Study sickness while you are well.
Thomas Fuller1
Something was wrong. I was in my forties, and the symptoms of menopause had already appeared. Hot flashes, bloating, irregularity, trouble sleeping, night sweats, emotional tension—I realized that I needed some kind of help to cope! The hormonal changes that every woman experiences at midlife were playing havoc with my body. So I went to see my gynecologist. He responded with the standard, widely accepted medical treatment: a program of hormone replacement therapy (HRT) using synthetic hormones. Specifically, this meant a prescription for Premarin (a conjugated estrogen) and Provera (medroxyprogesterone acetate, a progestin). These are manufactured substitutes for two hormones that play a central role in every woman’s sexual and reproductive life—hormones whose supply and balance are gradually altered as a woman passes through and beyond the normal childbearing years.
I had thought to myself, “Here I am in menopause. Finally, I’ll have freedom from my monthly periods.” But instead I was told that I needed to take these hormone supplements and continue drug-induced monthly cycles for the rest of my life. For twenty-five days each month I was to take one tablet of Premarin, and from the sixteenth through the twenty-fifth day of each month I was to take the progestin tablet. Then I was to stop taking both drugs for five days.
Even though I couldn’t help feeling that my body was being artificially regulated, my first reaction to the drugs was generally positive. My menstrual cycle stabilized, the symptoms diminished, and I began to feel confident about my doctor’s advice. By the second day my body was adjusting well. I became calmer and slowly began to feel better in many ways. “Why didn’t I do this sooner?” I thought. “Such a simple solution to all of these problems!” I wanted to believe that routine HRT was the answer.
Before long, though, my honeymoon with synthetic hormones came to an end. In the second month I started to worry. There were some unpleasant new side effects, including weight gain, bloating, painful breasts, and tension. I wondered whether this was not the answer after all—at least, not the whole answer. Perhaps a change was in order. Maybe the dosage of the Premarin or Provera needed to be decreased or one or both of them discontinued, or maybe the whole approach was wrong. Disappointed now with my doctor’s treatment, I consulted an endocrinologist, then an internist, and later still another gynecologist. All offered different suggestions, but none of their drugs helped my symptoms without bringing on some other abnormal discomfort. This trial-and-error period continued for several years.
Speaking with other women going through similar experiences, I heard a common complaint. They had gone down this same road with doctors who had prescribed variations of the same treatment, and as we all tend to do, followed their doctors’ advice and just “hung in there.” Women would come home from an appointment in tears of frustration because the doctor had made no change in their treatment regardless of the unpleasant reactions. The typical advice they got, as did I, was “You need to be patient. Just keep taking the pills a little longer until the body adapts.” Generally a physician will urge a woman to continue her treatment, either varying the dosage or keeping it the same, on the premise that her body will eventually adjust to synthetic hormones. I can tell you that such advice will drive some women to their psychiatrists or closest medical centers in an attempt to deal with the drugs’ multiple side effects.
I wanted my doctors to be right. So I did what they prescribed, over and over again. At first I’d be encouraged, because the drugs were making a few changes that I thought were good. But as time went on and it was clear that my body was reacting poorly, I began to feel additional symptoms: sharp uterine pain and inflammation and infection of the cervix, which was often quite painful. My bloating became more severe, along with digestive disorders such as colitis.
I feared another D&C (dilation and curettage), which some physicians routinely administer to women on HRT, and I dreaded the painful cauterization of cervical tissue that I’d been told was necessary to deal with the cervical inflammation. Yet I’d learned that the scar tissue resulting from some of the treatments I’d already had was probably causing even more harm to surrounding tissue! I grew more anxious still when a second endometrial biopsy (removal of a piece of the uterine lining by means of a plastic catheter) had to be performed in order to check for any deterioration of my uterus. Frustrated, I did not know what to do. I had to make up my mind before my next doctor’s appointment, when he’d indicated he would probably recommend a hysterectomy.
As I continued to ask questions, I began to understand that the doctors I had been seeing all along didn’t necessarily have all the answers. They didn’t seem to comprehend completely the complexities of menopausal problems, the PMS problems of younger women, or the side effects of the synthetic hormones they were prescribing. Not only were their answers contradictory to each other, I sensed a lack of conviction on their part that this was indeed the right way to go. I thought to myself, Is it any wonder women become confused, afraid, and discouraged during what can already be a stressful time?
