Women can now get the benefits of hormone replacement therapy without the risks and negative side effects of estrogen. A cream containing natural progesterone (from Mexican Wild Yam) is now being successfully used to treat symptoms of menopause and premenstrual syndrome (PMS) related to hormonal deficiencies and imbalances. (1,2,3,4,6)
Estrogen Replacement: The Good and the Bad
For many years, estrogen replacement therapy has been used to treat menopausal symptoms. Estrogen slows bone loss and the progression of osteoporosis. Then the bad news came . . . a series of studies links estrogen replacement to increased risk of breast cancer.(7) Then confusing news . . . studies show estrogen therapy reduces the risk of cardiovascular disease.(3) Which would you rather have? More bad news . . . a later study links estrogen replacement with increased risk of lupus erythematosus.(9) Many doctors now feel that estrogen should not be given casually, particualrly to women with a family history of breast cancer. And the good news is . . . natural progesterone can raise and balance hormone levels without the risks and side effects associated with estrogen therapy. (1,2,3,4,6)
Osteoporosis: Is Calcium Enough?Adequate calcium intake is a must for postmenopausal women. One gram to 1.5 grams daily is suggested. However, the age-dependent reduction in skeletal bone mass that begins in the thirties cannot be completely stopped by adequate calcium intake alone. In a comparison study, calcium supplementation alone resulted in significant slowing of bone loss from the femoral neck and improved calcium balance, but was less effective than calcium in conjunction with hormone replacement. (4)
Estrogen Slows Loss . . . Progesterone Rebuilds
Loss of bone density is generally related to an age-dependent decrease in gonadal hormones. The dramatic reduction in these hormones with menopause is associated with a sharp decrease in trabecular bone and a slower decrease in cortical bone.(5) Osteoporosis at menopause may be due more to a lack of progesterone than estrogen. There is a greater decline in progesterone than in estrogen and progesterone begins to decline earlier. While estrogen slows bone loss somewhat, progesterone can actually rebuild bone.(2) Dr. John R. Lee, M.D., reported a 10% increase in bone density in the first 6 to 12 months, followed by annual increases of 3-5% which stabilized at the levels of healthy 35 year olds. He found that progesterone encouraged the development of new bone in areas of low bone density. His office-based study reviewed 6 years experience with 100 postmenopausal women using a transdermal cream containing natural progesterone from Mexican wild yam, in conjunction with traditional ostoporosis therapy including diet, nutritional supplements and exercise. (1,2)
Progesterone Relieves Menopausal Complaints
Natural progesterone cream applied to the skin also eases hot flashes, depression and mood swings associated with menopause.(3) In Dr. Lee’s experience he found that natural progesterone can protect against facial hair and male pattern baldness that some women have after menopause. As for side effects…the women felt better, had more energy, some cases of vaginal dryness improved and sexual interest increased. (2)
PMS Appears to Be a Progesterone Deficiency
Premenstrual Syndrome (PMS) affects over 25 million women every month. This broad range of recurring symptoms usually appears between ovulation and the onset of menstruation when progesterone levels are low and estrogen is dominant. This hormonal imbalance which produces a variety of symptoms…bloating, anxiety, irritability, moodiness, food cravings, crying, breast tenderness, fatigue, depression and anxiety…could be considered a progesterone deficiency. Progesterone can restore balance and relieve PMS symptoms. Dr. K. Dalton, who has successfully used progesterone therapy for over 30 years in England, reports complete relief of symptoms for patients. (11)
Hypothyroidism and Other Disorders
Dr. Lee also found that his patients who were hypothyroid no longer needed thyroid supplements because progesterone can increase the action of thyroid hormone in the cell. Estrogen, on the other hand, interferes with this action.(2) Thyroid replacement in excess may also aggravate bone loss.(6) Since progesterone promotes balance and is a precursor for other hormones it is also useful in treating a number of other female disorders. Dr. Lee found it very effective in treating fibrocystic breast disease as well as uterine fibroids, urinary tract infections, ovarian cysts and endometriosis. (2)
Natural Hormones Found in Plants
