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The two main sexual hormones in women are estrogen and progesterone. Both are produced in men and women, although in different quantities. Progesterone is made from pregnenolone, which in turn comes from cholesterol.
Production of progesterone occurs at several places. In women, it is primarily produced in the ovaries just before ovulation and increases rapidly after ovulation. It is also produced in the adrenal glands in both sexes and in the testes in males. Its level is highest during the ovulation period (days 13 to 15 of the menstrual cycle). If fertilization does not take place, the secretion of progesterone decreases and menstruation occurs. If fertilization does occur, progesterone is secreted during pregnancy by the placenta and acts to prevent spontaneous abortion. About 20-25 mg of progesterone is produced per day during a woman's monthly cycle. Up to 300-400 mg are produced daily during pregnancy. During menopause, the total amount of progesterone produced declines to less than one percent of the pre-menopausal level. This drop is extreme.
Progesterone occupies an important position in the pathway of hormonal synthesis. In addition to being the precursor to estrogen, it is also the precursor of testosterone and the all-important adrenal cortical hormone cortisol. Cortisol is essential for stress response, sugar and electrolyte balance, blood pressure and general survival. In short, progesterone serves to promote survival and development of the embryo and fetus. It acts as a precursor to many important steroid hormones and helps to regulate a broad range of biological and metabolic effects in the body. During chronic stress, progesterone production is reduced as the body favors cortisol production to reduce stress. This is an important point, which we will look into later.
Estrogen is produced in the ovaries. It regulates the menstrual cycle, promotes cell division and is largely responsible for the development of secondary female characteristics during puberty. In non-pregnant, pre-menopausal women, only 100-200 micrograms of estrogen is secreted daily. However, during pregnancy, much more is secreted. Estrogen is produced in the ovaries, adrenal and fat tissues. During menopause, the amount of estrogen in the body declines by about fifty to sixty percent. Production, however, is augmented in the adrenals and in the fat cells.
Estrogen and progesterone work in synchronization with each other. They oppose each other in their actions and work as checks and balances to achieve hormonal harmony in both sexes.
Progesterone acts primarily as an antagonist (opposite) to estrogen in our body. For example, estrogen can cause breast cysts while progesterone protects against breast cysts. Estrogen enhances salt and water retention while progesterone is a natural diuretic. Estrogen has been associated with breast and endometrial cancer, while progesterone has cancer preventive effects.
Some of the functions of progesterone include:
breast, uterus, and ovarian cancer protection
a natural diuretic
a calming, anti-anxiety effect
contributes to formation of new bone tissue
Most significantly, it is shown that high amounts of estrogen can induce a host of metabolic disturbances, and the body's way of counterbalancing estrogen is progesterone. When this balancing mechanism is dysfunctional, a multitude of health related problems could arise.
Menopause is often a time when the hormonal balance between estrogen and progesterone is off.
Symptoms of such imbalance include hot flashes, vaginal dryness, water retention, weight gain, insomnia, mood swings, short-term memory loss, wrinkly skin and osteoporosis. The breakthrough in treatment of menopausal symptoms came in 1964, when Dr. Wilson first reported that the lack of estrogen causes menopause. Pharmaceutical companies introduced a synthetic estrogen hormone called Premarin. With this drug, symptoms of menopause such as hot flashes were greatly reduced. There was little doubt then that menopause was solely due to estrogen deficiency. Few doctors knew then that estrogen deficiency alone did not explain many of the symptoms of menopause.
For example, how does one explain the fact that women who are post-menopausal but cannot take HRT can experience relief from their menopausal symptoms when using progesterone replacement alone? Clearly there is more to the menopausal picture than deficiency of estrogen.
In fact, many women on HRT with estrogen alone are unhappy with fat accumulating at their hips and abdomen, osteoporosis, loss of sex drive and often swollen breasts. The common perception is that estrogen is the primary regulator of libido, but in reality, estrogen replacement often does not restore their previous sex drive. What is needed is progesterone and in some cases, testosterone. While the exact mechanism is not known, it is postulated that estrogen primes the brain cells but progesterone turns on the sex drive. This has been studied and clinically observed in laboratory rats whose ovaries are removed. Supplementing with estrogen alone does not increase sex drive, but supplementing with progesterone together with low dose estrogen does.
During menopause, the absolute level of estrogen decreased by fifty percent to a level below what is needed for pregnancy and enough for other normal body functions through the golden years. This is the way nature intended it to be. Menopause is therefore a normal physiological adjustment that does not produce any undesirable symptoms. It is not a disease. The current menopausal problem is an abnormality resulting from the relentless insult on the body's hormonal system from industrialized cultures' and deviation from a wholesome and healthy lifestyle. We shall examine this in more detail.
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Michael Lam, M.D., M.P.H., A.B.A.A.M., is a western trained physician specializing in nutritional and anti-aging medicine. Dr. Lam received his Bachelor of Science degree from Oregon State University, and his Doctor of Medicine degree from the Loma Linda University School of Medicine in California. He also holds a Master’s degree in Public Health. He is board certified by the American Board of Anti-Aging Medicine where he has also served as a board examiner. Dr. Lam is a pioneer in using nontoxic, natural compounds to promote the healing of many age-related degenerative conditions. He utilizes optimum blends of nutritional supplementation that manipulate food, vitamins, natural hormones, herbs, enzymes, and minerals into specific protocols to rejuvenate cellular function.
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