so
many possibilities with depression that you’ve got to think about the individual’s symptoms.
I think the minimum dose, if you’re going to use vaginal suppositories, is 400 mg twice a day. First of all, you want a high dose. But the second thing we know about the
unique characteristics of the progesterone receptor is that the first initial dose of progesterone, when you give it in rats, is effective; subsequently, they need a dose 40
times higher than the first dose to maintain the effect. What we tend to do there to overcome that is to use a high dose initially.
British gynecologists are not allowed by their Royal College to give estrogens within six weeks of childbirth because of the danger of thrombosis.This covers all estrogens
and includes estriol, the pregnancy estrogen.
There’s one other thing that I want to say about progesterone. One of the things we have learned is that in order for the progesterone to be used by the progesterone
receptors, one of the real essentials is that we must avoid low blood sugar; we must have a stable blood sugar level, and for that we insist that patients use the three-hourly
starch diet. The ideal is that they should eat in a way that does not cause a drop in the blood sugar, because a drop in the blood sugar will stop the utilization of progesterone
for seven days.
How do suppositories and troches compare with transdermal delivery, and what doses would you need to give transdermally to get the appropriate amount of
progesterone?
I don’t think transdermal administration can be used efficiently with normal menstruating women. Rectal absorption minimizes the first-pass effect, because anywhere in the alimentary tract it’s going to go to the liver.
We’ve talked about two different things concerning diets so far, sugars and starches. How else can diet affect HRT?
The other thing, of course, is that smoking decreases the appetite and upsets progesterone receptors. We do need a good nutritious diet with adequate protein and adequate
fruit and vegetables, roughage - all that I fully agree with. I go through individually each patient’s diet. Invariably I ask her what she had yesterday, and we go down the list as to what it contained and how much protein she had. I do the whole list each time.
International Journal of Pharmaceutical Compounding September/October 1999 6
What about alcohol use? Does that have an impact?
Small amounts are okay, but the alcohol effect varies in PMS patients.
With the depression we were talking about earlier, another question that comes up often regards the use of progesterone in the treatment of pain.
It depends on where the pain is and why it is occurring. It helps any pain that gets worse premenstrually.
You mentioned earlier something about toxemia in pregnancy.
About 50 years ago when I treated my first PMS patients, we noticed a high incidence of preeclampsia compared with normals, and when we did the first paper we wanted to
know what the incidence of PMS was in the world in general. So I did a survey of 1000 women, of whom 200 had experienced preeclampsia and 800 were normal. I got
them from factories, health food stores and clinics. This was in 1953. What we found was that 85% of those women who had preeclampsia once subsequently had PMS.
The interesting thing was that I would say, “I see that you had a son on July 7 of that year and that you were ill for the last week and went into the hospital.” And they
would say, “Rubbish, I was ill for six months; but the doctor said you’re perfectly alright, good blood pressure, good urine, your weight’s alright, forget it; and it was
only a week before the birth that they took me into the hospital.” I had that story again and again in 200 women who had preeclampsia.
So, having sorted out the incidence, I then went to University College Hospital and interviewed women between the 16th and 28th week of pregnancy. I had two books;
one had “yes” on it, and one had “no” on it. I saw these women just once and asked them only one question: “Are you as well now as you were before pregnancy?” And if
they said “yes,” I’d write their name in the “yes” book and put their hospital number, and say goodbye. If they said “no,” I would ask why, and I’d write down in the “no”
book what they were complaining of, headache, depression, vomiting, etc., along with their hospital number and say goodbye. I never saw those women again, but after they
delivered, what happened? The women who had symptoms at one interview in the middle trimester had three times as much preeclampsia as the others; in other words,
preeclampsia showed up in the middle months. But if you’re only going to do blood pressure and weight and urine, you won’t recognize it.
With PMS, if we measure them day by day, we will find that the severe ones in the premenstruum will have an increase in weight, they will have an increase in blood
pressure, they will have an increase in intraocular tension and urinary protein. In other words, preeclampsia and PMS are very much the same. They’ve both got three
stages: the first stage of symptoms, the second stage of signs (edema, hypertension, weight gain) and finally they have fits (eclampsia or epilepsy); it doesn’t matter what
we call it, it’s the same type of fit, and it’s preceded by severe headaches. So we’ve got two illnesses there, absolutely alike.
So, the next thing was, we know how to treat PMS, so we’ll treat preeclampsia like that. This was a controlled study by Prof. Dr. D. Reed of the University of London, who did the protocol for me. We interviewed women in the middle months of pregnancy, and if they had symptoms we would give them progesterone and I’d see them
International Journal of Pharmaceutical Compounding September/October 1999 7
regularly. They either had progesterone or they had symptomatic treatment. Symptomatic
treatment was if they were complaining of headache, we’d give them an analgesic; if they were complaining of nausea we’d give them magnesium trisilicate, and it was very easy to treat their symptoms. The symptomatic group had no difficulty and we saw them as often as the others and that was fine. But, in the end, when progesterone was given from the middle months of pregnancy, the results were excellent and statistically significant. Unfortunately, that paper came out at the same time as the thalidomide disaster; so, of course, then they said stop progesterone, stop everything, anything during pregnancy. Particularly, they didn’t know the difference between progesterone and progestogen; and progestogen caused masculinization of
the female fetus, so don’t do that. So, really, nobody bothered to repeat my published, controlled trials.
As soon as the trials were published, I began looking into the effect of PMS on glaucoma; I just changed over and went into that, which was very interesting, and I
thought the gynecologists would follow up, but they didn’t. So, ten years later, I repeated the same protocol with exactly the same results. Today it’s 1999, and a long
time has passed; and not too many physicians are using progesterone for preeclampsia.
There has been a lot of work done on preeclampsia, and they’ve learned a lot; the problem starts at about 16 weeks with the development of a poor placenta, which
causes either renal damage and preclampsia or fetal damage with fetal growth retardation.
And we know that something happens then - we don’t really know why - and then we know that at 28 weeks we start getting preeclampsia. In my files on preeclampsia, I had the weight of the babies delivered by mothers with
preeclampsia, the date they were delivered, and the number of weeks of pregnancy.
Recently I looked up my figures for my double-blind, controlled preeclampsia trials and looked to see the babies’ weights. The weights of babies born to women who had
had progesterone were high. We had some normals whom I interviewed who had no symptoms whatsoever during the middle months, and their babies’ weights were high,
but not as high as the weights of the babies of women treated with progesterone.
Women who were symptomatically treated, with or without preeclampsia, had babies with a very low birth weight. This fits in with new work suggesting that preeclampsia
and fetal growth retardation have a similar etiology.
But now, to jump a bit, a couple of years ago a paper was published in which 100 tests for preeclampsia were described, and not one would be able to be of any value before the 28th week, although we know it starts at 16 weeks. So what’s wrong? It is necessary
to look at the psychological symptoms in the middle months. What they have done recently is, they know now that we have the vascular growth hormone, and you
need progesterone to form the trophoblasts at the 16th week. We know if you don’t have enough progesterone then, you won’t get a good placenta, and you’ll either have
renal or placental interruptions. Preeclampsia represents renal complications, whereas placental complications affect fetal growth.
Can you just test the progesterone level at week 16 to see where it is?
That’s not much good, because we’re back with the old story of, it’s not the progesterone that matters, it’s the progesterone receptors that matter.
International Journal of Pharmaceutical Compounding September/October 1999 8
What doses were you giving in the middle trimester?
First of all, you know, I’d see them individually, so it was an individual dose. We would start them off on 400 mg twice daily, that is my minimum dose, 400 mg by vaginal
suppository. I want to have action. They would come back in a week if their symptoms were still present and progesterone hadn’t made any difference, and we would go up three or four or five times. If they said, it’s still no good, then we would give them injections. In those days when I did my trials, we didn’t know about the three-hourly
diet, we didn’t include it; and I think we could have had better results if we had. Today, I wouldn’t use progesterone without considering the diet.
When you make a change in a person, how long do you wait until you evaluate whether or not that change is effective before you make another change?
In the days when I had a long waiting list and I had to wait a long time for the next visit, we used to give a patient, when she finally got to me after the waiting list, two appointments, one six weeks later. So if we saw one in the premenstruum, we’d see her at a different time in the cycle six weeks later. But now I give it three weeks if I can.
Three weeks before any change?