The natural progesterone used by Dr. Lee is found in about 5,000 plants, but is particularly abundant in the Mexican wild yam. The natural progesterone is identical to that in the human body. It is not the same as synthetic progestins. The alteration of progestins can account for side effects including breast cancer, facial hair growth, depression, cardiovascular disease, liver disorders and other problems associated with progestin use. (2) The compound, diosgenin, was originally isolated by Professor Russell Marker in the 1940’s. The Mexican wild yam was the source for the original birth-control pill. Diosgenin is essentially a progesterone molecule with a smaller molecule addition. Mexican wild yam also contains dihydroepiandrosterone or DHEA, an adrenal hormone that decreases with age and in certain degenerative conditions including postmenopausal osteoporosis.(8) Although a balance of estrogen and progesterone is most beneficial, progesterone enhances receptor sensitivity to estrogen, so supplemental estrogen may not even be needed. Also, many plants also contain estrogenic compounds (estriol). Japanese women, whose diet is high in plant-derived estrogens, particularly from soybeans, have very little menopausal discomfort. They also have the lowest rates of two major killers of American women . . . coronary artery disease and cancer.(3) The most commonly prescribed form of estrogen is derived from the urine of pregnant mares. Estrogens from plants are more similar to human estrogen than estrogen from horses. Plant-based estriol appears to have no cancer risk and may possibly have a better overall effect.(10) Herbal products such as dong quai, licorice and alfalfa all contain nontoxic estrogenic factors. These “phytoestrogens” exert low estrogenic effects, approximately 1/400th the potency of human endogenous estrogens.(6) Supplementation with evening primrose oil and flaxseed oil can help the adrenal glands produce more estrogen. (3)
Use of Transdermal Progesterone Cream
By using a transdermal cream formula, the natural progesterone is allowed to flow through the skin and go directly into the bloodstream, completely bypassing digestion. The cream is applied to the largest possible area of thin skin such as the inside of the arms or legs, the face and neck, the upper chest and the abdomen. A two ounce jar should be used up over the course of a month. In postmenopausal women, the cream may be used 2 to 3 weeks of the month and then discontinued until the next month. Before menopause it is used from about day 12 to day 26 of the menstrual cycle. It should always be discontinued for at least 5 to 7 days each month. Otherwise the body may become insensitive to its effects.(2) Since progesterone enhances receptor sensitivity to estrogen, women who are taking estrogen should reduce their estrogen dose in half when starting progesterone. Many will be able to eliminate or reduce estrogen further in the next several months. For those taking progestin who want to use natural progesterone, Dr. Lee recommends tapering off the progestin gradually by cutting the dose in half for the first month as the cream is added. Then cut in half again the second month, taking it every other day if necessary. By the third month, the progestin can be safely discontinued. (2)
- Lee, John R., “Osteoporosis Reversal, The Role of Progesterone”, International Clinical Nutrition Review, July, 1990;10(3):384-391.
- Barnard, Neal, M.D., “Natural Progesterone: Is Estrogen the Wrong Hormone?”, Good Medicine, Spring 1994; 11-13.
- Gleason, Sharon, menopause: It’s Not a Disease. Natural Approaches to a Change of Life”, Good Medicine, Spring 1994;8-10.
- Aloia, John F., M.D., et al, Calcium Supplementation with and without Hormone Replacement Therapy to Prevent Postmenopausal Bone Loss”, Annals of Internal Med., January 15, 1994;120(2):97-103.
- Bronner, Felix, Calcium and Osteoporosis”, American Journal of Clinical Nutrition, 1994;60:831-836.
- Kidd, Parris M., Ph.D., “An Integrative Lifestyle: Nutritional Strategy for Lowering Osteoporosis Risker Townsend Letter for Doctors, May 1992; 400 – 405
- Steinberg, Karen K., Ph.D., MSc, et al, "Meta-Analysis of the Effect of Estrogen Replacement Therapy on the Risk of Breast Cancer", JAMA, April 17, 1991;265(15): 1985 – 90
- Hendler, S., The Doctors’ Vitamin and Mineral Encyclopedia, Simon & Schuster, New York, 1990
- Sanchez-Guerrero, Jorge, M.D., MSc, et al, "Postmenopausal Estrogen Therapy and the Risk for Developing Systemic Lupus Erythematosus", Annals of Internal Med., March 15, 1995;122(6): 430 – 433
- "Premarin – Pregnant Mare’s Urine" Good Medicine, Spring 1994;9. 11. Dalton, K., Once a Month, Hunter House, Inc., 1980
The Estrogen Alternative: Natural Hormone Therapy With Botanical Progesterone
by Raquel Martin and Judi Gerstung D.C.