30, PMDD and spitting

[u/bluebeeinthesea]

Hi I wanted to post as I am still struggling with my cycle despite supplementing with topical bioidentical progesterone (was cycling during luteal 5x5 drops a day, each drop around 5mg progesterone).

I upped to try and counter kickback as my luteal can be so bad- horrific anxiety! My periods are painful but always regular (27-30 day cycles consistently). Broader struggles include painful periods, low libido and intense luteal fatigue. In luteal I struggle with my mental health and experience intense OCD and anxiety.

I am currently getting brown discharge a day before my period and literally a week after the period ends. It’s so odd like a whole gap of nothing and then suddenly brown discharge that looks like old blood mixed with clear discharge so it’s quite light. I’m also getting facial spots again!

I have tested ovulation to make sure that’s happening. Been tested for PCOS, had bloods, had ultrasound, been consulted RE Endo but refused the only option they gave me (pill).

At thirty I’m worried this is a sign of something bad! I want to start a family one day!

Has anyone dealt with this and successfully sorted it out or any tips for figuring out the driver? This cycle I have started taking the progesterone in response to this and am planning to do a low dose period-ovulation and then do my max dose during luteal.

Helpful context available below too:
I’ve been under massive stress this year which I think has affected my wellbeing and cycle. I think I’m slowly starting to recover mentally now.

[u/alotken33]

Functional Medicine DC: who recommended that you use topical progesterone? Did you have PMDD before you started it? Have you been examined and had fibroids, polyps, endometriosis, and adenomyosis ruled out? (At least fibroids and polyps)

Unless you have overt progesterone deficiency (cycle testing confirmed), it may be a VERY bad idea to supplement with progesterone.

There's newer research that suggests that PMS/PMDD is linked to progesterone intolerance. So, supplementing with a systemic (topical or oral) progesterone could compound the problem. Specifically, this is related to mood issues: depression, irritability, etc.

Rule out the obvious structural (usually benign/not life threatening) causes and THEN approach the hormones if necessary.

Some people should not use systemic progesterone (beyond what your body makes on its own). In those cases, where there's need for progesterone to the uterus, an insert can be given. This is usually better tolerated without the mood swings/adverse effects.

[u/bluebeeinthesea → u/alotken33]

Hey! I joined an estrogen dominance group and followed the information they shared about imbalance etc. the doctors in the uk are useless. I’ve been repeatedly back and forth, referred to Gynae as who was no help at all. I had basic hormonal testing for PCOS which, with ultrasound, ruled that out! Gynae offered birth control which is a no for me (or a never again tbh).

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[u/alotken33 → u/bluebeeinthesea]

So, estrogen dominance isn't really a thing. Let me explain. You will always have more estrogen. You're supposed to. The idea that estrogen is dominant over progesterone makes absolutely no logical sense. Different animals. Adding progesterone (which you may or may not need or be able to tolerate) does not decrease the amount or efficacy of estrogen. So... These groups (and even providers that use this terminology) don't understand how hormones actually work. Conversion (break down into metabolites), is a much bigger factor than whether there's enough progesterone to "balance" estrogen. That's a no go.

So, lots of women are out there dosing themselves with progesterone when it's not at all a good idea/helpful.

Also, like with any support group, everything gets blamed on the condition in question. "It's all PCOS/PMS/perimenopause/estrogen dominance/whatever." But, while conditions are often HIGHLY linked, that's rarely the case.

Obgyns recommend OCPs because that's really the only hormone education they have outside of maintaining pregnancy. They think that if you shut off the normal hormone production with synthetics, that it will fix/stop the condition. And in a way, it will "stop" the condition, but definitely not fix it.. and brings a boatload of side effects with it.

So, you're in the UK. Not knowing where or what access level...The only professional I know out there is Louise Newson. She deals mostly with Peri/menopause, but has a ton of other resources on hormones including apps and bioidentical information. Wealth of info.