Why doctors remain cautious

Certainly, we can appreciate why doctors remain cautious and wary of a drug (like natural progesterone) that doesn’t show up in their manual, and does not appear to have any credibility attached to it at this point.

Being an unpatented drug, there is little evidence to support its usage. There are no drug companies, other than Wyett and Ayerst who have already patented their pure progesterone vaginal gel (which we will see more of in the future), who present strong evidence to weigh its usage. That is, until any one of these multi-national drug companies can devise a patentable delivery system of natural progesterone. Beyond that, women unfortunately stand alone in their fight with their GP for recognition of a treatment that they want and have the right to request.

Some doctors, on the other hand, mistakenly believe they are already prescribing progesterone to women when, in fact, they are issuing a prescription for artificial progestins. These doctors have been fed a lot of mistruths, compounded by misrepresention on the part of the drug companies who are leading doctors to believe their particular brand of progestogen is a ‘natural’ progesterone or derived from ‘natural’ compounds. This is stretching the truth somewhat because they have failed to explain to the doctors how these natural ingredients have been molecularly tampered with and are no longer ‘natural’ or bio-identical to the body.

Little wonder confusion reigns out there. And little wonder doctors are even more confused when a woman arrives in the surgery demanding a script for natural progesterone.

We have women who come back to us in tears stating that their doctors were adamant that they are already prescribing natural progesterone, and that the women are the ones that actually are misinformed and/or confused. That the women do not exactly understand what they are asking for, despite the fact that they have their information, books, tapes, and supportive evidence on progesterone . Doctors still dismiss them, make light of the issue, perhaps write out a script for some form of progestogen or blankly refuse altogether, then instruct them to stop being so silly.

It is standard procedure for drug manufacturers to provide your doctor with a Standard Product Information Leaflet on all prescription drugs he can legally prescribe or his patient might request. You now have access via this website to an ’sample’ of the information your GP would reference when prescribing natural progesterone provided by a pharmaceutical company. This this instances our information is provided by Lawley Pharmaceuticals who specialises in alternative and mainstream health care, focusing on natural progesterone as an adjunct to traditional hormone replacement therapy.

Many doctors don’t understand the difference between progesterone and a synthetic progestogen, so therein lies a problem to start with. The second problem lies in the fact doctors do not take kindly to being told they might be wrong. They don’t appreciate their patients turning up with more information on a drug like progesterone which they have failed to research. This deflates their ego and/or theatens them. Thirdly, a doctor is trained a specific way and has developed a certain mind set.

One suggestion would be, don’t go into your doctor’s surgery with a know-it-all attitude intent on ruffling feathers or upsetting egos if you genuinely want to help your GP become aware of your needs. You are, after all, asking him/her to support an alternative hormone replacement therapy that may or may not work, and to provide you with informed choices rather then drug propaganda.

Unfortunately, because most doctors are on very tight schedules, and are very busy people, they often don’t listen correctly to their patient’s needs. They sometimes don’t hear what is really being said or fail to read the information on progesterone that the women leave behind. These female patients are doing their utmost to meet their doctors half-way, yet, sadly, their doctor will have none of it. As a result, so many women turn to the black market to source their cream and self-medicate, or seek out alternative medicines.

Therein lies another problem, because a good many naturopaths won’t embrace progesterone purely on the basis they are not ‘authorised’ to sell an S4 drug (here in Australia).

Occasionally, we learn of naturopaths who acknowledge progesterone and encourage women to use it. But again, we come back to the common hiccup - if a woman needs to obtain a doctor’s prescription how does she obtain a script from her doctor? How do women break this rigid mind set? How do we get our doctors to understand what we are really asking for? Get our doctors to recognise our needs and to understand that perhaps his/her form of treatment or prescription drugs really hasn’t worked for us.

So many times women have recounted how they just couldn’t find the nerve to go back to their doctor because they’d have to admit that they didn’t go through with the prescribed HRT. That perhaps they threw the drugs down the toilet, or didn’t want to own up to the many side effects that caused them to stop HRT. In the absence of such negative feedback, these doctors go on to assume that synthetic hormone replacement therapy is a successful form of treatment.

On the other side of the equation, these women who are taking progesterone successfully, getting well again and realising a renewed quality life, don’t feel the need to go back to their GPs to report the excellent results. So, to be fair, their doctors are none the wiser.

Our organisation has always encouraged women to work closely with their doctors, and for doctors to draw closer to their patients. We feel the Women’s Guide to Natural Progesterone website has been like the ‘go between’, bringing natural alternatives into the domain of the doctor, and medicine into the domain of alternative therapy. That which is in the best interest of the patient is what matters most … not which side of the fence it is offered.

