Menopause, Hormone Replacement Therapy, HRT, estrogen, progesterone, Estrogen replacement therapy, ERT, excess estrogen theory, functions of progesterone

Alternative Medicine for Menopause

The Role Of Progesterone In Menopause

Some doctors question the medically prevalent hypothesis that bothersome menopausal symptoms are a reflection of estrogen deficiency. It is a question of progesterone deficiency, leading to a relative excess of estrogen, they contend. Chief among the proponents of "excess estrogen theory" is Dr. John Lee, author of " What Your Doctor May Not Tell You about Menopause." Many doctors do not agree with the theory put forward by Dr. Lee; but it is worthy of further examination.

The proponents of excess estrogen theory argue as follows:

First of all, women continue to produce estrogen throughout life, at levels that approximate 40-60 percent of the amount that they produced in their twenties. (no argument here.)

Progesterone production, on the other hand, often drops to levels lower than in men after menopause.

To get an idea of the variation of the hormones during a menopausal cycle, please see Hormones And The Menstrual Cycle.

Medical research has focused almost entirely on estrogen, however, neglecting the fact that progesterone has a variety of important functions beyond that of thickening the uterine lining to receive a pregnancy during the child-bearing years.

Functions of Progesterone

It stimulates bone growth

It is a natural diuretic and antidepressant.

It opposes some the effects of estrogen. For example, estrogen causes release of the stress hormone, cortisol, while progesterone neutralizes it; estrogen leads to water retention while progesterone is a diuretic. The ratio between the estrogen and progesterone is critical for the maintenance of homeostasis, or bio- chemical balance.

For a detailed look at the role played by progesterone, please refer to our section on progesterone.

	Menopausal symptoms, osteoporosis, and heart disease may not be due to estrogen deficiency, but to a relative estrogen excess, due to progesterone deficiency.
	The synthetic progestins, like Provera, that are included in most HRT prescriptions do not have the same biological effects as natural progesterone and can create a host of side effects including fluid retention, depression, breast tenderness, cervical erosions, jaundice, blood clotting, and stroke.
	Natural progesterone, on the other hand, has no known side effects. It is also not patentable and therefore of little interest to drug companies, but has been found helpful in shrinking fibroids and alleviating PMS, hot flashes, and other menopausal problems, as well as preventing and treating osteoporosis. And unlike estrogen, its benefits do not seem to be outweighed by risks.

During the perimenopause, progressively more cycles become anovulatory (the ovaries fail to produce an egg). These are characterized by low progesterone production relative to estrogen. These are the cycles accompanied by breast tenderness, decreased sex drive, depression, bloating, weight gain, headaches, and foggy thinking, a sign of progesterone deficiency.

The best treatment, according to Lee, is the use of low-dose natural progesterone cream, which is applied for the last two weeks of the cycle to areas where the skin is thin, such as the face, breasts, inner arms, backs of the knees, inner thighs, neck, or belly. The progesterone is absorbed into the subcutaneous fat and then released into the bloodstream. Such creams vary widely in progesterone concentration. Some have effectively none and others provide 20 to 30 mg in an average daily application of a half teaspoon to a teaspoon.

For some women, the cream may be an effective treatment for hot flashes, bloating, depression, headaches, and other symptoms that Lee believes are due to relative estrogen excess. Using X-ray bone density measurements, he has also found that progesterone is very effective in building new bone and treating osteoporosis. Nonetheless, relatively few large-scale studies on natural progesterone have been carried out.