Nexus Magazine, Sept 1996
© 1996 by Sherrill Sellman, Light Unlimited, Locked Bag 8000 - MDC, Kew, Victoria 3101, Australia, Telephone +61 (0)3 9810 9591 Fax: +61 (0)3 9855 9991 E-mail: firstname.lastname@example.org http://www.ssellman.com/
The History of Hormone
A Brief Gynaecological Tour of a Woman's Body
The Myth of Oestrogen and Synthetic Progestins
Enter Natural Progesterone
The Oestrogen Dominance Effect
EFFECTS OF OESTROGEN DOMINANCE
Anti-ageing Benefits of Natural Progesterone
Introducing Oestrogen Dominance
Oestrogen Dominance in the Environment
The Myth of Oestrogen Deficiency
Synthetic Hormones and the Havoc they Wreak
Hormone Balance and Illness: Debunking the Myths
For over 300 years, beginning in the 13th century and continuing well into the 16th century, the Inquisition was a reign of terror for the vast majority of people living throughout Europe and Scandinavia. The political, economic and religious forces of that time joined together to consolidate their power by eliminating those whom they perceived as impeding their ultimate objectives.
The unfortunate target of their efforts were the keepers of the healing arts and the ancient spiritual and cultural wisdoms. Historians debate the exact toll of such a hellish time-whether it was several hundreds of thousands or as many as nine million people-but what is undebatable is that the vast majority of the victims were women. In fact, the Inquisition is now regarded as a period of genocide against women, which successfully divested women of their power, self-respect, wealth, healing arts, and prominence and influence in their communities.
The Inquisition guaranteed that the Church fathers were the indisputable spiritual authorities. It was also successful in enshrining medical knowledge securely in the realm of men, since the Inquisition decreed that only trained medical doctors could now practise the healing arts and, needless to say, medical schools were barred to women (for that matter, so was any form of education).
What a relief that such a violent and misogynous era ended long ago. Or did it? Unfortunately, it appears that some traditions linger on. Women of today are still prey to vast political and economic interests, with dire consequences to their health, financial independence and personal power. Perhaps the Inquisition didn't end at all but just took on a more subtle and devious form.
Women are certainly big business to the medical and pharmaceutical interests. According to John Archer, author of Bad Medicine, about 600,000 hysterectomies are performed every year in the USA, and about 45,000 in Australia.1 In 1994, it was estimated that 45,000 Australian women were taking hormone replacement therapy (HRT).2 Many women are presently encouraged to remain on HRT for the rest of their post-menopausal lives.
According to Dr Stanley West, noted infertility specialist, chief of reproductive endocrinology at St Vincent's Hospital, New York, and author of The Hysterectomy Hoax, about 90 per cent of all hysterectomies are unnecessary. Gynaecological consultants to Ralph Nader's Public Health Research Group reached a similar conclusion in 1991 in their book, Women's Health Alert. According to Dr West, the only 100-per-cent-appropriate reason for performing an hysterectomy is for treating cancer of the reproductive organs.3 However, hysterectomies are all too frequently offered as treatment for a variety of conditions including endometriosis, fibroids, ovarian cysts, pelvic inflammatory disease and uterine prolapse.
It is no accident that gynaecologists happen to be the highest earners of all specialists. Throughout their lives, women are encouraged to be subjected continuously to various medical treatments and procedures. Natural female functions, from menstruation through childbirth and into menopause, are taken over by medical and pharmaceutical interventions. Barraged by misinformation, myths, propaganda and, in some cases, downright lies, it's no wonder that so many women are thoroughly confused about matters relating to their own bodies and their health.
The History of Hormone Replacement Therapy
Perhaps there's no topic of greater confusion to women than the highly publicised introduction of HRT for the menopausal woman. It is touted as the best thing for liberating women since the discovery of oral contraceptives-even though the statistics now show that the wide use of the Pill has given rise to health hazards such as breast cancer, high blood-pressure and cardiovascular disease on a scale previously unknown in medicine.4
Investigation into the theory of hormone replacement goes all the way back to the 1930s with the research of Dr Serge Voronoff. His research involved implanting fresh monkey's testicles into men's scrotums, with limited effectiveness. Offshoots of his research led to the grafting of monkey ovaries in women, with rather dire consequences. After several fatalities (to both monkeys and women), the search was redirected to the use of synthetic oestrogen. With the advent of World War II, research was put on hold.
Menopause didn't really come into vogue as a topic of concern for the medical profession until the 1960s. In 1966 a New York gynaecologist, Dr Robert Wilson, wrote a best-seller called Feminine Forever, extolling the virtues of oestrogen replacement to save women from the "tragedy of menopause which often destroys her character as well as her health". His book sold over 100,000 copies in the first year. Wilson energetically promoted menopause as a condition of "living decay". According to him, oestrogen replacement was a kind of long-sought-after youth pill that would save poor, fading women from the horrors of age. He popularised the erroneous belief that menopause is a deficiency disease.
Women's magazines eagerly seized upon his ideas and extensively promoted his concepts. This pleased Wilson no end, since he had earlier set up The Wilson Foundation for the sole purpose of promoting the use of oestrogen drugs. The pharmaceutical industry generously contributed over US$1.3 million to his Foundation. Each year he received funds from such companies as Searle, Wyeth-Ayerst Laboratories and Upjohn which made hormone products that Wilson claimed were effective in treating and preventing menopause. Pharmaceutical companies jumped on the bandwagon with aggressive promotions and advertising campaigns. His message hit a receptive chord: mid-life women need hormone drugs to be rescued from the inevitable horrors and decrepitude of this terrible deficiency disease called menopause.
Wilson pioneered the use of unopposed oestrogen. However, there had been no formal assessment of the safety of oestrogen therapy or its long-term effects. Unopposed oestrogen went out of vogue when it became obviously apparent that it shortened the lifetime of its users. In 1975, The New England Journal of Medicine examined the rates of endometrial cancer for oestrogen consumers, concluding that the risk was seven-and-a-half times greater for oestrogen users. Women who had used oestrogen for seven years or longer were 14 times more likely to develop cancer.5
As the popularity of unopposed oestrogen therapy waned, new approaches were sought. The focus was also directed away from the false claims of preserving feminine beauty and youthfulness and towards more urgent health matters. The pharmaceutical industry resurrected oestrogen replacement therapy with the new 'safe' hormone replacement therapy-a combination of synthetic progesterone and oestrogen which would supposedly protect menopausal women not only from cardiovascular disease but also from the ravages of osteoporosis.
While the so-called 'experts' on women's health are reassuring women that there are no, or at least only very minor, unpleasant side-effects, Dr Lynette J. Dumble, Senior Research Fellow at the University of Melbourne's Department of Surgery at the Royal Melbourne Hospital, believes that "the sole basis of HRT is to create a commercial market that is highly profitable for the pharmaceutical companies and doctors. The supposed benefits of HRT are totally unproven." She believes that HRT not only exacerbates the presenting health problems but also contributes to the acceleration of the ageing process of women. It either hastens the onset of other medical conditions or worsens the existing ones.
This perspective seems to be validated by the recent findings from a landmark study, published in The New England Journal of Medicine in 1995, involving 121,700 women, which revealed startling effects from HRT. It warned that women who used HRT to offset the symptoms of menopause also increased their chance of developing breast cancer by 30 to 40 per cent by taking the hormone for more than five years. In women aged between 60 and 64, the risk of breast cancer rose to 70 per cent after five years of HRT. Finally, the study concluded that women using HRT were 45 per cent more likely to die from breast cancer than those who chose not to use HRT or used it for less than five years.6
According to Leslie Kenton, author of Passage to Power, "everybody who is anybody will tell you that menopause is an oestrogen-deficiency disease and that you will need to take more oestrogen as you approach mid-life. What may surprise you is this: not only is most of such commonly given advice on menopause wrong, a great deal of it can be positively dangerous."
Fortunately there is another side to the hormone story-a perspective that not only can assist women of all ages to attain greater health but also to reclaim a greater sense of power, responsibility and dignity in their lives.
A Brief Gynaecological Tour of a Woman's Body
In order to understand the HRT debate, it is important, first, to have a rudimentary knowledge of a woman's cyclic nature.
Until recently, doctors thought that menopause began when all the eggs in the ovaries had been used up. However, recent work has shown that menopause is probably not triggered by the ovaries but by the brain. It seems that both puberty and menopause are brain-driven events.
