Thank you for your interest in Natural Hormone Replacement for women. We use estriol, natural progesterone and other natural medicines to help women balance their hormones as safely as possible. I trust you will find this information very valuable and useful.
Over the last 20 plus years, I have helped hundreds of women with PMS, menopausal related issues and conditions like anemia, fatigue, low thyroid, arthritis/muscle and joint pain, candidiasis (yeast infections), allergies, headaches/migraines, digestive problems, skin problems and osteoporosis care and prevention. Balancing the female hormones naturally can make a tremendous difference in the quality of life for women. I know this from the many testimonials and positive feedback I get from women that I have helped over the years. Knowledge is power and in the health field this is of particular importance. It brings me great joy to share this information with you. I can help you simplify this complicated area of hormonal health care, naturally.
The term estrogen is really a plural term. The body makes 3 types or forms of estrogen: estradiol, estrone and estriol .
Estradiol and estrone have been linked to cancer production, blood clots and other degenerative diseases in women.
Apparently, as far as I know, estriol has not been linked to the health problems that are associated with estradiol and estrone. Estriol seems to be the safest of the estrogens. However, it is not known at this time if it is totally without risk or side effects, to the best of my knowledge.
Estriol is contraindicated for anyone that should not use estrogen. If your doctor or other health care provider says you should not take estrogen or if you have had estrogen sensitive cancer then do not take estriol. Women with estrogen receptor-positive breast cancer should not use any form of estrogen.
Although there is some evidence that estriol may be protective or helpful to the body in certain instances. NO claims or guarantees are made explicitly or implied that estriol, and/or any other substance or treatment can protect a person from getting any disease.
In treating women who have a true estrogen deficiency, Dr. Sklovsky will try his best to correct this deficiency by the safest ways known to him. In general, this means using botanicals/herbs, nutrients and hormones where indicated to help correct this deficiency and/or to correct other deficiencies as well. Treatment may be different for each patient based on diagnosis and patient needs.
Please note that Dr. Sklovsky does not do comprehensive physicals, pelvic or rectal examinations. Physical examinations and laboratory services are limited to the conditions the doctor routinely treats. (The doctor does not check or screen for cancer.)
The purpose of running lab work and urinalysis is to assist me in evaluating and monitoring the conditions for which I am treating you. It does not take the place of gynecological, screening and/or comprehensive examination and evaluation, in any way for any medical condition.
You should continue to have regular check-ups and continue to follow the instructions of your other health care provider(s) for any health condition.
There is more than one way to treat estrogen deficiencies. The allopathic medical profession (M.D., D.O.) uses synthetic estrogens, some of which come from horses urine. They may use combinations of estradiol and estrone by themselves or in combination with synthetic progesterone (progestins). All of these have been proven to cause cancer and many other adverse effects.
No guarantees or claims have been made either explicitly or implied that estriol, progesterone and/or any substance or treatment can prevent or cure any disease or that estriol is totally without risk.
SOME REASONS FOR EXCESS ESTROGEN
We can get too much estrogen in relation to progesterone even without any estrogen prescription supplementation. Here are some major reasons for high levels of estrogen, (1,2,3):
Refined food intake
Lack of exercise
Xeno estrogens � estrogen like compounds that we get from the outside world that act like synthetic estrogens in the body.
a) Petroleum derivatives (partial listing)
2. pesticides, herbicides, P.C.B.�s DDT
3. foaming agents in soaps and detergents
4. other manufactured goods
5. fat soluble hormones in meats
7. plastic cookware
8. condoms, spermacides
Estriol and progesterone are easily metabolized by the body. Xeno estrogens are not so easily metabolized by the body, are stored mostly in the fatty tissue in the body, and can cause estrogens in women to be maintained at double their normal values, sometimes for a woman�s entire adult life. If you couple this with the fact that at menopause estrogen output drops about 40%, and progesterone levels drop to less that 5%, very often there is too much estrogen in relation to progesterone levels.
