The hormone era came into
its own with The Pill. Taken on a cyclical schedule monthly, synthetic
estrogen plus synthetic progesterone, or synthetic progesterone alone, send
signals to the master controller - the pituitary and hypothalamus - to shut
down ovulation. If no egg is release from the ovary, there's no pregnancy.
Presto! - sexual freedom without paying the piper! Fantastically convenient
Try telling that to Mother Nature. Ask
epidemiologists who chart the steady rise of breast cancer rates in the U.S. while other
cancers, except lung cancer in women, have decreased. Look up the manufacturers' product
information for any well-known oral contraceptive in the Physicians' Desk Reference.
Pages of tiny print list Cautions, Contraindications, and Adverse Reactions that include
life-threatening pulmonary embolism, cerebral thrombosis, and cerebral hemorrhage. Never
mind the 'milder' patient complaints such as nausea and vomiting, migraine, mental
depression, gallbladder disease, enlargement of uterine fibroid tumors, and loss of scalp
hair! (Just a sample, believe me.)
young women were snookered on a grand scale into accepting without a fuss the havoc The
Pill makes of their natural functions. The Pill's success ($$) and safety record (hah!)
helped launch the next campaign, Hormone Replacement Therapy (HRT) for the disease
of aging in women - medical salvation for a tragic medical condition!
The goal appears to be pharmaceutical control over every woman's 'female' functions,
beginning with puberty and stopping only with her obituary.
Besides generating monumental windfalls for the drug
firms, it makes steady work for journalists, ad-makers, medical experts, etc. whose job it
is to terrify women (and physicians) about the horrors of menopause, decrepitude, bone
loss, etc. - avoidable, they say, only through HRT. Skeptical doctors, slow to
prescribe it, risk an exodus of patients who turn to more caring physicians. Scan
the magnificent HRT ads in any medical journal, or read standard medical texts on
menopausal symptoms and treatment, if you think I'm overstating the case.
Each of the scores of synthetics developed for oral
contraceptives and HRT is patentable, unlike real hormones, creating the profit
incentive. Most important in terms of convenience, they work when taken orally.
Natural hormones are commercially extracted easily from plants but lose some effectiveness
when swallowed. So, what's wrong with making powerful hormones that work by mouth?
The answer lies in the story of
progesterone. In John R. Lee M.D.'s Natural Progesterone: The
Multiple Roles of a Remarkable Hormone (1993), the good doctor from Sebastopol tells
what happens to women who use the true hormone. The contrast between its benign effects
and the hair-raising ones caused by synthetics was a revelation to me. Like most people,
clinicians included, I didn't know about the difference*.
The synthetic analogues of progesterone are call progestins
- a term designed to blur the distinction. Another term is "progestogens".
No wonder doctors, patients, journalists - everyone but the drug makers - seldom know the
difference. Dr. Lee writes: "Gail Sheehy, in her popular 1991 book The Silent
Passage, for instance, admits to being so confused about the names that she decided to
call all of them 'progesterone' throughout the book even though she is generally writing
about the synthetic progestins."
The lists in Physicians' Desk Reference of
'adverse reactions' for Provera and the other progestins are very long and very scary.
For starters, they're known to increase the risk of birth defects, of breast cancer, and
of runaway blood clots (embolisms) that lodge in the lungs or the brain.
Natural progesterone doesn't have any harmful side effects
even during pregnancy, and actually protects against breast cancer and abnormal clotting.
Swallowed as a pill, however, it goes through metabolic
passes by the liver, losing some of its effectiveness. Earlier preparations of natural
progesterone needed to be injected, or were made for vaginal or rectal insertion - not
very convenient. (More recently, good absorption has been achieved from oral preparations
that deliver the desired doses.) Also, as we observed, the natural is not patentable.
The drug makers got busy. Starting with the real hormone, they did a little snipping here,
a bit of tailoring there - creative organic chemistry stuff! The reformulated molecules
were powerful inhibitors of ovulation, making them the drug of choice (along with
synthetic estrogens) for contraception.
The other beckoning market was the menopausal woman on
estrogen replacement therapy (ERT). Alas, these ladies were getting too many cancers of
the uterus. Back to the drawing board! Progestins saved the day. Taken cyclically, they
tend to cause bleeding that sheds the cancer-promoting buildup (stimulated by
tissues lining the uterus. Wunderbar! Mostly male doctors now have restored to us
older females the privilege of having monthly periods till we totter to the grave. Thanks
Question: Why is true progesterone good for us and the
synthetic analogs not so good?
Progesterone is the master
'starter' hormone from which the other great steroid hormones are made, i.e.,
testosterone, estrogens, and the adrenal corticosteroids. We're talking basic.** For example, Dr. Lee explains how cortisone's unique
anti-arthritic, anti-inflammatory effects can take place only if enough progesterone is
available as precursor to cortisone synthesis by the body.
Progesterone's second indispensable function is the
survival and development of the fertilized ovum. Ample amounts made by the placenta and
ovary are essential for a full-term pregnancy.
