Hormone Solutions | Lawley Pharmaceuticals

Natural Progesterone - Treatment Options

• Hot Flashes and Night Sweats
• Irregular and Heavy Menstrual Bleeding
• Breast Disorders
• Fibrocystic Breast Disease
• Depression and Anxiety Attacks
• Pre Menstrual Syndrome (PMS)
• Post Natal Depression
• Infertility
• Vaginal Dryness
• Breast Cancer
• Endometriosis
• Polycystic Ovarian Syndrome (PCOS)

• Hot Flashes and Night Sweats

  Hot flashes and night sweats are probably the most common and distressing problem that women face when going through menopause. They can last from a few seconds to several minutes and can be accompanied by heavy unabated sweating. When they happen at night (sweats) they can disturb sleep and cause serious fatigue and depression. The whole menopause management industry began in the late 1950's because hot flashes and night sweats were relieved by taking estrogen. It works and works well for these two symptoms. Estrogen supplementation quickly became the frontline treatment of menopausal symptoms courtesy of the pharmaceutical companies massive advertising campaigns and has remained so ever since. In the late 1960's uterine cancer directly attributed to unopposed estrogen use and more recently the issue of increased risk of breast cancer with long-term estrogen use have highlighted estrogen's checkered history. Many women find that their hot flashes reduce and their night sweats diminish with estrogen supplementation only to be replaced with the estrogen dominant symptoms of anxiety, depression, palpitations, loss of confidence, mood changes and irritability this is simply because supplementing estrogen without balancing the effects with natural progesterone increases the underlying hormonal imbalance. Remember menopause is the time when ovulation ceases and if there is no ovulation there is NO progesterone production. Many women find that at the time of menopause supplementing progesterone rather than estrogen improves the estrogen dominant symptoms as well as provides relief from hot flashes and night sweats it narrows the imbalance between the hormones. Progesterone provides a balance to the lack of naturally produced progesterone due to the cessation of ovulation at menopause.

• Irregular and Heavy Menstrual Bleeding

  In the U.S. 250,000 hysterectomies are performed annually.

  Frequently hysterectomy is the option taken to control irregular or heavy bleeding in pre and peri- menopausal. Many women are content to see the end of their periods and hysterectomy appears to be an easy quick and clean option. Hysterectomy for irregular and/or heavy bleeding is a medical response to a symptom rather than the treatment of an underlying cause. Progesterone's role in a reproductive woman is to hold the uterine lining together during the second half of the menstrual cycle (the luteal phase). Too frequently natural progesterone treatment is an untried option prior to undertaking hysterectomy. Irregular bleeding in pre and peri-menopausal is more often than not due to insufficient progesterone production the irregular and/or heavy bleeds are due to estrogen dominance. Using natural progesterone during the luteal phase of the cycle will usually regulate and control bleeding within two or three months.

  Hysterectomized women who undergo a surgical menopause (total removal of the ovaries) are traditionally given estrogen only supplementation with the ovaries natural hormones progesterone and testosterone is largely ignored by mainstream medicine. Balance with natural progesterone and natural testosterone and estrogen in these women is the only way to address surgical induced menopausal symptoms. A three legged stool is useless without all three legs estrogen, progesterone and testosterone!!!
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• Breast Disorders

  Breast tenderness, fibrocystic breasts and swollen breasts are all classical symptoms of estrogen dominance. The breasts are very responsive to hormone changes in particular breast tissue is extremely sensitive to estrogens. It is well known that when women start using the Pill or commence hormone replacement therapy (HRT) they will often complain of the breasts getting bigger and tender. Breast tissue proliferates and grows under the influence of estrogen it is estrogen that stimulates the development of the breasts and reproductive organs during puberty in young girls. In a normal healthy adult female the stimulatory effects of estrogen are tempered and balanced by the hormone progesterone. Progesterone is produced once ovulation takes place around day 12 of the menstrual cycle. Estrogen and progesterone levels peak around day 22 of the menstrual cycle. When a woman does not produce sufficient progesterone the effects of estrogen on the breast are unopposed and the breast tissue is affected.

  This is typified by painful and swollen breasts in the week pre menstrually. It is a sure sign that there is a progesterone deficiency and the addition of progesterone from days 12 -26 of the cycle will balance the estrogen dominance. Resolution of these symptoms usually is maximized in the third month of treatment.

