Natural progesterone is the new hormonal darling of the perimenopausal set, and well
deserving of its status. Women like to take it. It lightens heavy menstrual flow,
soothes and softens tender hard breasts, acts like a mild tranquilizer, makes you
sleep like a rock, and relieves water retention. The perfect antidote to PMS and
anovulatory periods, its main drawback until recently was how difficult it was to
All hormones, taken orally, are delivered straight to the liver where they are rather
efficiently broken down. First given by painful injections for threatened miscarriages,
progesterone was then prescribed in a variety of ways for PMS, including by rectal
suspension and vaginal suppositories. No wonder that women did not rush to
embrace these preparations. More recently, progesterone has become widely
available as a skin cream, sold over the counter. Just like the estrogen skin patches,
progesterone absorbed through the skin is not first passed through the liver so it is
more readily available for use by the body. In the last year, a major pharmaceutical
company has suspended micronized progesterone in peanut oil in a new,
well-absorbed, oral preparation called Prometrium.
There is sound justification for the use of natural progesterone in perimenopause for
heavy periods, tender breasts, bloating and irritability. There is evidence that it can
diminish hot flashes and prevent osteoporosis. There have been claims that it will
restore thinning hair and flagging sexual interest, as well as improve arthritis,
allergies, skin problems, and high blood pressure. It is not clear that natural
progesterone can deliver on these counts.
Synthetic versions of progesterone, called progestogens, have been used along with
estrogen to protect the uterus in post-menopausal women on hormone replacement
therapy (HRT). Unfortunately, no one likes to take these drugs (brand names Provera
, Cycrin and Aygestin). Their side effects of bloating and depression are one of the
main reasons that women give up on HRT. The availability of Prometrium has greatly
improved the choices for combination hormone therapy.
Natural progesterone cream comes in many different strengths but you should seek
a brand that provides about 1,000 mg. in 2 oz. cream. Small quantities, 1/4 - 1/2 teaspoonfuls,
are rubbed twice daily on the inner arms, thighs, abdomen, or chest, from mid-cycle
until menstruation. Do not buy wild yam cream; the body cannot utilize it to make
The cream cannot be relied upon to protect your uterus from the effects of
supplemental estrogen. In this post-menopausal setting, you must use the oral
preparations to be safe. Progesterone levels in your body are higher on an oral dose
than with the skin cream. Some women notice an anti-anxiety effect, or even a
drunken, sleepy feeling from its direct, anesthetic effects on the brain.
This information is intended to be general in nature and should not be relied upon
for specific treatment. If you need medical attention, please contact your personal
physician's office for an appointment.
Read many more of Dr. Paley's articles at: http://menopausemoments.blogspot.com/