PROGESTERONE USE Q&A

This page has many questions that are frequently asked of us. If you have a question that is not listed here, please feel free to contact us with your question.

COMMON QUESTIONS AND CONCERNS COVERED

WHAT IS ESTROGEN?

Generally refers to the class of hormones responsible for developing the female body and regulating the reproductive cycle. They dominate the first half of a woman's cycle before ovulating, preparing for a fertilized egg and pregnancy. Estrogens are also responsible for retaining water, swelling the breasts, fat deposition and stimulating cell growth.

WHAT ARE PHYTOESTROGEN'S?

Plant compounds, such as soya isoflavones with estrogen-like activity. They are usually considerably weaker than the body's own estrogens or synthetic xenoestrogens, and they compete for the same estrogen receptor cites throughout the body. Thus, they have often been used successfully to decrease symptoms of estrogen dominance by encouraging the body to lower its own estrogen production. As well, it helps block the absorption of xenoestrogens.

WHAT ARE XENOESTROGENS?

Synthetic, petroleum chemicals in the environment and ingredients in personal care and household products that mimic estrogen, are fat soluble and non-biodegradable. They are considered toxic to women, men, children, and to babies in the womb. They are linked to sterility, cancer, learning disabilities, and many diseases. Xenoestrogens include: paraben preservatives, triclosan (active ingredient in most antibacterial products), and numerous detergents. There are more hormone disrupting ingredients, but research has been limited in identifying the culprits. Xenoestrogens may also be found in meat products, petroleum products, plastics, pesticides and industrial chemicals.

WHAT EXACTLY IS NATURAL PROGESTERONE AND HOW DOES IT DIFFER FROM SYNTHETIC PROGESTERONE?

A precursor to most of the steroid hormones, including estrogen and testosterone. It has many important jobs including regulating menses, fertility and maintaining pregnancy. Made primarily in the ovaries, it dominates the last half of a women's cycle before menses (menstruation). Progesterone decreases some of the risks of Estrogen Replacement Therapy, helps to keep the body slim, and promotes healthy breasts, bones and skin, an active sex drive, and feelings of well being and contentment. Natural progesterone, a cholesterol derivative, comes from the Mexican yam or soybeans. It matches exactly the chemical formulation of the body's own progesterone and thus causes no side effects. Manufacturers of synthetic progesterone alter the chemical makeup of progesterone in order to create progestins. Progestins in their altered molecular structure may cause many side effects, such as birth defects or abortion, fluid retention, epilepsy, migraine, asthma, cardiac or kidney dysfunction and depression. Premarin, prescribed to millions of women as HRT/ERT (hormone replacement therapy and estrogen replacement therapy), with sales estimated at a billion dollars per year, is made from pregnant mares' urine and is one of the top selling medications with only 10 to 15 percent of the market captured. Women are becoming aware and leery of these drugs due to the potential side effects however.

WHAT IS HRT/ERT?

These are acronyms of prescription Hormone Replacement Therapy and Estrogen Replacement Therapy, which are now being prescribed to millions of women, with sales estimated at a billion dollars per year. For example, Premarin is made from pregnant mare's urine and is one of the top selling medications with only 10 to 15 percent of the market captured. Women are becoming aware and leery of these drugs due to the potential side effects, and recently, science has revealed an increase in heart disease with those using these methods.

WHAT IS A HOT FLASH?

The pituitary gland is the taskmaster responsible for monitoring progesterone and estrogen production. When the correct amount of hormones are not produced, the taskmaster sends a message to open the blood vessels that may be felt as a warm or hot feeling sometimes known as a hot flash. When the blood vessels dilate, the central nervous system has to speed up, which may cause slight nervousness to extreme anxiety, sometimes accompanies by mood swings, depression and other emotional symptoms.

WHAT ARE RECEPTOR SITES?

These features are located on the surface of cells in the skin throughout the body. A receptor site is likened to a "lock" that is responsive to various "keys", such as progesterone, estrogen, phytoestrogens and xenoestrogens. When any of these hormones occupy the receptor site on a cell, it produces a specific cellular activity.

WHAT ARE HORMONAL DISRUPTERS?

A substance (such as xenoestrogen or other chemical in the environment, xenobiotic), which occupies hormonal receptor sites in the body, thus disrupting or scrambling the normal function of hormones causing many unpleasant symptoms.

