Commonly Asked Questions & Answers about Hormones
Commonly Asked Questions & Answers about Hormones

Commonly Asked Questions & Answers about Hormones

What is natural progesterone and how does it differ from synthetic progesterone?
What's the difference between wild yam and progesterone?
What is U.S.P. Progesterone?
Will using natural progesterone with oral birth control pills interfere with their effectiveness?
Does using natural progesterone have any side effects?
Is it important to take a break from using the natural progesterone formulation?
Is a prescription needed for natural progesterone?
Can natural progesterone help PMS?
Can progesterone help with endometriosis?
Can natural progesterone help with:
Uterine fibroids?
Fibrocystic breast?
Vaginal dryness?
Can natural progesterone and estrogen help with amenorrhea (loss of period)?
What causes hair loss?
How can natural progesterone help with conception?
Breast-feeding and natural progesterone use?
In the case of hysterectomy, doesn't some form of estrogen need to be used?
A transition from hormone replacement therapy to natural progesterone?
Can estrogen be used without the natural progesterone?
What's the difference between synthetic and natural estrogen?
Can natural progesterone be used without estrogen for the prevention of osteoporosis?
What role does estrogen and progesterone play in bone health?
What are phytoestrogens?
Testing evaluations for bone mass and osteoporosis?
How can hormone levels be checked?
How much natural progesterone does one need to use?
Is there a relationship between weight gain and menopause?
How does progesterone affect the risk for cardiovascular disease?
Can men use the natural progesterone?
Who should use estrogen supplements?
If post-menopausal, will breakthrough bleeding occur with the use of natural progesterone?
Length of time with natural progesterone use before benefits are noticed?
What is Tamoxifen?
How to make and informed decision about prescription hormone use?

What is natural progesterone and how does it differ from synthetic progesterone?

In the body, cholesterol is the primary building block for progesterone and many other hormones. Progesterone is produced by the corpus luteum of the ovary (lower levels are also produced by the adrenal glands in both sexes). Progesterone is a precursor to other steroid hormones: this distinguishes natural progesterone from synthetic progestin’s, which are not capable of performing this function. The one similarity between the synthetic progestin’s and the natural progesterone is that each can stimulate uterine bleeding or menstrual flow, if needed. Natural progesterone can be derived from Dioscorea yams or soybeans, and the progesterone isolate or molecule is bio-identical to the progesterone molecule produced in the body. Synthetic progesterone’s are chemically synthesized from the plant derived progesterone, or from the male hormone, testosterone, which might be obtained from horse urine. These are prescription drugs and categorized as "progestin’s" or "progestogens"; they do not duplicate the molecular structure of natural progesterone. However, the similarity is close enough, in order to allow the "synthetic" to bind to progesterone receptor sites, but they do not provide the full range of beneficial functions that the natural progesterone would provide. These synthetic analogs cause confusion in a woman's body and actually reduce or interfere with the production of natural progesterone. They also cause a wide array of undesirable side effects

Back to Top

What's the difference between wild yam and progesterone?

Many companies today are producing "wild yam" creams that contain a concentrated extract of wild yam, Dioscorea barbasco. Wild yam contains diosgenin that can be converted to natural progesterone in a laboratory; however, the body does not have the ability to convert wild yam into progesterone. The body may absorb wild yam extract through the skin, which may in turn have some beneficial effects, yet research on both oral and transdermal applications of wild yam extract demonstrate no change in progesterone levels in the body.

What is U.S.P. Progesterone?

United States Pharmacopoeia (U.S.P.) Progesterone simply means progesterone that exactly duplicates the progesterone naturally produced in the body, or "bio-identical". The term "U.S.P." does not designate what source the manufacturer used to synthesize the progesterone. The title "U.S.P. Progesterone" differentiates natural progesterone from synthetic progestin’s or progestogens.

Back to Top

Will using natural progesterone with oral birth control pills interfere with their effectiveness?

