I noticed that my PsA went into remission with my pregnancy and my swelling disappeared when I started progesterone supplements to combat early labor. I was wondering if any ladies out there have tried progesterone treatments and what happened as a result.
I’m going to discuss it with my Dr this week…new one (I’ve had to jump around a lot). I just wanted to see if anyone has tried this.
My psoriasis went into remission during one of my pregnancies but I wasn't taking any hormones. Unfortunately, it came back soon after I had the baby. But, if progesterone helps put PsA into remission, I'll sign up for it! It's interesting that my definite signs of PsA started right around menopause! I hope others have some insight on this! Wouldn't it be great if we only had to take hormones to fix everything? I spose they come with warnings and side effects too, though.
My Dr gave me a birth control pill that is basically progesterone so that it won’t affect my milk supply. I just started it today, but in will keep you updated. It would be amazing if it worked! I didn’t do well on methotrexate and I’m scared to try other treatments.
NewbieT, I hear you about being scared to try other treatments. We’ve all been there, but there’s a good reason that we have a “Fear the disease, not the treatment” mantra here. Psoriatic arthritis is a devilishly difficult disease to diagnose and assess. It can sneak up on you, and make no mistake about it: there are people here who have sustained a lot of permanent joint damage from it. My advice is to find a doctor who you like and trust, and accept the most aggressive treatment that they are willing to give you. I know, that’s a lot to take on board.
A lot of people find that their PsA goes into remission during pregnancy. Interesting what Sybil mentioned: my experience was the same. I had symptom onset during perimenopause. Then, when my periods stopped, the PsA ran rampant through my body. Not that I knew it was PsA at the time – that came more than ten years later.
Such an interesting disease. 
I also had PsA symptoms that came and went with my monthly cycles only to come and stay once I went through menopause. My symptoms disappeared with pregnancy only to flair badly with postpartum.
I would be interested in what doctors have to say about this though I myself would not try it until there had been much more studies. Progesterone is responsible for PMS symptoms and breast tenderness in women's cycles. Progesterone alone is used to treat endometriosis which interestingly is also auto immune and a lot of us with PsA also have it. Estrogen is never given alone except for women who have had a full hysterectomy as it causes breast and endometrial cancer rates to rise.
I would never want to go through menopause symptoms again and I hate the stats in women's cancers when taking hormones so the studies would have to be compelling for me to try it.
It’s sure interesting that all of us noticed changes in our P or PsA when we had hormonal changes such as pregnancy or menopause. After going through menopause I fully understood why it is called the change of life! I know those hormonal changes are stressful on our bodies, so that’s most likely the trigger of increased disease symptoms. But, I wonder how many studies have been conducted to rule out a possible hormonal connection?
michael in vermont said:
I also had PsA symptoms that came and went with my monthly cycles only to come and stay once I went through menopause. My symptoms disappeared with pregnancy only to flair badly with postpartum.
I would be interested in what doctors have to say about this though I myself would not try it until there had been much more studies. Progesterone is responsible for PMS symptoms and breast tenderness in women’s cycles. Progesterone alone is used to treat endometriosis which interestingly is also auto immune and a lot of us with PsA also have it. Estrogen is never given alone except for women who have had a full hysterectomy as it causes breast and endometrial cancer rates to rise.
I would never want to go through menopause symptoms again and I hate the stats in women’s cancers when taking hormones so the studies would have to be compelling for me to try it.
I was wondering the same thing. About the studies…it seems odd that it gets better or worse based on hormonal fluctuations. There is definitely some sort of connection. I should mention that I didn’t have a flair up right after giving birth but after I stopped taking the progesterone birth control. I’m probably grasping at straws, but I am going to try taking it again.
You are willing to experiment with medications with a very known and well proven risk of breast cancer, while you have a family of breast cancer? Let me be blunt. while symptoms may change as hormanal levels fluctuate as does everything else going on in your body the disease plods right a long. You state a fear of medication that will effect the disease because of a fear it will cause cancer despite the fact that risk was determined years ago to not exist except one very rare form in teen age boys with Chrohns disease. (which they are at risk of anyway) There is a possible chance of some skin cancers but the connection is unclear as there is an increased chance of skin cancer with arthritis anyway.
I’m not trying to experiment, but using a birth control pill that is progesterone based. I can’t take other types while nursing. I am curious as to its effect on my PsA. This isn’t something that I am planning on taking long term.
Just a warning, some women are more sensitive to these. If you feel like you're milk supply is dropping, don't assume that it's not the birth control. There are non-hormonal options that can be really good as well.