There is another physiological drain on progesterone in the body and that is stress. Stress depletes adrenal hormones. When the body is under stress, progesterone is converted by the body into adrenal hormones such as hydrocortisone and cortisol. This depletion of progesterone from the adrenal gland furthers the imbalance in the body in favor of estrogen, hence too much estrogen in relation to progesterone. (3.)
Furthermore, when people drink caffeinated beverages this puts further stress on the adrenals to pump out more and more adrenal hormones, adding insult to injury and hence the "vicious cycle" of adrenal exhaustion is perpetuated.
It is interesting to note that to the best of my knowledge, scientific studies have not proved that estrogen deficiency can cause cancer, but research studies have proved that progesterone deficiency can cause cancer. "A John�s Hopkins study of 1000 women showed that progesterone deficient women had a tenfold increased chance of dying from cancer compared with women who have normal levels of progesterone." 4.
Hormone Deception by D. Lindsey Berkson, Contemporary Books, 2000.
Our Stolen Future by Theo Colburn, Penguin Books, 1999.
What Your Doctor May Not Tell You About Menopause, John Lee M.D., Warner Books, 1996, p68.
Cowan, L.D. M.D. "Brest Cancer Incidence in Women with a History or Progesterone Deficiency", Journal of Epidemiology 1981;114p209.
SOME OF THE POSSIBLE SIDE EFFECTS OF HORMONE REPLACEMENT THERAPY (OTHER THAN ESTRIOL):
increased risk of ovarian cancer
increased risk of breast cancer
increased risk of endometrial cancer
increased rate of heart attack/cardio vascular diseases
fluid retention, bloating
high blood pressure
hair loss or gain
REFERENCES: (Partial Listings)
New England Journal of Medicine, 19 June 97, 336:1821.
Archives of Internal Medicine, Oct. 23, 2000; 150:2897-2900.
Journal of the American Medical Association, July 26, 2000; 485-491, 534-535.
Journal of the American Medical Association, July 17, 2002; 288: 321-333.
Journal of the American Medical Association, July 17, 2002; 288:334-341, 368-369.
National Cancer Institute, Feb. 15, 2000; 92.
Obstetrics and Gynecology, 1992, 80:30.
New England Journal of Medicine, 1991, Vol. 325, pg. 756.
Hormone Replacement Therapy (HRT) is a commonly used term which generally means estradiol and estrone (not estriol), their synthetic derivatives and synthetic progesterone derivatives (commonly called Progestins).
Synthetic Progesterone derivatives (Progestins) are any progesterone derivatives that are not progesterone (Natural Progesterone).
REDUCING CANCER RISK WITH ESTRIOL
"Fortunately, there is a way to take estrogen that does not appear to increase the risk of cancer. In fact, this "alternative" method of estrogen replacement therapy could actually prevent cancer. Sadly, most physicians are unaware that there is another way to administer estrogen that is apparently as effective as, and probably safer than the standard approach."
"When doctors talk about estrogen, they usually forget the estrogen is not a single substance. On the contrary, estrogen exists in the body in a least three forms. The first two forms, estrone (abbreviated E1) and estradiol (abbreviated E2) are relatively potent estrogens, in terms of their ability to relieve hot flashes and other menopausal symptoms. Unfortunately, E1 and E2 also appear to be the forms of estrogen that promote cancer. The estrogen preparations usually prescribed for women contain E1 and/or E2 or other related compounds that are converted in the body into E1 or E2. However, a third form of estrogen, known as estriol, also occurs naturally in the body. And, in contrast to the cancer-promoting effects of the other two estrogenic compounds, estriol has actually been shown to have anticancer activity."
"Estriol is considered a weak estrogen because more estriol is required, compared to standard estrogen medications, to relieve menopausal symptoms. However, if an appropriate dose of estriol is given, these symptoms often do improve. A dose of 2 to 4 mg of estriol is considered equivalent to, and as effective as, 0.6 to 1.25 mg of conjugated estrogens or estrone." 3
3. Follingstad, A.H. 1978. Estriol, the forgotten estrogen? Journal of the American Medical Association 239:29-30.
PREVENTING AND REVERSING OSTEOPOROSIS, Alan R. Gaby, M.D., Prima Publishing, 1997, 131-132.
