Regarding Progesterone Cream
by Dr. Joseph Mercola
If one has not read Dr. Lee’s books on What Your Doctor May Not Tell You
About Premenopause and What Your Doctor May Not Tell You About Menopause, I would
highly recommend them. These books are classics and should be in everyone’s
natural medicine library. Progesterone cream has been one of the most important
supplements I have ever used in my practice.
I have come to a recent realization regarding the use of these creams. Most women
in our culture are estrogen dominant, so using the progesterone goes a long way
towards balancing hormones which usually decreases a woman’s risk for breast
cancer, improves her PMS and breast tenderness and normalizes her cycle. Like
most good things in life if one uses too much of the hormone cream, complications
can develop in disruption in one’s hormone balance.
Dr. Lee is fond of using the lower dose creams to avoid this. But this complication
can still occur with the low-dose creams. I always attempt to provide the most
cost effective solution in my practice so I use prescription strength 10% cream.
Theoretically, there is no problem with this if one uses it as directed. There
is a huge cost savings as this concentration is able to get the cost down to
$3 per month. However, if one uses more than 1/16 of a teaspoon, complications
appear to be inevitable.
The problem relates to the fact that progesterone is highly fat soluble and once
applied to the skin will store itself in a woman’s fat tissue. When one
first uses the cream, there is no problem here as the fat stores are very low.
But as time goes on, the cream accumulates and contributes to disruptions in
the adrenal hormones such as DHEA, cortisol, and testosterone. I have learned
that although progesterone cream is an enormously useful tool, it needs to be
used very cautiously.
I have also learned that it is FAR MORE IMPORTANT to work to normalize the adrenal
hormones first. Once the adrenal hormones are balanced, the progesterone levels
will frequently normalize and one will not require any cream. The wonderful thing
about adrenal normalization is that it usually only takes 3-6 months to balance
these hormones. Once they are balanced, one usually does not require any hormone
supplements to keep them balanced.
The balancing process involves lifestyle changes first. If you haven’t
already guessed it by now, the diet at Read This First on my home page www.mercola.com
is the first step. Secondly, one needs to get to bed by 10 PM. This is an essential
part of the process. If one is routinely going to bed after 10, then one’s
biorhythms will be disrupted. Addressing emotional stress in one’s life
is the other huge component. I believe that the therapy we are now offering in
with Applied Psychoneurobiology, APN, (see the article section on my web site)
is one of the most effective tools for this. APN clearly is not the only way
to address this and there are many other wonderful approaches out there. Journaling
is one of the better and least expensive ones, but there are many other approaches
Once the lifestyle issues are addressed, then one would ideally evaluate the
adrenal and female hormones. One of the better ways to do this is though measuring
salivary hormone concentrations. I had been using Aeron Labs, and they do good
work. Dr. Zava used to run it and now he runs his own company, which is also
a fine lab. However, I have recently been introduced to BioHealth Diagnostics
(800-570-2000) and I am hugely impressed with their services. They hold regular
seminars and are even having one this weekend in San Diego. I would have loved
to attend, but I am still catching up from my earlier learning tour. They also
hold weekly phone seminars for health care professionals, which are excellent.
I really believe they have a huge jump on the other labs as they run multiple
samples to make these measurements. One can certainly perform the same test at
other labs, but the bill for all the samples would literally by two to three
times as expensive. The other labs also do not have an educational component.
They have a wonderful clinician, Dr. Dan Bivens, who walks the health care professional
through proper evaluation of the test results.
Once the results are in, the hormonal manipulation generally involves using sublingual
hormones such as DHEA and pregnenolone or cortisol improving agents such as licorice
root extract. The exact dosage, timing and use are determined by the results
of the test. The absolutely incredible aspect of this testing and treatment strategy
is that it recalibrates the brain and helps the body to start making the hormones
by themselves so one is not stuck on hormone treatment for the rest of their
Getting back to progesterone cream, I have been finding that many of the women
who were on the cream have terribly elevated levels of this hormone. This is
not good. Progesterone is normally a cyclical hormone and the body really needs
to see a change in the concentration to affect a proper physiological response.
If the level is constantly above the concentration that it recognizes as "off" or
low, this is not possible. Fortunately, this is repairable. But it may involve
going off the cream for as long as two years to wash the progesterone out of
I am still in an evaluation stage and learning about how common this is in my
own practice as I have just started using this system for the past month. At
this point, I am relatively convinced that this is a big part of the picture
for hormone replacement.
If you are a health care professional and dispensing or recommending progesterone
cream, I would recommend you contact BioHealth Diagnostics for an information
kit. If you are not one of my patients, you can contact them for a health care
professional in your area. If you are one of my patients, there will be a huge
shift in the way that we are administering the dispensing of progesterone cream
in our office. We will not dispense any cream at this point without a proper
evaluation of one’s adrenal and female hormones. This will be done through
salivary hormone testing. This test is usually covered by one’s health
insurance. This will allow me to normalize and restore the finely tuned hormone
balance that one’s body is designed to have, rather than blindly slapping
on progesterone cream without any appreciation of the potential complication
or hormone disruptions.
Natural progesterone is the exact same hormone that is produced by a woman's
ovary. It is made from naturally occurring plant steroids found in the wild yam.
It is NOT the synthetic version that is commonly purchased as tablets with a
prescription such as Provera. The synthetic progesterone can produce severe side
effects including increased risk of cancer, abnormal menstrual flow, fluid retention,
nausea, and depression. Side effects are extremely rare with natural progesterone.
The only one of concern is that it might slightly alter the timing of the menstrual
Reasons Why Natural Progesterone Made by Your Body Is Good
Natural progesterone is very useful to balance excess estrogen. Natural progesterone
is also different from estrogen in that your body can use it as a precursor or
starting material to make other hormones such as adrenal hormones. It can even
convert it into estrogen or testosterone if your body needs it. The table on
the next page lists the properties of estrogen relative to progesterone. Some
of the reasons that estrogen is frequently in excess in many women are:
1. Over production of estrogen. Ovarian cysts or tumors can lead to excess estrogen
production. Stress also increases production, but probably the most common cause
is obesity. All body fat has an enzyme which converts adrenal steroids to estrogen,
so the more fat you have, the more estrogen is present.
2. Inability to breakdown estrogen. Excess estrogen is generally removed by the
liver. Diseases of the liver like cirrhosis or decreased enzyme activity can
lead to increased estrogen levels. Vitamin B6 and magnesium are necessary for
the liver to neutralize estrogen. Increased sugar intake will also excrete magnesium
and interfere with its ability to breakdown estrogen.
3. Exposure to pesticides in foods. Most of us eat foods that have pesticides
on them. These and many other unnatural chemicals share a common structure with
estrogen and serve as "false" estrogens which further stimulates the
body's estrogen receptors.
4. Estrogen supplementation. Clearly any additional estrogen given by prescription
will increase the level unless it is properly balanced with natural progesterone.
5. Decreased production of progesterone. Progesterone is necessary to counterbalance
estrogen. If women do not ovulate during their cycle they will not produce any
progesterone that cycle. This happens commonly and worsens the already disturbed
For More Detailed Information on Natural Progesterone: You can purchase What
Your Doctor May Not Tell You About Menopause by Dr. John Lee. It is paperback
book for $13 and was published in May of 1996 and the newer version What Your
Doctor May Not Tell You About Pre Menopause published in 1999 with a blue cover.
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