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What Women Need to Know About Hormones

progesterone hormone balanceMaintain a healthy balance of progesterone to estrogen.

The largest study ever undertaken on diet and health—the European Prospective Investigation into Cancer and Nutrition (EPIC)—has turned up some interesting findings on women’s hormonal balance.

For starters, this long-term investigation of 521,000 subjects finds that the female hormone estrogen and male hormones (or androgens) increase breast cancer risk—both before and after menopause. But the female hormone progesterone does not.

A 2010 analysis of EPIC data published in the International Journal of Cancer linked lower estrogen exposure—and higher levels of progesterone—with lower risk for endometrial cancer. “A reduction in endometrial cancer was observed in women with late menarche [onset of menstruation], early menopause,” and other factors relating to a normal estrogen-progesterone balance were observed in low-risk women.

“Progesterone is crucial for the establishment and maintenance of pregnancy,” scientists recently wrote in the journal Immunotherapy. And Chinese research finds that progesterone treatments in the first trimester can safely prevent miscarriage.

Other benefits of sufficient progesterone? This hormone helps the body metabolize fat for energy and is a natural diuretic, preventing bloating and “false fat.” Other research finds this hormone facilitates thyroid function, normalizes blood sugar levels and blood clotting, helps spark a healthy libido, calms anxiety, promotes sleep, stimulates bone formation, and helps prevent cyclical migraines.

More than 75% of all women suffer hormone havoc directly or indirectly related to progesterone deficiency. Whether you’re pregnant or are beginning to experience the first signs of the “change,” it’s critical to balance estrogen with progesterone.

First described by the late John R. Lee, MD, estrogen dominance has been on the rise for over 50 years, partly due to pesticides and other petrochemical residues. “Even in very tiny amounts, they will have estrogenic effects,” he discovered.

The EPIC data also shows that adult weight gain—which numerous studies have linked to estrogenic chemicals in our food supply and environment—significantly increase the risk for breast and other cancers. So it’s not too surprising that a new study published in Cancer Causes and Control shows physical activity can help balance hormonal levels and decrease breast cancer risk.

Interestingly, engaging in strenuous exercise during adolescence and moderate workouts after menopause appears effective in lessening cancer risk. At any age, get moving to keep your progesterone levels from going too low!

Normally, estrogen starts up about eight days after a woman’s period. Then from day 12 to day 26, the body produces 100s of times more progesterone than estrogen. But if that balancing female hormone is missing, “you have estrogen from day eight to day 26. . .a whole month of nothing but estrogen,” wrote Dr. Lee. No wonder that estrogen dominance is one of the major factors in PMS and menopausal symptoms.

What Are Your Hormone Levels?

According to Dr. Lee, any woman still having monthly periods has plenty of estrogen, although vaginal dryness and vaginal mucosal atrophy are clear symptoms of estrogen deficiency. “Lacking these signs, the best test is the saliva hormone assay.”

Salivary Hormone Test  is an individualized evaluation to determine levels of bio-available female hormones (estradiol, estriol, progesterone), the androgen testosterone, as well as DHEA and the stress hormone cortisol. These results can help determine the lifestyle modifications you need to make for optimal hormone balance. While testing for all six hormones is the best way to evaluate total health, if you’re experiencing estrogen dominance or suspect progesterone deficiency, testing for specific hormones only can sometimes be sufficient.

A Safe Alternative

Even though some women thrive on hormone replacement therapy (HRT), we’re not all created equal. Not only have I personally experienced problems with time-release forms, but many of my clients have also had trouble with HRT. And of course, findings from the Women’s Health Initiative study have linked synthetic HRT with breast and uterine cancer.

Integrative physician Robert Wascher, MD, says there is “almost no solid clinical evidence to support the notion that bio-identical HRT is safer or more effective than the conventional ‘conjugated equine estrogens.’ Within a woman’s body, estrogen receptors really don’t care much whether estrogen-like hormones come from horse urine or from the human form of estrogen.”

Recent data from the EPIC study also casts doubts about the safety of alternative forms of HRT. Combining that research with data from the Women’s Health Initiative, Dr. Wascher advises any woman going through menopause NOT to take HRT medications.

“If you are one of the approximately 3 to 5% of postmenopausal women who have unbearable hot flashes or other severe symptoms of menopause and you are currently using some form of HRT, then work with your doctor to reduce the dosage to the lowest possible levels that adequately treats your symptoms,” he suggests.