• Fibrocystic Breast Disease

  Fibrocystic breast disease is a condition where the breasts tissue is engorged, hard and extremely painful. The condition is very debilitating and usually is worse during the luteal phase of the menstrual cycle when progesterone should be at its peak. It is often a failure to ovulate or lack of progesterone production post ovulation that results in this severe symptom of estrogen dominance. Suffers of fibrocystic breast disease usually get most relief from the condition during menstruation when estrogen levels are at their lowest. The underlying cause of fibrocystic breast disease is the same as for pre-menstrual breast soreness and swelling estrogen dominance due to an underlying progesterone deficiency. Using natural progesterone from day 12 -26 or even day 7 -26 greatly assists women suffering from this debilitating and painful condition.
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• Depression and anxiety attacks

  During the peri- and early menopausal years mood swings, anxiety attacks and depressive thoughts are common. Interrupted sleep, loss of libido, body shape changes, crying spells, irritability, low tolerance and feelings of being "old and past it" are further experiences of menopause. Mixed emotions at this time are normal and women need to be reassured they are not "losing their marbles". These feelings are a reaction to what is happening to the body both physically and hormonally. The emotional swings and physical changes are a reflection of the hormonal revolution occurring within.

  Too often anti-depressants are routinely prescribed to address "mood disorders". While antidepressants certainly have their place in a medical practitioners arsenal of treatment options they are too often given to treat the symptom and not address the underlying cause of the problem.

  At the time of the menopause, like at the time of puberty, pregnancy and child birth, women undergo massive hormonal changes. During these pivotal phases emotions and feelings towards one's self and others can be volatile and complex. Hormones govern the way we think, the way we act and the way we respond. During times of hormonal turbulence, such as the menopause, the imbalance between estrogen and progesterone is of primary importance. Addressing this imbalance will go a long way to resolve many of the emotional symptoms associated with the menopause. Antidepressants can assist in the management of the symptoms, but have little effect on estrogen dominance and menopausal symptoms that is the role of natural progesterone.
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• Pre Menstrual Syndrome (PMS)

  When a collective of symptoms so wide and variable in their intensity of a population cannot be adequately categorized or adequately defined by evidence based medical standards it is generally labelled as a "syndrome". In simple terms a "syndrome" is conventional science's way of saying "we're not sure what it is and we don't know how to best treat it". To add confusion to the defining of the condition PMS does not affect all women nor is it restricted to certain age groups. The common thread to the condition is the timing of symptoms in relation to menstruation, hence the name.

  In healthy reproductive women with regular menstrual cycles PMS is typified during the 8-10 days premenstrually by breast tenderness, mood changes, irritability, fluid retention, headaches and migraines. PMS is a misunderstood and often ignored condition. It can vary from mildly disconcerting transient symptoms to a severe and debilitating condition that greatly affects a person's quality of life for over a week every month. Symptoms generally disappear at the onset of menstruation. People who have never experienced PMS symptoms often have little empathy or understanding for those experiencing PMS. Families and partners of PMS sufferers often have little or no idea how to respond to the mood swings and symptoms of those affected. Mainstream medicine offers little in the way of treatments it has for decades ignored natural progesterone.

  In a normal healthy adult female the stimulatory effects of estrogen are tempered and balanced by the hormone progesterone. Progesterone is produced once ovulation takes place around day 12 of the menstrual cycle. Estrogen and progesterone levels peak around day 22 of the menstrual cycle and remain high until just before menstruation when both hormone levels fall dramatically and the uterine lining sheds and the period commences.

  Women who experience PMS usually are under producers of progesterone or fail to regularly ovulate (annovulatory cycles). When a woman does not produce sufficient progesterone the effects of estrogen dominate and pre menstrual symptoms flourish. The more sustained the length of time the woman under produces progesterone generally the more severe the PMS becomes. PMS is not restricted to younger women as is commonly considered. Many women date the onset of their PMS to not long after having a second or third child. Hormonally and physically pregnancy exerts a massive assault on the female body –especially in women who become pregnant for the first time in their late twenties or thirties. The fact is that women who opt for childbirth in their later reproductive years do not spring back into shape hormonally (and physically) post pregnancy. After the pregnancy once the menstrual cycle returns ovulation usually recommences. Once the egg is released from the follicle at the surface of the ovary the follicle changes into what is called the corpus luteum. The corpus luteum makes progesterone. Without ovulation there is no production of progesterone. It is not unusual for women with young children in their mid to late thirties to produce less progesterones post ovulation than compared to women in their twenties. At this age however the ovaries are very efficient at estrogen production and estrogen levels remain high the platform for estrogen dominance is formed.

