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Why Prometrium after having a hysteroctomy

Posted by Elaine8 (My Page) on
Sun, Dec 30, 01 at 13:44

Hi, I hope someone can answer this question. I am currently taking Prometrium and Estradiol The information I found on the inter-net says Prometrium is used for women who "have not" had a hysterectomy. Is anyone else taking this after having a hysterectomy.

Follow-Up Postings:

RE: Why Prometrium after having a hysteroctomy

Ask your doctor why s/he prescribed this drug for you. It is not normally used in women who have had hysterectomy because it is unnecessary in such women and comes with a long list of side effects and adverse effects.

RE: Why Prometrium after having a hysteroctomy

Prometrium is natural progesterone. Estradiol may or may not be synthetic. Ask your doctor.

You DO NEED the progesterone especially so since hysterectomy AND there are No Toxic Side Effects with this natural progesterone. However if you do take too much you will become very relaxed, which is why it is to be taken at bedtime. Be thankful your MD put you on this and not synthetic progestins, which have very unpleasant and toxic side effects. These have given natural progesterone a bad name as people get the two confused.

It is highly questionable whether you need the estradiol or any estrogen supplementation. If you had a hysterectomy you were likely estrogen dominant (and still are), negating your natural progesterone production.

Natural estrogens are also available and estriol is the safest one to take, IF you really must have it.

Must read: The Estrogen Alternative by Raquel Martin. This will answer most of your questions and be a good starting point for more answers elsewhere online. And if your MD is receptive a fantastic book for him/her to offer patients. Your MD may even help women prevent hysterectomies with the information it provides.

RE: Why Prometrium after having a hysteroctomy

This is the nonsense that mlm scammers along with their buddies Lee and Vliet use to hawk their products. In this case the sheer absurdity of making a diagnosis of "estrogen dominance" over the 'net, sight unseen and with no evidence highlights the sheer silliness of this pseudoscientific babble.

Have a look at using prometrium as your search term to find out what the serious side effects of this drug are according to the manufacturer.

RE: Why Prometrium after having a hysteroctomy

Elaine, opinions on this are all over the spectrum, as you can see. In terms of experience, many women who have had hysts feel better or feel that they do better when they take progesterone with their estrogen. Since there is no commonly accepted and verifiable objective test for what is the "right" hormone situation for any woman, how you feel is taken by many doctors as the most useful measure of your hrt adequacy.

All hormones have effects, and all hormones can thus, if taken at doses inappropriate to your body's current needs or capacity to utilize them, have negative effects. In excess, progesterone tends to show up its depressive effects (drowsiness and depressed mood) first. Because these are rarely life-threatening effects, there is a tendency to brush over these on the part of the over-sell set while trumpeting these as doom by the anti-hormone set.

My personal feeling is that the truth lies, as it so often does, somewhere in between the extremes. My experience in taking first estrogen alone and then adding progesterone, having had a total hyst, is that I definitely feel better taking both hormones together. But you must search out and arrive at your own opinion. I suggest doing more research about what it does before making up your mind. The non-commercial link below, specifically referencing women who have had a hyst, will give you an overview of some of the things to consider and point you toward further research.

Here is a link that might be useful: Survivor's Guide to Surgical Menopause

RE: Why Prometrium after having a hysteroctomy

The mood enhancing/sedating effects of progesterone are of course perfectly obvious to most women. Remember how wonderful you always feel/felt in the last week before your period started? Remember how terrible you felt when your period started and how you felt worse and worse until the middle of your cycle when you began a slow improvement in mood gradually getting better and better until a couple of daysjust before your period? Oh, I'm sorry. You remember horrible pms in that week? You remember your period starting as a relief from that pms? Then progesterone is obviously not what you need since in the normal cycle it is only produced for the last two weeks. The level falls abruptly over the last 2 days thereby triggering menstruation.

The serious and immediate side effects of progesterone are hardly limited to depression and sedation.

From rxlist using prometrium/progesterone as the search term

Side effects: (There are also two tables which I cannot reproduce here)

"The most common adverse experiences reported in ?5% of patients in all PROMETRIUM Capsules dosage groups studied in this
trial (100 mg/day to 400 mg/day) were: dizziness (16%), breast pain (11%), headache (10%), abdominal pain (10%),
fatigue (9%), viral infection (7%), abdominal distention (6%), musculoskeletal pain (6%), emotional lability (6%),
irritability (5%), and upper respiratory tract infection (5%).

