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.

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

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.

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
mg.

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 INTERACTIONS

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 µM). 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."

" PRECAUTIONS

General

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
submitted.
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.

They list synthetic side effects on natural thyroid as well.

Keep reading ladies. The truth is out there.

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.

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 http://efn.org/~raypeat

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.