'Natural' Progesterone - why this is not the answer

In 1966 Dr Robert Wilson, a New York gynaecologist, wrote a book called Feminine Forever extolling the virtues of oestrogen replacement for women at the menopause. By taking it for the rest of our lives, he declared, we could partake forever of the ‘fountain of youth’ as he described it. Dr Wilson, a charming man, whom I once met, was certainly sincere enough in his desire to help women who experienced difficulties at the menopause. But it was his theories, expounded in this best-selling book, that created the concept of the menopause as a deficiency disease, an illness which could have dire consequences if left untreated. “Women will be emancipated only when the shackles of hormonal deprivation are loosened,” burbled the foreword written by another eminent doctor. The message was that we ignored the prospect of oestrogen replacement at our peril. It had a huge impact on popular health thinking at the time. Dr Wilson got quite carried away by it all, claiming there was ample evidence that the whole course of history has been changed not only by the presence of oestrogen but by its absence. Unstable oestrogen-starved women, he postulated, were a misery to themselves and everyone else, causing, at the extreme, alcoholism, drug addiction, divorce and broken homes. As you can imagine this changed the thinking of many women and doctors for decades. Oestrogen replacement became part of mainstream medicine, the great saviour. Then disaster struck.
Twenty years on doctors found that cases of endometrial cancer had risen greatly (to between four and eight times higher than those in non-hormone users) among the early generation of oestrogen takers. Progestogens were then added to help balance out the side effects of the oestrogen so that ‘oestrogen replacement therapy’ became ‘hormone replacement therapy’ and most women were required to take both the hormones. Everyone became a little more cautious about hailing oestrogen as the best thing since sliced bread.
All this happened decades ago. But we are now today seeing a similar pattern developing over another hormone, progesterone – or natural progesterone as its growing number of fans prefer to describe it. Enter the new hyped-up wonder hormone, now hailed as the real and ‘natural’ hormone replacement. Is history merely repeating itself? Are we now going through another phase where everyone is jumping on the bandwagon by promoting progesterone as safe and effective before the true picture has been established?
According to its supporters progesterone can help bone density and ‘cure’ an amazing selection of menopausal symptoms. Here is a list of some of them:
• anxiety • black circles under the eyes • blurred vision • breast pain and problems • cold hands and feet • constipation • cyclic acne • depression • disturbances in appetite • dry skin • exhaustion • fibroids • infertility • insomnia • irritability • lack of sex drive • lethargy • low blood sugar • migraines • mood swings • muscle and joint pains • panic attacks • poor concentration • poor digestion • sciatica • spontaneous abortion • spontaneous bruising • stiffness • thinning hair • water retention.
Similar claims, of course, were made when oestrogen was first introduced. It was only twenty years later that questions arose about the possible side effects. The whole history of health and medicine demonstrates the wisdom of skepticism about any ‘wonder’ substance that hits the headlines. I am suspicious about anything that is claimed to cure such a wide range of symptoms. And what is so ‘natural’ about the idea of women taking progesterone? Production of both oestrogen and progesterone decline at the menopause. And while we go on making some oestrogen all our lives the production of progesterone will stop completely. So are we seriously suggesting that nature has got this all wrong? At a time in our lives when both hormones are dropping and progesterone can be absent, why then should we be adding it back in? Progesterone is needed to maintain a pregnancy, so we can understand why the body doesn’t need it at the menopause. Why replace it?
What, actually, could be more unnatural than doctoring ourselves with progesterone, when Mother Nature has arranged for its removal from the body in the normal course of events? The thinking behind the growing popularity of progesterone therapy is as follows. As inhabitants of an industrialised world we are being constantly bombarded by xenoestrogens – substances which have an oestrogenic effect on the body. These xenoestrogens are nearly all petrochemically based and can come from packaging, plastics, foods and pesticides. They have been found in formula baby milk, presumed to have originated from the packaging used to contain the milk. They are believed to have a devastating effect on fertility, reproduction and health for both humans and wildlife. A number of disturbing developments are increasingly blamed on these chemicals. In the West it is reckoned that men’s sperm count may have dropped by 50 per cent in the last ten years. Other studies have linked these chemicals to the increase in breast and testicular cancers and to endometriosis, a painful uterine disorder. This major environmental factor lies behind the theory of oestrogen dominance.
The suggestion is that many of us are suffering from oestrogen dominance because of the increased amount of xenoestrogens we encounter daily. So, the argument goes, the answer is to balance all this unwanted oestrogen with progesterone – natural progesterone. I believe that our lifestyles and our environment have a profound effect on our hormones. That is why we must take a lot of care over our nutrition, which has such an impact on the body’s biochemical processes. I don’t however believe that the answer is to introduce ever more hormones into our bodies. And the question we should ask is, just how ‘natural’ is progesterone anyway?