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Freedom to Choose a Safer Form of Hormone Replacement Therapy (HRT)
by Catherine P. Rollins

While drug companies, politicians, doctors and health gurus argue what’s in the best interest of women’s health, women themselves are rarely given a voice in the hormonal health debate, an arena that sees women the casualties of exploitation and victims of political agendas.

Women are big business in the healthcare industry. Which explains why female baby boomers are led to believe menopause is a disease that requires synthetic hormone replacement therapy (HRT) for the rest of our lives. Rarely is it clarified that these drugs carry significant side-effects, all too often negating any benefit.

If we’re to offer our bodies to science in the trial of any drug, synthetic or otherwise – as is often the case – it should be with our consent upon full disclosure. We’re told synthetic HRT dosage is safe when individualised, based on a woman’s tolerance to the drug. Nonetheless, HRT makes some of us quite ill. We need and demand a more natural-to-the-body alternative when it comes to hormone replacement therapy.

Estrogen Dominance

Estrogen dominance is a term coined by the late Dr John Lee in his first book on natural progesterone. It describes a condition where a woman can have deficient, normal, or excessive estrogen but has little or no progesterone to balance its effects in the body. Even a woman with low estrogen levels can have estrogen-dominance symptoms if she doesn't have any progesterone.

And how do we become 'estrogen dominant'?

All too often our food chain is laced with toxic pesticides, herbicides and growth hormones – a sea of endocrine-disrupting chemicals that mimic estrogen in our body. If we are overweight, our body’s store of excess fat can be converted into estrogen. Insulin resistance leads to estrogen dominance. A visit to our GP for the odd hot flash or missed period can result in a prescription of estrogen pills, patches or implants.

Men are not excluded here. Estrogen gradually rises with age, while saliva levels of progesteorne and testosterone gradually fall with age. Thus, with aging, estrogen dominance occurs. A clear sign of estrogen dominance in aging men is their tendency to develop breasts. This indicates these men are low in progesterone and testosterone.

And yet unopposed estrogen in our bodies results in all sorts of hormone-related health problems such as PMS, endometriosis, uterine fibroids, infertility, weight gain, increased blood clotting, thyroid dysfunction, even cancer, in both men and women.

Dr Cavalieri, Professor at the Eppley Institute for Research in Cancer and Allied Diseases and his team at the University of Nebraska Medical Centre in Omaha Nebraska are on the brink of discovering that almost all the important human cancers that we get in Western civilisation have the same origin - which is estrogen. Estrogens, according to Dr Cavalieri, are initiators and promoters of cancer.

For women, cancer of the breast and/or in the uterus most often occurs with a progesterone (P) to estradiol (E2) ratio of less than 200 to 1. According to Dr David Zava of ZRT, who has amassed a database of tens of thousands of saliva samples and questionnaires, these cancers occur very rarely in women with a healthy P/E2 ratio.

We know that the micronised progesterone in our jar of cream is bioidentical to the progesterone molecule found in our body, making it extremely safe to self-medicate, is non-toxic, and has no recorded side-effects. It’s the drug of choice for women (and men) looking to offset estrogen dominance which, as we’re learning, can represent a potentially life-threatening state of hormone imbalance.

The Politics of Progesterone

The Australian Therapeutic Goods Administration (TGA) has classified Progesterone an S4 drug, available only on prescription. Anyone using progesterone, whether in the form of a cream, troches, drops, pessaries or orally without a doctor's prescription is using it illegally.

Regardless of its good safety record and extremely low toxicity, and its uses in women's cosmetics and moisturises in the United States over many years, progesterone is tagged an 'S4 poison' because of the category it falls under rather than its drug characteristics.

Problems arise when women are forced to track down a collaborative doctor who's willing to write a prescription ... and then track down a source for cream.

For example, Lawley Pharmaceuticals, located in Western Australia, manufacture a high-grade progesterone cream that is, paradoxically, only available to women within the state of Western Australia. Any woman ordering cream in from the Eastern states, even with a doctor’s prescription, is breaking the law!

