Uterine Fibroids and Natural Progesterone
We know that estrogen dominance causes the uterus to grow, and without the monthly balancing effect of progesterone it doesn’t have the proper signals to stop growing.
In some women this results in an enlarged uterus that presses on other organs, such as the bladder, and often on the digestive system, and generally causes discomfort and heavy menstrual bleeding. In other women estrogen dominance results in fibroids, which are tough fibrous, noncancerous lumps that grow in the uterus.
Fibroids always shrink at menopause, but the most common course of action a doctor takes when a patient comes in with a fibriod is to remove the uterus.
A number of women have managed to successfully control their fibroids with no less than 40mg/day (4%) progesterone cream as a baseline dose, while others have required an average maintenance dose of between 50~60mg/day.
Overall, an average of seven months on high levels of progesterone (ranging between 60~100mg/day, adjusting dosage accordingly) appears to be an effective timeframe to get some measure of control.
But we need to be aware that the jury is still out over this issue. Yes, progesterone therapy has proved successful for a majority of the women experiencing heavy bleeding associated with fibroids. However, there has been a couple of cases reported where fibroids have not responded to progesterone therapy. They, in fact, grew in size.
For this reason, I strongly urge women, working in consultation with a collaborative, open-minded physician, to undertake regular ultrasounds to monitor the stages of fibroid growth, and to determine the success of their progesterone dosage. Saliva assays would be helpful to capture a snapshot of hormones levels.
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."
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 low doses of progesterone supplementation in 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. Doris Brownlee writes,
"I hit menopause at 48 a few years ago, and a year later, my pelvic ultrasound showed a large ovarian cyst, about 10cm in diameter (that’s big!), and that the fibroids were still getting bigger. Two weeks ago, after 12 months on natural progesterone, I had another pelvic ultrasound. For the first time, every fibroid had shrunk, as had the ovarian cyst. I had noticed that I wasn’t getting lower abdominal and pelvic discomfort as I used to, and now I know why."
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