How will the special tests and my doctor’s examination benefit me if I want to use progesterone?

Certain tests will determine whether there is an absence, or presence of any underlying problems. If everything looks good, you can begin progesterone therapy.

A pap smear, for example, is advisable. This will detect cancerous or pre-cancerous cells, or changes in cell structure of the cervix.

A mammogram can detect early signs of breast cancer, lumps or abnormal cell changes (although regular self-examination is encouraged).

A bone mineral density (BMD) test can detect osteoporosis.

Your doctor can order a screening of blood sugar levels, and cholesterol LDL/HDL ratios.

Other specific tests such as liver function and thyroid function may be beneficial. Comparisons can be obtained through both blood work and saliva assays.

A blood count and salivary hormone profile will determine estrogen, progesterone, the follicle stimulating hormone (FSH), testosterone and DHEA levels. Abnormalities will indicate any sign of metabolic disorders and, where a woman is in her menopausal, peri menopausal or post menopausal stages, it will also show whether she has an absence of progesterone.

Urinalysis will show signs of any kidney disease, signs of infection, or even detect signs of glucose which indicates diabetes or pre-diabetic conditions.

A pelvic ultrasound will determine diseases of the uterus and the ovaries, and is useful for women where a pelvic examination may be uncomfortable, difficult or inconclusive. It also gives us a good picture of what is happening on the ovaries and also the state of the pelvis in general.

Some women also have a bladder function test to determine the amount of urine they can hold, and we have had lots of women who have required bladder hitching surgery, and others, bladder stretching on a regular basis. We believe this is hormonally linked and often women report improved bladder capacity 12-18 months after using progesterone on a regular basis.

The doctor’s physical examination should include:

• blood pressure: detect whether you run any risk of cardiovascular disease, hypertension (high blood pressure) and risk of stroke


• weight: determine whether you are underweight or overweight (very indicative of hormone imbalance, particularly estrogen dominance and Syndrome X)


• thyroid: detect if there is an abnormality, growth, enlargements, lumps; a thyroid function to determine overactivity or underactivity such as hypothyroidism


• breast examination: check the breast tissues and see that there are no abnormalities, puckering or presence of lumps or multiple cysts, changes occurring in texture / colour of tissue or nipple


• abdomen: check for any tenderness, lumps or swelling / distension particularly over the pelvic area or around the liver area


• pelvic examination: check your pelvic organs, the condition of your ovaries and whether they are tender or if there is any hardness, lumps, any enlargement, signs of cancer


• uterus : is it prolapsed


• vaginal tissue: signs of atrophy or whether the vaginal tissue is in good order and healthy skin colour and texture


• bladder: is it prolapsed, investigate problems such as discharge, thrush, stress incontinence or cystitis, and other related problems


• urethra: may be inflamed, doctor may also want to do a pap smear and bladder tests if you repeatedly complain of urethritis or vaginal itching and so forth, which can indicate low grade infection that may need a culture


• full blood profile: check haemoglobin reading (anaemia), B12 deficiency, and so on.

Because most GPs appear to be running to a very tight schedule and often under pressure, we recommend women take along their list to remind them of the things they would like checked out to ensure they get value for money, and book a double appointment if you feel you need more time.

It sounds pretty daunting doesn’t it? However, if you go in armed with knowledge, reasonable expectations, and your list, chances are the doctor will take you seriously, and know that you are not there to waste his time. That you have specific needs and requirements of his service to you.

Ultimately (we hope) your GP will respect you for having done your homework and for being a person of clarity. You are there for a specific purpose … to elicit the support of your GP in achieving optimal physical and mental health.

If your GP is uncooperative, then perhaps it’s time to change doctors.