Progesterone – The Yang to the Yin of Estrogen

Progesterone is a hormone that is the natural partner of estrogen in women. Progesterone in menstruating females typically rises in the second half (last fourteen days) of the cycle to prepare the lining of the uterus for a potentially fertilized egg. If no fertilization occurs, then progesterone drops and bleeding occurs. If pregnancy occurs, then the progesterone levels remain elevated to carry the child to term.  If progesterone levels drop, then this causes difficulty carrying a baby to full term and may lead to miscarriage.  These issues may be particularly pronounced in women with polycystic ovarian syndrome whom consistently have low or absent progesterone levels. Replacing this hormone along with some interventions too numerous to list here may allow these women to carry a child to term thus limiting the need for expensive fertility drugs and specialty obstetrics and gynecology clinics.

Ideal levels of progesterone provide the yang to estrogen’s yin. Progesterone optimization offers multiple health benefits to women. These include improvements in cardiovascular parameters, bone health, lipids, mood, quality of life, and contentment. Maximizing this hormone also protects against breast cancer, uterine cancer,  fibrocystic breast disease, and vaginal atrophy. This hormone is also the first line of treatment for premenstrual syndrome  (PMS) and menstrual migraines. High dose treatment is also helpful in managing endometrial hyperplasia (thickening of the cells in the lining of the uterus) which may cause abnormal bleeding and become a precursor for cancer.  Bio-identical progesterone has no known side effects. This fact is in direct contrast to the synthetic progestin Provera.  Provera causes significant side effects including breast cancer,  weight gain, water retention and bloating, breast tenderness,  blood clots, heart attack, stroke, and depression. The only thing that it protects against is uterine cancer. Therefore,  progesterone and Provera are not the same molecule and lumping them together must stop. The science is clear, and  bio-identical progesterone has a distinct advantage and should be the drug of choice for women requiring hormone replacement. The fact that Provera is still on the market with the multitude of side effects and deaths caused by this drug is reprehensible. Women are constantly placed in harm’s way with the combination of Premarin and Provera when safer and more effective alternatives are readily available. This is the pharmaceutical industry and the complicit doctors at their worst. Profits and propaganda over the health and welfare of women. If any healthcare practitioner attempts to prescribe  Premarin and Provera to you, turn and run to our office. I  will treat you according to the literature in an attempt to optimize your health and vitality and formulate A NEW  YOU!

These points are best illustrated by the following patient that I treated who was despondent when she presented to my office. I will call her Mrs. Menopause. She was a 57-year-old female who initially complained of low back pain. Diving deeper, the patient noted issues with memory and concentration, sleep, vaginal dryness, low libido, hot flashes and night sweats, and skin changes. Her energy levels were low, and she was depressed/emotionally labile. She had a recent DEXA (bone density) scan which showed her to be osteopenic with a loss of bone density. She was started on an antidepressant by her primary MD which caused side effects including nausea, constipation, and anxiety. She was also started on the benzodiazepine Ativan to help with sleep and anxiety. This medication made her feel dizzy and drunk. No lab work was done to assess her medical or hormone status.  No medications were started or exercises prescribed to combat the osteopenia/bone loss. The back pain was mild, and no specific treatment had been started for this disorder.  She was “a basket case” and needed help pronto.

I ordered a  battery of blood work to assess her medical status, hormone levels, and bone health. I also ordered a urinalysis to assess for infection and renal disease. X-rays were also obtained of her lumbar spine and pelvis. The studies showed no sign of infection or anemia. The NTX level was elevated consistent with bone loss. Her estrogen, progesterone,  testosterone, thyroid, and Vitamin D levels were all low and suboptimal. Her FSH (stimulating follicle hormone) and LH  (luteinizing hormone) levels were such (along with her low estrogen and progesterone levels) that she had reached menopause. She was started on oral estradiol, progesterone,  thyroid (Armour), DHEA, and Vitamin D. She was also started on a testosterone cream placed on the vagina at night.  The patient significantly improved and her symptoms resolved such that she stopped her antidepressant and Ativan.  She was started in a physical therapy and chiropractic regimen for her back issues. Repeat DEXA scan and NTX levels showed her bone density had returned to normal. These results are common and typical for the woman that has reached menopause with symptoms. This treatment has also improved her long-term health and survival.

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