  PMS, estrogen dominance and progesterone deficiency are integrally linked. The addition of natural progesterone cream from days 12 -26 of the cycle will balance the estrogen dominance. Resolution of the symptoms of PMS usually is maximized in the third or fourth month of treatment, often sooner. In the 1960's the English physician, Dr Katerina Dalton devoted her life to natural progesterone use in the management of PMS. Her work at the time was ridiculed by her peers and yet today it still remains the most relevant work done in this forgotten area of medicine.
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• Post Natal Depression

  Progesterone is the most pivotal hormone of pregnancy pro gestation - hence the name.

  During pregnancy progesterone levels rise from a non-pregnant daily production rate of about 20mg per day to up to 400mg per day. Estrogens also rise during pregnancy but not to the same degree as progesterone. The placenta is responsible for the massive increase in progesterone production, and takes over progesterone production from the ovaries at around week ten of the pregnancy. Progesterone levels are at their greatest during the third trimester of the pregnancy. It is during this time when many women "nest" and "bloom". Clarity of thought, mental acuity, high energy levels, confidence and zeal typify this period of many women pregnancies. With the birth of the child and the passing of the placenta blood levels of progesterone fall dramatically. The action of breast feeding has the natural action of inhibition of ovulation and progesterone levels remain virtual non existent until ovulation recommences. The "second day blues" is a common and transient phenomenon to the new mother, but the more lasting and pervading depression that can overcome some women is triggered by the huge hormonal withdrawal as a result of the birth.

  It seems strange that nature would engineer such a huge hormonal shift. In the animal kingdom many females eat the placenta immediately after the birth. Such an action would seem repugnant to humans, but the placenta is highly enriched with progesterone and mother nature may be assisting the animals more than we humans realize. It is logical that the addition of natural progesterone post partum to women who experience post natal depression will assist. Natural progesterone does not interfere with breast milk production and offers a far more reassuring treatment than antidepressants to the new mother. High dose natural progesterone cream treatment combined with professional counselling to assist with post natal depression is usually only required for a few months. The results can be greatly rewarding to both mother and child.

• Infertility

  The only area of mainstream medicine that natural progesterone is routinely used is in the area of assisted fertility. Natural progesterone injections and high dose natural progesterone pessaries are routinely used to prime the uterus for implantation of a fertilized egg. This use is limited and highly specialized, but does not cover all facets of infertility.

  Many women have little trouble falling pregnant, but failure to carry the pregnancy beyond week six to ten is an all too common experience for many couples.

  Once implantation of a fertilized egg takes place in the uterine wall it starts a cascade of hormonal triggers. One of the most important of these triggers is for the corpus luteum (the former follicle that released the now fertilized egg which metamorphosed to form a yellow mass on the surface of the ovary that commenced the production of progesterone) to increase its production of progesterone. Progesterone is the vital hormone that propagates the pregnancy. The corpus luteum is required to produce sufficient progesterone to maintain the integrity of the uterine lining until the placenta takes over the progesterone production at around week nine or ten to meet the increased progesterone demands of the pregnancy.

  The most vulnerable time for miscarriage in most women who are low progesterone producers during pregnancy is week six to week ten. If the corpus luteum cannot maintain production of sufficient levels of natural progesterone the uterine lining breaks down and sheds resulting in the miscarriage. It is women with a history of week six to ten miscarriage that benefit most from supplementing their natural corpus luteum progesterone production with natural progesterone cream. Often women will use the natural progesterone cream until full term. Treatment is usually dependant upon how advanced the pregnancy is in relation to commencing progesterone supplementation. For example if spotting occurs at week 6 or 7 a high dose of 100-200mg progesterone cream twice or three times daily is applied. Ideally a low dose natural progesterone supplementation can be commenced in the months and weeks preceding conception (days 12-26 of the cycle) until the pregnancy is confirmed then maintenance of a low dose daily natural progesterone supplement to support corpus luteal production.

