Luteal Phase Defect

Stock photo by lumix2004
The luteal phase of the menstrual cycle spans from ovulation at midcycle until menstruation. The luteal phase should last for at least 12 to 14 days. A luteal phase which is less than 10 days will have difficulty producing an environment favorable for implantation.

The luteal phase derives its name from the fact that the luteinized cells from the collapsed follicle undergo a structural transformation in response to increased vascularization, a process known as luteinization. Thereafter these two cell types produce progesterone; one of which is dependent on the secretion of luteinizing hormone.

When a pregnancy occurs, and the developing blastocyst burrows into the uterine lining, the embryo will secrete hCG, which stimulates the ovary to produce more progesterone. This process is called luteal rescue. If this process happens too late or if pregnancy does not occur, LH stimulation decreases, progesterone levels decrease and uterine prostaglandins are released. This causes the corpus luteum to shrivel. The uterine lining, because of lack of progesterone stimulation, is shed.

Read more: http://www.acudenver.com/articles/ArticlesRL8.pdf

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Could Biomimetic Dosing be the Answer to Hormone Replacement Therapy?

Bio-identical hormones can only be truly bio-identical if the hormones for replacement mimic not only those chemically found in the body, but also mimic the natural biological process as well.

New research shines bright light on healthy hormone replacement therapy (HRT), suggesting that women must cycle their hormones and have a menstrual bleed to be truly safe from cardiovascular events. According to a recent Danish study, a combined cyclic regimen with monthly bleeding creates a lower cardiovascular risk for women than continuous-combined estrogen/progesterone/progestin therapy, which does not cause a menstrual bleed. The study also found that overall there was no increased risk of heart attacks in current users of HRT compared to women who had never taken hormones.

Read more: http://thewileyprotocol.com/about-the-wiley-protocol

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Wild yam, fertility

From: http://www.susunweed.com/herbal_ezine/Weed_letter_Dec-01.htm#q8

QUESTION: I had a question about something you wrote:

"Interestingly enough, if wild yam is taken in small doses (a cup of tea or 10-20 drops of the tincture daily from onset of menses until mid-period) it increases fertility! In either case, the effect seems to be triggered by the large amount of hormone-like substances found in this root. When taken daily, these substances may be converted into progesterone, thus decreasing the possibility of conception."

It was my understanding that this was a common misconception about dioscorea, but that it actually does not affect the hormones in any way in its natural state. My understanding was that there are components in dioscorea (such as diosgenin) that can be made into synthetic progesterone, but that this conversion process does not naturally happen in the body, it must be done in a lab. For that reason, taking wild yam in hopes to alter or affect hormone levels is useless.

Susun's response:
Thanks for your note. The field of plants and hormones is expanding by leaps and bounds, but we are still far from understanding what happens in the body when we eat certain plants. Of course, I mostly speak from experience, not only mine, but those of thousands of women over thousands of years.

Many plants, especially large starchy roots, contain phytoestrogen and phytosterols. These substances are most definitely converted into hormones in the human body and numerous studies attest to it. They must, however, be fermented out of the plants by gut action and some people have too little gut flora to manage the job. There is no progesterone, or any other hormone, in wild yam, but your body can make hormones out of it if it is taken internally. Which hormones is up to your body, so I may be wrong when I say progesterone will be the result. But there will be a strong effect on hormones. Check out my book New Menopausal Years: the Wise Woman Way for an article I did debunking wild yam creams. I certainly agree with you completely as far as external use is concerned.

Green Blessings, Susun Weed

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Vaginal Progesterone Equally Effective in Achieving Pregnancy Outcomes as Injectable in DE Cycles

Photo by bies
Vaginal Progesterone is Equally Effective in Achieving Pregnancy Outcomes as Injectable Progesterone in Donor Egg Cycles

A retrospective analysis conducted at a large infertility center evaluated pregnancy outcomes for 225 donor egg recipients

A retrospective analysis of anonymous oocyte (egg) donation cycles, comparing the pregnancy outcomes between vaginally-administered progesterone versus intramuscular (IM) progesterone injections, demonstrates that vaginally-administered progesterone and IM progesterone achieve equal pregnancy outcomes, according to data presented by Brian Berger, MD, Boston IVF, at the Pacific Coast Reproductive Society annual meeting in Rancho Mirage, CA. The retrospective study was supported by a grant from Columbia Laboratories, Inc. (NASDAQ:CBRX).

“We found no significant differences in pregnancy outcomes between patients treated with vaginal progesterone versus progesterone administered intramuscularly,” said Dr. Berger. “Further, vaginal progesterone has the added advantage of avoiding painful intramuscular injections.”

In 225 egg donor cycles, 105 patients received vaginally-administered progesterone (CRINONE® 8% (a bioadhesive progesterone gel)) and 120 received IM progesterone. The implantation rate was 43.8% for vaginal progesterone versus 37.1% for IM progesterone (p=0.175). Recipients treated with vaginal progesterone achieved a 58.1% pregnancy rate and a 51.4% delivery rate, versus a 53.3% pregnancy rate (p=0.503) and a 48.3% delivery rate (p=0.689) for patients receiving IM progesterone. The pregnancy loss rate was 10.5% for patients using vaginal progesterone and 10.8% for IM progesterone users (p=1.00).

“This study clearly demonstrates that vaginal progesterone gel achieves the same pregnancy outcomes as progesterone administered via an intramuscular injection. This is important confirmation that CRINONE® 8% offers patients an efficacious and more convenient option for providing progesterone support in infertility treatment,” Berger added.

Boston IVF is one of America’s most successful fertility centers, providing patients with unparalleled medical care and the best experience with the expertise of premier doctors and professional staff, who are affiliated with Harvard Medical School. It is world renowned for its highly successful and innovative infertility treatments, highest quality service, state-of-the-art methods, ongoing scientific research, and on-site complementary healthcare at its Domar Center.

About Progesterone and Luteal Phase Support

Progesterone is the pregnancy hormone that creates a healthy environment in a woman’s uterus where a fertilized egg can implant and grow into a healthy baby. Most women undergoing infertility treatment need additional progesterone to help prepare the uterus for implantation and development of a fertilized egg.

Before ovulation, progesterone levels in a woman’s body remain relatively low, but rise after ovulation during the latter part of a woman’s menstrual cycle which is called the luteal phase. The luteal phase begins with the production of progesterone and ends with either pregnancy or menstruation, when the uterus sheds its lining. During pregnancy, progesterone helps to maintain the lining of the uterus, providing necessary nutrients to support and nurture a fertilized egg.

Source: http://www.businesswire.com/portal/site/google/?ndmViewId=news_view&newsId=20080414005254&newsLang=en

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How Does Vitex Promote Cycle Balance?

Vitex or chasteberry is not a hormone; however, vitex works by acting on the hypothalamus and pituitary gland, which in turn secrete hormones or send signals to other parts of the body to trigger the production of reproductive hormones.

Vitex has been shown to help increase the level of luteinizing hormone (or LH) while gently suppressing the secretion of FSH (follicle stimulating hormone). In effect, Vitex stimulates the hormones involved in ovulation and assists in restoring overall hormonal balance.