Women in all Eastern states of Australia must be content with creams formulated by a compounding pharmacist, only a handful of which have cultivated the skills and training in compounding customised medicines using traditional skills, advanced techniques and specialised knowledge.

While regulatory laws on natural progesterone exist in the UK, Canada, New Zealand and Australia, a doctor's prescription is NOT required in countries such as the USA. Natural progesterone creams can be legally sourced through whatever channels available - over the counter, via marketing distributors, or on-line over the internet. So, for the time being anyway, a US drug law does not apply to progesterone usage.

There have been rumblings, however, that America's Food & Drug Administration (FDA) will, in the next five years, impose changes to current drug law, restricting ad-hoc marketing of creams. The consequence of this decision will possibly push distribution underground and compromise the manufacture and cost of quality controlled progesterone creams. Pretty much the scenario forced upon Aussie women.

Whether we order cream in from overseas or via a local compounding pharmacist, the retail price per tub of cream is prohibitive at roughly A$50 per unit. But this wasn’t always the case. Prior to seizure of all commercially distributed progesterone creams in Australia in December 1997, the price of a tub of cream was at least A$20 cheaper. This considerable price hike pushed cream further out of reach of so many women who relied on progesterone to maintain optimal hormonal health. Once again, women lost out big time!

Here's the rub, though. Women need a script to get acces to bioidentical progesterone replacement therapy but our doctor's flatly refuse to prescribe it, despite empirical evidence collected over several years suggesting its a safe, non-toxic alternative to synthetic HRT.

It's unfortunate, but a fact nonetheless, women who need a script will get it any way they can, including a visit to doctors who take their money but offer no support or education. This is a real concern when women sneak around behind their own doctor's back, accept treatment that may be contraindicative of progesterone usage, perhaps unable to tell their doctor the full story, all of which has the potential to end badly.

Wild Yam Scammers

Pharmaceutical companies and politicians aren't the only ones guilty of exploitation of women. A good example would be the growing popularity of Wild Yam Extract creams. Word has caught on that progesterone, derived from Wild Yam Extract (Dioscorea Villosa) is restoring women's health.

Manufacturers of Wild Yam creams, unable to get access to USP (United States Pharmacopeia) grade progesterone, have sold women the notion that diosgenin, in its 'natural' Wild Yam state, can be converted into progesterone in the body. These claims fly in the face of the facts - that this is physically impossible because there's no enzyme in the body to take up disogenin. Diosgenin first needs to be 'synthesised' in the laboratory to render it identical to the human hormone. (Many of our modern steroids are manufactured from diosgenin extracted from them. Drugs like birth control pills are affordable due to this genus).

These Wild Yam creams that contain absolutely no USP progesterone are sold through health food outlets and by naturopaths as complying with Dr John Lee's protocol and research on progesterone. This simply isn't true.

According to the publication 'Herbal Medicine, Principles and Practice of Phytotherapy, Modern Herbal Medicine' "claims have arisen in the popular literature that the female body can manufacture progesterone from diosgenin, particularly if a wild yam cream is applied to the skin. No evidence exits for mammalian enzymes which are capable of effecting what is a difficult chemical conversion. The evidence that does exist strongly disputes the possiblity of this conversion. In fact, diosgenin appears to have estogenic properties in mice and lacks progesteronic effects."

Bioidentical, natural-to-the-body progesterone is not produced anywhere in the plant kingdom. Bioidentical progesterone is manufactured in a laboratory with the aid of an enzyme. The substance diosgenin, found in the Mexican Wild Yam or Soy plants, has to undergo a series of chemical changes whereby it is synthesised or converted from its raw state into United States Pharmacopeia (USP) grade progesterone.

And this confusion is not limited to lay women. Members of the medical fraternity, when arguing vehemently against the efficacy of progesterone, constantly make reference to homeopathic Wild Yam creams containing diosgenin.