AN ESTRIOL MYTH AND MISCONCEPTION EXPLAINED:
"Myth #4: Estriol is a weak and unimportant estrogen."
"Estriol has been largely overlooked by most American physicians and pharmaceutical researchers, who have long considered it to be an inactive, or at best, a weak and unimportant metabolite of estrone and estradiol. Why go through all the trouble of putting it into a pill if you don�t really need it?"
"This reasoning is completely wrong! As one researcher pointed out in a review of six decades of estriol research, "It would be unusual if nature produced three estrogens of which only one was utilized." Estriol is needed, and here�s why."
"It now appears that the primary cancer danger from synthetic HRT does not come from "unopposed" estrogen but from "unopposed" estradiol, estrone, and equilin. (Note: Equilin is horse estrogen). A number of scientific studies, published over four decades, have demonstrated that estriol�s unique, and perhaps most important role may be to oppose the growth of cancer, including cancer promoted by estradiol and estrone, themselves. Consider these facts:
The results of animal studies have suggested that when natural estradiol and estrone are "opposed" with estriol in normal (physiologic) proportions, the risk of cancer due to hormone replacement virtually vanishes.
When taken by itself, even in relatively high doses, estriol does not increase endometrial proliferation."
"The European medical community has been more open-minded about estriol. Doctors in Europe have accepted and prescribed it as a safe and effective alternative to 100% estradiol or Premarin for years. They have found it especially helpful for women with disabling postmenopausal symptoms, such as vaginal thinning, painful sexual intercourse, recurrent urinary tract infections, and urinary incontinence."
"In the United States and Canada, "estrogen" replacement has usually been accomplished with Premarin, with other patentable "estrogens," or with estradiol, a "natural estrogen. Unfortunately, estradiol has also been used alone. In our bodies, estradiol is always accompanied by estrone and estriol. Even more unfortunately, estradiol is suspected of being the most pro-carcinogenic of the three! Estriol is thought by many to be anti-carcinogenic (which may partly be the reason there�s normally more estriol in our bodies than estradiol and estrone combined). Perhaps for this reason, many European studies on estrogen replacement have used estriol alone."
"The molecular structure of replacement natural estriol is exactly the same as that of the estriol the body produces itself. The body cannot tell them apart. As a result, natural hormone replacement using natural estriol has been found to be as effective as of better than horse "estrogens" and other patentable treatments at reducing the symptoms of estrogen deficiency. Estriol stimulates the same estrogenic receptors as the others, but its effects are much more brief."
"Moreover, estriol produces virtually none of the common unwanted side effects of the patentable "hormones."
"Clinical studies, mostly from Europe, have shown that women who use estriol replacement experience a reduction in symptoms, like hot flashes and thinning of vaginal tissue (vaginal atrophy). Exactly how estriol (and other forms of estrogen) relieves hot flashes is still unclear. Estriol appears to prevent or reverse vaginal atrophy by increasing the number of cells in the vaginal tissue, and by improving the elasticity and lubrication of this tissue."
"In one major trial, 22 practicing gynecologists from 11 large hospitals in Germany treated 911 perimenopausal women with estriol and evaluated them regularly for five years. Estriol was found to be "very effective" against common menopausal symptoms and "well-tolerated" with "no significant side effects."
"A Swedish study evaluated estriol treatment for up to 10 years in 40 postmenopausal women with urinary incontinence (leaky bladders) . Significant improvement was seen in 30 (75%) of the women, including eight whose ability to regulate urination completely returned to normal."
"In the same study, symptoms of atrophic vaginitis (vaginal dryness, painful intercourse) disappeared in 79% of the women after four months of estriol treatment. After 12 months, 98% were symptom-free."
BUILT-IN CANCER PROTECTION
"Estriol actually may antagonize the proliferative activities of other estrogens, probably because it competes for and benignly occupies estrogen receptor sites that would otherwise be occupied by the other more proliferation-oriented estrogens. (1). Thus, it appears the Nature may use estriol to partially block these powerful hormones before they can do harm."
