Adenomyosis.

Resolved question:
I'm 43 and perimenopausal, have adenomyosis and recently had a cyst.At next exam cyst was gone that was 19 days ago.
I still haven't got my period (7 days late, not pregnant!) I live in Europe but spend 3 times a year in California. I do have a bioidentical progesterone cream 1000 mg (.25%) from my doc in U.S..
Can I use this cream to cause a period and could I start using the cream permanently without stopping - to prevent a period longterm or is it better having periods??
Mainly because I suffer from hot flushes and other menopausal symptoms ? I'm just wondering if this would be good regarding the adenomyosis or further cysts??
Thanks for your answer!

Submitted: 4 Days
Category: OBGYN

Expert:  Dr. Aarti Vazirani replied 4 Days.

Hello
Thanks for writing to DoctorSpring.com with your health concern.

Abruptly stopping the cream could result in a period due to progesterone withdrawal, but for this purpose ( inducing a period ) , progesterone tablets are much more reliable.

When taken for 5 days and stop, a period is induced within a week of stopping.
Using the cream permanently should result in no period technically, but many women experience some form of breakthrough bleeding or spotting.
For the adenomyosis , which is generally estrogen dependent, it would get better once you transit to menopause.

The cyst - I need details regarding what type of cyst it was.
It is not recommended to take the progesterone cream continuously or permanently just for the sake of preventing a period, there would be associated side effects.
It is best to use it for symptomatic relief of hot flushes ( not for inducing periods and neither for avoiding them ), and allow your normal menstrual pattern to resume and take course.

Once you transit into menopause, periods will cease in due course of time naturally.

All the best
Please feel free to discuss further.

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Patient replied :

If I understood you correctly you suggest I should just wait till my period comes, shouldn't I?
My U.S. doc recommended to use the bioidentical progesterone from day 6-26 due to adenomyosis.
I just wondered if I should start using the progesterone to cause a period as I don't want to end up with a cyst again due to not having a period yet after these 7 days overdue my cycle?
I don't know if this is actually related but my previous cyst (a chocolate cyst) I had after I got my period after 51 days having none. Although I was pretty regular before that time.
Would appreciate some advice here.. thanks!


Expert:  Dr. Aarti Vazirani replied 3 Days.

Hi
A chocolate cyst is a variant of endometriotic cyst.
It occurs due to estrogen excess, and is not related to the presence or absence of a period.
The menstrual irregularities and delays are due to your approaching menopause, having a period a few days late or early would not contribute to the formation of a cyst.
As menopause approaches, adenomyosis and endometriosis ( the chocolate cyst ) should only get better.
Yes, you can use it from day 6 - 26 to bring on a period, just for cyclical regularity, not for the scare of having a cyst.
Take care.

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