  Similarly, often for reasons unknown in more advanced pregnancies the placenta can under produce progesterone and the addition of natural progesterone will maintain the integrity of the uterine lining and women can carry fully term. It is a treatment option that can do no harm and usually brings much joy.
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• Vaginal Dryness

  Vaginal dryness is a symptom which many women find uncomfortable and physically distressing. Fortunately it is one problem that can easily be helped. A deficiency of estrogen will cause the lining of the vaginal walls to thin, become drier and less elastic (atrophic).

  Sexual intercourse is often painful which means that most women are less than enthusiastic about sex at this time. There are estrogen creams and pessaries that work locally and are not absorbed into the system. The use of progesterone creams externally may help with vaginal dryness by making the estrogen receptors in the wall of the vagina more responsive to naturally produced estrogen. Progesterone creams are generally not suitable for insertion into the vagina.

• Breast Cancer

  Breast cancer is one of the greatest fears that women face when they reach menopause and are offered estrogen based hormone replacement therapy. The issue of breast cancer and estrogens has been highly publicized in the media in recent years and there is often a great deal of concern for women when faced with the risks versus the benefits of using estrogen to manage menopausal symptoms. There is probably no single cause of breast cancer. It is most likely that there are a number of triggers genetic, familial, environmental and even physiological that when combined stimulate the cancers to become active. Dr John Lee, the pioneer of natural progesterone cream for treatment menopause before his death wrote a book called What your Doctor may not have told you about Breast Cancer. This work clearly and concisely outlines the vital role progesterone has in the breast and in prevention of breast cancer. It is highly recommended reading. One of the most controversial breast cancer and natural hormone medical studies ever conducted provides an insight into the profoundly positive effect natural progesterone has on cancerous breast tissue. Chang et al. In 1985 a joint French-Taiwanese medical team took 40 women with breast cancer who were scheduled for mastectomy and divided them into four groups. Each group was assigned to a treatment that was either estrogen only (E), estrogen and natural progesterone (E+P), natural progesterone (P) only or placebo (PL). The hormones were administered via a gel that was applied once daily directly to the breasts for ten days prior to surgery. After surgery the cancerous breast tissue was assayed and the rate of cell division (mitosis) was examined. In breast cancer, like for most cancers, the rate of mitosis of the cancerous cells is more rapid that for non-cancerous cell, hence the reason why cancers take over healthy cells. When the researchers examined the various cell groups that had been treated with the hormones the results were astonishing. As was expected the estrogen only group's mitotic cell division rate doubled compared to the placebo (untreated) group the stimulatory effects of estrogen on cancerous breast tissue is well known. The researcher's excitement stemmed from the results of the estrogen plus natural progesterone and the natural progesterone only groups. The E+P group's mitotic rate was the same as the placebo group. This indicated that natural progesterone had an inhibitory effect upon the estrogens stimulation of the cancerous cells. When the progesterone only (P) group was examined the rate of cell division was 85% less than the placebo group natural progesterone was inhibiting the spread of the cancer. Natural progesterone was potentially a potent treatment for breast cancer. This study had its critics. They said the numbers studied were too small to be significant and that the progesterone blood levels of the P and E+P groups did not rise. Therefore, it was considered that the progesterone hadn't been absorbed. When the actual tissue concentrations of the cancerous cells were examined the progesterone was found in very high concentrations in both progesterone groups and absent in the E and PL groups. The progesterone had been absorbed directly into the cells and not circulated in the blood. It was acting directly inside the cancerous cells and the mitotic rates proved it.