"On balance, the evidence arising from modern scientific research favors estriol as a noncarcinogenic, anti-carcinogenic, or at worst, lowest risk estrogenic substance. When modern science isn�t crystal clear, it�s always safest to mimic Nature as closely as possible."
Hisaw, FI, Velardo JT, Golsby CM. Interactions of estrogens on uterine growth. J. Clin Endocr. 1954;14:1134-1143
NATURAL HORMONE REPLACEMENT FOR WOMEN OVER 45, JONATHAN V. WRIGHT, M.D. & JOHN MORGENTHALER, SMART PUBLICATIONS, 1997, 26-27, 56-57, 89, & 95.
SOME OF NATURAL PROGESTERONE�S MANY ROLES
Precursor of other sex hormones (estrogen and testosterone) and cortisone
Maintains lining of uterus
Promotes the survival of the embryo and fetus throughout gestation
Protects against fibrocystic breasts
Promotes fat burning for energy (thermogenesis)
Acts as a natural antidepressant
Aids thyroid hormone action
Normalizes blood clotting
May help maintain sex drive
Helps keep blood sugar levels normal
Normalizes zinc and copper levels
Promotes proper cell oxygen levels
Protects against endometrial cancer
Helps protect against breast cancer
Promotes bone building and protects against osteoporosis
"Natural Hormone Replacement for Women Over 45"
By Jonathan V. Wright M.D.
Smart Publications, Calif: 1097, Page 67
PROGESTERONE TREATMENT OF OSTEOPOROSIS
The Lee Study
"In 1981, John R. Lee, M.D., from Sebastopol California, became interest in the potential value of natural progesterone. He began what is not a landmark study of progesterone in the treatment of osteoporosis. (7) One hundred postmenopausal women, ages 38 to 83 (average, 65.2), applied a cream containing 3% progesterone to their skin instead of taking the usual medroxyprogesterone acetate (Provera) by mouth. Most of women had already become shorter as a result of one or more spontaneous vertebral fractures. Conjugated estrogens such as Premanin (.03 to 0.625 mg/day; three weeks per month) were given when appropriate. However, more than one-third of the women did not receive estrogen because they had medical conditions that rendered estrogen therapy too dangerous."
"In this group of one hundred patients treated with progesterone for at lease three years, aches and pains in the muscles and bones disappeared, height loss was stabilized, and no further osteoporotic fractures occurred. These results by themselves were encouraging, but the most dramatic effect of progesterone therapy was on bone mineral density. In 63 of the 100 women in the study, bone density of the lumbar spine was measured by dual photon absorptiometry every three to six months (the other thirty-seven women could not afford the cost of the test, which is usually not covered by medical insurance). The natural history of osteoporosis would have predicted an average bone loss of 4.5% among lee�s patients. However, of the sixty-three women in whom bone density was assessed, not a single one lost bone mass. In fact, the opposite was true: Every one of the sixty-three women treated with progesterone had an increase in bone mass. Furthermore, in many cases this increase was substantial, far greater than what has been achieved with other osteoporosis therapies."
"Dr Lee frequently observed a 10% increase in bone mineral density after the first 60 to 12 months of therapy. Some patients even had a 20 to 25% increase during the first year. After the first twelve months of treatment, bone density continued to increase by about 3 to 5% per year until it stabilized at the levels seen in healthy thirty-five-year-old women. In the group as a whole, average bone density increased by 15.4%. The beneficial effects of progesterone were not affected by age; seventy-year-old women often had the same increase in bone density, as did younger women. The probability of improvement was most closely related to initial lumbar bone density. Women with the lowest initial bone densities had the greatest increases, whereas those with initially dense bones did not show as much improvement. It is encouraging that the best results occurred in women who needed them the most, and that progesterone can apparently help any woman, not matter how far her bones have deteriorated."
Side Effects Almost Nonexistent
"Many of the women receiving progesterone therapy commented that their mobility and energy level improved and that their low sex drive returned to normal. Side effects were almost nonexistent."
