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Comprehensive Progesterone Cream For Adrenal Fatigue And Estrogen Dominance Article

By: Michael Lam, MD, MPH

Hormone Basics

Progesterone cream is useful in Adrenal Fatigue recovery

Hormonal imbalances are unfortunately fairly common in women and in men. The two main sex hormones in women are estrogen and progesterone. Men also need both of these hormones, though in different quantities. These two hormones need to exist in a careful balance for good health in both genders. But when this balance is lost, it can cause a range of troubling problems and symptoms. One of the most common solutions for this type of problem is estrogen dominance progesterone cream. This is often used to increase progesterone levels and bring the hormones back to a more natural balance. Here’s what you need to know about this remedy and whether it’s worth trying.

What is Progesterone?

Progesterone is made from pregnenolone, which in turn comes from cholesterol. The production of progesterone occurs in several places. In women, it is mostly produced in the ovaries just before ovulation and levels increase rapidly after ovulation. It’s also produced in the adrenal glands in both sexes and in the testes in males.

In women, progesterone levels are highest during ovulation (days 13 to 15 of the menstrual cycle). If fertilization does not take place during this stage, the secretion of progesterone decreases and menstruation occurs. If fertilization does occur, then the placenta secretes progesterone throughout the pregnancy and acts to prevent spontaneous abortion. About 20-25 mg of progesterone is produced per day during a woman's monthly cycle. Up to 300-400 mg is produced daily during pregnancy. During menopause, the total amount of progesterone declines to less than 1% of the pre-menopausal level. This is a very extreme drop and it may be responsible for many of the symptoms experienced before, during and after menopause.

Progesterone is a very important hormone in the hormone synthesis pathway. In addition to being the precursor to estrogen, it is also the precursor of testosterone and the all-important adrenal cortical hormone cortisol. Cortisol is essential for stress management, sugar and electrolyte balance, blood pressure and general survival. Progesterone on the other hand serves to promote the survival and development of the embryo and fetus. It acts as a precursor to many important steroid hormones and helps to regulate a broad range of biological and metabolic effects in the body. When you’re under chronic stress, progesterone production is reduced as the body favors cortisol production to reduce stress. This is a vital point when considering your stress response and management.

Estrogen is produced in the ovaries. It regulates the menstrual cycle, promotes cell division and is largely responsible for the development of secondary female characteristics during puberty. In non-pregnant, pre-menopausal women, only 100-200 micrograms of estrogen is secreted daily. However, during pregnancy, much more is secreted. Estrogen is produced in the ovaries, adrenal and fat tissues. During menopause, the amount of estrogen in the body declines by about fifty to sixty percent. Production still continues during this stage however, in the adrenals and in the fat cells.

Estrogen and progesterone work in synchronization with each other. These hormones have opposite actions and act to balance each other to achieve hormonal harmony in both sexes. That’s why it can be so devastating when these hormones go out of balance. It’s also why many women consider using estrogen dominance progesterone cream to try to regain their health.

What Does Progesterone Do?

Progesterone acts primarily as an antagonist to estrogen in your body, which means that it acts in opposition to estrogen. For example, estrogen can cause breast cysts while progesterone protects against breast cysts. Estrogen enhances salt and water retention while progesterone is a natural diuretic. Estrogen has also been associated with breast and endometrial cancer, while progesterone has cancer preventive effects.

Some of the functions of progesterone include:

  • Breast, uterus, and ovarian cancer protection
  • A natural diuretic
  • A calming, anti-anxiety effect
  • Contributing to formation of new bone tissue

Most significantly, it is shown that high amounts of estrogen can induce a host of metabolic disturbances. The body's primary way of counterbalancing estrogen is progesterone. And when this balancing mechanism is dysfunctional, a multitude of health related problems can arise.

Symptoms of Hormone Imbalances

Women who have estrogen dominance or progesterone deficiency often experience a range of troubling symptoms. Estrogen dominance syndrome affects around 50% of women over 35 years old as they enter the transitional phase of aging (ages 35 to 45). It can occur during menopause when progesterone production falls to approximately 1% of its pre-menopausal level while the production of estrogen falls to about 50% of its premenopausal levels. But it can also occur at any point throughout your life due to a range of factors.

