Hormonal combination of estradiol and norgestrel- pcos theraphy?

Ulla

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Hey.

Regarding to PCOS and no periods at all, my doctor prescribed me a therapy consisted of norgestrel and estradiol valerate.

Therapy goes like 11 tablets of 2 mg estradiol valerate (E2) followed by 10 tablets of 2 mg E2 + 0.5 mg norgestrel. Then 7 days no therapy - meantime the period should come etc...

My goal is to get my own periods and later to get pregnant too.

I am not sure if this theraphy is a good idea for me.
I am using pregnenolone for 6 months now - 2 weeks on, 2 weeks off. 20 mg daily.
No period so far.
I gave my blood for TSH, FSH, LH, prolactin, testosterone but I need to wait for the results.


My questions would be:
- is norgestrel efficient form of hormone or is just another 'crap'?
- if I decide to take the therapy, would using pregnenolone topically in the last 10 days be a good idea to prevent estrogen dominance?
English is not my native language so I hope my post is understandable.
 
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I don't think PCOS is caused by insufficient estrogen and I would never think that a woman would be better off taking extra estrogen.

How is your thyroid, morning temps?
 

Blossom

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Norgestrel is a synthetic progestin. Have you ever considered any bioidentical progesterone products like Progest-e (Dr. Peat's formula), Progestene (Haidut's formula) or the newly released Simply Progesterone (from Health Natura)?
When I first started implementing Peat's ideas into my life I took Progest-e uninterrupted for close to a year. When I would feel like I was forming an ovarian cyst I would take an additional hundred milligram dose of Progest-e which Dr. Peat mentioned should resolve cysts in a KMUD radio interview. This is just my personal experience. I agree with ecstatichamster on the estrogen and thyroid. I think it is possible resolve the PCOS in a safer way with continued good nutrition, bioidentical progesterone and fixing any thyroid issues. I know we have some forum members who have struggled with PCOS and I'm hopeful that they will reply too!
 
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Ulla

Ulla

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Okay, here goes my short history:

After 6 years of taking contraception I quit them and after that I didn't get my own period. I was waiting for more than a year and my menstrual cycle still hasn't appeared. So I got that therapy (cyclo-progynova). That was in the end of year 2014. That time I was already low carb, thinking that I need so much fat so hormones could be produced :)
After 6 months of taking norgestrel + estradiol I still didn't get my period. While taking pills I had period but after quiting it, nothing happened.
I had an examination these days and got another prescription for the same pills but I really don't want to eat them. But on the other hand I am afraid of not having an ovulation. Osteoporosis, menopause...not being fertile... well, I am too young for all that.

So long story short:
  • I quit taking norgestrel + estradiol in April 2015.
    April 2015 - September 2015 - using Progesterone cream, 20 mg daily.
    September 2015 - January 2016 - using Haidt's progesterone
    All this time 14 days on, 14 days off...

I gave blood in July and Ocotber and I had both hormones, estradiol and progesteron, below-normal level.
In one thread Tara said that the level of estradiol in blood isn't necessary representative for a whole body, that estrogen is in fat tissue too.
But I don't consider myself as a fatty person, neither skinny fat.

I will get the new lab result in three weeks.

So if I get it correctly, I should avoid pills... thought so.. :)
 
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Ulla

Ulla

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ecstatichamster said:
post 118409 I don't think PCOS is caused by insufficient estrogen and I would never think that a woman would be better off taking extra estrogen.

How is your thyroid, morning temps?

TSH 2,6
t3 = 3,4
t4 = 12,1

morn.temp ~ 36,4 °C

hypo.. :)
 
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Blossom

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naninani said:
post 118439 I had an examination these days and got another prescription for the same pills but I really don't want to eat them.
I wouldn't eat them if you don't want to especially since you have tried that before and it didn't help.
naninani said:
post 118439 But on the other hand I am afraid of not having an ovulation. Osteoporosis, menopause...not being fertile... well, I am too young for all that.
I think getting enough nutrition from mixed meals (protein, carbs and saturated fats) and snacks can go a long way to helping your hormonal balance. If you feel you are managing this well then thyroid might be worth exploring. A woman's fertility is dependent on energy balance except for in extreme circumstances where the body makes a last ditch effort to procreate in times of scarcity. If it were me I'd honestly evaluate nutrition first and if that seems good then consider thyroid while staying with Haidut's progesterone. You don't necessarily need to use it uninterrupted but it wouldn't hurt either in light of the cystic condition of your ovaries.
I'm still hopeful for replies from those currently dealing with PCOS! I had a partial hysterectomy by the time I found Peat so my situation is slightly different than yours.
 