Menstruation depends on a complex network of hormonal communications between the ovary, the hypothalamus and the pituitary gland in the brain. The hypothalamus secretes gonadotropin- releasing hormone (GnRH) which triggers the production of follicle-stimulating hormone (FSH) by the pituitary gland. The FSH then stimulates the growth of the egg follicles (a small excretory sac or gland) in the ovaries to trigger ovulation. As the egg follicles grow, oestrogen is manufactured and released into the blood.
This chain reaction is not just one-way. Oestradiol, one of the ovarian oestrogens in the bloodstream, also acts on the hypothalamus, causing a change in GnRH. Next, this altered hormone stimulates the pituitary to produce luteinising hormone (LH) which causes the egg follicles to burst and the ovum to be released. After the egg is expelled, progesterone is also manufactured by the collapsed egg follicle which develops into the corpus luteum.
All the hormones released during the menstrual cycle are secreted not in a constant, steady way but at dramatically different rates during different parts of the 28-day cycle.
For the first eight to 11 days of the menstrual cycle, a woman's ovaries make lots of oestrogen. Oestrogen prepares the follicles for the release of one of the eggs. It is oestrogen which proliferates the changes that take place at puberty: the growth of breasts, the development of the reproductive system and the shape of a woman's body.
The rate of oestrogen secretion begins to fall off on about day 13, one day before ovulation occurs. As oestrogen falls, progesterone begins to rise, stimulating very rapid growth of the follicle. Beginning with this secretion of progesterone, ovulation occurs too. After the egg has been released from the follicle (known as the luteal stage of a woman's cycle), the follicle begins to change, enlarging and becoming a unique organ known as the corpus luteum. Progesterone is secreted from the corpus luteum, this tiny organ with a huge capacity for hormone production. The surge of progesterone at the time of ovulation is the source of libido-not oestrogen, as is commonly believed.
After 10 or 12 days, if fertilisation does not occur, ovarian production of progesterone falls dramatically. It is this sudden decline in progesterone levels that triggers the shedding of the secretory endometrium (the menses), leading to a renewal of the entire menstrual cycle.
Ovarian oestrogen and progesterone stimulate the growth of the endometrium, or lining of the uterus, in preparation for fertilisation. Oestrogen proliferates the growth of endometrial tissue, and progesterone facilitates the secretory lining of the uterus so the fertilised egg can implant successfully. Adequate progesterone, therefore, is the hormone most essential to the survival of the fertilised egg and the foetus.
At around 40 years of age, the interaction between hormones alters, eventually leading to menopause. It is still not clear how. Menopause may start with changes in the hypothalamus and the pituitary gland rather than in the ovaries. Scientists have conducted experiments where young mice have had their ovaries replaced with those from aged animals no longer capable of reproducing. The young mice can mate and give birth. This shows that old ovaries placed in a young environment are capable of responding. On the other hand, when young ovaries are put into old mice, these mice cannot reproduce.7
Whatever the mechanism triggering menopause, as fewer egg follicles are stimulated, the amount of oestrogen and progesterone being produced by the ovaries declines although other hormones continue to be produced. By no means do the ovaries shrivel up and cease functioning, as is popularly believed. With the reduction of these hormones, menstruation becomes scantier and erratic and eventually ceases.
However, other body sites such as the adrenal glands, skin, muscle, brain, pineal gland, hair follicles and body fat are capable of making these same hormones, enabling the female body to make healthy adjustments in hormonal balance after menopause-provided a woman has taken good care of herself during the pre-menopausal years with proper lifestyle, diet and attention to mental and emotional health.
Menopausal women have the opportunity to enter this phase of life empowered in their wisdom and creativity as never before. They have access to profound inner-knowing. The renowned sociologist Margaret Mead said, "There is nothing more powerful than a menopausal woman with zest!" In many cultures around the world, menopause is a transition and an initiation into the fulfilment of a woman's power, totally symptom-free. She is held in the highest regard in her community as a wise, respected elder.
The Myth of Oestrogen and Synthetic Progestins
The earlier research that led to the synthesis of oestrogen made possible the development of the oral contraceptive by 1960. With consent of the US Food and Drug Administration (FDA), the Pill was widely marketed as an effective, convenient method of birth control. True sexual liberation for women was at hand at last.
However, the entire basis for the FDA's consent was the result of clinical studies conducted on 132 Puerto Rican women who had taken the Pill for one year or longer.8(Never mind the fact that there were five women who died during the study without any investigation into the cause of their deaths.)
By the mid-1970s the death toll of women from heart attacks and strokes began to attract public notice. A newer, supposedly safer Pill was then created with a lower dose of oestrogen. But, in fact, there has never been any valid scientific proof that the Pill is safe-nor, for that matter, that any of the other forms of contraception presently available are safe. Women are only now discovering the price they have been paying for their sexual freedom: by altering their hormonal balance, many varied and devastating emotional and physiological dysfunctions have been created.
It is now 35 years on from the introduction of oral contraception and there are presently about 60 million women worldwide who are, in effect, 'trialling' the Pill. Its safety and long-term effects have still not been established conclusively. It is interesting to note, however, that it has produced a wide assortment of adverse effects and side-effects and has a significant link to breast cancer, high blood-pressure and, in particular, cardiovascular disease-the major cause of female deaths in Australia. In 1992, 27,833 women died from heart disease and strokes, compared to 2,438 from breast cancer.9Is this merely a coincidence, or do these statistics indicate, perhaps, the harmful side-effects of tampering with hormones?
While proclaimed also as the primary missing ingredient for the menopausal woman, oestrogen is strongly recommended by the medical and pharmaceutical industries for the prevention of cardiovascular disease and osteoporosis. Just about any doctor's surgery you walk into these days will warn women of the inherent risks of going through menopause and, for that matter, the post-menopausal years without the protection of oestrogen. Women are further reminded, once again, that menopause is a deficiency disease, which supposedly means that they are lacking oestrogen and therefore must have supplemental doses to maintain their health.
As Dr Lynette Dumble has noted, "Broadly speaking, cardiovascular prevention in women has overwhelmingly focussed on hormone replacement. Yet, as Elizabeth Barrett-Connor emphasises, the Big Trial, the Coronary Drug Project of 1973 that included two oestrogen regimens, was conducted in men. As part of the Big Trial design, oestrogen doses extravagantly in excess of physiological levels were deliberately administered to men in order to induce gynaecomastia [enlargement of male breasts] as an indicator of successful feminisation. This resulted in thrombosis and impotence and ultimately led to research failure because of treatment discontinuations amongst the study's participants."10
According to medical practitioner, independent researcher and author Dr John Lee, the one notable study (known as the Boston Health Study, conducted with a large sampling of nurses) which formed the entire basis of the positive oestrogen-cardiovascular link, was radically flawed. Although there is ample evidence from numerous other studies showing that, indeed, the opposite is true-i.e., oestrogen is a significant factor in creating heart disease-these findings have been virtually ignored in the frenzy for profits. He goes on to say that the pharmaceutical advertisements also neglected to mention the fact that stroke death incidence from that study was 50 per cent higher among the oestrogen users.
Dr Lee has compiled a list of side-effects and physiological impairments which result from taking oestrogen. They include increased risk of endometrial cancer, increased body fat, salt and fluid retention, depression and headaches, impaired blood-sugar control (hypoglycaemia), loss of zinc and retention of copper, reduced oxygen levels in all cells, thickened bile and promoted gall bladder disease, increased likelihood of breast fibrocysts and uterine fibroids, interference with thyroid activity, decreased sex drive, excessive blood-clotting, reduced vascular tone, endometriosis, uterine cramping, infertility, and restraint of osteoclast function.
With so many side-effects and dangerous complications, a woman must think very carefully about the HRT decision. Unfortunately, most doctors will tell her that there is no other alternative. While certainly most doctors are well-meaning and sincerely concerned about their patients, their primary source of education and product information comes directly from the pharmaceutical companies. Since most women also lack essential education and understanding about their options, menopause can be perceived as a rather frightening and perilous time.
Enter Natural Progesterone
For the past 15 years, Dr Lee has conducted independent research into a natural, plant-derived form of progesterone. His non-pharmaceutically-funded research presents a much broader understanding of a woman's hormonal options and offers a totally safe, effective alternative that is free of all side-effects. He has found that this natural hormone-used in conjunction with a good diet and lifestyle changes-is capable of eliminating much of the suffering associated both with premenstrual syndrome (PMS) and menopause. Thousands of women in the Western world now use natural progesterone-generally in the form of a non-prescription cream which is rubbed into the body. They claim that they not only have relief from female symptoms but experience increased vitality, better skin and renewed emotional balance.
