Questions and Answers about
Premenstrual Syndrome and Estrogen Dominance
Frequently Asked Questions
and Answers About Progesterone and Estrogen Dominance and Associated Migraine Headaches
by Elizabeth Smith, M.D.
I stopped my estrogen and started my progesterone. Now, I have hot flashes.
Suddenly stopping your estrogen,"Cold Turkey", will result in hot flashes one month later as the estrogen washes out of your body. Instead cut your dose to 1/2 of your normal dose and slowly taper off your estrogen over a period of 3-6 months. If you don't want to take the prescription estrogen, you can take estriol 0.3 mg/day to 0.625 mg/day or Maca 4 capsules/day three weeks out of four. Estriol is a natural estrogen that is a weak estrogen. Estriol will block the effects of the more potent Estradiol. You can discontinue the estriol slowly decreasing it over a period of 3-6 months. For more about hot flashes see page 121 of What Your Doctor May Not Tell You About Menopause.
I've been taking Progesterone for several
months now. My uterine fibroma (myoma) is still there. Why?
The most common reason is that xenoestrogens (using plastic wrap in the microwave oven) are not avoided. Women still drink coffee and still use plastic in their microwave oven. Occasionally, we see patients who have avoided the xenoestrogens faithfully. There are two possibilities. One, the xenoestrogen may still be stored in the body fat. In this case, exercise and sauna can help get the pollutants out of the body fat. A physician who does biodetoxification may be found at www.aaem.com. Secondly, the patient may be one of the few 5-10% of patients who do not absorb progesterone well through the skin. In this case, prescription oral progesterone may be used 200-400 mg/day or Maca 4 capsules per day. Also the progesterone cream that she has used may be improperly formulated with some estrogens. See Failures.
Isn't estrogen good for the heart? Shouldn't
I be taking estrogen for my heart?
In a nutshell, physicians were misled into believing that estrogen was good for the heart. The primary article cited is a 1991 New England Journal of Medicine report known as the Nurses' Questionnaire Study. Out of 121,700 female nurses 48,470 were included in the study. Essentially, sick nurses with diabetes (29.6% more), nurse smokers (29.5% more), and heavy nurses (53.1% more- body fat) were put in the control group NOT taking estrogen replacements. The healthy nurses were the ones taking estrogen replacements. In other words, the healthy nurses took the estrogen and the unhealthy nurses did NOT take estrogen. This led to the FALSE conclusion that estrogen is good for the heart. For a more detailed discussion see page 188 of What Your Doctor May Not Tell You About Menopause.
The highly regarded Framingham study showed no benefit for the heart with estrogen use. Other studies have found increased heart risk from estrogen use. The federally funded HERS study showed no benefit of estrogen on the heart. See the news release.
Does the estrogen that my physician prescribes increase my chance for breast cancer?
Yes. The question is by how much. A 1995 New England Journal of Medicine(1) article used the group of Nurses in the Nurses' Health Questionnaire's study. They found that women using estrogen for 5 years or more had increased risk of breast cancer of 41%. For women using estrogen for 5 years or more and 60 to 64 years old the increase was a whopping 71%. The breast cancer death rate increased 45% for women taking estrogen replacement 5 years or more. Read the abstract here.
1. New England Journal of Medicine 1995 Jun 15;332(24):1589-93.
The National Institute of Health, Nov. 29, 2002 confirmed that prescription synthetic estrogen and prgoestin increases breast cancer by 1.53 times. However, the breast cancer rate returns to normal after stopping for 6 months. Read the article here.
What is the latest buzz about xenoestrogens?
February 22, 2002, current research methods are too crude to measure the risk of xenoestrogen exposure that should include synergistic effects and storage of xenoestrogens in the fat. Read the abstract here.
If natural progesterone is so wonderful, why isn't it used by my doctor ?
This is the question most frequently asked of Dr. Lee during his more than 30 years of active clinical practice.
To quote from Dr. Lee: "The medical-industrial complex refers to the close knit association of organized medicine with the pharmaceutical manufacturers and governmental medical regulatory agencies....The system taken together is neither necessarily corrupt nor evil, but, like any human agency, is subject to the frailties and faults of humankind. Medical research is dependent on the $billions of grants from the National Institutes of Health (NIH) and the private pharmaceutical industry. The two are closely interlocked... Any given pharmaceutical company, like any private enterprise, must make a profit to stay alive. Profit comes from the sales of patent medicines. The system is not interested in natural (non-patentable) medicines, regardless of their potential health benefits. Thus the flow of research funding does not extend to products which cannot be patented. Few people know that the definition of malpractice hinges on whether or not the practice is common among one's medical peers and has little (usually nothing) to do with whether the practice is beneficial or not. A doctor willing to study, to learn the ins and outs of an alternative medical therapy, and to put what he has learned into practice in helping patients is potentially exposing himself to serious charges of malpractice..... But what does all of this have to do with Natural Progesterone? The answer is quite simple, really. Ample medical research regarding progesterone was carried on in the 1940's through the 1960's, and amply reported in mainline, recognized medical literature. Since the early 1970's, however, medical research has become much more expensive and the grants subsidizing progesterone research, (or any unpatentable medicine or treatment technique), have dried up and been blown away by the contemporary trade winds of synthetic drugs, particularly the progestins. The potential market for patentable progestins is vast -- contraceptive pills, irregular menses, osteoporosis, .... -- literally every woman through the age of puberty on is a target for a sale. Do you think the prevailing powers wish to see this lucrative market left to an over-the-counter natural product not in the hands of physician prescribers and not controlled by the pharmaceutical industry? Thus, when he or she (the physician) hears of the use of Natural Progesterone, they wonder why none of their associates know about it. If it is not commonly known, 'it must in some way be false and/or unapproved.' Having given lectures on the role and medical uses of Natural Progesterone, I have observed numerous instances wherein perfectly fine physicians will enquire about obtaining the product for use by their wives or mother-in-law but not for their patients. What can account for such behaviour by professionals? I suspect that it is fear of alienation from the flock that is paramount in their minds.... If progestins were the equivalent of Natural Progesterone in effect and safety, the argument would be moot. But progestins are not the equivalent of Natural Progesterone and never will be....... Patients are aware that they cannot leave their health care solely in the hands of the doctor. They must assume responsibility for their own health...." Dr. John R. Lee, California, USA.
Why do African Americans have a higher early puberty rate (50%) than whites (15%)?
African Americans favored shampoos with clinically active high doses of estrogen. They also used them on their children. In 1998 Tiwary, now retired, published a study of four girls - including a 14-month-old - who developed breasts or pubic hair months after beginning to use such products. The symptoms started to disappear when they stopped using them. The year before, he published a study showing that some of the products used by his patients contained up to one milligram (1 mg/oz) of estradiol per one ounce of shampoo. By comparison a normal adult topical skin dose for estradiol is 0.02-0.05 mg/day. This means that one ounce of shampoo contains 50 times the daily ADULT dose of estradiol. A small handful of this shampoo on your child every day may give her OR HIM breasts! See the article here.
Is there any evidence linking ovarian cancer to HRT?
A study shows a modest increased risk of ovarian cancer among women who use some forms of hormone replacement therapy. See the article here.