# Another (confusing) but timely article on Natural Hormones



## Persistance (Jul 11, 1999)

I wish this article was of more help - but it lays some of the problems out. http://www.latimes.com/features/health/la-...ral5aug05.story


----------



## Persistance (Jul 11, 1999)

Sorry. Seems no-one but Times archives members can pull the stupid things up (not fair, since any article less than two weeks old is free, anyway). August 5, 2002 *'Natural' Is No Guarantee* Drugs* Although more doctors are prescribing hormones derived from plants, no one knows if they are any safer than the traditional type. By SHARI ROAN, TIMES STAFF WRITER Like most other middle-aged women, Nancy Smith heard the news last month that a commonly prescribed hormone replacement regimen could increase the risk of heart attacks, strokes and breast cancer.But the Agoura Hills woman, 49, wasn't sure what the Women's Health Initiative study, which tested a synthetic estrogen-progestin pill called Prempro, meant for her personally. After all, she doesn't take Prempro."This study was on the one-drug combination," says Smith, a veterinarian. "What about everything else women take?"Smith is among a growing group of women who take so-called natural estrogen and progesterone, which come from plant sources and are chemically identical to the hormones women make. "Natural" refers to the substance's chemical composition, not its source.Natural hormones have long been touted by alternative health practitioners and some Internet-based pharmacies to be safer and easier to tolerate than hormones made by drug companies and sold under names like Premarin and Prempro. More mainstream doctors are also recommending natural hormones, which are typically dispensed through compounding pharmacies. These pharmacies blend and package hormones in specific formulations ordered by doctors for individual patients.Even some drug companies have developed brand-name products touted as natural because they contain one type of estrogen identical to what women's bodies naturally produce.And, in light of the recent findings, other doctors and women are wondering if natural hormones are a safer alternative.The answer is that no one knows."Unfortunately, we know less about those products than we do about the ones in the trial," says Dr. Elizabeth Barrett-Connor, a women's health researcher at UC San Diego. "There is no safety data. There is no efficacy data. They might be preferable. They might be worse."Divergent EffectsThere are clearly differences, however, in the way various hormone products are made, raising questions about whether they might have divergent effects in women.The estrogen in Prempro and Premarin is derived from the urine of pregnant mares and contains equine estrogens and estrone, a form of estrogen natural in women.Many women taking hormone therapy also take a progestin, a chemical that is synthesized to mimic a woman's progesterone, because taking estrogen alone increases the risk of developing uterine cancer.Natural estrogen and progesterone, in contrast, are made from plants, such as wild yams and soy, and are chemically identical to the hormones produced in women's bodies. The natural estrogens--estradiol, estrone and estriol--are available in compounded formulations called triple natural estrogen (TriEst) or dual natural estrogen (BiEst). Natural progesterone is also available in a compounded formulation.Some drug companies also make so-called natural estrogen products, such as Estrace, a pill, and Estraderm, a skin patch. But those products contain only estradiol.Both traditional and natural estrogens mimic what a woman's body makes and begins to lose during menopause. And some people say the natural hormones do a better job of that--not only because of their chemical structure but because the doses are typically lower."Most side effects from hormone therapy are related to doses. And the doses [made by drug companies] are just plain too strong for most women," says Dr. Jay S. Cohen, a San Diego doctor and author of the book "Over Dose: The Case Against the Drug Companies."Compounding pharmacies can also package natural hormones as pills, creams, gels, suppositories or drops--which may improve how women absorb and metabolize them.Difference in DeliveryThere may be some theoretical basis for believing that the way hormones are taken can make a difference, says Dr. Richard King, a menopause expert in Gainesville, Fla. King says he prefers to prescribe an estrogen patch, so that the hormone bypasses the liver and goes directly into the bloodstream--possibly making it safer.He also prescribes a natural progesterone called micronized progesterone that is made from yams. Micronized means the hormone is finely ground and is more easily absorbed by the body. Micronized progesterone synthesized from yams can also be ordered by prescription from compounding pharmacies and is available in a brand-name product called Prometrium.But to think that natural hormones are a "safe" alternative to the hormones used in the Women's Health Initiative study is too simplistic, many experts say."We're hearing that ... 'If you only get the product right, hormone therapy will work beautifully,' " says Dr. Maida Taylor, an associate clinical professor at UC San Francisco who has studied the issue. "But that is extremely unlikely. There is no reason to believe these will be safer."Compounded natural hormones may take longer to resolve menopausal symptoms, experts say. And compounded hormones, if not carefully constructed, can vary from batch to batch in their potency.Women who switch from the traditional hormones to natural hormones should not be told that they are receiving a much different product, Taylor adds. "It's very easy to make claims that something is better. But it's very hard to do quality research," she says.It's unlikely studies will be done to shed light on how different doses and formulations of estrogen and progesterone act. Since natural hormones cannot be patented--and accordingly, drug companies can't make huge profits from them--there is little incentive for anyone to test them. If you want other stories on this topic, search the Archives at latimes.com/archives.Click here for article licensing and reprint options a d v e r t i s e m e n t Copyright 2002 Los Angeles TimesBy visiting this site, you are agreeing to our Terms of Service.Privacy PolicyPowered by Genuity