Estrogen dominance progesterone cream can be an effective way to reduce or eliminate these symptoms as they will help to balance these hormones in a more natural way. If you have estrogen dominance, you can expect to experience:

  • Water retention
  • Mood swings
  • Weight gain
  • Painful periods
  • Hair loss
  • Headaches
  • Migraines
  • Irregular or heavy periods
  • Breast tenderness or swelling
  • Fibrocystic breasts
  • PMS

Some of the symptoms of progesterone deficiency can be very similar. The most common symptoms include:

  • Insomnia
  • Anxiety
  • Fibrocystic breasts
  • Painful periods
  • Heavy or irregular periods
  • Mid-cycle spotting
  • Irritability
  • Short cycles

The similarity between the symptoms of these hormone imbalances is often part of the reason why progesterone deficiencies are overlooked. However, if you want to be healthy then you need to have both of these hormones in the right levels, which means you may need to try estrogen dominance progesterone cream

The Problem with Hormone Replacement Therapy (HRT)

Progesterone cream and menopause

During menopause, many women experience hormonal imbalances and require estrogen dominance progesterone cream to help correct them. Some of the symptoms of these imbalances include:

  • Hot flashes
  • Vaginal dryness
  • Water retention
  • Weight gain
  • Insomnia
  • Mood swings
  • Short-term memory loss
  • Wrinkly skin appearance
  • Osteoporosis

The breakthrough in the treatment of menopausal symptoms came in 1964 when Dr. Wilson first reported that the lack of estrogen causes menopause. In response, pharmaceutical companies introduced a synthetic estrogen hormone called Premarin. With this drug, symptoms of menopause such as hot flashes were greatly reduced. There was little doubt at this stage that menopause was solely due to estrogen deficiency. Few doctors knew then that estrogen deficiency alone could not explain many of the symptoms of menopause.

For example, many women who are post-menopausal but cannot take HRT can experience relief from symptoms when using progesterone replacements. This fact clearly shows that there is more to the menopausal picture than a deficiency of estrogen.

HRM therapy can also cause side effects. These include fat accumulation at the hips and abdomen, osteoporosis, loss of sex drive and even swollen breasts. In addition, estrogen replacement doesn’t help increase a woman’s sex drive. Supplementing with estrogen alone does not increase the sex drive, but supplementing with progesterone together with low doses of estrogen does.

During menopause, the absolute level of estrogen decreases by 50% to a level below what is needed for pregnancy. This level is often enough for other normal body functions through the golden years. This is the way nature intended it to be. Menopause is therefore a normal physiological adjustment that does not produce any undesirable symptoms. However, many women experience a range of problems and symptoms because of menopause. This usually occurs because of hormonal circuit abnormalities.

Dr. John Lee - Pioneer on Natural Progesterone Cream

Dr. John Lee was a world-renowned authority on natural hormonal balance and author of the book Progesterone: The Multiple Roles of A Remarkable Hormone. He treated thousands of menopausal women in the 1980s and 1990s with a program that was contrary to popular medical thinking at that time. Instead of prescribing estrogen alone (the standard of medical practice then), Dr. Lee prescribed natural progesterone alone for treatment of menopausal symptoms. In addition to relieving the menopausal symptoms, the treatment was able to reverse osteoporosis and prevent cancer. Studies had confirmed that Dr. Lee's approach using progesterone alone had vast palliative effects.

Progesterone cream and weight gainThe key to Dr. Lee's approach is to understand the balance between estrogen and progesterone. In pre-menopausal women, estrogen is always in balance with progesterone. When these two important hormones are out of balance, hormone related illnesses emerge. Symptoms include weight gain, fatigue, auto-immune disorders, fibrocystic diseases, loss of libido, depression, headaches, joint pain and mood swings. These are just some of the common symptoms experienced during menopause, peri-menopause and pre-menstrual periods.

According to Dr. Lee, what is commonly perceived as an absolute estrogen level deficiency during the menopausal years is in effect estrogen dominance caused by an extreme low progesterone level. Since progesterone's role is to balance estrogen, the extremely low level of progesterone experienced after menopause leads to a relative dominance of estrogen, despite the 50% drop in estrogen levels.

Dr. Lee treated menopause as an estrogen dominance syndrome. His treatment was simple - reduce the estrogen to progesterone ratio by increasing progesterone. When the opposing force of progesterone is increased, the toxic effect of estrogen is decreased. Fortunately for many women who followed Dr. Lee's advice, their menopausal symptoms reduced remarkably using estrogen dominance progesterone cream and similar remedies.

