The Green Dispensary ~ Menopause

Progesterone

The rise and fall of Oestrogen and Progesterone in the monthly cycle is synchronized by the hypothalamus and pituitary glands in the brain which secrete other hormones thus initiating the production of these so-called sex hormones. At present it is not known exactly how this works, except to say that it is very complex. Figure 1, "The Normal Menstrual Cycle" shows how Progesterone levels rise significantly when ovulation occurs, and fall around day 25.

Menopause & Perimenopause

While menopause describes the time when a woman's periods cease, symptoms of menopause (eg irregular periods, hot flushes, sore breasts etc.) may occur for some years prior. This time is referred to as Perimenopause.

Until recently most doctors have prescribed synthetic Progestins and Oestrogens to ameliorate these symptoms but the recent report from the Women's Health Initiative, a large study of the effects of these synthetic hormones on menopausal women, has shown that there is an increased likelihood of cancer occurring in women who choose long term HRT with these synthetic drugs.

Dr John Lee, an American doctor, has pioneered the use of BHRT (Bio-Identical Hormone Replacement Therapy) using Natural Progesterone … Progesterone which is identical to that produced by the human body. He has also shown that while there is a reduction in hormone production, it is not Oestrogen production which falls dramatically around menopause, but Progesterone, and it is Progesterone which should be the first supplement to be given at this time.
Progesterone is readily absorbed through the skin using creams prepared by a Compounding Pharmacy and most women find that their optimum level (all women differ in their exact requirement) of supplementation can be achieved after 2 or 3 months.
If symptoms persist, a Bio-Identical Oestrogen may be added. Progesterone can also be taken in Troches (form of lozenge), capsules, or pessaries depending on patient preference.
For perimenopausal women, BHRT is begun usually on the 7th day of the cycle (day 1 is the first day of bleeding) and continued until the next period begins. In the case of post menopausal women or those who have had a hysterectomy, this is also true, except that the patient has to create an imaginary cycle. Some doctors, however, may prefer Progesterone to be used without a break.

Please Note

Premenstrual Syndrome (PMS)

Progesterone has been wrongly accused of being the hormone responsible for PMS because it's the one that's high just before menstruation. The truth is that women with PMS tend to have lower Progesterone than normal at that time of the cycle … in fact, it's Oestrogen which is dominant.
PMS occurs when Progesterone fails to be produced in sufficient quantity to counteract the effect of Oestrogen for 2 weeks prior to menstruation and with the simple application of Progesterone cream between days 12 to 25, symptoms may be relieved.

Application of Cream

When using BHRT cream, apply to a thin skin area ( e.g. sternum, neck, inside of upper arms) and vary the site on a daily basis. Rub the cream in well in the same way as a moisturizer.

Osteoporosis

While oestrogen supplementation has been shown to slow bone loss, recent evidence has revealed that Progesterone actually contributes to bone formation by activating osteoblasts (bone building cells) to produce new bone.
It is clear, therefore, that Progesterone helps prevent and treat osteoporosis in women.

Effects on Breast Tissue

A normal cell will have a regulated life and death dictated by genetic control. On the other hand cancer cells exhibit uncontrolled multiplication as a result of genetic mutation or malfunction.
Research has recently revealed that Oestrogen stimulates the gene BCL2 which causes breast cells to grow rapidly and it also prevents cell death.
Bio-identical Progesterone, however, stimulates the gene P53 which induces apoptosis (cell death), and it is because of this fact, that many doctors are insisting that oestrogen must never be given to a patient by itself (unchallenged), and that a women who is exhibiting oestrogen dominance should be given Progesterone to reduce the likelihood of uncontrolled breast cell division.

Other Beneficial Effects

Recently, in a study on the brain using Progesterone it was revealed that babies treated with increased intrauterine levels of Progesterone exhibited normal psychomotor development, while those untreated showed slightly delayed development.
It has also been suggested that because Progesterone increases the production of the neurotransmitter GABA, it may have some use in Alzheimer patients.
Progesterone also prevents the proliferation and migration of smooth muscle cells which are involved in the formation of plaque that blocks arteries in the heart and brain.

References & Further Reading

"What Your Doctor May Not Tell You About Menopause" (John R Lee)
"What Your Doctor May Not Tell You About Breast Cancer (John R Lee, David Zava, Virginia Hopkins)
International Journal of Pharmaceutical Compounding "A Review of Current Research on the Effects of Progesterone" (Diane Boomsma, Jim Paoletti)