Estrogen vs progesterone question

[rosemaryc]

Following on from my previous consultant post, one of the (many) questions that I was too surprised to remember to ask, was a basic one about the merits of different hormones.

Everything I have read on more alternative sites tends to portray progesterone (bio-identical) as the 'good' guy that deals with estrogen dominance that apparently plagues women in their 40s and beyond and causes most of the problems we experience. Everything I read from the mainstream implies that progesterone is often not tolerated and is often only used out of necessity (and in the minimum possible doses) to provide balance and protection when treating with estrogen/estradiol. I realize this is a very simplistic summary and everyone's needs are different but it seems there are 2 opposing camps? or am I missing something here?
thank you

You may well find that most of the 'alternative' sites are promoting a commercial product ( a type of progesterone cream) - so bear that in mind! It will be a jar of cream bought from a non-UK site and not available over the counter or on prescription. You can get progesterone cream as a pharmaceutical product but I have read on reputable sites that the amount needed to have any effect would not be 'user friendly'. Also, the amount in the commercial products is a) tiny b) not regulated in terms of quality and c) not able to be converted through the skin into progesterone.

The whole idea of oestrogen dominance is a theory put out by one guy in particular- John Lee- who also promotes progesterone cream. Most mainstream meno-expert drs who are also 'open' to complementary treatments do not subscribe to this theory.

Oestrogen dominance is a misnomer. What is behind it is that when the menstrual cycle becomes erratic and ovulation doesn't happen every month you won't get the progesterone phase of the cycle because it requires ovulation to start it. In some women this leads to heavy periods once they do have a cycle where they ovulate because there has been a build up of the lining.

The vast majority of peri and meno symptoms are caused by low oestrogen. This is not in doubt. Yes, progesterone and progestogens can cause PMT side effects in many women but if we want the benefits of oestrogen it's a necessary part of it. Some gynaes (mine included) are happy for this to be kept to a minimum with long-cycle HRT (this can be a cycle of maximum 12 weeks) as long as there as scans etc are done now and then to check the lining isn't overgrowing.

Does this help?

Just a ps. If progesterone was 'good' for us, then why do women who are many years post-meno not have symptoms any more when they no longer have any progesterone in their bodies? I've had a look at one of the sites promoting Lee's theories since you posted , and there are some glaring porkies- or at least 'errors' in what they say- such as oestrogen being bad for women, the cause of cancer etc, when in fact women who take only oestrogen as HRT ( they have no uterus) have a lower rate of breast cancer than women NOT using any type of HRT. So it's not as simple as oestrogen is bad for women.

Yes that's very helpful thanks Pinkfrocks :-) It has never made any sense to me how the 2 sides can have such opposing views. I had my progesterone checked last year and it was pretty low, but so was my estrogen and testosterone, and so the whole estrogen dominance thing wasn't really making sense. I had another progesterone check a month after trying bio prog cream for a few weeks (sold online) and my levels had gone to the top of the range - so it did work BUT I didn't feel any better for it at all (and possibly worse and more exhausted). Dr P said I think that he wanted to do something fairly continuous to level out the fluctuations but I am not sure yet how that works - hope I will get time to ask next time! I am meant to be going in for blood tests and scan on Monday but that's only if my period appears as I am now 2 days late (and normally v regular!) and tests have to be day 2-5.

The thing is- you can't be sure it was the cream that caused your levels to rise- you might have ovulated that month and the increase was because of that. In any case, there are risks with progesterone just as there are with oestrogen and no one ought to be using any of this stuff without supervision from a dr ( even if it did work!) because progesterone can cause blood clots and other side effects (the leaflet in Utrogestan lists them all!)
That's why I think it's a scam because if the cream was effective it ought to be licensed and not available to women to dose themselves up as if it was some innocuous substance.