----------



## Tiss (Aug 22, 2000)

I've been on 'natural' plant derived tri-est, testosterone, and Prometrium and Estrace cream for months. I wonder too if they are safer than the synthetics. The one thing I can say is that I had all kinds of side effects from the synthetic hormones and I've had NO side effects with the natural. The thing I also like is that you can work with your compounding pharmacist to adjust the doseages anytime you need to.


----------



## pennyann (Jul 29, 2002)

I use a progesterone cream that I bought on the internet. I rub a small amount on my stomach every day. I has helped ease my pms and cramps significantly. I used to get pms headaches but the cream has greatly reduced them. I am 33.


----------



## HipJan (Apr 9, 1999)

I've used nat. pro. cream for 1-1/2 years. The cream, in addition to gaining some weight back, was responsible for finally taking away my nearly daily unexplained pelvic pain (tons of infection-like burning, nerve pain; ovary pain; bloating; irritable bladder). It doesn't relieve my cramps, though, except that day 1 cramping may well be reduced; I believe that's because I have a separate problem that is not well relieved by hormones. Also, I believe the progesterone, while appearing to help the IBS, has caused other mild GI distress for me: gassiness and previous nausea attacks primarily. Still, I'm sticking with it for now.Thanks, Persist., for the articles. Yup, no patents and thus little incentive for studies. What a shame! So, we continue to bumble along!


----------



## Persistance (Jul 11, 1999)

I'm sorry to hear about this gassiness (nausea only previously, though, you say), HipJan. I don't know if the Progesterone would cause that taken as a cream. When I was going through perimenopause and not getting enough estrogen, it would cause mild nausea. I don't know if it's related with you. Guys -- I don't think the stuff you get over the Internet or OTC is as effective as when prescribed. The prescription-strength compounded progesterone cream, gel or micronized tablets are all 8-10% strength, whereas the others are anybody's guess -- usually around 3%, is what I have heard. The same thing for Prometrium -- stronger. I used to be able to relieve my cramps if I caught it in time, by using the stuff. I've never tried anything over-the-counter. Perhaps one of your doctors would give you a prescription to just try it, HipJan?


----------



## HipJan (Apr 9, 1999)

We'll see what the doc says this next time, in a couple months! 2%, which sounds low, is the typical strength of the OTC creams and is the recommended strength of certain author-doctors such as John Lee. (Maybe he thinks people are prone to overdoing it or something?)Here's my theory, for me... "Most" women can probably tolerate more progesterone than I can. Like I said, I believe it does contribute to some of my GI distress, esp. upper, though it also appears to quite help me in other ways. Also, a certain amount of progesterone will eventually convert to estrogen (and testosterone). My menstrual habits sure began changing after I began using my little dabs of pro. cream - first certainly for the better and then for the worse (unless it was a coincidence, which is possible). My theory, as yet "unproven," is that the normal conversion of pro. to estrogen in my body eventually made certain things worse for me - because I'm pretty sure I've been estrogen dominant for years (though that may not have been true when I lost most of my body fat a while back and thus my stored estrogen). As such, I believe my adenomyosis condition - causing horrid cramping and nowadays heavy, prolonged bleeding - worsened, that the hormones just fed the condition. The adeno. should "dry up" and go away upon menopause or as my hormones, esp. estrogen, become more depleted. (So, ironically, I am currently experimenting with actually lowering my doses of pro. cream again.)







