Bio- Identical Hormone Questions and Answers

1. Why would I want to chose this Natural Progesterone Therapy?

Natural USP Progesterone (Phytoprogesterone) is an important bio-identical hormone. It may help women who suffer with hot flashes, night sweats, insomnia, PMS, mood swings, depression, heavy and/or irregular periods, water retention, weight gain, fibrocystic breasts, bone fragility and osteoporosis as well as loss of sex drive and loss of energy WITHOUT the dangerous side effects of synthetic hormones.

2. What exactly is natural progesterone?

Natural progesterone, a cholesterol derivative, comes from plant steroids. It matches the chemical composition of our body's own progesterone. It can be derived from sarasapogenin and diosgenin from soybeans which are the most common source today.

3. Are there any side effects from using natural progesterone?

Most frequently, any side effects from natural progesterone are associated with dosage, and can be easily alleviated by changing the amount and frequency of the dosage.

Menopausal women might notice some spotting when they begin using natural progesterone. This should be alleviated with continued use and nothing to fear. If it does continue, see your physician.

4. I am post menopausal, will I start menstruating again or have breakthrough bleeding if I use natural hormones?

The Postmenopausal and Osteoporosis age group should not have any side effects at all. Occasionally, upon beginning use of natural hormone supplement, a post- menopausal woman could experience some break through bleeding, or a "period". This rarely happens, but if it should it is a perfectly normal response and is nothing to cause alarm. The progesterone is simply causing the body to rid itself of excess stored estrogen, which can sometimes stimulate a uterine shedding, thus breakthrough bleeding. This should be alleviated with continued use. If it does continue for longer than several months, please consult your physician.

5. Can men use natural progesterone?

If a young man under 45 uses very much, it will cause his testicles to shrink and libido (sex drive) to decrease. However, men over 45 who are overweight and therefore "estrogen dominant" should use natural progesterone once or twice daily, as it may cause the libido to increase, and more importantly for his health -  help him to lose weight! He should have a saliva test performed to evaluate his hormonal balance before considering this therapy.

Also, older men with arthritis have reported relief from pain and swelling after rubbing natural progesterone in a cream base on their joints.

Older men have been diagnosed with osteoporosis, use of natural progesterone and a specific nutritional regimen is recommended to help rebuild bones for them as well.

6. Do natural hormones help vaginal dryness/painful intercourse?

Vaginal dryness can occur in women of all ages for various reasons. It is primarily present in postmenopausal women as hormone levels drop. Natural hormones can be used and have been very successful in treating vaginal dryness and vulvar dystrophy associated with aging.


7. Should estrogen be taken without progesterone?

Definitely not! It is recommended that natural progesterone be used with any form of estrogen - natural or synthetic. Estrogen is a growth hormone and makes every cell in your body grow - without progesterone to offset this growth effect it can cause endometrial and vaginal carcinomas. Estrogen alone also blocks thyroid hormone function and can lead to water retention and thereby elevate blood pressure, and it can cause fibrocystic breast disease and even fibroid tumors and cysts. It is estimated based on lab results that only about 10% or less of the female population really needs to supplement estrogen.

8. Is it possible to build bone back?

Yes, natural progesterone builds bone back, even in older women. Natural progesterone is a valuable agent for the prevention of osteoporosis and for the management of postmenopausal osteoporosis.

Once a woman reaches age 75, there is little difference in bone density between those who have taken estrogen and those who have not. Estrogen treatment alone for 5 to 10 years after menopause is unlikely to preserve bone density or prevent fractures in old age. Progesterone seems to help.

9. How do I know whether I need natural progesterone alone, or natural progesterone with natural estrogen?

First of all a lab test using a saliva sample would determine your hormone levels to evaluate your estrogen-progesterone balance and determine if either is low.  If you personally have a history of cancer I would personally recommend only natural progesterone. If you have breast pain you might want to stick with natural progesterone, too. All others should base their decision to use natural estrogen on the results from their test.

10. What if I have had breast or uterine cancer?

Stick with natural progesterone products only.

