When to Use Natural Progesterone (book excerpt)

Discussion in 'Fibromyalgia Main Forum' started by lilwren, Jun 1, 2003.

  1. lilwren

    lilwren New Member

    I am estrogen dominant and it is causing all sorts of problems - I'm working on it though. I finally found someone willing to take hormone tests - ALL the male docs I've been to refused to test for it for years, and years! They kept telling me 'if your periods are regular then you're fine'. Docs are so arrogant! Anyway, my estrogen is through the roof and progesterone is at zero (even though I've been supplementing with cream and oil for the last 8 months). I'm going to start on a pill form of natural progesterone asap.

    Soy products contain estrogens and should be avoided if you're estrogen dominant. Before I knew better I made my condition worst by using excess soy to replace meat protein!

    Just wanted to share this - sorry it's so long.

    Sharon L

    (Excerpt from What Your Doctor May Not Tell You About Menopause by John R. Lee. M.D.)

    As I've mentioned throughout the book, in Western industrialized cultures, pharmaceutical companies buy natural progesterone (derived from yarns or soybeans), and then chemically alter its molecular form to produce the various progestins, which, not being found in nature, are patentable and therefore more profitable. Most physicians are unaware that their prescription progestins are made from progesterone (from yams or soybeans) and that natural progesterone is available, safer than progestins, more effective, and relatively inexpensive.

    Whether or not to use natural progesterone when a woman is premenopausal is a decision best made by each individual woman working with a health care professional familiar with female hormones and the use of natural progesterone, and based on the signs and symptoms of estrogen dominance that follows.

    Signs and Symptoms of Estrogen Dominance in a Premenopausal Woman

    Water retention, edema (swelling, bloating)
    Fatigue, lack of energy
    Breast swelling, fibrocystic breasts
    Premenstrual mood swings, depression
    Loss of sex drive
    Heavy or irregular menses
    Uterine fibroids
    Craving for sweets
    Weight gain, fat deposition at hips and thighs
    Symptoms of low thyroid such as cold hands and feet


    Depending upon the amount of progesterone in the jar or tube, you'll want to use anywhere from 1/8 to 1(2 teaspoon of the cream per day, or three to 10 drops of the oil.

    Normal production of progesterone during the middle of a normal menstrual cycle is 20 to 24 milligrams a day for 12 to 14 days. Thus, normal progesterone production during a menstrual month is 250 milligrams or so.

    Let's say each two-ounce jar or tube of 3 percent (by volume) or 1.6 percent (by weight) progesterone cream contains 950 milligrams. Thus one-half of a two-ounce jar or tube would be more than sufficient to maintain adequate progesterone needs in a post-menopausal woman for one month. This would amount to 20 to 30 milligrams per day.

    The best way to tell if enough is being used is whether your symptoms are relieved. For example, when estrogen dominance exists throughout the menstrual month, water retention and weight gain occur in the week before menstruation. After sufficient progesterone is supplemented, this cyclic weight gain no longer occurs. If you are menopausal and experiencing hot flashes or vaginal dryness, you will certainly know if those symptoms improve.

    Since there are varying amounts of progesterone in the creams, and every woman's biochemistry and ability to absorb and use the cream are different, the actual dose will vary. Since natural progesterone is notable for its freedom from side effects, such latitude in dosing carries no risk.

    For premenopausal women, stopping the cream at day 26 or 28 usually results in a normal menstrual period within 48 hours or so.

    For menopausal women, a short period of not using the hormone tends to maintain receptor sensitivity. Since many post-menopausal patients do not begin supplementation until after a number of years of deficiency, and since much of this fat-soluble hormone will be initially "lost" in body fat, it is wise to use the full two-ounce monthly dose for three months or so to overcome the deficiency state. After this, dosage can usually be reduced.

    The cream can be applied to the palms of the hands, the face and neck, the upper chest and breast, the inside of the arms, and behind the knees. Rotating among the various sites will maximize absorption. The size of the "gob" to use will become apparent as one proceeds through each monthly cycle.