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Ulla

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Thank you Blossom.

In my family no one has PCOS.. so I am still hoping for the best. I believe it is a lot about nutrition.
I will continue with progesterone, I think I feel better with it.
It is just that I feel confused with all that sex hormones under-normal level. Usually estrogen, prolactin is high but in my case not. Well...for prolactin I will find out in three weeks... will report...

So I hope for another replies here...
 

sweetpeat

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naninani said:
TSH 2,6
t3 = 3,4
t4 = 12,1

What are the reference ranges for the t3 and t4? Different labs use different ranges so I'm not sure if these are good or bad values.
 
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Ulla

Ulla

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sweetpeat said:
post 118465
naninani said:
TSH 2,6
t3 = 3,4
t4 = 12,1

What are the reference ranges for the t3 and t4? Different labs use different ranges so I'm not sure if these are good or bad values.
TSH 0,27 - 4,20
T3 3,1 - 6,8
T4 12,0 - 22,00
 
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Blossom

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naninani said:
post 118455 Well...for prolactin I will find out in three weeks... will report...
Please do! High prolactin can cause fertility problems and interfere with the menstrual cycle.
 
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Ulla

Ulla

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sweetpeat said:
post 118465
naninani said:
TSH 2,6
t3 = 3,4
t4 = 12,1

What are the reference ranges for the t3 and t4? Different labs use different ranges so I'm not sure if these are good or bad values.

these are my lab results for TSH...

From January 2015-July 2015 I was mostly low carb with carbs after training... sth like Biorythm diet.
 

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sweetpeat

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naninani said:
sweetpeat said:
post 118465
naninani said:
TSH 2,6
t3 = 3,4
t4 = 12,1

What are the reference ranges for the t3 and t4? Different labs use different ranges so I'm not sure if these are good or bad values.
TSH 0,27 - 4,20
T3 3,1 - 6,8
T4 12,0 - 22,00
Wow, those are definitely low, very similar to mine. I'm surprised your TSH isn't higher with levels in the basement like that. With such low thyroid function, it's no wonder your body is struggling to make your steroid hormones. It's almost as if your body thinks it's in menopause, based on the info you've given so far. I know that a certain amount of estrogen is needed in order for fertility to happen. I'm curious as to what your other lab work will show. But bringing up your thyroid function can only help, I should think. Is your doctor willing to treat you for hypothyroidism? Assuming, as Blossom said, that your diet is pro-thyroid.
 
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Sheila

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Hello Naninani
I have never seen oestrogen help in these cases and also find it hard to match blood tests/saliva tests with the person concerned so I further question their real worth, not to mention expense and false leads and wasted time. Thyroid tests can be falsely positive or negative from a whole raft of reasons, many of which are outlined on this forum, so I now personally consider them at best a guide, certainly not gospel. Improving thyroid function by supplementation might be an option. BUT jumping to another hormone might still not be tackling the foundational issues of adequate nutrition and lifestyle choices (or for example potentially over-training for where one is at metabolically, too little/too much sleep, work stress, not sufficient sunlight etc ) especially if your morning temps are being held up by stress hormones which I rather suspect. Pulse and more readings might reveal.

Everyone is an individual, but I have seen better results with a pro-metabolism diet, careful monitoring of cause and effect, then judicial hormone additions if necessary, than just hormones (of any type) and hope. I second pretty much everything Blossom has said and wish for her gift of succinctness (!), so please consider your diet monitored by temps and pulse to see what combinations work for you, there is no one diet for everyone.
The best of luck,
Sheila

PS Blossom, thanks for this "A woman's fertility is dependent on energy balance except for in extreme circumstances where the body makes a last ditch effort to procreate in times of scarcity" as I have observed this several times and thought that might be the explanation. This is seen in plants too, another example is bamboo, flowers and dies. EEEK!! You have to wonder, what's the next generation of bamboo like?? I have also quite a few documented cases of 'ovulation on demand' (so to speak)and follow on pregnancy which defies the belief that Day 12 - Day 14 is the key time for fertility. Sometimes I think the stress involved with sex at the 'perfect time' is yet another factor restricting successful anything. Cortisol and expectations, conscious and sub-conscious have a lot to answer for. Sx
 
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Ulla

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Thank you both for your replies.
Right now I am not at home so I can't write a longer answer.

