Progesterone Cream for Hot Flashes of Menopause and Healthy Happy Vaginal Lubrication and Getting Rid of Vaginal Dryness
by Eckhart, MD
Hot Flashes and Menopause
85% of hot flashes and insomnia of menopause is routinely taken care of by progesterone cream. Implausible as this may seem the medical community does not fully understand why hot flashes or insomnia occurs. John Lee, MD has written 10 pages in his book, "What Your Doctor May Not Tell You About Menopause" on the subject of hot flashes of menopause. The state of the art thinking according to John Lee, MD is that Gonadatropin Releasing Hormone (GnRH) is "shouting" and causing the vasodilation and hot flashes of menopause.
In a normal woman, Gonadatropin Rleasing Hormone (GnRH) causes increased Follicle Stimulating Hormone (FSH) and increased Luteinizing Hormone (LH). Follicle Stimulating Hormone (FSH) in turn causes a follicle on the ovary and this causes estradiol to be produced. Luteinizing Hormone (LH) in turn cause corpus luteum to grow. The Corpus Luteum produces progesterone.
After the age of 35, anovulatory cycles are produced. The woman is cycling normally, but the follicles are coming up, and no egg is popping out. Thus, a follicle is produced, but not a corpus luteum. Thus, estradiol levels are unchanged, but progesterone levels go to less than 1% of normal.
When full menopause occurs after age 55, the are no more follicles to be produced by the ovary. The ovary runs out of eggs. No more follicles are produced. Estradiol levels drop to 40% of normal. Body fat produces the 40% NOT produced by the follicle on the ovary. The body fat keeps producing estradiol even after the age of 55.
Thus, after the age of 35, progesterone levels drop to less than 1% of normal. After the age of 55, the esradiol levels drop to 40% of normal. Gonadatropin Releasing Hormone (GnRH) starts "screaming" going high for the ovary to make some more estradiol and progesterone. The ovary cannot comply. High GnRH directly gives rise to the hot flashes and insomnia. It is not really decreased estradiol and progesterone DIRECTLY, but indirectly.
Supplementing with progesterone takes care of 85% of hot flashes by double blind study. For the rest of the women, just give topical estradiol EVERY OTHER DAY 0.5 mg. Do not take it every day. Another dosage regime is 0.5-2mg /day for 2 weeks then 1 - 2 times per week as needed. Take estriol 3 weeks out of 4 weeks.
Most doctors do not know that because it is GnRH that is causing the hot flashes NOT the estradiol or progesterone that causes the hot flashes per se. So very carefully, you may taper the estriol and progesterone over a period of 6 months to a year. This SLOW TAPERING allows GnRH to SLOWLY get used to lower levels of progesterone and estriol, and stops the "shouting" of GnRH.
So you do NOT have to take progesterone cream and estriol cream forever. You only have to take it for 6 months to one year. But you need to slowly taper off the progesterone cream or estriol cream. If you taper it off too fast, then hot flashes will be the result. If you do get hot flashes, then increase the dose temporarily, and start the SLOW taper again.
Vaginal Dryness and Atrophy
Vaginal dryness after menopause may be caused by not enough progesterone and xenoestrogens and phytoestrogens. Xenoestrogens and phytoestrogens can fit into the estrogen receptor in the vaginal tissue to give an abnormal response.
Progesterone cream may be used to cause the pain to simply go away with increased lubrication along with avoiding the chemicals on the skin that cause the unhealthy vaginal tissue. Again anything put on the skin is 10 times the oral dose.
If vaginal bleeding on intercourse and vaginal atrophy is present, the use of Estriol cream or estriol oil may be used directly on the vaginal tissue to increase and thicken the vaginal skin. Your body makes 3 different natural estrogens. Your body makes Estriol, Estradiol, and Estrone. Estradiol is the strongest of all estrogens telling the body to be female. Too much estradiol may linked to a "pear" shaped body. Estrone and Estriol are considered to be "weak" estrogens. They go into the estrogen receptor and block all the other estrogens including xenestrogens. One study with breast tumors actually showed a decrease in breast tumors with the use of Estriol. Estriol is the estrogen of pregnancy. Estriol goes up 100 times during pregnancy. Estriol increases the toughness of the vaginal tissue and thickness of the vaginal skin in preparation fo the baby to pass through the birth canal. Vaginal bleeding on intercourse should be a thing of the past with the use of Estriol.
