bioidentical progesterone for PMDD?

[ange+174]

Dear Dr. Lara Briden

I live in a country where PMDD is rarely known, and so far just one doctor is working with tailored (compounded) bioidentical hormones. I have an appointment with him only in november this year. I do pretty much everything to alleviate PMDD symptoms, except bioidentical progesterone. You're mentioning on your website, that when using bioidentical progesterone for PMDD, there is a 'sweet spot' of 100mg to 200mg. My question is, do you recommend continuous administration of 100mg to 200mg daily over the whole cycle, or only in the luteal phase? My doctor has prescribed 200mg (Utrogestan) for 10-14 days, so for the second half of the cycle. But I do fear an even bigger 'crash' at the end of the cycle when progesterone drops anyway, as in PMDD it is the fluctuation of hormones, that causes all these debilitating psychological symptoms. So how do you see best results? And do you recommend to also treat with bioidentical estrogen when I'm in perimenopause with probable anuvolatory cycles here and there? Thank you best!

[Lara]

In general, many of my PMDD patients have done well on 100 to 200 mg during the luteal phase only. I hear what you're saying in terms of the potential 'crash' at the end of the cycle, but it seems to not be a problem as long as progesterone is continued right up to the bleed.