I decided I would have to take things into my own hands—maybe spend more time at the health store instead of the drugstore, and at least learn enough to direct my own treatment. I had lots of unanswered questions about why these hormone supplements were not working. What were synthetic hormones all about? Where did they come from and how did they work? What were the side effects—both immediate and long-term? Were alternative treatments available? What specific nutrients and exercises would help? And of course, the question that hung over it all: Whose advice should I believe, and what should I do?
Thus began my journey of discovery into the world of estrogen and progesterone and the roles these hormones play in women’s health—a journey that not only led me to the answers to my many questions but in the process prepared me to recognize the variety of available alternatives. The answer has restored peace and health to my life.
My goal became to find a complete and sound alternative treatment for my menopausal problems. After consultation with my doctor I immediately stopped using the synthetic progesterone substitute because it was causing dreadful feelings of stress throughout my body. I accepted his advice on the estrogen supplement, though, and continued to take it.
But I also began looking into other measures I had heard about, such as nutrition, herbs, and homeopathic remedies recommended specifically for menopause. I changed my diet to include more raw vegetables, fresh fruits, whole grains, seeds, and complex carbohydrates and less meat. These changes helped reduce some of my discomfort. I also added to my diet some known antioxidants, including vitamins A, C, and E, plus selenium as well as vitamin B complex and zinc. I learned that zinc plays an important role in enzyme activity, especially in relation to the lymphocytes, and is needed for the absorption of vitamin A.2 I had also become aware that many studies have shown that antioxidants help protect the body from toxins.
As long as I kept up my chiropractic treatments to enhance nerve flow and transmission, I was much less susceptible to gynecological infections and other disorders. I had learned that even though the right diet is important, the nervous system is the major regulator for all hormonal performance. I believe that spinal misalignments and subsequent nerve interference should always be addressed because of the close interconnection between the spinal nerves and the endocrine system.3
But those were the early years. Once the full force of menopause came upon me, some of the old symptoms resurfaced—though they were less pronounced than before. So either something major was still missing, or what I was taking (or doing) needed to be changed. I was ready to try anything just to feel normal. I talked to many other women in the same predicament, and eventually one of them gave me a new idea. She was a former nurse and knew about the Estraderm patch, a “time-release” patch that is placed on the surface of the skin so that estrogen is absorbed in small doses over time. I wondered why my doctor hadn’t mentioned this.
I asked my doctor to substitute this method for my oral Premarin, and he agreed. This small adhesive pad did, in fact, seem to work better for me initially. Certain symptoms, such as the joint pains I’d been experiencing, temporarily went away. I felt more energetic at first, but I knew we hadn’t found the solution yet.
I had read that estrogen should never be taken alone, so I sought out a female gynecologist and asked her about combining it with progesterone to cancel out the carcinogenic effect of the estrogen. When I told her I’d had a very bad reaction to Provera, she prescribed another of the synthetic substitutes for progesterone. Only later did I learn of the incredible difference between synthetic progesterone and natural (bioidentical) progesterone.
Before long I again lapsed into some of the same symptoms, and again it was from the effects of the synthetic hormones: nervousness, bloating, uterine cramping, and some sleepless nights. So I went to another doctor, and he decided to reduce the dose of estrogen to the lowest level available in patch form. As the months went by it became apparent that this wasn’t working either. I knew something still wasn’t right and was disappointed with all the experimenting. The vaginal dryness that had troubled me before I began HRT returned with all its associated pain and discomfort. I had also developed strange pains on the side of my breast, near the lymph nodes.
My doctor switched me to yet another synthetic progesterone substitute in the lowest dosage available. There followed more adjustments: less estrogen, then more, then back to Provera, then less of it, and so on. But nothing seemed to help. I kept trying in vain to find the right balance between the two drugs, thinking that the doctor knew best. I did not understand why my body was reacting as it did to these substances, or why they seemed to be doing more harm than good as time progressed.
I decided one day to stop the treatments completely. This decision came after I got out my magnifying glass and read the fine print that presented the risks and warnings on the leaflets accompanying the drugs. Some possible adverse reactions to synthetic hormones are liver disease, malignancy of the breast or genital organs, fluid retention, cystitis-like syndrome, headaches, nervousness, dizziness, edema, mental depression, insomnia, fatigue, and backache. The warnings on the package go on to point out that the drugs can cause or aggravate conditions such as epilepsy, migraine, asthma, and cardiac or renal dysfunction.4 And all of the other estrogens and progestins normally prescribed have similar lists of side effects.
