Menstrual cycle question

Lyme dysregulates your hormones. And your hormonal changes make Lyme (and co-infection) symptoms flare. They're all interconnected. Your mid-cycle bleed definitely sounds ovulation-related. Do you have mittelschmerz as well?

I was lucky to find an LL gynecologist, who finally validated all the hormonal symptoms that had changed for me since I've been dealing with Lyme. She validated that the surge of progesterone around ovulation causes digestive issues. Adrenal fatigue causes fewer bleeding days with a hiatus in the middle. I make almost no estrogen or progesterone but have almost all the symptoms of excess of both, because my body [mis]uses its cortisol for maintaining my menstrual cycle, and therefore doesn't have enough cortisol for other things. Lyme (or for you it sounds like bartonella specifically) flares with major hormonal shifts. The general inflammation and sensitivity of my nervous system make monthly ovarian cysts hurt terribly, whereas previously I didn't have cysts or at least didn't feel them at all. Migraines, blood pressure and blood volume changes, nerve pain, dizziness, digestive stuff - they all rise and fall with my menstrual cycles because of HPA axis dysfunction caused by Lyme. Sometimes I feel like I can't make progress with these infections because every time I improve, I slide right back down again before long because of ovulation, PMS, blood loss, or something else menstrual in nature.

My LL gynecologist and LLMD offered two approaches. One option was to put me into artificial menopause with pharmaceuticals and supplement proper amounts of bioidentical hormones (including cortisol, thyroid, testosterone, DHEA, estrogen, and progesterone), so that I'd feel more normal (in theory) while I treated the infections, and then wean off of those things once I was doing better. The other option was to focus on sleep, stress, nutrition, adaptogenic herbs and vitex, and restorative exercise, possibly adding in an adrenal glandular supplement or progesterone cream.

Good luck figuring out what works for you, and never worry about TMI! This is a perfectly natural thing that our bodies do, and it's no less appropriate than describing a headache.

I would not call you ignorant for hoping something would work, and do so quickly! Vitex I think needs to be taken for at least three months so see improvement. My understanding is that vitex should be used with adaptogens if there's any reason to believe that other hormone systems (adrenal, thyroid, hypothalamus, etc.) are dysregulated as well, as I suppose they often are for many of us with Lyme.

I noticed significant improvement with a low dose of topical progesterone cream, but only for two months, after which there was no more effect. I tried it again a year later, and the same thing happened - two months of easier menstrual cycles, and then back to crappy ones. The cream I tried was Karuna Progesterone Pure.

Another idea I like but have not tried is seed cycling. I started it for a few days but the huge amount of fiber was too hard on my gut. https://theherbalacademy.com/seed-cycling-for-hormonal-balance/