Natural progesterone seems to have been totally overlooked by medical science while the erroneous focus has been on oestrogen. Considering that it is non-patentable and inexpensive, it not surprising that this is so. It is important, however, to have a much greater understanding and appreciation for this remarkable hormone.
As was previously mentioned, it is progesterone that is responsible for maintaining the secretory endometrium which is necessary for the survival of the embryo as well as the developing foetus throughout gestation. It is little realised, however, that progesterone is the mother of all hormones. Progesterone is the important precursor in the biosynthesis of adrenal corticosteroids (hormones that protect against stress) and of all sex hormones (testosterone and oestrogen). This means that progesterone has the capacity to be turned into other hormones further down the pathways as and when the body needs them. The point needs to be emphasised that oestrogen and testosterone are end metabolic products made from progesterone. Without adequate progesterone, oestrogen and testosterone will not be sufficiently available to the body. Besides being a precursor to sex hormones, progesterone also facilitates many other important, intrinsic physiological functions (which will be discussed later).
The Oestrogen Dominance Effect
Female problems seem to be on the rise. Between 40 and 60 per cent of all women in the West suffer from PMS. In addition, women also suffer from a plethora of symptoms, some menopausal and others not. Something quite alarming certainly seems to be happening to women. There is indication that proper hormonal balance necessary for a woman's body to function healthily is being interfered with by a number of factors. Research has revealed that a good portion of women in their 30s (and some even younger), long before the onset of menopause, on occasion will not ovulate during their menstrual month.11 Without ovulation, no corpus luteum results and no progesterone is made. A progesterone deficiency ensues.
Several problems can result from this deficiency. One is the month-long presence of unopposed oestrogen with all its attendant side-effects, as already mentioned. Another is the generally unrecognised problem of progesterone's role in osteoporosis. Contemporary medicine is still unaware that progesterone stimulates osteoblast-mediated new bone formation. Actually, it is progesterone that stimulates new bone tissue and is capable of reversing osteoporosis at any age. Lack of progesterone means that new osteoblasts are not created and osteoporosis can arise.12 A third major problem results from the interrelationship between progesterone loss and stress. Stress combined with a bad diet can induce anovulatory cycles. The consequent lack of progesterone interferes with the production of the stress-combating hormones, exacerbating stress conditions that give rise to further anovulatory cycles. And so the vicious cycle continues.
Another major factor contributing to this imbalance between oestrogen and progesterone is environmental in nature. We in the industrialised world now live immersed in a rising sea of petrochemical derivatives. They are in our air, food and water. These chemicals include pesticides and herbicides (such as DDT, dieldrin, heptachlor, etc.) as well as various plastics (polycarbonated plastics found in babies bottles and water jugs) and PCBs. These oestrogen-mimics are highly fat-soluble, not biodegradable or well-excreted, and accumulate in fat tissue of animals and humans. These chemicals have an uncanny ability to mimic natural oestrogen. They are given the name "xeno-oestrogens" since, although they are foreign chemicals, they are taken up by the oestrogen receptor-sites in the body, seriously interfering with natural biochemical changes.
Mounting research is now revealing an alarming situation worldwide created by the inundation of these hormone-mimics. In a recently released book, Our Stolen Future, authors Theo Colburn of the World Wildlife Fund, Dianne Dumanoski of The Boston Globe and John Peterson Meyers, a zoologist, have identified 51 hormone-mimics, each able to unleash a torrent of effects such as reduced sperm production, cell division and sculpting of the developing brain. These mimics are not only linked to the recent discovery that human sperm-counts worldwide have plunged by 50 per cent between 1938 and 1990 but also to genital deformities, breast, prostate and testicular cancer, and neurological disorders.10
Dr Lee has discovered a consistent theme running through women's complaints of the distressing and often debilitating symptoms of PMS, peri-menopause and menopause: too much oestrogen, or, as he has termed it, "oestrogen dominance".
Now, instead of oestrogen playing its essential role within the well-balanced symphony of steroid hormones in a woman's body, it has begun to overshadow the other players, creating biochemical dissonance. The last thing in the world a woman's body needs is more oestrogen-either in the form of contraceptives or HRT. Then, when the oestrogen-dominant symptoms appear, guess what is prescribed? More oestrogen! The delicate natural oestrogen/progesterone balance is radically altered due to too much oestrogen. Progesterone deficiency is then exacerbated even more.
Dr Lee has been able to balance the oestrogen-dominance effect through the use of transdermal natural progesterone cream. Natural progesterone, a cholesterol derivative, is made from wild Mexican yams or soybeans whose active ingredients are an exact molecular match of the body's own progesterone. It is interesting to note that in countries in Asia and South America where women eat either the wild yams or soybeans, the term "hot flush" doesn't even exist in their languages. They also rarely suffer from the host of female problems presently plaguing Western women.
Supplementation with natural progesterone corrects the real problem: progesterone deficiency. Natural progesterone is not known to have any side-effects; nor have any toxic levels been found to date. Natural progesterone increases libido, prevents cancer of the womb, protects against fibrocystic breast disease, helps protect against breast cancer, maintains the uterus lining, hydrates and oxygenates the skin, reverses facial hair growth and hair thinning, acts as a natural diuretic, helps eliminate depression and increase a sense of well-being, encourages fat-burning and the use of stored energy, normalises blood-clotting, and is a precursor to other important stress and sex hormones. Even the two most prevalent menopausal symptoms-hot flushes and vaginal dryness-quickly disappear with applications of natural progesterone.
There is one other very significant benefit of natural progesterone that deserves a bit more attention. While most people are under the assumption that oestrogen protects against osteoporosis-one of the biggest selling-points for which a woman is encouraged to take HRT-this is definitely not the case.
The early studies on which the oestrogen-protection assumption was based had gross scientific defects. Canadian researcher Jerilyn Prior, chief endocrinologist at the University of British Columbia in Vancouver, and her colleagues, reporting in The New England Journal of Medicine, confirmed that oestrogen's role in osteoporosis is only a minor one. In their studies of female athletes, they found that osteoporosis occurs to the degree that they become progesterone-deficient, even though their oestrogen levels seem to remain normal. Prior continued her research with non-athletic women. They showed the same results. While both these groups of women were menstruating, they had anovulatory cycles and, therefore, were progesterone-deficient.
Prior then went on to discover that anovulation and a short-phase cycle now occur in up to 50 per cent of North American women's menstrual cycles during the final reproductive years.14 Unfortunately, these major findings went relatively unnoticed in the medical community.
As a result of her extensive review of published scientific evidence in this area, Prior confirmed that it is not oestrogen but progesterone which is the bone-trophic hormone; that is, the bone builder. She was even able to identify progesterone receptor-sites on osteoblast cells (bone tissue-building cells). Nobody has ever found osteoblast receptors for oestrogen. The bottom line is that it is in women with progesterone deficiency that bone loss occurs.15
These results were verified by a three-year study of 63 post-menopausal women with osteoporosis. Women using transdermal progesterone cream experienced an average 7 to 8 per cent bone-mass density increase in the first year, 4 to 5 per cent the second year, and 3 to 4 per cent in the third year! Untreated women in this age category typically lose 1.5 per cent bone-mass density per year! These results have not been found with any other form of hormone replacement therapy or dietary supplementation.16
Dr Lee believes that the use of natural progesterone in conjunction with dietary and lifestyle change can not only stop osteoporosis but can actually reverse it-even in women aged 70 or more.
At this point, it is important to make the distinction between the natural progesterone that is produced by the body and the synthetic progesterone analogues classified as progestins, such as Provera, Duphaston and Primulut. As you will learn, there is a big difference between the two in their effect in the body, although doctors most often use their names interchangeably. Since natural progesterone is not a patentable product, the pharmaceutical companies have molecularly altered it to produce synthetic progestins commonly used in contraceptives and HRT.
Synthetic progestins, because they are not exact replicas of the body's natural progesterone, unfortunately create a long list of side-effects, some of which are quite severe. A partial list includes headaches, depression, fluid retention, increased risk of birth defects and early abortion, liver dysfunction, breast tenderness, breakthrough bleeding, acne, hirsutism (hair growth), insomnia, oedema, weight changes, pulmonary embolism and premenstrual-like syndrome.17
Most importantly, progestins lack the intrinsic physiological benefits of progesterone, thus they cannot function in the major biosynthetic pathways as progesterone does and they disrupt many fundamental processes in the body. Progesterone is an essential hormone that also plays a part in the development of healthy nerve cells and brain and thyroid function. Progestins tend to block the body's ability to produce and utilise natural progesterone to maintain these life-promoting functions.