No wonder I was feeling bad. I began to resent the fact that the knowledge I desperately needed on such important health matters is not made readily available to women. At times I wondered how I would ever get through post-menopause if I couldn’t get a grip on these menopausal years. Frankly, I was now afraid to take estrogen and the progesterone substitutes, which I understood at the time to be the only available source of progesterone.
But admittedly, I was getting some benefit from these drugs. When I stopped taking them, the old symptoms flared up. I even noticed that my chiropractic adjustments held better when I was on HRT. I also experienced an interesting phenomenon during these years of off-again, on-again hormone replacement: every time I stopped taking my hormones, I felt joint aches and knee pains. The more I monitored my hormone therapy by such signs and symptoms, the more suspicious I became that hormones (or the lack thereof) might very well be contributing to this reaction. I have since learned that other women have also come to associate muscle and joint pains with menopause.
On one hand, not taking the drugs was an obvious way to avoid the adverse reactions they could cause; on the other hand, giving them up meant losing their temporary benefits. A constant battle raged within my mind and body. I went back on the Estraderm patch, but in the meantime started reading everything I could find on the subject of hormones to try to find a new direction.
My hopes were turned into real fear when I read this statement in a report by Dr. Brian Henderson: “The patch produces higher levels of the most potent form of estrogen (estradiol) than does Premarin, giving a woman almost as much hormone as she would have made herself.” Dr. Henderson continued, “The effect of that should be to make one’s breast cancer risk go up substantially more on the patch than on Premarin.”5 It took that warning of a worst-case scenario for me to end my nearly ten years of experimenting with synthetic hormone replacement. I never found any combination or dosage of synthetic hormones that gave me enough benefits to compensate for the side effects that always accompanied their use. I felt blessed that I had not yet contracted cancer, but I remained terribly confused. Where could I turn next?
The beginning of the solution came to me when Dr. Julian Whitaker’s Health & Healing newsletter arrived. What he had to say sent my hopes soaring. The information and phone numbers he included provided me answers to some of the questions I had asked doctors for so many years: “What specifically does progesterone do? How can we get natural hormones? Do we always need a prescription?” Could it be that what I was about to explore would actually resolve what had seemed a never-ending quest? Was it possible that my fears and anxieties could be a thing of the past? I truly hoped so.
My mailbox soon began to fill up with research reports and abstracts that I had requested. They told me that there was a natural, plant-based source of progesterone that had none of the side effects of the synthetic substitutes. Eager and willing, I kept rereading the encouraging words of Dr. John R. Lee from a statement in the periodical Medical Hypotheses: “Progesterone is inexpensive, being available from many plant sources…. Furthermore, it is remarkably free from side-effects.”6
More information arrived in an educational brochure distributed by the Women’s Health Connection in Madison, Wisconsin:
The process of producing natural progesterone, which is made from yams and soybeans, was discovered by Russell Marker, a Pennsylvania State College chemistry professor. While experimenting with sapogenins, a group of plant steroids, in the jungles of Mexico in the 1930s, Marker realized that progesterone could be transformed by chemical process from the sapogenin, diosgenin, which is found naturally in yams.
Unlike medroxyprogesterone [the chemical name for Provera], natural micronized progesterone is an exact chemical duplicate of the progesterone that is produced by the human body.
Another immediate difference between medroxyprogesterone and natural progesterone is that the synthetic hormone can actually lower a patient’s blood level of progesterone. Some women who take medroxyprogesterone to combat PMS or oppose estrogen in menopause, report headaches, mood swings and fluid retention.
The more information I acquired, the more questions I had. How, why, and where does natural progesterone work in the body? The answers later came to fill a whole chapter of this book. But I am getting ahead of myself. I was so relieved to find that such a natural hormone existed that I immediately ordered a jar of cream made from these naturally occurring plant sterols. No prescription was needed. When it arrived, I quickly read the directions and applied the cream to my skin. It is a fat-soluble compound that is absorbed into the skin and taken up by the fatty layer beneath. From there it is transferred into the bloodstream to circulate throughout the body.
In the days and months that followed, I experienced a peace of mind that I had not felt in many years. Enjoying my new sense of well-being was like living in a new body—no sharp uterine pains, no bloating, no tension. Best of all, my energy level was high, and I was able to sleep at night. I continued using the progesterone every day, secure in the knowledge that it was safe. It brought innumerable health benefits without artificially continuing my menstrual periods for the rest of my life.