Just a quick info I remembered...
Excatly three years ago I checked sex hormones, including FSH and prolactin.
FSH was under-normal, like all other hormones, but prolactin was normal. I am not sure if this is a safe zone (prolactin within normal range) if all other sex hormones are under-normal.
Back in these days I was eating eggs, (raw) veggies, no fruit, no sugars, low fat, lean meat, cottage, grains like buckwheat and rye...
Not enough calories (I see that now) explains my urges to binge back in that time (sweets mostly).
Later in 2013 I found out low carb and I went fully on (pufa, saturated) fats, zero on carbs.
 

HDD

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Hi Naninani,

I found these quotes in the audio transcripts that pertain to your situation and thought they might be helpful. I don't have the link to which transcript the first ones are from but if you need it I can try to locate it.

"If you look at the ovaries, when, in a dog or a cow, for example, they have removed the animal's thyroid, the ovaries develop a polycistic condition, instead of just one dominant egg follicle preparing for ovulation, the ovaries fill up with a lot of these fluid filled chambers, and ovulation is abnormal, and they develop the tendency to produce an excess of estrogen. So at many levels low thyroid leads to excess influence, persistence and overproduction of estrogen."

"And it's interesting that the accumulation of fluid -- it's one of these mucopolysaccharides again -- that swells up, fills up these many cystic follicles in the ovaries -- it's the same sort of material that fills up the eyeball in glaucoma, which is also promoted by low thyroid and high pituitary hormones."


This interview is linked for the quotes that follow it.
viewtopic.php?f=73&t=5322&p=63851#p63851

JR: So, while we’re on the topic, and I don’t want to go to much into PUFAs, but, let’s go and chat about estrogen levels, and how hypothyroidism can raise those, and I think it’s a huge concern, because a lot of women are being prescribed these medications, number one, most people are having issues with detoxifying their body of these estrogens, number two, and having this unopposed estrogen in the body can lead to specific dysfunctions or diseases like clotting and edema, fibrosis, and cysts and all these things.

RP: There are very close interactions between the increased estrogen, and you mentioned clotting, and estrogen increases serotonin dominance. And serotonin and estrogen both promote, and are promoted, by the polyunsaturated fats and the low thyroid condition. So it forms sort of a polar cluster with the energizing thyroid and the good nutrients, sugar, minerals, protein and so on, maintaining and energizing the structure. The emergency stress things, the prostaglandins, serotonin, histamine, cortisol and estrogen are all on the short term defensive side, but when they become dominant, they deform the proper regulatory systems.

There’s a special problem with the basis for diagnosing estrogen deficiency, because in the absence of anti-estrogen substances such as progesterone, the estrogen in the blood can go to a very low level, because the estrogen is staying inside cells, and progesterone knocks it out of cells, inactivates it, but causes it to appear in the blood stream on its way out the kidneys. So, in the absence of progesterone, doctors will measure a low level of serum estrogen, and prescribe it, even though, under that situation, it’s very likely that their tissues, breast and uterus in particular, are actually overloaded with a chronic supply of estrogen.
 
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thanks HDD.

What kind of dosages of progesterone can be helpful in the case of a woman postmenopausal with obvious estrogen overload (fibroids, hot flashes, hirsutism). It seems 10mg or 20mg isn't enough...
 

HDD

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ecstatichamster said:
post 118559 thanks HDD.

What kind of dosages of progesterone can be helpful in the case of a woman postmenopausal with obvious estrogen overload (fibroids, hot flashes, hirsutism). It seems 10mg or 20mg isn't enough...
This is from Progesterone Summaries on raypeat.com-
"Progesterone's effects on the pituitary apparently contribute to its protective effect against osteoporosis, hypertension, hirsutism, etc. But some women prefer to use progesterone without interruption after the menopause, for its protective antistress effects. Slender people usually find that two or three drops are enough, but this amount may be repeated once or twice as needed to relieve symptoms. Adequate protein in the diet and good thyroid function help the body to produce its own progesterone; even if the ovaries have been removed, the adrenal glands and brain continue to produce progesterone. "

In the same article, he states that if a woman doesn't feel any effect from 100 mg of progesterone that he thinks it indicates they need to use thyroid and diet to normalize their estrogen, prolactin, and cortisol.

I am post menopausal and used diet and supplements for several months before using progesterone. This included aspirin, vitamin e, pregnenolone and liver. I later added thyroid. I started with a few drops and eventually settled on 6 drops at bedtime (progest-e). I do not have the same symptoms but I do/did have estrogen dominance symptoms and hypothyroid history of symptoms. There are a few things that you should take note if increasing progesterone. If the thyroid gland is enlarged, progesterone can cause it to release stored hormones and cause a hyperthyroid state. This can be stopped using cabbage juice or carnitine (iirc) . The other is anesthetic effect of large doses.