The hormone story is certainly a very complicated one. Up until now, only one version of the story has been available to the majority of Western women, especially Australian women. Serious doubt has been cast on the efficacy and appropriateness of oestrogen and progestins in all the forms they take. Women are certainly suffering from a wide variety of female complaints.
What complicates the hormone story is that the prescribed treatments for these complaints are actually making the problem worse. Without understanding the far-reaching side-effects of oestrogen dominance and progestin, doctors are misdiagnosing the cause of these aggravated conditions. Often, other drugs are then prescribed with disastrous side-effects, as the spiral of unnecessary medication increases. What is the ultimate toll, not only on a woman's deteriorating health and emotional well-being but also on her financial situation, her relationships and her career?
Without adequate knowledge, education and access to natural products, women have been easy prey to the powerful campaigns of the multinational drug companies that have convinced doctors as well as governments of their claims. It is becoming more evident that women's interests are not always best met through such a biased approach. It is also not unusual for profits to take precedence over health and well-being. The last thing a woman needs is to have her natural bodily functions denigrated to deficiency diseases-thus necessitating ongoing medical attention.
It is indeed time for women to take even greater responsibility for their health, their choices and their lifestyles. The greatest weapon against compliance and ignorance is knowledge. It's time to ask poignant questions of your health provider, to demand answers and to be willing to investigate safe, alternative approaches. It is apparent that women will need to participate in educating their doctors about the other choices that exist as well as the ones that they prefer.
Certainly, women have it well within their own power not only to find safe, natural and effective ways to heal themselves but to live long, full lives, preserving their vitality, youthfulness and health. Women deserve the right to appreciate themselves and their bodies through all the stages of life. As women find the way to return to a greater balance within themselves, they will know profoundly the truth of what Dr Deepak Chopra has said about women: "Feminine wisdom is the intelligence at the heart of creation."
EFFECTS OF OESTROGEN DOMINANCE
1. When oestrogen is not balanced by progesterone, it can produce weight gain, headaches, bad temper, chronic fatigue and loss of interest in sex-all of which are part of the clinically recognised premenstrual syndrome.
2. Not only has it been well-established that oestrogen dominance encourages the development of breast cancer thanks to oestrogen's proliferative actions, it also stimulates breast tissue and can, in time, trigger fibrocystic breast disease-a condition which wanes when natural progesterone is introduced to balance the oestrogen.
3. By definition, excess oestrogen implies a progesterone deficiency. This, in turn, leads to a decrease in the rate of new bone formation in a woman's body by the osteoblasts-the cells responsible for doing this job. Although most doctors are not yet aware of it, this is the prime cause of osteoporosis.
4. Oestrogen dominance increases the risk of fibroids. One of the interesting facts about fibroids-often remarked on by doctors-is that, regardless of the size, fibroids commonly atrophy once menopause arrives and a woman's ovaries are no longer making oestrogen. Doctors who commonly use progesterone with their patients have discovered that giving a woman natural progesterone will also cause fibroids to atrophy.
5. In oestrogen-dominant menstruating women where progesterone is not peaking and falling in a normal way each month, the ordered shedding of the womb lining doesn't take place. Menstruation becomes irregular. This condition can usually be corrected by making lifestyle changes and using a natural progesterone product. It is easy to diagnose by having a doctor measure the level of progesterone in the blood at certain times of the month.
6. Endometrial cancer (cancer of the womb) develops only where there is oestrogen dominance or unopposed oestrogen. This, too, can be prevented by the use of natural progesterone. The use of the synthetic progestins may also help prevent it, which is why a growing number of doctors no longer give oestrogen without combining it with a progesterone drug during HRT. However, all synthetic progestins have side-effects.
7. Waterlogging of the cells and an increase in intercellular sodium, which predispose a woman to high blood-pressure or hypertension, frequently occur with oestrogen dominance. These can also be side-effects of taking synthetic progestogen [progestins]. A natural progesterone cream usually clears it up.
8. The risk of stroke and heart disease is increased dramatically when a woman is oestrogen-dominant.
(Source: Leslie Kenton, Passage to Power, Random House, UK, 1995)
Anti-ageing Benefits of Natural Progesterone
1. Progesterone is a primary precursor in the biosynthesis of the adrenal corticosteroids. Without adequate progesterone, synthesis of the cortisones is impaired and the body turns to alternate pathways. These alternate pathways have masculine-producing side-effects such as long facial hairs and thinning of scalp hair. Further impaired corticosteroid production results in a decrease in the ability to handle stress, e.g., surgery, trauma or emotional stress.
2. Many peri- or post-menopausal women with clinical signs of hypothyroidism, such as fatigue, lack of energy, intolerance to cold, are actually suffering from unrecognised oestrogen dominance and will benefit from supplementation with natural progesterone.
3. Oestrogen and most of the synthetic progestins increase intracellular sodium and water uptake. The effect of this is hypertension. Natural progesterone is a natural diuretic and prevents the cell's uptake of sodium and water, thus preventing hypertension.
4. Whereas oestrogen impairs homeostatic control of glucose levels, natural progesterone stabilises them. Thus, natural progesterone can be beneficial to both those with diabetes and those with reactive hypoglycaemia. Oestrogen should be contraindicated in patients with diabetes.
5. Thinning and wrinkled skin is a sign of lack of hydration in the skin. It is common in peri- and post-menopausal women and is a sure sign of hormone depletion. Transdermal natural progesterone is a skin moisturiser which restores skin hydration.
6. Progesterone serves a role in keeping brain cells healthy. A disorder such as premature senility (Alzheimer's disease) may be, at least in part, another example of disease secondary to progesterone deficiency.
7. Progesterone is essential for the healthy development of the myelin sheath which protects the nerve cells. Low progesterone levels lead to recurring aches and pains.
8. Progesterone creates and promotes an enhanced sense of emotional well-being and psychological self-sufficiency.
9. Progesterone is responsible for enhancing the libido.
(Source: John R. Lee, M.D., Slowing the Aging Process with Natural Progesterone, BLL Publishing, CA, USA, 1994, p. 14)
1. Archer, John, Bad Medicine, Simon & Schuster, Australia, 1995, p. 191.
2. Op. cit., p. 217.
3. Op. cit., p. 192.
4. Op. cit., p. 211.
5. Coney, Sandra, The Menopause Industry, Spinifex Press Pty Ltd, Australia, 1991, pp. 164-165.
6. The Sydney Morning Herald, 24 June 1995.
7. Coney, Sandra, op. cit., p. 584.
8. Archer, John, op. cit., p. 210.
9. Archer, John, op. cit., p. 211.
10. (a) Dumble, Lynette J., Ph.D., M.Sc., "Odds Against Women with Heart Disease", presented at Health Sharing Women's Forum, Royal College of Surgeons, Melbourne,Victoria, Australia, 14 September 1995. (b) Barrett-Connor, Elizabeth, "Heart Disease in Women", Fertility and Sterility (1994), 62(2):127S-132S.
11. Lee, John R., M.D., Natural Progesterone: The Multiple Role of a Remarkable Hormone, BLL Publishing, California, USA, 1993, p. 29.
13. Newsweek, 18 March 1996.
14. Kenton, Leslie, Passage to Power, Random House, UK, 1995, pp. 19-20.
16. Lee, John R., M.D., "Osteoporosis Reversal: The Role of Progesterone", International Clinical Nutrition Review (1990), 10:384-391.
17. Lee, John R., M.D., Slowing the Aging Process with Natural Progesterone, BLL Publishing, California, USA, 1994, p. 12.
Oestrogen is quite a high-profile hormone these days. For some, it represents the Golden Fleece that excites so many medical practitioners, pharmaceutical companies and writers in search of its miraculous properties. For others, oestrogen is a rather perilous hormone, fraught with many unknown and unspoken dangers. Most women are lost in the dark and bottomless abyss, somewhere between truth and fiction. All too often they are desperately confused about whether to trust their instincts or medical science. Their physical, emotional and mental health and long-term well-being hang in the balance.
The oestrogen story is similar to a modern-day thriller. It is a story of deception, betrayal, hidden agendas, propaganda and misinformation. As a story it could be quite entertaining, but as a real-life drama its effects are disastrous to the lives of tens of millions of women around the world.
