Menopause. The very word itself gives women pause as they age and approach that time of life often called simply “The Change.” Those common physiological changes— not to mention pronounced psychological perturbations—associated with a woman’s perimenopausal life include such debilitating downers as depression, sleep difficulties, night sweats, cardiovascular disease, high blood pressure, stroke, atherosclerosis and osteoporosis, thinning skin and hair, dreaded hot flashes, menstruation irregularities, vaginal dryness, painful Intercourse, flagging libido, cognitive decline, weight gain, anxiety, loss of muscle tone, stress intolerance, and of course moodiness. Menopausal Myths
In his best-selling book Natural Hormone Replacement for Women over 45, Dr. Jonathan Wright, one of the country’s best known complementary and alternative medicine (CAM) medical doctors, pointed out a number of myths associated with menopause. These “truths” have arisen in the collective female consciousness largely as the result of pharmaceutical propaganda and medical “malpractice” of suppressing the unwanted symptoms (see above) and thereby “curing” this midlife “disease” of every female on the planet. This is clearly a “big bucks” gambit at the expense of every woman who took the gamble and sadly lost more than money in one way or another “big time.” Among these menopausal myths with respect to progesterone are the following: Estrogen replacement alone is sufficient for dealing with menopausal discomforts Pharmaceutical progestins (synthetic substitutes) are identical to natural progesterone Natural hormones are not absorbed as readily as their unnatural copycats FDA “approval” of prescription hormones means that they are safer and/or better than their “unapproved” and “unproven” natural counterparts The truth of the matter is that hormonal balance and replacement therapy have proven to be therapeutically superior to what can be characterized as the conventional “standard of care” namely, hormonal drug therapy. Call it what it is. This conclusion has been borne out by both preventive (osteoporosis, senility) and protective (cardiovascular disease, stroke, sleep apnea) outcomes, functional improvements (libido, muscle mass, mood, memory), and reduced risks (breast cancer and depression), not to mention the significant reduction of those dreaded hot flashes.
Beyond the Body Benefit with Progesterone
“Why does dishing with a girlfriend do wonders for a woman’s mood?” ScienceDaily1 recently asked in reporting on a University of Michigan study published in the peer- reviewed journal Hormones and Behavior (June 2009). The answer: feeling emotionally close to a friend increases production of progesterone—the female and male steroid sex hormone—which reduces anxiety and stress while engendering a sense of well-being. For the first time researchers concluded that social bonding not only causes this hormonal shift, but also contributes to a “greater willingness to help other people.” Therefore, we can conclude that a menopausal progesterone deficit may very well contribute to an equally serious sociological deficit or adverse “side effect” as it were. Hormone Replacement Therapy—Naturally
But what about the mood or moodiness of those women who do not have a regular time of social bonding with their girlfriends? Well, for one thing they may most probably benefit from Natural Hormone Replacement (NHR) therapy with supplemental, bio- identical (i.e., plantderived, natural) progesterone. Such therapy is not to be confused with the controversial and discredited Hormone Replacement Therapy (HRT) or Estrogen Replacement Therapy (ERT) with its synthetic (i.e., lab-derived, chemically constructed, unnatural or manmade) ersatz estrogens made to mimic estriol, estradiol and estrone—the other, better known, steroid sex hormones available only by prescription. So then what is the meaning of the word natural as in Natural Hormone Replacement Therapy and natural progesterone? It simply means “of an identical chemical or molecular structure as that found in the body.” Bio-identical. Male Menopause?
