When I break from the progesterone, should I take a break from the other hormones as well?

Hi Catherine,

I am 40 and had a complete hysterectomy about a year ago. I am currenty using a small amount of estrogen, testosterone, and progesterone cream. When I take a break from the progesterone, should I take a break from the other hormones as well?

Thank you,

Marlene

Dear Marlene,

It’s important to remember that our ovaries do not pump out hormones continuously so why would we supplement them continuously? Whether we have an intact uterus and ovaries or they have been surgically removed, we ought to be following Mother Nature’s template.

Take a look at the diagram below and you can see quite clearly that a woman’s reproductive cycle has two distinct phases:

• Follicular Phase (Day 1 ~ Day 14)
• Luteal Phase (Day 14 ~ Day 28)

The hormone estrogen dominates in the Follicular Phase (proliferative - prepares the uterine lining), while progesterone dominates the Luteal Phase (secretory - maintains the uterine lining).

For at least 5 days of each menstrual cycle, a women’s output of etrogen and progesterone are at a healthy ‘low’.

(Printed with Permission - ‘Ask Dr Sandra
Cabot Newsletter, Edition 3′)

Progesterone and estrogen are normally cyclical hormones as evidenced in the above diagram, and the body really needs to see a change in the concentration to affect a proper physiological response. If your levels of progesterone, estrogen or testosterone are constantly above the concentrations that it recognises as “off” or low, this is not possible.

Some medical experts believe that low doses of estrogen may carry less risk than continuous administration.

It would make sense then to STOP taking progesterone and estrogen supplementation for at least 5 days a calendar month if you no longer have a period, or break during menstruation if you are.

While progesterone has a considerable safety margin at high levels, this is not the case when supplementing hormones like estradiol and testosterone. For this reason, you and your GP need to keep an eye on your levels to ensure you’re not putting yourself at risk.

Close clinical surveillance of all women taking estrogens is important, even those who’ve had a hysterectomy.

We’ve touched on the role of estrogen in previous articles but what does testosterone do? Well, testosterone promotes the development of healthy skin, organs, muscles and bones. Without testosterone our sex drive and energy levels as well as our muscles would be very difficult to maintain.

The production of testosterone in women is split about 50:50 between the ovaries and the adrenal glands. For women who’ve had their ovaries removed, testosterone production drops by roughly one-half, sometimes resulting in less-than-normal testosterone levels.

Women need to have their testosterone levels monitored more frequently for the simple reason that because they have only 10% of the testosterone level that men have. This means that even small drops in testosterone levels or small rises in testosterone levels will have more effect on a woman than on a man.

I was talking to a lady friend just the other day who’d been prescribed testosterone cream by her GP. She didn’t notice any great improvement to her libido, however, her GP was fortunately monitoring her levels. Turns out, this particular lady ended up with testosterone levels equal to that of a man!

Excessive testosterone can result in menstrual irregularities, hoarseness, deepening of the voice, increasing growth in facial hair, an enlargement of the clitoris and sometimes thinning of the hair and acne.

Most GPs will tell you that you can remain on these ovarian hormones indefinitely without giving cell receptors a ‘rest’. This could be considered a fair statement, but you do need to be aware that cell receptors may, over time, down-regulate requiring a gradual increase in dosage to remain free of symptoms.