I imagine no one's listening at this point, but I find this hormone stuff pretty fascinating - and wish the doctors, and I, knew more!


----------



## Persistance (Jul 11, 1999)

HJ -- I've read John Lee and take him with a grain of salt, because, remember, he's also trying to sell his product. I'll just say this -- most experts in the medical field say that the OTC stuff you get is so weak it's pretty close to ineffective when it comes to what a woman's body needs. I used to go to menopause groups in the 90's, some groups led by nurses, and some private groups with just a lot of us ladies comparing notes. I went to a ton of them. And this was the general consensus, as we all learned together.I am not sure about the progesterone converting to estrogen...maybe you know something I don't? Is that what John Lee says? Tell you what, call the Woman's International Pharmacy and ask to speak to one of their pharmacists, and put the question to them. They're just great: 1-800-699-8144 or 8143. And they make progesterone in every form, which insurance will pay for.Prolonged bleeding and cramps would be, yes, with lots of estrogen and not enough progesterone to counteract it -- which is the role of progesterone -- to "oppose" what estrogen does. Perimenopause -- if you are actually in it -- is usually when the body gradually stops making both hormones, but it's erratic. At certain times, it's too much estrogen and not enough progesterone -- hence, all the extra bleeding that goes on. For instance, they give women progesterone every day to take with their estrogen tabs, if the woman has decided she doesn't ever want to get periods, right? After a few months of this, the periods usually stop. If the woman doesn't mind a period, they give progesterone only during the last five-ten days or so of the cycle. That is the principle with birth control pills as well (at least when I was taking them). I'd get, say, 23 blue pills with estrogen in them, and five orange, with progesterone. It causes the lining to slough off and bleed when withdrawn. However, if you were just to take estrogen, your lining would build up to a dangerous level. And you'd start leaking and having breakthrough bleeding.But you have this other icky situation, the adenomyosis, which doesn't help, as you say. It sure sounds miserable. I hope your body works through this one, soon! I bet the perimenopause does make all of it worse. Well, let us know if lowering the progesterone helps you.Yeah, it's pretty fascinating.


----------



## HipJan (Apr 9, 1999)

But, P, John Lee doesn't have a product, except books, of course....







(And if he did, wouldn't he tell you to take more, not less?) That said, I don't doubt what your nurses were saying. And my own doctor doesn't seem enthused one way or the other over the bit of pro. I use, giving me the impression she doubts it's doing too much. And, of course, the amount needed can vary greatly per person. But....After using just a tiny bit of progesterone for 3 weeks, my sleep became notably better and my long-term pain was mostly gone, and the periods got more normal too (again, for a while). And I also got that nausea and stuff, which seemed to come with the little bit of progesterone I was using (Women's Transitions in Health finally admitted to me that progesterone in any form, even their cream, can cause gastro. upset for a few women; plus I've heard that from others too). So apparently, for me, "just a dab'll do ya" might be true. My body might be extra sensitive to the stuff.Oh, yes, I've read over and over that progesterone is a precursor to estrogen and testosterone. Sometime, I'll try to find a link or two other than from John Lee and Transitions in Health (the two aren't related); I say that, and maybe I won't be able to find one.







Yes, typically, lots of bleeding can be attributed to too much estrogen in comparison to progesterone. And/or it can be attributed to adenomyosis - or a combination of these two. You'd think bumping up my progesterone would help me. But the longer I took the progesterone, the more bleeding occurred (at first, for me, that was good, but later, ugh....); that does make some sense to a degree, as pro. can help both increase and decrease bleeding. And when I significantly bumped up my daily amount of low-dose progesterone, thinking I needed more, things just got worse. (But, like I said, this could simply be a coincidence. Do you think that's probably the case?) So, as an experiment, I have been lowering my dose again. Probably nothing will come of it.







P.S. You know, also in the case of adenomyosis, some of the bleeding is not from sloughed-off uterine lining. (I can't explain this well, as what I've read about this particular detail wasn't explained well.) Some of it somehow comes in response to the contractions, because the endometrial lining grows down deep into the muscle.