Other adverse events reported in <5% of patients taking PROMETRIUM Capsules include:

Autonomic Nervous System Disorders: dry mouth
Body As A Whole: accidental injury, chest pain, fever
Cardiovascular System Disorders: hypertension
Central and Peripheral Nervous System Disorders: confusion, somnolence, speech disorder
Gastrointestinal System Disorders: constipation, dyspepsia, gastroenteritis, hemorrhagic rectum, hiatus hernia, vomiting
Hearing and Vestibular Disorders: earache
Heart Rate and Rhythm Disorders: palpitation
Metabolic and Nutritional Disorders: edema, edema peripheral
Musculoskeletal System Disorders: arthritis, leg cramps, hypertonia, muscle disorder, myalgia
Myo/Endo/Pericardial and Valve Disorders: angina pectoris
Psychiatric Disorders: anxiety, impaired concentration, insomnia, personality disorder
Reproductive System Disorders: leukorrhea, uterine fibroid, vaginal dryness, fungal vaginitis, vaginitis
Resistance Mechanism Disorders: abscess, herpes simplex
Respiratory System Disorders: bronchitis, nasal congestion, pharyngitis, pneumonitis, sinusitis
Skin and Appendages Disorders: acne, verruca, wound debridement
Urinary System Disorders: urinary tract infection
Vision Disorders: abnormal vision
White Cell and Resistance Disorders: lymphadenopathy

The following adverse experiences have been reported with PROMETRIUM Capsules in other U.S. clinical trials: increased sweating,
asthenia, tooth disorder, anorexia, increased appetite, nervousness, and breast enlargement.

The following spontaneous adverse events have been reported during the foreign marketing of PROMETRIUM Capsules:
reversible cases of hepatitis and elevated transaminases. These events occurred mainly in patients receiving high doses of up to 1200

The following additional adverse experiences have been observed in women taking progestins in general: breakthrough bleeding,
spotting, change in menstrual flow, amenorrhea, changes in weight (increase or decrease), changes in the cervical
squamo-columnar junction and cervical secretions, cholestatic jaundice, anaphylactoid reactions and anaphylaxis, rash (allergic)
with and without pruritus, melasma or chloasma, pyrexia, and insomnia.


Drug Lab Test Interactions

The following laboratory results may be altered by the use of estrogen-progestin combination drugs:

Increased sulfobromophthalein retention and other hepatic function tests.
Coagulation tests: increase in prothrombin factors VII, VIII, IX and X.
Metyrapone test.
Pregnanediol determination.
Thyroid function: increase in PBI, and butanol extractable protein bound iodine and decrease in T3 uptake values.

Food-Drug Interaction:
Concomitant food ingestion increased the bioavailability of PROMETRIUM Capsules relative to a fasting state when
administered to postmenopausal women at a dose of 200 mg.
Drug-Drug Interaction:
The metabolism of progesterone by human liver microsomes was inhibited by ketoconazole (IC50 <0.1 M). Ketoconazole
is a known inhibitor of cytochrome P450 3A4, hence these data suggest that ketoconazole or other known inhibitors of this
enzyme may increase the bioavailability of progesterone. The clinical relevance of the in vitro findings is unknown.

Coadministration of conjugated estrogens and PROMETRIUM Capsules to 29 postmenopausal women over a 12 day period
resulted in an increase in total estrone concentrations (Cmax 3.68 ng/ml to 4.93 ng/ml) and total equilin concentrations (Cmax 2.27
ng/ml to 3.22 ng/ml) and a decrease in circulating 17b estradiol concentrations (Cmax 0.037 ng/ml to 0.030 ng/ml). The half-life of the
conjugated estrogens was similar with coadministration of PROMETRIUM Capsules."



1.The pretreatment physical examination should include special reference to breast and pelvic
organs, as well as Papanicolaou smear.
2.Because progesterone may cause some degree of fluid retention, conditions which might be
influenced by this factor, such as epilepsy, migraine, asthma, cardiac or renal dysfunction,
require careful observation.
3.In cases of breakthrough bleeding, as in any cases of irregular bleeding per vaginum,
nonfunctional causes should be borne in mind. In cases of undiagnosed vaginal bleeding,
adequate diagnostic measures are indicated.
4.Patients who have a history of psychic depression should be carefully observed and the drug
discontinued if the depression recurs to a serious degree.
5.Any possible influence of prolonged progestin therapy on pituitary, ovarian, adrenal, hepatic or
uterine functions awaits further study.
6.Although concomitant use of conjugated estrogens and PROMETRIUM Capsules did not result in
a decrease in glucose tolerance, diabetic patients should be carefully observed while receiving
estrogen-progestin therapy.
7.The pathologist should be advised of progestin therapy when relevant specimens are
8.Because of the occurrence of thrombotic disorders (thrombophlebitis, pulmonary embolism,
retinal thrombosis, and cerebrovascular disorders) in patients taking estrogen-progestin
combinations, the physician should be alert to the earliest manifestation of these disorders.
9.Transient dizziness may occur in some patients. Use caution when driving a motor vehicle or
operating machinery. A small percentage of women may experience extreme dizziness and/or
drowsiness during initial therapy. For these women, bedtime dosing is advised."

So much for the virtual guarantees of safety proponents of natural progesterone offer so glibly.

RE: Why Prometrium after having a hysteroctomy

Wow, what a list of negatives. After finding out that women without a uterus normally don't need it.....I'm beginning to wonder why the Doctor thought I should be taking Prometrium. I appreciate all the information.