Three weeks and then up the dose. I mean, if it’s severe we might do it earlier; postnatal depression I’ll see within a week, because the effect of progesterone in postnatal
depression you will see within a week, and you might need to increase the dose.
And hyperemesis?
Yes, and hyperemesis also within a week.
In terms of your work with postnatal depression, why haven’t the American doctors picked up on this?
That’s an unanswerable question.
Before you go on, is there any role for progesterone in chemotherapy? Or have you tried it?
No, all I can say is that, as far as breast cancer is concerned, you can use progesterone
just fine, as long as the oncologist agrees.
That was the next question, breast cancer. Go ahead and expand on the use of progesterone and estrogens in breast cancer.
First of all, don’t join the two together; estrogen and progesterone are completely different. I mean, you don’t join the pancreatic enzyme with insulin all the time;
they’re separate. What we do have is this overgrowth of cancer cells with estrogen receptors in them, but by and large progesterone receptor cells very rarely overgrow;
they’re completely different.
Does progesterone protect against breast cancer?
Yes, but I think I will put it the other way. The women that you give the estrogen to, they’re the ones who get the cancer. I very rarely have cancer in my progesteronetreated
PMS group, practically, I would say, never.
International Journal of Pharmaceutical Compounding September/October 1999 9
Has anyone used progesterone as birth control?
Yes.
What dose would be used for that?
I use 200 mg from day 8 to the onset of menstruation, but if they tend to have PMS and they’re going to increase at day 14, they might have 400 mg two to three times
daily until menstruation, and they’re perfectly safe. It’s as safe as the progestogen-only pill; we haven’t done enough cases to show the safety, whether it’s identical to the
estrogen progestogen.
In the Dalton protocol, it was published as 100 mg from day 8, and you said 200 just now.
I should explain that in Britain we have 400-mg vaginal suppositories; and, therefore, it is easier to cut those in half and use 200 mg a day from day 8 until the increase of
progesterone dosage at ovulation. However, you are lucky in America in that you can get suppositories of 100 mg progesterone, which is adequate for contraception from
day 8 until menstruation. The dose of progesterone from ovulation to menstruation can be increased if there is a history of PMS.
What about the use of progesterone in breakthrough seizures? Can it be used for seizure control?
Yes. By seizures, you mean what I mean by fits, epileptic fits? Yes, very definitely. And again, we need a careful record of the days on which the seizures have occurred, and the food they have had in the 24 hours prior to the seizures. In other words, there’s always something, either it is purely premenstrual; or there is another factor with it;
and the other factor with it, we’re learning now, is very much due to the progesterone receptors’ not working and common things, food gaps when the blood sugar drops
down. The other thing is sleep deficit, when the young girl goes out until 3:00 in the morning to party and then she has a fit, or the following morning, you know, the sleep
deficit; and she is much more sensitive to alcohol of course, and the result is you can treat her with progesterone, but it must be education plus progesterone.
And the dose on that would be...?
Again, I would start with 400 mg twice daily, which is my minimum, and then I would go up. But if they happen to be in the hospital, it is easier to give them injections.
What would be the equivalent intramuscular (IM) dose of progesterone?
I’d give 100 mg progesterone in oil IM once daily.
Just once a day. And that’s approximately equivalent to 400 mg twice a day
vaginally?
No, it seems to be more equivalent to 400 mg four times a day. It’s a big dose; but if they’re in the hospital, they’re there for a purpose, and they want to get out as soon as
they can.
International Journal of Pharmaceutical Compounding September/October 1999 10
What are your views concerning using progesterone as precursor therapy for total estrogen replacement, as it has been described that the body will make from progesterone the subsequent metabolites, estrogens and testosterones
down the line?
I agree with that.
And that there’s really no way to tell “how much goes where” in the individual person?
It has been presented that a woman basically does not need any estrogen supplementation postmenopausally, but she will get what she needs from progesterone only.
I agree with that completely. We can use progesterone instead of estrogen replacement therapy. Women don’t need any estrogen. Progesterone alone will do it. And,
what is interesting, if we look at the menopause, menopause being the last-ever menstruation, on the average we say it takes five years, right? Two years, first of all, we don’t have ovulation, then menstruation gets irregular, then we stop having menstruation,
then we gradually have this reduction, the uterus becomes smaller, the breasts become saggier, etc. So you can reckon that that’s five years. Now the first thing that
happens involves ovulation, which involves progesterone. So approximately two years before the actual menstruation stops, they will develop PMS; and I would like to put
them on progesterone, and then they don’t need the estrogen. How high a dose should one use in the perimenopausal woman to force her cycles into some regularity?
To force her cycles into regularity? Why? When we’re growing up, do we have to go backwards? We want to finish with menstruation. We don’t want to go on having
menstruation. I mean, two years before the menopause, when PMS comes before the estrogen deficiency comes, then I would use progesterone in a dose sufficient to ease
the PMS symptoms, which is different with each individual.
And that would be cyclical, or...
No, no, not cyclical, perfectly steady. I mean, two years before the early part of menopause,
they will have occasional menstruation; they stop for 14 days and start again.
Is there a range that you start off with for the perimenopausal women, or is it
still the same, the 400 mg twice a day?
Yes, it’s the minimum dose. But even some of those don’t need progesterone, they can just go on with their lifestyle, if we give them the three-hourly starch diet first.
One last thing concerning progesterone and HRT: have you seen much of an interest in its use and additional research here in the United States, and what do you project for the future?
Yes, I see a change and increased interest. We know now more about progesterone
receptors and estrogen receptors and that progesterone receptors are present in men, women, and children of all ages. It’s not only in women. It seems people are becoming
more aware that progesterone has other functions; it looks after the smoothness of the International Journal of Pharmaceutical Compounding September/October 1999
blood vessels; the myelin sheaths of nerves in men, women and children; and it looks after water retention in the brain in men, women and children. In other words, it’s
needed by men, women and children. It will probably continue to be a subject of much study, discussion and controversy in the future.
Copyright 1999 by the International Journal of Pharmaceutical Compounding.
The International Journal of Pharmaceutical Compounding is published bimonthly by
IJPC, 122 N. Bryant, Edmond, OK 73034-6301 USA
Website: www.ijpc.com
Toll Free: 1-800-757-4572
Posted by Thereishope on April 9, 2004, at 16:54:52
In reply to Re: pmdd, posted by Heather Hall on April 9, 2004, at 8:37:44
Thank you so much for this information. May God bless you. This info. is so timely.
I've been dealing with anxiety and depression since 2002 and have tried numerous antidepressants & antianxiety meds. About a week ago my ob/gyn prescribed CombiPatch, and with in the first hour of using the CombiPatch I felt so calm, peaceful, and more like my oldself. I haven't had such a feeling since using antidepressants.
I'm presently taking Wellbutrin, which helped somewhat with my anxiety and depression, but not those ten days before my period. By the way I'm 43 years old, will be 44 this year, an I'm experiencing perimenopausal symptoms, which seem to intensify those 10 days prior to starting my period.
I mentioned to my doctor about 5 years ago that I felt that I was going through menopause, but she stated that I was too young. Well I guess she doesn't know the meaning of peri/per menopause, and that women can experience symptoms 10 years prior to actually going through menopause. I've finally found a doctor who is willing to work with me to make this "change" in my life smooth.
She is will to use bioidentical hormone therapy. Praise God!!! I have an appointment with her next week.You mentioned trying to locate a doctor...well you might try this site:
http://www.menopause.org/
Welcome to the Web site of The North American Menopause Society, the leading scientific nonprofit organization devoted to promoting women's health during midlife and beyond through an understanding of menopause. This site contains information on perimenopause, early menopause, menopause symptoms and long-term health effects of estrogen loss, and a wide variety of therapies to enhance health.They have a list of certified doctors in North America. I don't know where you are located, but hopefully this will be of some help.
Thanks again!
> This article is long, but I pasted it because I couldn't remember where I found it to put in a link. The information is amazing - about how hormones work in our bodies etc. The PMS info is about half way in, but the whole article is so good! It gave me a lot of hope. I am currently searching for a doctor who will work with me on this approach.
>
> International Journal of Pharmaceutical Compounding September/October 1999 1
> Interview: Katharina Dalton, MD:
> Progesterone and Related Topics
> In the last 50 years Dr. Dalton has become the acknowledged authority on the part played by menstrual dysfunctions in confused and criminal behavior. She also has worked tirelessly in the treatment of postnatal depression and lectures extensively in Great Britain, Europe, North America and Australasia.
