Rescue Prescription for Menopause and Perimenopause

Natural treatment for menopause and perimenopause.

Perimenopause is the two to twelve years before menopause. It can cause heavy periods, mood swings, insomnia, and night sweats.

Menopause is the life phase that begins one year after the last period. It can cause hot flushes, weight gain, and insomnia.

Perimenopausal and menopausal symptoms can be relieved by natural treatments such as magnesium, taurine, progesterone, and transdermal estrogen.

Step 1. Magnesium plus taurine

Magnesium boosts GABA which is the brain’s main calming or inhibitory neurotransmitter. Together with the calming amino acid taurine, magnesium can improve sleep, mood, and hot flashes. I recommend 300 mg magnesium plus 3000 mg of the amino acid taurine.

A 2017 paper called “Magnesium in the gynecological practice: a literature review” found that magnesium is effective treatment for the symptoms of menopause and perimenopause and works by “normalizing the action of hormones (mainly progesterone) on the central nervous system.”

👉🏽Tip: For additional relief, consider adding 50 mg of vitamin B6, which is another good way to boost GABA.

For mood and sleep and hot flashes, magnesium could be as much treatment as you need. Try it for a few weeks, and then if you’re still suffering, stay magnesium, but look at adding the next step, progesterone.

Step 2. Progesterone or Prometrium for perimenopause

Natural progesterone or micronized progesterone is entirely different from the progestins used in birth control or conventional hormone replacement (HRT). It’s not a drug. It’s the beneficial hormone you used to make in your twenties and thirties.

Progesterone for perimenopause.

Progesterone has many benefits.

 👉🏽 Tip: Consider Prometrium or Utrogestan for perimenopause symptoms.

Magnesium + taurine + progesterone could be enough to relieve symptoms. Try that combination for a few weeks, and then if you still have symptoms, talk to your doctor about adding estrogen.

Step 3. Estrogen

Estrogen is a lot safer than you’ve been led to believe and can be incredibly helpful for sleep and mood and hot flashes. Most of the cancer risk from conventional hormone replacement was from the synthetic progestin, not estrogen.

If you do decide to add estrogen, choose one that is:

  • Low-dose such as Vagifem (10 mcg estradiol) or Estradot 25 or 50 (25 or 50 mcg estradiol).
  • Body-identical, which means it is identical to human estradiol or estrogen. Fortunately, most (not all) modern conventional estrogen products are body-identical. That includes brands like Vagifem, Estradot, and Sandrena gel. If you’re not certain if your estrogen prescription is body-identical or not, ask me in the comments.
  • Transdermal, which means you absorb estrogen through your skin from a cream, gel, or patch. It’s better and safer when taken this way.

You can take progesterone without estrogen. But if you take estrogen, you should take progesterone because it has many benefits for sleep and mood and breasts. That’s true even if you don’t have a uterus. 

For more information, see my upcoming book Hormone Repair Manual.

Dr Lara Briden

382 thoughts on “Rescue Prescription for Menopause and Perimenopause”

  1. Hi Dr Briden! How timely. I got this article to my inbox right after a call with my reproductive endocrinologist talking about hormone replacement. I’m 34 and recently over the last 6 months leading up to my 34 birthday i started experience erratic periods, hot flashes briefly and my FSH levels are through the roof. I do not yet have kids and would like to and the doctors I’ve seen are sighting diminished ovarian reserve with no logical reason. They’ve suggested hormone replacement therapy which I’ve been so weary of, but reading this article made me feel much better. The funny thing is- they have shared the term Perimenopausal, but i do not have heavy periods- i actually am sporadically getting them. Feeling defeated but grateful for you and your work 💛

    Reply
  2. I’ve just read an article on helloclue about magnesium & the menstrual cycle written by you. I think you are the person to help me to answer my question.

    I’ve been having menstrual problems and constipation issues and was told to try magnesium glycinate supplements because citrate caused a histamine reaction. I took one tablet yesterday morning 29 March 2021) and have changed nothing else in my diet or medication routine. I am 52 and I have the mirena coil fitted to prevent heavy menstrual bleeds. The coil was fitted on 21 January 2021. My last bleed was 5-13 February which was light and I’ve had no bleed since. I woke up this morning with a heavy red, brown bleed. Could it have been caused by taking the magnesium glycinate supplement? I am on rivaroxaban (anticoagulant), due to a pulmonary embolism in August 2020, but it hasn’t brought on any unusual menstrual bleed since starting it. I can see nothing else that could have caused it. I want to keep on with the magnesium supplements to help my symptoms. Is my body just clearing out what doesn’t need to be there or is the bleeding an abnormal occurrence?

    What are your opinions on this issue please? I would be glad of some expert advice.

    Reply
  3. Hi Lara! I was convinced I had symptoms of estrogen dominance but was just told that I am likely in perimenopause and just left it at that. I am 37! I have had somewhat irregular cycles and occasionally instead of a period lasting 5-6 days it will be twice that, my libido also seems very low. Here are my test results…. do you think perimenopause could be accurate? (low cortisol and free testosterone, high FSH (14.2), low LH (1.7), normal DHEAS (1.75), normal Estradiol (87.3), normal Progesterone (27.7)). Thank you so much for any thoughts!

    Reply
  4. I noticed that you seem to be a fan of licorice….and of Taurine. Does Taurine not pose heart health risks?
    And does licorice not pose a problem for those being treated for heart-related issues? Based on conversations I have been having with my doctors this year, and info I had been reading in heart-related patient literature, it surprises me to see these both being endorsed without an accompanying caution about risks to certain folks. 🤷🏻‍♀️

    Reply
    • Taurine does not pose heart health risks.

      Licorice certainly does, which is why the few times that I mention licorice for PCOS I also say:
      “Licorice raises blood pressure, so consult a clinician about safe use.”
      “Do not take licorice if you have high blood pressure. Please seek professional advice.”

      Reply
  5. Hi Lara, I was given HRT but I had to stop because my low moods were worse. After stopping I got very swollen and painful breasts, heavy period cramps and evening headaches. I get night sweats and don’t sleep much. I have a box of Ustrogestan still and, after reading this article, I was wondering if I should give it a go again and if so at what point in my cycle should I start? Thank you, Barbara

    Reply
  6. Hi Lara, I just started Peri, vour book PRM helped me alot and im waiting for HRM in Feb 2021. I have a question with regards to mental health and Peri-menopause. Im anxious, over thinking and feel extremely tired by 6pm. What research is there on the mental health issues women are experiencing?

    Reply
  7. Thanks for these info.
    I am wondering if light period ( much less flow) and less days is also a sign of peri menepause
    I am 46
    Had excision surgery for stage IV endo and Bilateral endometriama
    And fibroid surgery
    After that my period became lighter and now is very light , last only one day flow and spot before and after
    Also it is the first month that i miss one period, and first time in my life that i had two periods in a month ( last month)
    Am i close to menopause
    BTW i did not have any symptoms for endometriosis
    I listend to Dr ‘s recommendation to do the surgery
    Now i have most of the symptomes
    What bothers me most is if the surgery put me in an early menepause
    Out family age for menepause is 54 ( my mother , aunts)

    Thanks
    Asa

    Reply
  8. Wanted to know your thoughts on Duavee as estrogen. Doctor recommended but not taken it it yet. It was recalled and not available. So wanted any feedback. Thank you

    Reply
  9. What would be the safest HRT for me? 56, overweight, 1 lung blood clot about 5 years ago. 7 months w/o a period, peri started about 8 years ago.

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  10. Hello, I’m on 200mg continuous Prometrium Orally and taking 400mg Magnesium Glycinate and now will add Taurine per your recommendation. My question is two fold….I seem to have a bit of intolerance to Prometrium (GERD like symptoms) and wondering if I should try vaginally?? And if so, will I still have the same benefits such as improved sleep and mood. I am still struggling with night sweats and mild anxiety especially when I wake in the morning.

    Reply
  11. I’m in surgical menopause for a few months and mostly having sleep issues. Wake up can’t fall back asleep for a hour or more , have been taking 50 mg progesterone for over a year, recently added bi-est cream. The magnesium I have is taurate. Is that the same as taurine or should I add that also?
    Thanks for your work, I constantly recommend your book.

    Reply
    • Hi.. just reading through comments to see if someone has asked something I’m wondering and came across your question and saw it didn’t get an answer (Lara is one busy lady trying to save the world of female hormones 😂). Yes, magnesium taurate is magnesium in combination with taurine. If it’s been working for you, stay with it. If not it could be because the magnesium isn’t chelated. One of the best forms of magnesium is Chelated Magnesium Glycinate (bound with glycine) (it might also say bis-glycinate) because of its calming effect on the brain. When it comes to taurine and heart health it’s better to know just how much you are getting (Lara says between 500mg and 3,000mg / day) which you might not know specifically if it’s not listed separate on your supplement.

      Reply
  12. I am using BioLabs Pro All Natural Bioidentical Estrogen Bi-est 2.5. It says it contains 2.5 mg of estrogen but your article above recommends 25-50 – is this going to help me? Is it bioidentical? It says one 2.5 mg pump a day unless more is recommended by your doctor. Thanks!

    Reply
  13. I am 50 years old and going through a tough time with hot flushes, insomnia and no energy. I have tried sage and magnesium and did not seem to work . I had my last period about 3 years ago and have been exhausted all the time . I love exercise but find it very hard to keep going . I had breast cancer 9 years ago it was triple negative. I didn’t do chemo as I was trying to get pregnant which did not happen. I’m really struggling as I have anxiety and Iv always struggled with sleep . It is getting me very down as Iv no energy and have hot flushes throughout the day .
    If you have any advice please .
    Regards
    Liz

    Reply
  14. Is Vivelle Dot patch bioidentical?

    I live in Denmark, Europe. You wouldn’t believe how hard it is to find good natural supplements here. I can only get a hold of Vivelle Dot through my gynecologist.

    Thank you for your work, I appreciate it deppely.

    Reply
  15. Hi,
    I’ve had a hysterectomy 3 months ago and have one ovary left (Due to Endometriosis & Adenomysis) I’ve had hot flushes & I’ve been taking sage tablets which have helped but sleep is the main issue at the moment. I’m guessing hormones are adjusting after the op & it’s still early days.
    I’m also on 100mg Levothyroxine due to thyroidectomy last year. I keep reading about Magnesium & it’s benefits but I’m confused about different names when it comes to purchasing it. Would you recommend which one to get & preferably which Taurine please?
    Thank you, I’m UK based btw

    Reply
  16. Hi I was on sandrena gel and then stopped. I now have a bladder prolaspe . Do you think sandrena was helping as Dr says not. Thanks

    Reply
  17. I finally found taurine to take with my magnesium. How should the 3000 mg be divided through the day? The taurine I found is in 500 mg capsules.

    Reply
  18. Dear Lara, I’m Marcela, from Vulva Sapiens collective. Yesterday I was diagnosed with endometrial hyperplasia. The doctor suggested a new study with a camara in My uterus and I’ll return to do that un a few weeks. I really want to try all your recomendations, I’ll let You know how is it going. Abrazos

    Reply
  19. I”ve been readng about magnesium in relation to menopause and just listended to a podcast last night where they talked about the menopausal stages and what people can try to help sleep. Am I right in saying magnesium glycinate is the one to go for in terms of absorption and for menopause esp if one of the issues is insomnia? The podcast recomended 400mg. They also talked about 5-HTTP – is this safe to take if on antidepressants as I have a vague recollection it isn’t? The podcast then talked about a bedtime snack of healthy fat and sugar such as half a piece of fruit and 2 Tbsp of nut butter. The last thing they mentioned in relation to sleep was melatonin.

    Reply
  20. Hi

    I am based in Australia what brand /form of mag and taurine do you recommend . I cannot seem to find taurine supplement.
    TIA

    Reply
    • Australia is the best place to find a combination magnesium and taurine supplement. I typically prescribed Orthoplex Mag Taur or Metagenics Calm X. They’re kept behind the counter so you may need to speak to a naturopath or pharmacist.

      Reply
      • I’ve just read another article you wrote about magnesium & the menstrual cycle on hellocue. I think you are the person to answer my question. I’ve posted my question here because it may help someone else if they have encountered the same issue.

        I’ve been having menstrual & constipation issues and was told to try magnesium supplements. I tried citrate but I had a histamine reaction to it. I took one magnesium glycinate tablet yesterday morning (29 March 2021) and have changed nothing else in my diet or medication routine. I am peri-menopausal, 52 and I have the mirena coil fitted to prevent heavy menstrual bleeds. The coil was fitted on 21 January this year. My last bleed was 5-13 February which was light and I’ve had no bleed since. I woke up this morning with a heavy red, brown bleed. Could it have been caused by taking the magnesium glycinate supplement? I am on rivaroxaban (anticoagulant), due to a pulmonary embolism in August 2020, but it hasn’t brought on any menstrual bleed since starting it. I can see nothing else that could have caused it.

        Is this my body clearing out what is not serving it (a positive thing) in which case I’ll keep taking the magnesium? or is it an abnormal reaction in which case I’ll have to stop the tablets?

        What are your opinions on this please? I would be glad of some expert advice.

        Reply
        • I can’t think of any mechanism by which the magnesium capsule would have initiated a bleed. I think it’s likely to be coincidental but check with your doctor or pharmacist.

          Reply
  21. Are the progesterone & oestrogen products you mention available in ND & safe to rake if you’ve had breast cancer? My surgeon said HRT would be ok for a short period but I didn’t want to risk it. I would l8ke to get some decent sleep & minimise some other symptoms if I can though. Mamy thanks Sonya

    Reply
  22. I have not had the test done yet. Is this the test to take to find out for sure? I am self diagnosing with the symptoms I am having. I have always struggled with PMS but it seems as though in the last 6 months or so the symptoms have become worse, especially the nausea and dizziness, which I really never had before. I am also experiencing terrible acne around the mouth and chin. My mood swings and anxiety have become worse as well. My PMS would always be right before my period and now my symptoms seem to flare randomly throughout the entire month. I have also noticed an increase of skin sagging and wrinkles almost overnight. I will definitely have the test done, but could this just be worsening PMS and not early menopause? My periods are still regular but heavy as they have always been. My ferritin is 13 so I am on iron supplements to get my levels up. The B6 and magnesium definitely do help. I am so grateful for your book and all you do!

    Reply
  23. I recently watched your youtube video with Alexandra Pope. It is great and putting menopause in a much better light than anything I’ve ever read about. However, I don’t understand why a large number of women get vaginal atrophy, something you didn’t discuss. How is this nature’s plan or an evolutionary advantage? And what is it that one can do about it that doesn’t require life-long estrogen? Also what can someone do about Flagyl-resistant BV? Thanks so much.

    Reply
    • Hi I just stumbled on this page and thought you maybe able to help. I’m 49 and my last period was 18months ago. I have had many issues -vaginal dryness and vulvodynia, hot flushes/night sweats , histamine intolerance, cholinegic urticaria, rosacea and low libido. Since April I have used Estalis cont patches 50/140- which decreased the flashes/sweats and helped the histamine and urticaria issue but I had breakthrough bleeding and still vaginal issues so Last month I started on50/250 patches .I also use vaginal estrogen cream and have glutamine for the histamine issue. The stronger patches helped my vagina to start repairing and my sex drive was returning but after 3 weeks my hot flushes began again and the histamines ramped up so my dr said go back to 50/140.the flushes have gone but my vagina has already dried up again and libido is low. Do you have any suggestions?