COMMON QUESTIONS ABOUT USP PROGESTERONE CREAM

WHAT IS PROGESTERONE CREAM?

A cream made from plants containing progesterone, such as wild yams. It restores hormone balance and provides naturally occurring progesterone that is quickly absorbed through the skin into the bloodstream. It provides many beneficial actions throughout the body including restored progesterone levels, which helps eliminate estrogen dominant symptoms. When progesterone is taken orally it is relatively ineffective because the liver quickly disposes of it. A progesterone cream is the ideal delivery method.

DO I NEED A PRESCRIPTION TO BUY NATURAL PROGESTERONE CREAM?

No. Natural progesterone in a cream or oil base comes from wild Mexican yams and/or soybeans, which is technically a food product. Restored Balance uses wild Mexican yams in their product.

WHERE SHOULD I APPLY NATURAL PROGESTERONE CREAM?

Natural progesterone (derived from the Mexican wild yam root) in a moisturizing cream can be applied to the face, hands, chest, breast, inner arms, soles of feet, and in cases of osteoporosis, to the entire trabecular spine. The cream is readily absorbed and leaves no trace after a few minutes. During absorption the cream bypasses the liver and goes to specific receptor sites where progesterone is needed. When the action is completed, residue is then excreted from the body. Absorption rate varies from person to person as does the relative need for progesterone.

PLEASE NOTE: Everyone is different. Some women require more progesterone cream to alleviate symptoms, while others can use less. For the first 3 months, use one 2 oz. jar per month. Then try cutting back on the amount of natural progesterone each month. If symptoms return, resume previous usage. It is important to stop using progesterone cream at least five days each month.

HOW DO I KNOW IF I SHOULD USE NATURAL PROGESTERONE CREAM?

See application information. Summary below:

If you have PMS symptoms. PMS symptoms are those symptoms that occur consistently a week or 10 days before the period and stop with or shortly thereafter.
If you have estrogen dominance symptoms. These symptoms are water retention, breast swelling, fibrocystic breast, uterine fibroid, mood swings, depression, craving for sweets, weight gain, and fat deposited at hips and thighs.

If you have menopausal symptoms. Estrogen continues to be produced from the fat in cells even after menopause; however, progesterone production virtually ends. Hot flashes are the most prominent symptoms of menopause.

WHEN DO I USE NATURAL PROGESTERONE CREAM?

If you are still menstruating, use one-fourth to one-half teaspoon of cream twice a day after ovulation (which is generally 12-14 days from the first day of menstrual flow) until day 26. You do not need natural progesterone while menstruating; however, if you experience menstrual cramps try rubbing a small amount of cream on the lower abdomen. For migraines, rub cream on back of your neck.

If you have menopausal symptoms and are still menstruating, use one-fourth to one-half teaspoon cream twice per day beginning with the 10th day from day one of menstruation until day 26. [After 3 months, start using cream 12-14 days from day 1 of menstruation until day 26.]

If you have menopausal symptoms and are not menstruating, use based on calendar month. Use one-fourth to one-half teaspoon twice per day beginning on the 8th day of each calendar month and continue for the remainder of the month.

CAN NATURAL PROGESTERONE BE USED DURING PREGNANCY?

In his book, "Premenstrual Syndrome & You", Neils H. Lauersen, M.D., from Mount Sinai Medical Center in New York, states that natural progesterone may be helpful to maintain pregnancy. The cream in not only safe for use during pregnancy but is recommended. From conception to delivery, apply primarliy to abdomen, breast, low back, and upper thighs (where it will tend to prevent the skin from stretching). For the first six months of pregnancy, use an average of 1/2 to 3/4 teaspoon 2 to 3 times a day. Discontinue at delivery and resume again at a level of twice per day starting one month after delivery. The cream is also useful for post-partum depression, which many women experience after childbirth.

CAN YOUNG GIRLS USE NATURAL PROGESTERONE CREAM?

Yes. Low estrogen levels can adversely affect the general health of girls between the ages of 9 and 13. For a year or more before the onset of menstruation, blood calcium levels are so low that young girls often develop symptoms associated with menarche, which are usually accepted as normal behavior: emotional outbursts, irritable and temperamental behavior, and compulsive consumption of sweets. During puberty, the maturing ovaries require calcium to produce estrogen, thus diverting calcium from metabolic requirements. Introducing natural progesterone at this time will alleviate most of the symptoms mentioned above. Continued use of natural progesterone through the teenage years will

CAN NATURAL PROGESTERONE HELP WITH ENDOMETRIOSIS OR FIBROCYSTIC BREAST?