> Dr. Dalton has a consultant practice in London and was principal of the Premenstrual Syndrome (PMS) Clinic at University College Hospital, established in 1953. It was
> the first PMS clinic in the world and operated until 1996. In 1971 she became the first woman president of the general practice section of the Royal Society of Medicine. She
> has received numerous awards for her original research, including three from the British Medical Association.
> Dalton’s early training was as a chiropodist at the London Foot Hospital, where she wrote Essentials of Chiropody, a basic textbook. Her medical training began at the Royal
> Free Hospital and she qualified as an MD in 1948. During her first six months of general practice, she identified and successfully treated six women suffering from
> premenstrually related asthma, epilepsy and migraine. In collaboration with Raymond Greene, MD, she published the first paper on PMS in the British medical literature.
> Her books and publications include Premenstrual Syndrome, The Menstrual Cycle, The Premenstrual Syndrome and Progesterone Therapy, Once a Month, Depression After Childbirth, Premenstrual Syndrome Goes to Court, and Premenstrual Syndrome Illustrated.
> What are some of the latest trends in hormone replacement therapy (HRT)?
> What’s happening now that wasn’t happening five years ago?
> I think there are two important things. First of all, we have to send a message: we now have suddenly appreciated the difference between the levels of estrogen, which we
> measure in picograms, and the level of progesterone, which we measure in nanograms, a thousand times bigger. People imagine that the dosage should be almost the same
> but, of course, it isn’t. I think that’s one of the most important things. The other thing is an appreciation of progesterone receptors. When I was here in 1982, progesterone receptors had not yet been discovered in a single human cell; now we realize there are
> progesterone receptors in practically every system of the body, and progesterone receptors are present in all vertebrates. The early vertebrates have progesterone for
> glucose metabolism; but, of course, in mammals progesterone is there essentially for reproduction. So there is a tremendous advance and, as a result of that, the treatment of PMS has changed.
>
> We’re hearing a lot more about doing blood levels and saliva levels.
> What we really want to do is progesterone receptor function tests, because it is one thing to have a lot of progesterone receptors; but if you’re not going to use them, they’re no good. We now know the characteristics of the progesterone receptors; among them, first of all, they won’t pick up progestogen - progestins, I think you call them. The artificial ones, forget those. They will only pick up progesterone. They will not pick up progesterone if adrenalin is present, if there’s been a lot of stress, and they
> will not pick up progesterone when the blood sugar is low. So we’ve got to look after the progesterone receptors. It’s not a case of necessarily increasing the progesterone.
> And the progesterone blood levels are irrelevant.
> What do you think is going to happen in the future in terms of progesterone dosing and monitoring of receptor function tests?
> First of all, I think we’ve got to appreciate that progesterone receptors are present in men and women equally at all ages, from the fetal stage until death at 100. We have progesterone receptors; we all need systemic progesterone, which is essentially adrenal progesterone. Women have ovarian progesterone, which is colossal, 1000 times bigger than the systemic progesterone that men and children have.
> What is the role of progesterone in men?
> Yes, I think we’ve forgotten men altogether. But men need progesterone. Men have systemic progesterone and progesterone receptors, and we find those progesterone
> receptors particularly in the endothelial lining of blood vessels. And it’s those that keep it nice and smooth. With estrogen (estradiol), the exact opposite happens; they
> make it lumpy and bumpy; and, therefore, with estradiol you’re liable to have clotting diseases, strokes and angina. The interesting thing is that men who do not have a high
> amount of progesterone tend to get cardiovascular diseases in their 40s, whereas women are protected until after their 50s. Men also need progesterone for their
> bones, and they get osteoporosis earlier than women do; because women are protected to a certain extent, particularly with their pregnancies, when they have a lovely high level of progesterone for nine solid months. We all need progesterone for the brain, for the myelin sheaths. Trauma in women heals quicker than in men because women have progesterone, particularly menstruating women; they do very well because they have progesterone protecting them; and it minimizes water retention in the body.
> Is there a relationship in men between progesterone and atherosclerosis?
> Yes, because the narrowing of the blood vessels is related to the presence of progesterone receptors. The average man has adequate progesterone from the adrenals; it
> doesn’t matter, but there is a proportion of men who do not have sufficient adrenal progesterone, and that may show up one way or other in the many systems of the
> body and it can show up in the blood vessels. With adrenal stress, do you decrease the amount of progesterone produced? Yes, and, of course, you end up with progesterone deficiency at one or other sites of the body. And it might be in the blood vessels.
> Young women who are having cardiac symptoms are those who are the high-pitched, type A, pushing so much adrenaline out that they are neutralizing the effect of the
> progesterone.
> International Journal of Pharmaceutical Compounding September/October 1999 3
> Do you think that might be one of the reasons why there seems to be a higher proportion of type-A personalities with heart attacks at early ages?
> Yes.
> How do you test receptor sensitivity?
> Most of the work has been done on animals; but there’s a tremendous amount of work worldwide on progesterone, which is not really monitored at all. There are hundreds
> of peer-reviewed articles in medical and scientific journals covering about 38 different vertebrates, including humans.
> In terms of the dosages you use in men, do you still advocate using transdermal progesterone, like creams?
> My work has been essentially on women; I don’t treat men. But with the new realization of the vast differences between ovarian and systemic progesterone that men and women have, it is now appreciated that men may need very small doses of progesterone.
> Will men experience feminization while using progesterone?
> Why should they experience feminization? Estrogen is a feminizing hormone; progesterone is not and is present in men and women.
> The reason that I asked the question is that the lay public thinks there’s going to be feminization.
> I think this is one of the things we want to get over. Progesterone is not just a feminine hormone; men also have it.
> Dosing for osteoporosis for men, then, is approximately 5 to 10 mg daily?
> Yes, you can have a very low dose for men as long as they have it every day.
> What about taking the same approach when people have cardiac disease, starting men and women on progesterone just like you would start them on aspirin every day?
> Yes, why not? I am not so sure that oral progesterone is what we want, because all progesterone administered orally goes through the portal systems direct to the liver,
> where there are numerous progesterone receptors that metabolize the progesterone before it reaches the systemic circulation. Progesterone administered vaginally,
> rectally or transdermally goes directly into the systemic circulation.
> So you prefer a topical administration?
> Topical for men, because men only need a very small amount. They only need a very low amount throughout life.
> There are a number of cosmetic products with very, very low levels of progesterone in them. What’s your opinion on those?
> I don’t know anything about those. They are not available in the United Kingdom.
> International Journal of Pharmaceutical Compounding September/October 1999 4
> One way to get progesterone back in men, to have it be widely accepted, is to look at its effect on hair growth, is that correct?
> Yes, certainly, it works, in women’s hair growth. Many women lose some hair shortly after pregnancy; they’ve had a lot of progesterone, and suddenly the progesterone
> goes down, and they have hair loss, total hair loss sometimes, in some unlucky women. But give them progesterone, and their hair regrows amazingly. I can give you many examples of hair growth in women, but I don’t treat men. And, you know, there is a genetic effect of bald men: they tend to have female offspring with polycystic ovary disease. So if I am querying whether someone’s got polycystic ovary disease, I will certainly ask about male family members, whether they are bald, which would give me another clue, wouldn’t it? For men, should topical progesterone be given once or twice a day? And even for women who are getting their HRT topically, once a day
> versus twice a day? Which is, in your opinion, the best?
> First of all, I don’t know men at all. But for women, I find once a day is adequate for the group that does not require
> it for menstruation, that is, for the nonmenstruating, postmenopausal group.
> What is the best topical vehicle for estrogen and progesterone?
> That I wouldn’t know. When we do use a cream, we always tell them to use it after a bath when skin pores are open.
> You mentioned that, for men, progesterone is good in cardiovascular disease.
> Are there any other things for which it might be appropriate? Oh yes - cerebral accidents and trauma in both men and women. If you give women natural progesterone - and menstruating women have natural progesterone within 14 days of a severe accident - they heal up much quicker than a man with severe trauma,
> and they have far less water retention in the brain. Therefore, nowadays, some neurosurgeons tend to use progesterone injections prior to neurosurgery to prevent
> water retention.
> What is the best area of the body for topical application?
> The area with the thinnest skin. We’ve got a nice area on the inside of the upper arm with nice, thin skin.
> Can a woman ever have too much progesterone?
