Last Updated on April 18, 2023 by melissanreynolds
It seems I am always having to research obscure treatments and then share the information to get this knowledge out there. Bioidentical hormones and fibromyalgia is one such area.
In this post I am going to share how I ended up finding bioidentical hormones, some research and my experience trying some of them.
Endometriosis
I have had fibromyalgia and chronic fatigue syndrome for many years. I have also had heavy, painful periods for my entire menstruating career. In 2022, after my fourth baby, the periods got so bad that they suspected endometriosis.
With endometriosis, the official way to receive a diagnosis is through surgery. But the public system is so overwhelmed that the waitlist is very long, if you are even deemed severe enough to be granted a place on it. Using history, ultrasound and physical examinations, they can make a “probable” diagnosis. Which means they then ply you with medicine (usually birth control) and hope for the best.
A private specialist we paid to see recommended a laparoscopic hysterectomy. As the public system waitlist is so long, we took out insurance. But the standdown is three years. And in the first half of 2023, the endometriosis was so bad that I was having more painful days than not. It was worsening the fibromyalgia.
My research
In the meantime I have been researching other avenues for help. Because, of course. I have a blog with over 300 posts of my findings.
And I came across bioidentical hormones and fibromyalgia and endometriosis.
NOT synthetic hormones – bioidentical (or body identical), not what’s in birth control (I react terribly to that).
What are Bioidentical Hormones
The Cleveland Clinic says, “Bioidentical hormones are processed hormones designed to mimic the hormones made by your body’s glands. Taking bioidentical hormones can help people who experience symptoms of low or unbalanced hormones.” This article also covers who should not take bioidentical hormones, potential side effects and a lot of other information.
This usually includes progesterone, estrogen and testosterone.
They are often recommended for perimenopause, menopause, endometriosis, PCOS and other hormonal related issues.
Progesterone, specifically, is helpful for heavy menstrual bleeding. Read more here.
There is a lot of information available in the above and below links, I don’t want to weigh this post down with loads of data, but I do want to address the fact that there is a belief that hormonal treatment can increase risk of breast cancer. This is not true for bioidentical hormones. Read the information and discuss it with your doctor if you’re curious.
What I found upon further digging is that they have been studied in relation to fibromyalgia too.
Can hormone replacement therapy help fibromyalgia?
Doctor Teitelbaum mentions them in the hormone section of the SHINE protocol. In an older article about bioidentical hormones he says, “This compounded cream [progesterone and estradoil] can significantly reduce the symptoms of fatigue, pain, brain fog and disordered sleep that women with CFS/FMS have, as women with CFS/FMS often have low estrogen. (Research shows that for 25% of women with fibromyalgia, symptoms started with the onset of menopause.)” He still recommends hormonal supplementation, he just writes in less detail in more recent articles.
Doctor Jarred Younger was also involved in some research on hormones and fibromyalgia (he has also researched low dose Naltrexone for fibromyalgia and CFS). They say, in this article on HealthRising about it,
“this study Younger measured testosterone, progesterone and estradiol levels as well as cortisol in 8 women with FM for 25 days straight while having them record their pain levels. He found that both progesterone and testosterone were inversely correlated with pain levels; that is, the higher the FM patients’ progesterone and testosterone.”
This article on CityNaturopathic discusses one possible mechanism of how progesterone could help: “BHRT can help with fibromyalgia as hormones such as progesterone, have been found to exert an anti-inflammatory effects on the body. Detecting low levels of these hormones can warrant the use of this treatment.”
My experiment with progesterone and estradiol for fibromyalgia
Armed with this knowledge, I asked my doctor if she would be willing to conduct a trial. She agreed (for which I am so grateful).
Side note regarding asking your doctor for trials: Take some research/information and let them know what you hope to achieve, they may want some time to go through the information themselves. Remember the difference between bioidentical and synthetic is important here.
We began with topical estradiol and progesterone. I had topical testosterone available but it was the cost of the other two combined! They cost more than the LDN. So the combination is certainly prohibitive.
My baseline was hard to ascertain as I am currently very affected by different points of my cycle, including severe pain during menstruation. The week before my period is so different to what it used to be – worse sleep, emotions, sore breasts etc. I had also just been through a few month experiment with my dose of LDN. However my average pain and fatigue levels sat around 3-4/10. My sleep was around 7 hours per night with anywhere from 8-14% deep sleep (sometimes just inside the normal range).
Tips for application of topical bioidentical hormones
Across my extensive research (reading and watching videos) I gleaned that it was a good idea to consider night application, after a shower (so that the skin is clean), to areas where the skin is thinnest. Underside of the upper arms, inner thighs, backs of the knees. And to alternate the areas so that I don’t overwhelm the receptor in any one area.
Beginning low and slow is a good idea, otherwise we can feel a bit gross if we start too high and put ourselves off.
If you go ahead and try it out, your doctor will discuss doses and frequency. But generally it is taken cyclically, for the second half of your cycle (i.e.. days 15-26) but there are cases where people take it continuously.
Where to get bioidentical hormones
Topical applications come from compounding pharmacies. But some US information I read suggested there were prescription options of the bioidentical hormones available under their insurance system. Each country will differ in regulations and how you access them.
My experience with bioidentical hormones and fibromyalgia
I began 25th December 2022 (day 6 of my cycle) with progesterone. I applied it to my upper right arm just before bed.
My first period after trying the bioidentical hormones was a doozy. And it gave me a fright. So I stopped using the estradoil. And moved to oral micronized progesterone. Oral bioidentical hormones absorb and show effect much quicker.
In February I managed to get into bed just before the pain got to its peak. I avoided the worst of it. It also came earlier in the cycle (I tend to have a long cycle). So I (erroneously) thought maybe the progesterone had returned my cycle to the “normal” length.
Unfortunately my third period on bioidentical progesterone was so bad I nearly went to the hospital. It was so painful that I couldn’t move so I only didn’t go because I couldn’t get there myself and ambulances were so busy they would have taken hours to arrive. So I endured about five excessively high pain hours before subsiding into a more moderate pain level. This cycle was also a longer one again.
I can’t tell you what the progesterone has done because it’s clear the period issue is progressing. And I am booked in to see a private specialist. But I think it has helped reduce the bleeding. And it may be helping with my deep sleep (for the two weeks I take it).
Conclusion
Although bioidentical hormones didn’t radically alter my period, as I had hoped. I do believe it’s worth consideration. Many women’s symptoms do start due to hormones/perimenopause. If it can help sleep quality, that alone is a worthy outcome.
Have you tried them? Did they help?
