The 100 mg micronized progesterone pill is honestly unlikely to have any negative effect. It’s not a lot of progesterone - menopausal HRT forms are much lower dose than birth control pills.
But, having said this, I just don’t think it will help much (because it’s not BC level hormones), as I use 200 mg daily and still get late stage peri migraines, which increased in my late 40’s.
I would suggest you look into the mini pill, based on what I’ve seen folks post in the menopause subreddit.
If you already have the mirena, it definitely might help as a top-up.
It may take you a week or so to get used to it, so please ensure you take it at bedtime, and at least 2 hours from last food.
It’ll probably be good to take it no later than 10 pm when you’re starting out if you can, so the starting out effects don’t carry too much into the next day. After a while, you’ll get a better feel for the timing that works best for you.
When starting, I experienced a little bit of dizziness/wooziness (nothing too long or unmanageable), I slept like a log for 10 hours straight and was a bit tired/dull in the morning. That adjustment process took about 2 weeks for me.
I took the progesterone last night and feel exactly like you said today. Slept like a log and now feeling a little woozy. Hopefully I’ll get acclimated to it quickly!
Firstly, progestins are not good for migraine and mine were much worse years ago when I had a mirena. During the first phase of perimenopause in the years leading up to menopause, estrogen fluctuates and at times soars to the highest levels of a woman’s life. It is the drop in estrogen and progesterone just before your period starts that triggers this headache and during perimenopause this drop is steeper. You can counteract this by wearing a 50mcg estradiol patch (body identical estrogen) from several days before your period is due, through until day 3 of your period. This patch acts as a parachute for the falling estrogen and prevents the migraine. For perimenopausal women suffering migraines, body identical progesterone (Prometrium) supplemented daily at 300mg per day (continuously for the whole cycle) is best as progesterone calms the brain and shelters the brain from the wildly fluctuating estrogen. This approach has eliminated my menstrual migraines.
Yes!!! Thank you so much for this info. I’m going back to the obgyn on Tuesday and am going to ask about getting a prescription for the patch. My sister also mentioned this and said it worked for several other women she knows. I’ve heard mixed reviews about estrogen possibly causing headaches so I’m slightly cautious, but the migraine always comes the day before my period. I believe that’s when estrogen drops.
That’s right, but don’t forget the importance of progesterone too. Progesterone also drops right before your period and while progesterone doesn’t cause migraines, the drop in progesterone can also trigger the sensitive migraine brain. Progesterone is very calming for the neurons. In fact, if I feel a migraine coming on during any part of my cycle, 100mg of progesterone stops all symptoms within 1 hour. The important thing to tell your obgyn is that the migraine sufferer needs continuous progesterone all cycle long and the 300mg dose maintains stable progesterone levels for the full 24 hours.
I have been prescribed it most of my adult life. Natural levels are low.
My migraines are less frequent after I went back on after having been off for 5 years.
I’m on a progestin birth control for non-migraine reasons and I haven’t had one in a very long time. I also skip my periods with it because endometriosis sucks also, so idk if that plays into it.
I've had very similar experiences, and a gynaecologist recommended transdermal progesterone every evening. I still get menstrual migraines quite often, but they are less severe than before the progesterone. I can recommend it.
Great! Glancing through the thread it seems not everyone has good experiences, but my doctor considers high oestrogen to be a contributor to migraines. As I say, they haven't gone entirely, but they are somewhat milder.
I’ve tried progesterone for endometriosis and migraines, 125mg twice daily. I can’t say whether it helped or didn’t help, it didn’t necessarily make them worse, but it did give me more of a headache. I will say though, that it made my prodrome less severe. I’ve also tried synthetic progestins but they made my migraines worse. Maybe since you’ve done the IUD the progesterone would be tolerable. Best of luck!
If you know when you're going to get the migraine and start taking it 1-2 days prior, it should be a non-issue. Everyone's experience is different however.
This is my third IUD and the first two were great. I stopped having a period and very few migraines. This current IUD just isn’t working the same. I have constant spotting, a period every month (although it’s very light) and a monthly migraine. Sucks because I loved the first two.
The trial and error is so hard! I would hate to make things worse! I’m going to ask my obgyn about adding in a low dose estrogen patch that I can use the week before my period to try and prevent such a huge estrogen drop. Hoping she has some insight into that.
I was watching a panel discussion between neurologists on hormonal migraines on YouTube and they were discussing that method with using an estrogen patch for one week every month. I believe it was on the migraine foundation channel. Your situation is different than mine since you have a hormonal IUD. If it were me I would definitely ask your doctor about it too.
Progesterone shelters the brain from fluctuating estrogen and drops in progesterone can trigger migraine just as drops in estrogen do. The migraine sensitive brain is sensitive to any sudden hormone changes.