More specifically, vitex is effective in regulating pituitary gland function and in normalizing the balance of progesterone to estrogen levels. Vitex is particularly supportive in maintaining progesterone levels during the "luteal phase", or second half, of a woman's cycle.

A large percentage of menstrual problems and infertility issues are related to insufficient progesterone production during the luteal phase, which can result in a shortened luteal phase and may possibly contribute to PCOS. With regard to the former, a "short" luteal phase is often referred to as corpus luteum insufficiency or LPD (luteal phase defect). Luteal phase defect is characterized by low progesterone levels during the second half of your cycle.

With regard to PCOS, hormonal imbalance (namely insufficient levels of progesterone) may also contribute to the formation of cysts on your ovaries, or Polycystic Ovary Syndrome. As Vitex agnus castus has been shown to support progesterone production, Vitex may be suggested as a treatment for menstrual cycle imbalances, luteal phase defect, and possibly PCOS (as normalized progesterone levels and cycle regularity may suppress the development of ovarian cysts associated with estrogen dominance).

Clinical studies now support the fertility-enhancing claims associated with Vitex agnus castus - as well as its facility in treating common fertility disorders. In one commonly-cited study, sixty-seven women with fertility or ovulatory disorders were given a vitex agnus castus preparation, which resulted in a marked improvement of progesterone levels during the luteal phase, earlier ovulation, and thirty-eight achieved pregnancies (Bergmann, 2000).

In another study (Milewicz, 1993), vitex agnus castus was administered to hyperprolactinaemia female patients. The use of vitex resulted in reduced prolactin levels, as well as the normalization of luteal phase progesterone levels for women with luteal phase defect. Shortened luteal phases were therefore normalized (lengthened).

An earlier German study by Amann (1982) reveals that vitex exerts a favorable, positive effect on women with amenorrhea (the absence of menstrual cycle or period), further establishing the efficacy of vitex in restoring hormonal balance and cycle regularity. In another clinical trial conducted at Stanford, women with fertility disorders benefited from using a vitex-containing supplement, with more pregnancies in the vitex group than in placebo groups. Each of these studies demonstrates the fertility-enhancing properties of this unique herb.

Vitex is also recognized as a safe herb. It has no known side-effects, and chasteberry can be taken for up to 18 months continuously. When pregnancy is achieved, discontinue use of vitex-containing supplements, as well as any other herbal-nutritional supplements not specifically approved by your doctor. The benefits of vitex will increase over time, and maximum benefits are typically achieved after a few months of use. It is suggested to not take vitex or fertility supplements while you are using prescription fertility drugs.

Full article: http://www.early-pregnancy-tests.com/vitex.html

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Perimenopause is a time of “Endogenous Ovarian Hyperstimulation”

“Perimenopausal endogenous ovarian hyper-stimulation” is the exact opposite of “The Myth of the Shriveling Ovary”: High estrogen levels during perimenopause, coupled with characteristically intermittent ovulation, can explain much of the misery of perimenopause.

My hypothesis is based on the assumption that inhibin production decreases while there are still viable follicles (capable of producing both estrogen and eggs) in the ovaries and that this in turn stimulates FSH to increase the production of estrogen in the follicles. I offer five pieces of evidence for this hypothesis:

Perimenopausal changes are similar to changes caused by some infertility treatments.

In vitro fertilization (IVF) requires laparoscopic surgery (through a small tube in the abdomen) to suck up ovarian egg cells that are nearly ready to ovulate so they can be grown and fertilized in a laboratory and then injected into the woman’s uterus. In order to collect the maximum number of eggs, gynecologists override inhibin using a technique called “ovarian hyper-stimulation.” The woman is given daily injections of FSH until many follicles have been stimulated and estrogen levels are very high. She is then injected with another hormone (much like luteinizing hormone [LH], another pituitary hormone that stimulates the ovary) to mimic the normal mid-cycle HL surge and this triggers ovulation.

A rare pituitary tumor causes higher-than-normal FSH levels, resulting in hormone levels and symptoms similar to those experienced in menopause.

In an “experiment of nature,” a 36-year-old woman with a tumor on her pituitary gland complained of very heavy menstrual flow. An ultrasound of her pelvis showed seven ovarian cysts and an unusually thick endometrium (lining of the uterus). Her bleeding was successfully treated with medroxyprogesterone (Provera) for ten days each month. This woman’s FSH levels were increased, but only to a level commonly found in perimenopausal woman during the five or more years before the last menstrual period. Her inhibin level was in the normal range, but her estrogen levels during days four to eight of her cycle, were about 12 times higher than normal for the early follicular phase.

More ovarian follicles are used up each year during a woman’s late 30s and early 40s, as compared to earlier in her life.

Pathologists have observed that there is a steady decrease in the numbers of ovarian follicles as women age. (The highest number of follicles is present before birth). This gradual loss takes place during adolescence and young adulthood without any perceptible influence of FSH. The marked increase in the rate of decline in midlife is an indication that more follicles are being stimulated.

Women in their forties are more likely than younger women to be pregnant with non-identical twins (i.e. from two different eggs).

Many women try unsuccessfully to get pregnant for years and then are suddenly successful: compared to younger mothers, these women in their 40s are more likely to bear non-identical twins. In these cases, two ovarian follicles are stimulated, both ovulate and both are fertilized. This could well be due to lower levels of inhibin and higher FSH levels.

Average estrogen levels in perimenopausal women are higher than in younger women.

Although perimenopausal women often believe their estrogen levels to be high, scientists have been slow to acknowledge this possibility. However, two recent studies may change this. One study (subtitled “hyperestrogenism in the perimenopause”) compared the amounts of estrogen (estrone in urine, during one cycle) in two groups of regularly cycling women — one group aged 47 or over and another aged 19 to 38. Ovulation occurred in some cycles and not in others. The older women not only had higher levels of estrogen but also had lower levels of progesterone.

Another study involved a large, randomly selected group of women aged 45 to 55 in Melbourne, Australia. During the early follicular phase, these women showed unexpectedly high estrogen levels (averaging 226 pmol/L) as compared to the expected average of 175 pmol/L. Forty-two per cent of women in a subgroup who had skipped periods for three to 11 months, had levels higher than normal for that phase of their cycle and eight per cent had levels higher than the usual mid-cycle estrogen peak.

[I was gratified to find that high estrogen levels during the perimenopause had been found in a large, well-designed study. However, when I read the authors conclusion that the menopausal transition was characterized by “an increase in serum FSH and decrease in estrogen,” I felt I had to write. The authors subsequently acknowledged that I was probably right about high estrogen levels in the perimenopause.]

Women’s experience and “perimenopausal ovarian hyper-stimulation”
In the book Women of the 14th Moon, nurse practitioner Maura Kelsea says, “At [peri]menopause* life can turn into one long premenstrual experience. Hormones slap you up against the doors of your unfinished business.” Her description of “one long premenstrual experience” aptly describes the physical and emotional upset related to abnormally high estrogen levels. If a woman is to differentiate between moods caused by the social stress of the menopausal transition, and moods caused by high estrogen levels, it helps to be able to recognize the effects of abnormally high estrogen.

