Can progesterone cream actually increase fibroid size?

Uterine fibroid tumors, like breast fibrocysts, are a product of estrogen dominance

I am a 44-year-old woman and the mother of three children, all born while I was in my 30s. I was diagnosed with having a very large fibroid — 10 centimeters — earlier this year. My gynecologist recommeded a hysterectomy. However, upon the recommendation of my family practicioner, I recently started taking natural progesterone in vaginal suppository form. I can honestly tell you that the initial results have been astounding. I was suffering from very heavy menstrual periods. With my fist period on progesterone, my period was not just more normal but actually light. I could not believe it! I have been on large doses of iron since earlier this year because of anemia — mostly likely from the large fibroid. If this continues, I can look forward to ending my anemia and thus the iron supplementation in the future. However, I have become concerned because I keep finding references that progesterone actually increases fibroid size, especially for larger fibroids. What exactly “larger” means has not been fully defined, but I am assuming that my 10 centimeter fibroid would count as larger. Am I correct? Is it possible that the progesterone suppositories can increase the size of my fibroid while also controlling the bleeding? This does not seem logical — that the symptoms would improve while the condition might actually be worsening. But I am not a doctor. I am looking for some advice here because the medical literature I have come across on the internet and in Dr. Lee’s books is often contradictory. I am now considering a myomectomy (I absolutely do not want a hysterectomy if it can be avoided), but I would prefer to avoid all surgery if possible. If the reduced bleeding is a sign that the fibroid could possibly start shrinking then I might also be able to avoid the myomectomy. But if it is likely that fibroid might be growing from the extra hormone — well, I am in potential trouble. Please advise as I am both concerned and a little frightened. Thank you.Claire

My wife has been diagnosed for fibroid in her uterus. Kindly let me know whether operation is to be done to for that or any hormonal theapy is possible.Jvaithy

I am a 35 year old woman that got diagnosed with fibroids about a year ago, but I think I had been suffering much longer than that. However, I started progesterone treatment (bio-identicals) in early Dec. It helped regulate my periods a bit, but then I started having the worst periods of my life and heavy bleeding with major cramps. I am bordering on anemia, but am hanging in there. I got a new doctor in March and started a new regime of progesterone 0.5 ml 1x day days 4-13 and twice daily same dosage days 14-25. I started spotting more and more and the periods really didn’t improve. The pharmacist and my doctor said the spotting was probably a sign of not ovulating and perhaps needed more progesterone. I then upped the dosage for two weeks to 0.6ml twice a day. I started feeling horrible with terrible back aches. I knew instinctively something was wrong. Intuitively, I feel progesterone might not be my answer. I kept calling my doctor and she kept saying be patient, but she ordered another ultrasound and I got off the progesterone. My fibroids had doubled since Sept. She said I needed to resume my treatment along with some cleanses and simply be consistent and patient. I have not listened and have not resumed the progesterone and am waiting for her to order a saliva hormone test. Could this have increased the fibroid sizes? I have changed virtually nothing else in my life since then and I NEVER leveled out with my cycles after almost 6 months. Help? Not sure what to do, but my doctor and pharmacist are not up on the latest literature it seems. Any thoughts?April


Catherine responds …

Because no one knows for certain what causes uterine fibroid tumors ( myomas ), treatment is very much a grey area.

Uterine fibroid tumors, like breast fibrocysts, are a product of estrogen dominance (too much estrogen). Estrogen stimulates their growth, and lack of estrogen causes them to atrophy.

Uterine fibroids can cause infertility and miscarriage, and are one of the most common problems of perimenopause. The ‘solution’ in many cases tends to be a hysterectomy. But, for some women, understandably, this is their very last option.

We know that fibroids naturally atrophy after a woman enters menopause and her body’s estradiol (E2) levels drop by 40-60%.

Fibroid ‘tumors’ means a swelling or a growth, not a malignancy, not cancer. Less than 0.1% of all uterine fibroids are malignant.

Today, it is well known that the greater a woman’s exposure to estrogen, the greater her risk of developing breast and uterine cancer. So keeping our E2 levels within the optimal ratio is vitally important.

Over the decades, many studies have confirmed that prolonged, continuous exposure to estrogen is carcinogenic, and that progesterone offsets those effects.

Following the animal studies that showed that carcinogenesis by estrogen could be prevented or reversed by progesterone, studies of the endogenous hormones in women showed that those with a natural excess of estrogen, and/or deficiency of progesterone, were the most likely to develop uterine or breast cancers.

Women with progesterone deficiency have a markedly increased incidence of breast and others cancers (Cowan 1981). The application of progesterone cream to the breasts decreases proliferation activity in breast tissue while estradiol cream increases such activity (Chang 1995). In a study of women undergoing breast tumor excision, those who had higher levels of circulating progesterone at the time of excision had a significantly improved prognosis.

Progesterone is our body’s natural anti-estrogen. It is carcino-protective. It protects us against the ‘growth effect’ of estrogen. Progesterone is an important regulator of growth and differentiation in breast and uterine tissue. Prolonged exposure to estrogen, that can’t be offset by the homeostatic factors, such as progesterone, typically causes cells to enter a growth phase.

The cyclical waves of proliferation, differentiation, shedding and regeneration of human endometrium, which occur on average 400 times during reproductive life, are unparalleled in any other tissue of the body. And yet in spite of the pre-eminence of progesterone in female reproduction, its molecular mechanisms of action on target cell proliferation and differentiation are not well understood.

Dr Ray Peat writes, “When the ‘progesterone receptor’ lacks progesterone, it has the opposite effect of progesterone”.

