October 12, 2016
Bert, Ernie & the Progesterone Paradox

Progesterone is a steroid hormone produced in females by the corpus lutem upon ovulation and in smaller amounts by the adrenal glands. As ovulation becomes irregular and eventually ceases in the perimenopausal to menopausal years, a steep decline in progesterone levels with minimal decline in estrogen levels leads to a state of relative estrogen dominance, also termed progesterone insufficiency.

This state of progesterone insufficiency is commonplace in both the premenopausal and postmenopausal years. It can present with a host of symptoms, including weight gain, bloating, mood swings, breast tenderness, fibrocystic breasts, uterine fibroids, endometriosis, foggy thinking, difficulty concentrating, depression and irregular periods. Progesterone insufficiency can increase the risk of estrogen dependent cancers such as breast, uterine, ovarian and prostate. Progesterone is to estrogen as Bert is to Ernie; as peanut butter is to jelly. The two hormones are meant to work both in balance of one another and in unison.

Bioidentical progesterone supplementation has been shown to protect against the proliferative effects of estrogen, and also protect bone health, cognitive function and cardiovascular health. Additionally, progesterone has been shown to improve inflammatory markers and immune signaling factors- even in women with high life stressors. Moreover, the negative side effects associated with progestins are not seen in studies on bioidentical progesterone.

Through studying data on hundreds of patients using progesterone cream, Dr. John Lee found a small percentage of women notice an exacerbation of symptoms upon progesterone initiation for a short period of time. Why? The body’s estrogen receptors can become less responsive to estrogen over time when bombarded with elevated estrogen levels for too long. If a running coach demands an athlete to run harder and faster hour after hour, the runner will eventually tire out and ignore these demands. The estrogen receptors down regulate in a similar manner with an attempt to maintain homeostatic balance. Progesterone supplementation can cause a re-awakening of the estrogen receptors and a worsening of estrogen dominant symptoms for a period of time before symptoms resolve (think of progesterone supplementation as a shiny new whistle given to the running coach).

Understandably, some patients become discouraged and may even discontinue therapy during the recalibration phase, which can last up to three months. Providers should prepare patients on the possibility of exacerbation so it does not cause alarm. The dose of progesterone can be reduced for a time before working back up to a therapeutic level. If progesterone therapy is discontinued, further hormone imbalance may occur.

While symptoms alone may suggest estrogen dominance, testing hormone levels is warranted to measure the levels of estrogen and progesterone in the form of the Pg/E2 ratio, which will guide treatment decisions. Testing allows providers to establish baseline hormone levels and subsequently follow changes in hormone levels and symptoms after initiation of therapy. Labrix offers a Comprehensive Hormone Panel, which includes testosterone, DHEA and diurnal cortisol levels in addition to estrogen and progesterone levels, giving a complete assessment of a patient’s hormone balance.

References:
  • Lee J, Hopkins V. What your Doctor May Not Tell You About Menopause. Warner Books, 2004.
  • Mauvais-jarvis P, Kuttenn F, Gompel A. Antiestrogen action of progesterone in breast tissue. Horm Res. 1987;28(2-4):212-8.
  • Stephenson K, Neuenschwander PF, Kurdowska AK. The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women. Int J Pharm Compd. 2013;17(1):74-85.


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Labrix Advanced
Workshop
Las Vegas, NV
February 10-12, 2017

Labrix will be conducting the annual Advanced Workshop in Las Vegas in February. Due to increased demand, this event will now span three days of comprehensive presentations and discussions. Registration is $199 but if you sign up using promo code MARKETING before October 31, you will receive a $50 testing credit on your Labrix account (after completion of workshop.) Register today!

Denver Summit
Denver, CO
October 22, 2016

Labrix Clinical Sales Manager Nick Smith will be exhibiting at the Denver Summit in Colorado on October 22.


IWHIM
Portland, OR
October 21-23, 2016

Dr. Erin Lommen, co-founder of Labrix, will be speaking at the Institute of Women's Health & Integrative Medicine conference in Portland OR, this fall. Come visit the Labrix booth at the conference in Portland OR, this fall.


OANP
Portland, OR
December 3-4, 2016

Labrix will also be exhibiting at the Oregon Association of Naturopathic Physicians conference in Portland OR, December 3-4.


A4M
Las Vegas, NV
December 9-11, 2016

Stop by the Labrix booth and meet Labrix co-founders Dr. Erin Lommen and Dr. Jay Mead at the A4M Conference in Las Vegas this December.