Far and beyond its role in pregnancy, Lee explains, are
progesterone's multiple systemic functions, including these:
protects against breast fibrocysts
is a natural diuretic
helps use fat for energy
is a natural antidepressant
helps thyroid hormone action
normalizes blood clotting
helps normalize blood sugar levels
normalizes zinc and copper levels
restores proper cell oxygen levels
protects against endometrial cancer
helps protect against breast cancer
stimulates bone building
The fakes - progestogens, progestins, etc. - do two
things well: they prevent ovulation and they stop ERT-induced buildup of uterine lining
(endometrium) to cancer-promoting levels. The following fatal flaws, however, make it
impossible for them to take on most of progesterone's functions:
1) They can't be converted in the body into sex hormones and
2) All progestins have powerful effects when taken orally because they're not readily
metabolized (broken down) by the liver for excretion in bile and urine - unlike
progesterone. Not only do they persist in the body abnormally long, they occupy
progesterone receptor sites in tissues, taking over for the true hormone but not capable
of doing most of its jobs.
Many of progestins' adverse effects are believed to
arise from just this interference with highly complex natural processes. Reminds me of
trans-fatty acids that get into our system after we eat foods prepared with margarine and
other artificially hydrogenated oils. Trans fats displace vitally needed w3 and w6 fatty
acids in the cell membrane, but then can't fish or cut bait!
Question: Why are so many women beset after menopause with
stiff, aching joints, and loss of springiness and muscular strength, while men generally
retain not just male virility but physical power and vitality?
Adrenal glands make progesterone
for women and men both; but women depend on their ovaries for the main supply of
progesterone (also estrogen). When at menopause the ovary's output of both drastically
drops (but doesn't cease), the adrenal glands try harder but don't make up the difference.
In contrast, older men maintain their usual progesterone levels, which in the U.S. tend to
be much higher than in menopausal women!***
For women, progesterone loss means a big drop in corticosteroids,
which protect against stiffness, soreness, and weakness in joints and muscles. Men, on the
other hand, continue to maintain their corticosteroid levels.
Low progesterone also may lead to loss of bone
density and ready fractures from physical exertions, so that many women fear to
exercise or engage in sports, which only reinforces the stiffness, weakness, etc.
Question: Why do many pre-and postmenopausal women develop
excess facial hair and male-pattern hair loss?
When a woman has too little progesterone with which to
make the other steroids, the process has to proceed via an 'emergency' rerouting. This
bypass relies more on androgenic (male type) hormones than the route where progesterone is
the key precursor. Dr. Lee writes: "When this happens, the androgenic steroids
along this pathway will become more dominant..." The good news is that with a number
of patients "replacement of natural progesterone leads, in time, to disappearance of
the facial hairs and the restoration of scalp hair."
Question: Can young women also experience low progesterone
levels? What are the effects?
"...a good proportion of women in their 30's (and some even
earlier) and long before actual menopause, will, on occasion, not ovulate during their
menstrual month. Without ovulation, no corpus luteum results and no progesterone is
made," Dr. Lee writes. Stress, poor nutrition, smoking, and toxic chemicals in the
environment probably contribute to anovulatory periods. As these women approach the decade
before menopause, "they are producing much less progesterone than expected but still
producing normal (or more) estrogen."
Estrogen without progesterone's balancing effects are not
as benign as we're led to believe. As a matter of fact, he's convinced the discomforts
young women are most familiar with arise from unopposed estrogen in the face of a
relative progesterone deficiency.
For example, "they retain water and salt, breasts
swell and become fibrocystic, they gain weight (especially around the hips and torso),
become depressed and lose libido, their bones suffer mineral loss, and they develop
Natural progesterone, he and other doctors find, gives
young and premenopausal patients relief from any or all of these symptoms. It also tones
down sweets cravings!
The Felix Letter, P.O.B. 7094, Berkeley, CA
is published independently by Clara Felix
and supported solely by subscription.
Subscription $12/yr (6 issues), $22/2yrs (12 issues).
* I'm angry because I too was snookered long ago, when
my doctor at the time prescribed Provera, a synthetic, that she called a
"natural" progesterone. I stopped taking it after some years, and since
menopause I've relied on good nutrition, ginseng, and plenty of omega-3 flax oil and fish
oil to get me over the humps. (See my chapter in Women of the 14th Moon: Writings on
Menopause, edited by Dena Taylor and Amber Coverdale Sumrall, 1991, preface by Grace
Paley. The Crossing Press, Freedom ,CA, 95019). I wish I'd known about natural
progesterone sooner as well! (back to where you were)
** The body makes progesterone and all steroids from
its cholesterol, a small molecule with important stabilizing functions in every cell. The
process can take place in the adrenal glands of both sexes and the testes in males. In
women during their fertile years the ovaries are the major production site for
progesterone. During the early phase of monthly preparation for ovulation, about 2
milligrams daily of progesterone are secreted. Starting around ovulation, progesterone
increases to 25mg a day during the latter stage, then drops sharply unless the egg is
fertilized. If fertilization occurs, ovaries and the placenta rapidly increase
progesterone biosynthesis to 300 to 400 milligrams a day in order to maintain a healthy
The androgenic (male) hormones, testosterone and androstenedione, are made from
progesterone. In turn, they can form the three estrogens: estrone, estradiol, and
estriol. (D'you suppose that's where the story of Eve arising from Adam's rib came
All the sex hormones and corticosteroids are small molecules shaped very much like one
another and the parent molecule, cholesterol. Highly specific variation, created by
natural enzymatic action, are responsible for their different roles in the body. (back to where you were)
*** Yes, men have female hormones and women have male
ones! It's the balance that counts. By the way, a woman continues to produce estrogen
after menopause not just in her ovaries but in her fat cells, from the male
hormone androstenedione. (back to where you were)