    Premenopausal women can use progesterone approximately two weeks per month. Since normal progesterone production can reach 20 milligrams per day between days 15 to 26 of the cycle (day one being the onset of bleeding), I usually begin by recommending the cream be used between day 12 and day 26 to am proximate normal levels. Some women whose cycles are naturally longer will use it from day 10 to day 28.

    Some doctors will prescribe estrogen for premenopausal women with irregular bleeding. However, there is no reason to give estrogen of any sort to a woman who is still having menstrual bleeding. The fact of menstrual bleeding means there is no estrogen deficiency. Menstrual periods may be irregular due to progesterone deficiency. If you have been put on estrogen for

    irregular periods, taper down the estrogen and start using progesterone cream as described above.
    If bleeding starts before day 26 (or before it would normally begin), stop the progesterone and start counting up to day 12 again, and then start the progesterone again. It may take three cycles before you achieve synchrony with your normal cycle.

    Menopausal women not receiving estrogen supplementation have an even wider latitude in using progesterone cream. For convenience, they may choose to select a dosage schedule based on the calendar month. The cream may be applied over a 14- to 21-day time period and then discontinued until the next month.

    Menopausal women taking a cyclic estrogen supplement should reduce their dosage to one-half when starting the progesterone. Since progesterone replacement in women deficient in progesterone may initially (and temporarily) increase the sensitivity of estrogen receptors, it's important to reduce the dosage by one-half immediately. If you do not, you are likely to experience symptoms of estrogen dominance during the first one to two months of progesterone use.

    An abrupt reduction in estrogen can trigger resumption of hot flashes or vaginal dryness. These symptoms can be prevented by gradual lowering of the dose. There are several ways to reduce your dose of estrogen. I usually recommend reducing the dose by one-half when starting the progesterone. Then every two to three months you can try lowering the dose by half again. If the estrogen pill can be broken in half, the process is simple. If the estrogen pill is not easily broken in half (such as Premarin), you can take one every other day, every third day, and so forth.
    Estrogen and progesterone can be used together during a three-week or 24- to 25-day time period each month, leaving five to seven days each month without either hormone. The estrogen dose should be low enough that monthly bleeding does not occur but high enough to prevent vaginal dryness or hot flashes.

    As I discussed above, hot flashes are not a sign of estrogen deficiency per Se. They are a sign of lack of estrogen and/or progesterone response to the urgings of hypothalamic centers (the GnRH prompt). Often when progesterone levels are raised, the pituitary stops trying to signal the ovaries to ovulate, the hypothalamus settles down, and the hot flashes usually subside.
    (Note: If your physician wants to test the validity of this mechanism, the FSH and LH levels before and after adequate progesterone supplementation can be measured. A decline in FSH and LH indicates that the GnRH prompt has subsided.)

    I recommend you have a goal of getting off estrogen altogether. You can experiment with lowering the estrogen dose until you find the lowest dose that prevents vaginal dryness (my preference is a vaginal cream of estriol) and/or hot flashes. Since post-menopausal women continue to make estrogen (primarily in their body fat), many women find that estrogen supplementation can be eliminated altogether five to six months after starting the progesterone. The presence of progesterone makes estrogen receptors more sensitive, so that your own (endogenous) estrogen is sufficient. In this process of lowering your estrogen dose, you may have to ask your doctor to prescribe smaller doses of pills or capsules, since some are difficult or impossible to break into halves or quarters.

    If you are using Estraderm patches, you should be aware they come in two dosages. Generally, both dosages are too high; my patients experienced breast fullness and tenderness and water retention even when using the lower-dose patch. Physicians familiar with alternative health care approaches have access to corn-pounding pharmacies which can make a natural estrogen cream, which is another approach.

    Menopausal women taking an estrogen and progestin combination should stop the progestin immediately when progesterone cream is added. For example, if you are taking Premarin and

    Provera, the most common combination, you should stop taking the Provera. I have found no ill effects in stopping Provera abruptly.

    Again, the estrogen should be tapered slowly. There are now some estrogen/progestins combined in one pill, but I don't recommend these as it's important to go off the progestin when you start using progesterone cream.