----------



## Ks-Sunshine (Aug 23, 1999)

Thanks Pers. Even though the article didn't exactly address my questions, I did get some good info from it.Bottom line is -- my daughter asked me who my gyn is and I said I didn't have one. She then said she thought I should see one and ask about the HRT. Guess I will in a month or so.


----------



## HipJan (Apr 9, 1999)

"From progesterone are derived not only the other sex hormones, including the estrogens, but also the corticosteroids, which are essential for stress response, sugar and electrolyte balance, and blood pressure and survival. Because of the role played by progesterone in so many hormones, a deficiency of progesterone can cause a wide range of problems." (from an Internet site)"For every receptor that is occupied by progesterone, a molecule of estrogen is thus freed up to do its work elsewhere. In other words, putting progesterone into the system effectively raises the amount of estrogen available to do estrogen-only tasks. This is a slippery concept, but a critical one to keep hold of when working on hormone balance."Progesterone is not only a hormone in and of itself, but can also be used as a building block to produce either estrogen or testosterone. While it's not likely that you can meet your estrogen needs solely from progesterone conversion, many women are able to produce enough testosterone when they have an adequate supply of progesterone. "One word of caution we need to sound on progesterone and its popularizers, most notably Dr. John Lee. With all due respect to Dr. Lee for leading the way in legitimizing this hormone's use, his book must be taken with a grain of salt by women in surgical menopause. While it may or may not be true that women in natural menopause can meet their hormone needs by the use of progesterone alone, this is certainly not the case in surgical menopause. While we know of plenty of women who found his reasoning seductive, not one of them was able to stick to progesterone-only HRT." (from another site - nonmarketing)


----------



## Persistance (Jul 11, 1999)

Wow -- I can't believe they used the exact words I did, about taking Dr. Lee with a grain of salt (although they say only in surgical menopause). Initially, he did a real service to women by opening the doors to acceptance of natural progesterone when traditional doctors were all upright about it. My friends and I all excitedly read him and quoted him back in the 90's. But he goes a little far, I think, with this "progesterone is all" thing. I may be wrong that he sells progesterone. So many of his tapes and newsletters are offered for a price with certain progesterones, that I had thought he was involved in it. I remember calling up an 800-number from his site, and being told about the progesterone, but maybe he doesn't anymore.Well, HJ, what you present is too complicated for this feeble brain! So progesterone frees up estrogen to do its tasks? But what if you're running low on estrogen, too -- as we do in perimenopause and menopause? I've never met any menopausal women who could get by on progesterone alone -- BUT they give it to women in perimenopause to straighten out their periods (boy, I wish I'd been able to take advantage of that, but I was a little early!) This is when women start skipping a period for two months, and then have heavy bleeding the next few -- giving them progesterone straightens it all out -- and your mood and your state of being. I think that it's not going to "cause" bleeding in and of itself. There has to have been a proliferation, an estrogen build-up (however, the aden. thing is something else, which I don't know about). Then the proliferation is sloughed off by the progesterone. So in that sense, you are bleeding more, because it's getting rid of more. If you take adequate progesterone every day, estrogen never gets a chance to build up. If you take it the last 12 days of your cycle, there will be less bleeding than there would otherwise. I can see how it could cause some gastric distress, perhaps. Particularly when taken in pill form -- although if it's topical --not real sure how this would work. I never got the good sleep from topical progesterone that I did with the micronized capsules from Womens Intl. Pharmacy, because the capsules sit in the stomach, causing sleepiness.But again, you'll see. You'll test it on yourself and lower the progesterone, and see what happens. And report back to us, please!







Yeah, sure Sunny. It would be a good idea to see one. I'm sure she'd (he'd) go along with whatever you wanted to do, and have some good information, too.


----------



## HipJan (Apr 9, 1999)

P,Yeah, John Lee, to me, simplifies some of his info. He gives you the impression that progesterone is the cure-all - and it really isn't, though I'm convinced it can be quite beneficial in certain ways. So, I've learned to take him with a grain of salt (yup, I thought you'd like that part!) to a degree as well. However, I must say his books have still been quite useful for me. John Lee doesn't endorse any particular pro. cream, though he does "approve" of several different brands. Many of these brands of pro. cream, through their marketing, try to make it appear he does endorse them, however.Yes, according to my readings, adeno. causes yet more bleeding in and of itself - i.e., some of that bleeding is not even "menstrual," I read in a medical article. Fun. Not even progesterone is supposed to be able to reduce the amount of adeno. (which I believe I've found); John Lee even skirts around this issue, not making claims for pro. helping adeno. once it has established itself. (But, yes, if I took large amounts of pro. every single day, I could conceivably alter my cycles and reduce or stop the bleeding.) So, I guess the answer is that I should take small amounts or large, daily amounts - but nothing in between! Confusing.


