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Natural Progesterone Deficiency and Estrogen Dominance

Menopause is a stage of life that all women go through. In clinical terms it begins when the woman stops ovulating and menstruation ceases. This usually takes place between the ages of 45 to 55. At this time the ovaries which have been regularly releasing estrogen and progesterone slow down their production of these hormones.

The hormones estrogen and progesterone have a very close relationship. Estrogen is a very stimulatory hormone and natural progesterone tempers the stimulatory effects of estrogen. This effect of natural progesterone on estrogen is summarized in the list of effects of both hormones in below.

Progesterone has it's own intrinsic effects upon the body as well as exerting a significant effect upon the stimulatory actions of estrogens

Estrogen Effects Progesterone Effects
Builds up uterine lining Maintains uterine lining
Stimulates breast tissue Protects against fibrocysts
Increases body fat Helps use fat for energy
Salt and fluid retention Diuretic
Depression, headache/migraine Anti-depressant
Interferes with thyroid hormone Facilitates thyroid hormone action
Increases blood clotting Normalizes blood clotting
Decreases libido Restores libido
Impairs blood sugar control Regulates blood sugar levels
Increases risk of endometrial cancer Protects from endometrial cancer
Increases risk of breast cancer Probable prevention of breast cancer
Slightly restrains bone loss Stimulates bone building
Reduces vascular tone Propagates growth of embryo
Precursor of corticosteroid production

During the menopause transition, estrogen levels reduce and progesterone production ceases altogether. Estrogen blood levels are reduced but do not cease, whereas at menopause ovulation ceases and so does progesterone production. This leads to an imbalance estrogen is free to act untempered by the effects of progesterone.

This unbalanced decline in hormonal levels can lead to many women experiencing a variety of unpleasant symptoms what Dr John Lee called estrogen dominance'. These symptoms include hot flashes (flushes), sleep disturbances, poor bladder control, dryness of the vagina, mood swings and irritability. Some women also report weight gain, lack of energy, malaise, forgetfulness, cloudy thoughts, anxiety or panic attacks, sore bones and general aches and pains. Not everyone will experience all of these symptoms; however, even one or two can be difficult to cope with if not addressed adequately. Correcting any imbalance between the hormones estrogen and progesterone, especially the lack of progesterone, will usually rid an individual of many of these symptoms within a few months.

The time before menopause (peri-menopause) can, in many cases, be more distressing than the actual menopause itself. Peri-menopause is commonplace in women in their mid thirties and early forties. These women are still menstruating, but still experience many of the symptoms traditionally reserved for menopausal women. This creates a great deal of anxiety, depression and confusion for many women. Irregular or shorter intervals between periods, spotting, irregular bleeding and heavy bleeding are all indicators of hormonal imbalance. The long-held belief that these conditions and feelings are due to estrogen deficiency are rapidly being replaced by the understanding that progesterone plays an active role in preventing these changes from occurring prematurely. If the is a menstrual blood flow (regular or irregular) then there is plenty of estrogen being produced by the ovaries. It is estrogen that stimulates growth of the uterine lining. It is progesterone that holds the uterine lining together. If there is a deficiency of progesterone then the uterine lining breaks down and hence irregular and heavy bleeds result.

Often peri-menopausal women exhibiting symptoms are treated with the Pill to "stabilize" the hormones. The Pill overrides the natural hormone production of women and in the case of the peri-menopause adds estrogen but fails to address the progesterone deficiency because the Pill doesn't contain natural progesterone Often peri-menopausal women who take the Pill find their symptoms worsen rather than improve. This is due to the added estrogen of the Pill not being balanced by natural progesterone and "estrogen dominant" symptoms are exacerbated. The progestin in the Pill does not do what natural progesterone does in terms of balancing the effects of estrogen and therefore the Pill usually aggravates symptoms in an already estrogen dominant woman.

The alternative offered to the Pill is often hysterectomy (removal of the uterus) and this may or may not include removal of the ovaries (oopherectomy).

Hysterectomy makes no difference to the way the estrogen/progesterone balance should be viewed. Hysterectomy will certainly stop irregular bleeds and heavy blood loss, but does nothing to address the underlying problem of estrogen dominance due to progesterone deficiency. Addressing imbalances in these women is crucial in order to eliminate unwanted menopausal effects, be they natural imbalances or induced imbalances due to estrogen-only hormone supplementation.

In estrogen dominant peri-menopausal and menopausal women the first line of treatment should always be progesterone cream supplementation. Giving the Pill is giving the wrong hormone. A woman still getting a bleed (regular or irregular) is producing sufficient estrogen. It is the progesterone that is in deficiency and not estrogens. The medical profession has for decades been convinced by the pharmaceutical industry that women are estrogen only entities and that progesterone is a nebulous hormone. The truth is that progesterone is produced by the body in quantities a thousand-fold greater than estrogens. Progesterone is a pivotal hormone for the propagation of life and for the production of other hormones, including estrogens. Without progesterone there would be no menstrual cycle or reproduction. Progesterone has it's own distinct and active role to play in the body including keeping the stimulatory effects of estrogen under control.

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