by drjudy » Tue Nov 30, 2004 10:49 am
Dear Linda,
We doctors have certainly gotten reluctant to use hormones which is a shame as they can be so helpful for some. I too have read those books by Drs. Lee and Northrup, and Suzanne Sommers. I don't agree with all they say, but they have done women a great service by balancing all this negative press about HRT with positive messages.
Progesterone is a mixed blessing in perimenopause. On the one hand, it can balance high estrogen levels that occur in early perimenopause as our bodies attempt to "do the right thing" in response to pituitary signals to ovulate. If leftover eggs are hard to dredge up in response to FSH release, the ovaries, the adrenals, the breasts, fat and muscle tissue, all respond by making estrogen or converting other adrenal hormones to estrogen. The result of all this estrogen excitement are big breasts, irritability, terrible PMS, and crampy, heavy periods. While progesterone can balance this situation when taken the last half of the cycle--telling the pituitary that all is well so quit pumping out FSH--there is a downside to the hormone.
When progesterone is added to a body full of estrogen, the breasts respond by increasing glandular tissue. Tender breasts become worse than ever (I always felt like "two breasts with an attached woman" during times like that). While progesterone is sedating and promotes sleep, it can leave you feeling groggy and hungover. When rats were given natural progesterone, they could hardly keep themselves upright. In other words, some rodents and women too (including me) get dizzy with progesterone. You might find that it will make your inner ear troubles worse.
This entire hyperestrogen picture, compounded by progesterone, can definitely give you that "jump out of your skin feeling." If you take even more estrogen via cream or pills or troches, it all gets worse.
I don't know a great answer for some of these perimenopausal cycles from hell. I also am not a great fan of checking hormone levels during this phase as they change so frequently. I know Ms. Sommers loves those hormone checks. She also thinks we can all look and feel sexy and ready for "action." I think we need her support staff--personal trainer, cook, secretary, etc.--to feel that great.
Hang in there. It does get better. Hopefully, you will find a blend of hormones that works. I found that trying different solutions on different cycles worked...some of the time. I felt like I was living in the "invasion of the body snatchers" during perimenopause.
Best wishes,
Judy