> No, I don’t think she can. A normal menstruating woman can’t have too much because she can’t get up to that “normal” level that she has in pregnancy. Women have a
> colossal amount; and there’s a limit to the amount, with our present methods of administration, that we can get into the blood. Vaginally, we can use it. We’ve found 400 mg was the limit, and if you use 500 to 600 mg, it won’t go any higher. You can only put it in every two hours because of the wax in the matrix. So we’re limited by menstruation, after everything else, and the same with progesterone injections, we’re limited by the vehicle.
> As a general rule, is it safe to say that it’s better to overdose than underdose?
> Oh, definitely. There’s no harm in overdosing. You can’t reach it. Very definitely overdose.
> International Journal of Pharmaceutical Compounding September/October 1999 5
> When you’re prescribing progesterone for depression, what markers do you use for effectiveness?
> The individual patient. We have a full history at the beginning of treatment and a list of all the symptoms. We have answers to questions such as, “Are we clumsy?” “What’s the memory like?” “What’s the sleep like?” “What’s the eating like?” We go all through that, then we come back, and we have them on progesterone, and they’ve
> kept a chart, etc. Then we see them next month, and how are they? Have they noticed any difference, what difference have they noted, what difference has their partner
> noticed? We do it individually: one is more irritable, the other one is more tired, the other one cries, the other one has hysterical fits, they’re all different. There are so
> many possibilities with depression that you’ve got to think about the individual’s symptoms.
> I think the minimum dose, if you’re going to use vaginal suppositories, is 400 mg twice a day. First of all, you want a high dose. But the second thing we know about the
> unique characteristics of the progesterone receptor is that the first initial dose of progesterone, when you give it in rats, is effective; subsequently, they need a dose 40
> times higher than the first dose to maintain the effect. What we tend to do there to overcome that is to use a high dose initially.
> British gynecologists are not allowed by their Royal College to give estrogens within six weeks of childbirth because of the danger of thrombosis.This covers all estrogens
> and includes estriol, the pregnancy estrogen.
> There’s one other thing that I want to say about progesterone. One of the things we have learned is that in order for the progesterone to be used by the progesterone
> receptors, one of the real essentials is that we must avoid low blood sugar; we must have a stable blood sugar level, and for that we insist that patients use the three-hourly
> starch diet. The ideal is that they should eat in a way that does not cause a drop in the blood sugar, because a drop in the blood sugar will stop the utilization of progesterone
> for seven days.
> How do suppositories and troches compare with transdermal delivery, and what doses would you need to give transdermally to get the appropriate amount of
> progesterone?
> I don’t think transdermal administration can be used efficiently with normal menstruating women. Rectal absorption minimizes the first-pass effect, because anywhere in the alimentary tract it’s going to go to the liver.
> We’ve talked about two different things concerning diets so far, sugars and starches. How else can diet affect HRT?
> The other thing, of course, is that smoking decreases the appetite and upsets progesterone receptors. We do need a good nutritious diet with adequate protein and adequate
> fruit and vegetables, roughage - all that I fully agree with. I go through individually each patient’s diet. Invariably I ask her what she had yesterday, and we go down the list as to what it contained and how much protein she had. I do the whole list each time.
> International Journal of Pharmaceutical Compounding September/October 1999 6
> What about alcohol use? Does that have an impact?
> Small amounts are okay, but the alcohol effect varies in PMS patients.
> With the depression we were talking about earlier, another question that comes up often regards the use of progesterone in the treatment of pain.
> It depends on where the pain is and why it is occurring. It helps any pain that gets worse premenstrually.
> You mentioned earlier something about toxemia in pregnancy.
> About 50 years ago when I treated my first PMS patients, we noticed a high incidence of preeclampsia compared with normals, and when we did the first paper we wanted to
> know what the incidence of PMS was in the world in general. So I did a survey of 1000 women, of whom 200 had experienced preeclampsia and 800 were normal. I got
> them from factories, health food stores and clinics. This was in 1953. What we found was that 85% of those women who had preeclampsia once subsequently had PMS.
> The interesting thing was that I would say, “I see that you had a son on July 7 of that year and that you were ill for the last week and went into the hospital.” And they
> would say, “Rubbish, I was ill for six months; but the doctor said you’re perfectly alright, good blood pressure, good urine, your weight’s alright, forget it; and it was
> only a week before the birth that they took me into the hospital.” I had that story again and again in 200 women who had preeclampsia.
> So, having sorted out the incidence, I then went to University College Hospital and interviewed women between the 16th and 28th week of pregnancy. I had two books;
> one had “yes” on it, and one had “no” on it. I saw these women just once and asked them only one question: “Are you as well now as you were before pregnancy?” And if
> they said “yes,” I’d write their name in the “yes” book and put their hospital number, and say goodbye. If they said “no,” I would ask why, and I’d write down in the “no”
> book what they were complaining of, headache, depression, vomiting, etc., along with their hospital number and say goodbye. I never saw those women again, but after they
> delivered, what happened? The women who had symptoms at one interview in the middle trimester had three times as much preeclampsia as the others; in other words,
> preeclampsia showed up in the middle months. But if you’re only going to do blood pressure and weight and urine, you won’t recognize it.
> With PMS, if we measure them day by day, we will find that the severe ones in the premenstruum will have an increase in weight, they will have an increase in blood
> pressure, they will have an increase in intraocular tension and urinary protein. In other words, preeclampsia and PMS are very much the same. They’ve both got three
> stages: the first stage of symptoms, the second stage of signs (edema, hypertension, weight gain) and finally they have fits (eclampsia or epilepsy); it doesn’t matter what
> we call it, it’s the same type of fit, and it’s preceded by severe headaches. So we’ve got two illnesses there, absolutely alike.
> So, the next thing was, we know how to treat PMS, so we’ll treat preeclampsia like that. This was a controlled study by Prof. Dr. D. Reed of the University of London, who did the protocol for me. We interviewed women in the middle months of pregnancy, and if they had symptoms we would give them progesterone and I’d see them
> International Journal of Pharmaceutical Compounding September/October 1999 7
> regularly. They either had progesterone or they had symptomatic treatment. Symptomatic
> treatment was if they were complaining of headache, we’d give them an analgesic; if they were complaining of nausea we’d give them magnesium trisilicate, and it was very easy to treat their symptoms. The symptomatic group had no difficulty and we saw them as often as the others and that was fine. But, in the end, when progesterone was given from the middle months of pregnancy, the results were excellent and statistically significant. Unfortunately, that paper came out at the same time as the thalidomide disaster; so, of course, then they said stop progesterone, stop everything, anything during pregnancy. Particularly, they didn’t know the difference between progesterone and progestogen; and progestogen caused masculinization of
> the female fetus, so don’t do that. So, really, nobody bothered to repeat my published, controlled trials.
> As soon as the trials were published, I began looking into the effect of PMS on glaucoma; I just changed over and went into that, which was very interesting, and I
> thought the gynecologists would follow up, but they didn’t. So, ten years later, I repeated the same protocol with exactly the same results. Today it’s 1999, and a long
> time has passed; and not too many physicians are using progesterone for preeclampsia.
> There has been a lot of work done on preeclampsia, and they’ve learned a lot; the problem starts at about 16 weeks with the development of a poor placenta, which
> causes either renal damage and preclampsia or fetal damage with fetal growth retardation.
> And we know that something happens then - we don’t really know why - and then we know that at 28 weeks we start getting preeclampsia. In my files on preeclampsia, I had the weight of the babies delivered by mothers with
> preeclampsia, the date they were delivered, and the number of weeks of pregnancy.
> Recently I looked up my figures for my double-blind, controlled preeclampsia trials and looked to see the babies’ weights. The weights of babies born to women who had
> had progesterone were high. We had some normals whom I interviewed who had no symptoms whatsoever during the middle months, and their babies’ weights were high,
> but not as high as the weights of the babies of women treated with progesterone.
> Women who were symptomatically treated, with or without preeclampsia, had babies with a very low birth weight. This fits in with new work suggesting that preeclampsia
> and fetal growth retardation have a similar etiology.
> But now, to jump a bit, a couple of years ago a paper was published in which 100 tests for preeclampsia were described, and not one would be able to be of any value before the 28th week, although we know it starts at 16 weeks. So what’s wrong? It is necessary
> to look at the psychological symptoms in the middle months. What they have done recently is, they know now that we have the vascular growth hormone, and you
> need progesterone to form the trophoblasts at the 16th week. We know if you don’t have enough progesterone then, you won’t get a good placenta, and you’ll either have
> renal or placental interruptions. Preeclampsia represents renal complications, whereas placental complications affect fetal growth.
