My gynecologist tells me natural progesterone converts to estrogen and can cause cancer.

Hi Catherine,

I wrote you back in the winter about some problems I have been experiencing and you were gracious to return some helpful information to me. I have been using a natural progesterone cream since then, but recently I had visited my gynecologist and was surprised to have her tell me that since I had a complete hysterectomy (including ovaries) (1995) that I do not need this progesterone cream - since I no longer have a uterus and that, in fact, once absorbed, it actually converts to (too much) estrogen inside my body, and can lead to cancer. She strongly suggested that I take an estrogen patch instead, and gave me some samples of Climara (estradiol transdermal system) at 0.06 mg/day. I haven’t tried this but she believes this is what I need and told me that I have been given misinformation about natural progesterone cream.

I am so confused at this point. I told you previously, that I had been taking Premarin for 5 yrs - and then switched to Cenestin for the next 2 yrs. I finally gave up HRT altogether in 2002. I am only 46 years old, but I still don’t feel my best - I am experiencing colon problems - chronic constipation - and have a colonoscopy scheduled in two weeks. (An abdominal ultrasound showed no abnormalities).

I was also diagnosed with hypothyroidism several years ago - no one in my family has this condition! - which seems to be progressing, as the doctors have increased dosage 3 times this year.

Should I continue taking this progesterone cream, even though I had a complete hysterectomy? The one I am using is called FEM CREME 480 mg per ounce (100% chemical free) w/ classic herbs. Can you please give me some direction? Thanks so much.

Thank you,

Linda

Dear Linda,

The glaring anomaly that jumped out at me on reading your letter is this. On one hand your gynecologist informs you that bio-identical progesterone is dangerous (because it’s a precursor to estrogen in the body), then she goes on to recommend that you begin taking the most potent estrogen - estradiol - which has been linked to cancer!

What’s wrong with this picture!

Your doctor - and other medicos like her - are apparently ignoring the fact that individualised doses of bioidentical estriol combined with bioidentical progesterone at the lowest dose possible is indeed a safe and effective hormone replacement alternative for female patients who have undergone a complete hysterectomy.

Let’s just assume for the time being that your doctor is right - that natural progesterone is potentially dangerous. What safer alternatives is she offering you?

Let’s do a cursory scan of the conventional HRT prescribed or given to you as ’samples’:

• Premarin is not a natural estrogen for humans. It is natural for horses, and is made from the urine of pregnant horses. It is comprised of more than 40 different horse estrogens which are biologically very strong. Dr. Christiane Northrup, former Diplomate American Board of Obstetrics and Gynecology, recently stated for publication that not one “?is native to the human female body.”
• Cenestin is a synthetic conjugated estrogen that is not natural to the body and therefore carries a degree of risk for some women.
• The Climara patch (transdermal system) releases small amounts of the estrogen estradiol directly into the blood stream. Estradiol is the most stimulating to breast tissue and yet this potentially dangerous estrogen was given to you as a sample.

In my opinion (and that of other doctors I’ve had the pleasure to discuss this issue with), it borders on medical negligence for any GP to ‘offer’ a woman estrogen, particularly estradiol, if he or she has not first checked her baseline hormone levels prior to doing so, and included a thorough medical screening.

Estrogens, according to apoptosis). For example, the sloughing off of the inner lining of the uterus (the endometrium) at the start of menstruation occurs by apoptosis.

Whilst not a cure for cancer, progesterone can dramatically decrease cell multiplication rates, providing women with a degree of protection against estrogen-driven cancers. Normal levels of progesterone in the body can, therefore, actually help protect us against some forms of cancer.

Evidently excess estrogen in our body has a negative impact on thyroid performance. Emerging evidence suggests the symptoms of hypothyroidism occurring in patients with progesterone deficiency become less so when progesterone is added and hormone balance is achieved.

As stated in my newsletter some weeks ago, Dr. Zava is preparing to respond to the Bassett Healthcare Study and other related articles that claim bioidentical progesterone is considered to carry some of the same health risks as its synthetic progestins. Dr Zava, Ph.D., is a Biochemist Research Scientist and internationally known speaker on the subject of hormone imbalances, natural hormone replacement, saliva hormone testing and breast cancer. Over the past 25 years, he has published extensively on clinical research relating to the effects of estrogen and progesterone on breast cancer.

According to Dr Wright, “Natural hormone replacement (NHR) employs versions of the three human estrogens - estriol, estradiol, and estrone - plus progesterone that are identical to the hormones the human body naturally produces taken in close-to-natural proportions and timing. NHR is just as effective - probably even more effective - than conventional HRT at reducing the symptoms of menopause and minimizing postmenopausal risks.”

Removing the guess-work and reducing our risk …

Working in close consultation with a healthcare professional skilled in bioidentical hormones, we can remove some of the guess-work and subsequent risk from our hormone balancing regime. Here’s what we’ve learned so far in relation to bioidentical estrogen and progesterone supplementation:

• To protect ourselves against many estrogen driven cancers like breast cancer, we are advised to keep our progesterone to estradiol ratio in the vicinity of 200~300:1. For women, cancer of the breast and/or in the uterus most often occurs with a progesterone to estradiol ratio of less than 200 to 1.

  We can monitor our hormone levels using salivary hormone profile kits that are designed for the collection of saliva at home, and come with easy-to-follow instructions.

• Likewise, we need to keep an eye on the how our body break downs estrogen into ‘good’ and ‘bad’ estrogen metabolites via our liver. We want to shift the production of estrogen metabolites away from dangerous 16-hydroxy in favor of beneficial 2-hydroxy metabolites.

  Incorporating Di-Indoly Methane (DIM) supplements in an absorbable formulation actually encourages healthy estrogen metabolism.

  And 2 & 16 Hydroxy Estrogen Metabolites (Urine) hormone testing procedure makes monitoring relatively simple.

• Also, we can ascertain levels of our body’s three main estrogens - estrone (E1), estradiol (E2), estriol (E3) - and work towards keeping all three at appropriate levels. We can do this by adopting the following estrogen quotient (EQ): EQ = E3 / (E1 + E2).

  If a woman’s EQ is low, her risk of breast cancer is higher. Basically, the higher the EQ, the better. A saliva assay that includes a profile of all three estrogens will allow you to determine and maintain a healthy estrogen quotient.

• Proper thyroid function is a key to our metabolic health and hormone balance. The symptoms of hypothyroidism occurring in patients with unopposed estrogen (progesterone deficiency) become less so when progesterone is added and hormone balance is achieved.

  Blood Spot Testing (TSH, fT3, fT4) collection kits designed to be used at home can help us keep an eye on our thyroid hormone profile and track disorders / treatment.

As I stated in an earlier newsletter, I do believe GPs can source (without too much effort on their part) reliable medical evidence or, at least, allay fears of micronised progesterone’s efficacy and safety if inclined to look or begin networking each other nationally and internationally.

Yes, as Dr Doris pointed out to me only today, bioidentical HRT does sit outside “traditional biomedical practice”. But does that necessarily make this new innovative approach to women’s health unsafe? I’m reminded of the numerous medical break-throughs we now take for granted that were originally considered to be ‘quackery’ by the medical fraternity of the day.

When it comes to introducing drugs into your body, Linda, it’s as much a question of what intuitively feels right for YOU as what your physician feels comfortable prescribing!