One common factor in both these conditions is a higher level of circulating estrogen, indicating a hormonal imbalance. Progesterone-which helps to normalize all other endocrine hormonal activity in the body-may help to clear these conditions by helping to lower the level of estrogen. See application information.

DO NATURAL HORMONES HELP VAGINAL DRYNESS?

Vaginal dryness can occur in women of all ages for various reasons, but it is primarily present in post menopausal women. Natural hormones in a cream base can be used intravaginally and has been very successful in treating vaginal dryness and vulvar atrophy associated with aging.

SHOULD ESTROGEN BE USED WITHOUT NATURAL PROGESTERONE?

Definitely not. It is very important that natural progesterone be used with any form of estrogen. Estrogen without progesterone can cause endometrial and vaginal carcinomas. Estrogen blocks thyroid production and causes water retention; and it can cause fibrocystic breast disease and even fibroid tumors and cysts in the ovary area.

I AM ALREADY TAKING HORMONES FROM MY DOCTOR WHY SHOULD I SWITCH TO NATURAL HORMONES?

Natural hormones are simply an altenative to hormone replacement therapy. Synthetic progesterone (known as progestins) has many side effects, and synthetic estrogen can be dangerous to your health, especially if taken without any progesterone. If someone is taking both synthetic estrogen and progestins, a gradual step is to substitute natural progesterone cream; and gradually reduce the synthetic estrogen. (Reduce estrogen by one-half and continue to reduce over 90 days until discontinued use).

I'M POST MENOPAUSAL, WILL I START MENSTRUATING AGAIN IF I USE NATURAL HORMONES?

Occasionally upon beginning use of natural hormone 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 you should consult a physician.

I HAVE FACIAL HAIR, ESPECIALLY ABOVE MY UPPER LIP, THAT REQUIRES SHAVING OCCASIONALLY. WHAT CAUSES THIS?

This is a condition called hirsutism" (defined as excessive growth of facial and body hair). It indicates that there is a hormonal imbalance between estrogen, testosterone (the dominant male hormone) and progesterone. Progesterone acts as a regulator for the entire endocrine system. A woman who has the hirsute problem probably has PMS too. Both menopausal and menstruating women have reported that facial hair (and body hair) decreased or completely disappeared after three to six months of regular application of cream twice a day. Natural progesterone is needed to effect proper hormonal balance.

IS NATURAL PROGESTERONE USEFUL FOR HYSTERECTOMIZED, OOPHORECTOMIZED AND MENOPAUSAL WOMEN?

Yes. Many women experience hot flashes following pre-menopausal hysterectomy (removal of uterus) or oophorectomy (complete removal of ovaries) and in the beginning of the natural onset of menopause. The cream which contains natural progesterone is reported to be effective for relieving symptoms of hot flashes. Most women have reported a complete cessation of flushing within 3 to 8 weeks.

IS NATURAL PROGESTERONE INDICATED FOR OSTEOPOROSIS?

Many medical authorities tell female patients who are post-menopausal that osteoporosis is inevitable. A physician in Mill Valley California, John R Lee, has stated that this often repeated statement is simply untrue. It would be wise to read his books on the subject. The FDA however, denies his findings and thus we will not comment until further studies are completed.

CAN I USE NATURAL PROGESTERONE IF THERE IS FAMILY HISTORY OF BREAST OR UTERINE CANCER?

Yes. Breast cancer and endometrial cancer occur in tissue sensitive to gonadal hormones. Unopposed estrogen is the only known cause of endometrial cancer, though there may be other factors involved. Estrogen, or at least one or more of the various estrogens, are thought to contribute to breast cancer. Progesterone balances the estrogen level in the body, thus lessening the risk.

CAN MEN USE NATURAL PROGESTERONE?

Men over 45 can use natural progesterone. One benefit is an increase in the libido. Progesterone is the precursor of testosterone. Testosterone can stimulate new bone formation, increasing bone density; a lack of it can cause osteoporosis. Older men with rheumatoid arthritis have reported relief from pain and swelling after rubbing natural progesterone in a cream base on their joints.