For women who menstruate, there are two accurate signs of high estrogen levels that normally occur for a day or two at the middle of a menstrual cycle: front-of the-breast tenderness and stretchy cervical mucus. If estrogen remains high for several days, then the breasts also swell, become firmer and may develop the kind of tenderness often characteristic of early pregnancy. Stretchy mucus is caused by estrogen stimulation of the glands of the cervix (the mouth of the uterus). This mucus is clear and slippery (like raw egg white), can be stretched in a long thread 5-7 cm (2-3" long) and acts to assist sperm traveling into the uterus to fertilize an egg. This type of mucus disappears after mid-cycle when progesterone comes on the scene. Therefore, not only is mucus a sign of high estrogen levels, its disappearance is good evidence of ovulation.

Many perimenopausal women have a high estrogen mid-cycle peak without ovulation. FSH then stimulates another follicle to make high estrogen levels that peak a week or so later. At that point the endometrium has become thickened, is over stimulated and begins to bleed. Thus a common menstrual pattern in the perimenopause is for front-of-the-breast tenderness and stretchy mucus to begin in the middle of the cycle, but then to continue and be at their maximum at the start of a period. Menstrual blood mixed with this mucus may resemble currant jelly. When these signs are present, it is clear evidence that ovulation did not occur. It may also be associated with heavy flow, increased premenstrual moodiness, fluid retention, bloating, and sometimes with menstrual cramps.

What is the significance of these high estrogen levels – aside from breast tenderness and stretchy mucus? According to one recent study, estrogen serves to amplify our body’s hormonal responses to any kind of stress. This was demonstrated by randomizing young men to wear either a high-dose estrogen or a placebo patch and then subjecting all of them to a standard stress test (speaking and doing math problems in front of an audience). Those who were receiving estrogen were found to produce higher levels of the kinds of hormones manufactured in response to stress (i.e. ACTH, cortisol and norepinephrine).

Daytime hot flashes and night sweats are usually interpreted as indicators of low estrogen, despite the fact that they occur in response to rapidly decreasing estrogen levels. Many women who experience flashes find that they start while they are still menstruating regularly – before estrogen could be low. There is now good evidence that hot flashes are related to at least two conditions:

The brain must have been exposed to high estrogen levels at some time, and
The level of estrogen has to be decreasing. The brains of women who have regular periods and mid-cycle estrogen surges will become used to high estrogen levels.


When estrogen decreases – even from high to normal — hot flushes are triggered. Two studies have now shown that severe hot flushes can occur concurrently with either very high or normal estrogen levels.

Treating “perimenopausal endogenous ovarian hyperstimulation”
This picture of erratic (and explosive) estrogen levels in perimenopause not only can help us to make sense of our experiences. It can also guide us toward appropriate treatment choices, including the avoidance of supplementary estrogen until flow has been gone for a year and the possible use of cyclic progesterone.

In the normal course of events a 47-year-old woman seeing her doctor about night sweats, heavy flow and PMS would likely be given combined hormone (estrogen/progestin) therapy or the oral contraceptive pill. (She might even be told that she is too young to be menopausal and scheduled for a D & C). She is not likely to be told that there are many things she could do to help herself.



She could find and talk to other women who have come through the perimenopause; she could get more information about perimenopause at community seminars and read about perimenopause. She could also help herself by exercising regularly. Walking (or more strenuous exercise) for 30 minutes a day may not alleviate all premenstrual symptoms but will help reduce stress, control weight, allow more sound sleep, possibly relieve hot flushes and be good for both bones and heart. The hot flushes can also be helped by a daily dose of vitamin E (400-800 IU) and even more so, by relaxation training. Finally, she could use vitamin B6, oil of evening primrose and herbal remedies like black cohosh to see if they help.

If perimenopause is a time of high estrogen and low progesterone, a logical treatment is supplementary natural oral micronized progesterone or medroxyprogesterone, provided that the progesterone and/or progestin produce adequate physiological blood levels to be effective. At the outset, progestin/progesterone may briefly (for one cycle) exacerbate estrogen-related mood symptoms, migraines or breast tenderness. But if you persist, progesterone will block these unpleasant symptoms.

Progestin/progesterone therapy is certainly indicated when estrogen excess (relative to progesterone) causes spotting, heavy flow (defined as more than 16 soaked pads/tampons a period), periods too close together (e.g. two periods within the same month) or endometrial hyperplasia (over-stimulation of the cells lining the uterus). These situations are so common in the perimenopause that physicians or nurse practitioners should feel comfortable prescribing this therapy; gynecological consultation is rarely necessary and endometrial biopsies or ultrasounds are usually not needed.



The treatment involves either oral micronized progesterone (Prometrium®) in a dose of 300 mg at bedtime because of its drowsy side-effect, or medroxyprogesterone acetate (MPA) in a dose of 10 mg per day for 16 days – on days 12 to 27, counting from the first day of the menstrual period. This will usually bring flow back to normal.

To ensure an adequate counterbalance to the high estrogen, each 16-day course of progestin/progesterone must be completed, even if bleeding starts. In other words, the woman should finish the 16 days but – at the same time – start counting towards day 12 and the next dose from the beginning of flow. This means that during some cycles, she may be off progesterone for only a few days. Cyclic progesterone therapy should be continued for at least six months.

In some situations, if excess estrogen symptoms are severe, if flow starts before the ninth day of the progestin/progesterone therapy, or if breakthrough bleeding occurs, higher doses of progesterone may be needed. For instance, I have used cyclic natural progesterone (300 mg per day for days 12 to 27 of the cycle) and added daily progestin (Provera®) at 5 or 10 mg per day every day. The daily dose of progestin can be stopped when flow becomes scant or some periods are skipped, but the progestin/progesterone taken on days 12 to 27 should be continued for another six months.

We know that several old controlled studies showed that hot flushes were relieved by progestin treatments. So the cyclic progestin/progesterone treatment I recommend will not only control heavy bleeding, but also alleviate night sweats that often begin before flow. We also know that in premenopausal women experiencing abnormal cycles, ten days a month of Provera can increase spinal bone density by a high significant 2 per cent. Best of all is the knowledge that cyclic progestin/ progesterone therapy can bring estrogen and progesterone back into a healthy balance. You can monitor your feelings and bodily changes, as well as therapy, using a Daily Perimenopause Diary®.

By dispensing with “The Myth of the Shriveling Ovary” and learning the secrets of “perimenopausal endogenous ovarian hyperstimulation,” we can make sense of the chaotic physical and emotional changes of perimenopause.

by Dr. Jerilynn C. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research

Source: http://www.cemcor.ubc.ca/articles/misc/perimenopause_endogenous_ovarian_hyperstimulation.shtml

Types of Progesterone

Synthetic Progesterone (Provera)
Synthetic progesterone, which can be administered orally or via injection, is most commonly used to trigger menstruation. Because of its chemical makeup, it is less likely to cause some of the undesirable size effects of natural progesterone, such as sleepiness or dizziness. Unlike natural progesterone however, synthetic progesterone is generally *not* considered safe to use during pregnancy, which should be ruled out prior to its use.