Natural progesterone creams are referred to as ‘natural’ because the end result represents the same molecule naturally occurring in the body. It is chemically identical to progesterone of ovarian origin.

Doctors Don't Want to Know

The question is whether doctors are getting balanced information or just promotional material from the pharmaceutical companies.

As a patient, I know that a Wild Yam Extract cream containing 'diosgenin' is not a precursor to progesterone in the body. And that a synthetic progestin analogue such as Provera (medroxyprogesterone acetate) is a molecular modification beyond bioidentical progesterone. But most physicians do not. They derive their knowledge of drugs from pharmaceutical companies who, for obvious reasons, focus their marketing pitch on patented products only - such as synthetic HRT and the contraceptive pill.

Natural progesterone is referred to as ‘natural’ because it represents the same molecule naturally occurring in the body. It can be introduced into the body with relative safety and minimal side effects because the body recognises it.

And it's because progesterone is classified a naturally occurring medicine, drug companies cannot slap their logo on it, brand it as their own 'exclusive' product, and generate commercial application.

This lack of financial incentive for drug companies to inject millions and millions of dollars into research, development and marketing of a drug they cannot 'own' means progesterone is then overshadowed by its synthetic cousin - progestin - not because it's less effective but because, to these multi-national drug companies, biological progesterone represents a dodgy investment.

The 1995 PEPI (Postmenopausal Estrogen/Progestin Interventions) trial, a three-year multi-center, double-blind, placebo-controlled trial sponsored by the National Institutes of Health (NIH), clearly demonstrated that natural progesterone actually works better than synthetic progestin in terms of protecting the heart, and that natural progesterone can protect against uterine cancer as well as synthetic progestin. Yet, inexplicably, this message has not yet reached the medical community.

Chemically-altered hormones can shut down or reduce our production of natural hormones. Because the molecules have been changed, the synthetic hormones used in the Contraceptive Pill and HRT do not have the same effect on the mind and body as our natural hormones do. In fact, many of the effects of synthetic hormones are the exact opposite to the natural hormone they so ineptly replace.

It's quite obvious some doctors really struggle to come to grips with what exactly bioidentical HRT is, and why incorporating salivary hormone profiles offer more accurate results than blood tests. A flow on from this is that women often cop a 'dressing down' when they approach their GP requesting a prescription for progesterone and that a baseline hormonal profile be established using salivary assays.

Doctors are encouraged to prescribe a potentially harmful drug (which may cause and promote cancer), but see absolutely no reason why they ought to remain open-minded (at least!) to a safer alternative - progesterone - which may actually prevent cancer!

Some of us may manage to convince our GP to write a script, and go so far as to order a saliva hormone profile kit, but then our doctor leaves the interpretation of symptom relief and saliva assays reports, dosage adjustment, etc., up to us - the patient! We may as well revert back to the days when we sourced our cream through healthfood stores or MLM distributors which, of course, did not include hefty GP consultation fees and a 50% hike in the price of cream!

Technicially we're not self-medicating. We've elicited the cooperation of our GP required to legally obtain progesterone thereby meeting the guidelines set down by the TGA. But why aren't these same doctors monitoring our progress? Are they capable of monitoring our progress? Evidently not
Most doctors want nothing whatsoever to do with 'bioidentical' hormones, preferring instead to stick to tried and tested drugs they're more familiar with, resulting in a 'stand-off' between women and their family doctors.

In light of the recent US and UK findings that conventional HRT, once prescribed to millions of women to ease the immediate symptoms of menopause and to prevent osteoporosis and heart disease, has been found to increase the risk of heart disease, cancer and blood clots, and perhaps has legal implications for the manufacturers of HRT drugs, doctor would be well advised to embrace every opportunity to actually listen to the women who are using natural progesterone and who are not only getting well, they're remaining healthy (and happy) long term!

About the Author:

Catherine P. Rollins is the author of 'A Woman's Guide to Using Natural Progesterone' and Director of the highly popular website:

This article was syndicated from The Natural Progesterone Advisory Network:


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