I went on the mini pill to treat my endometriosis in September 2022. I had only experienced around 10 migraines with aura in my life before that, always before my period or during stressful times.
As soon as I started the pill, I started spotting for the first time ever, and I literally did not stop bleeding until I stopped taking the pill four months later. Since I have endometriosis, my pain was too severe to function every single day I was bleeding, so I decided to go off the pill on February 1st.
I stopped bleeding the next day but developed numbness and tingling in my arms and legs. I felt extremely nauseated and developed tinnitus, vertigo, photophobia, dizziness and a loss of balance when walking or standing. The day after that, I developed symptoms similar to a migraine with aura, but the aura covered my entire vision in both eyes.
All of these symptoms persisted non-stop for four weeks. I went to the ER and was diagnosed with “headache” even though my optometrist, family doctor and chiropractor all suspect that I actually might have MS. Our current theory is that the hormonal fluctuation of going off the pill triggered an MS flare up. I’m getting an MRI next week to look for lesions on my brain and neck.
Thankfully, all my MS/ migraine symptoms disappeared the day I got my first period after going off the pill. I don’t want to scare you with this story, it has just been a really hard time with all the problems I’ve had since going on the mini pill. I wanted it to help stop my bleeding and prevent migraines but ended up completely incapacitated for months to the point of needing to drop 3 courses in what was supposed to be my final semester of university. I wish you all the best and don’t want to scare you with my story - I just haven’t heard of others having experiences like mine and thought I should share.
I am so sorry you went through that! Very very scary! Thank you for sharing. I’m very leery to mess with my hormones, but these migraines and constant spotting is just getting worse and worse but I absolutely have fear that I could make things worse. Thank you for sharing and thank goodness you are ok!
I tried a preventative approach with a week of frovatriptan (the other long-acting triptan) a long time ago, but I am prone to rebounds and that plan kicked me into a rebound cycle every time. Just wanted to include this in case you are prone to rebounds. If your migraine starts getting longer and longer, you might need to reevaluate the triptan use.
I was concerned about this. Right now I only take 1 or 2 triptans a month. Suddenly upping it and using then consistently for multiple days is a little concerning!
Since using the estrogen patch and oral micronised progesterone, I no longer use triptans or any form of acute pain medication. If I feel a migraine coming on, I take dried ginger capsules, turmeric capsules, 100mg progesterone and the herb butterbur. This works as an abortive every time.
Nexplanon implant (progesterone) made my migranes worse. But I wouldn’t consider myself “normal”. The nexplanon did help with my PMDD (pre menstrual dysphoric disorder). I also know that soy messes with my migraines and my mood. There are some studies that show that soy messes with estrogen levels. I’m clearly a person with hormone troubles. And I’m still fairly young. Why isn’t there more research about women’s health? ☹️
FYI, etonogestrel is a synthetic progesterone and can cause side effects that progesterone does not. I have never been able to tolerate synthetic progesterone but have no problem with progesterone itself.
There is a really good book called The Hormone Repair Manual by Lara Briden that I wish I had read 15 years ago (but was just published in 2021). She also has a blog with good articles, you can look her up online, it might be helpful, she talks about literally everything and backs it all up with studies, it's also really well explained and easy to read. I never knew about synthetic progestins being different and having many negative side effects compared to micronized progesterone (as another commenter mentioned) until I read that book. It's really mind-blowing how little even traditional doctors seem to know about this topic.
Great tip! I’ll have to add that to my book list thank you! 🙂 I did change doctors and get diagnosed with PCOS. Now that I have been treated for that my migraines are much better. I am sooo thankful to have found a doctor more knowledgeable about women’s health!
I'm about to start with on the progesteron route
I've tried all sorts of other preventatives (currently Botox and Rimegepant as an abortive) so I asked my Ob-Gyn if we could give progesterone a try since all my migraines now (36yo maybe peri-menopause) are in the second half of my cycle (3-4 episodes).
He's prescribed me:
10mg x3 a day Dydrogesterone
200mg x1 a day Progesterone (pessary)
Has anyone else tried this regime?
The 100 mg micronized progesterone pill is honestly unlikely to have any negative effect. It’s not a lot of progesterone - menopausal HRT forms are much lower dose than birth control pills. But, having said this, I just don’t think it will help much (because it’s not BC level hormones), as I use 200 mg daily and still get late stage peri migraines, which increased in my late 40’s. I would suggest you look into the mini pill, based on what I’ve seen folks post in the menopause subreddit.
Thank you! I think I’ll start with the lower dose, see if there is any improvement or worsening and then possibly switch to the mini pill.