The remaining types of progesterone, described below, are all natural forms.

Oral Progesterone
Natural oral progesterone, such as Prometrium pills, is used primarily as a supplement in the luteal phase for patients undergoing natural or IUI cycles. The primary advantage of oral progesterone is its convenience; patients do have not have to learn to give themselves injections or deal with the discharge that may occur with vaginal application. Despite its appeal, however, oral progesterone has several disadvantages. Most seriously, at least one study suggests that it may be associated with lower success rates than some other forms of progesterone; it has been hypothesized that oral progesterone may be more effective at raising serum progesterone levels than at raising the level of progesterone within the uterine lining itself, which is where its true effect occurs. Additionally, oral progesterone is metabolized by the liver, and the byproducts may cause side effects such as dizziness or sleepiness.

Recently, some doctors have begun to have patients administer these same progesterone pills vaginally. Few data are yet available on the efficacy of this approach.

Progesterone Suppositories
Progesterone suppositories are compounded by individual pharmacists and consist of natural progesterone suspended in a base similar to cocoa butter. Upon insertion, the warmth of the body causes the suppository to melt and release the progesterone. Since suppositories are vaginally administered, the liver does not produce the high number of side effect-causing metabolites that can occur with natural progesterones taken orally. The vaginal administration also allows the progesterone to be targeted more specifically to the uterine area. Many women, however, find the discharge associated with suppositories to be overly messy or uncomfortable and there is some question as to how long the progesterone is effective after insertion. Additionally, it can be difficult to find a pharmacy that will compound the suppositories, and the individualized process may cause a lower level of dosing accuracy and quality control. Finally, some women may be sensitive to the suspending substance.

Bioadhesive Gel (Crinone)
Crinone gel is also applied vaginally. In contrast to suppositories, however, the progesterone is suspended in a bioadhesive gel (sold without progesterone under the brand name Replens) and is packaged in a tampon-like applicator. Crinone gel is highly efficient at the uterine level; in fact, the progesterone stays so concentrated in the uterus that Crinone often has minimal impact on serum progesterone levels. Crinone is frequently used as a progesterone supplement in IUI and IVF cycles.

This uterine level impact is one of the primary advantages of Crinone, as is the fact that many patients only need to apply it once a day. For many women, Crinone is far better at delaying premature onset of menstruation than are suppositories or oral progesterone. Some women do, however, find that the suspension gel accumulates in the vagina and may need to be removed every couple of days; additionally, patients occasionally experience vaginal irritation as a result of the build-up.

Injectible Progesterone
Injectible progesterone consists of progesterone suspended in an oil, commonly sesame or peanut. Used most frequently in IVF cycles, progesterone in oil is normally injected intramuscularly once a day, most commonly in a dose of one cubic centimeter (cc).

Progesterone in oil is highly effective at the uterine level; many physicians consider it to be the gold standard for progesterone supplementation, particularly in high stakes in vitro fertilization cycles. Additionally, unlike Crinone, progesterone in oil supplementation is also reflected in serum tests, allowing levels to be more easily, albeit indirectly, monitored. The once a day dosing is convenient for patients, and the cost is quite low, often only several dollars a day for a patient taking 1 cc.

For many women, the primary disadvantage of progesterone in oil is the manner in which it is administered. In addition to being intramuscular, progesterone injections must be performed using a 20 or 22 gauge needle to accommodate the relatively high viscosity of the oily solution. This gauge is larger than that used for most other infertility medications, and patients often find the change intimidating. Additionally, like progesterone suppositories, progesterone in oil normally has to be compounded by a specialty pharmacy or mail ordered. Finally, some women may be allergic to the oil in which the progesterone is most commonly suspended.

What about Progesterone Creams?
In contrast to the above products, progesterone creams are available over the counter. These products deliver a small amount of supplemental progesterone, and absorption may vary significantly from person to person. These creams may provide a bit of “insurance" to a woman with a fairly normal cycle, but the dosages are not high enough to treat significant hormonal issues. When you are trying to conceive, it is always a good idea to consult a knowledgeable professional about the use of any drug that might affect fertility.

What is the Best Form?
As is often the case, there is no one single treatment that is best for all women. Although oral progesterone may be sufficient for some women, Crinone and progesterone in oil do appear to be the most effective at the uterine level. The issue of whether either of these two supplementation forms is superior to the other remains unresolved. Some preliminary research suggests that progesterone in oil is superior at preventing bleeding in pregnancy, but that it may also delay bleeding in some cases where genetically abnormal pregnancies ultimately result in blighted ova. Definitive research is, however, yet to be done.

Source: http://www.conceivingconcepts.com/learning/articles/progesterone.html

Fibroids are a woman's worst nightmare

Few women care to have medical checkups often so tend to ignore symptoms that may be due to grave conditions such as fibroids

Many women live through painful periods and discomfort, totally oblivious of the possibility of enlarged fibroids until their reproductive system is affected. Ms Ann Kyobe discovered she had fibroids at 30 after two miscarriages and she had a premature birth by caesarean section after that.

Before this she had lived through painful and heavy menstrual periods that lasted two weeks each time. Occasionally, Ms Kyobe felt pain in her lower back. According to Dr Rhona Mijumbi of International Air Ambulance, Ms Kyobe exhibited “typical signs that one could be having enlarged fibroids”.

Ms Kyobe says that she had scanty knowledge of fibroids so there was no way she could suspect anything was wrong just because her periods were painful and heavy. “There are many women who have heavy or painful periods so I thought it was normal,” she says.Dr Mijumbi describes fibroids as non-cancerous swellings that grow in, on or around the walls of the uterus.

They could grow to as many as 20 or just one in varying sizes: they can be as small as a pea or as large as a basketball. The size, number and location determine severity and what effects they will have on their victims.

The most severe of effects are reproductive- related. They include birth by caesarean section, miscarriage, or failure to conceive in the first place. Frequent urination, a feeling of fullness in the lower abdomen, bleeding between periods and painful sexual intercourse could also indicate their presence. If they are growing on the outer lining of the uterine walls, the fibroids could cause the stomach to bulge.

“In school,we were taught that fibroids affected women above the age of 35 but the reality in the field is that although it is prevalent (in that group), even women as young as 20 are diagnosed with them,” says Dr Mijumbi.

According to Dr Charles Kiggundu a gynaecologist at Mulago Hospital, the prevalence rate for fibroids among Ugandan women is 30 percent. This accounts for three out of every 10 women in their 30s and four out of every 10 women in their 40s.

“These are however based on the women that have been diagnosed, excluding those that have not gone for medical check up,” he says.

Dr Mijumbi says although over time, black women have been found to be more prone to developing fibroids than their white counterparts and 20 percent of sufferers worldwide are above 40 years of age. Kiggundu further explains that women who give birth late or have few children are more prone to fibroids.

This highlights the fact that the more affluent woman who takes a longer part of her life studying, making money and thus gives birth later in life to fewer children is at a higher risk of suffering from fibroids.

