Topical Bio-similar Progesterone

Stephen Holt, MD

Many reports in the medical literature and lay press have concluded that conventional hormone replacement therapy [HRT] with estrogen and synthetic progesterone [progestins] combined, has often greater risks than benefits. Conventional HRT has been associated with an increased risk for breast and other types of cancer, blood clotting, and enhanced risk of cardiovascular disease, including stroke, pulmonary embolism, and thrombophlebitis. In an exclusive interview with Dr. John R. Lee, MD, [best selling author of the book “What Your Doctor May Not Tell You About Menopause”], published in the July/August 2000 issue of Natural Pharmacy, the late Dr. Lee revered the health benefits of natural progesterone applied to the skin for the support of premenstrual syndrome [PMS] and menopause.

Several authors have supported the assertions of Dr. Lee, that topical progesterone is well-absorbed and highly effective for the suppression of unpleasant symptoms of the menopause or PMS, but it does not carry the apparent risks of conventional HRT. The proposals of several protagonists of natural therapies have ignited intense interest in the use of topical progesterone creams for a variety of women’s complaints. Several progesterone creams exist in the market, in various dosages, formulations, and dispensation systems, with or without the addition of other natural substances, such as phyto-estrogens [soy or red clover isoflavones etc.]. While progesterone is readily absorbed through the skin, its absorption can be highly variable depending on many circumstances such as blood flow to the skin, room temperature, quality of formulation, etc.

It is clear that requirements for progesterone applications can vary depending on a woman’s hormonal status, and indications for usage in any circumstances of doubt, mature females should obtain the advice of a skilled healthcare giver before any attempts to self-medicate. That said, unique dispensation systems in convenient pumps that deliver predictable amounts of progesterone cream are to be preferred. There is no doubt that the application of progesterone cream involves some degree of trial and error to find an optimum required dosage, but new technology has resulted in the use of tiny, microbubbles of special fats in progesterone cream, to help deliver predictable amounts of progesterone. This technology is called liposome-delivery, and when used in a unit dispensing pump, it is the best and most convenient way of applying progesterone cream to the skin.

Natural progesterone creams are not drugs, and they are not simple cosmetics, but they should be used with self-education on hormonal needs. Topical progesterone should be used only by mature females, and it is not recommended for use in childhood or pregnancy. Over-dosing with progesterone or rapid transfer into the bloodstream of progesterone can cause troublesome side effects, such as dizziness, headache, and nausea. Therefore, progesterone applications should strictly follow label guidelines.

Dr. Lee and others have emphasized that natural progesterone is much more desirable than synthetic progesterone [progestins] and one cannot assume that al types of progesterone have the same biological effects. Indeed, there has been an increasing interest from doctors and healthcare consumers about the use of hormones that are more similar to naturally occurring hormones, and this is the concept of bio-similar hormones, which has been incorrectly called “bio-identical” hormones. I emphasize the importance of correct dosing of natural progesterone, with more predictable absorption and monitoring hormone applications by a healthcare professional in any cases of doubt.

Lee, J.R., What Your Doctor May Not Tell You About Menopause, Warner Books,
Lee, J.R., Natural Progesterone: The Multiple Roles of a Remarkable Hormone, BLL Publishing, 1993
Laux, M., Conrad, C., Natural Woman, Natural Menopause, New York HarperCollins 1997

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