I quickly learned that with natural hormone replacement therapy (NHRT), it was important for me to use the product daily for three weeks out of every month. I added this to my regimen of vitamins, minerals, other nutritional supplements, chiropractic care, and exercise. I found that all of these components were vital for optimal health and in supporting my natural HRT program. The plant-derived progesterone had greatly reduced the irritating conditions I’ve already described, such as fluid retention, colitis, joint pain, and sleep disorders. As my discomforts slowly diminished, I realized that this remarkable “phytohormone” had eliminated much of what used to be stress and had given me new stamina and energy.
I gradually became more active yet calmer when dealing with family and business issues. The benefits for me were obvious very quickly. Like most women I have talked to, I found that applying the contents of approximately one two-ounce jar of progesterone cream each month to various areas of the skin is quite sufficient to remedy the majority of problems. Further details on when and how to use the cream will be offered throughout the book; for other modes of hormone use, see appendix A.
Indeed, I have learned that progesterone can be found not only in the cream form but also in a capsule form (micronized for better absorption). I had my internist call in a prescription for a specific dosage of this to one of the numerous pharmacies that specialize in formulating natural products. At prescription strength, it is covered by most insurance companies, which makes NHRT quite affordable. The suppliers are located in various cities throughout the country (see appendix G). You can also order sublingual drops (applied under the tongue) or a micronized spray (applied to the mucous membranes of the cheeks) rather than the cream form. Some studies have found that the sublingual method provides approximately three times the concentration found in some of the nonprescription creams.7
I added this prescription for micronized capsules to my natural hormone program for two simple reasons: (1) I knew exactly how many milligrams I was taking, and (2) it was covered by insurance. At the time, I didn’t want to bother with the blood or saliva testing because of the inconvenience and the expense. My choice served me well for several years, and I had never felt better.
As I read and learned more, however, I realized that although the prescription indicated exactly how many milligrams I was ingesting, this was not necessarily the amount of progesterone that was being absorbed by my body. Questions arose for me, such as, “After progesterone is altered in the liver, how much of the real progesterone are you getting? Is your liver functioning at a hundred percent efficiency?” I didn’t have the answers, so I thought it prudent to begin dissolving my pills sublingually.*
At the same time I am quite happy with the results of using the transdermal progesterone cream on a routine basis. I have found that it also has many other uses. For instance, I sometimes massage it where I have back, hip, or knee pains. Doctors now report that rubbing progesterone cream or oil directly onto the joint or painful area helps their patients.8
It’s important for all of us to ask lots of questions prior to choosing the type of product (creams, pills, or drops) to use. We need to evaluate these according to strength, purity, and quality of the delivery system and relate these to the degree of our symptoms and estrogen dominance. I have concluded that it’s well worth the time and effort required to move toward the goal of satisfying one’s unique requirements.
I’ve learned a great deal about progesterone, especially since coming upon one of the most informative books of all on the subject: Natural Progesterone: The Multiple Roles of a Remarkable Hormone. Its author, John R. Lee, M.D., instructs us not only about progesterone’s molecular structure and the interplay of our natural hormones but also about the many advantages of using the cream. “How long should a woman stay on this natural progesterone cream?” Dr. Lee is often asked. He replies, “I want them to stay on it till they are ninety-six and then we’ll reevaluate!”9
Later, after putting into practice what I knew at last to be essential to my overall health, I learned of the wide-ranging implications of natural hormone replacement therapy for other health problems. Principal among these are cancer, osteoporosis, and heart disease. It is well known that the use of synthetic hormones increases a woman’s risk of breast and endometrial cancer; the use of natural progesterone changes those odds. As for osteoporosis, only recently has the importance of this type of hormone therapy become known for treating bone loss. I will show you evidence that natural progesterone therapy can halt and even reverse the effects of osteoporosis. Sections of this book cover each of these subjects, as well as the connection of progesterone to cardiovascular problems.10
For decades the medical community promoted estrogen for its health benefits for the heart only to find that it could actually cause long-term side effects such as heart disorders, blood clots, stroke, and even cancer.11–14 The first edition of this book was published in 1997. It explained then, as it does today, that natural progesterone offers protection in its antispasmodic effect in the body. In fact this natural hormone functions as a vasodilator to prevent or regulate coronary artery spasms, whereas progestins such as Provera often contribute to cardiovascular disorders.15–18 On this subject it was interesting to read a Health Dispatch Newsletter from Dr. David Williams (August 4, 2003) reporting that estrogen can elevate homocysteine levels and contribute to clogging of the arteries by depleting vitamins B6, B12, and folic acid.