“A hormone, oestrogen favours the growth of fibroids while another called progesterone, which is produced in large amounts during pregnancy helps counter the possibility of developing fibroids. The earlier one bares children therefore, the more progesterone they produce in their bodies which helps reduce their chances of developing fibroids,” explains Dr Kiggundu.

Having this in mind, many women have been driven to seek male companions in a rush to stop the hand of nature. Ms Julia Nabunya says that when her 42-year-old aunt found out she had fibroids, she advised her to get a baby as soon as possible to avoid developing them as well.

Thus, at 22, Ms Nabunya got pregnant, not caring much about who she picked for her child’s father. Although early birth may reduce the risk of getting fibroids, there is no definite way to prevent them.

At best, the doctors advise medical examinations if any of the symptoms are experienced so that if fibroids are found early, one can plan on how to manage pregnancy, for example.

“There are cases where we advise women to give birth early, but not to prevent them as some women think,” Dr Mijumbi says. “It is instead to ensure that one gives birth before the fibroids are too big to interfere with pregnancy.”

In other cases, the fibroids are cut out if found severe and causing a lot of complications. At worst, the entire uterus is removed. According to doctors, fibroids are not known to have any direct effect on fertility but rather interfere with conception and pregnancy depending on their size and location.

“If a fibroid is located at the entrance of the uterus or is blocking the fallopian tube(s) and is big enough to cause blockage, the sperm and ova might not get to meet and thus there is no fertilisation,” Dr Paul Ssemugoma of International Medical Centre says.

Dr Mijumbi adds that in cases where a fibroid grows at the entrance to the womb, sex could be painful and delivery complicated resulting into birth by caesarean.

“This is an example where we would need to operate and remove the fibroids but we can’t operate when one is pregnant so we wait and see whether the foetus survives long enough to be delivered by caesarean then operate later before their next pregnancy,” she explains.

The other instance where they are removed is when a swelling twists on its stalk. Fibroids have a stalk attached to the uterine wall. When one of the fibroid swellings begins to twist on its stalk, it causes unbearable pain. In that case, surgery to remove the fibroid has to be carried out.

Fibroid swellings thrive on oestrogen - a female hormone produced by the ovaries which increases in the body during ovulation, menstruation and pregnancy. They enlarge during heavy surges of the hormone in the body causing heavy and painful periods as they expand and contract.

“Some patients are in fact injected with oestrogen free hormones to hinder development of the fibroids but this hormone impacts negatively on their fertility rates,” says Dr Mijumbi.

During pregnancy, they enlarge and if they are growing on the inner walls into the uterus, they compete for space with the foetus and usually win thus causing miscarriages or premature births.In most cases though, even when the doctors diagnose fibroids, the patients are left to live with them.

“They are usually small and harmless save for the painful and heavy periods that most women can live with taking painkillers,” says Dr Ssemugoma. Otherwise, the fibroids die out with menopause because the ovaries stop producing the oestrogen they thrive on.

REAL LIFE EXPERIENCE:
It happened to me Grace Areymo a 49-year-old mother of five shared her experiences with Winifred Agudo When I was growing up, this complication was attributed to women who decided not to give birth. This was to change drastically in 1998, when my menstrual cycle became constantly heavier, more painful and would last two weeks.

I immediately sought medical help and fortunately, a female doctor attended to me. She recommended antibiotics for one week thinking it was an infection. A week later, with no improvement, I was forced to see the doctor again, this time round however, it was a male doctor.

He prescribed pills for my pain for 30 days thinking it was hormonal imbalance. I was fooled into thinking the problem was gone when the bleeding stopped but my next period was very painful so I was advised to see a gynaecologist.

After several tests, and sound scan in 2000 Ii was diagnosed with fibroids. My first reaction was shock, because society always had it that fibroids exist among Nuns, and women who deliberately refuse to give birth, besides am a mother. Since then my abdomen has gradually expanded so much that it is uncomfortable.

People who knew me before keep wondering what happened and this has put pressure on me to look like did before. Thinking back now, remember this complication could have started when was in my 30s though ignored it then.

I have tried some preventive methods like herbal medicine, which has slightly reduced the size of my tummy. I am still hestitant to have an operation because of the side effects.

Source: http://www.monitor.co.ug/fullwoman/fwoman09297.php

Exercise in Early Pregnancy: Risk, Low Progesterone, and Miscarriage

QUESTION: I'm 7 weeks and I'm an avid runner. My doctor advised that I not run because of a low progesterone. I'm on "Prometrium." Why can't I run?

ANSWER: Strenuous exercise has long been associated with decreased amounts of progesterone. Marathon runners are famous for what is called "Exercise-related Amenorrhea" (no periods). No one quite knows why this is, but it seems related to ovarian production of progesterone.

Ovarian progesterone is made in the second half of the menstrual cycle, and it prepares the lining of the uterus for implantation. When pregnancy occurs, this "second half" of the cycle continues until term, when progesterone finally falls off. But there's a transition at the end of the first trimester, because at that point the placenta takes over the job of making the progesterone.

Progesterone will only be produced at appropriate levels after an adequate ovulation. If ovulation fails to occur, as in some cases of ovarian cysts, or if the egg ovulated is faulty, the residual ovarian tissue at the ovulation site (where the progesterone is made) will not make enough progesterone. This ovulation site, the "corpus luteum," is then labeled as inadequate. Women with an inadequate corpus luteal phase of their cycle never prime the lining of their wombs enough to have a legitimate period, and so periods are either late, scant, or unusual in color.

The faulty lining also poses risk for implantation, and miscarriage is a risk... theoretically. This is why doctors use progesterone to supplement those with "inadequate" progesterone. The level can be easily determined with a blood test. The Prometrium you have been prescribed is a natural progesterone -- identical to the very stuff your own body makes.

But is the baby in danger because the progesterone is low, or is the progesterone low because the baby is in danger? This is why giving progesterone is controversial, because some feel if it's low, it's always because miscarriage is inevitable. Others feel that giving the progesterone does no harm, except to perhaps delay an inevitable miscarriage by supporting a bad pregancy beyond the time it would have miscarried.

I myself give progesterone. I'd rather take a chance on delaying a miscarriage than writing off a baby that just might make it.

Back to your question:

Does exercise actually consume the progesterone made in some strange metabolic way? Or is there low progesterone because exercise affects the ovulation that is the necessary precursor of progesterone? In your case, I would say moderate exercise wouln't be harmful, especially since you're supplementing your progesterone anyway. But I'm not your doctor. Perhaps there are other concerns about your first trimester. Or perhaps your doctor has had a tough time getting your progesterone up even with supplementation.

When posed with questions about exercise in pregnancy, obstetricians feel one can resume any exercise regimen that she's already used to. But this answer is not polluted by a progesterone problem: When the progesterone's low, we're dealing with a phenomenon that's not completely understood. Certainly NOT running will do no harm. Your doctor doesn't want to worry about possible problems while worrying about known problems.