      Reply
  24. Hello! I am 38 and I am definitely going through premature menopause. Not fun! Is there any way to reverse premature menopause? I know there are some health risks involved with premature menopause as I get older. I am already taking 60mg B6 and 300mg Magnesium everyday for the awful side effects… nausea, anxiety, dizziness, mood swings… but I would really love to stall this or completely reverse it. Is there anything I an do?? You’re advice would be greatly appreciated! Also, what brand of Taurine do you recommend, it’s not listed in your book.

    Reply
    • In general, there’s no known way to prevent premature menopause. Are you certain that’s what’s happening? ie. you’ve had two elevated FSH readings and your doctor said it’s premature menopause?

      Reply
  25. Hi Lara!

    I tried the B6 at 50mg for about a month or two. Unfortunately, my B6 plasma levels are high now. Is this common – to develop toxicity at this dosage for this time frame? I do have neurological symptoms – tingling in hands, feet and head.

    Thank you –

    Reply
    • and just to respond to your question about serum testing: when using B6 therapeutically for PMS and mood, it is expected to raise serum levels above the physiological reference range.

      Reply
      • Hi Lara –

        I checked with my peeps in the weird disease forum. It turns out that quite a number of us have had this experience with synthetic B6 supplementation – we develop toxicity from small amounts AND it takes our systems a long time to clear. This could be related to homocystinuria / methylation disorder.

        In my case – it stopped the hair shedding the first few days. After that, it didn’t seem to make a difference and then neuropathies appeared. That checks with what I have read re: classical homocystinuria.

        These conditions may or not be so rare. They are definitely not well understood, little is known, and most likely a lot of us are walking around undiagnosed. I have a hunch that quite a few us come to you – either in person to your consult, or to your book or blog. We tend to be quite neglected by the allopathic medical establishment, and we turn to other sources looking for answers and treatment.

        I think one has to be very cautious with B6. Be tested properly – B6, homocysteine, folic acid, B12.

        Reply
        • The funny thing is that taking the B6 and the resultant elevation in plasma levels is what helped me uncover my inherited metabolic problems – and to finally convince a doctor to request amino acid testing and hopefully on the road to diagnosis.

          Reply
  26. Lara do you know what happens in pregnancy specially first trimester when nausea hits, why is the mood tending to depression and sadness? What hormones change to make feel this way?

    Reply
    • Progesterone is high during pregnancy, which usually makes women feel calm and sleepy and good, but which can cause depression in some women.

      Reply
  27. Hola doctora, estoy atravesando la perimenopausia. Tengo 50 años. Inicié dieta keto el verano pasado, dos meses y muchos sofocos continuos, palpitaciones. Anteriormente solo había tenido sofocos en dos ocasiones coincidiendo con retraso de periodo que remitieron. El caso es que después de la dieta keto inicié dieta carnivora estricta. Llevo 4 meses y tengo palpitaciones y tinitus pulsatil. Mi colesterol es muy elevado, dicen que no me preocupe, que es porque mi organismo está liberando grasas, y que mi riesgo por accidente cardiovascular es bajo, mi colesterol remanente de 13, muy bajo. No obstante muy preocupada porque mis periodos suelen ser más cortos, de 21 días o largos de 35 días. Estoy tomando hierro bisglicinato 20mgs, aún así voy justa, ya que mis periodos son abundantes, quizá un poco más que los que tenía en estos dos últimos años, ya que siempre he tenido periodos abundantes. Sí que es cierto que no me duelen ni tengo sindrome premenstrual. Mi problema es el tinitus pulsatil que me impide descansar bien sobre todo antes o finalizando el periodo, así como palpitaciones, es cuando noto más esto. Por otra parte con esta dieta me noto sin energía, cosa que no ocurre a mi marido que también la hace. Alguna idea me puede dar?agradecida

    Reply
  28. Hi Lara,

    I am 49 and for the past 4 years (with a few breaks to keep it working) Vitex has helped me maintain regular ovulations/periods and I have felt extremely well. The past year I have missed a few periods with cycles of approx. 60 days instead. But this is to be expected, I guess.

    Now I have not had a period since 11th September 2019.
    At the end of October I started having hot flushes. Maybe 5-10 per day. Gradually they became worse, and I started on Taurine in mid-December. I already took Magnesium but upped the dose a bit to match your suggestion. The hot flushes did not disappear completely but after only a few days they were much lighter, fewer and no longer a problem “socially”.

    For the past 10 days though, I have had extremely sore nipples, and no hot flushes at all.
    I feel bloated and retain water. The same feeling as the time between ovulation and period can feel. However, I have not ovulated. I have taken my morning temperature every day since 2015, so I know this for sure.

    Does this just mean that there is a raise of estrogen levels in my body but it will not lead to ovulation?

    And is there anything I can do/take to reduce the extreme pain in my nipples and stop retaining water?

    I actually prefer to have hot flushes to feeling like this.

    Thank you very much for your input.

    Best regards from Denmark,
    Susanne

    Reply
  29. My daughter (21yrs old) has regular periods that are quite manageable, but her mood swings (anger outbursts a week before period) are becoming a problem. She exercises daily, eats very well (vego/vegan mainly and gluten free), good weight, no stress, good job, happy life – but anger outbursts that are dreadful.

    Reply
  30. Hi Lara,

    I’m 43 with 2.5 years with no period, intermittent for 2 years before then. vegetarian for 15 years. 2 children age 10 and 8. Breastfeed both 2 years. GP/Naturopath have done all testing, ultrasound, fasting BGL, DUTCH test, high FSH, low estrogen/progesterone/ normal to low testosterone/DHEA-s. Normal prolactin. Thyroid ok (TSH <3.0 over 2-3 year period). Low methylation on dutch test. Cortisol good. Symptoms are low libido, vaginal dryness (and mild prolapse), osteopaenia, dry skin, mild hair loss and small increase abdominal 'fat'. (Normal weight consistent weight approx. 70kgs 168 height). I have read your book, which has been really helpful, wish I found it 4 years ago. I have added meat products back into diet (weston-price style).

    I just wonder if I should follow the above advice regarding HRT, it makes sense to, however because I'm not having mood-swings, irritability, hot flushes I feel that maybe that's not the right choice? are my symptoms due to low testosterone?

    I appreciate that's alot of info and I'm not looking for personal advice or treatment, but perhaps direction?

    Thanks so much.

    Reply
  31. Do you have any suggestions for the magnesium and taurine. I am having hot flushes through the night and would like to try this combination. Thank you.

    Reply
    • as far as I’m aware, there is no patch contains body-identical progesterone.
      Also, progesterone generally works better as a capsule.

      Reply
  32. What is a natural form of progesterone to use if I was Keto and lost my period at 48 but now have too high FSH to have a period likely again. It has been 8 months since my last period and I have gained weight around my inner thighs and belly and am very depressed with high cortisol now and Hashimotos. I am desperate for HELP?!

    Reply
  33. I am 49 and Perimenopausal. I have been prescribed Utrogestan 2 x 100mg capsules and an estrogen gel called estrogen (oestradiol). Feeling very calm, but having period a week into taking the progesterone and feeling very bloated. Is what I have been prescribed bioidentical/micronised? I have no gall bladder.

    Reply
    • yes, utrogestan is body-identical progesterone.
      If you’re not responding well, part of the problem could be the dose of either the estrogen or Utrogestan. As I discuss in this post, there’s a case to be made for starting with progesterone on its own before adding estrogen. But speak to your doctor, of course.

      Reply
  34. After reading through this i’m still confused. I’m 58 haven’t had a period for 10 months and am having hot flashes and night sweats. What should I be taking?

    Reply
  35. Thank you for this information Dr. Briden. I’m 53 and have not had a period for 5 months. I started Prometrium 50mg at night 3 months ago and added the Esradiol patch .025 a month later and increased to .0375 a month after that. My sleep has dramatically improved and my hot flashes have decreased in severity and frequency. Should I already try stopping for 4 days a month or wait a few months to let the hormones build? I’m at the end of my second month and felt great for a couple of weeks but now feel like I need to increase the dose again as my symptoms are increasing again. Could that be due to attenuation of benefits and could a few days off help with that?

    Reply
  36. I’m 54, no periods in four month, terrible heavy flooding prior to them stopping. Had to use progestin to stop the flood . Now I’m having extreme wetness, fluid retention, sore breasts, after a couple good months. I have pcos. Should I use progesterone cream to balance the estrogen dominance? How much and for how long? What about testosterone? I’m a long distance runner and my running has suffered greatly plus I’ve gained 10 pounds .

    Reply
  37. Hi, I just finished reading The Period Manual and it gives me so much hope. I am a very active and healthy 41 year old who lifts regularly and gets 10k steps a day, my supplements are giving most of the vitamins and minerals you have suggested except magnesium. I have been going through perimenopause for a couple years and my doctor was of no assistance to correct my symptoms, which only started a few years ago. I have night sweats and horrible mood swings around the time I am about to start my period.

    My question is how much magnesium is too much? I track my food and supplements religiously and I get around 250 mg a day. Would adding a magnesium supplement be too much, the brand I trust offers a supplement with 450 mg per serving but I don’t want to cause any unintended side effects. Should I look for a lower dose option from another company?

    Reply
  38. Hello Lara, thank you for your blog.I am 46. The only form of magnesium that I could tolerate was transdermal magnesium chloride “oil”. But when I repeated blood plasma minerals test (red cell magnesium), I was still slightly deficient in magnesium, despite using maximum daily dose for months and eating diet high in magnesium. Unfortunately, I`ve had a paradoxical reaction to three forms of magnesium: glycinate (I felt spaced out), both oxide and sulfate (in Epsom salt bath) induced severe anxiety, several urgent bowel movements/evacuations during the night and made me feel very dizzy, weak and fatigues the following day. The reactions were so bad that I am afraid to try a new form of magnesium (I`ve bought malate, but just too afraid to try). Do you have any advice for me? Thank you very much!

    Reply
    • Hi Rosa, minerals need to be balanced, magnesium lowers sodium, which in turn can mess with the sodium/potassium ratio, which is important in adrenal health. My point is, if you take more magnesium, you may need to take more sodium and potassium to balance it. Adrenal cocktails are great for that.

      Reply
  39. Hi Lara!

    I have maybe a somewhat unique case …
    I was diagnosed with cancer and post some of the chemo but pre the stem cell transplant had one of my ovaries removed and frozen. Now a few years of remission we put the tissue back. The doctor has had great success with this, but my FSH just doesn’t seem to want to drop. Currently my FSH is 116!? My estrogen is undetactable most of the time and some month it jumps up – and I can feel it!
    M currently taking magnesium, zinc, fish oil, and folic acid.
    M currently 27 and have one child and would love to have another. Just can’t seem to jumpstart the ovary!
    Any recommendations to help lower my FSH? It would be greatly appreciated.

    Reply
    • Thanks for commenting and I hope someone will see your comment and be able to provide an answer.
      I don’t have any suggestions, unfortunately. As you say, it’s quite a unique situation. 🙂

      Reply
  40. I just turned 51 and have had on/off periods for the last two years. They’re not heavy but take around 10 days to stop, my last was around three months ago but I have also had them two weeks apart for months at a time. I was diagnosed with fibroids and my doctor told me they’ll disappear after menopause. What really bothers me is sleep disruption and you mention nasal congestion, which is something else I’m having trouble with. My doctor prescribed Avamys and it doesn’t agree with me, making me dizzy and anxious. I read your article about mast cells and almost all the things you list to avoid I consume regularly. Thank you for mentioning the B6 etc, I wish my doctor was as helpful as your articles.

    Reply
  41. Thank you so much for caring so much and doing all this research and sharing your knowledge with us – simply Thank You. From the UK

    Reply
  42. im 41 and think I’ve been in perimenopause for years now. just had my thyroid and FSH tested. thyroid is fine but FSH is 36. the biggest problem i have is severe anxiety. lately my scalp is crawling and burning and my hair is falling out fast. decided to try magnesium glycinate, but broke out in cystic acne and had stomach problems, so i stopped. i did feel much better overall though. any suggestions?

    Reply
  43. I’m curious to hear her reply. I have the same symptoms. I also feel that I am aging faster than I should. I’m turning 47 this year, but it was the same feeling as you describe at 45. I went from looking like I was in my early 30s to mid 50s in the years since perimenopause began. It started at 43, and I’ve always eaten well and exercised. Best to you.

    Reply
  44. Good evening Dr. Lara!

    I’m a little curious. Is it possible (at 45) to be having a monthly period regularly still, but be low in estrogen? My estradiol was 44.9 ( day 6) and I watched your video on YouTube with
    Dr. Cabeca. She mentioned it needed to be around 60 minimally during this time. Perimenopause. I do have signs of lower estrogen in myself. (Starting of sagging in skin, breast, unusual dryness of skin, vaginal etc. )
    Is there a way I can increase my estrogen at this point in my life? I know you don’t recommend using estrogen if you’re still having a cycle, but I was hoping there was something I could do to help raise my estrogen levels a little.

    I feel like I’m aging faster than I should. It’s pretty discouraging.

    Thank you!!

    Reply
  45. Thank you so much for your reply!! Your book and this site have been so helpful.
    Yes, I’ve had many anovulatory cycles this past year. I don’t have many ovulating cycles. A few months ago I had one, and it was weird! Good weird, though. I was able to sleep like a baby during the luteal phase. The amount of anovulatory cycles had me a little concerned. Your comment make me think it is more “normal. ” I guess I wasn’t expecting so many of them. I thought once I started having anovulatory cycles, I would eventually skip bleeds altogether. Should I keep up with the progesterone cream?

    Reply
  46. I have tried Taurine twice now. The first time I could only find it as a supplement aimed at those who use it for fitness.. .it gave me a really sore stomach.
    A year later and I found it as a vitamin from the brand I get all my vitamins from. I used it once and by 5 am I had horrendous abdominal pains and my first ever hot flush.
    I think I might give Taurine a miss!

    Reply
  47. I’m 46, in perimenopause. Last month I didn’t ovulate and used progesterone cream starting around day 15/16. I started a bleed (definitely not a period!) On day 21. This month, again I didn’t ovulate and started progesterone cream on day 15. Again, I started spotting on day 21. This time I stopped the cream and the spotting stopped. Why is this? Is the progesterone making me spot/bleed?

    Reply
    • you’re having breakthrough bleeds — not real cycles (because you’re not ovulating). So, there’s really no meaning in discussing the timing of a breakthrough bleed.. or the fact that your bleed came “early.”

      It’s not easy to ovulate at 46. Were you having real cycles prior to this? or anovulatory cycles?

      Reply
  48. I am taking prometrium 200 mg. I am 48 and my peri menopause symptoms were getting unbearable and my periods irregular. When they did my blood test my estrogen was still high so I only take the progesterone for 10 days to see if I have a period. Do you recommend this, or would I be better off to take the 100 MG throughout the month?

