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Progesterone Sensitivity
Some women notice low mood, irritability, anxiety or a loss of libido after starting hormonal contraception, progesterone or menopausal hormone therapy. These changes can be distressing, and they are often dismissed. James has specialist experience in working out what is happening and finding a hormone plan that suits you.
How can Dr James Brown help?
James takes a careful, unhurried history to understand when your symptoms began, how they relate to your hormones, and what has and has not worked in the past. He can then guide you through a considered, step-by-step approach to hormone treatment, so you can get the benefits you need without the side effects.
Progesterone sensitivity is not a formal diagnosis. It describes a pattern of unwanted symptoms that appear when a woman takes progesterone or a progestogen (a synthetic version of progesterone). Symptoms can include low mood, irritability, anxiety, tearfulness, fatigue, bloating, breast tenderness and reduced libido.
Research shows that most women do not have mood problems on progestogens. However, a smaller group of women appear to be more vulnerable to these effects. It is thought to be less about the amount of hormone, and more about how an individual’s brain responds to it.
Women who have had premenstrual dysphoric disorder (PMDD), significant premenstrual mood symptoms, or a poor reaction to the combined oral contraceptive pill in the past may be more likely to notice these effects. Many women have no such history, and the experience can still be real.
Assessment starts with the timing of your symptoms. Reactions to a new hormone usually appear within the first few weeks of starting or changing a dose. A symptom diary can help to show the pattern.
It is also important to check for other contributors, such as perimenopause, thyroid problems, low iron, poor sleep, or depression that has developed independently of treatment.
There is no reliable way to predict which progestogen will suit you, so treatment is often a careful trial of different options. Choices include:
- A different type of progestogen or progesterone. Body-identical micronised progesterone and other progestogens affect women differently.
- A different route. Options such as an intrauterine device, tablets or patches may be tolerated differently.
- The lowest effective dose. Often enough to protect the lining of the uterus or control bleeding.
- Treating an underlying condition. Where PMDD or another mood disorder is present, treating it directly can make hormone treatment easier.
The aim is to find a treatment that works for your body, and to avoid repeating a hormone that has already caused problems.
Have more questions?
Bookings: 1300 722 206