The late Dr John Lee, just weeks before his death, working with Virginia Hopkins completed a fully revised and updated version of his publication ‘What Your Doctor May Not Tell You About Menopause‘. In it he pointed out, “Fibroids tend to grow during the years before menopause and then atrophy after menopause. This suggests that estrogen stimulates fibroid growth, but we also know that once they get larger progesterone, too, can contribute to their growth.”

Dr Lee went on to state, “Some fibroids, when they reach a certain “critical mass” are accompanied by degeneration or cell death in the interior part of the fibroid and will have an interaction with while blood cells that ends up with the creation of more estrogen within the fibroid itself. It also contains growth factors that are stimulated by progesterone.”

We need to be aware the jury is still out over this issue. Yes, progesterone therapy has proved successful for some women experiencing heavy bleeding associated with fibroids. However, there have been reported cases where uterine fibroids have not responded to progesterone therapy. They, in fact, grew in size.


When treating smaller fibroids we should be thinking in terms of keeping our estrogen levels as low as possible. And when treating large fibroids, all hormones should be kept as low as possible.


It would appear that women with fibroids are often estrogen dominant and have low progesterone levels. In women with smaller fibroids (the size of a tangerine or smaller), when progesterone is restored to normal levels, the fibroids often shrink a bit and stop growing, which is likely due to progesterone’s ability to help speed up the clearance of estrogens from tissue.

Regular saliva/bloodspot assays will enable your physician to capture a complete snapshot of fluctuating hormones levels.

Stress is a biggie when it comes to balancing our hormones. Stress steals our body’s progesterone stores to make cortisol. So if you’re under constant stress, you’re going to need more progesterone.

Dr. Christiane Northrup believes fibroids represent creativity that was never birthed. She talks about dead-end jobs and relationships, and conflicts about reproduction and motherhood.

Stress and personal grief, fatty liver and other factors need to be considered here as to their potential to compromise the uptake of progesterone.

Feedback from women like Tiffany and Doris suggests that, in many cases, progesterone DOES work, and is often THE missing part to the puzzle.

I strongly urge women to work in consultation with a collaborative, open-minded physician to undertake regular ultrasounds that will monitor the stages of fibroid growth and determine the success of their progesterone dosage.


Avoid progesterone creams that contain herbs that have a strong estrogen effect known phytoestrogens. And make sure you’re NOT taking prescription estrogen. Are you exposed to estrogens in your environment?



How to treat fibroids

  • Decrease estrogen overload
  • Balance estrogen with progesterone cream – a key component
  • Support liver function
  • Increase pelvic and general circulation
  • Do a cleansing and detox, especially for the liver
  • Deal with emotional conflicts that might be playing a role
  • Keep blood sugar levels stable throughout the day and night to keep progesterone receptors working optimally
  • Other things to check for are low thyroid and adrenal function

To reduce estrogen it’s important to maintain a healthy diet and support the liver. If your liver isn’t working well, estrogen can stay in your system longer than it’s supposed to.


Progesterone dosing

Women who are estrogen dominant appear to benefit from progesterone supplementation in doses of 10-20mg divided into two daily doses from Day 12-26 of their cycle.

If bleeding starts while you are on progesterone, just stop the progesterone, wait 12 days and start over again for another two weeks.

It may take 3 to 4 cycles to get everything in synchrony.

Vaginal application of cream can, for some women, provide a more direct and effective route of delivery in the treatment of fibroids where topical delivery has rendered progesterone therapy less effective.


Healthy estrogen metabolism

In last decade, new research has come to light that demonstrates synthetic chemicals found in our environment and drinking water that are very different in structure to estrogen may act as an estrogen.

These foreign-to-the-body estrogens, known as xenoestrogens, may either bind to the receptor strongly or weakly. They may also stimulate the receptor strongly or weakly to imitate the effect of estrogen, or it may elicit a response that is an abnormal estrogen response.

Xenoestrogens are a primary cause of reproductive health problems in both women and men because they attach to and over-stimulate estrogen receptor sites. This causes changes in estrogen-sensitive tissues like the breasts, uterus and prostate. Xenoestrogens stimulate abnormal changes in these tissues, causing problems like breast cancer, uterine cancer, fibrocystic breast disease, ovarian cysts, endometriosis, premature sexual development, uterine fibromas and prostate enlargement.

In my article How to be Proactive in Your Breast Wellness I outline things you can do today to make changes in your health that will also have a positive impact on your uterus.


Alternative to medical and surgical intervention

Share’s one of our readers, “I wanted to let a woman know that she can avoid a hysterectomy by choosing: MR guided Focused Ultrasound Therapy is a non-invasive, outpatient procedure, which uses high doses of focused ultrasound waves (HIFU) to destroy uterine fibroids without affecting any of the surrounding tissue. This is what I am doing for mine. It’s just something people should look into and know about. Especially if they’re like me & have an autoimmune disorder and need to avoid surgery however possible.”

Magnetic Resonance-guided focused Ultrasound Surgery (MRgFUS) is gaining popularity as an alternative to medical and surgical interventions in the management of symptomatic uterine fibroids. Studies have shown that it is an effective non-invasive treatment with minimal associated risks as compared to myomectomy and hysterectomy.

In contrast to other invasive treatments for uterine fibroids, the relatively non-invasive MRgFUS can be performed as an outpatient procedure and requires no general anaesthesia.

And as always, if you have any questions, I’m here to offer my support and guidance.

Catherine P Rollins, Founder & CEO
In love & appreciation,
Catherine P. Rollins
Founder & CEO

Ethically Supporting Women’s Choice of BHRT Since 2001


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