Is progesterone supplementation appropriate in the treatment of uterine fibroids?

Hi Catherine,

I am perimenopausal and have been using “natural progesterone cream” for several years. I have recently been diagnosed with fibroids the size of a 14 week pregnancy and was dismayed to learn that progesterone can be a factor in fibroid growth.

I am most angry to think that my progesterone cream regimen is probably to blame! Evidence shows that antiprogesterones shrink fibroid growths by up to 50%. I will never use my cream again and am angry with John Lee for promoting this cream as being good for fibroids!

Nancy

Dear Nancy,

Just weeks before his death, working with Virginia Hopkins, Dr Lee completed a fully revised and updated edition 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 goes 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.”

This information is repeated in the 2002 publication ‘What Your Doctor May Not Tell You About Breast Cancer‘ authored by Dr Lee, Professor Zava and Virginia Hopkins.

The 1996 edition of ‘What Your Doctor May Not Tell You About Menopause‘ does not contain this revised ‘wisdom’. When this book first went to print, Dr Lee obviously believed that “when sufficient natural progesterone is replaced, fibroid tumors no longer grow in size (they generally decrease in size) and can be kept from growing until menopause“.

Clearly, in the ensuing years, Dr Lee saw the need to ‘qualify’ his position. As well he might following an exhaustive eight year stint on the international lecture circuit surrounded by some of the brightest minds medical science has to offer. And lets not forget all the women who shared their experiences with Dr Lee’s team.

I think we need to be aware that 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, such as yours, Nancy, where uterine fibroids have not responded to progesterone therapy. They, in fact, grew in size.

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.

Women who are, by all accounts, estrogen dominant do appear to benefit from progesterone supplementation in doses of 20mg per day from Day 12-26 of their cycle.

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.

For this reason, 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. Regular saliva assays will enable your physician to capture a complete snapshot of hormones levels.

Dr Lee, during the living years, dedicated a large chunk of his life to progesterone research and the plight of women (that’s you and me!) imprisoned by undiagnosed or misdiagnosed hormone imbalance. I don’t believe he ever claimed to have all the answers. Rather, he was, as I understood, primarily about getting accurate information out there into mainsteam medicine, media, etc. Dr Lee sought, in part, to achieve this through the Progesterone Research Institute which he founded before his untimely death last year.

Here’s a suggestion, Nancy. Instead of placing blame where it doesn’t belong, why not make a donation to the PRI? Get behind a worthy cause and help fund much needed research … which ultimately YOU might benefit from!