Estriol is the estrogen of pregnancy. We know that women that have multiple pregnancies have a smaller chance of breast cancer and endometrial cancer. So Estriol may be relatively safe.
Where to Apply
Apply the progesterone cream to the skin anywhere where the circulation is good. Do not use where any lotion, perfume, or cosmetic is applied. You may apply it on the leg, the arm, the back, inner thigh and the chest. The topical progesterone cream is absorbed into the subcutaneous fat, and then slowly released into the blood stream where it is carried on the Red Blood Cell membranes and the chylomicrons (normal microscopic fat bubbles in the blood).
Rotate sites when applying Progestelle. If you just use one site, then the subcutaneous fat will saturate and you will not be able to absorb any more progesterone. For instance, if you keep doing right arm, right arm and right arm day after day, then you will not be able to absorb any more.
When you first try Progestelle, use only one drop at first so that if you have an allergy you will not get a big reaction. Usually, this is a reaction to the coconut oil, and NOT the progesterone. We do have other oils available.
Use Progesterone Cream on days 6-26. Day 1 is the first day of your period. Use 20-40 mg/day of topical Natural Progesterone. Usually, you need 40 mg/day for the first 2-3 months, and then 20 mg/day for maintenance. Increased vaginal lubrication occurs in several weeks. If you do not have a period, then take progesterone 3 weeks out of 4 weeks.
Use topical estriol directly on the vaginal tissue with the progesterone 3 weeks out of 4 weeks. You may use topical estriol 0.5 mg EVERY OTHER DAY. Or you may use 0.5 mg - 2 mg topically for the first 2 weeks, then 0.5 - 2 mg once or twice a week as needed after that.
If you have in increase in pain, bleeding, or discomfort, stop the progesterone cream immediately. Then, cut out all xenoestrogens and phytoestrogens according to the information that comes with the product. After cutting out all xenoestrogens and phytoestrogens for about 1-2 months, try the progesterone cream again.
The use of synthetic prescription birth control pills or synthetic prescription brand name hormones is not recommended. Synthetic prescription progestins will block Natural Progesterone. It is suggested that you use a condom without spermicide.
Increase in bloating, breast tenderness, and migraine headaches with the use of progesterone cream indicates the presence of some xenoestrogen (fake estrogen) or phytoestrogen.
Estrogen dominance will depress and decrease the activity of the thyroid receptor and will make you appear to be hypothyroid. Taking progesterone and cutting out xenoestrogens and phytoestrogens will revive the thyroid receptor back to normal and you will need less thyroid hormone. Make sure to work with your physician or health care professionally to decrease the thyroid dose. Hair should become fuller and fat less.
Every woman absorbs, metabolizes and reacts to progesterone differently. So you may titrate the dose to what your body likes. Your job is to find the least amount of Progesterone Cream that you need to get the desired effect.
A woman usually makes about 20-40 mg/day during the luteal phase of her menstrual cycle. During one day of third trimester pregnancy, her body makes 400 mg/day of progesterone. So you can see that progesterone is quite safe. And there is a wide therapeutic range of progesterone that is effective and safe.
Birth Control Pills
Birth Control Pills may contain a synthetic progestin that blocks the Natural Progesterone. So Birth Control Pills cannot be used with Natural Progesterone. Progesterone is NOT recommended for birth control.
Estrogen Dominance (too much estrogen usually from xenoestrogens and phytoestrogens) causes thyroid receptor desensitivity. In other words, you become less sensitive to thyroid hormone. Thyroid tests are usually normal or below normal. However, the estrogen dominant patient looks hypothyroid. Hypothyroid patients have thinning hair, low temperature, and develop fat on the hips and belly. After 4-6 months of getting rid of xenoestrogens and phytoestrogens, and taking progesterone the thyroid receptor perks up usually and becomes normal. As a result, hypothyroid symptoms decrease and you become normal. Also IF you are taking thyroid supplements, these thyroid supplements should be slowly tapered off working with your doctor.
Before or After Ovulation
Progesterone taken before ovulation will fool the body into thinking it is pregnant, and the ovaries will not ovulate. In essence, the progesterone is saving your eggs for the future. However, progesterone taken after ovulation may encourage conception. Progesterone encourages a nice "nest" lining for the embryo to implant. You should work with your health care practitioner when using progesterone during pregnancy and lactation.