No, using natural progesterone should not interfere with the effectiveness of oral birth control pills, providing you keep taking the oral birth control pills as prescribed. Birth control pills may be progestin only pills, or a combination of progestin and estrogen. Adding supplemental progesterone will only increase the progesterone’s effect in the body, and may in fact reduce some of the undesirable side effects of birth control pills in some women.

Does using natural progesterone have any side effects?

Progesterone binds with progesterone receptor sites in the brain and causes a calming effect on the central nervous system. In excessive amounts, progesterone can have a relaxing effect on the brain, and may cause drowsiness. Most frequently, any side effects from natural progesterone are associated with usage, and can be easily alleviated by changing the amount and frequency of the dosage. In the PMS group, using too much progesterone over a protracted length of time (one to four months) can delay a period a day or two.

Discontinuing the progesterone will cause the period to start, and women with irregular periods might notice some spotting at ovulation upon beginning progesterone usage. What's indicated here is that the period is trying to regulate on a 28-day cycle. With continued usage, periods will become regular and the spotting will be alleviated. Women who are beginning menopause might also notice some spotting when they begin using natural progesterone. This too should be alleviated with continued use. The post-menopausal and osteoporosis age group should not have any side effects at all. In a very small group of women who are extremely sensitive, progesterone of any kind may aggravate hormonal headaches or PMS symptoms.

Back to Top

Is it important to take a break from using the natural progesterone formulation?

For women in their reproductive years (still menstruating), progesterone levels remain low from menses until ovulation. Progesterone rises as a consequence of ovulation and should remain high through the last two weeks of the cycle, after which time progesterone and estrogen levels drop. This stimulates the shedding of the endometrial lining. Using progesterone during the luteal phase (days 14-28 in a 28-day cycle) mimics the normal cycle of a menstruating woman.

For women who are post-menopausal (no longer have menstrual cycles), taking a 5-7 day break from using progesterone each month can be beneficial for several reasons:

1. Hormone receptors seem to retain their sensitivity (to hormones) when such hormone levels drop in a cyclical pattern.

2. A drop in progesterone allows for the shedding of the endometrial (lining of the uterus) if the endometrial has thickened over the course of the month. One of progesterone's functions is to mature or stabilize the endometrial growth that estrogen promoted.

3. A regular break from progesterone supplementation lessens the potential for progesterone levels to build up beyond the physiological range.

Back to Top

Is a prescription needed for natural progesterone?

No. Natural progesterone in a cream or fluid base comes from Dioscorea yams or soybeans, which are technically food products and all of the other ingredients, aside from a trace of some cosmetic ingredients, are natural.

Can natural progesterone help PMS?

There are several different types of PMS recognized. Women who suffer from certain types of PMS may have a relative excess of estrogen caused by decreased progesterone levels. This condition is often termed "estrogen dominance." Common symptoms of estrogen dominance include breast tenderness, bloating, irritability, and mood swings. If your PMS is affected by decreases progesterone levels and estrogen dominance, supplementing progesterone during the second half of your cycle (from the time of ovulation until you start bleeding) may help reduce PMS symptoms.

Back to Top

Can natural progesterone help with endometriosis?

John Lee, MD, in his book What Your Doctor May Not Tell You About Menopause , says the following about natural progesterone and endometriosis: "As an alternative, I have treated a number of endometriosis patients, some after failed surgery, with natural progesterone and have observed considerable success. Since we know that estrogen initiates endometrial cell proliferation and the formation of blood vessel accumulation in the endometrial , the aim of treatment is to block this monthly estrogen stimulus to the aberrant endometrial islets.

Progesterone stops further proliferation of endometrial cells. I advised such women to use natural progesterone form day 6 of the cycle to day 26 each month, using one ounce of the cream per week for three weeks, stopping just before their expected period. This treatment requires patience. Over time (4-6 months) however, the monthly pains gradually subsided as monthly bleeding in these islets becomes less and less and healing of the inflammatory sites occurs. The monthly discomfort may not disappear entirely, but becomes more tolerable."