Throughout this book we see, however, that the use of natural progesterone is the hormone that should have been heralded for its variety of physiological benefits. Studies demonstrate that natural progesterone, the all-too-often overlooked hormone, is effective in opposing estrogen’s stimulatory effect as found in cancer and other such “cellular over-growth” diseases—both benign and malignant.19, 20 Raising progesterone levels has also been shown to be effective for a variety of physiological disorders from osteoporosis and post partum depression to premenstrual epilepsy. Research continues to show us that rebalancing of hormone levels by focusing on progesterone deficiency is crucial in achieving wellness.21–28
As we unearth solutions that guide us toward optimal health, we often discover that the answers are found not in just one area of the natural sciences but in many. Raw foods, natural nutritional supplements, and exercise are among the many healthy ways we can encourage the body’s innate healing power. By addressing hormonal, neurological, and nutritional deficiencies, we can better attain a greater mental clarity and a more serene confidence in God’s power. Through these channels we can turn our negative stress and anxiety into positive opportunities for growth, learning, and service to others.
The thought of the legions of women who have met conflict and contention with their physicians in the search for better health prompts me to recall the struggle of Helen Keller, as depicted in a recent book about her life, Light in My Darkness. I could not help but be affected by what her editor described as Helen’s “unwavering faith in God’s plan, as she fought and then found through her religion that every human life is of sacred importance and dignity.”29
Faced with misfortune, we either succumb to our impediments and prejudices, or overcome them. And as Helen aptly expresses it, “Life is either a daring adventure or it is nothing.”30 As we forge ahead with the knowledge we have at hand, we are better prepared for tomorrow’s challenges—a bit wiser concerning our choices and more mindful of how to protect ourselves and our dignity.
As for myself, the moment I learned what is good and natural for home-ostasis—our internal balance—is a moment of truth I will never forget. I knew then (and my experience confirmed) what I must also convey to others who are suffering from the grim side effects of synthetic hormones and other related medication.
Trust your own intuition. If at first your doctor says, “Oh, you’re too young to worry about menopause and hormone replacement therapy,” you can ask for tests such as those for LH (luteinizing hormone) and FSH (follicle-stimulating hormone), which measure hormone messages between your pituitary and ovaries. Do this before you are given a diuretic or pills for pain, insomnia, “nerves,” or high blood pressure. However, note that although FSH does go up at menopause, Sandra Coney in The Menopause Industry: How the Medical Establishment Exploits Women, says there is disagreement among doctors as to the level that confirms the reaching of menopause. Furthermore, she says, “hormones can fluctuate wildly during the menopausal transition (40-50 years old) and even for some months after the last period; … therefore, biochemical tests cannot accurately predict whether a woman is menopausal [and] are really not much use.”31
According to Dr. John R. Lee, Harvard University’s Dr. Peter Ellison “has shown that you can get a more accurate measure of the functional level of estrogen and progesterone by measuring it in saliva” rather than in the blood. “It’s logical,” he says, “and less expensive.”32 To find out where you can order a saliva hormone level test kit to use in the privacy of your own home, see chapter 7. Certain laboratories also perform a more comprehensive version of this test, if ordered by your doctor.
Without any testing, the doctor may just prescribe stopgap medication, with the reassuring words, “This will calm you down so you can get through the day. It will also help you sleep.”
Does this sound familiar? And keep in mind that, with so many other patients needing attention, once you have left the office you may be “out of sight, out of mind.” In the end, you alone are responsible for yourself. No one else is likely to be willing to invest as much time or effort as you are in your own welfare.
I invite you to learn how and why plant-derived progesterone can help prevent the symptoms of PMS, menopause, osteoporosis,33 fibrocystic breast disease,34 and painful endometriosis35 and may reverse disorders ranging from blood clotting to vaginal atrophy36 and even some forms of cancer.37 And should progesterone alone not prove effective, I encourage you to examine your diet and research other natural alternatives such as maca, which is one of a variety of support systems we discuss in chapter 6.
I hope that for others who, like me, have experienced PMS or childbirth difficulties or the complicated trek through the premenopausal, perimenopausal, and postmenopausal passage, this book will provide some well-deserved solutions.
* Since individual needs can vary greatly, depending on the health of one’s liver and adrenals, some women may want to obtain an adrenal stress and hormone level evaluation.