> Can you just test the progesterone level at week 16 to see where it is?
> That’s not much good, because we’re back with the old story of, it’s not the progesterone that matters, it’s the progesterone receptors that matter.
> International Journal of Pharmaceutical Compounding September/October 1999 8
> What doses were you giving in the middle trimester?
> First of all, you know, I’d see them individually, so it was an individual dose. We would start them off on 400 mg twice daily, that is my minimum dose, 400 mg by vaginal
> suppository. I want to have action. They would come back in a week if their symptoms were still present and progesterone hadn’t made any difference, and we would go up three or four or five times. If they said, it’s still no good, then we would give them injections. In those days when I did my trials, we didn’t know about the three-hourly
> diet, we didn’t include it; and I think we could have had better results if we had. Today, I wouldn’t use progesterone without considering the diet.
> When you make a change in a person, how long do you wait until you evaluate whether or not that change is effective before you make another change?
> In the days when I had a long waiting list and I had to wait a long time for the next visit, we used to give a patient, when she finally got to me after the waiting list, two appointments, one six weeks later. So if we saw one in the premenstruum, we’d see her at a different time in the cycle six weeks later. But now I give it three weeks if I can.
> Three weeks before any change?
> Three weeks and then up the dose. I mean, if it’s severe we might do it earlier; postnatal depression I’ll see within a week, because the effect of progesterone in postnatal
> depression you will see within a week, and you might need to increase the dose.
> And hyperemesis?
> Yes, and hyperemesis also within a week.
> In terms of your work with postnatal depression, why haven’t the American doctors picked up on this?
> That’s an unanswerable question.
> Before you go on, is there any role for progesterone in chemotherapy? Or have you tried it?
> No, all I can say is that, as far as breast cancer is concerned, you can use progesterone
> just fine, as long as the oncologist agrees.
> That was the next question, breast cancer. Go ahead and expand on the use of progesterone and estrogens in breast cancer.
> First of all, don’t join the two together; estrogen and progesterone are completely different. I mean, you don’t join the pancreatic enzyme with insulin all the time;
> they’re separate. What we do have is this overgrowth of cancer cells with estrogen receptors in them, but by and large progesterone receptor cells very rarely overgrow;
> they’re completely different.
> Does progesterone protect against breast cancer?
> Yes, but I think I will put it the other way. The women that you give the estrogen to, they’re the ones who get the cancer. I very rarely have cancer in my progesteronetreated
> PMS group, practically, I would say, never.
> International Journal of Pharmaceutical Compounding September/October 1999 9
> Has anyone used progesterone as birth control?
> Yes.
> What dose would be used for that?
> I use 200 mg from day 8 to the onset of menstruation, but if they tend to have PMS and they’re going to increase at day 14, they might have 400 mg two to three times
> daily until menstruation, and they’re perfectly safe. It’s as safe as the progestogen-only pill; we haven’t done enough cases to show the safety, whether it’s identical to the
> estrogen progestogen.
> In the Dalton protocol, it was published as 100 mg from day 8, and you said 200 just now.
> I should explain that in Britain we have 400-mg vaginal suppositories; and, therefore, it is easier to cut those in half and use 200 mg a day from day 8 until the increase of
> progesterone dosage at ovulation. However, you are lucky in America in that you can get suppositories of 100 mg progesterone, which is adequate for contraception from
> day 8 until menstruation. The dose of progesterone from ovulation to menstruation can be increased if there is a history of PMS.
> What about the use of progesterone in breakthrough seizures? Can it be used for seizure control?
> Yes. By seizures, you mean what I mean by fits, epileptic fits? Yes, very definitely. And again, we need a careful record of the days on which the seizures have occurred, and the food they have had in the 24 hours prior to the seizures. In other words, there’s always something, either it is purely premenstrual; or there is another factor with it;
> and the other factor with it, we’re learning now, is very much due to the progesterone receptors’ not working and common things, food gaps when the blood sugar drops
> down. The other thing is sleep deficit, when the young girl goes out until 3:00 in the morning to party and then she has a fit, or the following morning, you know, the sleep
> deficit; and she is much more sensitive to alcohol of course, and the result is you can treat her with progesterone, but it must be education plus progesterone.
> And the dose on that would be...?
> Again, I would start with 400 mg twice daily, which is my minimum, and then I would go up. But if they happen to be in the hospital, it is easier to give them injections.
> What would be the equivalent intramuscular (IM) dose of progesterone?
> I’d give 100 mg progesterone in oil IM once daily.
> Just once a day. And that’s approximately equivalent to 400 mg twice a day
> vaginally?
> No, it seems to be more equivalent to 400 mg four times a day. It’s a big dose; but if they’re in the hospital, they’re there for a purpose, and they want to get out as soon as
> they can.
> International Journal of Pharmaceutical Compounding September/October 1999 10
> What are your views concerning using progesterone as precursor therapy for total estrogen replacement, as it has been described that the body will make from progesterone the subsequent metabolites, estrogens and testosterones
> down the line?
> I agree with that.
> And that there’s really no way to tell “how much goes where” in the individual person?
> It has been presented that a woman basically does not need any estrogen supplementation postmenopausally, but she will get what she needs from progesterone only.
> I agree with that completely. We can use progesterone instead of estrogen replacement therapy. Women don’t need any estrogen. Progesterone alone will do it. And,
> what is interesting, if we look at the menopause, menopause being the last-ever menstruation, on the average we say it takes five years, right? Two years, first of all, we don’t have ovulation, then menstruation gets irregular, then we stop having menstruation,
> then we gradually have this reduction, the uterus becomes smaller, the breasts become saggier, etc. So you can reckon that that’s five years. Now the first thing that
> happens involves ovulation, which involves progesterone. So approximately two years before the actual menstruation stops, they will develop PMS; and I would like to put
> them on progesterone, and then they don’t need the estrogen. How high a dose should one use in the perimenopausal woman to force her cycles into some regularity?
> To force her cycles into regularity? Why? When we’re growing up, do we have to go backwards? We want to finish with menstruation. We don’t want to go on having
> menstruation. I mean, two years before the menopause, when PMS comes before the estrogen deficiency comes, then I would use progesterone in a dose sufficient to ease
> the PMS symptoms, which is different with each individual.
> And that would be cyclical, or...
> No, no, not cyclical, perfectly steady. I mean, two years before the early part of menopause,
> they will have occasional menstruation; they stop for 14 days and start again.
> Is there a range that you start off with for the perimenopausal women, or is it
> still the same, the 400 mg twice a day?
> Yes, it’s the minimum dose. But even some of those don’t need progesterone, they can just go on with their lifestyle, if we give them the three-hourly starch diet first.
> One last thing concerning progesterone and HRT: have you seen much of an interest in its use and additional research here in the United States, and what do you project for the future?
> Yes, I see a change and increased interest. We know now more about progesterone
> receptors and estrogen receptors and that progesterone receptors are present in men, women, and children of all ages. It’s not only in women. It seems people are becoming
> more aware that progesterone has other functions; it looks after the smoothness of the International Journal of Pharmaceutical Compounding September/October 1999
> blood vessels; the myelin sheaths of nerves in men, women and children; and it looks after water retention in the brain in men, women and children. In other words, it’s
> needed by men, women and children. It will probably continue to be a subject of much study, discussion and controversy in the future.
> Copyright 1999 by the International Journal of Pharmaceutical Compounding.
> The International Journal of Pharmaceutical Compounding is published bimonthly by
> IJPC, 122 N. Bryant, Edmond, OK 73034-6301 USA
> Website: www.ijpc.com
> Toll Free: 1-800-757-4572
Posted by Heather Hall on April 9, 2004, at 20:02:48
In reply to Re: pmdd » Heather Hall, posted by Thereishope on April 9, 2004, at 16:54:52
Thereishope wrote:
You mentioned trying to locate a doctor...well you might try this site:I'm glad the article helped you, thanks so much fr the link!!!
Posted by gracie99 on July 26, 2004, at 19:57:40
In reply to Re: PMDD - Premenstrual Dysphoric Disorder, posted by Doug Anderson on November 15, 2000, at 23:55:25
A couple of doses of Ritalin over the few days prior to end of cycle was amazingly effective -- just canceled out my pre-menstrual snarling misery.
