I would also try Vitex before progesterone cream. My Naturopath put me on progesterone cream to help with the crashes, which worked wonderfully for about 2 months, then I started to have horrible side effects in the 3rd month. I have been off the cream for 2 months now, but the side effects persist -- some have faded, some have gotten worse, and some may have something to do with Mirena still. Funnily enough, one of the things I have been dealing with since Progesterone cream is a UTI that has lingered since early January, and a suspicion of BV and YI. I have never had BV before, and only had utis and yeast occasionally in the past, which were cleared up quickly. Now my Dr. fears i have interstitial cystitis, which can be triggered by hormone flux. Some people do fine on progesterone cream, just not me. I think after Mirena and this, I am off hormones for life!