Note: The normal level of progesterone is usually "15-20." If the progesterone level is ~13 or so, this is seen as salvageable. If the progesterone is <5, I've not really seen progesterone do any good.

©2000 GERARD M. DiLEO, M.D., F.A.C.O.G.
http://www.gynob.com/qqexerprog.html

The fourth (luteal) phase: (Day 15-27)

Around 20 eggs develop and the most mature egg gets released. While the eggs are developing, the sacs produce estrogen. And just before the most mature egg gets released, progesterone is also secreted in addition to estrogen.

Estrogen and progesterone have their respective functions. Estrogen increases the flow of blood to the uterus and helps thicken its lining. Progesterone helps produce substances that will nourish a Ovum fertilized egg implanted in the lining.

The sacs (follicles) produce estrogen and progesterone due to the stimulation of LH and FSH. And once estrogen and progesterone reach a certain level, the production of LH and FSH stops. This stops the development of the other eggs, after the most mature egg has released.

If fertilization takes place:

The ruptured sac, after the egg has broken through (Corpus luteum), continues producing progesterone, aimed at nourishing the growth of the embryo. Progesterone blocks the release of further eggs till pregnancy is terminated.

Estrogen, while regulating progesterone, begins one of the major processes of fetal maturation. Without estrogen, the lungs, liver and other organs and tissues cannot mature.

If fertilization does not take place:

Estrogen and progesterone levels drop. Without these hormones, the lining of the uterus breaks up and is released through the vagina, to mark the onset of the menstrual period.

What happens after the uterine lining is shed?

A new cycle menstrual begins.

Source: http://www.allaboutpregnancysymptoms.com/ebook/chap1_2.htm

Georgia Reproductive Specialists Participates in Largest-Ever In Vitro Fertilization Clinical Trial in the World

Georgia Reproductive Specialists is First to Evaluate New, Patient-Friendly Progesterone Supplement

ATLANTA, Aug. 2 /PRNewswire/ -- Georgia Reproductive Specialists in Atlanta, GA was one of 25 sites nationwide that recently completed the
largest in vitro fertilization (IVF) clinical trial ever in the world. The landmark trial of 1,211 women evaluated ENDOMETRIN(R) (progesterone) Vaginal Insert, 100 mg, a progesterone supplement used in patients undergoing assisted reproductive technology (ART) treatment. Progesterone is necessary to support embryo implantation and early pregnancy.

Based on the trial results, ENDOMETRIN, marketed and manufactured by
Ferring Pharmaceuticals, Inc., was approved by the U.S. Food and Drug
Administration (FDA) on June 21, 2007. As the first new, patient-friendly alternative to progesterone supplementation in a decade, ENDOMETRIN was shown to provide unprecedented luteal phase support, measured by ongoing pregnancy and live birth rates, with highly efficient delivery of progesterone.

"We're were honored to have been chosen as a site for this landmark
trial to give women undergoing ART treatment an effective, convenient
alternative to current progesterone treatments," said Dr. Perloe reproductive endocrinologist who led the trial at Georgia Reproductive Specialists. "Our goal is to help ease the patient's journey to parenthood by being able to provide treatments that are designed with the patient in mind. Patients have been dissatisfied with current progesterone supplements, such as progesterone-in-oil intramuscular injections, which can be painful, and suppositories and gels, which can be messy. With ENDOMETRIN, they now have an effective, patient- friendly option."

Clinical trials for ENDOMETRIN were conducted using BRAVELLE(R)
(urofollitropin for injection, purified) and MENOPUR (R) (menotropins for injection, USP) in the initial stimulation phase of treatment. Unlike other infertility treatments, these medications can be mixed in a single syringe for convenient, once-daily administration.

ENDOMETRIN answers an unmet, significant patient need. ENDOMETRIN is not a painful shot, melting suppository, has no build-up, provides dose-to-dose consistency and is easily self-administered. If you would like to learn more about ENDOMETRIN, contact Georgia Reproductive Specialists at 404-843-2229. Georgia Reproductive Specialists can also provide you with information about MENOPUR and

BRAVELLE. Landmark IVF Trial
The safety and efficacy of ENDOMETRIN compared with an active control
were evaluated in a multicenter, randomized, open-label, assessor-blinded
trial in 1,211 women, ages 18-42, undergoing IVF. Efficacy was measured by continuing pregnancy and live birth rates. An analysis was also conducted to evaluate once-daily compared with twice-daily dosing of gonadotropins
during the stimulation phase.

MENOPUR and BRAVELLE were used for the stimulation phase of IVF, with a minimum of one vial of MENOPUR per day. The centers had the option of combining Menopur and Bravelle and administering them as one single daily injection, which was done for approximately two-thirds of the patients (777). On the day of egg retrieval, patients were randomized to ENDOMETRIN 100 mg twice daily, ENDOMETRIN 100 mg three times daily, or an active control ((progesterone vaginal gel (90 mg) QD)).* In the study, 97 percent of patients randomized to participate in the trial received an embryo transfer.

The results showed that ENDOMETRIN was efficacious, with no significant differences in efficacy parameters between treatment arms. Continuing pregnancy rates were 44 percent with ENDOMETRIN TID and 40 percent with ENDOMETRIN BID. Live birth rates were also high: ENDOMETRIN BID 37 percent, ENDOMETRIN TID 40 percent. The groups showed equivalent tolerability, with no significant differences in the incidence of adverse events.

The efficacy of ENDOMETRIN was also evaluated in harder-to-treat
patients - women over age 35 or with elevated basal follicle stimulating
hormone (FSH) or body mass index (BMI). Excellent continuing pregnancy rates were observed across a broad range of patient types with the use of
BRAVELLE, MENOPUR, NOVAREL(R) (chorionic gonadotropin for injection, USP) and ENDOMETRIN.

Full article: http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/08-02-2007/0004638039&EDATE=

Study looks at progesterone therapy

Progesterone therapy does not reduce the chances of preterm birth in women pregnant with twins, reported researchers in a network sponsored by the National Institutes of Health.

An earlier study showed progesterone therapy reduced the risk for preterm birth in another category of high risk pregnant women, those carrying a single baby who had delivered a single baby prematurely in the past.

"This study shows that progesterone therapy is not beneficial for all women at risk for giving birth prematurely," said Duane Alexander, M.D., Director of the NICHD, the NIH institute that supported the research network. "So far, the evidence supports progesterone therapy as a means to reduce preterm birth only in women pregnant with a single baby who are at risk for premature delivery because of a prior preterm birth."

After the initial study showed progesterone therapy could reduce the likelihood of preterm birth in women carrying a single baby and who had previously given birth prematurely, many physicians began prescribing the therapy for women pregnant with twins and for other categories of women at risk for preterm birth as well. In addition to women carrying two or more babies, and those who have delivered prematurely before, also at risk for preterm delivery are pregnant women having a shortened cervix (the lower part of the uterus) and certain infections of the reproductive tract.

The study appears in the August 2, 2007 issue of The New England Journal of Medicine.

A large team of researchers from the NICHD Maternal-Fetal Medicine Units Network, led by Dwight J. Rouse, M.D., Professor of Obstetrics and Gynecology at the University of Alabama at Birmingham School of Medicine, conducted the study.