Now that progesterone has been tagged an S4 drug here in Australia, it is always going to remain under this classification. Therefore, we have to learn how to bring our doctors up to speed. Learn how best to demonstrate to doctors that what we are doing with natural progesterone is not dangerous but rather is proving to be a successful form of treatment for a majority of women, if used and managed correctly. Egos aside, we seek to break down the mind set, to be open to the possibility there is a safer form of hormone balancing available.

Women in some countries cannot purchase progesterone readily over the counter or through distributors. They can, however, lawfully purchase 2-3 tubes for personal use over the internet provided it is not used outside your immediate family.

Keep in mind, generally speaking only sick women return to their doctors. Those women using progesterone and realising fantastic results rarely report back to their doctors. Those healthy women who have enthusiastically returned to share with the GP their renewed hormonal balance have been met with comments such as, “It’s just placebo” or “we don’t know the long term effects”. This reaction by some of the medical fraternity is very discouraging and hurtful, especially if they profess to hold their patient’s best interest at heart (which bears further discussion at a later stage).

Doctors who embrace natural hormone replacement therapy perhaps feel more comfortable working in higher dosages, again because they don’t have the appropriate evidence to support the effectiveness of topical absorption and its effect on the endometrium at physiological doses. Nor are there trials/studies to back it. Of course, there are no trials or studies with troches or lozenges that we know of. Perhaps with the higher levels doctors feel they are conferring endometrial protection, and believe because they are following traditional hormone replacement therapy guidelines they will not be accused of negligence.

Women using troches need to be monitored by their doctor for symptom relief and to ensure their troches are tailor made. The catch here is that in order to get troches, lozenges or pessaries you need to have a doctor on side … and there are very few out there willing to write a script.

We have observed a few doctors raise their consultation fee for women seeking NHRT. If you are visiting a doctor who prescribes natural progesterone, make sure that doctor really is working with you, listening to you, and keeping an eye on your symptoms; monitoring your progress rather than sending you back to other doctors to oversee.

If a doctor is specialising in this area/niche in the market place, then that doctor ought to have you as a total patient not just the hormonal patient. This is a holistic approach and a holistic event. Your doctor needs to know what other forms of treatment have been prescribed to you. So often we have seen doctors who are willing to prescribe progesterone, hand out a hefty bill at the end of the consultation (maybe because they’re the only GP in town writing scripts) only to send that woman back to her family GP for tests and other forms of follow-up treatments.

Many bad situations have occurred. Here are a few (of many):

• a woman prescribed a cortisone injection for pain in her shoulder which totally negated the use of progesterone;


• doctor prescribing progesterone refusing to tell the endocrinologist that the patient is on progesterone and the patient having to cover her doctor’s tracks.

This is not on. If a doctor is going to take responsibility, he or she should be in there boots and all. None of this semi-commitment based on outcome. Be comfortable with your doctor and make sure it feels right.

Doctors are human beings and are not always ethical. It is sad that a small percentage of doctors recognise women’s desperation as a business opportunity. Perhaps their interest isn’t as much in the belief and benefits of the progesterone as getting bums on seats.

Unfortunately, but it’s a fact, women who need a script will get it any way they can, including a visit to these types of doctors who take their money but offer no support and/or education. This really is concerning because women are all too often left on their own to self-medicate. They’ve had to sneak behind their own doctor’s back, accept treatment that may be contraindicative of progesterone usage, maybe they’re unable to tell their doctor the full story … all of which has the potential to end badly.

Try and work with your own doctor. Be strong, courageous and assertive. Doctors provide a service; they are there to serve you. You pay the bill and they are accountable. Ultimately, it’s up to you to be the person who instigates what you want. Stand up for your values and beliefs, no matter how hard it may seem at the time, and no matter how intimidated you might feel. If you believe this is an opportunity you would like to explore, you have the right to do so. After all, what you are asking of your doctor is to have the unaltered, unpatentable form of progesterone that he/she is already prescribing; the progestogens such as Provera etc., are formulated from natural progesterone.

How can hundreds upon hundreds of women be wrong? There is a revolution going on, driven by women around the globe. It’s momentum is building. But it has to start with each and every individual woman. For change to occur we must be daring and willing to take it upon our own shoulders.

It only takes a second to change a mind set but we just don’t know how many women it will take to change the way the medical fraternity views natural progesterone. The trials that doctors require to be convinced may have to come from us. We are the walking, talking evidence.

Our stories and painstaking journals are living proof. We must go back to our doctors and keep gently referring to our good health, our improvement and quality of life, rather than avoiding the issue and feeling ashamed that we are taking something without their blessing.

We are the ones that have the power and control so why do we keep handing it over to our doctors? And why do we abandon ourselves, our true self, to gain approval or to place some other person’s needs or opinions above our own. We only get one body, one chance, one time here on earth. If we allow ourselves to be guinea pigs and manipulated by trends, drug companies, or greed, then we really have lost an opportunity to claim a part of our magnificence.