Rescue Prescription for Menopause and Perimenopause
Here are the symptoms you don’t want to talk about: heavy, flooding periods; mood swings; insomnia; hot flushes.
It’s not fun to bleed through your clothes or wake at night with your heart pounding and your sheets all wet. And part of you is thinking that maybe you’ve done something wrong to get into this situation. Or, at the very least, that you’ve made the shameful mistake of getting older and entering perimenopause or “the M-word.”
You’re okay. I’m here to throw you a lifeline and to assure you that you’ve done nothing wrong and that these symptoms will pass. And furthermore, there are simple things you can do now to feel better quickly. (Things that aren’t the hormonal IUD or the antidepressant that your doctor wants you to take.)
Please try these treatments IN ORDER, adding the next treatment only if you need it.
Step 1. Magnesium plus taurine
Together, magnesium and taurine boost GABA which is the calming neurotransmitter your brain needs as it adjusts to the great progesterone crash in your 40s. They’re incredibly soothing and can improve sleep, mood, and hot flashes. I recommend 300 mg magnesium plus 3000 mg of the amino acid taurine.
A 2017 paper called “Magnesium in the gynecological practice: a literature review” concluded that magnesium is an effective treatment for menopause and perimenopause.
👉 Tip: For additional relief, consider adding 50 mg of vitamin B6, which is another good way to boost GABA.
For mood and sleep and hot flashes, magnesium could be as much treatment as you need. Try it for a few weeks, and then if you’re still suffering, consider keeping magnesium, but adding the next step, progesterone.
Step 2. Natural progesterone cream or capsule
Natural progesterone or micronized progesterone is entirely different from the progestins used in birth control or conventional hormone replacement (HRT). It’s not a drug. It’s the beneficial hormone you used to make in your twenties and thirties.
Progesterone has many benefits.
- It makes periods lighter so progesterone can be used together with turmeric and other treatments to relieve the crazy heavy periods of perimenopause. For very heavy periods, a progesterone capsule such as Prometrium is preferable to a cream. (For a full discussion of heavy periods including the very important treatments of iron and stopping dairy, read Chapters 9 and 10 in Period Repair Manual and my blog post about heavy periods.)
- It relieves hot flashes—even on its own without estrogen. Progesterone works best in combination with magnesium and taurine.
- It improves mood and sleep because progesterone soothes the GABA receptors in the brain. For mood, a progesterone capsule generally works better than a cream.
- It helps to remove histamine from the body thereby relieving the mast cell and histamine problem that can flare during perimenopause and menopause.
- It stabilizes the HPA or adrenal axis and improves your ability to cope with stress.
👉 Tip: Other strategies to stabilize the HPA adrenal axis include rest and meditation.
Magnesium + taurine + progesterone could be enough. Try it for a few weeks, and then if you’re still suffering, consider adding a small amount of estrogen.
The strategy is to first take magnesium plus natural progesterone and then keep taking them while you add estrogen.
Step 3. Estrogen
Estrogen is a lot safer than you’ve been led to believe and can be incredibly helpful for sleep and mood and hot flashes. Most of the cancer risk from conventional hormone replacement was from the synthetic progestin—not estrogen.
If you do decide to add estrogen, choose one that is:
- Low-dose such as Vagifem (10 mcg estradiol) or Estradot 25 or 50 (25 or 50 mcg estradiol).
- Body-identical, which means it is identical to human estradiol or estrogen. Fortunately, most (not all) modern conventional estrogen products are body-identical. That includes brands like Vagifem, Estradot, and Sandrena gel. If you’re not certain if your estrogen prescription is body-identical or not, ask me in the comments.
- Transdermal, which means you absorb estrogen through your skin from a cream, gel, or patch. It’s better and safer when taken this way.
👉 Tip: You also need progesterone, even if you don’t have a uterus. Why? Because natural progesterone protects breasts and is good for mood.
What has worked for you? Share your story.
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3 thoughts on “Rescue Prescription for Menopause and Perimenopause”
My mum found Emerita Pro-Gest very helpful and had it prescribed by her doctor. You can’t get it on prescription any more, but when I was really struggling with anxiety, hot flushes and fatigue, I started using it. I find it makes an enormous difference to all of the above. Do you think it’s one of the safe creams?
I have to order it from the USA and it’s expensive (challenge to afford! But essential to sanity!). Are there better options in the UK that are easy to get hold of?
I teach full time, my son’s had an accident so is struggling and can’t get drive (he’s 20) my 12 year old daughter needs me to taxi her to music, dance and Scouts…and my husband works away a lot. (Trying to rebuild life after business went under). So life is full and challenging and I definitely need help to sleep and not feel anxious. I also take 50+ vitamin tablets which seem to be very helpful. I’m 48.
My sister has also been diagnosed with triple negative breast cancer recently. (She asked if I was more at risk and was told no. It’s not something I’d worried about.) I haven’t spoken to my GP….
Hi Ruth, thanks for commenting! We’re glad you found a product that works for you! We don’t give out personalised advice regarding supplements publicly here, or products, as everyone is an individual, and has different contraindications. We always want to do the best for you, and without knowing more about your unique health, we would be doing you a disservice.
If you’re finding your regular licensed practitioner is not helpful, please reach out to one of our experts privately for more personalised help. It sounds like life is challenging for you and we hope to be a continued support for you! Please feel free to send a private email if you have any more questions, and thanks for using the Hub.
Thank you so much for your advice, Dr Briden! You’ve included your recommended dosages of magnesium, taurine and estrogen. What is your recommendation regarding progesterone?