The Causes of Estrogen Dominance

Your body normally functions in perfect homeostasis. But this has changed over the last 70 years because of many factors, including the environment. With the advent of modern society and the industrial state, the female body has been subjected to unprecedented insult from environmental estrogen-like hormones. This has raised the demand for effective remedies like estrogen dominance progesterone. There are a range of causes of estrogen dominance including:

  • Commercially raised cattle and poultry fed with estrogen-like hormones.
  • Commercially grown vegetables that contain pesticide residues whose chemical structure is similar to estrogen.
  • Synthetic estrogens & synthetic progesterones (Progestin, progesterone Acetate and birth control pills).
  • Exposure to xenoestrogens. Petrochemical compounds found in general consumer products such as creams, lotions, soaps, shampoos, perfume, hairs spray and room deodorizers. Such compounds often have chemical structures similar to estrogen and act like estrogen. They are fat soluble and non-biodegradable.
  • Hormone replacement therapy with estrogen alone without progesterone. This increases the level of estrogen in the body.
  • Overproduction of estrogen from ovarian cysts or tumors.
  • Stress, causing adrenal gland exhaustion and reduced progesterone output. Stress is one of the most frequently overlooked causes of estrogen dominance.
  • Obesity Fat has an enzyme that converts adrenal steroids to estrogen. The higher the fat intake, the higher the conversion to estrogen.

Progesterone cream and cirrhosis

  • Liver disease such as cirrhosis that reduces the breakdown of estrogen.
  • Deficiency of Vitamin B6 and Magnesium, both of which are necessary for neutralization of estrogen in the liver.
  • Increased sugar intake leading to a depletion of magnesium.
  • Intake of process and fast foods that are deficient in magnesium.
  • Increase in coffee intake.
  • A poor diet that consists of processed and fast foods instead of fruits and whole foods.
  • Lack of exercise.

This shows that lifestyle is the single most important factor in causing estrogen and progesterone imbalance. And this can also be a key factor in the development of Adrenal Fatigue Syndrome (AFS) and Hormonal Circuit imbalances.

Hormonal Circuit Imbalances in AFS

Stress is a key cause of hormonal imbalances, but this problem is compounded when you have AFS. Stress can be very damaging for the body. Fortunately, the NeuroEndoMetabolic (NEM) stress response is designed to protect your body from that damage. But this is a short term solution. When you’re under stress on a chronic basis because of poor lifestyle choice, a poor diet, lack of exercise, environmental factors, or a combination of stressors, this system can start to break down.

The adrenals excrete the stress hormone cortisol, which is essential for the NEM stress response. As a result, when you’re under stress, the demand for cortisol is very high. If this continues over the long term, it can result in adrenal fatigue. The body consists of interconnected circuits and systems, so as the adrenals start to decline in health then it affects the connected systems as well. This is particularly relevant to the Hormonal Circuit, which includes the adrenals as well as the ovaries or testes and the thyroid. As a result, hormonal imbalances are very common in people who have AFS, and will only worsen if the underlying adrenal fatigue is not addressed.

This is a big problem when it comes to conventional treatments for hormonal imbalances. The medications used are harsh chemicals which can cause additional stress, worsening adrenal fatigue. Many of these remedies add additional estrogen to the system, which can cause problems as well. Estrogen dominance is very common in people with AFS as the Hormonal Circuit functioning declines. Progesterone levels can drop and estrogen dominance symptoms can appear. Adding extra estrogen to this situation can obviously be very detrimental to your overall health and to the health of the Hormonal Circuit.

Progesterone Levels in AFS

Progesterone deficiency is very common in AFS. Chronic stress can cause the adrenal glands to go into overdrive, with excessive secretion of cortisol. Excessive cortisol can block progesterone receptors, making them less responsive to progesterone. Additional factors that often occur with AFS, such as circuit malfunctions, inflammation, bowel disturbances, and other symptoms will only compound this problem. They will cause an even greater demand for cortisol and further impede progesterone uptake.

As AFS progresses, the adrenals can become exhausted. This can cause a lowering of general hormone production, including progesterone. Production of progesterone by the adrenals comes to a halt as the body focuses on producing cortisol and not progesterone or other sex hormones. Insufficient progesterone production then leads to estrogen dominance.

It is prudent to optimize the adrenal gland function prior to or with progesterone supplementation with estrogen dominance progesterone cream or other strategies. You will need a doctor’s supervision to assist with AFS recovery, but some good general strategies include:

  • Multiple hormonal supplementation such as DHEA, pregnenolone, low dose natural cortisol or a cortisol enhancing agent like licorice root extract.
  • An optimal and balanced intake of vitamins and minerals from a healthy diet to serve as a good foundation for hormonal balance.
  • Supplements as necessary, which may include 500 mg to 3000 mg of vitamin C, 400 I.U. of vitamin E, and 10,000 to 25,000 I.U. of beta-carotene.
  • Supplementation with important minerals such as selenium and magnesium as well as amino acids such as lysine, proline and glutamine.
  • Natural hydrocortisone or cortisone acetate in doses of 2.5 to 5 mg two to four times a day c to replenish depleted adrenals.