In the study, 655 women pregnant with twins were randomly assigned to receive weekly injections of a placebo or the form of progesterone known as 17-alpha hydroxyprogesterone caproate (17-OHPC), explained Catherine Y. Spong, M.D., Branch Chief of NICHD's Pregnancy and Perinatology Branch, and the NICHD author of the study.

Progesterone is a female hormone that is produced in large quantities during pregnancy. Researchers with the Maternal Fetal Medicine Units Network reported in 2003 that weekly injections of progesterone reduced the risk of preterm birth by 34 percent among pregnant women who had given birth prematurely in an earlier pregnancy.

Women in the current study were randomly assigned to groups receiving weekly injections of either 250 mg of progesterone or a placebo. The injections started when the women were 16-20 weeks pregnant and continued until the 35th week of pregnancy or until the woman gave birth. Women in both groups had similar characteristics such as age, race, and marital status.

The researchers found that the use of progesterone did not reduce premature birth in twin pregnancies when compared with the placebo group: 41.5 percent of women on progesterone treatments delivered prematurely (before 35 weeks) or experienced fetal loss vs. 37.3 percent of women receiving placebo injections. Fetal loss describes the loss of the baby because of such factors as stillbirth or miscarriage, said Dr. Spong.

There was no difference between the two groups in the amount of time the baby spent in the womb before it was delivered. Progesterone treatment did not affect the proportion of deliveries before 37 weeks or before 32 or 28 weeks, when compared to the placebo group.

Whether the child was conceived using assisted reproductive methods or conceived spontaneously did not affect these results, nor did the type of placentation (whether the babies shared a placenta or had two separate placentas). The study could not determine whether progesterone therapy could reduce the chances of preterm birth in women pregnant with twins who had delivered prematurely in a previous pregnancy. Fewer than 10 percent of women participating in the current study had experienced a prior preterm delivery,a number too small to allow a reliable estimate of the effect of treatment in this group of women.

Premature infants are often very small and at greater risk for life-threatening infections, blindness, breathing problems, learning and developmental disabilities, and cerebral palsy. Premature babies are also more likely to die from SIDS (sudden infant death syndrome) than full-term infants. Premature birth is one of the leading causes of infant death.

Women pregnant with twins are at higher risk for preterm birth than are other pregnant women, with more than half delivering prematurely, said Dr. Spong. Over one quarter of all very low birth weight infants (less than 1500 grams or 3.3 pounds) are the result of a multiple pregnancy. Multiple pregnancy accounts for one in seven infant deaths, she said.

Overall, the number of twin births has increased in recent years. Between 1980 and 2004, the rate of twin birth rose from 18.9 to 32.2 per 1000 live births, the study authors wrote, citing data from the National Center for Health Statistics.

Dr. Spong added that NIH-funded researchers are testing progesterone in other groups of women who are at risk for preterm birth, such as women with shortened cervixes and women pregnant with triplets.

Source: http://www.news-medical.net/?id=28366

Childhood Environment Influences Reproductive Function

A study led by researchers at UCL (University College London) demonstrates that female reproductive function is influenced by childhood environment. This suggests there is a critical window of time from about 0-8 years of age that determines the rate at which girls physically mature and how high their reproductive hormone levels reach as adults.

Published today in PLoS Medicine, the study compares reproductive hormone levels of groups of Bangladeshi women who migrated at different periods of their life. It finds that women who migrated from Bangladesh to the UK during infancy and early childhood reach puberty earlier, are taller, and have up to 103 per cent higher levels of the hormone progesterone as adults in comparison to women who migrated at a later age, as well as those who had remained in Bangladesh. These higher hormone levels could potentially increase a woman's ability to conceive.

Lead author Dr Alejandra Núñez de la Mora, UCL Department of Anthropology, said: "The findings point to the period before puberty as a sensitive phase when changes in environmental conditions positively impact on key developmental stages. Put very simply, the female body seems to monitor its environment throughout childhood and before puberty, to gauge when and at what rate it will be best to mature. It then sets development, including reproductive hormone levels, accordingly. This is an advantage in evolutionary terms, as it makes the best of the resources and energy available for reproduction in any given circumstance.

"Girls who migrate at a young age seem to mature more quickly when they find themselves in an environment where the body has more access to energy. In other words, when they're under less physical strain due to factors like a better diet and general health. When energy is a limited resource, it must be allocated between maintenance, growth, and reproductive functions - the body makes trade-offs within the constraints it experiences. When conditions are better, these constraints are relaxed and more energy is diverted towards reproduction."

The results of this study are relevant not only to Bangladeshi groups, but to other migrant groups and populations in transition worldwide. These findings add to accumulating evidence that humans have an evolved capacity to respond to chronic environmental conditions during growth and to make decisions about how to apportion energy between reproductive and other bodily functions.

Five groups of women were selected and compared for the study. These included women who had grown up in Bangladesh but moved to the UK as adults; those who had moved to the UK as children; second generation Bangladeshi women living in the UK; women who were born and raised in Bangladesh; and a comparison group of women of European descent who were born and raised in the UK. Bangladeshi migrants were chosen for this study because of the long and on-going history of migration to the UK and the general contrasts in conditions between the two countries.

The subjects in each group gave saliva samples over an extended period, to measure levels of the female hormones progesterone and oestradiol. These are key fertility hormones, influencing the female menstrual cycle, pregnancy and embryonic development. Health information and body measurements were also provided by the subjects.

Co-author Dr Gillian Bentley, UCL Department of Anthropology, who directed the project added: "The theory that early environmental factors may affect reproductive function has been suggested previously by anthropologists*, but this field study is the first to use measurements of hormone levels to demonstrate a link between childhood environment and reproductive maturation and function. However, hormone levels are not just relevant to reproduction. The significant increase in progesterone levels that we document in migrant women may result, for example, in higher breast cancer risks in subsequent generations of this community. The potential health implications are far-reaching."

Bangladesh, in South Asia, is one of the most densely populated countries in the world. The Bangladeshis who took part in the study were middle class women from the Sylhet District. Although a relatively affluent area of the country, inhabitants still suffer from higher immune challenges, primarily due to poor sanitation and limited access to healthcare. These aspects of the environment in Bangladesh are thought to be responsible for the slower development of the Bangladeshi women who grew up there.

The study was co-authored by Dr Robert Chatterton in Obstetrics and Gynaecology at Northwestern University, Chicago who supervised the laboratory work, and Dr Osul Choudhury of the Sylhet Osmani Medical College, Bangladesh who co-ordinated research with Dr Núñez de la Mora in Bangladesh.

-- The paper 'Childhood Conditions Influence Adult Progesterone Levels' is in the latest edition of PLOS Medicine, doi:10.1371/journal.pmed.0040167
-- Dr Gillian Bentley and Dr Alejandra Núñez de la Mora conducted this research while working for UCL's Department of Anthropology. They both now work at Durham University.
-- *This theory was developed by Professor Peter Ellison, founder and principal investigator of Harvard University's Reproductive Ecology Laboratory.

