Dr James Schaller
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Natural Hormone Replacement:
Feel Better, Be Safe, & Understand Your Body

PMS, Perimenopause and Menopause Treatment
Breast/Uterine Cancer Prevention
Osteoporosis Prevention

*I will go through talk first for those who have to leave.

*Yet, if a point or word is unclear I will try to make clearer.

*I will stay after talk to make sure Your questions and concerns as time allows.

But please realize this is a challenging subject at first. Once you have some basics down you can learn and come to your own conclusions. You may feel confused the first few times you look at this material --

Learning This Subject is a Process.

Also, expect traditional Surgeons to take the opposite position at times.

Sample Person--Linda

Linda is in her 40's and feels that something is wrong with her. She discussed it with her family doctor and GYN and they suggested "the pill," a hysterectomy, or said she "was fine." She felt rushed and unheard. She tried some herbal products and felt 30% better. But she is not sure why.

Linda said bluntly, "I feel I have the 5 B's"

"What are they," I asked. Almost afraid of the answer.

"I feel bloated, bitchy, bleed excessively, my breasts are tender, and sometimes my face breaks out... Oh, and by the way, my sex drive is meager and if I eat nothing but lettuce I still gain weight."

Do YOU know why this happens to Linda?

Number one killer of woman aged 45-50 is breast cancer

Our PMS success rate so far has been very high, better than any anti-depressant drug.

"It is so controversial. I just don't know who to trust. My GYN & Family Doctor say one thing, and other things I hear about say the opposite. They are nice doctors but it is not like they are going to spend an hour or two just with me about my questions. I want to be healthy for many decades. But who can I trust?" Linda explains.

The Basics of The Menstrual Cycle & Changes Over Time.

Estrogen -- makes primitive basic breast and uterus tissue.

Progesterone -- makes the primitive "blobs" of tissue into more complex developed tissue. It takes lumps of primitive paint and makes a painting. Developed tissue is less likely to be cancerous.

Estrogen retains fluid in your body and brain. You feel Enormous. Progesterone makes you Pee off excess water. Peaks at 32-35 y/o according to some researchers and clinicians.

The Average Routine Menstrual Cycle

First Half of Cycle -- estrogen makes crude lining of uterus

Mid-Cycle--spike of estrogen (reason some feel bloated for 24 hours)

Second Half of Cycle -- progesterone develops the uterine lining for a potential fertilized egg

--progesterone makes special curly blood vessels that allow for small blood loss when they break.

Problems in Ideal Cycle

PMS 1 -- the serenity hormone, progesterone, falls much earlier than estrogen and you have tons of excess estrogen retaining fluid, making primitive tissue, and bloating you. Feel better when period starts. MOST WOMEN. "Estrogen Dominant."

PMS 2 -- women with very low body fat. When period starts the estrogen falls super low because no fat estrogen. I have 18 y/o women with Dexascans showing bone loss. Not trivial.

Perimenopause -- ovary sputters out estrogen so levels change every day. Large fluid shifts and hot flashes. Happens in thirties for at least 5% of women. 5% are in Menopause at 40! Can last many years.

Menopause -- no period for a year. Patients all have worthless levels of progesterone and often other hormones, e.g., usually trivial testosterone and low "normal" thyroid from 35-40 on. Yet have to test levels to be certain and to tailor to each person.

Bio-identical Progesterone grows bone, helps sleep, relaxes and helps reduce breast lumps and eccentric growths in the uterus according to many clinicians.

Bio-identical low dose Testosterone grows bone, appears to improve circulation, etc

Estrogen primarily prevents bone loss, etc.

Natural Bio-Identical Hormones and Synthetic

HRT -- "hormone replacement therapy." A meaningless expression because used of too many things and things entirely unrelated.

Xenoestrogens -- This means foreign estrogens. DDT is most famous, but thousands exist. Some in food, home products, herbicides. Xenoestrogens are higher in breast cancer tissue. The case of the plastic tubing: estrogen from ovaries (estradiol) was added to breast cancer tissue in one dish and water was added to the other tissue sample. Both grew significantly. The point? It seems the medical plastic tubing gave off a faint amount of a powerful synthetic estrogen or Xenoestrogen that made the tissue grow.

Progesterone vs. Progestin -- work very differently. For example, progesterone is what your body makes and it increases fertility. Progestin is synthetic and decreases fertility.

The Pill -- a synthetic strong estrogen and a synthetic progestin. It decreases testosterone and impacts thyroid. Do not use unless you read at least 3 handouts on them. Often shrinks wild endometriosis tissue (which is uterus tissue out in the belly), and stop fibroid bleeding. Sometimes various synthetic hormones are needed to strongly shut off endometriosis growth. Simply, sometimes it is surgery or them for this condition. Research this year reports increased cancer, stoke and heart attacks with synthetic progestin. Past research showed the same thing with synthetic estrogen alone or natural estrogen without progesterone, according to many studies and clinicians. Surprisingly, some researchers are taking another look at synthetic estrogens again, which many felt caused unchecked growth when given alone.