Ways to Increase Progesterone Levels

Once the concept of estrogen dominance is understood, the solution is simple--reduce the estrogen load and/or increase the progesterone load. If you have AFS, then part of this has to include normalizing adrenal function to rebalance the Hormonal Circuit. This can be a complicated process that involves overall stress reduction as well as remedies for individual symptoms and issues that arise as a result of AFS.

There are a range of strategies that can rebalance the hormones. One of the most effective is to try physiological doses of progesterone (approximately 20-30 mg/day) to overcome the estrogen dominance and reestablish hormonal balance. Progesterone can also be supplemented orally or topically through estrogen dominance progesterone cream.

Progesterone cream oral alternatives

There are also certain foods that will help replenish your progesterone levels. Phytoestrogen rich food such as soy products can help. These foods contain weak estrogens that competitively take up the estrogen receptor site, making estrogen less available for use. Foods and herbs that have estrogenic effects include:

  • Oats
  • Peanuts
  • Cashew nuts
  • Wheat
  • Apples
  • Almonds
  • Ginseng
  • Black cohosh
  • Alfalfa
  • Pomegranate
  • Licorice

While widely promoted as the miracle food in recent years by the soy industry, it should be noted that soy products have their own set of problems. Unfermented soy products such as tofu contain acid, which can rob the body of many valuable nutrients and should not be eaten in large quantities. Fermented soy products, such as miso, do not have this problem and are a healthier choice.

The Benefits of Estrogen Dominance Progesterone Cream Include

Estrogen dominance progesterone cream can be one of the most effective solutions for hormonal imbalances. Some of the benefits of these solutions include:

  1. Stimulates osteoclast bone building (osteoporosis reversal)
  2. Helps use fat for energy
  3. Natural diuretic
  4. Natural antidepressant
  5. Restores sex drive (libido)
  6. Normalizes zinc and copper levels
  7. Facilitates thyroid hormone action
  8. Prevents endometrial and breast cancer
  9. Protects against fibrocystic breasts
  10. Normalizes blood sugar levels
  11. Normalizes blood clotting
  12. Restores proper oxygen cell levels
  13. Normalizes menstrual cycles

The Dangers of Synthetic Progesterone

The natural form of progesterone is derived from wild yam. It is very different from the synthetic unnatural form made in a laboratory (the widely prescribed Provera). The synthetic version is a chemical compound called progestin. It is a prescription drug commonly used in small amounts to balance the estrogen effect in a hormone replacement program. As a synthetic drug, progestin is far more powerful than a woman's natural progesterone. It is metabolized in the liver into toxic metabolites which can severely interfere with the body's own natural progesterone. This can create other hormone-related health problems and further exacerbate estrogen dominance. And if you have AFS, it can add to the toxic overload in your body, increase your stress levels, and worsen the underlying adrenal fatigue.

The structural differences between natural and synthetic progesterone are significant and have direct bearing on their functionality. Whereas natural progesterone causes a reduction in water and salt retention, synthetic progesterone does the opposite. This is why some women taking synthetic progesterone experience bloating and fluid retention. In fact, studies have shown that the administration of synthetic progesterone lowers the blood level of the body's natural progesterone.

Reported side effects of synthetic progesterone can include:

  • An increased risk of cancer
  • Increased risk of birth defects if taken during the first four months of pregnancy
  • Fluid retention
  • Abnormal menstrual flow
  • Nausea
  • Acne
  • Hirsutism
  • Depression
  • Nausea
  • Insomnia
  • Masculinization

This medication is contraindicated in those with thrombophlebitis, liver dysfunction, and known or suspected malignancy of the breasts and genital organs. One of the metabolites in this medication also has an anesthetic effect on brain cells.

Progesterone cream from wild yam sourcing

What is Natural Estrogen Dominance Progesterone Cream?

Natural progesterone is obtained by extracting diosgenin from wild yams and then converting this component into natural progesterone in the laboratory. It’s referred to as natural because the body can convert it into molecules that are identical to progesterone molecules manufactured in the body.