Back to Top

Can natural progesterone help with?

While there is little research regarding non-surgical treatment of uterine fibroids, using progesterone has helped some women's fibroids to stop growing until they reach menopause, when the fibroids naturally shrink due to lowered estrogen levels. Estrogen stimulates the growth of fibroids; therefore, many women with fibroids have used natural progesterone to help balance what is often an estrogen dominance (relative excess of estrogen) problem. Dr. John Lee related he had a patient with a grapefruit-sized fibroid which reduced to the size of a walnut after a year of natural progesterone use (Pro-Gest®). Natural progesterone may also help stabilize heavy bleeding and prolonged or irregular bleeding caused by fibroids. Since uterine fibroids are generally stimulated by excessive estrogen, products that help tone the liver and uterus may be beneficial as well. It is the liver's role to break down excess estrogen. A product to consider is ground flax seeds (2 tsp. per day) which have been shown to decrease circulating estrogen levels by binding to estrogen in the intestines. You may also be interested in reading Susan M. Lark, MD's book, Fibroid Tumors & Endometriosis: A Self-Help Program. (Westchester Publishing Co.) for more information about self-management of uterine fibroids.

Back to Top

Vaginal dryness can occur in women of all ages for various reasons, but this condition is usually more common in post-menopausal women. Natural progesterone in a fluid or cream base can be used around the vaginal area to help alleviate this problem. Natural vaginal lubricants are also helpful. Dr. John Lee, in his book Natural Progesterone, The Remarkable Roles of a Remarkable Hormone, writes: "Conversely, estriol is the estrogen most active in the vagina, cervix, and vulva. In cases of post-menopausal vaginal dryness and atrophy, which predisposes a woman to vaginitis and cystitis, estriol supplementation would theoretically be the most effective and safest estrogen to use."

Back to Top

Can natural progesterone and estrogen help with amenorrhea?

Amenorrhea can be the result of prolactin-producing pituitary tumors, anorexia nervosa, or intense long-distance running associated with undernourishment. these conditions cause cycle irregularities and ovulatory disturbances, which in turn affects the levels of circulating estrogen and progesterone. If a woman is not ovulating, she will most likely develop an estrogen deficiency, which can be brought under control by natural progesterone, and possibly some natural estrogen. If the time between ovulation and menstruation (luteal phase) becomes less than ten days, a progesterone deficiency can develop, because during the luteal phase is when progesterone is produced. The use of natural progesterone and some sort of nutritional regimen should cause menstruation to resume, If it foes not, it is strongly recommended that progesterone therapy be continued, to prevent accelerated bone loss associated with estrogen deficiency.

Back to Top

What causes hair loss?

The most common cause of hair loss is low thyroid function, which is common among menopausal women. Other causes include, but are not limited to: changes in hormone levels (decrease or increase), increased testosterone, increased stress (physical or emotional), and heredity. Any time sudden hair loss is experienced, one must consider events which took place up to three months prior to the hair loss, as factors affecting hair loss can often take up to three months to have an effect. Subsequently, any treatments for hair loss should be given at least three months to have noticeable effects. Dr. John Lee, in his book, What Your Doctor May Not Tell You About Menopause, discusses the issue of hair loss at menopause: "When progesterone levels fall as a result of lack of ovulation, the body responds by increasing its production of the adrenal cortical steroid, androstenedione, an alternate precursor for the production of other adrenal cortical hormones.. Androstenedione conveys some androgenic (male-like) properties, in this case, male pattern hair loss. When progesterone levels are raised by natural progesterone supplements, the adrostenedione level will gradually fall, and your normal hair growth will eventually resume. Since hair growth is a slow process, it may take four to six months for the effects to become apparent."

Back to Top

How can natural progesterone help with conception?

