What could be causing increased hunger at night and mild morning muscle pain (myalgia) while taking progesterone 400mg vaginally at 7 days post-ovulation (dpo)?

Increased Hunger and Mild Morning Myalgia with Progesterone Supplementation at 7 DPO

The increased nighttime hunger and mild morning myalgia you're experiencing are likely side effects of progesterone supplementation, with the hunger potentially related to progesterone's metabolic effects and the morning muscle pain possibly due to fluid retention or hormonal fluctuations. 1

Progesterone Effects on Hunger and Metabolism

• Progesterone can affect appetite regulation and metabolism, particularly causing increased hunger at night when natural hormone levels fluctuate 1
• The increased levels of progesterone can slow gastrointestinal motility, which may contribute to feelings of hunger despite adequate food intake 1
• Nighttime hunger is a recognized effect of progesterone supplementation, as the hormone can influence blood glucose regulation and metabolic processes 1

Morning Myalgia Explanation

• The mild morning muscle pain (myalgia) that resolves within 10 minutes is consistent with progesterone-related fluid retention effects 1
• Progesterone can cause temporary fluid shifts in tissues, leading to morning stiffness or discomfort that typically resolves quickly after movement 1
• The timing of symptoms at 7 days post-ovulation coincides with when progesterone levels would be peaking naturally, with supplementation potentially amplifying these effects 1

Vaginal Progesterone Pharmacokinetics

• Vaginal progesterone at 400mg daily achieves high local uterine concentrations while also maintaining systemic levels similar to luteal phase levels 2, 3
• The vaginal route avoids first-pass liver metabolism, resulting in more stable hormone levels but also potentially causing more pronounced systemic effects 3
• After vaginal administration, progesterone reaches peak serum concentrations within 4-12 hours and maintains relatively stable levels throughout the day 2

Management Recommendations

• These symptoms are generally considered normal side effects and not concerning for adverse outcomes 1

• For nighttime hunger:

  • Consider consuming a small protein-rich snack before bedtime to help regulate blood glucose levels overnight 1
  • Ensure adequate hydration throughout the day, as thirst can sometimes be misinterpreted as hunger 1

• For morning myalgia:

  • Gentle stretching upon waking may help resolve the symptoms more quickly 1
  • Maintaining adequate hydration can help minimize fluid retention effects 1

When to Seek Medical Attention

• If myalgia becomes severe, persists throughout the day, or is accompanied by other symptoms such as fever or significant swelling, medical evaluation is warranted 1
• If hunger becomes extreme or is accompanied by other symptoms like nausea, vomiting, or abdominal pain, consult your healthcare provider 1

Common Pitfalls and Caveats

• Don't confuse progesterone-related symptoms with pregnancy symptoms, as they can be similar (both are caused by progesterone) 1
• Avoid self-adjusting your progesterone dosage without medical guidance, as proper dosing is important for the intended therapeutic effect 1
• Be aware that symptoms may fluctuate throughout the course of supplementation as your body adjusts to the medication 1