  Larger scale clinical studies have never been conducted to confirm these findings from 20 years ago. With the modern day rigours and political correctness of Ethics and Scientific Committees, the massive funds required to undertake clinical trials and the complex insurance obligations to undertake such trials it is unlikely that it will be repeated on a larger scale. The pharmaceutical industry's charted is to discover the next block buster patentable drug natural progesterone does not meet this criteria. The early results are conclusive and natural progesterone cream is available. With time, progesterone may prove to be the missing link in the quest to prevent and treat breast cancer. The challenge is for there for mainstream medical researcher and governments to take up.
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• Endometriosis

  Endometriosis is a condition whereby tissue normally located on the surface of the uterine wall

  (endometrium) migrates into areas such as the muscle tissue of the uterus, the Fallopian tubes, the surface of the ovaries and even into the pelvic cavity. This tissue is responsive to the surges of estrogen encountered during the menstrual cycle. The tissue will swell during the month and bleed at the same time of menses. Unlike endometrial tissue (the tissue lining of the uterus) which sheds into the uterine cavity the endometriois bleeds into the intercellular spaces and has nowhere to go. The condition is painful, often debilitating and may greatly hinder fertility. Treatment varies from analgesics (pain killers) to high-dose synthetic progestins to surgical procedures including hysterectomy.

  Often pregnancy, if possible, is suggested as the best treatment. During pregnancy, when progesterone levels are high and estrogen relatively low, endometriosis virtually disappears. The very high levels of progesterone produced by the placenta during pregnancy suppresses and overcomes the endometrial tissue. Occasionally with the return of menses post pregnancy the endometriosis will return.

  Endometriosis has various degrees of severity and current treatment is aimed at symptom management unfortunately natural progesterone is rarely offered as an option. Endometriosis is a condition at the extreme end of the scale of estrogen dominance. The underlying cause is progesterone deficiency. Treatment with high dose progesterone cream, even in severe cases usually achieves improvements in the condition. In milder cases often there is a full resolution of symptoms with pain free periods. Depending upon the severity of the endometriosis the treatment may take three to six months to achieve full benefit. For many women yet to start a family this is a better option than endometrial ablation, hysterectomy or long-term hormonal suppression.

  Natural progesterone cream offers a viable alternative to current mainstream endometriosis treatments because it safely tempers the stimulating effects of estrogen.
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• Polycystic Ovarian Syndrome (PCOS)

  The process of ovulation involves the ovary responding to chemical messengers sent from the brain. The brain controls the chemical signals sent to the ovaries based upon chemical signals it receives back in response to its signals. It's called a feedback mechanism. At birth every female has around 400,000 immature eggs in follicles contained within the ovaries. At puberty the reproductive organs, under the influence of estrogens, mature and a key part in the process of ovulation is that the brain releases a hormone called Follicle Stimulating Hormone (FSH).

  FSH stimulates a number of immature eggs to mature, rise to the surface of the ovary and usually one follicle releases a mature egg into the Fallopian tube - this release is ovulation. The unused semi mature follicles are broken down reabsorbed by the body. The follicle that released the egg then undergoes a spectacular metamorphosis. It's entire structure changes and it forms what is called the corpus luteum. Visually the corpus luteum appears as a yellow mass on the surface of the ovary and the corpus luteum plays the vital role of being the production site for progesterone. The progesterone produced by the corpus luteum is released into the bloodstream. As the progesterone concentration in the blood increases this is detected by the brain which in turn shuts off the production of FSH, because it now knows that ovulation has successfully taken place. Without the production of progesterone the brain will think that ovulation has failed to take place and it will keep producing FSH to stimulate ovulation. Progesterone is the key!!!

  Women with PCOS fail to ovulate. The follicles mature, rise to the surface of the ovary, but for reasons unknown they fail to release. The corpus luteum doesn't form and no progesterone is produced. The brain doesn't detect any progesterone rise in the blood and therefore releases more FSH to stimulate more follicles. The surface of the ovary looks lumpy and bumpy with many semi-matured follicles just below the surface all having failed to ovulate - like a teenager with acne. Because of this disruption to the normal hormonal cycle PCOS sufferers generally develop higher levels of the hormone testosterone due to ???. With time this has the effect on the PCOS sufferer of weight gain, acne and oily skin, and increased facial and body hair. Associated with these physical changes the body becomes resistant to the effects of insulin and as a result the normal process of sugar metabolism is disrupted. Sugar is converted to fat and the PCOS sufferer usually has significant weight problems. PCOS usually affects younger women and is often undetected for many months and even years. Often symptoms are associated with the physical maturation of the body and expected to settle down with time.

  There are numerous non specific treatments for PCOS which involve management of symptoms rather than addressing the underlying cause.
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