One of my favorite books is by Dr. John R. Lee entitled “What Your Doctor May Not Tell You About Menopause…The Breakthrough Book on Natural Hormone Balance”. In this book, Dr. Lee talks about many of the different conditions which can be helped by taking bioidentical progesterone. This is not the primary reason why I enjoyed reading this book, as overall he provides some valuable information not only for menopausal women, but information which can benefit anyone with a thyroid or autoimmune thyroid condition.
While I’m not completely opposed to having my patients take natural progesterone, as well as other bioidentical hormones, I usually don’t recommend them taking any natural hormones unless absolutely necessary. An example of this would be a woman who received a complete hysterectomy, as there is a good chance that this person would need to take natural progesterone. On the other hand, I have consulted with numerous cycling women who currently take or have taken natural progesterone, and this usually is unnecessary, although there of course are exceptions. The same concept applies to men, as many men who are low in testosterone take bioidentical testosterone, which usually isn’t necessary.
Why Are Many Doctors Recommending Natural Hormones?
If there are risks when taking bioidentical hormones, then why do so many doctors recommend them to their patients? First of all, I wouldn’t assume that natural hormones are completely safe just because doctors advise their patients to take them. As we are all aware of, there are many medications and other conventional medical treatment methods which are risky, yet recommended frequently by medical doctors (radioactive iodine anyone?). So I wouldn’t assume that bioidentical hormones don’t have any risks just because they are recommended by numerous doctors.
Many people assume that bioidentical hormones are safe not because they are recommended by many healthcare professionals, but because they are natural. Plus, just like nutritional supplements, people can easily purchase natural progesterone and other bioidentical hormones online. So because they are “natural” and are readily available, AND at the same time are recommended by numerous doctors, many people think that natural hormones are completely harmless.
The Difference Between Bioidentical Hormones & Nutritional Supplements
Many people think of natural hormones as being similar to taking nutritional supplements. But hormones are very complex, and should not be mistaken as being the same as supplements and herbs. While there are risks with taking certain supplements and herbs, it is much easier to develop problems from taking hormones, as they are very powerful. One of the most common problems with hormones is overdosing. For example, many people take bioidentical progesterone or testosterone. Doing so will frequently make the person feel better initially, but there is the potential to overdose, which can lead to a whole host of symptoms. This is true even when you are careful with taking specific dosages, as especially with hormone creams there is a good chance of overdosing.
When Are Bioidentical Hormones Necessary To Take?
Although I’m not in favor of giving bioidentical hormones out like candy, there are times when I will recommend them to my patients. The main problem I have is that they don’t get to the underlying cause of the problem. So for example, if someone has a deficiency in progesterone, testosterone, or any other hormone, then I want to find out what caused the deficiency. This is similar to the approach I take with hypothyroidism and hyperthyroidism, as I want to find out why the person has a deficiency or excess in thyroid hormone, and not just give thyroid hormone to people with hypothyroidism, or a drug to suppress the production of thyroid hormone in people with hyperthyroidism.
So there are essentially two cases when I will recommend bioidentical hormones to my patients:
1. When the person has had a gland or organ removed. As I mentioned previously, a good example of this is when I consult with a woman who has had a complete hysterectomy, as there is a good chance this person will need to take natural progesterone because her body no longer can produce a sufficient amount on its own.
2. When someone has a severe deficiency. If someone has a severe deficiency then I also may give that person natural hormones on a TEMPORARY basis. So for example, if someone has very low DHEA levels then I very well might have that person take DHEA on a temporary basis. On the other hands, an herb like Tribulus can sometimes raise low DHEA levels in menopausal women and men, and so not everyone with a low DHEA level needs to take bioidentical DHEA. But when someone with a severe deficiency needs to take bioidentical hormones, my goal is to put them on them temporarily.