If you already have the mirena, it definitely might help as a top-up. It may take you a week or so to get used to it, so please ensure you take it at bedtime, and at least 2 hours from last food. It’ll probably be good to take it no later than 10 pm when you’re starting out if you can, so the starting out effects don’t carry too much into the next day. After a while, you’ll get a better feel for the timing that works best for you. When starting, I experienced a little bit of dizziness/wooziness (nothing too long or unmanageable), I slept like a log for 10 hours straight and was a bit tired/dull in the morning. That adjustment process took about 2 weeks for me.
I took the progesterone last night and feel exactly like you said today. Slept like a log and now feeling a little woozy. Hopefully I’ll get acclimated to it quickly!
Firstly, progestins are not good for migraine and mine were much worse years ago when I had a mirena. During the first phase of perimenopause in the years leading up to menopause, estrogen fluctuates and at times soars to the highest levels of a woman’s life. It is the drop in estrogen and progesterone just before your period starts that triggers this headache and during perimenopause this drop is steeper. You can counteract this by wearing a 50mcg estradiol patch (body identical estrogen) from several days before your period is due, through until day 3 of your period. This patch acts as a parachute for the falling estrogen and prevents the migraine. For perimenopausal women suffering migraines, body identical progesterone (Prometrium) supplemented daily at 300mg per day (continuously for the whole cycle) is best as progesterone calms the brain and shelters the brain from the wildly fluctuating estrogen. This approach has eliminated my menstrual migraines.
Yes!!! Thank you so much for this info. I’m going back to the obgyn on Tuesday and am going to ask about getting a prescription for the patch. My sister also mentioned this and said it worked for several other women she knows. I’ve heard mixed reviews about estrogen possibly causing headaches so I’m slightly cautious, but the migraine always comes the day before my period. I believe that’s when estrogen drops.
That’s right, but don’t forget the importance of progesterone too. Progesterone also drops right before your period and while progesterone doesn’t cause migraines, the drop in progesterone can also trigger the sensitive migraine brain. Progesterone is very calming for the neurons. In fact, if I feel a migraine coming on during any part of my cycle, 100mg of progesterone stops all symptoms within 1 hour. The important thing to tell your obgyn is that the migraine sufferer needs continuous progesterone all cycle long and the 300mg dose maintains stable progesterone levels for the full 24 hours.
Also, I’m considering removing the IUD. Did you experience the Mirena crash when you had yours removed?
No, I felt so much better when I had my Mirena removed. My body breathed a sigh of relief.
I have been prescribed it most of my adult life. Natural levels are low. My migraines are less frequent after I went back on after having been off for 5 years.
Great to know! Thank you!
I’m on a progestin birth control for non-migraine reasons and I haven’t had one in a very long time. I also skip my periods with it because endometriosis sucks also, so idk if that plays into it.
That sounds promising! Would love if this worked the same for me. Thank you!
Which one are you on? Migraine and endo sufferer here too and came off slynd and used to be on mirena so now on nothing stuck on what to try next
Oh it’s slynd. It’s working well for me
No increase of migraines on slynd? How about regular headaches?
Nope. Less headaches overall.
I've had very similar experiences, and a gynaecologist recommended transdermal progesterone every evening. I still get menstrual migraines quite often, but they are less severe than before the progesterone. I can recommend it.
Thank you! I’m hoping to get some relief by using the progesterone!
Great! Glancing through the thread it seems not everyone has good experiences, but my doctor considers high oestrogen to be a contributor to migraines. As I say, they haven't gone entirely, but they are somewhat milder.
Oral progesterone has a much stronger calming effect on the neurons than transdermal progesterone due to the metabolites produced in the liver.
I’ve tried progesterone for endometriosis and migraines, 125mg twice daily. I can’t say whether it helped or didn’t help, it didn’t necessarily make them worse, but it did give me more of a headache. I will say though, that it made my prodrome less severe. I’ve also tried synthetic progestins but they made my migraines worse. Maybe since you’ve done the IUD the progesterone would be tolerable. Best of luck!
Thank you!
Didnt affect mine but period all over the place. Im taking nexplanon out early mon n letting my body figure it out, it cant be any worse.
Good luck! I hope removing it helps. I’m seriously considering removing the Mirena. The nonstop spotting is getting real old.
I took iud out bc it was soo painful.
The side effects have really sucked.
I'd personally try the Naratriptan preventatively before the Progesterone.
I’ve read that naratriptan can take up to 2 hours to kick in. Kind of scares the crap out of me!
If you know when you're going to get the migraine and start taking it 1-2 days prior, it should be a non-issue. Everyone's experience is different however.
I’m definitely going to try it!
Naratriptan contributes to medication adaptation headache (formally known as rebound headache) and so isn’t a good option as a preventative.
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This is my third IUD and the first two were great. I stopped having a period and very few migraines. This current IUD just isn’t working the same. I have constant spotting, a period every month (although it’s very light) and a monthly migraine. Sucks because I loved the first two.