Source: http://www.medicalnewstoday.com/medicalnews.php?newsid=70913&nfid=crss

Drs won't prescribe progesterone in Australia

Did you know that there actually are those who sell OTC progesterone in Australia?

This one has independent dealers in Australia:
All On Health
http://allonhealth.com/natural-progesterone-infertility-sub.htm

and there MUST be drs prescribing it in Australia, because I found this:

Quote:
NATURAL HORMONES IN AUSTRALIA
Natural hormones, including progesterone, are a prescription-only item in Australia.

Compounding Pharmacy
MJ Health & Beauty, 103 Isabella St, Wingham, NSW, 2429, Australia, Ph: 1300 66 90 45, http://www.mjhealthandbeauty.com.au

Went to their forum and found this (but go read the rest of the postings for more info):

Quote:
You can rest assured that our cream is not a "Wild Yam" cream. We use imported natural progesterone that is structurally identical to the progesterone produced in the female body.

Your doctor will advise you as to the usage instructions. We supply the cream with a small "spoon" to help you get a measured dose.

Our most common products are 2% and 4% 100g creams. They are in a macadamia base, which we believe to be the best base we have found so far.

Postage costs are the same Australia-wide: $5.50 for orders under $55.00, otherwise free.
http://www.mjhealthandbeauty.com.au/forum/forum_posts.asp?TID=10

Their product ranges from $20-$35 AUS
http://www.mjhealthandbeauty.com.au/shopdisplayproducts.asp?Search=Yes

Is Natural Progesterone Safe?

QUESTION: My dr says that women who are given progesterone during pregnancy have children who when they are in the 20's have been diagnosed with cancers of the reproductive organs?

ANSWER: What I have read is that it is the synthetic progesterone that may cause problems, but the bio-identical progesterone is safe. Provera is a synthetic progesterone.

Warnings about SYNTHETIC progesterone:

Quote:
Warnings (Possible side affects of medroxyprogesterone acetate, including Provera):

* Increased warnings of birth defects such as heart and limb defects if taken during the first four months of pregnancy
* Beagle dogs given this drug developed malignant mammary nodules.
* Discontinue this drug if there is sudden or partial loss of vision.
* This drug passes into breast milk, consequences unknown.
* May contribute to thrombophlebitis, pulmonary embolism, and cerebral thrombosis.
Source: http://www.yourlifesource.com/estprog.htm


But bio-identical progestone is considered safe:

Quote:
NATURAL PROGESTERONE - THE SAFE ALTERNATIVE

Natural progesterone is not progestin, although many physicians believe they are the same thing. The difference between the two is two-fold:

1. Natural progesterone starts with a plant extract and, through fermentation and other steps, is converted to a substance that has the same molecular structure as the progesterone produced by the human body.

A progestin can start with the same plant extract, but is converted to a molecular structure that is not of the same molecular structure produced by the body.

2. According to Dr. Lee, when natural progesterone is used in servings of up to 40 mg per day, there have been no reported side effects, other than occasional menstrual spotting.

As noted above, there are many side effects of progestins.

Dr. John Lee has used natural progesterone for 15 years in his clinical practice and currently travels worldwide speaking on natural progesterone. Dr. Lee has published two books on natural progesterone -What Your Doctor May Not Tell You About Menopause and Natural Progesterone: The Multiple Roles of a Remarkable Hormone - and a number of articles on natural progesterone in peer-reviewed journals.

Dr. Lee notes, "In the fifteen years since (I have started using natural progesterone in my practice), I have seen the consistent benefits and the safety of natural progesterone therapy." (2)

Dr. Lee also comments on a study done by Hargrove et al. "When Hargrove et al., compared oral progesterone with medroxyprogesterone acetate (Provera) in combined hormonal therapy with estrogen for menopausal women, they found superior symptomatic improvement, an improved lipid profile, amenorrhea without endometrial proliferation or hyperplasia, and no side effects in the group given progesterone." (2)

The Hargrove study Dr. Lee quotes also states that of the ten women given estrodiol/progesterone (natural progesterone) none experienced side effects and wished to continue the therapy, while two of the ten women using conjugated estrogen and medroxyprogesterone acetate requested discontinuation due to side effects. The study itself notes that, "Most significantly, the adverse effects of synthetic progestins on lipoproteins and cholesterol were eliminated by using natural progesterone." (3)

Dr. Lee concludes his technical book, Natural Progesterone: The Multiple Roles of a Remarkable Hormone, by saying, "because of its many benefits, its great safety, and particularly its ability to oppose the carcinogenic effects of estrogens, natural progesterone deserves far more attention and application than generally given in the prevention and care of Womens Health today. "(2)

Studies support Dr. Lee's assertions on the efficacy and safety of natural progesterone - An article in the May, 1996 issue of Pharmacotherapy concerns the administration of a micronized form of natural progesterone. The authors of the study comment that "Most of the problems that accompany progestins could be avoided or profoundly reduced if natural progesterone could be administered …." They go on to say, "This oral product has been effective and safe in women with absent ovaries, premenstrual syndrome, and premature labor, and for postmenopausal hormone-replacement therapy." (4)

An article in the March, 1985 issue of the American Journal of Obstetrics and Gynecology discussed how progestogens (progestins) and natural progesterone affect high-density lipoprotein cholesterol in estrogen replacement therapy. It notes that "natural progesterone had no apparent influence on high-density lipoprotein cholesterol or its subtractions and may develop into an attractive alternative to synthetic progestogens." (5)
Source: http://www.yourlifesource.com/estprog.htm


Quote:
Medical evidence shows that the benefits of using natural progesterone include:
1. Prevents Endometrial cancer
2. Helps prevent breast cancer
3. Protects against fibrocystic breasts
4. Stimulates osteoblast bone building. (Osteoporosis Reversal)
5. Helps use fat for energy
6. Natural Diuretic
7. Natural antidepressant
8. Restores sex drive (Libido)
9. Normalizes zinc and copper levels.
10. Facilitates thyroid hormone action
11. Normalizes blood sugar levels
12. Normalizes blood clotting
13. Restores proper oxygen cell levels
14. Precursor of corticosteroids (Arthritis)
15. The concentration of Progesterone in brain cells is 20 times higher than in the blood serum levels. Dr John Lee in his book addresses the significance of progesterone and it’s connection to
a) restoration of the thinking powers of the elderly
b) elimination of depression after childbirth
c) reduction of the severity of brain injury
d) fetal brain development
e) improved sleep patterns
16. Babies whose mothers received natural progesterone show improved intelligence (reported by Dr Katherina Dalton). Other investigators report that progesterone babies have strong, serene independent characters. (Ref - Progesterone in Orthmolecular Medicine – Dr Ray Peat)
17. Research relating to the significance of progesterone levels and
a) it’s remarkable effect on enlarged prostates and prostate cancer in men. Books and research papers on this subject are about to be published.
b) serious surgery. Researchers have reported on and documented the dramatically improved prognosis for patients undergoing serious surgery.
Source: http://www.progesterone.nu/natural.asp