The Hormone Puzzle – Progesterone

Progesterone

The Hormone Puzzle Series – Progesterone

As we mentioned in the last series on estrogen, many hormones are influenced by each other and need to be monitored. One of these hormones is progesterone, the complementary partner to estrogen.

Indeed, high estrogen without the opposing balance of natural progesterone is linked to elevated rates of breast cancer. [1] Whatever the cause, estrogen dominance will result in breast tenderness and the uterine cells multiplying faster. Ensuring that there is adequate progesterone levels stops uterine cells from multiplying, decreases the rate at which breast cells multiply, and eliminates breast tenderness. Synthetic progesterone will not protect you from breast cancer but natural forms (made from wild yam or soy) just may do that.[2]

How is Progesterone made?

Luteinizing hormone (LH) from the pituitary gland stimulates the ovaries to make progesterone. It is secreted in the ovaries, just like estrogen.  Whenever you hear the word ‘complementary partner’, you know that there is a need to balance these hormones.

Low progesterone can lead to hormonal irregularities, pre-menstrual syndrome (PMS), uterine fibroids, ovarian cysts, breast tenderness, breast cysts and cancer.[3]

What causes Estrogen-Progesterone Imbalance?

There are several causes. One study cites exposure to hormone-disrupting chemicals, as affecting ovary development during the embryo stage.[4] Other studies have shown that environmental chemicals like phthalates, PCBs, herbicides and hexachlorobenzyne can suppress the production of progesterone.[5], [6]

Low progesterone levels can occur as the result of prolonged stress and high levels of the adrenal hormone cortisol. Some other things to know about progesterone:

  • Progesterone competes with cortisol inside the cell.
  • If you raise progesterone levels (using a progesterone cream, or naturally), cortisol levels go down and stress symptoms decline. PMS and breast tenderness may also decline.
  • When insulin (another hormone) levels are persistently high, the ovaries may prevent progesterone from being secreted. Instead, testosterone will be produced.
  • Testosterone then converts to estrogen in the fat cells, in order to ‘help balance’ things.

What does Progesterone do in Different Areas of the Body?

                                                          Target Sites and Affects of Progesterone
Target Sites                                         Effects of Progesterone
Uterus Prepares uterus for implantationMaintains the development of the placenta

Protects against endometrial cancer

Breasts Responsible for breast enlargement or ‘maturation’ during pregnancyDevelops milk-secreting cells during pregnancy

Protects against fibrocystic breast disease

Helps protect against breast cancer, in most cases

Kidneys Acts as a natural diuretic
Brain Restores libidoActs as a natural tranquilizer
Adrenal Glands Helps to normalize blood sugar levelsActs as precursor to adrenal hormones
Bone Stimulates osteoblasts and may help to build bone
Thyroid Helps action of thyroid hormone and raises body temperature
Fat Cells Helps to use fat for energy
Rest of Body Normalizes zinc and copper levels; normalizes oxygen levels in the cellStimulates the pancreas to release insulin. Acts as a vasodilator.

Source: Kaur, S.D, N.D., (2003). The Complete Natural Medicine Guide to Breast CancerToronto, ON: Robert Rose, pp. 75.

Checking for Deficiency – The Most Accurate Way to Test Progesterone Levels

The Salivary Hormone Test is the most accurate way to test your progesterone levels. It is best done in the morning between days 19 and 22 of your monthly cycle when progesterone is usually highest. Count from the first day of your menstrual period.

What is the Ideal Dose?

Over a decade ago, John R. Lee, M.D., first published his conclusions about synthetic hormone replacement therapy: they don’t work and they pose a safety risk to women.[7] Dr. Lee suggests that the ideal amount of oral progesterone is 400-500 mg progesterone per ounce. This amount delivers about the same amount that the ovaries normally produce when dosages of ¼-1/2 teaspoon are taken daily (or for a portion of the menstrual cycle). More information is available from his website, http://www.johnleemd.com or his book, What Your Doctor May Not Tell you about Breast Cancer http://www.johnleemd.com/store/more_breastcancer.html or  http://www.amazon.com/What-Doctor-About-Breast-Cancer/dp/044652686X

Progesterone cream is not a curative – it only supplies you with progesterone while you are using it. If you choose to supplement by using a the cream form, you will need to monitor how your body responds to a particular dosage, as the amount needed will vary from woman to woman. To ensure that all three estrogens (estrone, estadiol, and estriol) stay in the ideal range, consider follow-up testing using a Saliva Hormone Panel Test. It is suggested you go for testing two months before starting progesterone supplementation and the every six months after that.

Read the label

Many ‘natural’ products now claim to contain progesterone but in fact only contain diogenin, a component of wild yam, which must be converted in the lab to natural progesterone. The body is not capable of making the conversion into progesterone.[8] According to ‘Healthy Breast’ expert Sat. Dharam Kaur, N.D., while high-quality progesterone is available in the United States, in Canada it is only available by prescription from a compounding pharmacist.

How Can You Naturally Stimulate Progesterone?

The supplement melatonin has some ability to do this. Some (not all studies) show that melatonin levels are higher during the latter half of the menstrual cycle (the luteal phase). The hormone T3also helps with the production of progesterone – something to think about if you too are faced with what seems to be a widespread epidemic of low (hypo) thyroid. Many scientists are postulating that this is caused by radiation and environmental chemical exposure. Iodine used to be added to bread in Canada. It has been since been replaced by bromine (‘new car smell’ chemical), and linked to low thyroid – we will cover more on this topic in another post.