This yam-derived natural progesterone should not be confused with yam extracts commonly sold in health food stores. The human body easily converts natural progesterone into the identical molecule made by the body. However, it cannot convert yam extracts into progesterone. There is no evidence that such extract is converted into progesterone once it enters into the human body. No conclusive formal studies have ever been conducted that identify any particular benefits from wild yam extracts.So, if you have hormonal imbalances, it’s much more effective to look for natural estrogen dominance progesterone cream rather than using untried products.

You will also need to choose between high dose or low dose estrogen dominance cream and this will depend on the benefits you’re looking for. Always discuss this with a medical professional before making a choice.

Low vs. High Dose Progesterone Cream

Estrogen dominance progesterone cream comes in a variety of concentrations. Which is best? Low dose cream costs a little bit more, but it’s usually the better way to go for two important reasons.

Firstly, excessive progesterone in high dose (10%) cream is metabolized in the liver. Some of the metabolites that are produced as the progesterone is broken down may have anesthetic properties on the brain, causing lethargy and depression. Secondly, progesterone is rapidly absorbed from the skin and there is a danger of uneven progesterone release into the bloodstream. Since progesterone has a half-life of only 5 minutes once in the blood, its effectiveness is limited.

Other physicians favor a higher potency progesterone cream ( up to 10%) because they have better results. Regardless of whether it is high or low dose, the key is that your progress is monitored by a qualified health care professional. Whichever cream is recommended for you, make sure that it’s natural as this is more easily utilized by your body.

Side Effects of Natural Progesterone Cream

No known side effects exist when using natural estrogen dominance progesterone cream in physiological amounts (20-30 mg a day for women and 6-10 mg a day for men) under normal conditions. It is therefore very safe. However, as with most substances, too much of a good thing can cause problems. Too much progesterone is actually counterproductive, as chronically high doses of progesterone over time causes progesterone receptors to turn off. This reduces the effectiveness of the medication and may result in toxic side effects. Some possible side effects include:

  • Sleepiness, caused by the down-regulation of the estrogen receptors, which are essential for serotonin production.
  • Paradoxical estrogen dominance symptoms as the receptors are re-sensitized by the progesterone.
  • Edema (water retention)
  • Candida.
  • Lowered libido, particularly in men, because excess progesterone blocks the conversion of testosterone to DHT.
  • Increase in androgen production and estrogen production as the body shunts the excessive progesterone to these other hormones.

Progesterone cream use instructions

If you notice any of these symptoms, please see your medical practitioner immediately. In fact, you should not attempt any treatment for hormonal imbalances such as estrogen dominance progesterone cream without medical supervision and help. This is particularly true if you have AFS and need to avoid additional stress and poor health.

Routes of Progesterone Delivery

Natural progesterone can be administered orally, topically, sublingual or by injection. Oral administration is relatively ineffective as it is quickly metabolized in the liver. Injection is very effective but can cause irritation to the injection site and it can be quite painful. To achieve a physiological dose (and not a higher pharmacological dose), the best method is sublingual or topical.

Estrogen dominance progesterone cream is easily absorbed by the skin and is 5 to 7 times more effective in reaching the bloodstream than oral forms of progesterone. In other words, 100-200 mg of oral progesterone is needed to obtain the equivalent benefit of 20-30 mg of transdermal progesterone. There is some danger of progesterone build up in the body when it’s applied to the skin. This is commonly seen in those who are self-administering topical progesterone cream in the wrong area. Progesterone cream should be applied to areas of the body that have good circulation but are not high in fat. These areas include the wrist, back of the neck, and under part of the upper arm. Areas such as the abdomen, buttocks, and breasts are high in fat and will retain progesterone faster than other parts of the body.

Another route you can try is sublingual progesterone. This offers the best and most direct delivery route, as it is well absorbed directly into the bloodstream. However, the required alcohol based for sublingual drops may not be tolerated by some.

For best stabilization of progesterone absorption and effectiveness, natural progesterone should be taken or applied in divided doses, two to three times a day.

Topical Estrogen Dominance Progesterone Cream

To pass the skin barrier and achieve maximum absorption, natural estrogen dominance progesterone cream should be carried in an oil/water emulsion that contains the same fatty acid composition as the skin. Mineral oil will prevent the progesterone from being absorbed into the skin if topical progesterone is used.

There is a wide variety of dosages available. Topical estrogen dominance progesterone cream should contain at least 400 mg to 600 mg of natural progesterone per ounce. Each one-half teaspoon application then supplies a minimum of 26 mg of progesterone (women usually produce about 20 mg of progesterone daily during normal circumstances). To simplify matters, the better suppliers use a pump, with one pump delivering about 20 mg of progesterone. To get the physiologic dose, women should usually apply one full pump a day (20 mg), while men can apply one-half pump a day (10 mg).