    Reply
  49. Thanks Lara, I’m a bit confused …..so do I take the capsule opened, with half removed- could I use the other half rubbed into my skin the next night so as not waste it? Would it work that way? What do you suggest please. Thank you, Joa

    Reply
    • My patients who have done it squeeze out half the capsule and swallow that, and then swallow the rest of the capsule the next night.
      It’s also possible to ask a compounding pharmacist to make 50 mg capsules.

      Reply
      • Thanks so much, and is half a capsule enough to take alongside a low dose estradot patch (37.5 or 50) to protect the uterine lining? thank you, Joa

        Reply
  50. Thank you Lara. One more question please, I’m finding I’m doing okay just on the prometrium 100 each night and flushes have stopped- without the estradot, – however I am so tired in the day, the prometrium is causing this as I’ve stopped and notice the tiredness stops – can I take the prometrium every few days, would that be effective for symptom relief or would you not recommend- or is there a dose lower than 100 prometrium. It gives me the best sleep but I am so so tired during the day. Thanks so much for any advice, Joa

    Reply
  51. I found a copy of the saliva tests:
    Prog 149 (318-1590)
    Test 197 (25-190)
    E2 66 (2-18)
    E1 31 (1.7-29)
    E3 168 (2-53)
    E3 / (E2+E1) 1.73 (>1.00)
    P4/E2 2.3 (4-108)

    I’d appreciate your opinion. Things aren’t great and getting help AND results has proven useless, expensive and depressing. Thank you.

    Reply
  52. Serum SHBG 44. Cant find the saliva results at the moment but recall low prog; “crazy” estrogen (GP description), and elevated testosterone. Not borne out in serum tests. Hence my confusion and questions.

    Oh – and no history of OCP use for well over 20 years.

    Reply
    • Oh, ok. the testosterone was high on saliva test? i thought you’d said high on serum testing.
      High testosterone on a saliva test is a false reading and means nothing. (it happens because some oral bacteria can make testosterone).

      Reply
  53. Hi Lara. Post menopausal. Testosterone and free testosterone and SHBG were all tested. My GP has prescribed Prometrium 100mg cap plus E2/E1 troche. I’m thinking of swapping to Estradot patch.

    Reply
  54. Ooh! Youre in luck – just found an old email copy of it.

    “I think this was missed maybe, so I’ll ask again if I may:

    I’m curious and confused in my case. I had both serum and saliva hormone testing done prior to any HRT. Serum estrogens were low, as was progesterone, testosterone was high – I’m assuming because it was unopposed??; however … saliva estrogens were sky high with very low progesterone and just above normal testosterone.

    What are your thoughts on this please? And which tests are best for hormones? And what would your suggestion be regarding estrogen supplementation given the differing results? I’m not confident about my GPs advice to be honest. Thank you.”

    Reply
    • Are you post-menopause? In truth, I don’t think there’s much value in either serum or saliva testing hormones post-menopause for any reason including to decide how much hormone to take. In general, it’s best to put natural (micronized) progesterone in place first. And then, if there are still symptoms, add a low-dose estradiol patch (the lowest dose that will get rid of hot flushes).

      Your testosterone being high on a blood test is a little unusual. Was it total testosterone or free testosterone? as in, was SHBG tested? Had you been on the pill recently before that?

      Reply
  55. Unfortunately I’d have to do the same and dont have time at the moment. Perhaps you could search via my name? Sorry.

    Reply
  56. Sorry to jump on the bandwagon … but any chance you could answer my question too please? Ive posted it twice earlier this year. Thank you. Sam

    Reply
  57. Any chance you could please reply to my post from May Lara. I have your book and it is excellent but just don’t feel this was answered in it. Thanks so much if you can, regards,
    Joa

    Reply
    • Hi Joa,

      was that the question about the ongoing dosing of Estraderm plus Prometrium? Most doctors do recommend daily dosing as ongoing. Many of my patients choose to have a break for 3 or 4 days every month.

      Estrogen can cause fluid retention but progesterone is a diuretic and usually helps with fluid.

      Reply
  58. I am a very healthy 45 year old. I have never taken birth control as I have never felt it was healthy. I eat clean, exercise regularly, test well….however started some of the symptoms of perimenopause. I have had some minimal hot flashes and night sweats the past year but not enough to cause issues. However I have missed my first period. I am not pregnant. But I feel pregnant. For 2 weeks I continue to feel like I am going to start my cycle, my breasts hurt and are super sensitive. Is this normal? I haven’t seen my GYNECOLOGIST yet, and when I ran across your information I felt like you might have some recommendations.

    Reply
    • the main thing that starts to happen in our 40s is that we start to have cycles when we don’t ovulate or make progesterone. That progesterone deficiency can cause the symptoms. See Chapter 10 of my book Period Repair Manual.

      Reply
  59. Can progesterone cream cause spotting? I’m 46 and in perimenopause. I’ve been using it this month and am spotting brown blood. I didn’t ovulate and it’s day 20-21. My cycles tend to be regular (28 days) or longer (35 days). I don’t use progesterone every cycle, just when I know I’m not ovulating, which seems to be more frequent than not. I think my estrogen is really low. The last two times I had it tested it was. Also, oddly, when estrogen “feels” low, my breasts get really saggy. It’s strange. Or is it? Typical perimenopause – anything goes, right?

    Reply
  60. Reading through all that was great. I’ve been considering having the rod taken out and I’m more informed now. Thank you. Wondering what might be occur when I take it out as the body will be doing some recalibration good? What might I expect?

    Reply
  61. Hi Lara,
    For hot flushes at menopause I’m using estraderm 37.5 patch plus prometrium nightly. Is this the ongoing regime you would recommend or should I take a break from prometrium occasionally. I feel I have joint pain and fluid retention- could this be the progesterone side effect. Thank you, Jo

    Reply
  62. I hesitantly got a hormonal IUD a year ago as a solution for my extreme periods. It has thankfully stopped my periods altogether but has been murder on my skin. Is it still beneficial to take the magnesium, et al? Or is it better to take the supplements after removing the IUD? Thank you.

    Reply
  63. unfortunately she didn’t measure my DHEA. However, I viewed my bloodwork from almost exactly a year ago and it was not elevated. I don’t think my DHEA has ever been elevated.

    I’m just conflicted on how to approach my issue because I fall into 2 categories.
    As a former PCOSer, Who has battled my hair thinning, skin issues, slight facial hair
    for ever.

    To now being almost 45 and peri menopausal but still having those issues yet the blood work shows no reason why I should still have those symptoms. (DHEA scares me, but maybe I need it?)

    Along with new symptoms like low libido, some insomnia, dry eyes, etc. (no heavy periods, or hot flashes)

    According to your article (the ups and downs of estrogen) my issues could maybe not be testosterone related( like I always assumed) but estrogen related.

    I guess I’m just trying to figure where to begin. Start with progesterone? My
    Periods aren’t heavy though and have gone down to 3-4 days, if that matters.

    I apologize for all this confusion. My hair loss has always been my driving factor for years, but I think I’ve just about decided there’s nothing I can do about it anymore. 🤷‍♀️

    Your articles have always been such a great resource to me for years. Thank you for sharing your research and knowledge with those of us who are struggling to understand this human body.

    Reply
  64. Hello, I am 43 years old (Japanese background), peri-menopausal for about three years but I do not particular hormonal symptoms except some digestive issue such as bloating and flatulence. My menstruation has been irregular and on and off. My progesterone was quite low with pathology test 3 years ago, and tendency to get stressed and feel anxiety. I have been on Mag and Taurine, Gamma-Aminobutyric Acid, Chaste tree, Withania, Rhodiola, active B’s, EPA/DHA, EPO, and so forth (some are in powder, tablets, and liquid herbs). All those supplements are working well. I have a relatively good energy level through out the day.
    I sleep better than before, and the mood is okay most of the time. I still have occasional mojo too;-), and no significant PMS if I have menses. My diets are pretty clean, D/F, G/F, mild Ketogenic, decaf coffee with almond milk, green tea drinker, barely drink alcohol, and often eat soy products (mainly organic tofu, miso and edamame). Also, no contraception, I do not like using them! (I experienced with horrible acne issue when I was on pills a few years ago) I am no planning to get pregnant, so it is no issue to have some absent menses, but I was wondering what your view on my case is? Do you think I should work on getting regular menses back? My gut feeling is not against ageing. I can still age well, being active and healthy. I thought it would be great to hear your advice. Thank you very much for your attention.
    I look forward to hearing from you. Warm Regards, May

    Reply
  65. Dr. Lara,
    I’m almost 45, former PCOS, ( started having regular periods at 36…go figure) Dr told me I was peri menopause. She wanted to start right off with 25 mg of DHEA ever other day.
    Blood work showed
    estradiol- 44.9
    Fsh-10
    Tpo ab- 28
    Testosterone free total- 40.2
    Testosterone free- 1.4

    My concern is that I’ve dealt with high testosterone symptoms my entire life. ( slight chin hair, occasional jawline acne, and most depressing of all, hair thinning)
    I’m so leary of DHEA. I just want to optimize my hormones as I ease into menopause but also hopefully stop my hair thinning. Is there any other way that I could go than right into DHEA first?

    Reply
    • did she test your DHEAs? Might not be the best option if you’re already tending to androgen symptoms.
      As I discuss in the post, my favourite treatments for perimenopausal symptoms (if you’re having symptoms) are magnesium and progesterone.

      Reply
  66. Dr. Briden- I was diagnosed with estrogen dominance- this was going on long before my 40’s. I’m now 46. My cycle is about to come on so you could say I’m pms-img ugh.. I’ve had magnesium (Natural Calm) in my kitchen cabinet for quite some time and was not taking it. I started taking it again last night and it was like a miracle happened- I instantly started feeling better.. I began to look up articles again on magnesium and depression etc.- there are so many benefits. I came in contact with your website and find the information very beneficial. I’m going to keep up with the magnesium everyday and also look into the taurine. Thanks so much for sharing this information. You are making a world of difference. ❤️

    Reply
  67. Hi Lara – I’m 48 and on the mini pill (progestin only) which has worked well for me until recently to help my heavy periods. I have been to my ob/gyn and there is no other cause for this other than perimenopause (my night sweats and acne are much worse now so I know I am having a hormonal shift)/ Wondering if adding progesterone cream along with the mini pill is safe, and do you think it would help me?

    Reply
  68. What’s the best advice for trying to have a baby during peri menopause… is it still possible and what can be done to improve the chances?

    Reply
  69. I’m confused, I thought estrogen gives you energy. Why can’t I take estrogen during perimenopause? My main symptom is depression and exhaustion, too much sleep. I sleep all day except the 10 days after I start bleeding I feel great. How do I feel that way all month or at least closer to that? And I assume you take the magnesium, taurine and progesterone at night?

    Reply
  70. I think this was missed maybe, so I’ll ask again if I may:

    Thanks for this. Great information.

    I’m curious and confused in my case. I had both serum and saliva hormone testing done prior to any HRT. Serum estrogens were low, as was progesterone, testosterone was high – I’m assuming because it was unopposed??; however … saliva estrogens were sky high with very low progesterone and just above normal testosterone.

    What are your thoughts on this please? And which tests are best for hormones? And what would your suggestion be regarding estrogen supplementation given the differing results? I’m not confident about my GPs advice to be honest. Thank you.

    Reply
  71. could you please tell me if the generic estradiol 0.05mg patch by sandoz is bio-identical? Thank you so much for this website and all of this helpful information.

    Reply
  72. If using low dose natural progesterone and low dose estrogen during perimenopause, is it possible to get pregnant? (I know pregnancy in perimenopause is possible, I just don’t understand if the natural progesterone and a low dose estrogen patch are then basically acting like birth control, or not). Thanks!

    Reply
  73. Do you have a suggested protocol for a 51 year old woman who had an oophorectomy 6 years ago? I’ve tried BHRT pills and pellets and have been on a hormonal teeter-totter ever since. 😞

    Reply
  74. Can I start a lower amount of bio-identical progesterone on day 5 of my cycle to help with migraines? Then go up to the full dose on day 14?? Otherwise I have a chronic headache until I get to day 14 and can take my progesterone.
    My estrogen is super super low too, consistently But I am ovulating on and off.

    I should note my pituitary doesn’t work and I am adrenal Insufficient.

    Reply
  75. Thanks for this. Great information.

    I’m curious and confused in my case. I had both serum and saliva hormone testing done prior to any HRT. Serum estrogens were low, as was progesterone, testosterone was high – I’m assuming because it was unopposed??; however … saliva estrogens were sky high with very low progesterone and just above normal testosterone.

    What are your thoughts on this please? And which tests are best for hormones? And what would your suggestion be regarding estrogen supplementation given the differing results? I’m not confident about my GPs advice to be honest. Thank you.

    Reply
  76. I am 49 and just hit the year mark for no period. I have Hashimotos low thyroid and some endometriosis. Surgery for endometriosis only worsened my symptoms. Starting this past August my face, mouth and nose are dry and burning. My gums are receding from dry mouth. We assume this is a horrible side effect of the loss of hormones. Due to endometriosis I was put on low estrine/ minestrine birth control and when I stopped it at age 45 tons of my hair fell out. I have been fighting hair loss from over exposure to the androgen in that pill ever since. For that reason taking progesterone antagonizes the worsening hair loss now that I have no hormones. Blood test showed .5 for progesterone and zero estrogen. The burning skin and loss of gums from dry mouth threaten the loss of my teeth – I don’t want to be bald and toothless but it is a real possibility at this point. My doctor wants to try me on a small amount of bio identical estrogen in spite of my endometriosis. Does the burning skin and dry mouth ever go away? I am devastated and in pain. Is it normal to have zero estrogen? Any thoughts would be extreamly appreciated. Thank you so much.

    Reply
    • Jennifer,
      I so sympathize with you and relate to your symptoms. I lost my ovaries 6 years ago and life has been a challenge and my doctor can’t seem to find the right dose of hormones to help balance me.
      Wishing you good answers, good health and good luck in your future!🍀

      Reply
      • Me too! I too have Hashi’s and I am thinking it plays a big role in how difficult your menopause will be. I’m 47 and my cycle ended almost two years ago. I am also struggling to find hormonal peace. The creams just don’t seem to work (my levels always show non-existent hormones). The hot flashes and chronic insomnia have taken a huge role on me. In addition, my dryness is in the eyes and nose and I believe my intestinal tract. My eyes are so dry, they have peeled away from the vitreous layer inside my eyes leaving me with a blizzard of floaters and blurred vision. My nose is so dry and inflamed that I have to wear nose vents and strips to be able to breathe at night, and my instestinal tract must be dry as a bone because it is causing terrible constipation. It is something I have not dealt with since my 20’s, before my thyroid problem was diagnosed and I was started on thyroid medication. The fatigue is out of this world. I just need a break from how rotten I feel. And, to top it off, bio progesterone cream/pills and I don’t mix well. It causes me so many issues (acne, oily skin, hair thinning, and a wired feeling at night). My mom just went on HRT (because back then, that was the only option) and never looked back, never really suffered through menopause and had and still has WAY more energy than I do and she is 70. :(.