At any other time of the month, a drug like Ritalin would make me unpleasantly antsy. But at that time of the month, it seemed calming and cheering, the perfect combination.
I felt it is was a fairly safe, low toxicity treatment, given that it was just two doses/month.
It's a pity that more doctors don't know about this treatment PMDD and/or are willing to prescribe it.
(When the doctor who prescribed it for my PMDD moved away, I was never able to find another doctor who would prescribe it for that reason -- they all treated me like a drug abuser, some even became hostile and ordered me out of their offices! Fortunately my PMDD eventually got better over time, and I no longer need to treat it.)
Posted by Heather Hall on July 26, 2004, at 20:39:33
In reply to Ritalin for Premenstrual Dysphoric Disorder, posted by gracie99 on July 26, 2004, at 19:57:40
My doc put me on it with Prozac for awhile. The Prozac didn't have any effect but the Ritalin worked really well. I chose to discontinue it because I kept crashing harder and harder when it wore off. She had me on it continually, 2 doses a day, but at the lowest available potency. I wonder if the occasional would have been better. At the time, I was over the top all the time, it was just worse with my cycles. I am much better now. I did some progesterone, some NeuroModulation Technique. Those got me a little better, now I am going to a homeopath with FABULOUS results. I only had a 2 hour freak out this months, padded by a mildly cranky day on either side.
> A couple of doses of Ritalin over the few days prior to end of cycle was amazingly effective -- just canceled out my pre-menstrual snarling misery.
>
> At any other time of the month, a drug like Ritalin would make me unpleasantly antsy. But at that time of the month, it seemed calming and cheering, the perfect combination.
>
> I felt it is was a fairly safe, low toxicity treatment, given that it was just two doses/month.
>
> It's a pity that more doctors don't know about this treatment PMDD and/or are willing to prescribe it.
>
> (When the doctor who prescribed it for my PMDD moved away, I was never able to find another doctor who would prescribe it for that reason -- they all treated me like a drug abuser, some even became hostile and ordered me out of their offices! Fortunately my PMDD eventually got better over time, and I no longer need to treat it.)
Posted by LynneDa on July 27, 2004, at 14:27:07
In reply to Re: Ritalin for Premenstrual Dysphoric Disorder, posted by Heather Hall on July 26, 2004, at 20:39:33
Wow, I just found these posts and appreciate all the knowledge and information that was shared on this thread. I too have been diagnosed PMDD. I'm 40 and peri-menopausal. I can't believe I may have 10 more years of this, but that's life. So, I did Lexapro for 9 months and it cleared up pretty well, except for a couple of times per month, but tolerable. But, it made me sooooo sleepy after upping to 20mg. I am now on Wellbutrin. I'm no longer sleepy, but I'm back to crying, raging, etc. for part of the month. So, my doc said to combine the WB with just 10mg of Lex.
I would love to try something different, never heard of the Ritalin idea til these posts. Also, what is neuro modulation? And, what sort of treatment has your homeopath recommended?
Thank you for your help, both of you. It does feel good to be validated by others that PMDD does exist and does have a biochemical root!
~ Lynne
>>>>>>>>>>>>>>>>>>>>>>>>>>
Posted by jakesmom on August 11, 2004, at 20:09:38
In reply to Re: pmdd, posted by Heather Hall on April 9, 2004, at 8:37:44
I was wondering...has anyone ever heard of taking Lexapro for only the week before your period to treat pmdd? I told my doctor I had mood swings before my period and she recommended I take 5 mg. of Lexapro only the week before to help. From what I am reading here...about Lexapro is that it takes a while to really get working and the side effects go away after 3-4 weeks. So how will taking it only for the week I experience the pmdd help in the long run? Any experience with this anyone? I haven't started it yet...want more information.
Posted by LynneDa on August 12, 2004, at 9:41:02
In reply to Re: pmdd and Lexapro, posted by jakesmom on August 11, 2004, at 20:09:38
Hi -
I'm no authority, but here is my opinion. You need to take the Lex for several months to see if it even helps your PMDD symptoms. Then, you may be able to back off of it and only take it at certain times of the month. I think you need to establish certain levels in your system, maybe? My doctor told me I could take 5 mg for part of the month then boost up to 20mg during ovulation and the week before my period. I'm now taking Wellbutrin because the 20 mg of Lex made me too sleepy, but the WB doesn't relieve all my PMDD symptoms. I am going to try adding 5mg of Lex back in and see if it helps and then my doctor said I could just use it at certain times of the month. I hope this makes sense and is helpful!It's certainly worth asking your doctor if that would work for you eventually. But, SSRIs have to build up in your system. They don't work as instantaneously as, say, allergy medicine.
Good luck!
~ Lynne
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>I was wondering...has anyone ever heard of taking Lexapro for only the week before your period to treat pmdd? I told my doctor I had mood swings before my period and she recommended I take 5 mg. of Lexapro only the week before to help. From what I am reading here...about Lexapro is that it takes a while to really get working and the side effects go away after 3-4 weeks. So how will taking it only for the week I experience the pmdd help in the long run? Any experience with this anyone? I haven't started it yet...want more information.
Posted by Mariposa on August 12, 2004, at 10:12:44
In reply to Re: pmdd and Lexapro » jakesmom, posted by LynneDa on August 12, 2004, at 9:41:02
I was Dx - PMDD and depression, Rx - Lexapro. Currently @30mg, have been taking 16 mos. Really helps but if I miss a day I get bad headaches and feel bitchy next day. Not sure how taking 5mg one week out of month will work as you need to take 2+ mos. before it starts to work. Does your doc have other patients doing this?~~~8|8
Posted by perkidoom on December 6, 2004, at 9:39:16
In reply to Re: PMDD:So many questions!, posted by shelby on January 29, 2001, at 11:01:32
I believe I am pmdd. Im 33 and have been to doctors who thought maybe depression maybe manic depression. I dont totaly fit in that catagory because It revolves around my cycle. Iam so scared I am newley married and driving my husband away to the point of him just wanting out at times "during those attrociouse weeks". I seem to have 0ne week a month where every day is stable but the rest of the weeks I am so crazy.
I do crazy things like run away for the afternoon swearing never to come back, to thoughts of sucide I make terrable acusations to my husband, have jelouse rage and sever mood swings. All of witch totally close my husband off to me and I end up totally exahuasted from the whole or deal. "thinking what was all that about>" Its like for 1 to 1 1/2 weeks a month Im loving and happy like a sunny spring day then for the rest I am an evil storm of unstability. I am seeking some psciatric advise tommorrow. I really want so bad to have a normal life and live in love and harmony with my husband. I want us to be happy and have a child, however he doesnt want to have a child with me when Im unstable. so I get even more insecure about the outcome of all this. Have tried anti depressants dont really help at all was on hormones they just messed up my cycle. My gyno said in sever cases like mine she has performed hystorectomies with success. But they had children all ready. So I cant have a child if I dont get stable but if I want to be stable I might need to end my periods so either way child birth is not looking bright for me. It makes me even more depressed and crazy during my bad weeks. I think my husband is so to the end of his rope with me and I am really trying to seek help. I dont really know what my question is but any POSITIVE feed back would be so great for me and my husband. Thanks for listening
Posted by LynneDa on December 6, 2004, at 10:08:29
In reply to soo happy to find some info, posted by perkidoom on December 6, 2004, at 9:39:16
Hi! Your story is exactly like mine! Mine has been going on for about 5 years; I'm 41 now and had my daughter when I was 33. I have the worthless, sucicidal thoughts, jealous rages that are totally irrational, crying jags, angry about everything and anything to downright depression.
You can get better!!!! Don't give up hope! I know exactly how awful you feel and how not normal it is for you to have these personality changes. It is good that you know it's based on your cycle.
If one anti-depressant doesn't work, try another. Change dosages before giving up on one. Hopefully your psychiatrist will have some ideas.
There are lots of natural, common sense things you can do too, of course: exercise, eat right, take vitamins/supplements, lower your caffeine intake, take herbs (alternative board), massage therapy, acupuncture, etc. Believe me, I've tried them all. But, I haven't really stuck to anything :-(.
I'm on 300 mg Wellbutrin SR and 5 mg Lexapro. That seems to work fairly well. I would say I am down to only 2 bad times per month: ovulation and about a week before my period; each lasting about 2 days or so. (I am on the pill and I don't know if it helps or hurts.)
