Cyclic Progesterone Therapy for PCOS

[catgirl90]

https://www.larabriden.com/cyclic-proge ... -for-pcos/

After reading the above blog, I was fortunate enough to be sent a copy of Dr Briden's journal article about the use of cyclic progesterone in treating symptoms of PCOS. I took this journal article to my endocrinologist, however they still refused to prescribe cyclic progesterone because I have a Mirena, which they insisted was chemically the same.

Fast forward a couple months, and now having seen Dr Briden's most recent Facebook post about progesterone versus progestin, I'm thinking I should have been more adamant in asking my endocrinologist for bio-identical oral progesterone tablets to use on a cyclic basis.

Alarmingly, my endocrinologist has instead prescribed both the contraceptive pill and Roaccutane for the treatment of (relatively mild) hormonal acne, which feels extreme. I'm too scared to follow those prescriptions! Years ago I did take about a six month course of progesterone tablets and never felt better; extremely rare acne, better weight control, reduced mood swings, reduced menstrual pain and fewer migraines. However I was told that a Mirena was the only long-term solution for treating my PCOS, and that only Roaccutane could 'stop' acne. I'm not totally comfortable with this advice.

I would love to find a doctor/ specialist in Australia where I am based who would be happy to review the role of cyclic progesterone in treatment of my PCOS, especially as I approach the decision on whether or not to try for a baby with my husband (I am aged 31, approaching 32 years, no children.) If anyone in this forum can kindly point me in the right direction, that would be much appreciated please. Thank you!

[Lara]

Oh dear. That is concerning that an endocrinologist would say that the levonorgestrel in Mirena is chemically the same as progesterone...

One tip is to ask for progesterone by brand name. Say something like: "According to this Canadian endocrinologist, taking Prometrium two weeks on two weeks off can help to lower androgens and promote ovulation." And then show them our paper. (By "Canadian endocrinologist," I'm referring to my co-author Prof Jerilynn Prior.)

If that doesn't work, maybe enquire at https://wellfemme.com.au/ for a possible telehealth consult with Dr Kelly Teagle. Technically, it is a menopause clinic (and you are clearly not in menopause) but they are well versed in body-identical hormones and at least know what Prometrium is.

[catgirl90]

Thank you so much! I will give this a try.

[paula_ribeiro]

Hello,
I am sorry to invade your post. I am in the progesterone cyclical therapy since September last year. I am also taking Spironolactone to decrease the androgens. Bad thing is my cycle is shorter (maybe because the Spiro?) and also I am having very bad cramps. I have ever experienced something like that. Somebody else feeling the same? Anyone has an idea what is going on?

[Lara]

It's fine to chime in. With regard the cramps, did you have them at any other time in your life? And before the treatment, were you having natural ovulatory cycles? (ie. not on the pill, or having anovulatory cycles?) Just to try to understand what might have changed.

[Lisa]

Hi, I had a similar problem with endocrinologist. Got diagnosed with PCOS when I was 18, then prescribed the pill and after stopping it I didn’t get my period for 2 years. In September my gyn prescribed me cycling progesterone therapy. After first cycle I got my period, I also started to feel better, so I was very happy as it seems I was finally starting to get better. Last week I had an appointment with endocrinologist, who told me to stop taking progesterone as it will cause even higher levels of testosterone and lower my estrogen. I was told that my labs look like in postmenopausal women and that I will never able to have children if I continue. I have low estrogen, high testosterone, LH FSH ratio is 2, BMI 19,5, low fasting insulin. I’ve been on low carb, gluten free and dairy free diet for a year now, tried taking vitex.

Endocrinologist prescribed me metformin. I am desperate as I am only 24 and I really want to have children some day.

Is it worth to continue and finish six months course of progesterone or start metformin right away? Is it true what she said about progesterone?