ARE THERE ANY OTHER BENEFITS OF NATURAL PROGESTERONE USE?

Additional benefits for women include: improved brain function, diminished muscular aches and pains, improvement of skin problems including acne, seborrhea, rosacea, psoriasis and keratoses, and improved sleep pattern.

I STARTED PROGESTERONE AND NOW I FEEL WORSE. WHY?

Constant estrogen ingestion in the form of pills or xenoestrogens causes the estrogen receptors to down regulate. In other words, the woman's body has so much estrogen that the estrogen receptors become less sensitive. A good analogy would be when you enter a noisy room. When you first enter the room you notice the noise. However, after being in the noisy room for a while, the noise becomes less noticeable. Your ears become less sensitive to the noise. In effect, your ears down regulate. Thus, if you take estrogen supplements or get doses of xenoestrogens after a while your body will become less sensitive to estrogens. This is because your body has too much estrogen, and the body tries to become less sensitive. However, when you take progesterone the estrogen receptors are re-sensitized to their original sensitivity. In other words, when you begin to take progesterone, you regain your original sensitivity to estrogen.

Women after menopause produce 40% of the estrogen that they did before menopause. Progesterone levels fall to less than 1% of premenopause levels. Progesterone resensitizes the body's cells to estrogen. So estrogen pills can be cut back and eventually stopped.

The solution is to cut back on the dose of estrogen. Dr. Lee recommends immediately cutting back the dose to 1/2 of the normal dose. He recommends stopping the estrogen dose altogether over a period of 3-4 months phasing out the dose of estrogen slowly. He maintains that women's bodies produce enough estrogen already.

In rare cases, the patient may change his lifestyle and take Natural Progesterone and still get worse. In this case, there may be an unrecognized source of estrogen in the form of pesticide/herbicide spraying nearby; or the xenoestrogen may be stored in the body fat. Xenoestrogens may stored in the body for decades. Sauna treatment may be used to get rid of these stored xenoestrogens. A physician that uses sauna treatment may be found at www.aaem.com.

CAN YOU GIVE ME SOME SUGGESTIONS OF WHAT I MAY BE DOING THAT IS ADDING XENOESTROGENS IN MY LIFE?

According to the Dartmouth University Study, plastic wrap heated in oil in a microwave oven contained 500,000 times the minimum amount of xenoestrogens needed to stimulate breast cancer cells to proliferate. Heating plastic wrap with food is very bad. Heat food in a ceramic bowl, cover it with a plate in the microwave oven. Coffee is a known phytoestrogen that exacerbates fibrocystic breast disease. Since it is a phytoestrogen, decaffeinated coffee may still be able to act as an estrogen. Laundry detergent cannot be fully rinsed out of the clothes and is absorbed through the skin. Change to health food store detergent without the alky phenols that mimic estrogen.

Anything that is put on the skin is absorbed directly into the body. Anything that is eaten is first pass metabolized by the liver. The liver can eliminate 90% of a prescription conjugated estrogen before it gets to the body. In contrast, an estrogen patch goes directly into the body bypassing the liver. Thus, the patch dose is 10 times less than the oral dose. Or put another way anything that is put on the skin is 10 times the oral dose. Most skin creams contain methyl paraben, propyl paraben, or butyl paraben. The parabens are known xenoestrogens, and are now being investigated by the European Union as a contributor to breast cancer. Be very careful about what you put on your skin. Many of the cosmetics also contain these same preservatives as well.

HOW LONG BEFORE I BEGIN TO NOTICE IF NATURAL PROGESTERONE IS WORKING FOR ME?

Take Natural Progesterone for 2 months and then test for saliva progesterone. Blood level progesterone will certainly be zero since the Natural Progesterone is being absorbed through the skin. Order the kit from ZRT laboratories or thru us. ZRT is the laboratory that tested our progesterone for effectiveness and they supply us with the lab tests as well. You simply spit in the plastic tube provided and send it back through the mail. Lab results are mailed back.