My therapist is 41 and had a hysterectomy. It did work wonders, but obviously it's not an option for you right now.
I would also suggest that your husband go to a counselor either with you or without you so he can understand this crazy stuff we women have to go through! I am newly married as well (2 years, 2nd marriage). My husband doesn't completely get it, thinks that we should be able to control our emotions, etc. But, the counseling and some reading he did helped to legitimize it.
Another piece of advice I can give you. When you are feeling crazy, try another outlet besides your husband, if you can. Call a friend or sister or counselor and just ramble. Or write to us here. I was, and still am, terrible in that I unload all my irrational feelings and fears on him.
When you're feeling bad most of the month, I know it is hard to help yourself get better and do positive things. But, you will get better and as your hormones and chemicals get straightened out with meds, you can take steps to do some of the other self-help things. It's a gradual process, but you will get better!!!
Let us know how you're doing. We care!!
~ Lynne
>>>>>>>>>>>>>>>>>>>>>>>>I believe I am pmdd. Im 33 and have been to doctors who thought maybe depression maybe manic depression. I dont totaly fit in that catagory because It revolves around my cycle. Iam so scared I am newley married and driving my husband away to the point of him just wanting out at times "during those attrociouse weeks". I seem to have 0ne week a month where every day is stable but the rest of the weeks I am so crazy.
> I do crazy things like run away for the afternoon swearing never to come back, to thoughts of sucide I make terrable acusations to my husband, have jelouse rage and sever mood swings. All of witch totally close my husband off to me and I end up totally exahuasted from the whole or deal. "thinking what was all that about>" Its like for 1 to 1 1/2 weeks a month Im loving and happy like a sunny spring day then for the rest I am an evil storm of unstability. I am seeking some psciatric advise tommorrow. I really want so bad to have a normal life and live in love and harmony with my husband. I want us to be happy and have a child, however he doesnt want to have a child with me when Im unstable. so I get even more insecure about the outcome of all this. Have tried anti depressants dont really help at all was on hormones they just messed up my cycle. My gyno said in sever cases like mine she has performed hystorectomies with success. But they had children all ready. So I cant have a child if I dont get stable but if I want to be stable I might need to end my periods so either way child birth is not looking bright for me. It makes me even more depressed and crazy during my bad weeks. I think my husband is so to the end of his rope with me and I am really trying to seek help. I dont really know what my question is but any POSITIVE feed back would be so great for me and my husband. Thanks for listening
Posted by perkidoom on December 6, 2004, at 10:28:16
In reply to Re: soo happy to find some info, posted by LynneDa on December 6, 2004, at 10:08:29
oh thank you lyne I just burst into tears of relief to hear that i am on a path. It is so good to see that you where so similar and are getting better. THANK YOU!!!!
Posted by dove on December 6, 2004, at 11:06:12
In reply to Re: soo happy to find some info, posted by perkidoom on December 6, 2004, at 10:28:16
I also have PMDD, and when I'm pregnant (I've had six children) I do very--very well mentally and emotionally. What hits me very hard is after the baby is born, and I must be extremely vigilant about getting enough sleep, taking my meds (and I take quite a few), and allowing other people to help.
Also, urgently try to find another outlet for your rage, anguish ect... other than your spouse, it is vital! I've been married 13 years and that was the one item that attempted to take the marriage down in flames.
Still stable on a combo of Effexor, Prozac, Adderall, Klonopin and Remeron.
dove
Posted by perkidoom on December 6, 2004, at 13:12:00
In reply to Re: soo happy to find some info, posted by dove on December 6, 2004, at 11:06:12
well it is good to here everything I want to learn everything and different opptions. In the past I have tried all sorts of b control pills but always had some adverse effect. Plus it is so hard because I really want a baby some day, I believe I will be My self and the happy loving fun person I am when my periouds end. But a hystorectomy would cause depression also for wanting a child. I dont know if I really would call my symptoms rage more like lashings and my life spins out of control to the point of wanting to just run and hide. I am still learning and of course dont know the exact wording for my symptoms other then crazy for part of the month. But I deffinetaly need an outlet because it is driving a wedge between me and my husband and my family.
Posted by Liv on December 6, 2004, at 14:55:11
In reply to Re: soo happy to find some info, posted by dove on December 6, 2004, at 11:06:12
If you have $3,000 to spend (and for me it was worth every penny) I will highly recommend that you get an appointment with Dr. Elizabeth Lee Vliet at HER Place in Arizona. She is an M.D. that has the knowledge and the interest in helping women in our situation. Too many ob/gyn have no interest in our female hormone changes and think everything is in our “head”. I will predict that your estradiol, progesterone, testosterone, insulin and glucose is way out of whack.
I have read Dr. Vliet’s book: “Screaming to Be Heard” It’s very informative and helped me see that there actually is something physically wrong with my body, and THERE IS HELP & TREATMENT. I’m just mad that my ob/gyn was not willing to listen to me and my information. Dr. Vliet has written two other books (which I have not read): “It’s My Ovaries, Stupid!” & “Women, Weight, and Hormones”
Take a look at www.herplace.comIf you can not afford Dr. Vliet (it would be the best money you ever spent! I have submitted my claim with the insurance, but do not know how much of it will be covered), you need to insist that your dr. do at least a few tests. (Before I went to HER Place she had me draw blood for about 40 different things, which was included in her fee) I will suggest that you ask your dr. to check:
On your first day of bleeding (second day if you start your period on a Saturday/Sunday)
Estradiol on day 1
Progesterone day 1
Total Testosterone
Free Testosterone
TSH
Free T4
Free T3And 20 days after your first day of your period:
Estradiol on day 20
Progesterone day 20
Post Prandial Glucose and Insulin test . This is when you eat a normal meal (breakfast) and have your blood drawn 2 hours later. You do NOT drink any sugar drinks at the lab.If your dr. know of Dr. Vliet and are willing to follow her recommendations, you are in luck! If not, try to find one that are willing to work with you. Someone that has an interest in PCOS and treatment of Early Menopause (It is all hormone problems). Your Estradiol on day 1 should be 80 or higher & on day 20 your estradiol should be over 200 (mine was 17 and 55, which is too low for ovulation) The problem with most ob/gyn is that they do not know what normal levels of these hormones are. I had my dr. test my Estradiol on day 1 three years ago and it came back at 22. He said it was suppose to be that low, well IT IS NOT. He offered me PremPro, which is NOT the type of hormone I need! I’m now on Estradial, Vagifem, Prometruim (it is important to use these natural forms of hormone and not the once that has been extracted from horse urine) and metformin. And I’m a new person. We are all different individuals, and you need to find someone that will work with you and your hormones and find the right thing for you. Do not let the dr. talk you into take PremPro or Premarin.
Posted by mel32 on December 7, 2004, at 8:32:30
In reply to soo happy to find some info, posted by perkidoom on December 6, 2004, at 9:39:16
> I believe I am pmdd. Im 33 and have been to doctors who thought maybe depression maybe manic depression. I dont totaly fit in that catagory because It revolves around my cycle. Iam so scared I am newley married and driving my husband away to the point of him just wanting out at times "during those attrociouse weeks". I seem to have 0ne week a month where every day is stable but the rest of the weeks I am so crazy.
> I do crazy things like run away for the afternoon swearing never to come back, to thoughts of sucide I make terrable acusations to my husband, have jelouse rage and sever mood swings. All of witch totally close my husband off to me and I end up totally exahuasted from the whole or deal. "thinking what was all that about>" Its like for 1 to 1 1/2 weeks a month Im loving and happy like a sunny spring day then for the rest I am an evil storm of unstability. I am seeking some psciatric advise tommorrow. I really want so bad to have a normal life and live in love and harmony with my husband. I want us to be happy and have a child, however he doesnt want to have a child with me when Im unstable. so I get even more insecure about the outcome of all this. Have tried anti depressants dont really help at all was on hormones they just messed up my cycle. My gyno said in sever cases like mine she has performed hystorectomies with success. But they had children all ready. So I cant have a child if I dont get stable but if I want to be stable I might need to end my periods so either way child birth is not looking bright for me. It makes me even more depressed and crazy during my bad weeks. I think my husband is so to the end of his rope with me and I am really trying to seek help. I dont really know what my question is but any POSITIVE feed back would be so great for me and my husband. Thanks for listening
Dear Shelby,
I have been where you are, except that I had a son 6 years ago, and my pmdd got worse. I tried many anti-depressants, to no avail. I also tried birth control, and became suicidally depressed.
