Overview
Progesterone is a sex steroid that is produced by the ovaries and adrenal glands and plays an important role in pregnancy, preparing the uterus' lining for implantation of a fertile egg and then helping to maintain it during pregnancy. It also signals the uterus to shed its lining if pregnancy doesn't occur, prompting monthly menstruation in pre-menopausal women. Progesterone is not produced by the body after menopause.

Here's the deal on progesterone. Most physicians base their recommendations for HRT on current research, and the prevailing research on progesterone indicates that this hormone is neither necessary nor beneficial for women who have had their uterus removed -- in fact, the use of synthetic progesterones (progestins or progestogens) carry inherent health risks that make their use in hysterectomized women contraindicated.

Progesterone has a significant effect on endometrial tissue - studies have indicated that taking synthetic progesterone in conjunction with estrogen significantly reduces the incidence of endometrial cancer in post-menopausal, intact women versus unopposed estrogen (estrogen alone with no progesterone "opposing" the estrogen) use. Estrogen therapy became available for menopausal women in the 1940s, and was administered then in high doses without progestin. In the l970s, however, it became clear that women who received estrogen alone had a six to eight times higher risk of developing cancer of the endometrium (the lining of the uterus) than non-users. Since then, researchers have found that the addition of synthetic progesterone to estrogen reduces the risk of endometrial cancer. As a result, it has become increasingly common to prescribe estrogen-progestin replacement therapy for women who have not had a hysterectomy. Recent studies have additionally shown a correlation between synthetic progesterone/estrogen replacement and an increased incidence of breast cancer versus estrogen-alone use, with the relative risk for breast cancer increased by 8 percent per year for the estrogen-synthetic progesterone therapy compared to 1 percent for estrogen therapy alone in women who had used hormones during the previous four years.1

So, given this evidence of increased breast cancer, why would a woman who has had a hysterectomy, and therefore no uterus to protect from the effects of unopposed estrogen use, consider taking progesterone?

Natural progesterone vs synthetic progesterone
"Progestin" or "progestogen" refers to the wide range of synthetic, non-bio-identical progesterone products that are currently on the market. These synthetic progesterones are what have been tested in the majority of clinical trials on progesterone use in women, especially in relation to endometrial and breast cancer.

"Progesterone" refers to the naturally occurring hormone that your body produces - it is bio-identical. The only major study performed to date using natural progesterone is the PEPI trial, which compared estrogen, estrogen/synthetic progesterone, and estrogen/natural progesterone in their effects on heart disease (cholesterol levels), and in which the use of natural progesterone showed significant benefits versus the synthetic progesterone on cholesterol levels.

In a JAMA discussion of the results of the PEPI trial, physicians agreed that perhaps the biggest surprise of the trial was the beneficial effect of micronized natural progesterone on HDL (good cholesterol) levels vs. synthetic progesterone.3 These results were not anticipated because it was assumed that the close chemical composition of synthetic progesterone and natural progesterone would produce similar results, which they did not - natural, in this case, was superior.

PEPI STUDY-LINK

Further review of studies concerning natural hormone replacement versus synthetics are summarized nicely by Dr. Uzzi Reiss author of the book "Natural hormone balance for women"

The data published by several key health researchers from The Mayo Clinic, the University of California at Los Angeles (UCLA), the American College of Obstetrics and Gynecology, the University of Quebec and information from the Journal of Obstetrics and Gynecology:

Professor Lorrain Fitzpatric, M.D., Professor of Medicine and Director of the Women's Health Fellowship at the Mayo Clinic and Mayo Foundation, Rochester Minnesota presented the following data in Washington DC, via a satellite conference organized by the University of Florida College of Medicine on September 5, 2000.. Dr. Fitzpatric said:

In other words, Provera promotes diabetes and all the significant associated increased risks to the cardiovascular system.

This should be more than enough to denounce a drug that is regularly prescribed too more than 14 million women annually. The Heart and Estrogen Progestin (chemicalized progesterone) Replacement Study (see below) demonstrated a significant increase in cardiovascular disease when women took Premarin Provera. The problem was not the Premarin, the problems was the addition of the chemicalized Progestin. Ironically, previously scientists never attributed the negative outcome of these studies to Provera. In failing to make the connection, these same scientists tragically confused women and their doctors, rather than educating them about obvious risks.

Other medical professionals concur:

Doctor Howard Hodis, the Director of Arteriosclerosis Research Unit at University of California at Los Angeles (UCLA), was one of the first scientists to demonstrate that treatment with estradiol (one of the three natural forms of estrogen) arrests the progression of coronary artery disease (cardiovascular disease) in women with ongoing arteriosclerosis. Dr. Hodis emphasized that his data was different from other recent studies because no one of his research subjects were also taking Provera (the chemicalized Progestin).

Additionally, many scientific studies, including the well-known PEPI Study, indicate that any time progesterone (the natural hormone) is used, there is no interference or reduction of the many benefits of estrogen.

Dr. Deborah Crady, from The Heart and Estrogen Progestin (chemicalized progesterone) Replacement Study, published in January 2000 in the Journal of Obstetrics and Gynecology, announced some interesting information: Dr. Crady found that women with stress incontinance (spontaneous leakage of urine) have increased complications of their urinary problems when treated with Premarin Provera. On the other hand, for years, medical studies and treatments have demonstrated that (natural) estrogen treatment benefits women with urinary complications. This has also been my experience in treatment of more that 10,000 women with natural estrogen combinations and more than 20,000 women with natural progesterone medication. So why give the synthetic substitute? Again, I think you cannot treat poor body function with drugs - you must use the same natural hormones that your body ideally produces.

BACK TO TOP OF PAGE

Disclaimer: The information contained on this website has not been evaluated by the FDA. This information is not intended to treat, diagnose, cure or prevent any disease. All material provided in the Dr. Brizel's web site is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health program.

©2002, All Rights Reserved, Center For Clinical Age Management, Inc.