Progesterone: Natural Hormone is First Choice – Elemental, Versatile & Bio-Identical to that Produced by the Body
By Ward Dean, MD
Some of the most common symptoms experienced by women in the peri- and post-menopausal period are problems with weight gain, fatigue, loss of libido, depression, headaches, joint pain and mood swings. Other frequent problems include uterine fibroids, cancer, fibrocystic breast disease, menstrual problems, autoimmune disorders, pre-menopausal bone loss and a high incidence of osteoporosis. These symptoms and diseases often have a common cause — an imbalance between the primary female sex hormones, progesterone and estrogen. (1) Progesterone and estrogen, along with DHEA, pregnenolone, and cortisol are classified as steroid hormones. Progesterone is a precursor to most steroid hormones (Fig. 1) and performs a myriad of different functions (Table I).(2)
Estrogen regulates the menstrual cycle, promotes cell division, and causes the development of secondary female characteristics during puberty. In non-pregnant pre-menopausal women, only 100-200 micrograms of estrogen are secreted daily. But during pregnancy, much more is secreted (Fig. 2). Progesterone is made in the ovaries of menstruating women, and by the placenta during pregnancy. About 20-25 mg of progesterone are produced per day during a womans monthly cycle and up to 300-400 mg are produced daily during pregnancy (Fig. 3). An important difference between estrogen and progesterone is that high amounts of estrogen are toxic to the body and can cause a number of harmful side effects. (3) On the other hand, progesterone has a balancing effect that prevents excess estrogen from being toxic and harmful to health, and is relatively free of serious side effects, even in high amounts. (4)
During the third trimester of pregnancy, women secrete 20 times more progesterone than during the last two weeks of their normal menstrual cycle (Fig. 4). Despite the discomfort of carrying excess weight, many women describe that they never felt better in their lives than during the third trimester of their pregnancies! The reason is that the high levels of progesterone at this time produce increased energy and a state of serene well-being. But after delivery, when progesterone production drops suddenly, many women develop postpartum depression due to extremely low levels of progesterone. (5)
Estrogen Dominance – Key to the Puzzle
Many women suffer from a syndrome known as Estrogen Dominance. According to Dr. John Lee, who has pioneered research in this area, estrogen unopposed by progesterone results in a number of adverse effects. These include hypertension, salt and water retention, abnormal blood clotting, excessive body fat, hypothyroidism, painful breasts, fibrocystic breast disease, increased risk of endometrial cancer (cancer of the uterus) and breast cancer.
Estrogen dominance usually occurs at the age of menopause, when progesterone production falls to approximately 1% of its pre-menopausal level. At this time, the production of estrogen falls to about 50% of its premenopausal levels. This dramatically alters the estrogen: progesterone ratio, causing estrogen to become toxic without progesterone to oppose it. As a result, the risks for breast and uterine cancer, fibrocystic breast disease, ovarian cysts, uterine fibroids, cervical erosions and/or dysplasia, and osteoporosis increase. (4)
Orthodox physicians usually consider menopause primarily as an estrogen deficiency syndrome, and consequently treat menopausal symptoms only with synthetic estrogen. (6) The real cause of many menopause-related problems may not be a lack of estrogen, but a lack of progesterone. Furthermore, the problems of estrogen dominance are not confined only to peri- and post-menopausal women. Today, it is extremely common for women to experience recurring menopause-type complaints 10 to 15 years before the time of menopause (when menstruation ceases). Women as young as thirty years of age often complain of menopause-type problems. This is known as pre-menopause syndrome. (7)
Premenstrual and Pre-menopausal Syndromes
In 1931, scientists investigating problems of menstruation identified a symptom complex that included extreme fatigue, depression, and irritability, which was often experienced by many women during the premenstrual period. They labeled this symptom complex premenstrual tension (PMT). As research continued, it became evident that this syndrome included more than 100 documented symptoms. Consequently, the name was changed to premenstrual syndrome (PMS). The most common PMS complaints are weight gain, bloating, irritability, depression, loss of sex drive, fatigue, breast swelling or tenderness, cravings for sweets, and headaches.