Effects on Fractures
"As mentioned, not one of the one hundred women in the study suffered a new osteoporotic fracture. Since most of the women had already had one or more spontaneous vertebral crush fractures and many were becoming progressively shorter, it is remarkable that no further fractures of height loss occurred. Additional evidence of the effectiveness of progesterone was seen in three women who did suffer fractures, not because of osteoporosis, but as a result of trauma. One eighty-year-old woman fractured her knee in an automobile accident; another (in her seventies) fell while hiking and broke her arm; a third woman broke her arm after falling down the stairs. All three of these fractures healed well and the treating orthopedists commented on the excellent bone structure of these women."
Impact of Estrogen
"Another noteworthy finding in Lee�s study was that estrogen did not enhance the bone-building effect of progesterone. In other words, women who receive both estrogen and progesterone had no better results than women who received progesterone alone. If Lee�s observations are correct, then osteoporosis can be effectively reversed by progesterone alone, regardless of whether or not estrogen is used. The fact that progesterone can be converted to some extent into estrogen within the body may also explain the observation that progesterone alone is effective."
SAFETY OF PROGESTERONE
"The results reported by Lee are substantially better than those obtained with ant other treatment for osteoporosis. The absence of side effects is also very encouraging. Further, while progestins (synthetic progesterone) frequently cause adverse changes in cholesterol levels, progesterone had no such effect. Nor is there evidence that progesterone poses any cancer risk. On the contrary, in a study on guinea pigs, administering progesterone prevented the precancerous changes in the cervical lining caused by estrogen therapy. In addition, of seventeen women with cervical cancer who were treated with progesterone eleven showed evidence of tumor regression. (6).
Progesterone has also been used with some success to treat vaginal cancer in women exposed to DES (stilbestrol)."
"Natural progesterone appears to be extremely effective for preventing and treating osteoporosis. In contrast to synthetic progestogens, which have many side effects and risks, progesterone is quite safe. The use of progesterone may eliminate the need for estrogen replacement therapy in many cases."
6. Hertz, R., et al. 1951. Observations on the effect of progesterone on carcinoma of the cervix. J Natl Cancer Inst 11:867-873.
7. Lee, J. R. 1991. Osteoporosis reversal: the role of progesterone. Int Clin Nutr Rev 10(3):384-391. Lee, J.R. 1990. Osteoporosis reversal with transdermal progesterone. Lancet 336:1327. Lee, J.R. 191. Is natural progesterone the missing link in osteoporosis prevention and treatment? Med Hypothesis 35:316-318.
PREVENTING AND REVERSING OSTEOPOROSIS, Alan R. Gaby, M.D., Prima Publishing, 1997, 150-155.
Proper diet, eliminating sugar and doing weight bearing exercise, where indicated, are also very important in helping to prevent/reverse osteoporosis.
The Misconceptions of Bio Identical Hormones
The main problem with most so called Bio Identical hormone formulas is that these formulas contain the estrogens estradiol or estrone or both as ingredients in their formulas. These estrogens have all of the problems associated with estrogen which include but are not limited to cancer, strokes, high blood pressure, blood clots, gall bladder disease etc. As the level of estrogens rise and progesterone plummets as women age, what would be �bio identical� about increasing ones chances of producing the above mentioned diseases? There is a place for estrogen therapy if one has a frank deficiency of estrogen or other clinical reasons that truly necessitate estrogen therapy. Having said this, from my clinical experience over the last 28 years in practice, most women who have pre menopausal, peri menopausal or post menopausal symptoms do very well with Natural Hormonal replacement using primarily Natural progesterone. John Lee M.D. in his book �What Your Doctor May Not Tell You About Menopause (TM): The Breakthrough Book on Natural Hormone Balance��, copyright 1996, clearly illustrates how progesterone is the major starting material for all hormone production whether it be female hormones, male hormones or adrenal hormones and how the body naturally converts progesterone into all of the other hormones. When indicated, Natural progesterone is a safe natural therapy for most of the above mentioned hormone related conditions. In most cases, from feedback from my women patients, Natural progesterone works very well for them.