Use the same recommendations as for a menstruating woman. Ideally, use the serum or cream after ovulation, when progesterone levels normally rise. Increased levels of progesterone before ovulation may theoretically suppress ovulation. Normally in each menstrual cycle, the ovary begins to mature several ova (eggs). At the time of ovulation, one of the ova bursts out of its follicle and begins its journey through the fallopian tubes to the uterus. Once the follicle has released the egg, it becomes the "corpus luteum" and begins to produce progesterone. Dr. John Lee, in his book, What Your Doctor May Not Tell You About Menopause, states that ". . . the chief cause of early loss of pregnancy is now thought to be luteal phase failure, in which the ovarian production of progesterone fails to increase sufficiently during the first several weeks after fertilization. Maintaining the secretory endometrium (uterine lining) and the development of the embryo are dependent upon adequate luteal-supplied progesterone." If you have been having difficulty conceiving, you may wish to discuss progesterone testing and supplementation with your physician.

Back to Top

Breast-feeding and natural progesterone?

According to the Journal of Steroid Biochemistry and Molecular Biology, 1991, the amount of the steroid secreted in mother's milk is not effectively absorbed by the infant. Also, according to Dr. Katherine Dalton--whose studies on the use of progesterone in prenatal care, recorded in the British Journal of Psychiatry, 1968---Progesterone in the natural form: protects the fetus from miscarriage, increases the feeling of well-being of the mother, including the prevention or reduction of toxemia and morning sickness; increases the potential IQ of the child; produces calmer, less colicky babies; contributes to greater success of breast feeding and the enhancement of lactation (unopposed estrogen, in excess, may reduce the flow of breast milk); and helps to prevent or diminish the symptoms of post-partum depression.

In the case of hysterectomy, doesn't some form of estrogen need to be used?

Not necessarily, if the hysterectomy involves removal of the uterus only, natural progesterone alone should be adequate in controlling menopausal symptoms and helping to prevent osteoporosis. In the case of a complete hysterectomy (removal of the uterus and ovaries), it is recommended to start using natural progesterone only. If no relief occurs within 2 weeks to a month, some estrogen is probably necessary (as natural as possible). Herbs and foods containing phytoestrogens should also be considered.

Back to Top

A transition from hormone replacement therapy to natural progesterone?

Natural progesterone is simply an alternative to hormone replacement therapy. Synthetic progesterone has many side effects, and synthetic estrogen can be dangerous to your health; especially if taken without progesterone. If someone is taking both synthetic estrogen and progesterone, a gradual step might be to at least substitute natural progesterone for the synthetic, then gradually back off the synthetic estrogen and let the natural progesterone take over. If hot flashes or any other symptoms occur and the natural progesterone doesn't clear them up within 1 to 2 months, some natural sources of estrogen might be added to the program, including dietary sources found in plant foods.

Can estrogen be used without natural progesterone?

Definitely not. It is very important that natural progesterone be used with any form of estrogen. The physiological effects of unopposed estrogen include, but are not limited to; creating proliferative endometrium; increased risk of endometrial cancer; increased risk of ovarian cancer; increased risk of fibrocystic breasts and breast cancer; impairing blood sugar control; salt and fluid retention; depression and headaches; interfering with thyroid hormone; increased blood clotting; decreased libido; reduced oxygen levels in all cells; increased risk of gall bladder disease; and slightly restrains osteoclast function (in bones).

Back to Top

What's the difference between synthetic and natural progesterone?