Warning: Most Healthcare Professionals Don’t Know Much About Natural Hormones
One of the big problems is that many healthcare professionals don’t know much about bioidentical hormones, yet they recommend them frequently to their patients. Some have had a weekend crash course, while others don’t know any more than their patients. So you really do need to be careful when speaking with any healthcare professional about bioidentical hormones. And if you have a deficiency, don’t hesitate to ask your doctor “why do I have the deficiency, and how will taking these hormones permanently correct it?” Don’t be surprised if they don’t have a good answer for you.
In summary, although bioidentical hormones such as natural progesterone can help many people, you need to remember that in most cases they don’t do anything for the underlying cause of the problem. The truth is that most people don’t need to take any natural hormones, and when they do need to take them, it usually should be on a temporary basis. And please don’t take bioidentical hormones on your own, as you really do want to speak with someone who is competent in this area, as this can lead to a lot of problems. This is especially true if you are taking hormone creams.
This blog is so timely since my naturopathic doctor recommended I start using natural progesterone cream based on the results of saliva testing that confirmed I have a low progesterone to estrogen ratio as well as elevated testosterone. However, I’m not comfortable using natural progesterone cream because it can build up in fatty tissues and result in other hormonal imbalances. I would be most comfortable taking sublingual progesterone drops if necessary but waiting to talk to my OB/GYN about this. In the meantime I feel like it is more important to help optimize how my liver metabolizes and eliminates the toxic estrogens from my body. I am on high quality multi-vitamins and Mediclear and also just started taking Estrobalance with DIM because it is supposed to help this process.
Hi Laura,
I agree that if you’re going to take natural progesterone it’s safer to take it sublingually since it won’t build up in the tissues this way. And you’re right, as many people do need to focus on their liver health.
I just started a round of natural Progesterone cream, as it was determined through saliva tests that I am estrogen dominant. (Now post-menopausal-Went through menopause last year; was one of those individuals that just stopped having my periods, with no perimenopausal symptoms prior. Age now 54). As soon as I started menopause, insomnia struck for the first time in my life. Ithas wreaked havoc on my health over the past year. Within one week of using the Progest once daily in the a.m., (NOT 2x/day as directed), I’ve been sleeping great. I wanted to use the minimal amount necessary to balance out my hormones, and it seems to have worked. I am having saliva tests redone in a week or so.
Hi Valerie,
Many people do feel much better initially when taking natural progesterone cream. The problem is that the creams have a tendency to build up in the tissues, and so if someone needs to take natural progesterone, then it’s usually best to take sublingual progesterone.
I am 43 years old and want to have another baby. My doctor checked by progesterone level and it was in the low range and he suggested that I take progesterone. After reading this article, I am not sure if I should. Isn’t it normal to have low progesterone as we age?
Hi Catherine,
Yes, it is normal for the hormones to decrease as we age, but this doesn’t mean that your body can’t produce a sufficient amount of progesterone on its own…especially at age 43. Most 43 year old women should produce enough progesterone on their own, although many women have hp-axis dysfunction, which is affecting the output of progesterone. This is common with both cycling and menopausal women. So when this is the cause of the low progesterone then it is possible to increase progesterone output without taking natural progesterone by correcting the underlying problem.
I just discovered you today Dr Eric and wonder if I have finally found a gem in the health profession after 7 years of searching! If this article is a hint of your philosophy towards healing how I wish you could be my Dr, though I don’t suppose you can help someone in Australia?
Hi Tania,
I’m glad you enjoyed the blog post. I do consult with people who live internationally, and actually have consulted with a few people who live in Australia. However, I do require for people to first get diagnosed by a medical doctor, preferably an endocrinologist. Plus, as I state on the “consultations” page of my website I also require people to attend one of my free webinars on natural thyroid health.
I am 43 and lab tests consistently show that I have zero progesterone , zero testosterone and low thyroid but always make sufficient estrogen .
I was prescribed bio identical progesterone but I feel worse taking it . I don’t know what else to do .
I supplement with magnesium , vit b , vit c and vit D . My symptoms are muscle aches , migraine , no energy , no libido … this all happened when I was taken off a combined pill aged 40 … this pill was anti androgen which I had been kept on for 18 years !!!!! Please can you advise my next step because I’m really lost with all of this . Thank you so much .