Monthly Archives: September 2013
So, Doctor, I get the Science. But what does Progesterone Deficiency have to do with ME? Will I Benefit from using it?
When I think about progesterone, I think of it as the calming hormone. Anxiety during perimenopause is a very common problem. As I have stated before, I was guilty of prescribing antidepressants for the 35-45-year-old woman coming in complaining of anxiety or depressive symptoms. You know, I always got the question, “Why me? My life is just fine. I have nothing to be anxious about.” My typical answers were, “We don’t know,” or, “It just happens.” Good scientific explanations, right? I now think completely differently Continue reading
Everyone knows about estrogen. I don’t think I have ever seen a woman in my office having hormonal symptoms who didn’t ask about estrogen. I hardly ever have someone come in and ask about progesterone. In the world of hormones, a very important concept is hormonal balance. Insulin secretion keeps blood sugar controlled and prevents it from going too high. What about low blood sugar? If there were not hormones to balance insulin, we would all be bottoming out our blood sugar after a meal when our insulin went to drive the blood sugar into cells. The hormones that assist in keeping us from hypoglycemia or low blood sugar include cortisol, glucagon and the catecholamines.
Hormones stimulate things. Insulin stimulates glucose or blood sugar transported out of the blood and into cells. Unopposed insulin therefore would create a state of low blood sugar if we did not have something to balance the blood sugar as above. In a like manner, estrogen stimulates growth of cells. If cells continue to grow unopposed, what is the eventual outcome? Continue reading
So, in general, there are two main reasons that women may consider hormone replacement therapy. The first is for symptom relief and the second is a much broader reason to include protection of cognition, bone health, heart health and its beneficial effect on insulin.
With respect to symptom relief, one can also go a couple of different routes. The first is obviously replacing the hormones that are low or missing. One of the keys here is that in order to do this, we need to actually measure the different hormones.
Progesterone is a wonderful hormone. Most of the symptoms starting in perimenopause are due to Continue reading
I, as well as many other physicians, remember in 2002 when the Women’s Health Initiative trial came to an abrupt end because of the increased risk of invasive breast cancer. The telephones at physicians’ offices started ringing and patients all over the country stopped taking their hormone replacement therapy. This was several years before I knew anything about bio-identical hormone replacement therapy. Estrogen was named as the culprit at the time. However, after review of the data, it became clear that synthetic progestins were the primary cause of the increased risk of breast cancer. This is not to say that synthetic progestins are the only cause; however, Continue reading