The body naturally produces three main forms of estrogen: estrone (E1), estradiol (E2), and estriol (E3). Estradiol is converted to estrone in the liver. considered the most carcinogenic form of estrogen, estrone (E1) increases after menopause, when the adrenal glands play a more prominent role in hormone synthesis than do the ovaries. Synthesized in the ovaries and metabolized in the liver, estradiol is the most physiologically active form of estrogen. When taken orally, estradiol is converted into estrone in the small intestine. Increased serum estradiol levels are linked to an increased risk of breast disease and endometrial cancer. Estriol is the shortest acting estrogen and has a weaker effect than both estradiol and estrone. Estriol remains intact when supplemented orally, i.e., estriol is not converted into estrone, as is true with estradiol supplementation. Because estriol competes with estrone (E1) for receptor uptake when given in large or repeated doses, it can have an anti-estrogenic effect in selective tissues like the breast and uterus. Estriol doses must be increased up to three times the dose of estradiol to achieve similar effects (e.g. reducing preferred hot flashes and vaginal dryness in menopausal women). In Europe and China, estriol is the preferred form of estrogen for HRT. Many of the hormone replacement therapy and birth control pharmaceuticals in the U.S. contain estradiol, the strongest of the three forms of estrogen. Some of the estrogen's produced in the United States exactly duplicate one of the three forms of estrogen produced in the body, estradiol, so technically they are "natural". Many physicians are now prescribing "Tri-est", a name given to a combination of the three major estrogen's that the body naturally synthesizes, in a ration that Jonathon Wright, MD claims most closely duplicates the ration of estrogen's produced in the body: 80% estriol, 10% estrone, and 10% estradiol. These natural estrogen's can be formulated by compounding pharmacies with a physician's prescription. Other estrogen's available differ chiefly in the source of the estrogen, e.g., whether they were derived from animal or plant products, or synthesized chemically. One commonly prescribed estrogen contains equillins, equillenins, and alpha estradiol (derived from the urine of pregnant mares), all of which are estrogen's that occur naturally in horses, but are foreign to the human body.

Back to Top

Can natural progesterone be used without estrogen for the prevention of osteoporosis?

Absolutely, some feel that supplemental estrogen is not generally necessary for menopausal and post menopausal women who still have their ovaries. If vasomotor flushes--hot flashes-- are occurring, the natural progesterone is usually adequate in relieving them. It is generally recommended to use natural progesterone daily and then every fifteen minutes during a hot flash. If after 1 month hot flashes are still occurring, some natural estrogen is suggested, always accompanied by natural progesterone. Estrogen use should continue until the hot flashes have ceased completely, then natural progesterone by itself can continue indefinitely.

Note: Many women try to increase their consumption of plant food sources of estrogen's (phytoestrogens or isoflavones), such as black cohosh and soy food products, before they resort to prescription estrogen therapy

What role does estrogen and progesterone play in bone health?

bones are living tissue and can mend when broken and continue to renew themselves throughout life. Our bones are constantly "remodeling", replacing old bone tissue with new bone. Estrogen helps stop the action of osteoclasts, the cells that cause the break down or resorption of bone tissue, while progesterone stimulates the action of osteoblasts, the cells that stimulate the formation of new bone tissue. It is important to understand that osteoclast cells constantly travel through bone tissue to seek out older bone that is in need of renewal. The osteoclasts then reabsorb, or dissolve away this old bone and leave tiny unfilled spaces. The Osteoblasts then move into these spaces and produce new bone. this process, called "remodeling", is the mechanism that keeps bones strong and healthy. The role that estrogen plays, in retarding the action of bone reabsorbing osteoclasts, can slow the condition of osteoporosis, but not reverse it, especially when progesterone is absent. Evidence has been presented that osteoblasts have receptors for progesterone, but not for estrogen. Since some estrogen production continues in post-menopausal women, supplementation with progesterone alone, in many cases, is sufficient to prevent and/or reverse osteoporosis, along with a program of diet, mineral/vitamin supplementation and moderate exercise.

Back to Top

What are phytoestrogens?

Phytoestrogens are plant based estrogen-like substances. There are hundreds of plants that contain phytoestrogens. Some are edible and some are medicinal, non-edible plants. These phytoestrogens are not actually estrogen; they are plant constituents that mimic estrogen closely enough to bind with estrogen receptor sites and exert a weak but beneficial effect in the body, while exerting an anti-estrogenic or estrogen blocking effect where needed. Some findings have shown that the action of phytoestrogen's ability to bind receptor sites may protect against Exposure to xenoestrogens, which are toxic estrogenic substances of petrochemical origin in the environment. Sources of phytoestrogens include: black cohosh, Don Quai, alfalfa and licorice. The best food source of phytoestrogens are the isoflavones found in soy foods and soy products. Soy isoflavones provide very versatile health giving benefits for both men and women, as well as children. Fermented soy products, such as miso and tempeh, might be preferable for individuals who have digestive problems with most soy foods. Sprouted soybeans are extremely nutritious, easy to digest, and an excellent source of isoflavones. They are available in a dry form in powder or caplets (Regenezyme™ Soybean Sprout Concentrate).