Middle-age men and menopause? Yes, there is such a thing! But it cannot be denied that in the course of our common conversation on the subject we tend to forget about or perhaps unknowingly ignore the relevance and impact of this flip side of menopause on the male of the species—more commonly known as andropause and clinically defined by the acronym ADAM (Androgen Decline in Aging Males). Symptomatic manifestations of this midlife, male malady include a host of systemic and metabolic issues including loss of energy, fatigue, muscle weakness, anxiety, irritability, depression, memory loss, decreased libido, impaired performance (euphemistically termed ED for Erectile Dysfunction), and worst of all—especially for the macho man— plain and simple impotence. It should be noted too that, while male menopause is rightly attributable to a decline of testosterone—the primary male steroid sex hormone—it is almost always accompanied by a decreased level of progesterone. Natural progesterone supplementation may also help men with prostate cancer by inhibiting the conversion of their testosterone to dihydrotestosterone (DHT), which is
known to accelerate the growth of malignant prostate tissue. This inhibition is effected by blocking the enzymatic activity responsible for the conversion. Pharma’s Phony Hormones
Big Pharma’s introduction of its patented, synthetic estrogen Premarin® (derived from the urine of pregnant mares, hence the name), after billions in profits for the industry and over decades of use by unsuspecting menopausal patients, was shown to cause cancer of the endometrium of the uterus. So much for HRT’s synthetic pharmaceutical drugs posing as “hormones”—the real thing—with all their toxic “side effects.” So much for HRT’s promise of hormone heaven for those perimenopausal women plagued by all the manifold discomforts of menopause whether earlier or later in life. Since progesterone is known to block or oppose estrogen’s cancer-causing properties or tendencies, however, Big Pharma later introduced its popular Provera®, a synthetic progesterone substitute or analogue (“progestin”)—a chemically similar but molecularly altered, “look alike” of the real thing. While natural or bio-identical progesterone offers virtually no untoward “side effects,” protects against endometrial cancer, and supports estrogen’s cardiovascular protection, Provera® does nothing to reduce or lessen still another serious risk associated with ersatz estrogen replacement, namely breast cancer. Indeed, it was recently revealed by ScienceDaily2 that while natural progesterone serves to promote normal breast development, “exposure to [synthetic] progesterone in menopausal hormone therapy is known to increase breast cancer risk.” In addition to breast and uterine cancer, other common conditions associated with unnatural, i.e., drug, hormone therapy include: ovarian cancer, increased risk of blood clots, mood swings, nausea, vaginal bleeding, water retention, bloating, and breast tenderness. What Is It about Progesterone?
We know that words by definition have intrinsic meaning. In the familiar alphabet world of vitamins the value and importance of the vitamin E complex, for example, are defined by the names of its principal factors—the tocopherols and tocotrienols. The etymology of these terms emphasizes their significance, since they originate from the Greek meaning “child bearing” or “carrying offspring” and the like. The same holds true in the complex world of hormones. Knowing its etymological origin (from the Latin pro + gestare meaning “to carry for” or some such), we can better appreciate progesterone as a truly vital hormone—a life-sustaining substance, just like vitamin E—and absolutely essential for human life. Progesterone production plays an important role in preventing hormonal imbalance especially during the second half of the menstrual cycle. Also it is well-known that estrogen dominance over progesterone may be caused by such things as excessive
stress, poor “fast food” diet, birth control pills and foreign environmental “xenoestrogens” so-called. Progesterone’s Sexual Health Benefits
Research and clinical experience have uncovered a veritable host of important health benefits attributable to the topical application of exogenous, natural progesterone cream. Among those diseases and dysfunctions which may be effectively addressed are the following: Amenorrhea – Restoration of the body’s progesterone-to-estrogen ratio Endometriosis – Reversal of endometrial tissue proliferation Infertility – Improvement of the potential for pregnancy Menopause – Alleviation of many legendary discomforts including “hot flashes” Fibrocystic Breast Disease – Resolution within three or four menstrual cycles Mammary Dysplasia – Contribution to the prevention of this pre-malignancy Chronic Menorrhagia – Reduction of excessive or prolonged bleeding Miscarriage – Prevention of premature shedding of supportive endometrial tissue Ovarian Cysts/Polycystic Ovary Syndrome(PCOS) – Alleviation of these conditions Pre-Menstrual Syndrome (PMS) – Opposition to “estrogen dominance“ Sexual Desire – Restoration and maintenance of healthy libido or sex drive Uterine Fibroids – Opposition to “estrogen dominance” causation Vaginal Atrophy/Vaginitis – Lubrication and support of vaginal mucous membranes Progesterone’s Somatic Health Benefits