Newbie_Teach said:
My Dr gave me a birth control pill that is basically progesterone so that it won't affect my milk supply. I just started it today, but in will keep you updated. It would be amazing if it worked! I didn't do well on methotrexate and I'm scared to try other treatments.
I will definitely keep that in mind and discuss it with my Dr.
The answer in a nutshell is that women with PsA have low prgesterone and high estrogen. I need to interject the usual "assocition does not equal causation" and no one knows what the horse and what the cart is. The effect of artificial progesterone is mechanically identical to any of the glucosteroids, but at a lower level. It has an effect on symptoms, not on disease. No studies have confirmed that the balance is corrected. Given the high risk of side effects I would doubt you would find a doc willing to do progesterone therapy absent a total hysterectomy. There are few other side effects that some of the nurses might share with you........
That was what I suspected Lamb. It would relax smooth muscle and calm the joints but the joint destruction would continue.
But I have forgotten that progesterone alone is implicated in increased breast cancer rates.
I do know one side effect of progesterone alone therapy is spotting mid month. Like all month long!
I see Newbie that you have met our gruffest Mod, The Illustrious Mr Lamb!
He is our go to for research and medical facts; he appears all gruff but he is as gentle as a lamb and has a heart of gold. Never mind the gruffness till you get to know him then you will see the humor we all love so much.
I guess my next question would be if there are medications for PsA that are safe during pregnancy. I know I had to be off methotrexate for 6 months before we could even start trying. I had to be on the depo shot while on medication for arthritis…
Again, work with your doctor on this. Some of the biologics seem to be acceptable during pregnancy. There is a great book that is also available as an app, Medications and Mother's Milk, by Dr. Hale. It's chock full of great information, and one that every doctor should have, in my opinion. It covers pregnancy and breastfeeding.
This is a link to the app information http://www.infantrisk.com/our-apps
Newbie_Teach said:
I guess my next question would be if there are medications for PsA that are safe during pregnancy. I know I had to be off methotrexate for 6 months before we could even start trying. I had to be on the depo shot while on medication for arthritis...
Progesterone-only is one of the safer meds, unless you have a hx of breast cancer or familial history. It’s not as effective and carries a higher risk of dysfunctional uterine bleeding. Something to keep in mind.
However, it’s odd that you would feel safer taking MTX, than with a bio. Methotrexate has more side effects and risks of long-term physiological damage than the bios do. Plus there are a TON of changes occurring in the body with pregnancy. Don’t attribute pregnancy induced remission to just one thing.
It’s great that you are doing so well, and CONGRATS ON THE BABY :-), but don’t be afraid of the meds. My PsA hit when my kids were older, but it still sucked. There are so many things that I am not able to do, which often makes me feel like I have failed my children. I can’t imagine where I would be without the Remicade that I take. I’d never manage as well as I do now (even with the things that I can’t do, I have to remember all of the things that I still CAN do). If your doc has recommended a biologic for you, please reconsider. You want to be able to keep up with your kids. And I mean simple things: playground, baseball games, overnight scout trips, museums, school activities, etc… It’s amazing to me how much being on both a bio and a DMARD have help me keep up with my kids, and I cannot imagine where I would be without these drugs. My children would probably be raising themselves, and would be wild heathens by this point if I had not decided to follow my doctor’s advice as far as medications.
I really don’t feel safe on MTX and I think I was misinformed. I understood from my rheumatologist that it was the safest drug with the least chance of side effects but it was terrible for me. I guess I figured that if the “safest drug” did that to me, what would the other ones do. We never even discussed bios 
why do I feel like I got shafted in the rheumy department?
Well, methotrexate is usually the first drug any rheumatologist almost anywhere would put you on. Some people do respond very well to it. It is an old, well-known and inexpensive medication. Some people have no side effects with it, but others do get quite ill. In that case, a rheum will usually switch to the injectable form, which sometimes solves the problem. I’m no pharmacologist, but I would not call it the safest drug – others, like Lamb, are more knowledgeable than I am about that aspect.
Why did she do that? Because it’s quick and easy, and it had a chance of working for you. And giving you the script got you out of her office and got her one patient closer to going home.
Shafted? I don’t think so. Methotrexate is a good starting point. And many insurance companies expect a trial of mtx (or other DMARD(s)) before they will cough up the big bucks for a biologic. I would have expected, though, that she’d have had you back after three months to see how you were doing. Then I would have expected her to have switched you to an injectable for another three or four months, and checked you again. But that’s what I would expect, and I’m no specialist.
I’m glad you are going to ask the internist for a referral to another rheumie. It doesn’t have to be the way it was for you.