11. I'm already on hormone replacement therapy from my doctor, why should I switch to natural hormones?

Natural hormones are simply a NATURAL AND SAFER ALTERNATIVE to hormone replacement therapy. Synthetic estrogens and synthetic progestins have many side effects, increased risk of cancer is the major one. Women with a history of hypertension, diabetes, weight problems, varicose veins and atherosclerosis should not be on synthetic estrogen and synthetic progestins because it will worsen these conditions. Then there is the weight gain - this could be from 10-40 lbs. - do you really need that extra baggage???

12. How do I get off synthetic estrogen and onto natural hormones?

First, see me for a consultation and to have saliva testing performed to determine your hormone balance. If you are taking synthetic estrogen, whether by itself or in combination with synthetic progestin we would then start natural hormones along with only synthetic estrogen for a month. We would then wean slowly off synthetic estrogen over several months. PLEASE DO NOT go off synthetic estrogen suddenly, otherwise your menopausal symptoms will return with a vengeance!!

13. How do I get off synthetic progestins?

If someone is taking synthetic progestin, in combination with synthetic estrogen, once they have begun using natural progesterone, simply cease the use of synthetic progestin at the end of its current 12-day cycle of use. A slightly higher dose of natural progesterone may be required initially to remove the progestins from the cell receptors.

14. Can I mix synthetic estrogen with natural progesterone?

Yes. It will decrease your cancer risk.

15. How long should I be on natural hormone replacement therapy?

It is recommended that women should use natural hormones as long as they feel the hormones are of benefit to them - improved weight, mood levels such as anxiety and depression, skin texture, and bone density (as demonstrated by bone density testing) should all be weighed in the balance. It's also a great help for vaginal dryness causing painful intercourse.

16. Do I need a prescription for natural progesterone?

No. Natural progesterone in a cream or oil base comes from a wild yam plant or soybeans, which are technically food products. All of the other ingredients, aside from a trace of some cosmetic ingredients, are natural, herbal products.

17. Why is transdermal absorption preferred?

Natural hormones are small, fat-soluble molecules that are readily absorbed through the skin. They pass directly into the skin to the subcutaneous fat layers, then to blood circulation. So first it goes into body fats and then into the blood. Oral forms are available for those who prefer to take it that way, and I actually use oral progesterone at bedtime at times to help some women sleep as it enters the same pathway as many of the prescription "nerve pills" without the addicting side effect potential. Oral hormones often must be taken at higher doses as a portion of the hormone absorbed from the gut is broken down by the liver in what is referred to as "first pass metabolism".

19. Where is the best place to rub in natural hormone creams?

Recommended places are the inner aspects of arms and thighs, the face and neck, upper chest or abdomen. Be sure to alternate sites on your body to keep the hormone receptors in your skin sensitive to absorption.

20. How long before I notice changes in my body?

It may require 2-3 months use before maximum benefits are experienced. Don't give up too quickly. Some women report immediate improvement. Use the adequacy of vaginal secretions as your guide. If you notice your vagina is moist and your mood is even, you are on the right track! My patients report a 4-6 week use before noticing sexual interest.

21. How important is diet?

Vital - make sure that you have a balanced diet that includes sufficient fiber along with enough vegetables and good antioxidants. Vitamin C is a good place to start, adding Vitamin E, a B-complex, and others we discuss in your individualized consultation. For women with elevated estradiol-E2 level, add DIM or an IC3 supplement to your diet.

22. What do I say to my physician who thinks this is silly?

Educate him or her! More and more physicians are finding out that synthetic hormones have too many undesirable side effects.

23. How safe is this Natural Progesterone?

The safety of natural progesterone is well established up to 800 mg per day. There have been no reports to the FDA of problems with it, hence the FDA permits the sale of progesterone cream at the levels I offer my patients without a prescription.

24. What can I do if I want to study natural hormones in more depth?

Read "What Your Doctor May Not Tell You About Menopause" by John R. Lee, M.D.

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