While we typically think of estrogen and progesterone (and testosterone too) in terms of their defining roles as sex hormones having to do with gender and reproduction, we tend to overlook or seriously underestimate their widespread physiological impact beyond the endocrine system upon all the other systems of the body. For example, let’s take a brief look at the multi-faceted role of natural, bio-identical progesterone in the following somatic systems: Cardiovascular
In addition to its potential for preventing heart attack and hypertension, progesterone also may help to prevent many types of Cardiovascular Disease (CD) by minimizing its well-known risk factors such as greatly elevated LDL cholesterol and triglycerides. Stroke
recovery may be aided and atherosclerosis may be avoided by progesterone’s inhibition of excessive proliferation of the smooth muscle (endothelial) cells of the blood vessels. Skin and Hair
Progesterone’s topical application in adult women may serve to alleviate acne by counteracting excessive androgen production. It may also alleviate other common skin conditions such as psoriasis, rosacea and seborrhea. And what woman would not be blessed by progesterone’s potential for moisturizing dry skin and diminishing age- related wrinkles? Concerning both hair loss in post-menopausal women as well as unsightly hair gain (hirsutism) with menstruating and menopausal females, research and anecdotal reports suggest favorable outcomes in just three to six months with twice daily topical applications. Immune
Progesterone cream plays a major role in supporting immune function having to do specifically with dreaded autoimmune diseases and many common cancers. It is believed that the former may be alleviated by damping down what is known as “estrogen dominance.” Optimal levels of endogenous progesterone have been shown to assist in the prevention of breast, uterine and endometrial cancers—not to mention prostate cancer in men (by inhibiting the conversion of testosterone to dihydrotestosterone [DHT] and opposing cancer-causing estrogenic effects). Musculoskeletal The good news here concerns the scourge of post-menopausal osteoporosis: natural progesterone supplementation may prevent and possibly actually reverse osteoporosis by stimulating osteoblast (bone-building) activity. According to Hyperhealth: “Progesterone deficiency appears to be a major cause of Osteoporosis and clinical studies have shown that supplemental Progesterone increases bone mass density (BMD) by 7% after one year of supplementation, by 12% after two years, and by 15% after three years. Women administered supplemental Progesterone up to the age of 80 following Menopause exhibit strong Bones without evidence of Bone loss while continuing to use natural Progesterone” (Progesterone – Biological Function/ Therapeutic Applications: Musculoskeletal System). Metabolism Women challenged by weight gain and fatigue will be heartened to hear that progesterone may facilitate the metabolism of adipose (fat) tissue in enhancing energy production. And at the same time total serum and LDL (“bad”) cholesterol may be lowered, while HDL (“good”) cholesterol is increased.
Innumerable neurological benefits result from natural progesterone therapy. Some of these may include allaying anxiety, reducing irritability, diminishing brain damage in head injury, improving concentration, alleviating some forms of depression including postpartum, helping with migraines, and restoring normal sleep patterns. Furthermore—and this is not insignificant—offspring of mothers on exogenous natural progesterone may manifest “increased intelligence” as well as “superior verbal fluency.” Phytoestrogen Enhancement of Progesterone
Some foods, herbs and vitamins are known or claimed to be supportive of progesterone production or function in the overall hormonal scheme of things. Fermented soy, for example, contains phytoentrogens (plant estrogens) with anti-cancer, phytochemical properties. Traditional menopausal herbal remedies such as Chaste Berry (Vitex agnus), Mexican Wild Yam (Dioscorea villosa), Sarsaparilla (Smilax medica), and Suma (Hebanthe paniculata) are said to mimic, stimulate, or modulate certain progesterogenic actions. Studies have concluded that Vitex, for example, does increase endogenous progesterone production under some circumstances. Some research suggests that certain vitamins may increase or restore progesterone production. Vitamin B5 (pantothenic acid), for instance, may increase hormonal production and secretion in the adrenal glands, which serve to replace ovarian function following its decline in and around menopause. It is therefore absolutely essential to support optimal adrenal function in the menopausal female—and the andropausal male as well for that matter. Other vitamin factors supportive of both the female and male sexual systems include: Vitamins B6, C and E which are responsible for such outcomes as restoration of normal progesterone levels in premenstrual syndrome (PMS), resolution of unexplained infertility, improvement in both female and male fertility, prevention of miscarriage, alleviation of menstrual irregularities such as dysmenorrhea, and reduction in the severity of menopausal hot flashes, menorrhagia and pelvic pain in endometriosis. VerVita™ Natural Balancing Cream