        Reply
  77. I’ve just started micronized progesterone at 50 mg. Blood tests show progesterone is very low, progesterone high. My current period is at 6wks that is heavy and lots of clotting. I have transexamic acid and medroxyprogesterone. I’d like the bleeding to stop, which would you recommend.
    Thanks

    Reply
  78. Can vegetable juicing make period heavier and worsen PMS? I`ve tried juicing for a month in the past, which lead to a very heavy period and terrible symptoms on the day 1 (extreme fatigue and brain fog, feeling ill and not quite myself, even flat mood). At the time I`ve been drinking 3 glasses of freshly squeezed organic vegetable, sprouts and wheat grass juices aday. Was it “detox reaction”? Is it typical?
    Now I only drank one glass of vegetable juice a day for 3 days prior to my period, and again, my period is heavier and I have severe fatigue, some degree of brain fog and feel ill.
    Is there a toxin binder that I shall take while drinking juices, like charcoal?
    Thank you very much!

    Reply
  79. Hello and thank you for your blog. I`ve tried Magnesium Glycinate (Pure Encapsulations), and I have the following questions:
    The instruction on the product says “to be taken with food”, however, I would like to take it before bed, and I eat my last meal at about 6-7 pm. If I take magnesium then, I feel spaced out an hour later, when it is still too early for me to go to bed. Is it normal to feel like this? Can I take it just before bed with only water on an empty stomach? Is it absorbed differently with vs without food like in case with some drugs?
    Thank you very much!

    Reply
  80. What do you think of the new FDA approved bioidentical drug for menopause symptoms coming out this spring called, Bijuva? It comes with a blackbox warning. I was looking forward to getting a prescription for it, but after reading the warning, I am afraid it has some serious potential risks. I have tried OTC progestrone creams for a short time but the hot flashes and night sweats are still a problem. I am 58 and postmenopausal. Do bioidenticals carry the same risks as the synthetic hormones? the Black box warning seems to indicate that.

    Reply
    • Hey Anette!
      I have looked at that drug and what I can see is that the warnings they are giving are based on women’s health initiative (WHI) studies, which were done with synthetic progestins. So while you’re waiting for an answer from Dr Biden, I thought that may help you decide. You can read more about it yourself but they mention that study right under the warnings. Good luck!

      Reply
  81. Thanks Lara for this post- you have listed here some of my favourite natural treatments for my peri-menopausal age!
    I absolutely agree that these work very well: magnesium, taurine (finally someone stressed out this amazing amino acid), rhodiola- just awesome mild mood stabilizer, ashwagandha- greatest adaptogen (I rotate it every 2-3 months with Astragalus).
    I use vitex and DIM on and off, too…

    Reply
  82. Hello. I just came to your blog from your Phoenix Helix podcast appearance. I am 42 and am almost certainly in a perimenopause Hashimoto flare! I have found your conversation with Eileen so encouraging. I have had some improvements with pms and heavy bleeding just from taking taurine and magnesium as you recommend. I am trying to take better care of myself and am going to buy some progesterone cream on Amazon. A question: is a product that includes Dong Quai ok for autoimmune disease? And the cream says Bioidentical USP progesterone. Is that the right stuff? Thank you so much!!

    Reply
    • hi Claire, in general, dong quai should be ok for autoimmune disease. And yes, bioidentical USP progesterone is natural progesterone.

      Reply
  83. Hi ,im at my wits end ,a few years ago i had hives ,i was on mirena coil at the time ,after removal of mirena they went only to come back again after depo provera injection for birth control ,im not off all hormone birth control yet still having hives day in day out ,im also peri menopausal and had just two periods a year after stopping depo ,and now no periods at all ,they were very heavy after stopping the depo ,ive got natural progesterone cream but unsure when to use it as im not menstrurating ,im not having hot flashes ,just hives which are getting me down ,i just want them to stop 🙁 any advice would be great ,thank you

    Reply
      • Hi! I would appreciate any input anyone can give me. I’ve been to a couple of doctors in my area and I’m feeling like a human experiment!
        I’m 49 and have been on low dose birth control for years. I’m experiencing every peri menopausal symptoms you can think of. My doctor added 1 mg estradiol to the birth control regimen and progesterone cream. The night sweats are better but I’m extremely tired and my vision is blurry. Any ideas??

        Reply
  84. Hi Lara,
    I have read the period repair manual, and am doing what you’ve suggested.
    But. I still have a question.. I am skipping periods and when they come, they are extremely light and last 2-3 days.
    I also have terrible irritability, insomnia and migraines but not before my period, AFTER,.. Up until day 12., when I start to take my bio-identical progesterone again.
    I’ve tried taking progesterone throughout and it didn’t help.
    My estrogen comes back extremely low on tests but my fsh still shows I’m not menopausal. (yet have vaginal dryness)

    Any suggestions?
    Thank you for the wonderful book!

    Reply
    • First, a light period of 2-3 days is normal.
      Next, are you ovulating? You can tell by tracking temperatures before you start the progesterone.
      If you’re not ovulating, then the key is to figure out why not and fix that (assuming you’re younger than late 40s?).
      A couple of considerations about the progesterone. Depending on the dose, it could be giving you a withdrawal bleed (which is not actually a period), and started on day 12, it could be preventing ovulation….

      Reply
    • yes, utrogestan is natural progesterone.
      And generally, my patients take just as much low-dose estradiol as is needed to feel better. And not aim for any particular serum level.

      Reply
  85. If you want to take natural progesterone to help
    With peri menopause but are still having periods what is the best way to take it. Do you take every night and still
    Only come off for 5 days. If so when do you have your period?

    Reply
  86. I would definitely buy a book of yours about menopause too! Or appreciate a recommendation of someone else’s book/website. Specifically I am wondering if the supplement/hormone regime you describe here is the same thing you would recommend once someone is menopausal with no more periods (to deal with hot flashes/sleep disturbance)? Or are there other things that would be helpful at this stage too – calcium? Soy isoflavones? Thank you!

    Reply
  87. I am a 59 year old women. My last period was 3 years ago. I have always had heavy bleeding and large fibroids in my uterus. I have been prescribed Vagifem 10 for about 2 years now for vaginal dryness and thinning of vaginal wall and bladder leaking. Now after 2 years a Vagifem 2 times per week my uterine fabroids are still present and cause a bit of soreness in my lower abdomen area, should I quit the Vagifem and hope that the Fibroids will shrink or is the Vagifem not the cause for my fibroids. Could I take Vagifem together with DIM?

    Reply
  88. I had my remaining ovary removed in 2017 due to abnormal growth (my hysterectomy the previous year was due to endo and adenymiosis with one ovary too involved to save). Since the second surgery I’ve been on estradot which I’ve got down to a little over half a 25mcg patch and utrogestin 100mg as well as Ovestin cream. I’m still getting hot flashes but I really don’t want to increase my estradot and I’m starting to get what feels like mild period pain which makes me wonder if the endo is coming back. I’m taking magnesium orally as well as using a transdermal to help with the restless legs (It doesn’t stop this completely unfortunately). First of all are all the hormones I’m on bio identical? Anything else I can do? I’m having bowel issues as well which I think are related to an overdose of coconut in my diet a few months ago and am now on the low FODMAP diet to see if that helps, which I think it may be now that I’ve worked out the coconut factor. I was on the pill for years, have had 2 children naturally and donated eggs twice which I suspect started this whole thing off.

    Reply
  89. Thank you for your blog. Can sun exposure/drinking trigger hot flash and headache on day three of a cycle in a perimenopausal woman? Thank you very much!

    Reply
  90. Please be aware that Rhodiola can have devastating effects if you have an over active immune system I took it and had a massive outburst of allergic dematitis

    Reply
  91. Hi Lara! What brand of magnesium / taurine would you recommend in Canada? I use Preferred Nutrition MagSense Powder with lower concentrations of magnesium (280mg) & taurine (500mg). Should I consider additional taurine supplementation? Thank you!

    Reply
  92. Interested in Progesterone drops. This is what my nutritionist uses and recommends. I am post menopause. I think I have a histimine intolerance. Saliva testing for hormone showed very low progesterone and high estrogen ( was on birth control for 25 years). I take Magnesium Glycinate. Never heard of taurine. Any suggestion would be appreciated. Thanks
    J. Shelton

    Reply
  93. Hi Lara i need your answer if you have time. I am 53 years old and still have periods every 4 to 5 months. I am taking your resque treatment. Magnesio, Taurine and micronized progesterone. But i still have hot flashes once at night. I read your book and you recomend starch and stops sugar. When I started with keto diet i feel really better. So my question is: ir i am not ovulating anymore and if menopause is now, do you thing i do need starch and 30mg of fructose? Or is ok to go into keto and quit with carbs?

    I wiil apreciate your answer.

    Thanks from Ecuador South America.

    Reply
  94. Hi Lara,

    I’m in perimenopause, age 47. Skipped periods, hair loss, hot flashes, sleep and anxiety issues, vaginal dryness. I take magnesium glycinate (240 mg), tried taurine, use progesterone serum and black currant oil (1000-1200) and tried phytoestrogen cream. I can’t seem to get my protocol right to keep me feeling ok. The gynecologist recommended antidepressants, birth control and HRT. I am seeing a chiropractor who specializes in female hormones — her next steps would be pregnenolone or DHEA.

    I had my hormones tested this summer before adding progesterone serum or phytoestrogen cream on day 5 of my cycle: Estrone 8.9, Estradiol 40.3, Estriol <0.07. LH 20.7, FSH 47.4, Progesterone <0.20, DHEA 31.3.

    I've been on black currant oil and/or fish oil the past few years to deal with hair loss after I stopped progesterone cream in my earlier 40's and my omega 6 levels are now high.

    I've read your Period Repair Manual book and blogs regularly. Can you give me some feedback on how you would apply your protocols to my situation? I need a nudge in the right direction.

    Thank you for your work and being an advocate for women.

    Jennifer

    Reply
  95. Dear Lara,
    Thank you for the book Period Repair Manual I would like to ask you if the estradiol Lenzetto in spray is biodentical?
    Kind regrads and thanky you for your answer
    Irma Boh

    Reply
  96. Hello Lara,
    I’m 55 years old and have been taking oral estrogen (Estradiol 1mg tab) and progesterone (Prometrium 100 mg cap) mainly for recurrent bladder infections and hot flashes. I’ve been in menopause about 2-3 years. I would like to know if my prescription is for bioidentical hormones and also if it is a typical dosage. With these medications, do you still recommend going off them for 5 days per month?
    Thank you,
    Tara

    Reply
    • Yes, those are bioidentical hormones and typical dose. Although I do prefer the lower dose estradiol patches like estradot (25 mcg).

      The potential advantage of stopping them for a few days each month is that it seems to prevent attenuation of their benefit. That’s what I observe with my patients.

      Reply
  97. Hi Dr Briden,
    I am newly menopausal – no period for 14 months. Would progesterone be beneficial for losing weight around midsection and increasing energy? If so you talk about skipping for 5 days in a cycle, so how would I take it without a cycle?
    Thanks

    Reply
  98. Thank you for all your posts! What about posmenopousal wonen?How much estrogen ?Is 1 mg of estradiol hemihydrate high dose? I was diagnosed with Atrophy of genitalno urinary tr. I take 1/5 femoston conti and got have very tender paiful breasts. Is it progesteron effect? Thank you so much

    Reply
  99. I wish Progesterone was the cure for me, but from perimenopause that began in my 30’s to final menopause in my mid 40’s, I have miserably trudged along, taking and trying various delivery methods and dosage levels, yet I still have so many issues with it. For one, it does not promote sleep but actually wires me at night (so I avoid it at bedtime). It also makes me oily and REALLY zitty. It does not calm me, or make me feel wonderful as it is touted. I find no value in it, other than the breast protective value it provides (even moreso now that I take a tiny bit of bi-est with it). It has been a thorn in my side for over 12 years. Anyone else????? Hormone balance has been an immense struggle. My menopause has been the single most difficult thing I have struggled with from hot flashes every 20 minutes to extreme fatigue, intense insomnia and zero libido (my poor husband).

    Reply
    • Thanks for sharing your story. Some women have a variant of the progesterone receptor gene that can result in progesterone having a somewhat stimulating effect. I’ve confirmed that with a DNA test for some of my patients who report this paradoxical effect.

      I then find that what they need is a much LOWER dose of progesterone to get the same sedating effect. And just get the full picture, do you mind sharing the dose of progesterone you tried? And was it oral or transdermal? (oral progesterone is far more sedating)

      Reply
      • Thanks Lara! I have tried it all from 6.25mg of compounded oral (you would think it was too low to do anything, but I have saved photos of what it did to my face several years back) up to 50mg bioidentical cream. I’ve put drops under my tongue. I have tried the prometrium (100mg) vaginally as well as orally. I have messed with it all: applied to thin skin, thick skin. Over the years I have been able to very, very gradually build up to between 25-40mg transdermal, but only in the morning and I still have acne and oily skin and zero benefits. If I stop it altogether, my skin settles down over several weeks. I feel like a unicorn lol. I am certain I have some kind of gene mutation as you suggest. I do know I am heterozygous for the c677t, but I can’t imagine that that would be a part of the issue. P.s. I do have hashi’s.

        Reply
        • are you sure it was 6.25 of micronised progesterone? That does seem very low.
          But yes, I would have said maybe 20 or 30 mg of oral could work.

          Reply
          • Hi Lara, yes, 6.25 mg of compounded progesterone taken twice daily (I still have the bottle from 2013. I’m looking at it as I type. I need to find a place that will take these old hormones lol), but I had to go down to once per day and then completely off it because my face looked like a 12 year old pre-teen 😬. Since then, I tried several delivery methods/dosages with the same results, so I settled on transdermal and tiny incremental increases, gradually over time. I wonder if I could tolerate the 20-30mg of oral now? I’m currently taking 25mg of P cream and 1.25mg bi-est. I mean, I still break out but it is not NEARLY as bad as back in 2013. I don’t love the acne, but if it helps with sleep, it’s worth the 10 zits I have to deal with because lack of sleep is a big part of the fatigue. Thanks for trying to help.

          • I’m really surprised progesterone affected your skin that much! Many of my patients use progesterone to HELP with acne.

            Another option is to put in place simple anti-acne treatment (zinc and dairy-free diet) which might enable you to tolerate the progesterone.

            And if you do have the DNA test for the progesterone receptor gene (PGR), maybe come back to comment and let me know the result. Or send me a private message. I’m interested in the about 1/20 women who have the progesterone gene variant/SNP.

      • Thank you very much for your reply Dr Lara. I thought ethinyl Estradiol was Bioidentical. Is there any way to get similar hormones in one Bioidentical product or would it have to be two different products?

        Reply
        • you shouldn’t need estrogen of any kind. Micronised progesterone (Prometrium) works very well for both migraines and heavy periods. Have you read Period Repair Manual?

          Reply
        • Also, ethinyl estradiol is not bioidentical. There are pills with bioidentical estradiol (Zoely or Qlaira) but they still have the progestin drug nomegestrol, which is definitely not progesterone.

          My view is why use a progestin drug when progesterone itself is so helpful for migraines!

          Reply
          • Thank you again for sharing your vast knowledge. I have ordered and started reading your book. I did take bioidentical progesterone (20 mg/day cream) for 3 months but it did not help the migraines. I also tried micronor for 3 months. I notice that prometrium is a higher dose (100 mg) so maybe that would work better.

        • Alexandra FYI in case it helps- I take progesterone cream for heavy periods and migranes daily for 14 days and this alone does not stop my migranes coming.

          However, if I apply several applications of progesterone cream at 20 min intervals when I first get the migrane usually 2 days before my period, it stops it completely. Considering being maxed up on painkillers couldn´t touch my hormonal migranes I am happy. If the migrane starts to come back later in the day I just use a little more.

          So far I´ve not had any side effects from too much cream.

          Reply
          • Hi Sam – thanks for the tip! I did try that once (applying every 20 minutes) and it didn’t work for me but I have since changed a lot of things (diet etc) so perhaps another try would be a good idea.

          • I hope you don’t mind me commenting Alexandra, but I am interested in how you stopped your migraines. I’ve been getting them for around 8 years {still perimenopausal and have tried all the doctors solutions. I wonder if you could tell me the name and make of progesterone cream and where is it best to apply it. I shall certainly give it a go! The migraines are totally debilitating and come every 21 _ 24 days. Thanks in advance. Andrea x

          • Hi Andrea,

            I empathize with you – I have tried so many things and nothing seems to work (at least not for more than a month). The progesterone I had was prescribed by my naturopath and made by a compounding pharmacy – I don’t know of any brand name. I applied it to my inner thighs and biceps. Maybe Sam can comment on what type of cream works for her?

            Alexandra

          • Thankyou so much for your reply. I will do some research on naturopaths in my area and see if I can get an appointment, if my local doctor can’t prescribe something bioidentical. Fingers crossed we will all find a solution one day! Xx

  100. Hi Dr Lara, I started your recommendations of Magnesium, Taurine and micronized progesterone for hot flashes, mood swings, and extreme sleep deprivation. They have worked beautifully! I cant thank you enough for this guidance. My question is about the estradiol patch. I am 43 years, peri–menopausal, haven’t completely lost my cycle but was very light then flooding then irregular before starting Prometrium. My dexa has worsened. Spine has progressed from osteopenia to osteoporosis and I have a large degree of vaginal dryness. I would like to ask my OB/GYN to prescribe the estradiol patch (low dose, 0.025mg/day). Would this be the next step you’d recommend for me? In addition, do you still suggest stopping the prometrium and estrogen patch 5days/ cycle if you’re using it for sleep disturbance and for bone health?
    Thanks so much!
    Lara

    Reply
  101. Hi, I am so happy I found your post. I have been looking high and low for answers and someone who actually knows something! i found you thru AIP podcast with Eileen. Long story short (i’ll try): I am 48 and almost 3 years into menopause. my hormone levels are very low for years…I have been suffering with CFS/ME and therefore have been in adrenal exhaustion for years as well (to note CFS/ME is not “just” adrenal exhaustion, but AE is an added bonus of secondary).
    My CFS doctor – for reasons too long to go into here – recommended I only go on low dose estrogen and come off P and T (all bioidentical BTW) last year. in my major CFS brain fog and bed ridden ordeal, I was getting worse and worse and kept upping my Estrogen (E2) cream to about 17mg finally – as blood work kept coming back low E with high SHBG and hot flashes worsening! with no P or T. Since then I began developing an auto-immune condition called Sjorgen’s Syndrome, with terrible dry eyes and mouth (i’m beginning to have decaying teeth). my CFS symptoms were so overwhelming that I barely noticed the dryness until 6-8 months in.
    I have since realized I was estrogen dominant and added back in P (50-200mg) and T (3mg) and reduced E down to 3mg. belly weight (10lbs in one year), hot flashes are still here…and anxiety and insomnia etc. (all symptos of CFS as well).
    the other factor in all this is: i’m healing from my CFS (if you can believe it in the midst of menopause causing CFS symptoms, a new autoimmune issues, and coming off a benzo – which I successfully have) via brain retraining and neuroplasticity healing trauma in my brain.
    but i’m suffering the way no one should have to with bad advice after bad advice trying to read info on internet with severe dry eye and figure this out myself…and have come to conclusion that I need low dose E on patch and lowered my P.

    Compounding factors: I’ve read thru Dr. Lam that P is not good to take in very weakened adrenal glands, like mine as it can cause a crash and there is the pregnelone steal by taking P and turning it into the much needed cortisol that I lack (and then add belly fat on). And what of the possibility of blunted receptor sites? i constantly smell of Progestereone thru my armpits – telling me i’m probably OD’d even at 50mg of cream.

    In my research i have found two possible scenarios: one being menopause caused my autoimmunity. and the other being common in some – that hormones CAUSED my auto-immunity. (they are steriods by the way). OR did estrogen dominance cause this?

    Question: I’m unsure how to proceed due to all the factors. Scrap the hormones and just stay on my brain retraining and AIP diet (recently started) or shift to low dose E patch and reduce my P down to even lower dose (I have also read that if you don’t have high enough P and are also low in E, the P will just convert to E leading to an even more E dominant state.

    to note: I’m already on daily injections of magnersium/taurine since 2015 for CFS along with B12 injections. i take sublingual P5P already as well.

    I know I just wrote out a lot! if you do long distance consults – I would really like that. to note: today I’m getting blood work and doing a saliva testing at the same time to assess hormones levels.
    Thanks so much.
    Susan

    Reply
  102. Hi! I heard your interview on Phoenix Helix and I have your book. Such great information, thank you! I’m inquiring for my friend. She is taking Progesterone and Estrogen as she had her uterus removed after childbirth a few years ago. She still has her ovaries. I wanted to check with you about the brands she is using.
    Bionpharma Progesterone 200 mg
    Teva Estradiol .5 mg
    Are these micronized/Bioidentical?
    Thanks so much in advance. She’s due for her annual soon, and would like to switch if these aren’t the micronized products, but would like the most affordable options.

    Reply
    • yes, those are bioidentical hormones.

      But if she is not yet menopausal, then she arguably should not require estradiol. (but could benefit from progesterone). As a general rule, I prefer that my patients do not take estrogen until after menopause. (menopause is not caused by losing the uterus)

      But of course, she should check with her doctor.

      Reply
  103. I was prescribed combined bio-identical hrt for horrible peri menopause symptoms such as mood swings chronic insomnia and night sweats. I felt absolutely terrible on the estrogen gel and stopped it after a few days but carried on taking 200-300mg of utrogestan 12 days before my period. It hasn’t helped my low moodor insomnia at all and I notice I have been extremely aggressive the past 2 months. Do you think I should try using the Estradiol gel again?

    Reply
    • oh dear. The utrogestan did nothing for your sleep? Did you have the magnesium in place first? I find the treatment works best when in the order I outline in the post. First magnesium. Then continue the magnesium and add the progesterone. And then continue both and try a tiny bit of estrogen.

      Reply
  104. Hi Lara, I would really love your opinion please. I’m almost 47 and been suffering perimenopausal symptoms for a few years now, mostly wild mood swings, sometimes night sweats and memory problems. The mood swings are sudden and so out of character and generally happen a week either side of my period, but can be anytime sometimes. I’ve been regular generally, with periods getting lighter. Earlier this year I had a virus (slap cheek I suspect) rash first then a lot of joint swelling which my GP treated with 4 days of cortisone when tests showed nothing. Immediately after this I missed my period, then next few cycles were 23 days, 27 (lasting 10days), 24, 33. I had some hormones tested but the Dr said everything was normal, although my ferritin sometimes gets lowish at 28. Due to my distress regarding the severe mood swings I have started using natural progesterone cream 10mg morning and evening from day 7, feeling quite good mood wise, but now I’ve had a short bout (1day) of bleeding at day 14! Should I treat this as day 1, or treat it as an anomaly and keep using the cream until I get a proper flow. Could all this irregularity be caused by the cortisone or do you think I’m approaching menopause? Any thought ideas would be great. Thank you 🙏🏻

    Reply
  105. Hi Lara! I just listened to your podcast interview with Eileen Laird, and heard you say you should never take progesterone continuously. I had a full hysterectomy three years ago and have been prescribed oral bioidentical progesterone for two years. Should I still try a five day detox, or are the recommendations different for fully menopausal women? Thank you! —Kitty

    Reply
  106. Hi! I heard your interview on Phoenix Helix and I have your book. Such great information, thank you! I’m inquiring for my friend. She is taking Progesterone and Estrogen as she had her uterus removed after childbirth a few years ago. She still has her ovaries. I wanted to check with you about the brands she is using.
    Bionpharma Progesterone 200 mg
    Teva Estradiol .5 mg
    Are these micronized/Bioidentical?
    Thanks so much in advance. She’s due for her annual soon, and would like to switch if these aren’t the micronized products, but would like the most affordable options.

    Reply
  107. I was given a prescription for Prometrium. But it came as progesterone, generic for Prometrium is this still bio identical and is it the same as Prometrium

    Reply
  108. Hi! Thanks so much for all you do. I heard you on Phoenix Helix and bought your book. I’m asking a question for my sister. I have started taking Progesterone cream and love it. I was about to recommend it to my sister (we are both in late 40’s), but then we realized she has had a Mirena in for the last 2+ years for BC. Is it safe to use progesterone cream and have a Mirena in? I see from your blog that Mirena actually resembles Testosterone more than Progesterone. It also looks like you don’t recommend hormonal IUD, but in this circumstance, is it most likely safe? Thanks so much

    Reply
  109. Hi Laura, so far reading on this blog has been very helpful, thank you I am 48 years old and I feel like I’ve been in perimenopause for the last 3 to 4 years, I just went and saw my OB and she did a blood test my FSH was at about 19 and she said my estrogen level was high at the time of the draw. But I’m just now getting to the point where my periods are starting to stop I haven’t had one in four months. She put me on the natural progesterone 200 mg she wants me to take it day one through 10 to try and force a period so I don’t have any flooding periods Symptoms of later I’m wondering if this is what is best, or if I should take a lower dose for longer in my cycle to help with The peri menopause symptoms and then see if I have a period for the five days that I’m off, not adding any natural estrogen yet even though my periods have stopped, they’ve only recently stopped in my estrogen level tested pretty high thank you for all your help, Nicole

    Reply
  110. You said magnesium. There are so many chemical names in supplements! Which magnesium? Citrate? Glycinate? I see there is mag taurate, is that good? Thanks, I am eager to implement your advice!

    Reply
  111. Hi Lara, what is the name of the product you recommend to your client with 300 mg magnesium plus 3000 mg of the amino acid taurine? I am in Australia – would like to give this a try to see if they can relieve the hot flushes. Thankyou x

    Reply
  112. Thank you Lara for this information. From it, I’ve made changes to my diet and have hope to sleep well again. Together with magnesium and zinc, I started Promethium – days 14-25. Is it normal to have significant brown discharge/spotting each of these days, with light period starting day 24, and heavy a few days later?

    Reply
  113. Hello Lara,

    I have been taken 100g of Evening Primrose oil for painful breasts and migranes with ligjtheadness during my period and foliculr phase. If did improve the situation (not completely through) and made my period regular. However, now I seem to start having PMS symptoms a few days before my period, which I did not have before. Is it possible that Evening Primrose oil raised my estrogen levels to high?

    Thank you in advance.

    Reply
  114. My doctor has prescribed me to take 2 pumps of Estrodial gel called Estrogel. I am also to take 2 tablets of Prometrium progesterone from days 1-12 of each month. I have been doing this since December and I still do not have a period. I am 40 and went off of the pill at age 38 after being on it since the age of 16. I have Hypothalamic Amenorrhea and that is why she wants me on HRT, in order to prevent bone issues and for good hormone health. I haven’t had a period since I was 33. I have reduced my intense exercise and increased my calories, I have gained 10lb but I still do not have a cycle. I am swollen and feel bloated all the time. I know this stuff takes time. I just want to be healthy. Do I need a period to be healthy?

    Reply
    • At 40, you shouldn’t need hormone replacement. Instead, you should still be able to establish ovulatory menstrual cycles, and enjoy the benefits of those before perimenopause starts at 45-ish. To recover from HA, you need 2100-2500 calories per day including starchy carbs. Is that what you’re doing?

      Reply
      • I am slowly increasing my calories as I also have to watch myself…I am a former bulimic and was an over exerciser. I know that I need to keep working on my health and let go of staying lean. I have moved my calories up from 1400-1700 and will keep moving them up until I get to 2100-2500.I have added in more oatmeal and fruit. Next I will bring in rice and sweet potatoes.
        I know that if I go all in it would be better, but I do not feel ready. I need to stay mindful of my triggers to my former Eating disorder tendencies. Thank you for your time, and I will keep reading all of your articles!

        Reply
        • Oh also, if I was to try and get my period back naturally, do I just start to wean off the estrodial? I have been reading a lot about this, and wonder if I back off to every second day, then third day etc and keep trying to do as you say, eat more calories and carbs, then I won’t need the HRT? I guess I should discuss this with my endo, but I know she will want me to stay on the HRT.

          Reply
  115. Dear Laura! Thanks a lot for your book, it’s really helpful! I’m 45, and I took the birth control for more then 10years (because I had the little ovarian cist, it was surgically removed, and the little
    endometriosis was found during laparoscopy, it was removed as well). I decided to stop with birth control 6 months ago, and my period has not yet returned((, I have e a severe hair loss also, greasy hair. In the rest I feel good, nothing symptoms like hot flushes, insomnia etc.
    I take omega3, vit.C, iron (I have iron anemia) and Vitex for last 2 months and I feel pretty good with it. My FSH decreased from 74 in April to 8 in July. But my gynecologist purpose me to start with TSH…Really, I don’t want to do it, hoping my period will come back and because it doesn’t seem to be real pre-menopause situation. Could you give me your opinion, please, if I’m in the right way?
    Thank you again!🌺

    Reply
  116. Hello. What do you recomend me to take if 21 years ago i had my uterus and ovaries removed and my main problems are that i’m always swollen, have insomnia and and difficulty to low my weight?

    Reply
  117. Hi Laura
    I´, 50, and went off the combined pill 7 months ago and so far no periods. I´m going to try the magnesium and taurine combo. I live in Spain. The Mg glycinate I have found is a 400 mg does. Is this too much and should I try to cut the 200mg tabs in half? Also the taurine I´ve bought is a 500mg dose. Should I be taking six of these a day? Warm regards and thank you for your information- it´s really helpful! Regards Michele

    Reply
    • Have you had your FSH checked? to see if it’s possible to have more periods or if you are in menopause. What is your main symptom?

      Reply
  118. I just turned 49 yesterday. I had a 5 week period last June and was low iron from it. Got back on track with a period a few weeks later that was normal. Then no period till winter. Starting in January I have been bleeding or spotting till 3 weeks ago when I have had a heavy period since then. I was working with a homeopath but that hasn’t touched this so I started with progesterone cream. 2/day 20mg a day. The period is slowing down a bit but its still about 3 -4 regular tampons a day. A month ago I started the mag/taurine and sleep has been pretty good. I am starting with a new dr soon because current dr. isn’t interested in non pill/iud or ablation options. My question is how to get a never ending period to stop, keep it from happening again, etc. Its so hard. I am an athlete, eat pretty good, and am a mom of an 8 year old so I am pretty busy. I had blood tests on May 5th and my dr. wouldn’t do a full thyroid t4,etc but just the basic came back normal. Thoughts and suggestions on how to manage this naturally?

    Reply
    • hi,
      I am 47 and on progesterin cream . I have histamine intolerance which has been helped with use of quercitn , vitamin c and DAO along with Histaminx probiotic. I take ashgawanda due to high anxiety . I am wondering is is excess histamine or estrogen that cause weight to be held on hips and thighs ? is estrogen what makes bellies actually protrude on women ? I am struggling to reduce the fluid on hips , thighs and stomach along with calming my extreme anxiety?

      any helpful info would be great

      Reply
  119. Hello, I have been in menopause for 18 months with no period. I had severe insomnia and fatigue. Doctor has had me on 0.5mg Estradiol and 100 mg Progesterone. My symptoms improved a lot . I sleep approx. 6-7 hours a night now (waking 1-2 times); I fall asleep easily but wake up a few times. Energy is better. For the past 3 months, I have been starting to slowly wean off these hormones–I’ve been taking them two of every three days. They are synthetic, correct? So, not good for me? Initially, I had a dip in energy for about a week, but sleep seemed maybe even a little better. But after 2 months started getting a few hot flashes–not too bad, and sleep may be a little worse, but again, not too bad. I’ve gotten used to these inconsistencies. I plan to decrease to every other day on the hormones in a few weeks. I do take the magnesium, and will add taurine as you suggest.. If my sleep begins to suffer as I further wean off the synthetic hormones, should I start on the natural versions you have suggested? Or are the Estradiol and Progesterone acceptable? Or more cancer risk? Thank you for your recommendations.

    Reply
    • Hello Yvonne, I learned so much through Lara and her ebook. I supported my transformative time very much. I got some hot flashes, sleep interuptions and sight hearth races at night and added a product call Alsifemin Royale Gelee (it is a European product) and since I take them I had no hot flashes. What a difference this makes not to wake up at night being drenched in sweat and wrought out the next day. With Lara’s regimen and Iodine from the Dr. Brownstein protocol I was stable. A month ago my heart became uncomfortable again (I did not want to sleep on my left side) – knowing through the education here that estrogen can cause these heart changes I checked what I could do to support estrogen supply naturally so that would be stable and available in my bloodstream and came up with Pomegranat. I either take fresh juice (when possible) or a natural capsule if I cannot get to my juice bar… and it works fantastic. So far my heart symptoms are all gone. Naturally, I am extremly careful with my diet and in away I become healthier now in this transformative phase than I have been before. All in balance and moderation. Another factor which really makes a difference is exercise – I added strength training/HIIT (less is more) and Hot Yoga – both keep me strong and mentally centered. All these factors play a role but I am so glad I that I am able to support my system completely with natural foods/supplements. Perhaps something might be of help as I had the same issue as you – I am totally resolved that nature knows best and that I will try as far as possible to go through my metamorphosis with her support and guidance. Very best wishes to you all – may we all get to the best and strongest soul centered place in our lifes.

      Reply
      • Danae,
        Thank you very much for your suggestions. I will definitely try the pomegranate juice and a bit of exercise. I currently have enough energy for some gentle walks with the dogs every day, but I will definitely try a little strength training and Hot Yoga. I eat quite healthy. I have been slowly and steadily improving over the past 2 1/2 years (3 steps forward, 2 steps back). I have read about the iodine, but not tried that yet. I have come a long way, but I know my body and hormones are quite out of balance. I am grateful for the progress thus far. All the best to you. Blessings!

        Reply
        • I wish you all the best and follow your intuition. The most important part is that all gets better – step by step and yes, there are always setback’s. But that is why I love this site and Lara’s guidance I can actually learn from my mistakes and become more aware than ever of the miracle of this female transformative body. I respect much more that I should support this system if I like it to work for me…. and sadly how long I was ignorant as ‘normal’ medical doctors no nothing about supporting the endoctrine system but surpressing in through chemicals. So what other choice had my body but to rebell! I would have too – being treated with ignorance! So I think we are in such a good position here. Wishing you all the best in your health journey and that we free ourselves in this phase and open ourselves to new horizons – as this is what it is meant to be – a metamorphosis…

          Reply
      • Hi, what are the ingredients (in English) for the product Alsifemin Royale Gelee? i can’t find it (I’m in usa). also for the pomegranate, make sure you are doing supplements (life extension has a good one) and not juice as it’s too much sugar.

        Reply
        • Contents of Alsifemin Royal Gelee. Hope this helps. So far even though there are couple of ingredients I could do without – this is the best ever. It stops hot flashes for me an my friend within 30 mins of taking it. For me it takes one capsule for my friend who has much stronger symptom 2 twice a day.
          Vitamin D3, Vitamin B12, Folic Acid, Gelée Royale, Vitamin E, Ginseng
          Soy oil, Weatgermoil, Glycerin, Sorbitol, Sojalecithin, Emulgator Monoglyceride Ginseng-Extrakt (Panax Ginseng C.A. Meyer; contains Siliciumdioxid), Butterreinfett, Gelée Royale 0,37 g, Vitamin E. Titandioxid, Riboflavin, Eisenoxide ,Eisenhydroxide, Folic Acid, Vitamin D3 Vitamin B12
          But currently I go again weeks without it – as the hot flashes seem to be stopped wtih Pomegranate proper nutrition as I explained before. I take occasionally a fresh juice of Pomegranate and as it is just a glass I am fine with the sugar. But e.g. I nearly eat a Blueberry Smoothie every day now and things like this seem to have made big positive changes. Another women here added Q10 and the jury for me is still out on that. Happy Health and a great day for all of you.

          Reply
      • Thank you Lara. I have been taking the magnesium and taurine for a month now, and my sleep has been improving and more consistent. I also reduced the progesterone/estradiol to taking only every other day. I’m slowly and steadily improving. Thank you for your very helpful article and advise.

        Reply
  120. Hi Lara,

    I’m 49 with no period since November and numerous menopausal symptoms since January. I took 100 mg micronized progesterone pills for one month at bedtime. It increased depression but helped anxiety and sleep. Stopped 3 weeks ago and this week I started Progesterone cream sourced from soy. Right away I noticed increased need to urinate and mild pressure around bladder area. Could this be result of progesterone cream? It wasn’t an issue with the pills.
    I’m taking cranberry supplements and using a brand name pill to reduce the urgency. I don’t feel like it’s a UTI, yet.
    May stop the progesterone cream and see if that relieves symptoms.

    Thanks
    Kate

    Reply
    • I have experienced this very thing when I try to wean off of estrogen patch. Once went into horrible UTI. I now cut the .375 patch in half and am doing fine with both progesterone and reduced estrogen. (71 years old surgical hysterectomy)

      Reply
  121. I am 55 and in Menopause, no periods for 5 years now, insomnia is horrible, getting very little sleep a night, tried all kinds of natural products, along with Amitriptyline,Trazodone but the problem with all of these things is they all work for a short time. They may work for a week, three days or not at all. I am desperate for some help. I am currently using Garden of Life Vitamin Code, Raw Calcium for Bone loss. It has 386 mg of Magnesium in it and was wondering if adding more magnesium would be ok? What would use suggest that I start with to help with my insomnia?.. I would appreciate any help you can give me.. Thanks in advance

    Robin

    Reply
    • As I explain in the article, estrogen (together with natural progesterone) can be very helpful for sleep. But please speak to your doctor.

      Reply
  122. I loved your book. However, when I take Progesterone, my heart rate goes sky high so I cannot solve my insomnia (onset and waking up in the middle and getting up too early). I am 49 and fairly lean. I am on a very low dose estrogen patch as I never resumed a cycle after being on the pill for 13 years. It’s been 8 years since I have had consistent sleep – tired of being so tired.

    Reply
  123. I’ve been suffering from peri-menopausal insomnia and depression and went on an estrogen patch and natural progesterone last year. But bc I still have regular periods, I’m wondering if I may be estrogen dominant. I get headaches if I’m the least bit dehydrated and around my period. Do you recommend weaning myself off the patch, even though it’s been really helpful with my mood? I’m only using 1/3 of a dose.

    I’ve also been taking Magnesium with Taurine upon your suggestion which I think has been helpful!

    I was considering getting my hormones checked, using the Dutch Test. Do you recommend it? What is your opinion of the Dutch test?

    Thank you!!!

    Reply
  124. Hi Lara

    I am one of your patients in Sydney and you have certainly helped me stay on track over the years. Thank you! I am now 5 weeks past my “normal” due date/ cycle, had some hot flushes for about a week. I am taking-
    Permular x 1 in the morning
    BioCeuticals Mag powder – at night.
    B6- x 1 in the morning
    Adrenoplex- x 3 ( I was pretty anxious) ( and only the past month)
    Zinc x 1
    Iodine spray x 2 sprays when I remember
    Progesterone Cream x 1 x pump nightly.

    My question is –
    How do I use the cream? As I haven’t had a period or do I just have a break of 5 days whenever?
    I’m feeling really good. My periods were regular, 28 days and then just stopped.

    Thanks so very much
    Jo

    Reply
  125. Hi Lara, I just started reading your blog after hearing you speak with Georgia Lienemann the other day. I am menopausal (or maybe through it now – how do you tell?) I had all the symptoms you mentioned in your blog but now am feeling better with the help of a functional medicine doctor. I also have Hashimoto’s, which is almost under control but my issue is weight gain. I loved all the food stuff you talked with Georgia about and would love some more info re menopause and food intake as well as general health when we no longer ovulate.
    I would absolutely by your book if you were to write one 😉

    Reply
  126. For someone who is menopausal, please could you provide a schedule for using these bio-identical hormones? For example would you take progesterone continuously or for a certain length of time and then a break. With the vaginal pessary would you just use when needed ( to alleviate bad vaginal dryness)? If a patch is needed, how long would you use this for before having a break, (if at all)? I cannot find this information in your book at the moment. Thank-you.

    Reply
    • I need to write a book about menopause! In general, I recommend natural progesterone every day. And a low-dose estradiol patch a couple of times per week. And the stop both hormones for 4 or 5 days per month. I like the 5-day break because it allows the hormones to clear from the body and the hormone receptors to calm down. It’s also a window to see if you actually need that much hormone. If it’s the right dose, then you should be missing it (ready to go back on it) by the end of the 5 break. But please speak to your doctor for individualized advice.

      Reply
      • Yes, please! It would be wonderful to have a book with more indepth information about the change. I ran into it not having the slightest idea what it is all about. It is such a profound change as it is a conscious step to gather and renew for a totally new journey in our life. And for that journey we need strength and emotions which are centred and good sleep. Women are the holders of families. If we are aligned and looking after ourselves – this strength is going out to our community in a ripple effect. So, YES, please dedicate a book to this important transition. Thank you!

        Reply
      • is it safe to come off progesterone with no titration (even for 5 days)? especially with those of us with adrenal exhaustion and for those of us coming off a benzo (progesterone acts on gaba receptors)? thanks

        Reply
  127. Can magnesium, taurine, progesteron, rhodiola and ashwagandha be all taken at the same time? If yes, what is the best order to introduce them? Thank you very much!

    Reply
  128. I am 48 and pretty much menopausal at this point. I was only missing a few periods per year but suddenly none and at the one year mark one period in January. I have autoimmune thyroid – tried taking natural thyroid for that but I could get my TSH anywhere near normal and had to go back to synthroid. I started trying bioidentical cream (both estrogen and progesterone ) but my hair was falling out like crazy. I’ve never had hot flashes and my estrogen levels have bottomed out. I started fighting hair loss when I was put on loestrine birth control for painfulbcramping at age 39 and stopped it a little over 4 years ago. I assume the progesterone cream may make me lose more hair because the estrogen is low – ? I do not want to be put on antidepressants but I’ve had bone crushing depression. I take magnesium glycinate every night and that’s helped until now. Should I stay away from bioidentical progesterone cream – my hair is coming out so bad I need a wig which is reason enough to be depressed – just suffer through the constant cramps and depression and hope it stops someday? My husband has left me and I’m looking for work so right now I can’t afford acupuncture. Thank you for any response you can give.

    Reply
    • I would have to think that it was NOT the estrogen and progesterone that caused your hair loss. Both hormones are very GOOD for hair. What else was happening at the time and in the six months before you took the bioidentical hormones? And, was there DHEA or testosterone in your formula, by any chance? Because they can cause hair loss.

      Reply
  129. Loved your book! I am going to give your suggestions a try. It is definitely nerve wrecking to have irregular and heavy periods now after having wonderful ones growing up and into my twenties. Thirties were not great but I at least could function. The forties have been a complete disaster. I have been checked and no cancer so I am going with your vitamins etc. It makes sense, now looking back. Thank you for putting this information out there and writing the book. 🙂

    Reply
  130. Dr. Briden, I am 47, was diagnosed with PMDD 20 years ago, and I have been charting my cycle religiously to help manage my disorder. I recently came off Vitex after reading your blog and I am now taking magnesium, taurine and natural progesterone cream. As per the directions I started on day 14 of my cycle and stopped on day 28. My cycle has been a stable 28 days with obvious ovulation day 11-14 for years. My periods are light due to an endometrial ablation at the age of 30. I had become anemic from severely heavy periods. My new supplement regime is working wonders already, I haven’t felt this good in years, although the Vitex seemed to help relieve symptoms for about 6 months before it stopped helping. This is my first month on progesterone and my period is late. I should be on day 2, not day 30. Should I wait until I bleed to restart the cycle count or should I follow the calendar? I want to keep taking the progesterone on days 14 thru 28 as directed. Please advise. Many thanks, Richelle.

    Reply
  131. I am 45 and have frequent, prolonged periods with flooding. I asked my doctor about them and she wanted to replace my copper IUD with a hormonal IUD. I’ve had the copper IUD for 7 or 8 years with somewhat heavy periods, but it recently got much worse- my breaking point was two months where I was bleeding almost constantly and flooding often. I read your blog and book and realized that I was probably low in progesterone.

    My doctor agreed to give me a prescription for micronized progesterone when I asked (but didn’t volunteer this and still wanted to put me on the hormonal IUD). Even my acupuncturist who takes hormones herself didn’t explain the likelihood of progesterone deficiency!

    I am now in my 4th month of taking cyclical progesterone- at first, the doctor gave me 10 pills to be taken from the 20th to the 30th of each month. I felt so good on the progesterone- better sleep, mood, and much less bleeding, but the timing seemed off and the 20 off-days seemed too much. I started supplementing with an over-the-counter creme, and I asked for 14 pills every 28 days. My periods are still heavy (with flooding for 2 days), but much shorter.

    Now, my period has been arriving about 5-6 days early (while I’m taking the progesterone). So I stop and let my cycle start, and readjust my “day 1”. My question is, how should I adapt the cyclical progesterone to a shorter cycle- 22/23 days? What I’d like to do is be on the progesterone all but about 5 days when I’m having my period. What should I understand about the off-days? Is it OK to just take it every day?

    Thanks for this amazing resource!

    Reply
  132. Hi Lara
    So glad I came across your posts am ordering the book today
    I’m sure I posted a few questions on this site a few months back but will try again (brain fog I forget everything lately).
    So basically my question is what is the best combination for me to take please .
    I am peri menopausal I’m 44 have had no monthly period for 18 months I was prescribed everol sequi which I used for 3 months then has a turn which lead me to be in A &E suspected mini stroke (very scary) ,after a couple of visits to stroke clinic doctor is happy it was not a TIA so is happy for me to go back to using patches but I am a little worried ,I have asked my GP lots of questions but answers was of no real help so am trying to do my own research hence how I came across your blog
    SYMPTOMS:no sleep at night so restless ..anxiety.. No libido..occasional hot flashes but not bad no sweating just get very hot ..excess weight around tummy and legs and the odd down day .
    MY MED HISTORY :was having pains in chest and palpitations had test but all seems ok
    Have had 2 ops on leg veins which still sometimes flares up right leg swells and aches and veins are visible 🙁
    I am worried to start using patches again as I am not totally convinced I did not have a TIA as I did not get great care at A&E
    My question is what is your opinion as from reading up on menopause I understand you need estrogen for your bones so am taking Adcal D ,should I go back on patches if so do I stop Adcal D ?? Or is there a combination of natural tablets I can take to help all my symptoms ?
    SO SORRY FOR LONG POST BUT AM DESPERATE .HELP ! With thanks Miss M .

    Reply
  133. Hi Lara
    Do you have a preference for estradiol or estriol vaginal cream for vaginal dryness? I see both are available and have read some information that suggests estriol may be safer. Are you comfortable with people using the vaginal estrogen without progesterone given it is not supposed to be absorbed much into the bloodstream? I am perimenopausal with short periods every few months currently.
    Thank you

    Reply
  134. Interesting. Although I just looked through the symptoms of CBS mutation and they don’t sound like me so I don’t think that is the reason for the taurine sensitivity in my case.

    Reply
  135. Hello Lara,
    Thank you for all your work, I really enjoy your information!
    I have been in menopause for three years, have no uterus, and my gyn has me on 1mg of oral estradiol. I’ve read your information and am going to add a natural progesterone cream but would an estriol cream be helpful also or should I not add that when I’m on estradiol?
    The estradiol has kept me comfortable up until recently. I’m having bladder and uretha pain and spasms, along with anxiety(all of which I had when first diagnosed with menopause). We’ve tried so many different things and nothing is working but we haven’t done anything hormone related. I thought adding progesterone cream would be worth a try, I’m starting to feel desperate!
    Thank you for your time !
    Mary

    Reply
  136. Hello Lara,
    Do you know of any natural treatment ideas for women who feel that they are more forgetful during/after menopause?
    Do you have recommendations for women in perimenopause who feel their sleep pattern has suddendly changed? To not being able to fall asleep?
    Could both be related to hormonal changes? And if so, what can one do about it?

    Many thanks for all your ideas and the work you do! It is really wonderful.

    Reply
    • Hi Danae, yes, memory and sleep are common symptoms during perimenopause. They can be helped by the treatments described in this post.

      Reply
      • Thank you Lara. Do you have a good micronised progesterone brand? On Amazon I only find Wild Yams capsules here in Europe and Pregnenolon products. I take Magnesium for a long time (unfortunately Taurine did no quite agree with me) so I guess the next step would be Progesteron.

        Reply
        • In the step by step plan, I recommend magnesium first (with or without taurine), and then STAY on the magnesium and consider introducing progesterone. Micronized progesterone is a prescription medication called Prometrium. (very different from Primolut or Provera)

          Reply
          • Thank you! This blog is more informative than anything else I found – I bought your book with is so helpful but your feedback here and learning from all the other women has made a big difference in my life. I feel I am getting my health back together… THANK YOU!

  137. My daughter is 13years old she started her period last year in June 2016.She had her period in June July and August.In September to December she didn’t see her period. In January 2018 she started seeing the period and bled for more than 10 days. We saw a gynae doctor and he placed her on levofem contraceptive pill for 3months. Is this ok for a teenager considering the side effects? Pls are there any nutritional options we can explore? Can she take supplements? If yes which and the dosage.Thank you.Love to hear from you soon.

    Reply
  138. Hi Lara,
    I’ve been prescribed Femoston 1/10 mg for amenorrhea – really as a last resort to protect my bones (I’ve had missing periods for years now).
    It contains 1mg oestradiol (as hemihydrate) and 10mg dydrogesterone.
    Is this a bioidentical oestrogen?
    Would you recommend any of brands (perhaps more natural) over this medication for my particular case?

    Reply
  139. Hey, I am so so grateful to have found your site!!! After ten years of telling mty ob I felt likeI was entering into perimenopause or menopause and him not believing me and wanting to put me on some form of birth control which I did not want to do. I finally switched over to another OB who did a Fsh test it was at 60. She said you are in full menopause and you just have to miss a full year of periods . My question is what is the dosage for step number one 🙂 Is it every day? 🙂

    Reply
  140. Hi Lara,
    I’m 50 and had a hysterectomy (for heavy bleeding and fibroids) a year ago with removal of left ovary. My gynae says I should use oestrogen patches (Climara 50) for prevention of osteoporosis and CVD risk due to surgery sending me into menopause. He also says it will improve symptoms (muscle aches, insomnia and extreme mood issues). I’m worried about using synthetic hormones, can you please share your opinion? He has said I don’t need progesterone although my GP (an experienced women’s Dr) suggests aching is due to progesterone withdrawal. I’m a natural therapist (new grad) and I take magnesium (not taurine at this point).

    Reply
    • Hi Jo, Climara is natural (bioidentical) estradiol, so that’s good. It’s not synthetic. But it’s a bigger dose than I think is usually necessary. (I prefer more in the 25 mcg range)
      And you do need progesterone even without a uterus. I explain why in Chapter 10 of my new book, which I strongly recommend you buy. As a natural therapist, it will help you treat your patients’ periods. And it will help you to understand natural hormones for menopause.

      Reply
      • Thank you for replying Lara. I have just purchased your new book on Friday as periods and hormones are of particular interest to me, waiting for it to arrive! Good to know re Climara, may have to see if a Dr is wiling to prescribe a lower dose. Would you recommend Progesterone in the form of a cream? If using a capsule does that need to be prescribed by a Dr?

        Reply
  141. Hi Lara,

    My naturopath has just recently told me that “my body has antibodies to the GDA enzyme which inhibits your body from making GABA (anti-anxiety neurotransmitter)”. Can you explain to me what this means? He is a good doctor and is working on some homeopathic anti anxiety things for me, I already take taurine and magnesium but still suffer terribly from anxiety and depression. I am post menopausal and on some bioidentical troches which have high estrogen and low progesterone. Could this be the problem? I see him again in a couple of weeks, but what does this mean? He also said that my brain registers having suffered a PTSD episode (which I did), but how can I make GABA (or get rid of the antibodies) which is the neurotransmitter to help me push past this crazy anxiety. What else can I do? I am not very medically clever and really could use some help from this. Thank you so much for your terrific articles. You are a huge help to so many.

    Reply
  142. I am 70 with surgical hysterectomy at age 27 (total). Have been on estrogen ever since, now using the patch 0.375. Have been taking Dermatologist prescribed Propecia for 10 years for hair loss with little positive results. I have just started progesterone cream 1/4 tsp.on my own two weeks ago. I am sleeping better. Should I stop taking Propecia? Weight 112lbs 5’4″ diagnosed with muscle wasting. I feel the Propecia has caused the wasting. Thank you for your informative Blog.

    Reply
    • The decision about the medication should be made with your doctor, but I will say that if the finasteride (Propecia) has not helped you in 10 years, then I can’t see why there’s any reason to continue it.

      Reply
  143. Dear Lara,

    I am 25 and I recently lost my virginity a couple of months ago, but something hasn’t been quite right. I have been having pain during intercourse. A pain I don’t think is normal. I am not talking about first time virgin pain. Instead, I am having sharp, tight/full/pressure pain in my lower tailbone when penetrated. Certain positions do make it worse, but I feel it in all positions. I have PCOS and have had recurrent vaginal infections nearly monthly over the last decade and the last time I had BV I quit taking the antibiotics due to side effects, which was over a year ago, but I have continued to have symptoms, so I may still have the BV or a yeast infection, which I thought the antibiotics might have given me. I haven’t seen a doctor. Orally, Fem-Dophilus hasn’t rid my infection symptoms, should I try vaginally? Any idea what might be causing my pain during intercourse? Thank you so much.

    Reply
    • There could be several different explanations for that kind of pain. Please start with a visit to your doctor.
      And just a note that PCOS does not cause pain (so it’s not that).

      Reply
  144. Hi Lara, thank you for the wealth of information that you freely share.It’s refreshing to know that there are natural alternatives! I was diagnosed with Stage 4 HER2+ breast cancer in 2011. The chemo put me into an unpleasant and severe menopause which I still wrestle with. The oncologist steer clear from any hormonal remedies. I am a fit and strong 55 and would like to know if your 3 Step Rescue Prescription can apply to me? With much appreciation, Emee

    Reply
  145. Hi Lara,

    2017 was rough, lots of stress and a week of antibiotics because I kept getting ear infections (I’m 32), but I’ve discovered your book (love it BTW) and have started to see some changes with adding in magnesium and zinc! My issue right now is insomnia, especially before my period. I’ve been using progesterone cream in the luteal phase only but still struggling to sleep through the night, my ears itch and so does one side of my lady parts. I had my hormones tested a couple of months ago on day 21 of my cycle. My total estrogen (418.4 pg/mL, range for luteal 130-460pg/mL) since antibiotics have almost doubled, and my e2 has decreased by almost double as well (127 pg/mL, range for luteal: 6-214). I also have shown low iodine levels through blood test at 36 mcg/L, range: 52-109mcg/L. So I’ve been taking potassium iodide 500 mcg daily for 2 months. I need sleep!! What can I do?

    Reply
  146. Hi Lara, what an interesting read. I was diagnosed with POF. I am 40 and have not had a period for almost 2 years. I am on hrt. Can I follow the above regimen whilst of hrt?

    Reply
  147. Hi Lara! At 24 (I’m now 31) I got diagnosed with interstitial cystitis, painful bladder syndrome. I’ve read that many women get this during menopause. I’ve had a frequently need to urinate my whole life (since childhood). But as an adult my symptoms got worse. Burning pain in my bladder. The pain now is unbearable. I get up every half an hour at night to pee. It has been like this the last 1 1/2-2 years. I’m exhausted! The doctors have variety of knowledge, and I can’t seem to get much help other then getting botox in my bladder walls. A treatment I don’t want. I want tontreat this naturally. Do you know anything about IC? Do you know what kind of natural treatment that can help?

    Reply
    • My IC/bladder problems and dry vagina started after I stopped birth control pills when I was 23-24. Could this be a link to my IC?

      Reply
        • I’m 31. So I should not be in menopause? I’ve read that bladder problems also can be connected to candida/yeast. I’ve been bothered with constipation and nasal congestion for a while also.

          Reply
        • Thank you for this! I’ll try it out. I noticed that she also took quercetin. I’m breastfeeding. Is it safe to take quercetin then? Is there any other supplements that is safe taking while I breastfeed? Aldo read that Calcium Glycerophosphate is something that could help with this condition, but too afraid taking anything durin bf.

          Reply
    • I know that this response is over 2 years old but I just saw this. I am 60 years old and have had bladder infections since I was in my 30’s, been put on too many antibiotics to only have the pain and burning return. Finally I went to an Urologist who confirmed through a surgical procedure that I have interstitial cystitis for over 7+ years. Diet change can be the biggest help but who wants to give up all the foods you love + wine. To make a long story short, I was at the Urologist office seeing the PA and she mentioned in passing that she has women taking the over the counter Prelief which actually takes the acid out of food. This supplement has changed my life. I take 2 in the morning, (coffe always bothered me) and if I am going to eat spicy food or wine. I never get bladder pain anymore and if I do I just take another pill. Prelief is Calcium and magnesium. I have told other women who also suffered from this and they too have reported the same positive results. Check it out.

      Reply
  148. Hi Lara,
    I’m 50 years old and have had terrible hormonal swings for most of my reproductive years. I have PMS the week before my period. I have been in perimenopause for awhile now, but still have regular periods. I am currently using 20 mg progesterone cream for 14 days after ovulation. I stop the cream a day before I expect my cycle, but have PMS until it comes. Would it hurt anything if I just continued the progesterone through my cycle each month, to keep from experiencing the PMS symptoms? (Mostly depression and anger)

    Reply
    • During perimenopause, it is generally fine to use progesterone for most of the days of the cycle. You’re probably not ovulating anyway. I still recommend at least 5 days off per month. Usually from days 2- 7 of the cycle

      Reply
      • Thank you for your response to my previous question.
        I have another question in regards to my daughter. My daughter has had PMS, depression, and anxiety since puberty. She is now 25 years old and just gave birth to a beautiful baby girl. She has taken an anti-depressant (Welbutrin) for about 2 years for depression and anxiety. After giving birth, she is back to the same symptoms. Is it possible for her to take progesterone along with her antidepressant until her hormones balance out, and then wean off the antidepressant?

        Reply
  149. Hi Lara,
    Is it possible for bioidentical hormones to cause severe bloating and gas? My mother has had these symptoms for months coinciding with her starting a combination of bioidentical oestrogen (6mg), progesterone (200mg) and testosterone (16mg) for menopause. I think maybe her dose is too high but would love to know if this is a potential side effect and where I might find some more information?
    Thanks for your help!

    Reply
  150. Doc, what about estriol topical for perimenopause symptoms. I am 43 perimenopausal….progesterone topical brought relief earlier but it no longer relives irritability etc. Can I take a low dose estriol cream say 1.5 mg for cycle days 1 to 25 (along with progesterone cream from cycle day 12 to 28)? Please help.

    Reply
  151. Dear Lara, I am very happy to have found this blog. I am in my 40’s and have been having all the problems you describe in this post. I am a nutritionist and I have been trying to resolve the issues as best I can knowing what I know about nutrition. I have been taking Magnesium Taurate and it surely helped a lot. Just recently I went to see a couple of very good endocrinologists and one of them suggested I start a very low dose hormonal replacement combination of estrogen+progesteron, but another firmly prescribed progesterone alone. I still get periods although they became sporadic and that’s what prompted an endocrinologist’s evaluation. I have been taking progesterone (duphaston) days 16-25 of cycle. Only been one cycle so far and I loved it. My sleep is back! And my skin is amazing, not a singe breakout during the cycle (I have been having acne over the past year). After I bought the duphaston I learned of the better form of progesterone replacement, utragestin and I hope to get my hands on it as soon as I can.
    This whole year I have been having problems with hair (it’s thinning a lot) and also cracks on hills. I wonder if these are also due to progesteron deficiency. If so, I hope to see improvements now that I’ve started taking progesterone.
    Thank you for your blog and I am looking forward to reading new posts.

    Reply
    • I read an article the other day where it said that estrogen dominance can contribute to the thyroid problems. Sub clincial syptoms included cracked heels, brittle nails, losing hair, foggy thinking, mood swings and more! DId your doctor run any thyroid tests?

      I am estrogen dominant and started included 2/3 brasil nuts per day and seaweed into my diet just to naturally support my thyroid, just in case.

      Might be worth looking into……….

      Reply
  152. Hi Lara, thank you for all this wonderful information. I am almost 52 and still get regular periods (quite light). I take Mg and Premular which help with PMS but not sleep. I wake at 3 or 4am most days and struggle to get back to sleep so am tired most of the time. Should I start using progesterone or is the premular helping to make it for me? Thanks Jane

    Reply
  153. Thank you so much for your info and very helpful website Laura! I’m 41 and have been suffering from insomnia and fatigue 2 times a month – during ovulation and before my period. My periods have been short and light but regular. I started on an estrogen patch and a progesterone pill for a few months and it’s helped a lot with my sleep and PMS. My concern is that you recommended NOT to take estrogen while you still have your period. Why is that? Is the patch ok? It’s Estaboil .025 MG. I cut it on half and use it for 2 days before putting putting on another half. I was getting headaches when I took the patch off after my period. So my gyno recommended keeping the patch on all month. I take progesterone all month too. According to your research/opinion, is this amount and duration safe? Thank you!

    Reply
    • Thanks for your question.

      First of all, is your progesterone a micronized progesterone such as Prometrium? It’s not a progestin, is it?

      I recommend that natural hormones (including natural progesterone) not be taken continuously. Instead, I recommend they be stopped for at least five days per cycle. Or in the case of someone who is still menstruating (like you), I generally recommend the be stopped for a week to 10 days (days 2-12 of the cycle). Of course, please speak to your doctor about your particular situation.

      For women who are still menstruating, I generally recommend to not take estrogen because you shouldn’t need it. By definition, you’re still making lots of making estrogen. And progesterone on its own should be enough.

      Reply
      • Thank you for the response Lara! I’m taking micronized progesterone, not Promethium. Plus the Estraboil Patch. Can you tell me why it’s best not to be using the estrogen patch, or to remove it at least for a week after my period? Is it more risky to take when your body already produces estrogen? It’s been very helpful to minimize my PMS mood swings. So I’d like to be able to continue using it at least until my period starts. But I was getting a migraine when I’d go off it. Is there a way of preventing the headaches or minimizing them if I decide to remove the patch? Thx!

        Reply
  154. Hi Lara, I have been getting debilitating hormonal migraines for around 7 years now (am 48 yrs old) and tried all the doctors treatments over the years from triptans, beta blockers, anti epileptic to more recently oestrogen patch. Unfortunately none have worked so far. Recently I read a migraine blog which mentioned your book which I ordered Last week and have now stopped using the patch. My cycle is still regular (around 21 days) I have had an allergy to wheat since the birth of my 2nd child (skin rash type allergy) your book is giving me hope that I can get my life back. Thankyou for that! I’m looking forward to trying out something new xx

    Reply
    • Hi Andrea, I too suffered from debilitating hormonal migraines for years and am 47. As my hormones results came back within normal ranges my doc wasn´t interested.

      So I started my own research and discovered the following. Obviously I´m not a doctor but hopefully some the info will be useful to you. Actually this rather wonderful website was a valuable source of my research.

      I used to suffer from 2 days of migraines mid cycle, pre period & post periods. No painkillers would touch them. I suffer from heavy painfull periods and although my progesterone was within normal levels I discovered that the ratio of progesterone to estrogen in the luteal phase of my cycle was low = estrogen dominance.

      I reduced sugar, started taking magnesium, agnus castus & maca root. I started taking bioindentical progesterone cream from days 12 to 26 (roughly) and wow this really helped me sleep better & stopped the pre period spotting. On the days of the headaches I was able to apply the progesterone cream several times and until the headaches went, just like magic. Some months I didn´t get the headaches at all. This cream helped the mid cycle and pre period migraines.

      I tried the progesterone cream on the migraines that started day 5-7 but it made them much worse! Then I read that these type of headaches may to due to “estrogen withdrawal” where I needed a little extra estrogen until it starts to rise on it´s own. I apply bioindentical estrogen cream, again until the migraines go. I have tried using the estogen cream a few days before to slowly build up but it doesn´t seem to be enough. I have to apply on the day of the headaches until I reach that estrogen level my body needs on that day. My estrogen levels were low side of normal so I´m not too worried about using estrogen for these couple of days.

      I am looking into which foods will help me produce these hormones naturally. I´ve realised the good cholesterol is at the top of the sex hormone making process so I´m including olive oil, coconut oil, avocados & butter, so no low fat for me! And, I´ve started including miso with seaweed into soups just to help keep my thyroid healthy.

      Like I said, I´m only a female whose doctor wasn´t interested but I know how disruptive these migraines are and so I hope my histroy helps in some way.

      Reply
      • Thank you so much Sam and Lara for your reply.
        I am keen to try this bioindentical progesterone cream and Magnesium. I live in England. Could you give me a heads up on where to purchase it?
        Best wishes
        Andrea

        Reply
  155. Hello. I’m from Poland. How to deal with the symptoms of low estrogen at the age of 41? The progesterone cream I use for 1 year, helped with anxiety and other symptoms. But it does not work well for hot flashes, sweating. Recently, it has intensified, I started to get back, I have a problem with sleep, insulin, dryness of the vagina, hair loss, fatigue. I had to reduce the progesterone cream, it’s a little bit better. I noticed that the symptoms are worse before menses, during and when progesterone naturally grows. I have not received menstruation a few times because the endometrium was thin. Menstrual periods are short, painless, last three days. How to help yourself to balance estrogen. I started dying evening primrose oil. The addition of estrogen cream is not good at the moment?

    Reply
    • hi Asia, do you know if you ovulate? If you’re reaching ovulation, then, by definition, you have enough estrogen.
      That said, you could use some vaginal estrogen such as Vagifem to relieve the dryness. And also, please ask your doctor to test you for thyroid and celiac disease. (gluten sensitivity can cause estrogen deficiency symptoms).
      And please read my Estrogen Deficiency post.

      Reply
  156. I take Mg Taureate from Douglas labs here in the States. Works well for me. I tried turmeric in the Merida brand, and it ruined my nails. I had lovely nails, and within a few weeks they were horribly short, weak, and ripping and breaking all the time. Now that I have stopped it they are slowly coming back in. Not sure why that happened.

    Reply
  157. Hi, since stopping the pill my skin has stared having breakouts. It’s really freaking me out. What can you suggest please? 0Thanks in advance. Lucy

    Reply
  158. Hi Lara! Thanks for the helpful post! Say if I patient comes to you with 350-400ml blood lose during period , waht would the dosage of Prometrium you would start? and how long one supposed to take this drug? Thank you!

    Reply
    • another question is on the warnings of Prometrium, it says women who have endometrial hyperplasia (overgrowth of the lining of the uterus) should not be taking prometrium. Any ideas why women with this condition should no be taking it? Thank you!

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      • Prometrium prevents endometrial hyperplasia (reduces the thickness of the uterine lining). But my understanding is that it is possibly not strong enough to treat severe endometrial hyperplasia. In that case, it might be necessary to resort to a progestin like medroxyprogesterone (Provera).

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      • Thanks for the answer Lara! From your book thats what i thought (that the progrestone should thin the lining but I thought i would ask since I saw the warning)… I am not super overweight but I do need to loose 25 pounds and deal with my insulin resistance. ( I know it causes thickening of uterine lining- which causing my heavy flows per the ultrasound i have, my doctor in Turkey suggested D&C but i refused since it doesn’t solve underlying problem ).. I will also stop dairy… I am 41 and super tired from dealing with heavy flows. I am very regular but have heavy flows.
        I have no other complaints…. I am on iron pills as well but I am not sure that I am able to fill my stores as fast as i am loosing. So it kinda creates a vicious circle:( If dairy free, and fixing my insulin resistance doesn’t lighten my flows than I will consider prometrium hopefully my doc will be on board to prescribe it. Thank you for ALL you do…. You are AMAZING to share this vast knowledge you have with us so willingly! Thanks for being so generous!

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  159. Hi Lara,
    Happy new year to you!
    After a decade of appalling insomnia I have changed to a fodmaps diet and discovered inositol (which I buy from iherb). I have recently added the ‘Now’ double strength L-Theanine 200mg plus inositol 100mg. I take one capsule in the morning followed by a 500mg inositol capsule 2-3 hrs before bedtime. I am sleeping every night since starting this routine . It is really extraordinary!
    I have bioidentical oestrogen and it made all my symptoms worse.

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  160. Any suggestions on where to purchase progresterone cream from? I’ve asked my GP and gyno previously, and was told there was no such thing?! I’m Auckland based if that helps. Thanks.

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  161. Hi Lara, do you come to Toronto often? I live in Toronto and I’d like to see you as a patient. I lost my period 6 years ago when I was 41. My main problem is hair loss. Also, I have stuborn belly fat and joint pain. I take daily (for a year now): 30mg of zinc, 200 mg of magnesium, 800 mg of kelp extract, progesterone cream and recently started saw palmetto for hair loss. I don’t eat dairy, gluten or any kind of sugar. I don’t know what else to try because it seems nothing works.

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  162. Thanks for the helpful information Dr Biden. I commenced on Duavive (DUAVIVE is 0.45 mg conjugated oestrogens (CE) and 20 mg bazedoxifene taken as a single oral tablet). I’m currently in menopause but still getting hot flushes (much milder now that I’m on Duavive) and mood swings. I haven’t tried any other forms of HRT – do you feel I should also take Taurine and Magnesium (I take 600 gms magnesium for cramping) – appreciate your advice, thank you.

    Reply
    • I find that most women feel a lot better on progesterone and low-dose oestradiol rather than the old-school prescription of conjugated equine estrogens, or horse estrogen.

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  163. I had crippling anxiety as a perimenopausal symptom and was getting to the point that couldn’t drive without becoming panicky. From another post on this site, I learned that taurine was good for anxiety. Literally after a week of taking the taurine, I started to feel more normal, less anxious. I continued to take the taurine and my anxiety is now about 80-90 percent better.

    On progesterone cream: Every time I take it, my breasts get so sore. I tested my hormones this past year and they were all low, but “in the normal range.” My naturopath tested them, read the test, and I trust her, especially because she didn’t want to give me estrogen since I still have periods. I’m so glad you mention this, Dr. Briden, this is an extremely helpful point.

    Is there anything one may do (non hormonally) for low sex drive? After ovulation, or during the last two weeks of my cycle (not sure if I always ovulate), I have no sex drive.
    Thank you again for the informative posts.

    Reply
    • You could look at the new Julva cream for libido. It’s herbs + a very low dose of the hormone DHEA. (so technically, it’s hormonal, but a small dose)

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      • I would like to try Julva cream but you cannot legally import DHEA into Australia. I’d be interested to hear from anyone who has purchased the cream and not had it seized at the border.

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        • You can have a compounding chemist make up dhea pills for you with a doctor’s prescription in Australia. Best dose for females is 10-25 mg. It assists greatly with libido and lubrication as well as mood elevation. Best of luck.

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      • Thank you for your reply! I saw that Amazon (U.S.) carries the Julva cream and has a 7 day trial size. I’m very interested in trying this, as the lack of libido is distressing.

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  164. I have not had a period in five years and I’m lost as to what to do . Frequent night sweats, very emotional, some hot flashes mostly very sensitive emotionally depressed and anxiety. can you give the names of products to try?

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  165. Why shouldnt you take estrogen if you are having periods still? If your blood tests show you are low on estrogen then why not add it in?

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    • By definition, if you’re reaching a period, then you’re making enough estrogen. You can’t rely on a blood test because estrogen varies greatly depending on the day of your cycle. For example, it’s perfectly normal to have very low (menopausal) levels of menopause on day 2 or 3 of the cycle.

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        • no, the worst of the symptoms are during the transition. Most women report good mood in all the decades after periods have stopped.

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          • This is such good news. I have wondered so much about this. I’m appreciative of the periods, for the “monthly report card,” but I am also looking forward to more stable moods and no pms.

          • I am in Menopause for 5 years now and still miserable with almost all symptoms, but had no symptoms peri… go figure

  166. Dr. Briden, How much progesterone cream should I use daily for my heavy, heavy periods before trying the capsule which I imagine is only prescription? I currently use the NOW brand which says 1 pump = 20mg of progesterone- is this enough once daily? Please help.

    Reply
    • I’m not sure progesterone cream will be enough to treat what you describe as a “heavy, heavy” period. If you’re losing more than say, 100 or 150 mL per cycle, then you might want to approach your doctor for a possible prescription for Prometrium capsules. My rescue prescription for flooding periods is: dairy-free diet + turmeric capsules + iron + Prometrium. And the back-up plan is Mirena.

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  167. Does anyone have major water bloat in lower belly? That is the main symptom that bothers me, the rest I can deal with. Anything I take makes it worse, especially anything progesterone or related to improving your own levels, even though they say progesterone is a diuretic it makes me retain water. I am even getting it during ovulation time or when I am supposed to ovulate but I am not. I rarely see this listed as a symptom and it has gotten worse for me in perimenopause. I don’t have swollen hands/feet/ankles or breasts….it is always lower belly pooch.

    Reply
    • That kind of hormonal abdominal distension you’re describing seems to respond best to vitamin B6. Plus maybe avoiding dairy products.

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  168. For some people, taurine can make anxiety a lot worse. I don’t know why, but it does for me. I read somewhere that it’s a sulfur issue, but I’m okay with lots of other sulfur based nutrients so no idea why. But man, magnesium taurate gives me tremendous anxiety!

    Reply
      • I also have an idiosyncratic reaction to taurine. I have not taken magnesium combined with taurine, but have taken taurine on its own and it makes me ‘wired’. Even if I take it in the morning I can’t sleep that night. Magnesium glycinate does the same thing. The only way I have been able to successfully take magnesium is transdermally through cream and baths.

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          • I went down the SNP route for years following Amy Yasko in attempt to heal CFS. the CBS mutation seemed very common – as common as MTHFR. however, I never got better addressing “possible” genetic SNPs – especially with adding X supplement for X mutation. at all. and who is to say it is giving a problem – expressing? i have since understood that epigenetics play a much large role in turning this on these possibiities that can also be turned off thru healing trauma. and genetics that are set in stone are very small % and only account for things like hair color etc. are destinies are not in our DNA and we can change them.

            the reason you probably had a paradoxical effect with mag/taurine as I have had nothing but paradoxical effects could be, as in my case, you have low ATP production and this is an indirect way of getting energy. i have CFS and have been on mag/taurine injections for years FOR energy. that’s how depleted CFS people are – mag actually gives us energy due to the chain of reactions from ADP to ATP conversion it helps.

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