But then a weird thing happened. After feeling mostly symptom-free for several months, I started to notice my pain rear its ugly head for a few days every month. I would be fine for 27-ish days, but then for the next three or four, even taking a few steps would make me wince. And then I’d be fine again. It made absolutely no sense. That is, until I brought it up to my doctor. To test out her theory, she recommended I apply a small amount of natural OTC progesterone cream (Emerita Pro-Gest, derived from the wild yam and a much lower concentration than prescription progesterone) to the thin skin on my wrists and arms every day for the two weeks leading up to my period. Being the skeptic that I am, I thought it was a complete waste of money, but also being desperate, I tried it. The verdict: Holy sh*t, it worked. Not only did it make an obvious dent in my pain, but it drastically reduced my menstrual cramps, too. But before I sing the praises of this natural progesterone cream, let’s take a step back. Why was my progesterone low in the first place, and how was it even causing these weird symptoms? That, my friends, can be explained with a quick lesson on hormones. “In a stressful period, when your body is basically in fight-or-flight, the body prioritizes the production of cortisol,” says Kristann Heinz, M.D., R.D., a doctor board-certified with the American Board of Integrative-Holistic Medicine, who also happens to be my doctor. “When this happens, the precursor hormones that normally go toward making our sex hormones get diverted to make cortisol. Because of this, we get this phenomenon called ‘progesterone steal,’ where instead of progesterone being made as the final product, the precursor [pregnenolone] gets shunted to make cortisol because that’s the priority at that moment.” Some other things that your body can interpret as stress, which can also lead to progesterone steal: chronic viral infections, hidden food allergies, and super-intense exercise. For some women, low progesterone can result in intense mood swings and cramping, poor sleep quality, a general lack of resiliency, and anxiety. “Progesterone is a precursor to GABA, the biggest relaxing neurotransmitter in the body; so when levels get low, that’s why people can have anxiety and trouble sleeping,” explains Dr. Heinz. For me, I had nearly all of these symptoms just before my period (when progesterone is supposed to be highest), plus ankle and knee pain. But why the ankle and knee pain? It’s not a classic low-progesterone symptom, after all. “Progesterone is a smooth muscle relaxer,” says Dr. Heinz. “So when women go through high progesterone states like pregnancy, they often get very loose and limber because their muscles are really relaxed. For you, it’s not 100 percent clear if this was the case, but your pain may have been a form of muscle cramping or tension.” Cramping or tension or whatever, it certainly got better after using the cream, so I’m inclined to believe my doctor’s theory and continue using it. But that doesn’t mean I have to use it forever. “Usually I say, let’s try this for six months. The goal is to use it for a limited amount of time to support the body while simultaneously addressing what got you into this situation in the first place,” says Dr. Heinz. And then, you stop. For me, that means using this progesterone cream while simultaneously implementing stress management practices like yoga and continuing to manage and treat my chronic Lyme. For other women, that could mean working on identifying a hidden food allergy or quitting a toxic job or relationship. It’s just a little something to help you get over the hump as you identify the root cause of your low progesterone; it’s not the “cure.” If you do suspect low progesterone, chat with your doctor or find an integrative or functional medicine practitioner knowledgeable in hormones who can help confirm or deny your hunch after assessing your symptoms and/or running a blood or saliva test. Above all, I hope my experience inspires you to tune into your body and notice patterns that indicate something’s not quite right—because things you may have brushed off as random or unavoidable may actually be completely treatable.