----------



## Persistance (Jul 11, 1999)

Nah -- don't go experimenting around by yourself. Wait till you see a GYN. I have a feeling this will all work itself out. Perimenopause is miserable. In the meantime, you could "Ask the Expert" on Power Surge and "Ask a Pharmacist" on Women's International Pharmacy webiste -- I'd rather see you talk live on the phone to a pharmacist at the latter than e-mail. They used to take quite a lot of time with callers.Okay -- to try and unconfuse this a bit. What if you were to try a schedule: progesterone for the last 12 days of your cycle -- that would duplicate the way normal women's progesterone kicks in for about two weeks after ovulation. I am wondering if you would not straighten things out (that's what HRT does -- it mimics a woman's normal cycle. Menstruating women normally make estrogen for two weeks, which peaks at ovulation, and crests right after that, when the progesterone kicks in). That is -- if it's NOT the adeno problem. Eek.


----------



## HipJan (Apr 9, 1999)

I might try chatting at the places you mention. Thanks. I use pro. cream for about 14-16 days. (Just before ov or at ov till end)


----------



## Patty (Mar 18, 1999)

I have noticed that taking the Estratest HS caused me diarrhea! That I hate!I'm really confused about it all now.....Have you all heard of Remifemin? I got a free sample of that in the mail yesterday. It says it contains NO estrogen, but relieves moodiness, sleepliness, hot flashes, night sweats....To try or not to try ----- that is the question....


----------



## HipJan (Apr 9, 1999)

I wonder what is in that, Patty? Phytoestrogens? Herbs? Wishing you good luck.An Update (for anyone interested): After doing my little "test" - that is, simply lowering my small dose of OTC pro. cream for a couple months - my menstrual symptoms appear to have gone down a notch (a bit lighter, a bit less cramping), though the jury is still out. Still not a day at the beach but an apparent difference. I believe I will keep my dose at a very small one for now; sometimes that may not work (esp. those times I have anovulatory cycles), but overall, I think that's better for me for different reasons. Now, if I can only get through the next few years...and beyond...without too many wild symptoms!







I am upset by some of the marketing associated with various manufacturers of natural pro. cream - telling one to use so much of the stuff (not that I personally ever used that much). I speculate that, eventually, more research will show that "less" is better than "more" - for many of us, at least. Again, though, it depends upon your goals and individual needs. I also speculate that, eventually, more mainstream MDs will be advising the use of nat. pro. cream - in small quantities - as well as other alternatives. But there are so many unknowns remaining at this point, so I can see why many of them are remaining rather mum. (P, I have a feeling some doctors in CA may be more "progressive" than docs in other parts of the country.)P.S. Patty, speaking of D, recently my "IBS" has returned! I associate most of it with changing hormonal levels. I am not surprised the Estratest caused D for you.


----------



## Patty (Mar 18, 1999)

I think the main ingredient in Remifemin is Black Cohosh (sp).


----------



## carolauren (Mar 14, 2002)

I believe that is correct. It may also have some soy in it. You can get black cohosh by itself at a health food store for less money--I found it quite effective at relieving hot flashes, though it took about three weeks to take effect.


----------



## Persistance (Jul 11, 1999)

Try it, it can't hurt. One of the doctors on Power Surge (maybe Christine Northup? Or Ann Gittleman? was mentioning it). HJ -- maybe just L.A., but don't forget, while progesterone CREAM is all the fad now, almost any of your doctors will have heard of the FDA-approved Prometrium, which is the same thing, in micronized pill form, and probably more easily measurable. And again, if any of you want to have a list of doctors in your area, write to the North American Menopause Association (I believe they're in Chicago), or get them on the web and download the list. Womens International Pharmacy, in Wisconsin and Arizona, will also (or used to), tell you some doctors in your area who use their products.


----------