Vitamins which may help increase progesterone include B6 and vitamin E. B6 has been shown to reduce blood levels of estrogen and to increase progesterone.[9]  Vitamin E works by enhancing absorption of progesterone. Helpful minerals include boron, zinc, and selenium. If you are a breast cancer patient with osteoporosis, know that by increasing levels of boron in the diet, blood levels of both estrogen and progesterone are raised. While this is good for bone density, doing this is contraindicated if you are dealing with estrogen-receptor positive breast cancer. Zinc, on the other hand, is good, however it will lower both progesterone and estrogen levels and you need to be aware of this. (85) In animal studies, it has been shown that selenium supplementation can increase progesterone. Keep in mind that natural selenium – i.e., that from eating one or two Brazil nuts daily – is better than taking supplemental selenium when you have cancer. One large Brazil nut contains approximately 200 mgs of selenium.

Certain herbs have been traditionally used to stimulate production and availability of progesterone but some work better than others. David Zava and his co-workers tested over 150 various herbs, food, and spices and found that none increased salivary progesterone in women. On the other hand, a few herbs were able to bind to progesterone in test tube studies. The strongest of these was bloodroot (Sanguinaria canadensis). The herb stoneseed has also been found to stimulate secretion.[10]Mistletoe, mandrake, and juniper were also found to inhibit both estrogen-positive and estrogen-negative cell lines.[11] Bloodroot and mistletoe have a long history of use in treating breast cancer, especially in Europe.

Using Progesterone as a Treatment for Breast Cancer

The jury is not out yet on this question. Some studies[12] are showing that progesterone increases quantities of a growth factor called VEGF that stimulates formation of a blood supply to breast cancer, thereby helping cancer cells to grow. The deciding factor is the amount of 5alpha-reductase in a woman’s breast cells. If there is a lot of it (and in cancer situations there is), then progesterone therapy is not a good idea. If there is not a lot of 5alpha-reductase present, progesterone may be protective in the absence of breast cancer. If you have a familial history of breast cancer, or if there is a suspected undetected tumour present, progesterone therapy should not be used.

Stay tuned for our next discussion on Prolactin.


[1] Kaur, S.D, N.D., (2003). The Complete Natural Medicine Guide to Breast CancerToronto, ON: Robert Rose, pp. 75.

[2] Berkvist, L., H.O. Adami, I Perrson, R Hoover, and C. Scharier. The risk of breast cancer after estrogen-progestin replacement. New England Journal of Medicine, 1989; 321:293-97.

[3] Lee, John R. What your Doctor, May Not Tell You About Menopause. New York, NY: Time Warner, Inc., 1996:323.

[4] Cowan, L.D., L. Gordis, J.A. Tonasisa, and G.S, Jones. Breast cancer incidence in women with a history of progesterone deficiency. American Journal of Epidemiology, 1981; 114:209-17.

[5] Boukard, M.S. et al. The toxicological effects of the herbicide 2,4-DCPA on progesterone levels and mortality in Wistar female rats. Meded Rijiksuniv Gebt Fak Landbouwkd Toegep Biol Wet, 2001; 66(2b):891-95.

[6] Foster, W.G., et al. Hexachlorabenzene (HCB) suppresses circulating progesterone concentrations during the luteal phase in the cynomologus monkey. J. Appl Toxicol, 1992; 12:13-17.

[7] For further reading see the official website of Dr. John R. Lee, http://www.johnleemd.com/. Although Dr. Lee passed away in 2003, his foundation continues to regularly update research on the topic of hormone-replacement therapies and other issues of relevance to women.

[8] Zava, D., Dullbaum, C., Blen,M. Estrogen and progestin bioactivity of foods, herbs, and spices. Biol Med, 1998; 217(3):339-78.

[9] Reichart, R., Comparing Vitex and vitamin B6 for PMS. Quarterly Review of Natural Medicine, 1998; 19-20.

[10] For discussion on Stoneroot, see: Reichart, R., Comparing Vitex and vitamin B6 for PMS. Quarterly Review of Natural Medicine, 1998; 19-20.

[11] For discussion on Mistletoe, see: Erichsen-Brown, C. Medicinal and other uses of North American plants: a historical survey with special references to Eastern Indian tribes. New York, NY: Dover Publications, Inc., 1995.

[12] Hyder. S.M., C. Chiapetta, G.M. Stancel. Pharmacological and endogenous progestins induce vascular endothelial growth factor expression in human breast cancer cells. Int J Cancer, 2001 May15; vol. 92(4):469-73.

Other studies showed that breast cancer patients who were given progesterone had an improved disease-free survival rate (See: Jato, I. Neoadjuvant progesterone therapy for primary breast cancer: rationale for clinical trial. Clinical Therapies, 1997; 19(1): 55-61, discussion 2-3). Progesterone had no effect on breast cancer cells that lacked the receptors for it (See: Fromby, B., T.S., Wiley. Bcl-2, surviving, and variant CD44 v7-v10 are downregulated and p53 is upregulated in breast cancer cells by progesterone: inhibition of cell growth and induction of apoptosis. Mol Cell Biochem, 1999 Dec; 202 (1-2) 53-61) however in lab settings where the cells were progesterone-receptor positive, a 1999 study showed that progesterone caused a 90% inhibition of breast cancer cell growth.