Hormones are very powerful substances. Begin tampering with Nature's finely tuned messengers of life's processes and you are asking for trouble. This is especially true for women. A woman's psyche is intimately connected to her monthly flow of hormones. Hormones not only direct and determine her physiological processes, but also influence her emotional and psychological state. Besides creating myriad health problems, hormonal imbalance can undermine self-esteem, creativity, mental acuity and a healthy sex-drive.
Perhaps the bigger picture about the oestrogen story is the fact that the introduction of synthetic hormones, as a legitimate need of women, is basically experimentation under the guise of standard medical practice. As a result, medical science has expanded its control of women's lives.
Germaine Greer sums up the medical establishment's intrusion into a woman's hormonal health quite astutely when she says, "Menopause is a dream speciality for the mediocre medic. It requires no surgical or diagnostic skill; it is not itself a life-threatening condition; there is no scope for malpractice action. Patients must return again and again for a battery of tests and check-ups."1
Quite simply, tampering with a woman's hormones is tampering with her power.
Introducing Oestrogen Dominance
The natural design of the body is to produce the two hormones, progesterone and oestrogen, in a very sensitive and precise balance so that reproductive ability is maximised. These two hormones are closely interrelated in many ways and, although they are generally antagonistic towards each other, each helps the other by making the cells of a target organ more sensitive.
Oestrogen really isn't a single hormone. To be accurate, it refers to a class of hormones with oestrus activity (i.e., proliferation of endometrial cells in preparation for pregnancy). The oestrogens are named oestradiol and oestrone-both of which are implicated in stimulating abnormal cell growth when found in higher-than-normal amounts in the body-as well as oestriol, which is known to be cancer-inhibiting. Each type of oestrogen has a different function in the body. These oestrogens are produced mainly in the ovaries, although small quantities are secreted from the adrenal glands, the placenta during pregnancy, and fat cells.
When puberty arrives, oestrogen encourages in a girl the development of breasts and the expansion of the uterus. Oestrogen contributes to the moulding of female body contours and maturation of the skeleton. After that, it helps regulate the menstrual cycle and plays other necessary roles in maintaining bone-mass and keeping blood-cholesterol levels in check. When excessive quantities of oestrogen, regardless of source, are present in a young woman's body they will contribute to the 'burnout' of her ovaries and undermine fertility.
In the case of progesterone, however, we are talking about only one specific hormone. Thus, progesterone is both the name of the class and the single member of the class. In the ovaries, progesterone is the precursor of oestrogen. Progesterone is also made in smaller amounts by the adrenal glands in both sexes and by the testes in males. It is the precursor of testosterone and of all important adrenal cortical hormones. From progesterone are derived not only other sex hormones but also corticosteroids, which are essential for stress response, sugar and electrolyte balance and blood pressure, not to mention survival.2
While oestrogen is the primary hormone during the first two weeks of a woman's menstrual cycle, fulfilling its role of preparing the endometrium for pregnancy, progesterone is the major female reproductive hormone during the latter two weeks of the menstrual cycle. Progesterone is necessary for the survival of the fertilised ovum, the resulting embryo and the foetus throughout gestation when production of the progesterone is taken over by the placenta.
There is a very delicate balance between the interplay of oestrogen and progesterone. If that balance is interfered with, devastating effects occur. Unfortunately, introduced synthetic hormones as well as environmental pollutants are presently wreaking havoc with our hormones.
"Oestrogen dominance" is a term that was first used by Dr John Lee. A retired medical practitioner from California, Dr Lee has spent the better part of the last two decades exploring the basis for the proliferation of such female problems as PMS, endometriosis, ovarian cysts, fibroids, breast cancer, infertility, osteoporosis and menopausal problems. From his clinical experience in the field of female health, as well as from his published research, Dr Lee believes that many women are suffering from the effects of too much oestrogen. He finds that stress, nutritional deficiencies, oestrogenic substances from our environment, and taking synthetic oestrogens, combined with an ensuing deficiency of progesterone, are the likely contributing factors to the creation of oestrogen dominance.
The following is a list of symptoms that can be caused or made worse by oestrogen dominance: acceleration of the ageing process, allergies, breast tenderness, decreased sex-drive, depression, fatigue, hair thinning, excessive facial hair, fibrocystic breasts, foggy thinking, headaches, hypoglycaemia, increased blood-clotting, increased risk of stroke, infertility, irritability, memory loss, miscarriage, osteoporosis, pre-menopausal bone-loss, PMS, thyroid dysfunction mimicking hypothyroidism, uterine cancer, uterine fibroids, water retention, bloating, fat gain (especially around the abdomen, hips and thighs), gall bladder disease and auto-immune disorders such as lupus and thyroiditis.3
In addition to the synthetic oestrogens, women are also prescribed synthetic progestins. They have been added to the oestrogen formula to offset the hazards of oestrogen drugs. Nancy Beckham in her book, Menopause-A Positive Approach Using Natural Therapies, was able to identify more than 100 adverse effects for the most commonly prescribed oestrogen and progestin medications.
According to Dr Lee, many of these common health problems can be offset by increasing the level of natural progesterone. The problem is not always that progesterone levels are actually lower than normal, but they are low in comparison to elevated oestrogen levels.
Due to increased exposure to these oestrogenic substances in the body, women become more affected by oestrogens made in the body from their mid-30s onwards. Around this time, women do not ovulate with every menstrual cycle. Since progesterone is made from the ripened follicle (corpus luteum), if there is no ovulation there is no corpus luteum formed and hence no progesterone made.
Stress, nutritional deficiencies and chemical pollutants all contribute to anovulatory cycles. The frequency of these anovulatory cycles increases as menopause approaches, changing the menstrual pattern to an either heavier or longer menstrual flow.
While not commonly understood by medical science, the growing incidence of anovulatory cycles, even in young women, and the ensuing hormone imbalance are creating huge health problems. Women of all ages are now exposed to a higher risk of the entire range of oestrogen-dominant conditions.
Oestrogen Dominance in the Environment
Extremely disturbing events are being reported globally about the alarming changes happening in the environment.
Not long ago in Lake Apopka in Florida, wildlife biologists discovered that strange biological effects were happening in the alligators living there. In 1980, a toxic spill occurred which dumped huge amounts of a pesticide similar to DDT into the lake. That event was almost forgotten until five years later when it was discovered that 90 per cent of the alligators had disappeared. Most of those that remained were incapable of reproducing or had no urge to mate. The males were born with penises that were not only 75 per cent shorter than average but were also deformed. Further testing indicated that their testosterone levels were so low that they hormonally resembled females. Moreover, the females had abnormal ovaries and follicles, described as "burned out".4
Recent reports show that strange fish caught in Port Phillip Bay in Victoria, Australia, were hermaphrodites. Similarly, a major British study revealed that male fish downstream from sewage treatment plants changed sex as a result of oestrogen chemicals which had not been removed from treated effluent.5
Dr Ana Soto, an endocrinologist at Tufts University in the United States, had been experimenting with cancer cells taken from the breast and then cultured. She found they would only grow if they were fed oestrogens. One day, the test simply stopped working. The cancer cells continued to grow for four months, even when no oestrogens were fed to them. Dr Soto then realised that the manufacturer of the flasks she had been using had started to use a different plastic-one that, when it becomes warm, releases minute quantities of the oestrogen-like compound, nonylphenol! Her tissues samples were being contaminated by the xeno-oestrogens from the plastic flasks!6
The widespread use of herbicides, pesticides and plastics have created a problem that has never before existed on this planet. We are polluting our environment and ourselves in a sea of oestrogen-like mimics. They are everywhere: in the air, water, soil, and overabundantly in our bodies. Called xeno-oestrogens, these are substances which have a powerful oestrogenic effect on the body, are fat-soluble and non-biodegradable. They are also dangerously toxic.
We presently live in a world awash with petrochemicals. Petrochemicals are everywhere. Our machines run on petrochemicals, and millions of products including plastics, microchips, medicines, clothing, foods, soaps, pesticides and even perfumes are either made from petrochemicals or contain them. The popular slogan in the early 1950s, "Better Living Through Chemistry", is returning to haunt us.
The legacy of this pollution has resulted in an epidemic of reproductive abnormalities, including the steadily increasing number of cancers of the reproductive tract, infertility, low sperm- counts, poor sperm-quality and the feminisation of males. The potential consequences of this overexposure are staggering, especially considering that one of the consequences is the passing on of reproductive abnormalities to offspring.7
Just how serious is this problem? In a May 1993 article in the British medical journal, The Lancet, researchers in Scotland and Denmark hypothesised that xeno-oestrogens are responsible for a steadily declining sperm-count in men. According to Neils Skakkebeak of the University of Copenhagen, sperm counts have dropped by more than 50 per cent since 1940. Meanwhile, the rate of testicular and prostate cancer in the United States and Europe has tripled in the past 50 years. Reproductive abnormalities such as undescended testicles have become increasingly common.
