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Other names: Nor-qd, Ortho Micronor

ALTERNATIVES TO HRT: PROGESTERONE AND MENOPAUSAL SYMPTOMS
You may have heard that progesterone can help menopausal symptoms and protect you from osteoporosis. The same question that is asked about HRT would have to be asked in progesterone’s case as well: when do you stop taking it? According to Dr John Lee, the Californian physician, the answer is, ‘Do it until you are ninety-six and then we will reconsider. You will not be the same at seventy as you are at fifty-six, so how do you know how much to use? Are you oestrogen dominant or are your hormones doing what they are supposed to at that age anyway? Yes, you can have your hormones tested and know what the profile is, but if you then continued to use progesterone cream for years, you would need to keep having tests to know whether you were overdosing or not. It’s all a bit hit and miss.
The cream is rubbed into the skin so it can be absorbed directly into the bloodstream. A team of researchers in Belgium found that the cream tended to accumulate in the skin instead of being fully absorbed into the bloodstream. Dr. John Lee advises applying the cream on a rotational basis to different parts of the body. You can imagine that if you use the cream for forty years, from the menopause to age ninety-six as he suggests, you will have used all the possible sites available and it is unknown what the side effects of the hormone accumulation in the fat cells will be. Dr Lee also believes that during the initial stages of using the cream it temporarily sensitizes the body to oestrogen. It is oestrogen sensitivity that has been linked to breast and endometrial cancers, fibroids and endometriosis. So by using progesterone cream are you increasing the risks of disease? And progesterone has some well known side effects. In the British National Formulary (BNF), which many doctors have in their surgeries, progesterone is listed separately from progestogens. And according to the BNF the side effects of progesterone include acne, urticaria, fluid retention, weight changes, gastrointestinal disturbances, changes in libido, breast discomfort and menstrual irregularities. Claims have been put forward that progesterone can protect against breast cancer, although there are arguments that higher levels of progesterone may be a risk factor for breast cancer. In animal studies cancer of the ovary, uterus and breast were all linked to increased progesterone.
Even Dr Lee admits that women taking ‘natural’ progesterone may experience exaggerated pre-menstrual or menopausal symptoms at the beginning. There are possibilities of breakthrough bleeding (bleeding that occurs at times in the cycle other than during a period) and other cycle irregularities as well. Linda, who is forty-seven, came to see me after using a progesterone cream over a period of two months. She had been recommended to use it even though she had had no menopausal symptoms and was still getting regular periods. She then started to get breakthrough bleeding halfway through the month. She was obviously concerned about this but was told that it was ‘normal’ and her body would adjust. The bleeding continued, so she decided to stop using the cream. At this point, she was overwhelmed by hot flushes and tiredness which she had not had before. Linda was getting hot all over, and waking up during the night; then she would feel really cold. She had lost her sex drive and felt ‘very fed up’. By this time she had not had a period for six weeks which was very unusual for her. Obviously she was worried. I recommended a good nutritional programme tailored to her needs and herbs to redress the imbalance. By the time she returned in a month, the hot flushes had gone, her energy was back and her periods had returned. I felt that the progesterone had had a pronounced effect on her hormone levels and it was only by taking a more gentle, natural approach that her body was able to balance itself.
*22/101/5*