ZRT Laboratories
1815 NW 169th Place #5050
Beaverton, OR 97006

If you are absorbing Natural Progesterone well, after 2 months your saliva levels should be at least 500-1000. If you are not absorbing Natural Progesterone well then your saliva levels will be less than 100. If you are premenopausal, make sure to take into account your period. We also have a second choice of progesterone cream that contains Maca, a cruciferous Peruvian Herb. It seems to have a progesterone effect and is used by Peruvian M.D.'s. It is a safe herb because it has been used for centuries, or even thousands of years for female problems, and male erection problems.

If you are one of those patients that do not absorb Natural Progesterone well through the skin, you may take Natural Progesterone sublingually (under the tongue), or orally in a pill form. We do not have a good source at this time to refer you to, but we are looking. Using a women's supplement like our OsteoSoy is also beneficial, and for some, may be only what their body requires.

I HAVE BEEN USING A YAM CREAM THAT WAS SUGGESTED BY A MIDWIFE, IS IT THE SAME?

"Yam Extract" is NOT progesterone and will not have the same effects as progesterone. Women have been led to believe that the body will convert chemicals in the wild yam products into DHEA, and that the body will then convert the DHEA into testosterone and estrogen. The hoped-for result, of course, is that this will restore the libido. But the fact is, there is no proof that wild yam is converted into DHEA in the body. Absolutely none!

WHAT WOULD CAUSE TREATMENT FAILURES WITH PROGESTERONE CREAM?

The most common treatment failure is that the patient does not avoid estrogens and/or xenoestrogens in his environment. In this case, the symptoms may actually get worse. In rare cases, even though the patient avoids all estrogen and changes her lifestyle there is still a treatment failure. In this case, xenoestrogens stored in the body fat or from an recognized source may be considered. The second most common failure seems to be the inability of the patient to absorb Natural Progesterone through the skin. This problem seems to be occur in less than 10% of the patients. Another obvious reason for treatment failure is the use of progesterone cream that is not formulated correctly. Mineral oil can block absorption of Natural Progesterone. The Natural Progesterone cream can have the inappropriate amount of Natural Progesterone, or contain herbs or preservatives that stimulate estrogen receptors and mimic estrogens. Improperly Formulated Progesterone Cream could also do this. You should take anywhere from 20-60 mg/day of Natural Progesterone in an oil or cream depending on the condition you are treating. Many progesterone creams do NOT contain enough progesterone. Some only have "Yam Extract". "Yam Extract" is NOT progesterone and will not have the same effects as progesterone. Natural Progesterone is made most commonly from yams or soy. The most common preservative used in these creams is methyl paraben or propyl paraben. The parabens are xenoestrogens. The parabens are being questioned by the European Union for estrogen activity and a role in causing breast cancer.

Should I use natural estrogen and progesterone blends if progesterone isn't enough? And what about using them at the same time if I get them seperately?

See our new comments on this under our Estrogen newsletter from Dr. John Lee.

Is progesterone safe to use before or after breast surgery and if you've had cancer?

Most assuredly you can use progesterone after any kind of cancer and before or after surgery. Check out Chapter 8 of Dr. Lee's breast cancer book for more details.

Some additional information:

UCLA researchers found that women who use estrogen were 25% less likely to have dry skin than women who didn't use estrogen. The impact on wrinkles was even greater, with the study showing that estrogen users were 30% less likely to have wrinkles than non-users. ~Los Angeles Times, 1997
Osteoporosis is a disease that affects more than 25 million Americans. Regular exercise and a healthy diet may reduce the risk. Bone loss is contributed to estrogen loss and unbalanced progesterone production.
That natural hormone, micronized progesterone, improves the quality of life for post-menopausal women. In a study, 80% of participants reported increase satisfaction with the natural progesterone as compared to previous therapies that used synthetic progesterone. It appears naturally occurring progesterone can reduce the occurrence of sleep disorders, hot flashes, anxiety, and symptoms of depression. ~Mayo Clinic Study, Journal of Women's Health, May 2000
Elizabeth Smith, M.D - on xenoestrogens

Recommended Reading

John R. Lee, M.D. with Virginia Hopkins What Your Doctor May Not Tell You About Menopause. The Breakthrough Book on Natural Progesterone. New York: Warner Books, 1996.

John R. Lee, M.D., Jesse Hanley M.D., and Virginia Hopkins, best selling authors of What Your Doctor May Not Tell You About Premenopause. Warner Books, 1999.

PLEASE NOTE THAT DR. JOHN R. LEE HAS PASSED AWAY.