A sample rotational application protocol

  • Day 1 morning: Apply to the right side of the back of the neck.
  • Day 1 before bed: Apply to the left side of the back of the neck.
  • Day 2 morning: Apply to the right wrist area, with palm facing up.
  • Day 2 before bed: Apply to the left wrist area, with palm facing up.
  • Day 3 morning: Apply to the underside of the right upper arm.
  • Day 3 before bed: Apply to the underside of the left upper arm.

Repeat this cycle from day 4 onward. In other words, day 4 will be the same as day 1, and day 5 will be the same as day 2, etc.

Progesterone cream and topical application

You must read the label carefully before use. Studies have shown that many commonly used topical commercial progesterone formulations contain less than 15 mg of progesterone per ounce. In fact, some of these creams contain as little as 2 mg of progesterone. Also, ensure that your estrogen dominance progesterone cream is legitimate by checking for the "U.S.P. Progesterone" on the label. U.S.P. stands for United States Pharmacopoeia, which is the international standard of purity. It confirms that the progesterone is the identical molecule as that produced by the human body.

How Much Topical Estrogen Dominance Progesterone Cream?

Using progesterone cream in the proper amount

You will obviously need to talk to your doctor before you try estrogen dominance progesterone cream or any other hormone replacement. If you try to do this on your own, you may cause more damage. This is especially true if you have AFS and your system is oversensitive. But as a general guide, the goal of progesterone replacement is to restore the normal physiological progesterone level in the body for two to three weeks out of a month; the way it was designed by nature. An ovulating woman makes about 20 mg a day for about 12 days each month after ovulation. That works out to about 240 mg of progesterone per month.

An effective estrogen dominance progesterone cream should supply 480 mg of progesterone per ounce (960 mg per 2 ounce). This means that each two-ounce jar or tube will contain 3% by volume or 1.6% by weight of U.S.P. Progesterone. Using one ounce over two or three weeks will provide about 240 mg if the absorption is 50%. This is the ideal target dose to apply. This works out to 1/8 to 1/2 teaspoon of the cream per day, or three to 10 drops of it in oil form. For creams that come in pre-set metered doses, one full pump normally contains the equivalent of 20 mg progesterone. This is simple to remember - one full pump a day for women and half a pump a day for men in divided doses.

If sublingual drops are used, make sure that the drops are applied sublingually and washed in the mouth for best absorption. Do not take in more than 6 drops at a time as it can be swallowed easily and lose its effectiveness.Sublingual progesterone drops are 99% absorbed, while micronized progesterone in a capsule is only about 40% absorbed, and some studies even report an absorption of less than 15%.

Application of progesterone cream on the back of the neck

Estrogen Dominance Progesterone Cream for Specific Complaints

The following are general recommendations for topical estrogen dominance progesterone cream application that may need to be modified for specific situation:

Women in premenopause - still ovulating:

  • Use: progesterone cream can be used to relieve PMS, painful cramps with periods, menstrual irregularities, prevent cancer and to protect against osteoporosis later in life.
  • Directions for those on no hormonal supplementation: Count the day the period begins as the first day. Apply 20 mg (one full pump when properly dosed) of natural progesterone every day from day 12 to day 26. Those with longer cycles may wish to use from day 10 to day 28. Begin the cream after ovulation, which usually occurs about 10 to 12 days after your period begins. If bleeding starts before day 26, stop the progesterone and start counting up to day 12, and start again.
  • Directions for those on synthetic progesterone (progestin) supplementation: Taper off the synthetic progesterone gradually and replace with natural progesterone over a 3-6 month period. Synthetic progesterone can be reduced to every other day and then further tapered off.

Women in perimenopause (still menstruating with menopausal symptoms and/or PMS but not ovulating):

  • Use: progesterone cream can be used to relieve PMS symptoms and prevent osteoporosis.
  • Directions: Count the day the period begins as the first day. Apply 20 mg of natural progesterone (one full pump when properly dosed) from day 7 to day 27. If your period begins early, stop using progesterone cream while you are bleeding.