Two English physicians–Drs. Katharina Dalton and Raymond Greene–published the first medical report on PMS in 1953. Dr. Dalton observed that injecting progesterone relieved her own menstrual migraine headaches. Dr. Dalton then injected progesterone in other women and found that their PMS was also cured. (8,9) Other researchers such as Dr. Joel Hargrove at Vanderbilt went on to show a 90% success rate in relieving PMS symptoms with an oral supplement of progesterone! (10) The scientists also identified a chronic condition similar to PMS which they called pre-menopause syndrome. They identified two primary causes:  anovulatory cycles (i.e., a cycle that does not result in the release of an ovum, or egg); and  adrenal gland exhaustion due to chronic, excessive stress. In an anovulatory cycle, a woman does not ovulate, and there is no corpus luteum. With no corpus luteum, there is no progesterone secretion. Therefore, women with anovulatory cycles are truly progesterone deficient prior to menopause. (11) Adrenal gland exhaustion from chronic excessive stress may also contribute to a progesterone deficiency. A combination of anovulatory cycles and adrenal gland burnout often results in the symptoms of estrogen dominance early in life in the form of the pre-menopause syndrome. Progesterone can alleviate and prevent both premenstrual and pre-menopause syndromes. Progesterone secretion in women is highest during the two weeks before menstruation. With insufficient progesterone to block the toxic effects of estrogen, PMS often results. Raising the level of progesterone by supplementation (orally, by injection, or topically) often provides dramatic relief from PMS. (4)
Progesterone and Osteoporosis
One common and almost universal change with age is loss of bone density (Fig. 5). When this loss becomes severe enough, it is diagnosed as osteoporosis, the disfiguring and potentially fatal brittle-bone disease. In many western countries, patients with hip fractures occupy more hospital beds than patients with any other disease. For more than fifty years physicians have believed that lack of estrogen was the primary cause of osteoporosis. Quite simply, a lack of estrogen by itself does not cause osteoporosis. (8) Tamoxifen citrate is an anti-estrogen drug that is prescribed for breast cancer-prone women, due to its ability to block the uptake of estrogen hormones. If lack of estrogen were the cause of osteoporosis, then tamoxifen would presumably increase bone resorption and cause loss of bone density. However, Tamoxifen does not cause that to occur. (13) In addition, there is significant bone loss during the 10 to 15 years before menopause, despite an ample supply of estrogen. But during that time, there is often a shortage of progesterone. Although estrogen inhibits the bone-destroying osteoclast cells, it cannot rebuild bone. (10,11) On the other hand, progesterone rebuilds bone by stimulating the osteoblast cells that remineralize and restore bone mass.
Supplementing with natural progesterone has proved useful to prevent and heal osteoporosis. (11) Osteoporosis becomes most severe following menopause when women’s bodies stop producing progesterone. Dr. John Lee and many other physicians believe that progesterone is a key to maintaining healthy bones. (12,13) Dr. Lee reported in the July 1990 issue of International Clinical Nutrition Review on the effectiveness of natural progesterone. It was common to see a 10 percent increase (in bone density) in the first six to 12 months, and an annual increase of three to five percent until stabilizing at the levels of healthy 35-year-olds. Lee adds, The occurrences of osteoporotic fractures dropped to zero. Dr. Lees results run counter to current medical thinking about osteoporosis. The results of this study suggest that osteoporosis is not an irreversible condition, he says. Reversal has been demonstrated by the bone density tests and by the clinical results. This cannot be said of any other conventional therapy for osteoporosis. (14,15,16,17) [We have subsequently learned that Xylitol also appears to stop bone loss.
Natural vs. Synthetic Progesterone
Theres a world of difference between natural progesterone and synthetic progesterone, the type most frequently prescribed by orthodox physicians. Provera^(TM), the most frequently prescribed synthetic progesterone is not really progesterone at all–it is a progestin. Progestins are synthetic progesterone-like compounds that are manufactured by pharmaceutical companies. These synthetic progesterone analogs are far more powerful than the body’s own natural progesterone and are metabolized as foreign substances into toxic by-products. These synthetic progesterones can interfere with the body’s own natural progesterone, creating other hormone-related health problems and further exacerbating estrogen dominance. (20) Side effects of synthetic progesterone include increased risk of cancer, abnormal menstrual flow, nausea, depression, masculinizing effects, and fluid retention. (21) Natural progesterone is identical to what the body produces. It is manufactured in scientific laboratories from wild yams and soy beans. On the other hand, yam-derived natural progesterone should not be confused with yam extracts that are sold in health food stores. The body easily converts natural progesterone into the identical molecule made by the body. The body cannot, however, convert the yam extracts into progesterone. Adverse side effects are very rare with natural progesterone. The only side effect of concern is that it might slightly alter the timing of the menstrual cycle, when taken inappropriately.
The Progesterone Solution
PMS, premenopausal syndrome, and osteoporosis can have the common cause of estrogen dominance and relative progesterone deficiency. Consequently, they can often be prevented or mitigated by supplementing the body with physiologic dosages of natural progesterone (approximately 20-30 mg./day) to overcome the estrogen dominance and reestablish hormonal balance. Natural progesterone can be administered orally, topically, or by injection. However, I believe that the best way is topically (transdermally). Transdermal delivery is gaining in popularity as evidenced by the growing use of estrogen, testosterone, nitroglycerine (for angina) and even nicotine patches. Equivalent dosages of transdermal natural progesterone are 5 to 7 times more effective than orally ingested natural progesterone. Only 10-15% of the orally ingested progesterone reaches the bloodstream. Therefore, it is necessary to take much higher doses, 100-200 mg./day of oral progesterone to obtain the equivalent benefit of 20-30 mg./day of transdermal progesterone. Once progesterone reaches a saturation level in the underlying skin tissue, it diffuses into the capillaries, then passes into the general blood circulation for use by the body. Some women feel effects in less than a week of usage. For those who are especially deficient in progesterone, it may take two to three months to restore optimum levels.