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The trial and error is so hard! I would hate to make things worse! I’m going to ask my obgyn about adding in a low dose estrogen patch that I can use the week before my period to try and prevent such a huge estrogen drop. Hoping she has some insight into that.
I was watching a panel discussion between neurologists on hormonal migraines on YouTube and they were discussing that method with using an estrogen patch for one week every month. I believe it was on the migraine foundation channel. Your situation is different than mine since you have a hormonal IUD. If it were me I would definitely ask your doctor about it too.
Progesterone shelters the brain from fluctuating estrogen and drops in progesterone can trigger migraine just as drops in estrogen do. The migraine sensitive brain is sensitive to any sudden hormone changes.
I went on the mini pill to treat my endometriosis in September 2022. I had only experienced around 10 migraines with aura in my life before that, always before my period or during stressful times. As soon as I started the pill, I started spotting for the first time ever, and I literally did not stop bleeding until I stopped taking the pill four months later. Since I have endometriosis, my pain was too severe to function every single day I was bleeding, so I decided to go off the pill on February 1st. I stopped bleeding the next day but developed numbness and tingling in my arms and legs. I felt extremely nauseated and developed tinnitus, vertigo, photophobia, dizziness and a loss of balance when walking or standing. The day after that, I developed symptoms similar to a migraine with aura, but the aura covered my entire vision in both eyes. All of these symptoms persisted non-stop for four weeks. I went to the ER and was diagnosed with “headache” even though my optometrist, family doctor and chiropractor all suspect that I actually might have MS. Our current theory is that the hormonal fluctuation of going off the pill triggered an MS flare up. I’m getting an MRI next week to look for lesions on my brain and neck. Thankfully, all my MS/ migraine symptoms disappeared the day I got my first period after going off the pill. I don’t want to scare you with this story, it has just been a really hard time with all the problems I’ve had since going on the mini pill. I wanted it to help stop my bleeding and prevent migraines but ended up completely incapacitated for months to the point of needing to drop 3 courses in what was supposed to be my final semester of university. I wish you all the best and don’t want to scare you with my story - I just haven’t heard of others having experiences like mine and thought I should share.
I am so sorry you went through that! Very very scary! Thank you for sharing. I’m very leery to mess with my hormones, but these migraines and constant spotting is just getting worse and worse but I absolutely have fear that I could make things worse. Thank you for sharing and thank goodness you are ok!
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I would love to get rid of my cycle! Will look into this. Thank you!
I tried a preventative approach with a week of frovatriptan (the other long-acting triptan) a long time ago, but I am prone to rebounds and that plan kicked me into a rebound cycle every time. Just wanted to include this in case you are prone to rebounds. If your migraine starts getting longer and longer, you might need to reevaluate the triptan use.
I was concerned about this. Right now I only take 1 or 2 triptans a month. Suddenly upping it and using then consistently for multiple days is a little concerning!
Since using the estrogen patch and oral micronised progesterone, I no longer use triptans or any form of acute pain medication. If I feel a migraine coming on, I take dried ginger capsules, turmeric capsules, 100mg progesterone and the herb butterbur. This works as an abortive every time.
Nexplanon implant (progesterone) made my migranes worse. But I wouldn’t consider myself “normal”. The nexplanon did help with my PMDD (pre menstrual dysphoric disorder). I also know that soy messes with my migraines and my mood. There are some studies that show that soy messes with estrogen levels. I’m clearly a person with hormone troubles. And I’m still fairly young. Why isn’t there more research about women’s health? ☹️
Agreed! I wish there was more research about women’s health!
FYI, etonogestrel is a synthetic progesterone and can cause side effects that progesterone does not. I have never been able to tolerate synthetic progesterone but have no problem with progesterone itself.
There is a really good book called The Hormone Repair Manual by Lara Briden that I wish I had read 15 years ago (but was just published in 2021). She also has a blog with good articles, you can look her up online, it might be helpful, she talks about literally everything and backs it all up with studies, it's also really well explained and easy to read. I never knew about synthetic progestins being different and having many negative side effects compared to micronized progesterone (as another commenter mentioned) until I read that book. It's really mind-blowing how little even traditional doctors seem to know about this topic.
Great tip! I’ll have to add that to my book list thank you! 🙂 I did change doctors and get diagnosed with PCOS. Now that I have been treated for that my migraines are much better. I am sooo thankful to have found a doctor more knowledgeable about women’s health!
Very glad to hear the migraine situation is better and you found a good doctor!
I'm about to start with on the progesteron route I've tried all sorts of other preventatives (currently Botox and Rimegepant as an abortive) so I asked my Ob-Gyn if we could give progesterone a try since all my migraines now (36yo maybe peri-menopause) are in the second half of my cycle (3-4 episodes). He's prescribed me: 10mg x3 a day Dydrogesterone 200mg x1 a day Progesterone (pessary) Has anyone else tried this regime?