    [This Message was Edited on 06/02/2003]
  2. zggygirl

    zggygirl New Member

    Thanks for the info. I use the progestone cream even though I haven't been tested-no money, no doc who will, etc.
    But it does help!
    My worry is not that my doc. put me on DHEA because it is so low, and it will raise my estrogen and testostrine <SP?> (I can't spell).
    I sure hope THAT won't make me feel worse.
  3. GettSmartt

    GettSmartt New Member

    Dr. Gaby and Dr. Wright are also good and don't seem to walk lock step with the medical establishment. I have Dr. Gaby's book -- "Preventing and Reversing Osteoporosis: What You Can Do About Bone Loss --A Leading Expert's Natural Approach to Increasing Bone Mass" by Alan R. Gaby

    And the book which helped me to get back from Osteoporosis to Osteopenia (I'm only 46 and still premenopausal!) was:
    "The Bible Cure for Osteoporosis" by Dr. Don Colbert. The weight bearing exercises and lunges in there helped me to do it!

    I want so badly to take Strontium supplements -- but my endocrinologist still won't ok them for me! Dr. Wright's newsletter brought them to my attention. It's a mineral that seems to be the flip side to calcium which our bones need too.
  4. Notonline

    Notonline New Member

    Thank You...you recommended this book and another "Female Hormones in Context -- by Raymond Peat" to me awhile back in a post about birth control pills.

    I purchase both (took a little more searching to find the book by Raymond Peat, but I did) and read them from cover to cover, I tossed the Medroxyprogesterone my GYN had prescribed for me, and starting using the natural progesterone in Vit E. I hadn't had even one "normal" period in over 4 years, but for the last two months since starting this I have.

    THANK YOU!!!!!
  5. lilwren

    lilwren New Member

    .... we'd get a lot better medical treatment!

    Ziggy – I’m not sure how you tell – I suppose if the symptoms subside you’re doing something right. That's how it was for me.

    GettSmartt – thanks for the book recommendations I will check them out – they sound really terrific! :) I’m going to ask my doc about the Strontium supp. Thanks!!

    Danny – THAT’S WONDERFUL NEWS! I know that was A LOT of reading, and brain fog. :) I wish we could leave our e-mail addresses in our profiles (stupid spam) I could have told you where to get the Ray Peat book – oh well, all’s well that ends well. :) The oral, oil, form, has helped me a lot too, however, it evidently still isn’t enough since my test came back showing extremely low levels of progesterone and high levels of estrogen. I guess my liver is not working well enough to dump all the estrogen! If your doc will work with you there is a web site my doc had me go to and fill out a questionnaire – it’s called europahealth dot com – and then I did a blood test, and now I’m getting a prescription of capsule form progesterone. Since I got such good results from the oral, oil, form I can’t wait to see what happens with the capsules. If you get a chance check it out.

    Keep on keeping on - my sisters in arms – we’ll beat this DD yet!!!

    Love to you all,
    Sharon L
  6. klutzo

    klutzo New Member

    .....my new holistic M. D. put me on Progesterone drops made specially by a compounding pharmacy. Within 30 mins. of the first dose, I felt normal for the first time in almost 18 yrs. (See Dr. Russel Roby's website for explanation of why this works). I've been on the drops a week now, and except for some minor neck pain from my degenerative disc disease, I have been a normal person. This is in spite of having cheated on my diet big time this week. I can hardly believe it, and am keeping my fingers crossed.
  7. lilwren

    lilwren New Member

    I'm keeping my fingers crossed for you too. :) That's so incredible for you! I am so happy for you! I’ll look up Dr. Russel Roby on-line. THANKS! I love this board and all of you guys! Don't know what I'd do without your support and friendship! It really is a gift to be able to come here and share and learn with all of you.

    Sharon L
  8. Applyn59

    Applyn59 New Member

    Just wanted to add that they sell hormone test
    kits in health food stores. One for women
    and one for men. I think they are anywhere
    from 49-59 dollars. They are also available online.