Premarin -- a commonly used pill, which is derived from pregnant horse urine and used for decades. According to the manufacturer and known by very few physicians is that it contains over 200 different substances. My research shows some are known cancer agents.

Prempro -- Premarin plus Provera. Provera is a synthetic progestin.

Cenestin -- a curious attempt to be "natural" and not get the hormones from horse urine. Unbelievably, the lab folks actually made some horse hormones and included them in this mix of estrogens. Side Effects: Headache 68%, Insomnia 42%, Nervousness 28% etc.. I want their marketing dept.

Estratest -- estrogen plus a synthetic testosterone called methyltestosterone. Adding the methyl part means the liver must work harder. Some doses increase liver cancer.

Prometrium -- an FDA approved natural progesterone in a peanut oil base with fair absorption.

  1. Basic Common Treatment for PMS -- Good B Complex, Omega 3 fish oil, natural progesterone morning and bed before your period -- could be for 2 weeks or for 5 days before period, magnesium for spasms and headaches, multi-vitamin. We see better success than using antidepressants like Sarafem, Prozac, Zoloft, etc. for 2 weeks a month.
  2. Basic Perimenopause Treatment -- Plant estrogens from diet and supplements like Soy and Red Clover (handout has food list). Standardized Black Cohosh. If breast lumps consider adding Vitex or chasteberry. Progesterone am and bed from day 13 till 30 or bleed.
  3. Basic Menopause Treatment -- progesterone am and bed every day of the cycle. This will make your uterine lining thin so you are less likely to get uterine cancer. Other hormones are usually added but are very tailored to each person. One size never fits all. It is like a dress.

Is Non-Emergency Preventive Medical Care A Subspecialty?

A Growing Minority of Thousands of physicians feel that preventive medicine is such a huge area, that you will just do fair work without extra training and study. American medicine is great at acute emergency care, but our chronic disease and death rate needs major improvement. Former editor of JAMA says not getting the results from all the money we spend in his book.

Other Sample Treatment Options for PMS, Perimenopause and Menopause which are Often Used to Fit You Uniquely

  1. DIM or Indoplex -- plant derivative which converts cancerous 16 fat estrogen into safe 2 fat estrogen.
  2. Low dose bio-identical Thyroid for "40's drift." Common and basic Thyroid lab screens will not catch low normal levels where you are tired with a lower mood. A good test is a free T3 level and a check for antibodies against your own thyroid. These antibodies make basic labs look OK--but the thyroid is useless.
  3. Bio-identical Testosterone -- men use 10-400 mg while I use 1/2 to 2 mg for women. Some reports of its benefit in growing bone, increasing resilience, increasing blood flow to the heart and other organs and helping libido. Eugene Shippen has a good book on this hormone and Jonathan Wright also has a good one. Many exist currently, where merely a dozen a few 5 years ago.
  4. Tiny Doses of Bio-identical Estrogen -- We sometimes use very tiny doses of Bi-Estrogen or "Bi-Est." This is a combination of your ovarian estrogen (E2) and your pregnancy estrogen (E3). Like all bio-identical hormones, this comes from plants and matches your own estrogen. Some research suggests that pregnancy estrogen (estriol or E3) reduces cancer and it is mild. As a trend, if you feel bloated the dose is too high or not enough progesterone.
  5. First we get you feeling better, then we make it as simple a program as possible. If too intense most people will cut back even if feeling good! For example, once you are satisfied with how you are feeling we often combine most of these into one cream.

    NDF -- a fragmented chlorella product that removes toxic metals. See article on my website and the Internet. Some preventive medicine physicians like this substance, especially when the chlorella is pulverized into small fragments to grab more heavy metals.

    No fasting -- Try to eat every 3 hours even if just a piece of fruit. When we test blood levels of active non-diabetics, it is common to see their blood sugar fall 4 hours after lunch and before their late diner. They are trying to get in as much work as possible before leasing and "leaving" their blood sugar in the gutter. Such eating habits make hormone issues worse. Some researchers feel that if your sugar falls it makes your thyroid levels slightly less and progesterone may not work as well.

    What about DHEA and Human Growth Hormone? I do not believe they are ever starting hormones. First, because DHEA can become things you do not want it to become -- like hormones that bloat or cause acne. And Growth Hormone is a tiny subcutaneous injection and is not cheap. I believe it should never be the first hormone added when replacing declining hormones.


    Do not assume anything I say is approved by the FDA, AMA, any State Board or is the "Standard of Care" anywhere. It is merely what I would suggest for my relatives. Do not self-treat based on this material and only treat yourself under the supervision of a fully licensed medical practitioner.

Bank Towers, Tamiami Trail, Naples, FL
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