If (like most women) you’re low in progesterone, I’ve found that all-natural progesterone crème derived from wild yam like ProgestaKey can help balance hormones and lessen symptoms of estrogen dominance. Depending on your life stage or age, follow the crème’s instructions for dosage and frequency. I recommend applying progesterone crème  to soft skin rich in capillaries on a different area of the body (your neck, upper chest, breasts, inner arms, abdomen, back of your hands, and face) each day.

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Comments (38)

  • Jeanette October 18, 2013 - 12:17 pm Reply

    I’m confused. Isn’t ProgestaKey a bioidentical hormone replacement for Progesterone? The article seems to advise against hormone replacement, but then suggests taking progesterone.

    • Irene October 18, 2013 - 10:22 pm Reply

      They advice against HRT which is a synthetic form of estrogen but recommend using ProgestaKey which is a natural form of progesterone to balance your estrogen.

      • Dana October 20, 2013 - 11:17 pm Reply

        Like, Jeanette, I, too, am confused. I thought that ProgestaKey is a bioidentical hormone replacement for Progesterone? It seems that Dr. Wascher is recommending against BHRT and the EPIC questions the safety. Is that specific to estrogen replacement? If so, that is not clear by the article.

  • Sophie October 18, 2013 - 1:06 pm Reply

    What is the current safety data on the use of herbs and plants with their so called phytoestrogens? And wild yam capsules which reportedly have a progesterone-like effect?
    This topic is so important and there is much confusion. Thank you for your guidance.

  • Jeanette October 21, 2013 - 7:00 am Reply

    HRT means “hormone replacement therapy”…this term can also be used to refer to bio-identical hormones, such as Progestakey. You are confusing people by using the term HRT to only refer to “synthetic” hormone therapy.

  • Jeanette October 21, 2013 - 2:45 pm Reply

    I thought bio-identical meant the body could not differentiate it from it’s own hormone (as opposed to synthetic). Maybe we need an article that explains the difference between all of these types of hormones.

  • Ann Louise Gittleman October 22, 2013 - 8:50 pm Reply

    Ladies: Thank you for your comments. Let me get back to you on your comments regarding HRT and bio-identical hormone replacement therapy. My initial understanding of Wascher’s comments were related to all forms of estrogen replacement – not progesterone or the bio-identical progesterone in ProgestaKey which contains U.S.P. progesterone. Thank you!

  • Sophie October 23, 2013 - 8:35 am Reply

    This blog served to bring us up to date on estrogen and progesterone — much appreciated as I am longstanding user of natural progesterone cream.

    In a future blog, would you kindly offer us your science based guidance on the subject of herbal formulas for balancing hormones and alleviating symptoms? For example, what is the latest safety data on the use of such herbs/plants as soy, black cohosh, dong quai, etc.
    Do phytoestrogens carry risks? Thank you!

    • Team ALG October 24, 2013 - 10:49 am Reply

      Thank you for your comments! We will certainly keep your interests in mind. In the meantime, we never promote the use of soy, but for some, the use of black cohosh and dong quai can be very helpful. A good idea for evaluating their efficacy in your own body would be to do a baseline reading with the Salivary Hormone Test through UNI KEY. Then you could experiment with one addition at a time and measure the result with subsequent testing every 2-6 months.

  • Sherry October 23, 2013 - 9:31 am Reply

    Any recommendations on dietary measures that can lower estrogen levels in the body?

    • Team ALG October 24, 2013 - 10:44 am Reply

      Plenty of dietary fiber from vegetables and fruits, an emphasis on green foods, only organic and grass-fed meats, and possibly a daily cup of roasted dandelion root tea. You will find more complete details in Ann Louise’s book The Fast Track Detox Diet

  • Dr. Karen October 23, 2013 - 10:33 am Reply

    Are these hormonal symptoms really a progesterone deficiency or an imbalance due to an overabundance of estrogen?
    There are several natural things you can do to clear excess estrogen from your body to bring the ratio back into balance, hopefully without adding more hormones. Exercise, avoiding xenoestrogens in your personal care products, and increasing cruciferous vegetables are a couple of great strategies to start with.

    • Team ALG October 24, 2013 - 10:41 am Reply

      Those are wonderful suggestions, Dr. Karen! These hormonal symptoms can be experienced due to absolute progesterone deficiencies or progesterone deficiencies relative to estradiol. Liver cleansing is an important part of reducing excess estradiol and balancing hormones naturally.

