ENDOMETRIOSIS

Progesterone and Endometriosis

Endometriosis impacts around 20% of women globally from puberty to menopause, with occurrences being rare thereafter. Studies suggest that individuals with endometriosis produce inadequate amounts of progesterone, and that their luteal phase is shorter than average. In certain instances, the endometrium fails to react to the progesterone signals from the ovaries, necessitating a substantial dose of supplemental progesterone.

Using Natpro progesterone cream as a supplement can effectively address this issue; however, a higher dosage is often necessary. In certain cases, a 200mg/6ml dosage per day may suffice, while more severe situations may require 400mg/12ml or even higher. It’s advisable to begin with the higher dose and only reduce it once symptoms have resolved, as decreasing the dosage too soon may lead to a resurgence of symptoms and reverse the progress made. Prioritise symptom relief first, then gradually taper off. For guidance on tapering off the cream SLOWLY, please refer to How to use NATPRO Progesterone Cream. Some individuals may experience significant pain upon initiating progesterone use, but this discomfort typically diminishes with continued application. It’s challenging to predict when the pain will subside, as responses can vary greatly among individuals; in some cases, users may not experience any pain at all when starting.

It is recommended that progesterone is used EVERY DAY for the first 2 to 3 months or until things have improved. Once it does you can begin to follow your a cycle, use the cream for the last 14 days only, ie from ovulation to bleeding. Some people prefer to continue using every day regardless, especially if entering the peri-menopause stage. If the symptoms have responded to the progesterone and you prefer to follow your cycle again, stop using the cream. Bleeding should occur shortly after this, resume again on day 15 and use it for the next 14 days. Although this gives a 28 day cycle, it's something to go on while the body adjusts to the natural cycle length. Once ovulation has begun again, start using the cream from this point on for the next 14 days. Please rub the cream on the painful areas as often as you need it as progesterone is an excellent anti-inflammatory and will help to ease the pain a little. 

Endometriosis is one of the most challenging conditions to manage. While progesterone may alleviate pain for some women, it does not work for everyone. Recent studies indicate that oxidative stress is a contributing factor to endometriosis, and without addressing Inflammation, one will continue to struggle. Therefore, a significant intake of antioxidants is essential, particularly N-Acetyl-Cysteine (NAC) and vitamin D3. Cysteine serves as the rate-limiting factor in the cellular production of glutathione, arguably the most crucial antioxidant we produce, requiring at least 5000mg per day. The other two amino acids necessary for glutathione synthesis are glycine and glutamine. These are typically abundant in our diets; however, under stress, the conversion of glutamine may be insufficient, so it is advisable to consume up to 8000mg per day. If feasible, consider undergoing a GSH:GSSG test to determine if adequate glutathione is being produced. If testing isn’t an option, it’s recommended to supplement with the three precursor amino acids: N-Acetyl-Cysteine, glutamine, and glycine, with particular emphasis on cysteine.

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Have your Vitamin D3 level tested. We are currently facing a pandemic of vitamin D3 deficiency, with over 50% of the population affected. This crisis began when we were advised to avoid sun exposure and rely on sunscreens! It is recommended to take at least 5,000iu's per day, and if a severe deficiency is detected, an intake of 10,000iu's per day may be necessary.

The standard treatment for endometriosis typically involves progestins; however, these can cause significant side effects and are generally not advised. Progestins are synthetic forms of progesterone, which is a natural hormone, leading to considerable confusion between the two. Many individuals claim they are using progesterone when, in reality, they are utilizing progestins. It is crucial to be aware of what you are actually using.

The endometrium can grow in locations outside the uterus, primarily in the pelvic region, including the ovaries, fallopian tubes, the front and back of the uterus, as well as the intestines and bladder. However, it has also been discovered in the eye, brain, lungs, diaphragm, and skin. As the endometrial cells within the uterus swell and proliferate in response to rising estrogen levels during the first part of the cycle, the displaced endometrial cells follow suit, leading to a spectrum of pain that can range from mild to extremely severe. Additional symptoms may include lower back pain, painful intercourse, discomfort during bowel movements or urination, spotting between periods, fatigue, and Infertility.

Two 'theories' have been proposed for the cause of endometriosis:

  1. Endometrial cells travel along the fallopian tubes and settle in the pelvic region. However, this explanation lacks validity, as it fails to account for the presence of migrating cells in the brain, lungs, skin, and other areas.
  2. Another line of research suggests that the issue begins during fetal development in the uterus. Excessive exposure to estrogen, whether from natural sources or xeno-estrogens, leads to the misplacement of certain endometrial cells that should properly reside in the endometrium. As the child enters puberty, these cells contribute to the development of related complications.

Treatment typically involves anti-inflammatory medications, aromatase inhibitors, continuous hormonal contraception to stop monthly bleeding, surgical options, and medications that stimulate gonadotropin-releasing hormone production, leading to a significant reduction in both estrogen and progesterone levels, which may result in menopausal symptoms and an increased risk of osteoporosis.

When a woman approaches menopause, it is often recommended that she be patient, as the decrease in estrogen levels results in reduced stimulation of the endometrial tissue, leading to a decrease in pain as well.

Endometriosis Symptoms

For reasons that remain unclear, certain endometrial cells move to other areas of the body. Unlike typical uterine cells, these cells cannot be shed, leading to the formation of cysts commonly referred to as 'chocolate cysts.' The blood within these cysts becomes oxidized and turns brown since there is no way for it to be expelled. As these cysts increase in size with each menstrual cycle, they can cause pain in some individuals.

These cells are most often found:

  • in the pelvic area
  • the bladder
  • the intestines
  • on the ovaries
  • the fallopian tubes
  • back and front of the uterus

However, they have also been found:

  • in the eyes
  • on the brain
  • on the lungs
  • on the diaphragm
  • on the skin
  • in the rectum

As the cells in the endometrium of the uterus expand and develop in response to the increased estrogen during the follicular phase or the initial part of the cycle, all the displaced endometrial cells also experience similar growth.

Endometriosis symptoms that can occur are:

  • pain - from mild to severe in the pelvic region
  • lower back pain
  • painful sex
  • painful bowel movements
  • pain when urinating
  • spotting between periods
  • fatigue
  • infertility
Remarkable outcomes have been attained through the following protocol for managing oxidative stress, which is also effective for heavy, persistent bleeding.
  • NATPRO Progesterone Cream - 400-500mg per day.
  • N-Acetyl-Cysteine (NAC) - 2000mg per day. 
  • Taurine - 2000mg per day.
  • Vitamin D3 - 5000iu's per day, more if vitamin D3 level is low. Co-factors are vital when taking vitamin D3. 
  • Bioflavanoids - 1000mg per day.
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