Back to Top

Testing evaluations for bone mass and osteoporosis?

Risk evaluation for osteoporosis results from identifying an individual's Bone Mineral Density (BMD). Tests that measure a current level of bone mass, or baseline, include both dual photon absorptiometry (DPA) and dual X-ray absorptiometry (DEXA). For referral to a DEXA center near you, call Act Against Osteoporosis at 1-800-464-6700. These measurements can be repeated every 1 to 3 years to monitor changes in BMD. In addition to changes in bone density, bone turnover can be measured by urinary excretion in pyridinium, a specific marker of bone breakdown that is excreted in the urine. Most labs can run this test, and it can be ordered by your physician. One company that offers this type of testing is Great Smokies Diagnostic Laboratories. Your physician can call them at 1-800-522-4762 to get more information about the test.

How can hormone levels be checked?

In the past, blood serum levels were used. However, the newer saliva hormone assays are probably better. When the ovaries make estrogen and progesterone for circulation in the watery blood serum, they bind them to protein (sex hormone binding) globulin in the case of estrogen or cortisol-binding globulin in the case of progesterone, to make them more water-soluble. Protein-bound hormones are not biologically active, but they represent 90 percent of the hormones found in the serum. Thus, the serum results do not accurately reflect the biologically available hormones. Saliva hormone assays are less expensive, very accurate, easier to obtain, and more relevant than serum assays. Great Smokies Diagnostic Laboratories also offers this testing. (1-800-522-4762).

Back to Top

How much natural progesterone does one need to use?

Each woman's need for natural progesterone is different, as each one has specific symptoms that are affected by many different factors, including poor nutrition, stress, and physical illness.

Back to Top

Is there a relationship between weight gain and menopause?

Women have been found to gain an average of 10-15 pounds at menopause. These added fat cells are a site of estrogen production once ovaries "retire" at menopause. Estrogen can affect weight in several ways. Estrogen not only impacts water metabolism and can cause bloating, but it can also affect the body's ability to utilize thyroid hormone. Low thyroid function can also slow down metabolism and increase weight gain. There is also some research linking estrogen to an increase in insulin production which can promote fat storage. Since the fat cells are where some adrenal hormones get converted to estrogen, this can cause a cycle of increasing weight gain. Progesterone may help normalize weight by balancing relative estrogen excess. Progesterone also functions to make thyroid hormone receptors more sensitive, aiding thyroid activity in the body. In What Your Doctor May Not Tell You About Menopause , Dr. John Lee discusses the role of progesterone in helping balance blood sugar. Of course, exercise and diet are important factors too. One of the best ways to increase your metabolism (and therefore the rate at which you "burn" your food) is to exercise. Regular exercise, at least 1/2 hour of aerobic activity every day, can increase your metabolic rate, helping you to lose weight in addition to helping maintain your bone mineral density.

Back to Top

How does progesterone affect the risk for cardiovascular disease?

In addition to sensible nutrition and exercise, natural progesterone may have a protective effect on the heart. Some very recent research showed that natural progesterone helped reduce spasms of the coronary arteries, which is relevant to reducing the risk of heart attacks. Blood vessel occlusion by cholesterol plaques combined with vasoconstriction, can severely restrict blood flow to the heart, resulting in a "heart attack."