What makes the VerVita™ Natural Balancing Cream product a competitive standout among all the progesterone products in today’s healthcare marketplace? Its unique formulation and clinical efficacy in balancing estrogen and testosterone levels in both the male and female. In addition to its 400 mg of progesterone proper, it is comprised in part of precursor hormones such as pregnenolone and DHEA, almond, coconut, and jojoba oils rich in unsaturated and saturated fatty acids, with aloe vera and vitamin E for their outstanding immune and skin supporting properties. Clinical Application of Progesterone Cream
When taken orally, even natural progesterone is poorly absorbed, and only marginally effective in terms of bioavailability following its metabolism by the liver. Transdermal or topical application on the other hand works quite efficiently and quickly to deliver the hormone to the skin’s subcutaneous tissue for slow, measured release into the bloodstream over time for distribution to the targeted tissue. Favorable results normally become noticeable within two to four weeks with blood serum progesterone levels generally found to be increased after about three months of therapy as more accurately determined by saliva rather than blood testing. Female
Clinicians will typically recommend to their perimenopausal and postmenopausal patients a dosage of 20 to 40 mg (approximately ¼ to ½ tsp) of progesterone daily. Topical application is generally limited to the breasts, abdomen and thighs on a rotating basis to prevent single site saturation. Progesterone therapy for postmenopausal women with acute osteoporosis requires a greater dosage: ½ tsp both morning and evening for the first two ounces of cream, followed by ½ tsp daily thereafter. Those women in their early 30s who suffer from PMS (Premenstrual Syndrome) will benefit from the same dosage as above taken on day 12 through 26 of their menstrual cycle. Male
Progesterone therapy dosage for men is typically 6 to 12 mg per day without the need to cycle its application. It is thought that application to soft skin parts such as the female breast and the male scrotum will trigger an increase in the production of DHEA (Dehydroepiandrosterone), the steroid hormone precursor to both estrogen and testosterone production. Conclusion
Menopause need not be the hormonal thorn in the flesh of maturing women and “getting older.” While Hormone Replacement Therapy (HRT) treats and perpetuates its symptoms, Natural Hormone Therapy (NHT) addresses and corrects its cause— hormonal deficiency and imbalance. NHT works and natural progesterone delivers on the promise of a return to balanced hormonal health and happiness. Hormonal balancing therapy through natural supplementation is simply the sine qua non of women’s healthcare. It alone is the quintessential healthcare capstone, the missing piece to the midlife puzzle for vibrant health in concert with all the other integrative factors including organic diet, adequate hydration, robust exercise, satisfying sleep,
targeted nutrient supplementation, a merry heart, and wonderful vertical and horizontal relationships. Hormones, in brief, are to life itself as atoms are to the molecules of matter. Noting that the female’s endogenous production of progesterone falls very close to zero around menopause (and even lower than that of the male), Hyperhealth aptly concludes: “Supplemental, exogenous Natural Progesterone can alleviate the discomfort experienced by many women prior to, during and immediately following Menopause” (Progesterone – Factors that Interfere with: These Factors May Decrease the Body’s Production of Progesterone). VerVita™ Natural Balancing Cream. Don’t leave hormones without it. Sources 1University of Michigan. "Feeling Close to a Friend Increases Progesterone, Boosts Well-being and Reduces Anxiety and Stress." ScienceDaily, June 3, 2009. Balch, Phyllis A., CNC. Prescription for Nutritional Healing, 3rd ed., 2000. Hyperhealth Pro CD-ROM, Version 8.0, 2008 by In-Tele-Health. Lee, John R., MD with Virginia Hopkins. What Your Doctor May Not Tell You about Menopause: The Breakthrough Book on Natural Progesterone. Warner Books, 1996. Lee, John R., MD, David Zava, PhD and Virginia Hopkins. What Your Doctor May Not Tell You about Breast Cancer: How Hormone Balance Can help Save Your life. Warner Books, 2002.
2Michigan State University. "Progesterone Leads To Inflammation, Scientists Find." ScienceDaily 21 August 2009. 1 September 2009 <http://www.sciencedaily.com /releases/2009/08/090819135440.htm>. Wright, Jonathan V. MD and John Morgenthaler. Natural Hormone Replacement for Women over 45. Smart Publications, 1997.
Cornwall & Isles of Scilly Devon, Plymouth and Torbay Peninsula Health Technology Commissioning Group Commissioning decision: Bevacizumab for diabetic macular oedema The Peninsula Health Technology Commissioning Group (PHTCG) has come to a decision on the use of bevacizumab for the treatment of diabetic macular oedema. This treatment will not be routinely commissioned.
For a CME/CEU version of this article please go to http://www.namcp.org/cmeonline.htm, and then click the activity title. Multiple sclerosis (MS) is a common cause of disability in young adults. Althoughnot curable, effective immunomodulators, which alter the development of disabil-ity, are available and should be initiated early in the disease process. Optimizingcare of patients with MS requi