Endometriosis and perimenopause

[MinunEndo40]

Hi,

I am 40 yr old wannabe mother, who is trying to figure out what to do. I have tried all the pills (HRT) out there including strong progestin only pills. They have ended up giving me increasing depression (especially morning depression), anxiety, hair loss, low libido, mood swings (my mood can change just during one day multiple times!), and of course spotting. I have always had to double or triple my dosages but of course then the side effects increase too.
My last contact to the doc was 2 weeks ago and their only suggestion now was to go with induced menopause with hormones (for 3-6 months) and then another laparoscopy and maybe IUD and some pill afterwards.

I have always been geared towards more natural way of treating my illness and a 6 years ago tried to live (for 4 years) without any HRT and went with progesterone cream at first (without a doc's supervision as they do not believe in such things here in Finland). Then I tried acupuncture and chinese herbs. This was by far the best solution for me, but unfortunately the effects did not last that long and I was unable to continue the treatment.
Along the years I have been independently trying to build up a supplement plan (vitamin D, B, iron, NAC, serrapeptase, zinc, calcium, magnesium, digestive enzymes, melatonin) with various results.


I think I might be suffering already of perimenopause, but is there a way of checking that other than based on symptoms and AMH levels? Especially if you are on constant progesterone pill then how to identify what is a side effect of the treatment and what is related to other age related physiological effects of the body?

I also probably suffer from central hypothyroidism, that is not showing in blood tests. I gave up my thyroid meds last December and trying to see if I can now be without. I have seen many doctors and unfortunately no one is experienced in both endo and other hormone related illnesses. Nutrition is never mentioned with conventional doctor appointments.

What is also bothering me is that I recently found a research article about iron levels and endometriosis. It is claiming that it most endometriosis patients suffer from low iron levels due to heavy bleeding and yet apparently endometriosis leasions "collect" iron from the body to themselves. Conclusion: endometriosis causes iron deficiency but cannot be treated with iron supplements as it makes the condition worse?


I do not really know what I need help with, except everything. Most tiring is having to carry the burden of the illness alone and knowing that your main options are either bleeding in pain most of the time or feeling numb, depressed and disconnected from yourself and everyone around you. So any advice on what to do next or thoughts on how to argument with doctors would be great.

[Lara]

Have you read the endometriosis section in my perimenopause book Hormone Repair Manual? There, I discuss important strategies including avoiding gluten and dairy and identifying and treating SIBO. (Most women with endo have some degree of SIBO).

As for whether you're in perimenopause, there is no test, but at 40, it is likely. But, of course, you can still conceive in perimenopause.

You say you're on a constant progesterone pill. Do you mean a progestin pill? Or are you on natural progesterone?

[MinunEndo40]

Yes, I am on progestin pill (Primolut, so it is norethisterone). Two weeks ago I actually stopped taking it to see if it improves my mental issues. I had my period two days after. Mental issues so far equally bad, but I guess it takes time for the body to get adjusted.
I would like to try the bioidentical progesterone, but sadly I do not think I can find a doctor over here who would prescribe it and monitor the proper dosages. With the creams and oils I used topically before I found it very difficult to figure out how much to use every day.
I have not read your book, but considering getting it. I have other books though that discuss the hormonal balance issues and how they can be treated.

[Lara]

Actually, many doctors are now willing to prescribe progesterone as either Prometrium or Utrogestan (depending on your country). It's best to ask for it by brand name, rather than saying "natural progesterone." See the "how to speak with your doctor" sections in Hormone Repair Manual.

[meowallthetime]

Hi Minun, I’m in the same situation as you. On Norethindrone/Norlutate with side effects. I’ve asked for natural progesterone/Prometrium but my doctor here (Canada) refused to consider this option.

My ND has prescribed estradiol (vaginal suppository) and that has been helping with some of the side effects. But not sure what more I can do.

[meowallthetime]

One more thing - just to share my experience, I previously was on 200mg natural progesterone for the last 2 weeks of my cycle for about a year (with the goal of making endo manageable while TRC). This was prescribed by my Naturopathic Doctor. It helped make my period lighter but the pain and other endo symptoms were still unmanageable. This was why I ended up on continuous progestin (Norlutate/Norethindrone).

I had also been on Lupron for 3 months a few years before all this, but the beneficial effects lasted only 1 cycle after stopping lupron. This was done in preparation for IVF/IUI. The side effects during the 3 months were brutal. The gyne said the endo symptoms usually don’t come back until 1 year after using lupron and that my case was unusual.

I hope you are able to find something that works for you, and I’d love an update from you with your progress! Best of luck to you!