In a study by Miyagawa, et al, progesterone plus estradiol was protective against vasospasm, whereas estradiol plus medroxyprogesterone allowed vasospasm, concluding that medroxyprogesterone increases risk of coronary vasospasm, while natural progesterone does not. (Miyagawa K, Rosch J, Stanczyk F, and Hermsmeyer K: Medroxyprogesterone interferes with ovarian steroid protection against coronary vasospasm. Nature Medicine, Vol. 3, No. 3, 324-327.)

Natural progesterone is also significantly beneficial in raising good cholesterol (HDL). In a study called the PEPI trial, natural progesterone was more effective than synthetic versions, called "progestin’s" (e.g., medroxyprogesterone acetate) in raising HDL's or good cholesterol, we have, the lower the risk of coronary artery disease. (The Writing Group for the PEPI Trial: Effects of Estrogen or Estrogen/Progestin Regimes on Heart Disease Risk Factors in Postmenopausal Women. JAMA, 1995; Vol. 273, No. 3: 199-208.)

Back to Top

Can men use the natural progesterone?

If a young man under 45 used very much, it may cause his testicles to shrink and his libido to decrease. However, older men 55 and up can use natural progesterone daily and it will cause the libido to increase. Older men with rheumatoid arthritis have gotten relief from the pain and swelling after rubbing natural progesterone in a cream base on their joints. However, a very small number, older men have actually been diagnosed with osteoporosis. In these cases, use of natural progesterone and a specific nutritional regimen is recommended as well.

Who should use estrogen supplements?

Estrogen works especially well for hot flashes and vaginal dryness. These symptoms can be taken as a sign of estrogen deficiency. However, because progesterone is a biochemical precursor to estrogen, it alone is often sufficient to restore estrogen levels to normal and eliminate these symptoms. If a three-month trial of progesterone, plus proper diet, supplements of magnesium and B6, as well as herbs and foods that contain phytoestrogens (plant hormones) do not relieve hot flashes or vaginal dryness, then low dose natural estrogen may be helpful. (Estrogen is not recommended in those women with a history of breast or uterine cancer, obesity, diabetes, or a history of clotting or vascular disorders.) If used for hot flashes, find the lowest dose of estrogen that works. If vaginal dryness is the problem, vaginal gels, suppositories or creams containing estriol can be prescribed. Often, a small dose applied in the vagina only twice a week, three weeks a month, will be effective.

Back to Top

If post-menopausal, will breakthrough bleeding occur with the use of natural progesterone?

Occasionally upon beginning use of natural progesterone supplement, a post-menopausal woman could experience some breakthrough bleeding, or a "period." This is a perfectly normal response and is nothing to cause alarm. The progesterone is simply causing the body to rid itself of excess stored estrogen which can sometimes stimulate a uterine shedding--thus breakthrough bleeding. If this continues for longer than several months, one should consult with a healthcare provider.

Length of time with natural progesterone use before benefits are noticed?

Every woman's body is different, and there is no exact way to predict when benefits will be noticed. In a study done by Dr. John Lee on women with osteoporosis, bone scans indicated that 5% new bone density occurred in a period of six months after each woman used natural progesterone daily and followed a specific nutritional regimen.

Back to Top

What is Tamoxifen?

The following is excerpted from The Estrogen Alternative, by Raquel Martin with Judi Gerstung, DC.,"Tamoxifin is a synthetic hormone, a "nonsteroidal antiestrogen," and is related to the carcinogenic hormone DES. It has been used since 1977 to treat advanced breast cancer, but is now believed to have many unusual side effects, some of which are similar to those of estrogen, which can promote more tumors. Nevertheless, doctors are considering tamoxifen for use in hormone replacement therapy. In one study almost half of the tamoxifen recipients complained of 'persistent vasomotor, gynecologic, or other major side effects'".

The women enrolled as volunteers in the clinical trials of tamoxifen as breast cancer deterrent were apparently informed of a statistically known increased risk of endometrial cancer. In February 1996, a review by the International Agency for Research on Cancer---based in Lyon, France and composed of scientists from various countries-concluded definitely, according to published reports, "that there is sufficient evidence to regard tamoxifen as a human carcinogen that increases a woman's risk of developing.... cancer of the endometrium, the inner lining of the uterus."