I am much better now, and here is what I prescribe. Eliminate caffeine, above all, this was really contributing to my mood swings. Drastically reduce your sugar intake. Drink 2 quarts of water a day. Exercise 5 times a week. Eat healthy, high fiber, etc...Most important, keep a calendar on the fridge with your period marked, and highlight the 12-14 day period before your next menstruation so that everyone(you and your husband) knows when the crazy train is scheduled to arrive! I believe that pmdd is a serious physiological problem, but I also believe in mind over body. So if you know what you are up against and when, it is much easier to rationalize things and calm yourself down. When i feel irrational feelings coming up at my bad time, i can say uh oh, my period is coming, and I know that my tendency is to totally overreact and it diffuses it a little. Then sometimes, i just go and cry and scream into a pillow. It is very important that your husband understands that this is a serious hormonal imbalance, and that you did not ask to be this way, but that you are willing to make the changes necessary to help your body get better. Also, Estroven PMS formula available at health food stores is AWESOME! It really does calm you down in less than 20 minutes. Check it out and good luck! Post a message to me if you want to exchange emails or if you have any questions. Melody
Posted by dove on December 7, 2004, at 8:59:53
In reply to Re: soo happy to find some info, posted by mel32 on December 7, 2004, at 8:32:30
I am happy to see all the responses, the new posters (Welcome!), and the variety of advice. I've had a lot of labs done also, including a thorough Thyroid work-up and glucose tolerance. Due to my pregnancies (and genetics) my thyroid is hyper, hypo, and sometimes working within the range of "normal". I haven't had the money to get everything rechecked within the last 6 months--since I had the last baby--but would highly recommend that everyone who is dealing with these issues get it done. And realize that different Doc's interpret results differently; whereas, an endocrinologist might see problems a GP might tell you everything looks fine.
There are a few natural remedies that really do help and are worth looking into. And marking the calendar can really help everyone in the family, yourself, and your doc's, when they need exact info. I kept one calendar just for my moods and cycles for over five years. Sometimes I merely marked a plus or a minus sign for whether the day was overall positive or negative, other times I wrote major physical, emotional and mental symptoms I was experiencing. I was able to predict the time of the month when I should start struggling, as well as marking when I actually did. It helped enormously, giving me a real view of what was happening, and revealing what meds were beneficial or detrimental. This is how I discovered that low dose Prozac was actually very effective for many of my PMDD symptoms.
Hope you find some relief!
dove
Posted by LynneDa on December 7, 2004, at 9:17:44
In reply to Re: soo happy to find some info, posted by dove on December 7, 2004, at 8:59:53
I agree with Dove - all this information is really wonderful, thanks to all who've posted!
So, those of you who had all the different hormone and chemical levels tested, what did your doctor do with that information? Did he/she prescribe different meds than just anti-depressants to correct the imbalances? I'm especially interested in a thyroid that goes up & down, as I think mine does. Also, with a glucose imbalance, is that just correctable through diet, similar to a diabetic?
Thanks for all the great info!
~ Lynne
Posted by banga on December 7, 2004, at 9:28:12
In reply to Re: soo happy to find some info, posted by LynneDa on December 7, 2004, at 9:17:44
Lynne,
Glucose imbalance can indeed be helped by diet...the principal is basically the same--reduce anything that raises blood sugar levels quickly. This means sugars, simple carbohydrates (white flour products, some other things like potatoes, juices, caffeine, to name a few). I used to follow a diet siilar to the Atkins diet or Zone diet--not for weight loss, but because it takes into account blood sugar fluctuations.
I sympathise with everyone here--I dont have this conditions as bad as many of you, the 1-2 days before my period are extremely rocky however. good luck.
Posted by jujube on December 7, 2004, at 10:05:16
In reply to Re: soo happy to find some info, posted by LynneDa on December 7, 2004, at 9:17:44
I, too, suffer greatly each month with PMDD. I find that as I get older, the symptoms seem to get worse. In August, I was put on Depo Provera by the gyno that I had been referred to by my gp. Up to that point, I thought that nothing could be as bad as my monthly PMS suffering. Boy, was I wrong! After the Depo shot, I went through what I can only call three months of sheer hell. I threw up every morning for 1.5 months to 2 months, I had severe mood swings and the worst depression and anxiety I have ever experienced. The shot has now worn off, and I will never have another one. Now I am in the process of trying to balance my hormones naturally.
The first thing I am going to try is Vitex (Chasteberry), which is supposed to be a very good natural supplement for PMDD. In my research on Vitex (Chasteberry), I found the following: Recent findings confirm that Chaste Tree helps restore a normal estrogen-to-progesterone balance. It can not only ease, but with time, actually cure premenstrual syndrome, which has been linked to abnormally high levels of estrogen, especially if symptoms tend to disappear when menstruation begins. European herbalists also used it historically to treat fibroid tumors and other female complaints. As the baby-boom generation passes into menopause, this herb will be rediscovered by women looking for a natural alternative to estrogen replacement therapy.
In addition, I just came across an article in a women's magazine I read about a woman who suffered greatly each month, and had seen one endocrinologist after another. The last one she saw recommended calcium, and told her the calcium would cure her PMS. The article went on to say that a finding recently reported in the American Journal of Obstetrics and Gynecology revealed that low calcium intake is the underlying factor wreaking havoc with many women's monthly hormonal cycles, leading to irritability, depression, tension, cramps, cravings and more. It further stated that calcium is essential for the synthesis, release and secretion of hormones that regulate muscles and nerve tissues. The mineral is so key, in fact, that after taking 1,200 mg of calcium daily for just three months, the women in the study reported a 50% reduction in their PMS symptoms. It is recommended that women include 1,000 to 1,500 mg of calcium in their diet combined with vitamin D since D enhances calcium's absorption and efficiency. So, if you are going to supplement with calcium, make sure to choose a formula that includes vitamin D.
Tamara
> I agree with Dove - all this information is really wonderful, thanks to all who've posted!
>
> So, those of you who had all the different hormone and chemical levels tested, what did your doctor do with that information? Did he/she prescribe different meds than just anti-depressants to correct the imbalances? I'm especially interested in a thyroid that goes up & down, as I think mine does. Also, with a glucose imbalance, is that just correctable through diet, similar to a diabetic?
>
> Thanks for all the great info!
>
> ~ Lynne
Posted by LynneDa on December 7, 2004, at 10:15:28
In reply to Re: soo happy to find some info » LynneDa, posted by jujube on December 7, 2004, at 10:05:16
Tamara - This is wonderful stuff, thank you!!
~ Lynne
Posted by Mariposa on December 9, 2004, at 12:00:43
In reply to Re: soo happy to find some info, posted by LynneDa on December 7, 2004, at 10:15:28
I just wanted to add my kudos... LynneDa, jujube, Mel32, Liv, Banga - ALL GREAT INFO and recommendations!!!! Dr. Vliet is OUTSTANDING, and all the things mentioned - calcium!! etc. are well worth the second look as possiblilities.
Am 49, no children or pregnancies, suffer PMDD which has worsened with age. Married 15 years and husband still has problems w/me even though I beleive he kind of understands. Keeping calendar VERY important for showing HIM the *cycle of violence*. Finding another outlet for RAGE is very important!!!
Currently on 30mg Lexapro - a lifesaver in my opinion. Has *cured* my insomnia, have not had problems w/weight gain. After 9 mos. or so was able to enjoy sex again.
I just hope there are others who will give Lex a chance to work (it does take a WHILE, but results for me were worth the wait) and not give up too easily without investigationg ALL of the options and possibilities out there!!!
Best of Luck to us all!~~~8|8
Posted by perkidoom on December 10, 2004, at 20:23:16
In reply to Re: soo happy to find some info, posted by LynneDa on December 7, 2004, at 9:17:44
I just had some blood work done I will find out and also take what I have learned hear to my doctor. I am so thrilled thatI can get the scoop hear rather then just shoting in the dark. THANK YOU FOR SHARING, this really helps people learn about this.
Posted by perkidoom on December 10, 2004, at 20:27:43
In reply to Re: soo happy to find some info, posted by perkidoom on December 10, 2004, at 20:23:16
wow it is pretty scary having to try all these different hormone and meds. Hummm but its worth it to me and my husband and family if somthing really will work.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.