Natural Hormone Replacement. Which School Should You Embrace: “Normal Aging” or “Keep Hormones Normal?” [Progesterone)

Currently, the only FDA approved prescription for bio-identical natural progesterone is Prometrium. It is not for patients who have peanut allergies, since the round hormone capsule is in a peanut oil base.

Bio-identical progesterone is also available from pharmacists who have had special training in making medications. A skill that was routine in past decades. The powders used are high quality USP FDA approved powders, and can be made into capsules, transdermal creams of many varieties, sublingual tablets and some physicians are researching placing hard pellets under the skin. My father has used natural progesterone with great success for over 40 years as an OB/GYN with advanced skills in biochemistry.

The article abstracts below address the use of another type of product. The use of progesterone creams which have a low dose and are able to be purchased without a prescription.

"Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an underground dictatorship ... To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un-American and despotic and have no place in a republic ... The Constitution of this republic should make special privilege for medical freedom as well as religious freedom."

Dr. Benjamin Rush, signer of the Declaration of Independence


Effect of sequential transdermal progesterone cream on endometrium, bleeding pattern, and plasma progesterone and salivary progesterone levels in postmenopausal women.

BACKGROUND: Transdermal progesterone is being used in some countries as a purported treatment for menopausal symptoms, either alone or prescribed in conjunction with estrogen, but little information exists regarding the biological activity and effectiveness of this method of delivery of progesterone in protecting the endometrium from excess proliferation. This study was designed to evaluate the use of sequential transdermal progesterone. End-points evaluated included endometrial cellular response and bleeding pattern as well as plasma hormone levels and salivary progesterone estimations. METHOD: Twenty-seven postmenopausal women were treated with continuous transdermal estrogen (28-day cycle) and a cream containing 16, 32 or 64 mg of progesterone in each 4-cm extrusion from a tube of Pro-Feme administered daily in a sequential (days 15-28 of cycle) regimen. Blood and endometrial samples were analyzed for progesterone response prior to therapy, after the first 14 days of unopposed transdermal estrogen and following 14 days of transdermal progesterone. Saliva samples were taken during the last 14 days of the 84-day study, when the final progesterone cream therapy was being applied. RESULTS: Hormone assay indicated that physiological levels of estradiol were achieved, but progesterone levels were insufficient to induce any detectable change in the endometrium. Only one patient experienced bleeding during the study period. Levels of salivary progesterone were so variable as to be considered completely unreliable in determining the potential influence on biological activity. INTERPRETATION: Pro-Feme transdermal progesterone administered in a 16-, 32- or 64-mg daily dose for 14 days in a sequential regimen does not appear to be effective in inducing a secretory change in a proliferative endometrium. Salivary progesterone levels were not of value in managing the therapy of postmenopausal women.

Climacteric. 2000 Sep;3(3):155-60.

Wren BG, McFarland K, Edwards L, O'Shea P, Sufi S, Gross B, Eden JA.

Thoughts On This Useful Study

  1. First, most woman using natural hormones in menopause do not add any type of natural estrogen. Many have fat that makes estrone, which becomes estradiol. If they add any type of estradiol or estriol (weak pregnancy estrogen) it is usually a low dose. If one adds estrogen, then one needs even more progesterone.
  2. The low dose progesterone used in this study appears similar to many over the counter progesterone creams which do not require a prescription. This low dose product did not achieve useful levels.
  3. Dr. Schaller has tried many different saliva tests. He knows some physicians that feel they are credible. However, this staff have struggled to get meaningful and reliable saliva levels. These authors also did not find saliva testing useful.
  4. Many physicians use progesterone in postmenopausal women most days of the month. My father thought it might induce a hormonal atrophy of the uterine lining, which would be less likely to get cancer. The merits of this thinking are not something these authors or I will address.

Bolding and enlargement by Dr. Schaller

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