Tamoxifen has also been linked to liver cancer, eye disease, and depression. "Despite that," says Dr. Marcus Laux, "there's talk of selling this to millions of women at high risk as a 'preventive'!" No wonder Dr. John Lee says that other countries view our giving tamoxifen to postmenopausal women as "another American joke."

Back to Top

How to make an informed decision about prescription hormone use? (From The Estrogen Alternative)

With prescription in hand, ask your pharmacist for a copy of the package insert which is prepared for the doctor and the patient. the warnings and contradictions concerning the drug will be clearly stated. Also, the warnings on the inserts are so small that it is easy for your 'vision' to fade after the first few sentences. However, it is essential to read on. You can also refer to the Physicians' Desk Reference (PDR) and other books available at your library.

Back to Top

1) The Estrogen Alternative: Natural Hormone Therapy With Botanical Progesterone, by Raquel Martin with Judi Gerstung, DC: Healing Art Press, Rochester, VT 1997.

2) Preventing and Reversing Osteoporosis , by Alan R. Gaby, MD, Rocklin, CA: Prima Publishing, 1994.

3) Once a Month, by Katharine Dalton, F.R.C.G.P., Pomona, CA: Hunter House, 1979

4) Natural Progesterone: the Multiple Roles of a Remarkable Hormone, by John R. Lee, MD, Sebastopol, CA: BLL Publishing, 1993.

5) Nutrition for Women (Fifth Edition), by Raymond F. Peat, Ph.D., Eugene, OR: Kenegen, 1993.

6) Hormone Replacement Therapy: Yes or No? , by Betty Kamen, Ph.D.., Del Marin Keys, CA: Nutrition Encounter, Inc., 1991.

7) The Silent Passage: Menopause, by Gail Sheehy, New York: Pocket Books, 1993.

8) What Your Doctor May Not Tell You About Menopause, by John R. Lee, MD, with Virginia Hopkins, New York: Warner Books, 1996.

  • Uterine fibroids?
  • Fibrocystic breasts?

    There are many factors that contribute to this condition, one being a higher level of circulating estrogen, indicating a hormone imbalance.

    Progesterone helps to normalize this imbalance.

  • Vaginal dryness?
  • For menstruating women in their reproductive years, natural progesterone is usually needed for 14 days off (7 days being during the menstrual period and 7 days before ovulation) and 14 days on (14 days being after ovulation and prior to commencement of next menstrual period).
  • Amounts used might increase in the 7-10 days before the period if PMS symptoms occur. After several months’ usage, this will probably taper off and natural progesterone will be necessary only 5-7 days before each period.
  • Menopausal women can use natural progesterone every day---increasing amount if hot flashes occur. Again, usage will probably taper off as hot flashes decrease. After a woman has been free of hot flashes and menopausal symptoms for 1 month, she might be wise to continue using natural progesterone indefinitely (but skipping use for 5-7 days each month) for prevention of osteoporosis.
  • Women who have osteoporosis can also use natural progesterone every day---especially if bones have already thinned and are starting to break.
  • In the case of PMS, some women will notice immediate benefits--within minutes. Some women might not notice a relief from symptoms for 2-3 months.
  • Women who experience dysmenorrhea (cramping upon menstruation) or migraine headaches, should continue to use the natural progesterone during their period in order to get relief; whereas use of natural progesterone should normally be stopped with the onset of the period.
  • Menopausal women who are experiencing hot flashes are advised to use natural progesterone every 15 minutes until the hot flash has ceased. On an average, menopausal symptoms will be relieved, or at least significantly decreased in 2-3 months. There are many exceptions here though; one being a woman who has had a complete hysterectomy (removal of the uterus and ovaries), and may need to use some natural estrogen in addition to the natural progesterone to relieve her symptoms.
  • Suggested Reading List: