Progesterone After Menopause

Dear Dr. Meletis,

I am 74 years old and had been taking Gentle Changes® for several years. Last year, I stopped taking it around July or August due to a friend saying, “why are you still taking hormone replacement therapy (HRT)? You are too old.”

Since then I have had several health issues: high blood pressure, diagnosed as a pre-diabetic and at present have itching all over my body—no rashes. I went on a special diet and have lost weight and my blood sugar is okay. I took myself off the BP meds due to terrible side effects and possibly the reason for the itching—my blood pressure is okay without the meds and my doctor agrees.

I keep thinking that I should not have gone off the progesterone. I have noticed that my body heat has gone up, especially at night, no sweats, just uncomfortable with wearing a nightgown. I have the itchiness mainly around my waist and my bra, where it is warm. My doctor says it’s probably my nerves, but I don’t agree. If it continues, she will send me to an allergist.

How long can you take the HRT and going off it, would there be any adjustments or side effects to my body? Thanks for any input you can give me.

Ms. R.

Dear Ms. R.,

Thank you for your insightful observations and excellent question. I have women well into their 80s on bio-identical progesterone. As you know there is bio-identical estrogen, progesterone, testosterone, etc. So, one really has to look at the term bio-identical hormones as individual therapies that at times are combined for desired effect. Therefore a woman on estrogen may be on bio-identical therapy, yet that is significantly different than let’s say a low-dose, bio-identical progesterone.

Progesterone by the way, also supports a healthy stress response relative to cortisol/cortisone that the body makes on a daily basis to help deal with life effects and aches and pains.

Sometimes when women stop one or more bio-identical hormones, I have clinically observed blood pressure go up. This can be due to many things, including the fact that snoring and sleep apnea increase with menopause, which is the time in a woman’s life hormone cessation occurs. This cessation in your particular case occurred later in your life due to the use of bio-identical hormones. So, if you snore, wake up with a dry mouth or feel tired, then one or more of these symptoms warrant looking into getting a screening test to see if apnea is an issue for you. Many of my patients with apnea get warm at night. Normally, stopping hormone therapy takes 3 to 6 months to allow for a slow transition to hormone-free status; yet there may also be other contributing factors, yet to be diagnosed, that are adding to your symptoms.

It is noteworthy that heat will lead to irritation often where fabric, fabric softener or other items ride against the skin with pressure. Much like infants get heat rashes along a spot of skin where fabric rubs.

As a first step, you may choose to test your cortisol, progesterone, estrogen, testosterone and DHEA levels to see how you are doing. Also a Vitamin D Test is prudent relative to normal blood pressure impact. A Salivary Hormone Test (Comprehensive Hormone Panel) and a Vitamin D3 Blood Test are available here. These tests can offer insights for you and your physician.

Sincerely,

Chris D. Meletis, ND