Xeno-oestrogens are also implicated in impaired brain development in children.8 They are also directly implicated in the 30 to 80 per cent increase in breast, ovarian and uterine cancers in women over the past 50 years.9
In some rural communities in Australia, where heavy pesticide use has left residuals in drinking water, there have been reports of boys with abnormally small penises, along with reports of the feminisation of males and the masculinisation of females.
It is time for us to wake up and pay heed to these warnings for the sake of future generations. You can play your part in protecting your grandchildren and great-grandchildren in the same ways you can protect yourself: by refusing to use pesticides, minimising your use of plastics, purchasing hormone-free meat and organic produce, using 'green' products for detergents and household cleaners, and, in general, using 'natural' products in favour of petrochemical products.
The Myth of Oestrogen Deficiency
The trend these days is to push hormone replacement therapy (HRT), featuring synthetic oestrogens and progestins, onto all menopausal women. Unfortunately, however, this enthusiasm for drugs is not backed up by the facts. Oestrogen deficiency is loudly proclaimed by medical practitioners, pharmaceutical advertising and many lay publications as the primary cause of all the symptoms attributed to menopause and post-menopause, such as mood swings, depressions, hot flushes, vaginal dryness, loss of sex-drive and accelerating osteoporosis.
But is there really such a thing as oestrogen deficiency? While it is true that menopause is associated with decreasing oestrogen levels, it is not known whether these decreased levels of oestrogen do in fact cause all the symptoms of menopause.
Dr Carolyn DeMarco, author of Take Charge of Your Body and a physician specialising in women's health issues, says there is no direct proof that oestrogen-lack causes heart disease or other ailments associated with the menopause.
Germaine Greer, well-known feminist and author of The Change, writes that "the proponents of HRT have never proved that there is an oestrogen deficiency, nor have they explained the mechanism by which the therapy of choice effected its miracles. They have taken the improper course of defining a disease from its therapy."
Dr Jerilyn Prior, researcher and Professor of Endocrinology at the University of British Columbia in Vancouver, BC, Canada, points out that no study proving the relationship between oestrogen deficiency and menopausal symptoms and related diseases has yet been done. "Instead," says Dr Prior, "a notion has been put forward that since oestrogen levels go down, this is the most important change and explains all the things that may or may not be related to menopause. So oestrogen treatment at this stage of our understanding is premature. This is a kind of backwards science. It leads to ridiculous ideas-like calling a headache an aspirin-deficiency disease."10
Considering that Western women tend to have a 10-to-15-year period prior to menopause when they are oestrogen-dominant and suffering from oestrogen-dominance symptoms, why are their doctors prescribing them still more oestrogen?
Dr Prior has shown that, during menopause, progesterone decreases to 1/120th of baseline levels, whereas oestrogen decreases to one-half to one-third of pre-menopausal baseline levels. Would it not be wiser to consider the progesterone-loss effect when evaluating post-menopausal symptoms and such related conditions as osteoporosis, heart disease, depression and loss of sex-drive?
In most menopausal women, oestrogen levels are below those necessary for pregnancy but sufficient for other normal body functions. The oestrogen "deficiency" hypothesis as an explanation of most menopausal symptoms or health problems is thus not supported by the facts of oestrogen blood levels, by worldwide ecological studies or by endocrinology experts.
Dr Lee believes that "Menopause per se should be regarded as a normal adjustment reflecting a benign change in a woman's biological life away from child-bearing and onward to a period of new personal power and fulfilment. The Western perception of menopause as a threshold of undesirable symptoms and regressive illness due to oestrogen deficiency is an error not supported by fact. More accurately, we should view our menopause problem as an abnormality brought about by industrialised cultures' deviation from a healthy lifestyle."
Synthetic Hormones and the Havoc they Wreak
With hindsight, it will very likely be recorded in history that the widespread prescribing of synthetic hormones to women was the biggest medical bungle of the century. Most women taking the contraceptive pill and HRT have very little idea about the hormones they are putting into their bodies; nor are they knowledgeable about their side-effects.
Oral contraceptives are made with synthetic oestrogen and synthetic progestins (known as the combined Pill). In the early 1960s the Pill was widely marketed as an effective, safe and convenient method of birth control. However, the initial trials were flawed and inadequate.11 Nonetheless, the Pill was promoted with all the enthusiasm the pharmaceutical companies could muster.
Dr Ellen Grant, author of The Bitter Pill and Sexual Chemistry, was an early researcher of synthetic hormones and their effects on health. Back in the 1960s she was shocked when synthetic hormones were not withdrawn from the market due to their known, serious side-effects.
So, just what are the effects of suppressing natural hormones with synthetic ones? The Pill literally stops menstruation, and bleeding occurs each month only because the synthetic hormones are not taken for seven days of the cycle. The bleeding that occurs would be more accurately termed "withdrawal bleeding", not menstruation.
Taking the combined Pill increases the risk of coronary artery disease, breast cancer and high blood-pressure. The side-effects include nausea, vomiting, headaches, breast tenderness, weight increases, changes in sex- drive, depression, blood clots and increased incidence of vaginitis. Also, women with a history of epilepsy, migraine, asthma or heart disease may find their symptoms worsen.12 Many of these effects may persist long after women discontinue taking the Pill.
According to Nancy Beckham in her book, Menopause-A Positive Approach Using Natural Therapies, "Women on the Pill have a greater tendency to liver dysfunction and to more allergies. Oestrogen drugs also affect vitamin concentrations. Vitamin A levels may be raised in the blood; vitamins B12 and C may be lowered. The clinical significance is not yet known."
The introduction of the mini-Pill and Depo-Provera, both of which are made from synthetic progestins, is equally disturbing to women's hormonal health, with all the previously listed side-effects and risks.
Hormone replacement therapy was the next great discovery to arrive, following on from the Pill. The pharmaceutical companies had found another lucrative market for their synthetic hormones: the menopausal woman! While HRT is given at lower doses than the Pill, the side-effects are often more subtle and are slower to show up. HRT is now available in a variety of forms: pills, patches and implants. One of the most popular synthetic oestrogens is Premarin, which is made from the urine of pregnant mares-just what a woman's body needs!
What is little-known about taking HRT is that it is an addictive drug. A former president of the London Royal College of Psychiatrists warns that oestrogen used in HRT to counteract symptoms of menopause could be as addictive as heroin.13
In the 1970s, testing was conducted on two groups of menopausal women. Half received oestrogen replacement and the other half sugar pills. All were monitored for insomnia, nervousness, depression, dizziness, weakness, joint pain, palpitations, prickling sensations and hot flushes.
Both groups of women experienced dramatic improvement during the first 90 days of the study, except that the sugar-pill group experienced more discomfort from hot flushes. When the groups were switched, those who had initially received oestrogen experienced a pronounced return of their symptoms. It became apparent that, once oestrogen replacement stopped, a 'cold turkey' withdrawal effect was often experienced. This was especially true with implants, since the blood oestradiol levels may become much higher than the body would normally produce.14
Nancy Beckham warns that "Women on hormone replacement therapy who have enhanced well-being when their oestradiol levels are very high, but feel unwell when their blood levels are normal, may be experiencing reactions similar to those of people on social drugs.
"It is well-researched knowledge that when you first have these drugs they give you a lift, which is pleasant. As you get used to the substance you find you need more to give you the same effect, and ultimately your body craves a high level even though you may be unwell. When the substance in your blood drops below a certain level, you can experience withdrawal symptoms such as flushing, perspiration, sleep disturbance, shaking and other nervous reactions."
While it is easy to prescribe HRT for women, there is hardly any medical data concerning the effects of stopping HRT in women who have received long-term treatment.15 In one trial lasting three-and-a-half years, withdrawal lasted for six months.
So, unbeknownst to women, 'menopause's little helper' could in fact be making oestrogen junkies out of them. It's great news for the pharmaceutical companies, but a calamity of untold proportion for women. Not only do they experience a wide range of physical symptoms but they also suffer from psychiatric disturbances.
Dr Ellen Grant has said that "when higher-than-expected rates of attempted suicide and violent deaths were recorded among HRT-takers, the excuse was that more women suffering from depression are put on oestrogens in an attempt to treat them." Oestrogens are rarely considered as an implicating factor in depressive behaviour.
