Progesterone During Breastfeeding

[Emunagal]

My baby is 6 weeks now, and I am breastfeeding exclusively. Generally I have all sorts of issues with low progesterone and have been taking progesterone for years now, with great results overall, including during pregnancy, with great results reducing preterm contractions and more.

My question is: with every child (this is #3) I have experienced, and am once again starting to experience, intermittent bleeding while breastfeeding, after the initial bleeding stopped and before getting my period back (approx months 1-6 postpartum). I also have huge swings in breastmilk supply corresponding to the bleeding. Generally the bleeding is about 10 days bleeding, 10 days no, and then repeating (far too short a cycle to be a period, and longer bleeding than a normal period as well, also for what it's worth, I just was checked by my doctor who said the ultrasound shows that I am NOT ovulating yet).

My doctor said supplemental progesterone could be causing the bleeding. That flies in the face of what I know - usually bleeding is caused by too little progesterone, not too much (and I doubt it is too much anyway - I have WAY too much estrogen in my cells due to years of birth control pills and thyroid problems, and when I stop taking progesterone, right away all sorts of estrogen caused problems start right up again) and I found some studies that showed that menstruation returned earlier in women with less progesterone, not more.

Anyway, I admit that postpartum I have not been good about taking progesterone every day. So I have no idea if the bleeding is because I am taking it at all (and I should stop), or because I am not taking it enough (and I should increase)!

Does anyone have knowledge about this? What does Peat say about progesterone during breastfeeding and/or how it affects irregular bleeding etc? What do you recommend I do about taking progesterone right now?

 

[Emunagal]

Also I remember Peat saying that daily progesterone can even stop menstruation altogether, which would be wonderful, since generally I start again about 6 months postpartum and I would be happy to delay as long as possible. So that seems to also point to taking progesterone as opposed to not. But if the progesterone is going to cause bleeding, then I don't want to take it. Confused.

 

[Emunagal]

I reconfirmed with the doc that I SHOULD be on progesterone. She gave me an RX for Utrogestan (Prometrium in the US) brand name (not generic) 200mg. I have taken it before - I didn't want the gelatin and titanium dioxide in the capsule, and figured on the skin would get me better absorption rate. So I put on the cream transdermal and discarded the cap.

How would that compare with Progest-E? I don't like putting it on the gums, so I also take that transdermally, with a little bit of olive oil on the skin first to help it absorb better (recommended by Peat). How much Progest-E would be equivalent to the 200mg and would I really need that much?

It's a bit hard to turn down the Utrogestan, since it is SO much cheaper for me (about $10 per month after insurance versus 1-2 equivalent in bottles at $35 a bottle or so (assuming I take 100-200mg daily of the Progest-E). Also I don't have to ship in the Progest-E from the US. But I am scared that even though it is supposed to be natural, micronized, equivalent progesterone and not a progestin, anything connected to Big Pharma makes me nervous.

Thanks!

 

[tca300]

Ive been trying to figure this out with my wife. She bleeds a little sporadically ( gave birth 7 months ago ) and is very estrogen dominant. I worry that progesterone might interfere with breast milk production, but the studies I have read indicate no difference from ~10mg transdermal progesterone during breast feeding in milk production ( I dont think 10mg per day is enough to correct estrogen dominance ). Hopefully someone with more knowledge and experience on this subject will respond. 200mg per day does seem like a lot.

 

[HDD]

Here's a thread where I posted a few things I had found.
Ovarian Cysts While Nursing- Can I use Progest-E?

 

[Emunagal]

Ive been trying to figure this out with my wife. She bleeds a little sporadically ( gave birth 7 months ago ) and is very estrogen dominant. I worry that progesterone might interfere with breast milk production, but the studies I have read indicate no difference from ~10mg transdermal progesterone during breast feeding in milk production ( I dont think 10mg per day is enough to correct estrogen dominance ). Hopefully someone with more knowledge and experience on this subject will respond. 200mg per day does seem like a lot.

I can say this - from the research of Dalton (showing progesterone supplementation increased length of breastfeeding, among other things), and my own experience fiddling with progesterone with my previous babies, the idea that progesterone interferes with milk production is wrong - not sure 100% of the time, but definitely wrong for estrogen dominant women. In theory everything is supposed to be low, and prolactin is high. But if there is estrogen in the cells (even if it isn't being actively produced) then the woman is still in a state of imbalance without the progesterone production to offset the estrogen, and the estrogen definitely limits breast milk production as evidenced by the research on estrogen based birth control affecting milk supply! (BTW those progestin only (supposedly progesterone, really estrogen) BC pills also affect supply in about 10% of women - namely the women who already have too much estrogen). So without having done a study myself, I am quite confident that an estrogen-dominant woman needs progesterone to keep her supply stable. As I mentioned, I know my issues are estrogen based - fluid retention, too cold - standard estrogen stuff. Then suddenly I get a rush of something, get crazy hot, and have a huge increase in milk supply. Then it wanes and the cycle repeats.

I also question if the idea of progesterone affecting supply might be wrong in the first place - wouldn't surprise me at all if the research was done with progestins, not real progesterone - perhaps even specifically to steer women away from what might help them. And in any case, Big Pharma says their progestin birth control doesn't affect supply (but of course it does because it's really estrogen - ironic). So I want to see evidence even for women without estrogen issues. Besides which I find in general the research on women's issues is sorely lacking, in amount and in quality. Big Pharma doesn't want to help women breastfeed successfully - they want them to give up and buy their cash cow formula.

So the issue is finding the right amount of progesterone to correctly balance the estrogen that IS there, whether it is "supposed" to be there or not.

RE: the 200mg - even transdermal application doesn't get 100% uptake. Although I do prefer if there was an easy way to take it in chunks instead of all at once.

 

[tca300]

@Emunagal Your probably on to something! Thanks for the thoughts!

 

[Cheesecake]

With both my kids I took progest-E just a few weeks postpartum. Ray advised me that so long as milk production was established, it was safe. If it affected milk supply to pull back. Estrogenic compounds are what's in things like Fenugreek, that women often supplement with to up their supply.