  • Sally Bennett October 23, 2013 - 9:50 pm Reply

    Is the Estring estradiol vaginal ring safe for breast cancer survivors to use?

    • Team ALG October 24, 2013 - 10:37 am Reply

      Sally, I would recommend having that conversation with your health care provider. In situations such as this, it is very important to design a hormone replacement therapy with your health history carefully in mind.

  • Kimberly October 28, 2013 - 1:44 pm Reply

    Hi-yes, this article was a bit confusing as Dr W says the body can’t differentiate between equine hormones and natural (bioidenticals). Then the article goes on to recommend progesterone anyway.
    Ok, my question is what would you suggest for those women who are progesterone intolerant?
    Do you believe there is such a thing as progesterone intolerance (even with bioidenticals)? Than you! Very interested in your response!

  • Ann Louise October 28, 2013 - 6:51 pm Reply

    Hi Kimberly: For women who are progesterone intolerant, we would suggest some of the mineral precursors to progesterone which include the minerals zinc and manganese. Yes – there are women who are progesterone intolerant.

  • JMM October 28, 2013 - 9:08 pm Reply

    I gained 40 pounds in two years.have always been slim.I was put on estrogen and progesterone 9 weeks ago (bio-identical) Haven’t seen any change in my weight..My breasts are itchy and swollen..The nurse just said I must carry on it will improve.Every time I weigh myself I am heavier.The only improvement is the brain fog and the night sweats.I also take armour thyroid for hypothyroidism..my levels are normal..Has anyone got any suggestions?

    • Team ALG October 29, 2013 - 12:01 pm Reply

      Most commonly we find that women with your symptoms are estrogen dominant and in need of progesterone supplementation only. You may wish to try the ProgestaKey Creme, and plant-based bioidentical that will improve your ratio of estradiol to progesterone.

  • annmarie finkel October 30, 2013 - 10:39 pm Reply

    Thanks so much for this information, I had a stroke in 2010 and my GYN will not give me anything, I am 58 years old & pass menepause but I have a lot of dryness, can you help me?

    • Team ALG October 31, 2013 - 2:23 pm Reply

      You may find that an aloe based lubricant (like one available through UNI KEY Health- http://www.unikeyhealth.com) can be quite helpful, or unrefined coconut oil may work just as well for you!

  • Julie November 19, 2013 - 11:30 am Reply

    Phytoestrogens for hormone balance – Good or Bad?

    • Team ALG November 20, 2013 - 1:05 pm Reply

      Phytoestrogens (not including GMO soy) may be an appropriate addition to the diets of some women who are low in estrogen. Salivary hormone testing is recommended in order to determine this.

  • debbie November 22, 2013 - 10:20 am Reply

    I am 48 years old and since the age of 12 have always had horrible pms and cramps in fact I cannot function without taking naproxen the first two days each month. at this time my periods haven’t skipped a beat but I have all the peri symptoms except the hot flashes. just picked up the book “before the change “and want to follow all the herbal suggestions. I believe I am estrogen dominant and would like to try the progesterone cream. would like to try the progestakey is it hurtful to take if your periods are regular still?

    • Team ALG November 22, 2013 - 1:49 pm Reply

      Not at all Debbie. Women in all different stages may benefit from the ProgestKey. If you would like a specialized protocol for balancing your hormones, you may be interested in a Salivary Hormone Test through UNI KEY.

  • AJ December 2, 2013 - 12:24 am Reply

    It is my first time using progesterone cream, I am 53 and in perimenopause,since starting i have been bleeding, at first it was spotting and now i am bleeding more with lots of blood clots, it’s my 12th day now. I don’t know whether I should stop using the cream or carry on.

    • Team ALG December 5, 2013 - 11:42 am Reply

      Hi AJ, If the creme is helping with your other symptoms, you may wish to continue with it until your cycle normalizes. This can take up to 3 months. If you’re not comfortable with that, you might consider reducing the dose or discontinuing. Thank you for your question!

  • Fabi December 26, 2013 - 11:27 am Reply

    any thoughts on Novasure? I just started having problems with my period. excessive bleeding which made me anemic. Im planning on having the novasure procedure in January.

    • Team ALG December 27, 2013 - 1:07 pm Reply

      It may be an appropriate procedure for some women. Have you tried balancing your hormones naturally first? Sometimes a thorough detox and liver cleanse is enough to reset hormone metabolism and correct imbalances that cause excessive bleeding.

