John R. Lee, M.D. and Virginia Hopkins|
Q: What is progesterone?
A: Progesterone is a steroid hormone made by the corpus luteum
of the ovary at ovulation, and in smaller amounts by the adrenal
Progesterone is manufactured in the body from the steroid hormone
pregnenolone, and is a precursor to most of the other steroid hormones,
including cortisol, androstenedione, the estrogens and testosterone.
In a normally cycling female, the corpus luteum produces
20 to 30 mg of progesterone daily during the luteal phase of the
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Q: Why do women need progesterone?
A: Progesterone is needed in hormone replacement therapy
for menopausal women for many reasons, but one of its most important
roles is to balance or oppose the effects of estrogen. Unopposed
estrogen creates a strong risk for breast cancer and reproductive
Estrogen levels drop only 40-60% at menopause, which is just enough
to stop the menstrual cycle. But progesterone levels may drop to
near zero in some women. Because progesterone is the precursor to
so many other steroid hormones, its use can greatly enhance overall
hormone balance after menopause. Progesterone also stimulates bone-building
and thus helps protect against osteoporosis.
Q: Why not just use the progestin Provera
as prescribed by most doctors?
A: Progesterone is preferable to the synthetic progestins such
as Provera, because it is natural to the body and has no undesirable
side effects when used as directed.
If you have any doubts about how different progesterone is from
the progestins, remember that the placenta produces 300-400 mg of
progesterone daily during the last few months of pregnancy, so we
know that such levels are safe for the developing baby. But progestins,
even at fractions of this dose, can cause birth defects. The progestins
also cause many other side effects, including partial loss of vision,
breast cancer in test dogs, an increased risk of strokes, fluid
retention, migraine headaches, asthma, cardiac irregularities and
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Q: What is estrogen dominance?
A: Dr. Lee has coined the term "estrogen dominance,"
to describe what happens when the normal ratio or balance of estrogen
to progesterone is changed by excess estrogen or inadequate progesterone.
Estrogen is a potent and potentially dangerous hormone when not
balanced by adequate progesterone.
Both women who have suffered from PMS and women who have suffered
from menopausal symptoms, will recognize the hallmark symptoms of
estrogen dominance: weight gain, bloating, mood swings, irritability,
tender breasts, headaches, fatigue, depression, hypoglycemia, uterine
fibroids, endometriosis, and fibrocystic breasts. Estrogen dominance
is known to cause and/or contribute to cancer of the breast, ovary,
endometrium (uterus), and prostate.
Q: Why would a premenopausal woman need
A: In the ten to fifteen years before menopause, many women
regularly have anovulatory cycles in which they make enough estrogen
to create menstruation, but they don't make any progesterone, thus
setting the stage for estrogen dominance. Using progesterone cream
during anovulatory months can help prevent the symptoms of PMS.
We now know that PMS can occur despite normal progesterone levels
when stress is present. Stress increases cortisol production; cortisol
blockades (or competes for) progesterone receptors. Additional progesterone
is required to overcome this blockade, and stress management is
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Q: What is progesterone made from?
A: The USP progesterone used for hormone replacement comes from
plant fats and oils, usually a substance called diosgenin which
is extracted from a very specific type of wild yam that grows in
Mexico, or from soybeans. In the laboratory diosgenin is chemically
synthesized into real human progesterone. The other human steroid
hormones, including estrogen, testosterone, progesterone and the
cortisones are also nearly always synthesized from diosgenin.
Some companies are trying to sell diosgenin, which they label "wild
yam extract" as a medicine or supplement, claiming that the
body will then convert it into hormones as needed. While we know
this can be done in the laboratory, there is no evidence that this
conversion takes place in the human body.
Q: Where should I put the progesterone cream?
A: Because progesterone is very fat-soluble, it is easily absorbed
through the skin. From subcutaneous fat, progesterone is absorbed
into capillary blood. Thus absorption is best at all the skin sites
where people blush: face, neck, chest, breasts, inner arms and palms
of the hands.
Q: What is the recommended dosage of progesterone?
A: For premenopausal women the usual dose is 15-24 mg/day for
14 days before expected menses, stopping the day or so before menses.
For postmenopausal women, the dose that often works well is 15 mg/day
for 25 days of the calendar month.
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Q: What amount of progesterone do you recommend
in a cream?
A: Dr. Lee recommends the creams that contain 450-500 mg of
progesterone per ounce, which is 1.6% by weight or 3% by volume.
This means that about ¼ teaspoon daily would provide about
Q: How safe is progesterone cream?
A: During the third trimester of pregnancy, the placenta produces
about 300 mg of progesterone daily, so we know that a one-time overdose
of the cream is virtually impossible. If you used a whole jar at
once it might make you sleepy. However, Dr. Lee recommends that
women avoid using higher than the recommended dosage to avoid hormone
imbalances. More is not better when it comes to hormone balance.
Q: Wouldn't it be easier to just take a progesterone
A: Dr. Lee recommends the transdermal cream rather than oral
progesterone, because some 80% to 90% of the oral dose is lost through
the liver. Thus, at least 200 to 400 mg daily is needed orally to
achieve a physiologic dose of 15 to 24 mg daily. Such high doses
create undesirable metabolites and unnecessarily overload the liver.
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Q: Where can I get more information on progesterone
A: For a detailed explanation of women's hormone balance issues,
a hormone balance program, as well as detailed descriptions of how
to use natural progesterone, the following books by John R. Lee,
M.D. are recommended:
What Your Doctor May Not Tell You About Menopause: The Breakthrough
Book on Natural Progesterone, (Warner Books, 1996)
What Your Doctor May Not Tell You About Menopause:
The Breakthrough Book on Natural Progesterone, (Warner Books, 1996)
What Your Doctor May Not Tell You About Pre menopause:
Balance Your Hormones and Life from Thirty to Fifty (Warner Books,
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Please Note: Using Dr. John R. Lee's
name does not imply in any way that Dr. Lee endorses or recommends
any of the products presented on this website. John R. Lee, M.D.
does not endorse or recommend any one brand of progesterone cream,
nor does he make money from the sale of any progesterone cream.
©2016 Dr. Bonnie E. Travis, DC
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