I recently read about hot flashes but can't recall right now what stood out but will see if I can find it later today.
 
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Ulla

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HDD said:
post 118556
There’s a special problem with the basis for diagnosing estrogen deficiency, because in the absence of anti-estrogen substances such as progesterone, the estrogen in the blood can go to a very low level, because the estrogen is staying inside cells, and progesterone knocks it out of cells, inactivates it, but causes it to appear in the blood stream on its way out the kidneys. So, in the absence of progesterone, doctors will measure a low level of serum estrogen, and prescribe it, even though, under that situation, it’s very likely that their tissues, breast and uterus in particular, are actually overloaded with a chronic supply of estrogen.

Wau, thanks for all that quotes -- very helpful for understanding pcos more ;)
Especially the last paragraph explains well about serum estrogen. I had a couple of years drinking only soy milk because I had anginas many times a year and I thought that I am somehow allergic to milk. So I was consuming soy milk when teenager. When I got a little bit older, anginas suddenly disappeared. I don't know what caused that happened.

Lab work from Jan 2013:
FSH - 3,58 mlU/mL [follicular phase: 6.9 - 12.5;; luteal phase: 3.6 - 7.7]
LH - 3.96 mlU/mL [follicular phase: 5.9 - 12.6;; luteal phase: 4.3 - 11.4]
prolactin - 5.81 yg/L [4.79 - 23.3]
estradiol - 62.61 pmol/L [ovulation: 315 - 1828;; follicural phase: 46.0 - 607;; luteal phase: 161 - 774;; menopause: <18.4]
progesterone - 1.66 nmol/L [ovulation: 2.4 - 9.4;; follicular phase: 0.6 - 4.7;; luteal phase: 5.3 - 86]

Everything below-normal except prolactin. That was three years ago. Can't wait for new lab results..
 
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HDD

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These are from some older posts from forum members that were very familiar with Ray Peat's work.

Peatarian said:
women who've been diagnosed with PCOS. Usually they developed uterine myoma later. When you use enough progesterone, the syndrome disappears and will not occur again. It's just that too much estrogen triggers too many oocytes to enlarge. Nothing serious and when the estrogen is opposed, it doesn't occur anymore.
viewtopic.php?f=198&t=626&p=3435&hilit=Pcos#p3435

Rayser said:
Lindsay, I know of several women who have been using large amounts of progest-e-complex every day for years. Most of them got the recommendation from Ray Peat himself (like me). It cured them of several conditions. PMS, PCOS, infertility, endometriosis, myoma, cysts, osteoporosis, depression, migraines, heavy bleeding, no bleeding, scar tissue after surgery or other tissue trauma ... There are no negative effects from using progesterone. Ray Peat says there is the possibility of overdosing which would make you euphoric or tired. 19 women I know very well are using progest-e-complex, many of them on occasion a bottle in one to three days and not one of them ever felt tired or euphoric. You do feel mentally stable, not teary or insecure or helpless. If you feel like that when you use less, it's a sign you should use more. After I while you find out for yourself how much you need to be comfortable and that's usually a sign that you have the right dosage to repair inner damage as well.
I know it can be scary to "use hormones". The name alone has a bad reputation because of estrogen's and insulin's terrible effects. But as far as I can tell after four years of using progest-e-complex and recommending it to others: There are no negative effects. I doubt I would say that about any other supplement or drug. If you have any questions, you can always ask.
viewtopic.php?f=177&hilit=Pcos&p=23161&t=1937

Ray Peat said:
Since an essential mechanism of progesterone's action involves its opposition to estrogen, smaller amounts are effective when estrogen production is low, and if estrogen is extremely high, even large supplements of progesterone will have no clear effect; in that case, it is essential to regulate estrogen metabolism, by improving the diet, correcting a thyroid deficiency, etc. (Unsaturated fat is antithyroid and synergizes with estrogen.)
 

SQu

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"There’s a special problem with the basis for diagnosing estrogen deficiency, because in the absence of anti-estrogen substances such as progesterone, the estrogen in the blood can go to a very low level, because the estrogen is staying inside cells, and progesterone knocks it out of cells, inactivates it, but causes it to appear in the blood stream on its way out the kidneys. So, in the absence of progesterone, doctors will measure a low level of serum estrogen, and prescribe it, even though, under that situation, it’s very likely that their tissues, breast and uterus in particular, are actually overloaded with a chronic supply of estrogen."

Great thread.
And great quote on confusion about "low estrogen".
 

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