For Prostate Health
By James South,
middle-aged and older men, especially
those over age 50, prostate problems
are an unpleasant fact of life. It is
estimated that half of men in the 50-plus
age group suffer from benign prostatic
hyperplasia (BPH), an abnormal enlargement
of the prostate gland.1
This swelling of the prostate usually manifests as urinary problems: urinary
frequency, urinary hesitation, reduced urinary flow, etc. The prostate gland
is also the most common site for cancer to develop, with over 300,000 new cases
in the U.S. in 1996.1 The medical establishment places the blame for these prostate
problems on the male hormones testosterone (T) and dihydrotestosterone (DHT),
yet this belief generates an obvious paradox. The highest levels of T/DHT occur
in young men, and T/DHT levels drop with aging. Yet prostate problems are almost
non-existent in young men, while they increase with age, affecting 90 percent
of all men by age 85, when T/DHT levels are extremely low.2
The Estrogen Connection
An important determinant of male hormonal health is the testosterone/estrogen
balance (T/E). Healthy male physiology depends on a high T:E ratio. Although
testosterone is the “male hormone,” men naturally produce small amounts
of estrogen from testosterone.3 With aging, the T:E ratio drops, often dramatically.
An enzyme called “aromatase,” especially prevalent in fat cells,
converts testosterone to estrogen.4 Since most men lose muscle and gain fat as
they age, aromatase activity increases, reducing testosterone even as it increases
estrogen. Many scientists have commented on the importance of estrogen and the
T:E ratio in promoting prostate problems. M. Krieg and colleagues note “…numerous
experiments indicate that estrogens might also be involved in the abnormal growth
of the human prostate.”5 “The data in this communication show a clear-cut,
direct biochemical effect of estrogens on the human prostate and provide a cellular
mechanism by which estrogens may affect prostatic physiology [negatively].”2
In a review on benign prostatic hyperplasia (BPH) and estrogen, W. Farnsworth
reports that “…the induction of BPH is shown to be determined by
the androgen [T+DHT]/estrogen ratio….”6 S. Boehm and coworkers conclude
that “… estrogen suppression may be considered an efficient pharmacotherapeutic
strategy in the medical treatment of uncomplicated benign prostatic hyperplasia.”7
Progesterone to the Rescue
Most people think of progesterone as a “female hormone.” Yet men
normally produce progesterone as well, in both their adrenal and testicular tissue.8
Unfortunately, male progesterone levels drop with aging, just as do male testosterone
levels.4 Severe, prolonged stress also depletes progesterone, since the “state-of-siege” stress
hormone cortisol is made from progesterone, as are testosterone, estrogen, aldosterone
and other steroid hormones.8
And as researcher Ray Peat emphasizes, one of the most important roles for progesterone
is to oppose the many toxic effects of excess estrogen.9 Progesterone expert
Dr. John Lee noted multiple roles for progesterone in antagonizing estrogen and
promoting prostate health.
Progesterone inhibits the conversion of testosterone to DHT.4 DHT is a weaker
androgen than testosterone, and thus lowers the androgen/estrogen ratio in favor
of estrogen. In addition, DHT is a far more potent stimulant of prostate cell
growth than testosterone.4 Both testosterone and progesterone stimulate
the activity of a protective gene called “p53.”4 The products of
this gene activation are anti-cancer, and promote healthy apoptosis.10 Apoptosis
is a “programmed cell suicide” that plays a key role in preventing
cellular overgrowth (e.g., BPH) and cancer.10 Estrogen, on the other hand, activates
a gene called “bcl2.”4 Bcl2 products inhibit healthy apoptosis.10
Progesterone may even help with prostate cancer. V. Petrow et al reported results
of their study with rats and prostate cancer in 1984. “Growth of the Dunning
R 3327-H prostatic adenocarcinoma, implanted in the rat, is inhibited by 6-methylene
progesterone. This compound is a potent inhibitor of rat prostatic 5-alpha-reductase
[as is progesterone; 5-alpha-reductase is the enzyme that converts testosterone
to DHT] and in-vivo produced marked involution [shrinkage] of the prostate. Thus,
this tumor requires dihydrotestosterone and not testosterone for growth.”11
Andrews and colleagues also
note: “Another steroid hormone that interacts with the androgen receptor
in LNCaP [prostate cancer] cells (progesterone) also promotes apoptosis of these
Progesterone for Men
Dr. John Lee has recommended a dose of approximately 4 to 6 mg once or twice
daily for men in their late forties or older.4,13 Approximately 6 mg can be achieved
with one-eighth level teaspoon of a cream containing 900 to 1,000 mg progesterone
per 2 ounces. The cream should be rubbed onto thin skin areas such as inner forearm,
chest, neck or scrotum morning and/or evening. Do not exceed the recommended
Progesterone therapy is especially relevant for obese men; those with a family
history of prostate cancer; those with proven low androgen/low progesterone/high
estrogen levels. Progesterone may reduce fertility in men,14 and it is to be
avoided by men with nonalcoholic liver cirrhosis.15
1. Wright, J. and Lenard, L. Maximize Your Vitality and Potency, Petaluma, CA:
SMART Publications™, 1999: 158.
2. Nakhla, A. et al. “Estradiol causes the rapid accumulation of cAMP in
human prostate.” Proc Natl Acad Sci USA 1994, 91: 5402-05.
3. Kutsky, R. Handbook of Vitamins, Minerals and Hormones, NYC: Van Nostrand
Reinhold, 1981: 418-19.
4. Lee, J. “Prostate disease and hormones.” The John R. Lee, M.D.
Medical Letter Feb. 2002.
5. Krieg, M. et al. “Effect of aging on endogenous level of 5 a-dihydrotestosterone,
testosterone, estradiol, and estrone in epithelium and stroma of normal and hyperplastic
human prostate.” J Clin Endocrinol Metab 1993, 77: 375-81.
6. Farnsworth, W. “Estrogen in the etiopathogenesis of BPH.” Prostate,
1999, 41: 263-74.
7. Boehm, S. et al. “Estrogen suppression as a pharmacotherapeutic strategy
in the medical treatment of benign prostatic hyperplasia: evidence for its efficacy
from studies with mepartricin.” Wien Klin Wochenschr 1998, 110: 817-23.
8. Kutsky, op. cit. 427-28.
9. Peat, R. Progesterone in Orthomolecular Medicine Eugene, OR, 1993: 4-6.
10. Hetts, S. “To die or not to die: an overview of apoptosis and its role
in disease.” JAMA 1998, 279: 300-07.
11. Petrow, V. “Endocrine dependence of prostatic cancer upon dihydrotestosterone
and not upon testosterone.” J Pharmacol 1984, 36: 352-3.
12. Andrews, P. et al. “Dihydrotestosterone (DHT) modulates the ability
of NSAIDs to induce apoptosis of prostate cancer cells.” Cancer Chemother
Pharmacol 2002, 49: 179-86.
13. Mercola, J. “Progesterone cream can help prostate cancer.” 1998.
14. deLarminat, M. and Blaquier, J. “Effect of in vivo administration of
5 alpha reductase inhibitors on epididymal function.” Acta Physiol Lat
Am 1979, 29:1-6.
15. Farthing, M. et al. “Progesterone, prolactin, and gynecomastia in men
with liver disease.” Gut 1982, 23: 276-79.