RE: Why Prometrium after having a hysteroctomy

These nasty side effects are from SYNTHETIC PROGESTERONES. For what reason they list them on natural progesterone is unknown to me, but probably a legal maneuver of some sort.

They list synthetic side effects on natural thyroid as well.

Keep reading ladies. The truth is out there.

RE: Why Prometrium after having a hysteroctomy

It is interesting to read this lengthy list of so-called adverse effects. No information is given as to how many women in a control goup also had these same adverse effects. I would venture to say, the incidence of many of them would be the same in the control group. The drug company is required to list every complaint presented by a test subject whether there is any correlation to the trial drug or not.

Elaine 8. The truth is that women are not all the same. After hysterectomy, there is no way to predict which form of estrogen, and/or which combination of estrogen/progesterone/testosterone will most benefit an individual woman. Some experimentation has to take place if the the first prescription is not satisfactory. For many years the general medical belief was that estrogen alone was needed after hysterectomy because there was no endometrium to protect. When Premarin was first touted as the panacea for women's menopausal woes, many cases of endometrial cancer were found in the women taking Premarin. Since progesterone was not absorbed when taken orally, Provera was invented. It is a drug somewhat chemically similar to progesterone and did work to counter the endometrial cancer problem. So when women had a hysterectomy, it was thought they did not need anything but estrogen. Today, more is being learned about the effects of all the sex hormones on all the tissues of the body. Since some women after hysterectomy feel better with both estrogen and progesterone, some doctors are prescribing it initially. Prometrium is the first oral progesterone chemically identical to the progesterone our bodies make. It is called "micronized" progesterone because a patented process makes it able to be absorbed from the gut. I believe it is a completely different drug from Provera and other molecularly altered progestins and can not be compared to them, yet most research makes no distiction between real progesterone and the altered "pretend progesterones". Many naturopaths and other alternative medicine practitioners turned to otc natural progesterone creams because it was the only way to obtain the molecularly identical progesterone. Drug companies did not want to manufacture and market this cream because it was not patentable, therefore not profitable. Also many doctors are skeptical of the transdermal route. My own internist, who is pretty open minded for a medical doctor, had the audacity to say to me when I was having excruciating breast pain from transdermal estradiol patches, that perhaps I wasnt absorbing it well through the skin. I looked incredulously at him and asked, why was I having the breast effects if I was not absorbing it; he became embarrassed and said, oh, I see what you mean; well it's my experience that many people do not absorb drugs well through the skin. I believe he has a set belief about transdermal drugs and leaves no room for differences in this area, even though he is open minded about others.

RE: Why Prometrium after having a hysteroctomy

The comparisons with placebo are in the tables which I could not reproduce. You can find them at

RE: Why Prometrium after having a hysteroctomy

My main concern about asking the Prometrium question was due to musculoskeletal discomfort and the slight pressure I was feeling around my ears. I then began to research the two drugs I am currently taking and discovered Prometrium was not normally used for people without a uterus. This immediately made me wonder "why" I was taking both drugs and maybe the combination of the two was creating a problem and all I really needed was Estradiol (by itself). At this time...I am seriously thinking of eliminating the Prometrium caps-SV and see if there is an improvement with the conditions I mentioned.

RE: Why Prometrium after having a hysteroctomy

Reconsider the Estradiol alone. This is likely the problem drug and at least needs balance with natural progesterone. If not what you have been prescribed than another one.

Read The Estrogen Alternative before making a decision to delete the Prometrium. You may find a different natural estrogen that you need...and you may find you don't need any estrogen. Just progesterone.

The Prometrium capsule has excessive amounts of progesterone to make up for it's ingestion. So much is wasted by this method. I poke my capsule and lick off 1/2 or less and let it absorb through my mouth's mucosa.

You will know almost immediately that you have taken it. Normal daily production of progesterone is 20 mg or so.

read articles at

RE: Why Prometrium after having a hysteroctomy

Raymond Peat is a joke in scientific circles. I actually do urge people to read the article on menopause at the site above. In its pure unadulterated stupidity, it serves to discredit hazelpopcorn's information more completely than anyone trying to point out the biological absurdities in her numerous posts could.(You will need to add a/ to the url - hazelpopcorn, in her zeal to proseletize here and sell her product(s) hasn't checked her urls.)

RE: Why Prometrium after having a hysteroctomy

The url works fine from my computer.

A few of you seem to be quite jealous that someone other than you might have a solution or even a hint of one for those asking.

Fortunately there are a few more who can quietly override your silliness.

RE: Why Prometrium after having a hysteroctomy

Framboise, I just wanted to thank you for the internet site you recommended. It has answered many of my questions. Whether a person has had a hysteroctomy or not, the Survivor's Guide to Surgical Menopause is extremely informative and well worth reading.

RE: Why Prometrium after having a hysteroctomy

Thank you Leigh.

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