Hormone Balance and Illness: Debunking the Myths
HRT is now almost universally recommended to menopausal women for a wide variety of reasons. The two most significant reasons women are encouraged to embark upon the HRT bandwagon are HRT's supposed contribution in preventing or lessening the effects of osteoporosis and of cardiovascular disease. The tremendous fear of these two illnesses that is instilled by well-meaning doctors-who, after all, are the targets of effective pharmaceutical advertising and education (usually the only source of information they receive about these products)-often overrides a woman's natural instincts.
It's time to unravel the myths that hide the real story.
MYTHS OF OSTEOPOROSIS
Dr John Lee, author of What Your Doctor May Not Tell You About Menopause, writes this about the myths of osteoporosis:
Myth #1: Osteoporosis is a calcium-deficiency disease.
Most women with osteoporosis are getting plenty of calcium in their diet. It is quite easy to get the minimum daily requirement of calcium in even a relatively poor diet. The truth is that osteoporosis is a disease of excessive calcium-loss caused by many factors. In osteoporosis, calcium is being lost from the bones faster than it is being added, regardless of how much calcium a woman consumes.
Myth #2: Osteoporosis is an oestrogen-deficiency disease.
Not even basic medical texts agree with this. It is a fabrication of the pharmaceutical industry with no scientific evidence to support it. Osteoporosis begins long before oestrogen levels fall, and accelerates for a few years at menopause. Taking oestrogen can slow bone-loss for those few years, but its effect wears off within a few years after menopause. Most importantly, oestrogen cannot rebuild new bone.
Myth #3: Osteoporosis is a disease of menopause.
This is at least a decade short of the truth. Osteoporosis begins anywhere from five to 20 years prior to menopause, when oestrogen levels are still high. Osteoporosis accelerates at menopause or when a woman's ovaries are surgically removed or become non-functional, such as can happen after hysterectomy. It is staggering to think how many thousands or millions of women have been doomed to a crippled old age or early death because their ovaries and/or uterus were unnecessarily removed before menopause and natural progesterone replacement was ignored.
To understand osteoporosis it is important to know a bit about bones. Bone-forming cells are of two different kinds. One type are called osteoclasts, and their job is to travel through the bone in search of old bone that is in need of renewal. Osteoclasts dissolve bone and leave behind tiny unfilled spaces. Osteoblasts move into these spaces in order to build new bone. A lack of oestrogens, as experienced at menopause, indirectly stimulates the growth of osteoclasts, thus increasing the risk for developing osteoporosis. HRT containing oestrogen should therefore help prevent osteoporosis. From this point of view it does.
However, osteoclast cells have been shown to have no oestrogen receptors in themselves, so cannot directly build new bone. On the other hand, osteoblast cells, which are responsible for making new bone, have been shown to have not oestrogen but progesterone receptors. What this means is that it is progesterone (the natural form, not the synthetic progestins), not oestrogen, which is responsible for building bone tissue.
This view is upheld in the Scientific American Updated Medicine Text 1991, which states, "Oestrogens decrease bone resorption, but associated with the decrease in bone resorption is a decrease in bone formation. Therefore, oestrogen should not be expected to increase bone mass." The authors also discuss oestrogen side-effects, including the risk of endometrial cancer which "is increased sixfold in women who receive oestrogen therapy for up to five years; the risk is increased to fifteenfold in long-term users."
Dr Kitty Little from Oxford found masses of tiny clots in the bones of rabbits treated with hormones. She is convinced that HRT in the form of oestrogen and progestins will increase the risk of osteoporosis. Blood clots originate from sticky clumps of platelet cells in the blood. She believes that blood clots in the bones can cause bone to break down, leading to osteoporosis.16
More and more research findings are emerging that challenge the oestrogen-deficiency/osteoporosis relationship and reinforce the progesterone-deficiency link. The results of a three-year study of 63 post-menopausal women with osteoporosis verify this. Women using transdermal progesterone cream experienced an average 7 to 8 per cent bone-mass density increase in the first year, 4 to 5 per cent in the second year, and 3 to 4 per cent in the third year! Untreated women in this age category typically lose 1.5 per cent bone-mass density per year! These results have not been found with any other form of hormone replacement therapy or dietary supplementation!17
Bone loss is the result of many other factors besides progesterone deficiency. Excess protein in the form of meat and dairy products (contrary to the dairy industry's advertising) contributes to bone loss. An acidic condition is created in the blood which then pulls out calcium from the bones to neutralise it. Another major factor is lack of exercise. Bone growth is dependent on weight- bearing exercise. In addition, sugar, diuretics, antibiotics, fluoride, cigarettes, alcohol abuse and cortisone are all deleterious to bones.
To sum it up, post-menopausal osteoporosis is a disease of excess bone-loss caused by a progesterone deficiency and, secondarily, by a poor diet and lack of exercise. Progesterone restores bone mass. Natural progesterone hormone is an essential factor in the prevention and proper treatment of osteoporosis at any age.18
Oestrogen is being touted by mainstream medicine as a great preventer of cardiovascular disease in women and therefore a major reason to have women on HRT.
According to Dr Lee, the one notable study which formed the entire basis of the positive oestrogen-cardiovascular link-the 1991 New England Journal of Medicine report known as the Nurses' Questionnaire Study, conducted with a large sampling of nurses-was radically flawed and the statistics manipulated.19 Although there is ample evidence from numerous other studies showing that, indeed, the opposite is true-that oestrogen is a significant factor in creating heart disease-these findings have been virtually ignored in the frenzy for profits. He goes on to say that the pharmaceutical advertisements also neglected to mention the fact that stroke death incidence from that study was 50 per cent higher among the oestrogen users.
Nancy Beckham's research into the oestrogen-cardiovascular link reveals the following:20
High doses of oestrogens are likely to be thrombogenic (blood-clotting) during use, and it is possible that even moderate doses may increase the risk of clotting among women who smoke or who already have clogged arteries. Reports are now starting to come in, indicating that high-dose oestrogens, particularly as experienced with oestradiol implants, cause hypercoagulability, which means that the blood has a tendency to clot, thereby increasing the risk of heart attack and stroke.
A British medical report also states that the cardiovascular effects of synthetic progestins used with oestrogen in the much larger number of women who have not undergone hysterectomy are unknown.
Some researchers do not consider that heart disease is linked to the cessation of the body's oestrogen production. (Actually, it is inaccurate to use the word "cessation", since oestrogen production is only reduced in menopause.)
Natural progesterone also seems to play a significant role in protecting women from cardiovascular disease. We know now that anovulatory cycles and lowered progesterone levels occur prior to menopause, and progesterone levels after menopause are close to zero. Oestrogen, on the other hand, falls only 40 to 60 per cent with menopause. A woman's passage through menopause results in a greater loss of progesterone than of oestrogen. Perhaps the increase in heart risk after menopause is due more to progesterone deficiency than to oestrogen deficiency. Dr Lee has noted in his clinical experience that lipid profiles improve when progesterone is supplemented.21
What is known about progesterone is that it increases the burning of fats for energy and, in addition, has an anti-inflammatory effect. Both of these actions could be protective against coronary heart disease. Progesterone protects the integrity and function of cell membranes, whereas oestrogen allows the influx of sodium and water while allowing the loss of potassium and magnesium. Progesterone, a natural diuretic, promotes better sleep patterns and helps one deal with stress. When the known actions of progesterone are reviewed, it is clear that many of its actions are also beneficial to the heart.
When it comes to increased risk of coronary heart disease, dietary factors are extremely important. Heart disease risk is increased by the following: overeating in general; animal fat, sugar and refined carbohydrates; overprocessed foods; excess salt or sodium; trans-fatty acids; lack of fibre; magnesium and/or potassium deficiency; and lack of antioxidant-rich food or supplements such as vitamins C, E, and A, beta-carotene and selenium. Stress is also a risk factor for heart deaths.
The evidence connecting female cancers of the breast, uterus and ovaries with high oestrogen levels is growing. Oestrogen's job in the uterus is to cause proliferation of the cells. Under the influence of oestrogen, uterine cells multiply faster, and then progesterone should normally come on the scene with ovulation and stop the cells from multiplying. Progesterone causes the cells to mature and enter the secretory phase that causes the maturing of the uterine lining, which is now ready to receive a possible fertilised egg. Oestrogen is the hormone that stimulates cell proliferation, and progesterone is the hormone that stops growth and stimulates ripening.
