Hormones Resource
Center
FAQ's
About Progesterone Cream
by John R. Lee, M.D. and Virginia Hopkins
Q: What is progesterone?
A: Progesterone is
a steroid hormone made by the corpus luteum of the
ovary at ovulation,
and in smaller amounts by the adrenal glands. Progesterone
is manufactured in the body from the steroid hormone
pregnenolone, and is a precursor to most of the other
steroid hormones, including cortisol, androstenedione,
the estrogens and testosterone.
In a normally cycling female, the corpus luteum produces
20 to 30 mg of progesterone daily during the luteal
phase of the menstrual cycle.
Q: Why do women need
progesterone?
A: Progesterone is
needed in hormone replacement therapy for menopausal
women for
many reasons, but one of its most important roles is
to balance or oppose the effects of estrogen. Unopposed
estrogen creates a strong risk for breast cancer and
reproductive cancers.
Estrogen levels drop only 40-60% at menopause, which
is just enough to stop the menstrual cycle. But progesterone
levels may drop to near zero in some women. Because
progesterone is the precursor to so many other steroid
hormones, its use can greatly enhance overall hormone
balance after menopause. Progesterone also stimulates
bone-building and thus helps protect against osteoporosis.
Q: Why not just use
the progestin Provera as prescribed by most doctors?
A: Progesterone is
preferable to the synthetic progestins such as Provera,
because
it is natural to the body and has no undesirable side
effects when used as directed.
If you have any doubts about how different progesterone
is from the progestins, remember that the placenta
produces 300-400 mg of progesterone daily during the
last few months of pregnancy, so we know that such
levels are safe for the developing baby. But progestins,
even at fractions of this dose, can cause birth defects.
The progestins also cause many other side effects,
including partial loss of vision, breast cancer in
test dogs, an increased risk of strokes, fluid retention,
migraine headaches, asthma, cardiac irregularities
and depression.
Q: What is estrogen
dominance?
A: Dr. Lee has coined
the term "estrogen
dominance," to describe what happens when the
normal ratio or balance of estrogen to progesterone
is changed by excess estrogen or inadequate progesterone.
Estrogen is a potent and potentially dangerous hormone
when not balanced by adequate progesterone.
Both women who have suffered from PMS and women who
have suffered from menopausal symptoms, will recognize
the hallmark symptoms of estrogen dominance: weight
gain, bloating, mood swings, irritability, tender breasts,
headaches, fatigue, depression, hypoglycemia, uterine
fibroids, endometriosis, and fibrocystic breasts. Estrogen
dominance is known to cause and/or contribute to cancer
of the breast, ovary, endometrium (uterus), and prostate.
Q: Why would a premenopausal
woman need progesterone cream?
A: In the ten to fifteen
years before menopause, many women regularly have
anovulatory
cycles in which they make enough estrogen to create
menstruation, but they don't make any progesterone,
thus setting the stage for estrogen dominance. Using
progesterone cream during anovulatory months can help
prevent the symptoms of PMS.
We now know that PMS can occur despite normal progesterone
levels when stress is present. Stress increases cortisol
production; cortisol blockades (or competes for) progesterone
receptors. Additional progesterone is required to overcome
this blockade, and stress management is important.
Q: What is progesterone
made from?
A: The USP progesterone
used for hormone replacement comes from plant fats
and oils,
usually a substance called diosgenin which is extracted
from a very specific type of wild yam that grows in
Mexico, or from soybeans. In the laboratory diosgenin
is chemically synthesized into real human progesterone.
The other human steroid hormones, including estrogen,
testosterone, progesterone and the cortisones are also
nearly always synthesized from diosgenin.
Some companies are
trying to sell diosgenin, which they label "wild yam extract" as
a medicine or supplement, claiming that the body
will then convert
it into hormones as needed. While we know this can
be done in the laboratory, there is no evidence that
this conversion takes place in the human body.
Q: Where should I put
the progesterone cream?
A: Because progesterone
is very fat-soluble, it is easily absorbed through
the
skin. From subcutaneous fat, progesterone is absorbed
into capillary blood. Thus absorption is best at all
the skin sites where people blush: face, neck, chest,
breasts, inner arms and palms of the hands.
Q: What is the recommended
dosage of progesterone?
A: For premenopausal
women the usual dose is 15-24 mg/day for 14 days
before expected
menses, stopping the day or so before menses.
For postmenopausal women, the dose that often works
well is 15 mg/day for 25 days of the calendar month.
Q: What amount of progesterone
do you recommend in a cream?
A: Dr. Lee recommends
the creams that contain 450-500 mg of progesterone
per ounce,
which is 1.6% by weight or 3% by volume. This means
that about ¼ teaspoon daily would provide about 20
mg/day.
Q: How safe is progesterone
cream?
A: During the third
trimester of pregnancy, the placenta produces about
300 mg of
progesterone daily, so we know that a one-time overdose
of the cream is virtually impossible. If you used a
whole jar at once it might make you sleepy. However,
Dr. Lee recommends that women avoid using higher than
the recommended dosage to avoid hormone imbalances.
More is not better when it comes to hormone balance.
Q: Wouldn't it be easier
to just take a progesterone pill?
A: Dr. Lee recommends
the transdermal cream rather than oral progesterone,
because some 80%
to 90% of the oral dose is lost through the liver.
Thus, at least 200 to 400 mg daily is needed orally
to achieve a physiologic dose of 15 to 24 mg daily.
Such high doses create undesirable metabolites and
unnecessarily overload the liver.
Article
syndicated from www.JohnLeeMD.com:
http://www.johnleemd.com/store/faqs_progest_crm.html