Women in menopause (not menstruating):

  • Use: For prevention or reversal of osteoporosis and relief of menopausal symptoms.
  • Directions for those who are not on estrogen replacement therapy: Choose a calendar day, such as the first day of the month. Apply 20 mg of natural estrogen dominance progesterone cream (one full pump when properly dosed) daily from day 1 to day 25. Let the body rest for the rest of the month. If you haven’t been making progesterone for a number of years, then your body-fat progesterone is probably low. In this case, double up on the application for the first 2 months, and return to normal physiological dose thereafter.
  • Directions for those who are on estrogen replacement therapy: Reduce the dosage of estrogen supplementation to half when starting progesterone. Women who fail to do so will likely experience symptoms of estrogen dominance during the first one to two months. Progesterone cream and estrogen replacementEvery two to three months, reduce the estrogen supplement again by half. Estrogen and progesterone can be used together during a three-week cycle each month, leaving a rest period of 7 days without either hormone. The estrogen dose should be low enough that monthly bleeding does not occur but high enough to prevent vaginal dryness or hot flashes.
  • Directions for those taking estrogen and synthetic progesterone (such as Provera) combination: Stop the synthetic progesterone immediately when progesterone cream is added. Estrogen should be tapped off slowly.
  • Low dose natural estrogen (estriol) may be added for 3 weeks out of the month in cases of menopausal symptoms such as vaginal dryness and hot flashes unrelieved by progesterone cream alone.

Other Special Uses

  • Osteoporosis: Apply 20 mg daily from day 1 to day 25 of the menstrual cycle. A baseline bone mineral density (BMD) test should be performed. If after 1 year bone density increases, the amount can be reduced by half. If BMD does not increase, other factors such as exercise, diet and optimization of nutrition should be undertaken together with a full medical workup to identify other underlying causes.
  • Severe PMS or Endometriosis: Apply 20 mg from day 12 to day 26.
  • Uterine Cramps: Apply above the pubic area at onset of cramps.
  • Hormone Related Headaches: Apply creams to the sides of the neck just behind the earlobe at onset of headache. Do not use on day 28.
  • During Hot Flashes: Apply a small dab to the inside of the wrist at the onset of hot flashes.
  • Premenstrual Migraine Headaches: Apply 20 mg progesterone cream during the 10 days before the period begins. Be alert to the aura that usually precedes these headaches. You can apply a small glob (1/4 to 1/2 teaspoon) every 3 to 4 hours until symptoms subside.
  • Polycystic Ovary Disease: Apply 20 mg of progesterone cream during day 14 to 28 of the menstrual cycle. Adjust accordingly for longer or shorter cycles. As the hormonal balance is regained, facial hair and acne, two commonly associated symptoms, will disappear.
  • Progesterone Cream and Pregnancy: According to Dr. Lee, one of the chief causes of early pregnancy loss is the failure of the body to increase progesterone production sufficiently during the first several weeks after fertilization. Women who are having difficulty conceiving or who may be at risk of a miscarriage may wish to speak with their physician about natural progesterone supplementation after ovulation.
  • Breast Cancer Prevention: Breast cancer occurs most often during estrogen dominance. Dr. Graham Colditz of Harvard postulated that unopposed estrogen is responsible for 30% of breast cancer. Preventive low-dose progesterone supplementation (12-15 mg per day) can be used 24 to 25 days a month and should be considered, especially for those at risk.
  • Breast Cancer Patients: progesterone supplementation should be maintained for life with all breast cancer patients, before, during and after surgery.

Progesterone cream and uterine fibroids

  • Uterine Fibroids: 20 mg of estrogen dominance progesterone cream can be used from day 12 to day 26. You can start as early as day 8 and go through day 30. Ultrasound tests can be obtained initially as baseline and after 3 to 6 months of use. A 10-15% reduction in size of the fibroids is generally expected or at least the size should not increase further. Continue this treatment until menopause if it is successful. At menopause, progesterone application can be reduced. Fibroids normally atrophy after menopause as estrogen level reduces.
  • Breast Fibrocysts: Apply 20 mg of progesterone cream from ovulation (day 12 to 14) until a day or two before the period starts. Normal breast tissue will return within 3 to 4 months. Also, take 400 IU of vitamin E at bedtime, 600 mg of magnesium and 50 mg of vitamin B6 a day. Also refrain from coffee and reduce sugar and fat intake.
  • PMS: Apply 20 mg of progesterone cream from days 10 to 12 to days 26 to 30. This is best done in two divided doses, with a small dab at night starting on days 10 to 12 and gradually increasing to two dabs per day, morning and night. Finish off the last 3 or 4 days with bigger dabs. Each days total should not exceed 20 mg.
  • Pre-Menopausal Women with Hysterectomy or Ovaries Removed: Apply 20 mg of progesterone for 25 days of the calendar month and rest from day 26 to the end of the month.
  • Menstrual Migraine: Apply 20 mg of progesterone cream during the 10 days before your period (days 16 to 26). Apply a small amount every 3 to 4 hours when you sense the "aura" coming until the symptoms cease.
  • Increase Libido: progesterone and testosterone are both important factors in libido. Testosterone is much more potent. Natural progesterone is the preferred choice.
  • Hair Loss: When progesterone level drops due to ovarian follicle failure (lack of ovulation), the body responds by increasing the synthesis of androstenedione, an adrenocortical steroid. This has some androgenic properties, resulting in male pattern hair loss. Natural progesterone supplementation for 6 months may be helpful to reduce the androstenedione level, at which time normal hair growth will resume.
  • Hypothyroid: Thyroid hormones and estrogen have opposing actions. Progesterone also opposes estrogen. Symptoms of hypothyroidism occurring in patients with unopposed estrogen or estrogen dominance (progesterone deficiency) become less symptomatic when progesterone is replaced.