Oestrogen dominance also stimulates breast tissue. Premenstrual women who suffer from oestrogen dominance often suffer from breast-swelling and tenderness. Progesterone, as a hormone of maturation, brings the cells back into balance and thus can eliminate breast tenderness.
There is certainly an alarmingly high incidence of breast and uterine cancer amongst Western women. There is evidence that breast cancer occurs most often at the stage of life when oestrogen is dominant for the full month and progesterone is not coming in at the halfway point of ovulation. Dr Graham Colditz, of Harvard University, maintains that unopposed oestrogen is responsible for 30 to 35 per cent of breast cancers.22 Some experts would put that percentage even higher.
Johns Hopkins Private Obstetrics and Gynecology Clinic accumulated 40 years of research which was published in the American Journal of Epidemiology in 1981.23 What they discovered was that, when the low-progesterone group was compared to the normal-progesterone group, the occurrence of breast cancer was 5.4 times greater in the women in the low-progesterone group. That is, the incidence of breast cancer in the low-progesterone group was over 80 per cent greater than in the normal-progesterone group.
When the study looked at the low-progesterone group for all types of cancer, they found that women in this group experienced a tenfold increase for all malignant cancers, compared to the normal-progesterone group. This would suggest that having a normal level of progesterone protected women from nine-tenths of all cancers that might otherwise have occurred.24
It is interesting to note that the study disappeared into oblivion when there was no money available to pursue the obvious implications of a progesterone-deficiency role in cancer.
In a 1995 study published in the Journal of Fertility and Sterility, researchers did a double-blind randomised study examining the use of topical progesterone cream and/or topical oestrogen in regard to breast cell growth. The results showed that women using progesterone had dramatically reduced cell-multiplication rates compared to the women using either the placebo or oestrogen. The women using only oestrogen had significantly higher cell multiplication rates than any of the other groups. The women using a combination of progesterone and oestrogen were closer to the placebo group.25
This exciting study provides some of the first direct evidence that oestradiol significantly increases breast cell growth, and that progesterone impressively decreases cell proliferation rates even when oestrogen is also supplemented.
At this point, it's important to explore the implications of the experimental drug Tamoxifen which is being prescribed to women with breast cancer. Since it is proposed to have anti-oestrogenic effects, it is used as a breast cancer treatment since it blocks the uptake of oestradiol and oestrone (the cell-proliferating oestrogens), thereby protecting the breast tissue from the cancer-promoting oestrogens present in the body. A growing number of doctors insist that the same results can be achieved by giving natural progesterone.
Uterine cancer is one of the possible side-effects of Tamoxifen. One study showed that 27 per cent of women taking Tamoxifen showed hyperplastic (unfavourable new growth) changes in their wombs within 15 months.26
Tamoxifen is carcinogenic and can cause an early menopause, osteoporosis, endometrial cancer, liver cancer and clotting disease. Taking 20 milligrams of Tamoxifen per day can increase the risk for developing endometrial cancer by up to five times. Clotting disorders are seven times more frequent. One study showed just a meagre 0.7 per cent benefit for women taking Tamoxifen preventively to reduce the risk of developing further tumours in the breast.27
It is also interesting to note that menstruating women who have breast surgery carried out during the second half of their menstrual cycle-the luteal phase, when progesterone is high in order to balance oestrogens-survive far longer than do women whose surgery is done early on in their cycle during the oestrogen-dominant follicular phase.28
The only known cause of endometrial cancer is unopposed oestrogen. Here again, the culprits are oestradiol and oestrone. Oestrogen supplements given to post-menopausal women for five years increase the risk of endometrial cancer sixfold, and longer-term use increases it fifteenfold. In pre-menopausal women, endometrial cancer is extremely rare, except during the five to 10 years before menopause when oestrogen dominance is common.29
Synthetic hormones are also linked to cervical cancer. The cells of the cervix are extremely hormone-sensitive. Levels of synthetic progestins, low enough not to alter the cells of the lining of the womb, have been shown to change the cells that line the cervix. Progestins dry up cervical secretions, and this may be part of the reason why cancer of the cervix develops quickly in the presence of cervical infections.30
It was predicted in the 1960s that the Pill would increase the chances of a woman developing a melanoma, the most lethal of all skin cancers. Hormones control the pigmentation of our skin, and melanoma cancer cells have oestrogen receptors which can make the growth of cancer more likely. Women taking HRT are at greater risk of developing melanomas than the average woman.31
Dr Lee strongly believes that because of its many benefits, its great safety, and particularly its ability to oppose the carcinogenic effects of oestrogens, natural progesterone deserves far more attention and application than it is generally given in the prevention and care of women's health problems today.
The long road we have been travelling over the past 35 years, that has encouraged and promoted the wide range of synthetic hormone products, is taking us to a deadly dead-end. The scare-tactic techniques and intimidation employed by doctors and pharmaceutical companies alike to use such products, often overriding a woman's better judgement, have pushed millions of women into using drugs that are unproven and unsafe. It is no surprise, therefore, that Dr Lee has issued an ominous warning when he says, "We will soon regard making oestrogen the key ingredient in hormone replacement therapy as a major medical mistake."32
Women must be able to make educated, informed choices about their bodies and their health treatment preferences. It's impossible to make important health decisions if fundamental facts are missing or misconstrued. It is also evident that the health care providers, whom we have come to rely upon, either have not received adequate, unbiased education themselves or have become imprisoned by their own arrogant and narrow-minded points of view.
It is really up to every woman to read, question, trust her natural instincts and learn about her own body. It is also essential that a woman honour her own cyclic nature and intuitive wisdom. It is a woman's right to choose with dignity the best approach to her own health care.
1. Greer, Germaine, The Change, Hamish Hamilton, London, 1991.
2. Lee, John R., M.D., What Your Doctor May Not Tell You About Menopause, Warner Books, New York, 1996, pp. 67-68.
3. Op. cit., pp. 42-43.
4. Kenton, Leslie, Passage to Power, Random House, London, 1995, p. 34.
5. Archer, John, The Water You Drink: How Safe Is It?, Pure Water Press, Australia, 1996, p. 34.
6. Kenton, Leslie, op. cit., p. 32.
7. Lee, John, op. cit., p. 50.
8. Op. cit., p. 56.
9. Wheel of Hormones, TV production with Lars Mortensen, TV2 Denmark, 1995.
10. Lee, John, op. cit., p. 44.
11. Archer, John, Bad Medicine, Simon and Schuster, Australia, 1995, p. 210.
12. Neil, Kate, Balancing Hormones Naturally, ION Press, London, 1994, p. 28.
13. Beckham, Nancy, Menopause-A Positive Approach Using Natural Therapies, Penguin Books, Australia, 1995, pp. 36-37.
14. Ibid., p. 36.
15. British Medical Bulletin (1992) 48:458-68.
16. Neil, Kate, op. cit., p. 46.
17. Lee, J. R., "Osteoporosis Reversal: The Role of Progesterone", Intern. Clin. Nutr. Rev. (1990) 10:384-391.
18. Lee, John R., M.D., What Your Doctor May Not Tell You About Menopause, p. 183.
19. Op. cit., p. 18.
20. Beckham, Nancy, ibid., pp. 42-43.
21. Lee, John, op. cit., p. 197.
22. Op. cit., p. 207.
24. Op. cit., p. 208.
25. Chuang, King-Jen, M.D., T. Y. Tigris, Lee, M.D., Gustavo Linares-Cruz, M.D., Sabine Fournier, Ph.D., Bruno de Lignières, M.D., "Influences of percutaneous administration of estradiol and progesterone of human breast epithelial cell cycle in vivo", Journal of Fertility and Sterility 63:4 785-791, April 1995.
26. Beckham, Nancy, op. cit., p. 48.
27. Neil, Kate, op. cit., p. 40.
28. Kenton, Leslie, op. cit., p. 94.
29. Lee, John, op. cit., p. 220.
30. Neil, Kate, op. cit., p. 41.
32. The Sunday Telegraph, London, 12 May 1996.
About the Author:
Sherrill Sellman presently lives in Melbourne where she conducts a private psychotherapy practice, in addition to giving lectures, researching and writing about topics of interest and concern to her relating to women's health empowerment. She is a contributing writer to holistic publications in Australia, New Zealand, Canada and the United States.
For further information about natural progesterone, please send a self-addressed envelope to: Light Unlimited, Locked Bag 8000 - MDC, Kew, Victoria 3101, Australia; phone +61 (0)3 9810 9591; fax +61 (0)3 9855 9991; e-mail: email@example.com.