PROGESTERONE — THE BALANCING HORMONE
The ovary makes two different female sex hormones, oestrogen and progesterone. Progesterone balances the effects of oestrogen upon the uterus and is necessary to produce regular periods.
In women with a uterus, if oestrogen is taken it is universally accepted that progesterone must be given for at least twelve days every calendar month to prevent uterine cancer. If oestrogen is taken alone there is an increased risk of cancer of the uterus. It is most reassuring to know that if progesterone is added to oestrogen in women with a uterus, the risk of uterine cancer decreases to less than that in women not on HRT!
Opinion among the experts is somewhat divided as to the necessity of adding some progesterone to oestrogen replacement in women without a uterus (hysterectomised women). Some studies show that progesterone given for twelve or more days each month may exert a protective role against breast cancer, but this debate continues and the protective role of progesterone is not proven. I personally do not recommend progesterone tablets to women without a uterus.
Unfortunately natural progesterone is not effective if taken in tablet (oral) form as it is destroyed by the liver. Currently, the progesterone tablets that are used along with oestrogen in HRT are synthetic progesterone. Synthetic forms of progesterone are called progestagens. Progestagens are not as good as natural progesterone because they don't quite fit, all the progesterone receptors on your cells, although they do balance the effect of oestrogen upon the uterus.
Some of the progestagens currently used can have unfavorable effects on your cholesterol and this could reduce the good effect of oestrogen upon your blood vessels. While the debate continues, it is best to be guided by your own doctor and use a progestagen such as Provera or Duphaston that will not cause ill-effects upon your cholesterol balance.
Some women refuse to take any progestagen tablets because they get annoying side-effects such as irritability, depression, headaches and weight gain. If such side-effects are intolerable, progestagen tablets can be safely left off in hysterectomised women or progesterone injections (Proluton Depot injections) can be given every four to six weeks. In my experience, these progesterone injections are very well tolerated and generally free of sideeffects. Proluton Depot injection acts in a similar way to progestagen tablets in regulating the menstrual cycle and brings on a regular menstrual bleed.
Patches containing either synthetic or natural progesterone may soon be available, and these may be a good alternative for women unhappy with progestagen tablets.
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CAN MENSTRUAL BLEEDING BE AVOIDED?