      • Fabi December 28, 2013 - 9:42 am Reply

        Thank you so much for the reply

  • Lynn December 30, 2013 - 11:24 am Reply

    May I get some advice…am postmenopausal for 8 yrs, currenntly at age 55. Whenever I try to supplement with progesterone type OTC cream, I get horrible headaches, and feel drugged upon wakening, similar to a bad hangover, and extremely sleepy. This happens using the lowest dose @ 1/8 t. cream applied once a day.

    Why do I get these bad side effects that make me feel so ill? I have all the symptoms of estrogen dominance and losing hair, high weight gains without overeating, etc. Please advise as I was hoping progesterone would at least help my hair loss and horrible ridged fingernails. Thanks so much for your time and this blog!

    • Team ALG December 30, 2013 - 12:15 pm Reply

      Hi Lynn, We are sorry to hear of your uncomfortable symptoms. A salivary Hormone Test would be recommended in order to assess your hormonal balance and determine what type of HRT is appropriate for you. If you do not tolerate progesterone well, perhaps you might do better with pregnenolone, which may possibly convert into progesterone within your body without the negative side effects. Hormone testing every 3-6 months is recommended when supplementing with pregnenolone.

  • linda January 24, 2014 - 4:17 pm Reply

    My Dr. got my hormone results from a blood test; is this as accurate as a saliva sample? They said I was low in testosterone, estrogen and progesterone & have just now put me on progesterone 100 mg. estradiol 1 mg. and testosterone cream 3.5 mg. They are also putting me on Melatonin 20 mg.to get me back on a healthy sleep pattern as I am up until 2- 3 AM every night. I am 54 and have NEVER EVER taken medication so I am REALLY concerned about being on all this stuff; I prefer to go thru life without being medicated. So is this stuff supposed to be natural (bio identical) or is it a synthetic drug made in a lab. I am under a lot of stress and malnourished, I weigh 104. The Dr. I am seeing said I need all of this to get things back where they need to be to improve my health. He also gave me a D3 shot and has me on 10,000 UI of D3 plus some fish oil and supplements. So is it safe for me to be on all these hormones? I stopped having my period 10 years ago and he said that was way too soon; we feel it happened due to a traumatic stressful incident I went thru at that time. He feels these hormones will help me get balanced. So is this safe or not? As for eating, I rarely eat unhealthy, I eat almost all fresh foods and meat without antibiotics or hormones, I just FORGET to eat or jut don’t take the time to eat which is why I am malnourished.

    • Team ALG January 27, 2014 - 3:23 pm Reply

      Blood testing shows a very short window of time, and does not take into consideration “bound or unbound hormones”, so as a method of HRT prescription it tends to be less accurate. Salivary hormone testing is very accurate and shows the levels of metabolically active hormones. That being said, it sounds like your doctor has made some helpful suggestions for improving your health. There are more natural methods of hormone balancing, and if you are interested, you may wish to speak with a UNI KEY Health Wellness Consultant. 1.800.888.4353

      • Joanne February 4, 2014 - 4:58 pm Reply

        After reading these comments, I would like to know if I take the salivary Test, will a recommendation of products be included so I can seek proper balance?

        • Team ALG February 5, 2014 - 6:33 pm Reply

          Hi Joanne, Yes with each test we evaluate the individual results and make appropriate recommendations based on the findings. These recommendations are all detailed in a personal letter, along with a supplement chart as a quick reference.

  • linda February 24, 2014 - 2:18 am Reply

    I saw my regular Dr. last week & told her about my visit to the “other” Dr. as mentioned in my post on 1/24/14 & she agreed that blood tests are not very accurate in testing hormone levels. I will update when I get my saliva test results back. Thank you Team ALG

  • Maria April 1, 2014 - 11:30 am Reply

    I’m so glad to find this source of natural progesterone. When I was 40,I was a big fan of Dr. Lee, listed in the links on this page (http://www.johnleemd.com/index.html). I did the saliva hormone test and found the ratio of estrogen and progesterone totally unbalanced. I used a natural progesterone like Progest Key until I had a good ratio again. Last few months my period hasn’t being like clock work as it used to be, I’ll get a saliva test and then see if I need some Progesta Key, It’s been 13 years since the last one! Thank you Dr. Gittelman for offering a reliable source of this cream.

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