If one has not read Dr. Lam’s books on What Your Doctor May Not Tell You About Premenopause and What Your Doctor May Not Tell You About Menopause, I would highly recommend them. These books are classics and should be in everyone’s natural medicine library. Progesterone cream has been one of the most important supplements I have ever used in my practice.
I have come to a recent realization regarding the use of these creams. Most women in our culture are estrogen dominant, so using the progesterone goes a long way towards balancing hormones which usually decreases a woman’s risk for breast cancer, improves her PMS and breast tenderness and normalizes her cycle. Like most good things in life, if one uses too much of the hormone cream, complications can develop in disruption in one’s hormone balance.
Dr. Lam is fond of using the lower dose creams to avoid this. But this complication can still occur with the low-dose creams. I always attempt to provide the most cost-effective solution in my practice so I use prescription strength 10% cream. Theoretically, there is no problem with this if one uses it as directed. There is a huge cost saving as this concentration is able to get the cost down to $3 per month. However, if one uses more than 1/16 of a teaspoon, complications appear to be inevitable.
The problem relates to the fact that progesterone is highly fat soluble and once applied to the skin will store itself in a woman’s fat tissue. When one first uses the cream, there is no problem here as the fat stores are very low. But as time goes on, the cream accumulates and contributes to disruptions in the adrenal hormones such as DHEA, cortisol, and testosterone. I have learned that although progesterone cream is an enormously useful tool, it needs to be used very cautiously.
I have also learned that it is FAR MORE IMPORTANT to work to normalize the adrenal hormones first. Once the adrenal hormones are balanced, the progesterone levels will frequently normalize and one will not require any cream. The wonderful thing about adrenal normalization is that it usually only takes 3-6 months to balance these hormones. Once they are balanced, one usually does not require any hormone supplements to keep them balanced.
The balancing process involves lifestyle changes first. If you haven’t already guessed it by now, the diet at reading This First on my home page www.mercola.com is the first step. Secondly, one needs to get to bed by 10 PM. This is an essential part of the process. If one is routinely going to bed after 10, then one’s biorhythms will be disrupted. Addressing emotional stress in one’s life is the other huge component. I believe that the therapy we are now offering in with Applied Psychoneurobiology, APN, (see the article section on my website) is one of the most effective tools for this. APN clearly is not the only way to address this and there are many other wonderful approaches out there. Journaling is one of the better and least expensive ones, but there are many other approaches also.
Once the lifestyle issues are addressed, then one would ideally evaluate the adrenal and female hormones. One of the better ways to do this is through measuring salivary hormone concentrations. I had been using Aeron Labs, and they do good work. Dr.used to run it and now he runs his own company, which is also a fine lab. However, I have recently been introduced and I am hugely impressed with their services. They hold regular seminars and are even having one this weekend in San Diego. I would have loved to attend, but I am still catching up from my earlier learning tour. They also hold weekly phone seminars for healthcare professionals, which are excellent.
I really believe they have a huge jump on the other labs as they run multiple samples to make these measurements. One can certainly perform the same test at other labs, but the bill for all the samples would literally by two to three times as expensive. The other labs also do not have an educational component. They have a wonderful clinician, Dr., who walks the health care professional through a proper evaluation of the test results.
Once the results are in, the hormonal manipulation generally involves using sublingual hormones such as DHEA and pregnenolone or cortisol improving agents such as licorice root extract. The exact dosage, timing, and use are determined by the results of the test. The absolutely incredible aspect of this testing and treatment strategy is that it recalibrates the brain and helps the body to start making the hormones by themselves so one is not stuck on hormone treatment for the rest of their life.
Getting back to progesterone cream, I have been finding that many of the women who were on the cream have terribly elevated levels of this hormone. This is not good. Progesterone is normally a cyclical hormone and the body really needs to see a change in the concentration to effect a proper physiological response. If the level is constantly above the concentration that it recognizes as “off” or low, this is not possible. Fortunately, this is repairable. But it may involve going off the cream for as long as two years to wash the progesterone out of the system.
I am still in an evaluation stage and learning about how common this is in my own practice as I have just started using this system for the past month. At this point, I am relatively convinced that this is a big part of the picture for hormone replacement.