COMMENT:ESTROGEN OVERKILL

There is a common misconception that at menopause, a woman no longer makes female hormones, that she has a deficiency disease, requiring estrogen replacement. The truth is that she merely makes less estrogen than is necessary for the monthly preparat

Progesterone levels, on the other hand, do fall to zero, or very close to it, with menopause or even for some time before menopause. Blood levels of progesterone in menopausal women are lower than that of a man’s.

A peculiarity of industrialized societies is the prevalence of uterine fibroids, breast and/or uterine cancer, fibrocystic breasts, premenstrual syndrome, and premenopausal bone loss as well as a high incidence of postmenopausal osteoporosis. If estrogen loss is the major hormonal factor in female osteoporosis, for example, why should significant bone loss occur during the 10-15 years before menopause? It is a fact that, in the US, peak bone mass in women occurs in the mid-30s and that a good percentage of women arrive at menopause with osteoporosis well underway.

The common thread running through all these conditions is estrogen dominance as well as a relative insufficiency of progesterone. How can this happen in menstruating women? It happens when a woman has cycles in which she doesn’t ovulate, called anovulatory cycles. Progesterone is produced by the corpus luteum, itself formed at the time of ovulation. If she doesn’t ovulate, she doesn’t produce enough progesterone.

Low premenopausal progesterone, as a consequence of anovulatory cycles, can induce increased estrogen levels and lead to symptomatically significant estrogen dominance prior to menopause. The most common age for breast or uterine cancer is five years before menopause.

If estrogen levels do not fall to zero at menopause, why do some women suffer from vaginal dryness, uterine fibroids, an increased risk of breast and uterine cancer, hot flushes, and dry, wrinkly skin when menopause occurs? One of the paradoxes in female hormone physiology is that the presence of progesterone makes body target tissues more sensitive to estrogen, and vice versa. Each sets the stage for the body to be more responsive to the other.

Phenolic compounds with estrogen like activity are common among petrochemicals which are pervasively polluting our environment. Some of these are extremely potent estrogenic compounds (called xenoestrogens), even at miniscule doses. Known xenoestrogens include pesticides such as DDT and kepone; and a combustion by-product, 3,9-D-dihydroxybenz [a] anthracene, present in the exhaust fumes of automobiles. This unrecognized exposure to estrogenic compounds, in addition to the estrogens added to our dairy and meat products and making their way into our water supply, could be a significant cause of breast cancer and the recently identified decline in male sperm production. These benzene compounds also have a role in creating estrogen dominance and lowering progesterone levels.

Just as with phytoestrogens, many (over 5000 known) plants make progesterone like substances. In cultures whose diets are rich in fresh vegetables of all sorts, progesterone deficiency does not exist. Not only do the women of these cultures have healthy ovaries with follicles producing sufficient progesterone, but, at menopause, their diets provide sufficient progestogenic substances to keep their libido high, their bones strong, and their passage through menopause uneventful and symptom free.

Our food supply system uses many processed foods and foods that are picked days before being sold. Their vitamin (especially vitamin C) content falls and their progesterone levels fall. We do not receive the progestogenic substances our forebears did. A recent Lancet report of bone mineral density results of bones buried almost 300 years ago in England showed better bones at all ages compared to our skeletons of today. It is likely that both exercise and diet had something to do with that.

Worldwide, however, the most common source of natural progesterone is the wild yam, grown for the purpose. Yam produces the sterol, diosgenin, which is quite easily converted to natural progesterone. Diets high in yam consumption (eg, as by the Trobriand islanders) provide sufficient progesterone to prevent the sort of pre and post-menopausal problems doctors see every day in their surgeries.

In western industrialized cultures, pharmaceutical companies buy natural progesterone (derived from yams) and then chemically alter its molecular form to produce the various progestins, which, being not found in nature, are patentable and therefore more profitable.

Most physicians are unaware that their prescription progestogens are made from progesterone (from yams), and that natural progesterone, through food or when indicated with food supplements, is available, safer than progestins, more effective and relatively inexpensive.

Dr John Lee is performing clinical work in supplementation with natural progesterone. Extracted with permission from Natural Progesterone: The Multiple Roles of a Remarkable Hormone (BLL Publishing) available for £12 including p&p from Higher Nature, Burwash Common, East Sussex, TN19 7LX.

!AJohn Lee