This is a summary of What Your Doctor May Not Tell You About Menopause, by John R. Lee, M.D. with Virginia Hopkins, 1996, Warner Books. Information from Dr. Lee's Newsletters and Dr. Ray Peat's books is also incorporated. Dr. John R. Lee worked as a family physician until he retired in 1989. This book tells of his years of detective work that started with an experimental use of natural progesterone cream for the treatment of osteoporosis. It lead to the discovery of a whole array of symptoms that result from progesterone deficiency. I strongly urge everyone to read this book. Dr. Lee's this book is available online at amazon.com and at his Web site. Dr. Ray Peat is an endocrine physiologist/nutrition consultant who pioneered the physiological study of progesterone as well as formulation and application of natural progesterone cream and oil. His newsletters and books written for general public can be found at Dr. Ray Peat's Web site. I recommend Progesterone in Orthomolecular Medicine as an excellent Introduction.
For more up-to-date information, read Hormone Balance; a Matter of Life and Health by Kristine B. Klitzke, R.N. 2002, Sound Concepts, Inc. (available online at amazon.com)
Cycle | Estrogen | Progesterone | Related Events |
Day 1, Menstruation | Low | Low | If pregnancy does not take place, the uterine lining is shed (menstruation), and another monthly cycle starts. |
Day 3 | GnRH from hypothalamus stimulates the pituitary to send follicle stimulating hormone to the ovary, initiating follicle (egg sack) maturation and thickening of uterine lining. | ||
Day 10 | Surge to high | Mature follicle releases estrogen to promote thickening of uterine lining and to stimulate the pituitary gland's secretion of luteinizing hormone that induces ovulation. | |
Day 14, Ovulation |
Medium |
Starts to rise | If ovulation fails, Progesterone is not produced. |
Day 24 |
Drops to low level |
Drops to low level |
If the egg is fertilized, progesterone from ovary continues to rise. Any drop in progesterone level results in menstruation or miscarriage. Later during pregnancy, the placenta produces up to 3000 to 4000 mg/day of progesterone . |
Day 1, menstruation |
Low |
Low |
The drop in estrogen and progesterone level triggers menstruation as well as GnRH secretion in hypothalamus. |
After menopause |
estradiol: 15% of premenopausal level |
Low |
Estrogen still produced in fat, muscle and skin cells by converting androstenedione produced in the ovary and adrenals. Low level of progesterone still produced by adrenals and brain. |
Bone loss in pre-menopausal women occurs with progesterone deficiency that results from anovulatory cycles (menstruation without ovulation). Women athletes who train too hard often have anovulatory cycles and develop osteoporosis, indicating exercise alone dose not prevent bone loss.
Progesterone cream combined with some nutritional supplement and moderate exercise is one of the safest, most effective, and logical bone loss prevention/reversal treatment known to date. It is also effective for men who is at risk of osteoporosis after surgically or chemically removing male hormone due to prostate cancer. All other alternatives such as estrogen, Fosamax (a biphosphonate), Evista, calcitonin, and fluoride have limited effectiveness and unpleasant, if not serious, side effects. Fluoride is a potent enzyme inhibitor and causes pathologic changes in bone, making bone brittle. The rest derive their benefits by inhibiting resorption of old bone and loss of calcium. None of them work on formation of new bone. Accumulation of old bone slows down the formation of new bone and make bone brittle by third to fourth year of use.
In general, post-menopausal women produce estradiol at 15% of pre-menopausal level and estrone at 40 to 50% of pre-menopausal level. Estrone is produced mainly in fat cells by converting androstenedione produced in the ovary and adrenals. Estradiol is produced in the gut and lever from estrone. Progesterone helps the body use estrogen better by increasing the estrogen receptor sensitivity. Being a precursor of androstenedione, progesterone supplementation may also help estrogen production. Both estrogen and progesterone, when taken orally, must be processed by the liver and in the process, thickens bile and promotes gallbladder disease. Estrogen pills also increase production of the enzymes renin and angiotensin in the kidneys, which cause an increase in blood pressure. To avoid these adverse effects, patch, cream, or gel can be used.
(Note: A large dose of birth control pills containing synthetic progestins and synthetic estrogen is often used as morning after pills. It's exact effects in blocking pregnancy is not known. One possibility is the toxic effects it has on the ovaries, uterus, and the egg. Both the synthetic estrogen and synthetic progestins used in the birth control pills are toxic and many women experience strong side effects using large dose as morning after pills. Interestingly, the mini pills which contain synthetic progestins alone seem more effective and have far less side effects compared to regular pills which contain synthetic estrogen as well as progestins.) A person trying to use natural progesterone cream to sustain pregnancy must monitor the ovulation and conception closely and start using the progesterone right after the ovulation, and should not stop until the placenta starts to produce progesterone at about the third month. Also, many brands of natural progesterone cream contain herbs, but their effects on pregnancy and breast feeding are not well known. It is best to avoid those products that contain herbs during pregnancy and breast feeding.
Before and around menopause
After menopause Synthetic progesterone (progestins) are NOT progesterone
Major Cause of estrogen dominance/progesterone deficiency symptoms
Estrogen dominance is a condition where estrogen's toxic effects are not countered by progesterone. When there is a progesterone deficiency, a woman experiences a variety of estrogen dominance symptoms. Progesterone is the key to a woman's hormonal balance.
After menopause (natural or surgically induced), ovaries no longer produce estrogen or progesterone.
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