Estrogen Dominance Progesterone Cream and Men

Men too can benefit from estrogen dominance progesterone cream. Males also produce estrogen and estradiol (E2), but in much lower amounts than women. They also produce progesterone, but about half the amount than women do. This hormone is produced in the testes and in the adrenal glands. While the level of progesterone in males is significantly lower than in females, some womens' progesterone levels fall below that of men of the same age during menopause.

Progesterone cream and testosterone

The male hormone, testosterone, is an antagonist to estradiol (E2). Like progesterone, testosterone can stimulate new bone formation, increase bone density, and a lack of it causes osteoporosis. Testosterone is made from progesterone, so low levels of progesterone can affect testosterone levels. Under normal conditions, men normally continue to produce a relatively normal level of testosterone well into their seventies.

Physiological doses of progesterone can also enhance the sex drive. It may also help decrease male balding, which occurs because of a rise in testosterone.

Male Hormones and the Prostate

Contrary to common perception, testosterone does not cause prostate cancer. Studies have shown that men with the highest level of testosterone have the least prostate enlargement. Conversely, men with the highest level of estrogen often have enlarged prostates. Benign prostatic hyperplasia (BPH), a prostate enlargement condition, is a common condition affecting the majority of males above age 50. Progesterone cream can help to reduce prostate size. It also has an inhibitory effect on 5-alpha reductase, which is responsible for converting testosterone to di-hydrotestosterone (DHT), a chemical linked to prostate cancer. So, ensuring that you have adequate progesterone levels can actually help protect your prostate against cancer.

Estrogen is also a factor in prostate cancer risk. Declining testosterone from aging, together with increasing levels of estrogen, is the most likely reason for prostate enlargement and cancer in men. Since progesterone has an antagonistic effect on estrogen, using estrogen dominance progesterone cream could indirectly improve testosterone levels and reduce the effects of estrogen, lowering prostate cancer risk.

The Takeaway

Modern society has brought with it many external hormonal insults to our body. Such insults are often seen in symptoms associated with menopause, PMS and perimenopause. The common thread of these symptoms is often relative estrogen dominance rather than absolute estrogen deficiency as traditionally thought. Some strategies for correcting these issues include:

  1. Reduce your overall stress levels with yoga or meditation or remove sources of stress.
  2. Include more whole foods in your diet such as fruits, vegetables, whole grains, and lean proteins.
  3. Talk to your doctor about natural estrogen dominance progesterone cream.

If you have hormone imbalances and want help identifying effective solutions, then contact the team at +1-626-571-1234 or click here to use the Ask The Doctor System.

Dr. Lam's Key Questions

First-trimester miscarriage is usually due to low progesterone. This is associated with AFS.

If a woman's hormones are balanced, there should not be any symptoms like hot flashes.

Progesterone cream can be used to balance the estrogen load in the body. Depending on many conditions, such as adrenal health, weight issues, stress issues, etc. you may or may not need to use it.

It is best to consult your doctor first before starting progesterone cream. Sometimes you may have other health related issues such as AFS or Thyroid imbalance that may affect the ovarian hormones.

Some people with AFS feel great during pregnancy due to progesterone's calming effect, while others are not so fortunate. They tend to crash and become sluggish as the pregnancy progresses. If it is more severe, a first-trimester miscarriage that tends to be more prevalent. With those who are in advance stages of AFS before becoming pregnant.

© Copyright 2001-2021 Michael Lam, M.D. All Rights Reserved.
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