Both men and women produce progesterone throughout their lives. As we age, progesterone levels decrease significantly in both sexes.

A woman’s progesterone begins declining at age 35 and a man’s progesterone begins falling at age 45. The decline of progesterone is associated with mood disorders, anxiety and depression, poor sleep, osteoporosis, breast and uterine cancer, prostate cancer, as well as aging of the brain and nervous system.

To slow the aging process both men and women should test their progesterone levels regularly and take a natural progesterone supplement if their levels get too low. Progesterone is the natural counter balance to the harmful Estrogen known as Estradiol.

Excess Estradiol / Deficient Progesterone

Estradiol is the principal estrogen found in both men and women. A small amount is necessary for optimal function. However, too much Estradiol is associated with causing cancer of the breast, uterus and prostate.

Estradiol is fed to beef cows in the U.S. to make them put on more weight so that they can get them to market sooner and sell for more money. Estradiol is also concentrated in milk due to modern dairy farming techniques designed to boost milk production, including feeding cows hormones and milking pregnant cows until very late in their pregnancy.

Unfortunately, the trade-off we suffer is a higher rate of Estrogen induced disease, including cancer, which is not recognized or at least not admitted by the Dairy and Beef Industry.

Estrogenic Compounds in Plastics Linked to PMS and Cancer

Polyethylene terephthalate (PETE), the main ingredient in the plastic bottles most widely used for water, sodas, fruit juices, sports drinks, ketchup, mayonaise, peanut butter, vinegar and just about every other food you can think of, has been found to leach harmful estrogenic chemicals into the bottles’ contents. Known as phthalates, these chemicals have now been linked to the disruption of both male and female hormones and may be a significant reason for the dramatic increase in PMS, uterine fibroids, endometriosis and cancer.

To learn more about how PETE plastics may affect your health, click here.

Progesterone Deficiency in Women

In women, a deficiency of Progesterone and/or an excess of Estradiol is associated with PMS, uterine fibroids, endometriosis and Osteoporosis, as well as Breast, Ovarian and Uterine Cancer. Progesterone is the natural counter-balance to Estradiol. Progesterone activates Tumor Suppressor Protein (p53) to suppress excessive cell growth that can lead to cancer.

Progesterone and PMS

A deficiency of Progesterone and/or too much Estradiol causes excessive menstrual bleeding and cramping. It also causes PMS moodiness, bloating, acne, and breast tenderness. By raising your progesterone levels you can totally eliminate the symptoms PMS. Here’s how it works.

Progesterone and Mood/Sleep

Progesterone has a calming effect on the nervous system through its action on GABA, the calming neurohormone. Progesterone produces a valium-like effect on the stressed nervous system and creates a healthy EEG sleep pattern in the brain similar to that produced by valium.

Progesterone and Cancer

Progesterone increases the Tumor Suppressor Protein known as p53, the “guardian of the cell” and decreases the cancer activating protein known as bcl-2.

The Tumor Suppressor Protein p53 guards against cellular mutations that can cause cancer in the following ways:

• Activation of DNA repair
• Stops Cell growth when necessary to allow DNA time to repair
• Initiates programmed cell death (apoptosis) when DNA damage is irreparable

Estradiol, on the other hand, does the opposite of progesterone. It causes a decrease in p53 and activates bcl-2, the opposite acting protein that promotes cancer cell growth.

Here’s the take home message: Breast cancer cells do not multiply when women have a sufficient supply of progesterone. Progesterone likewise also prevents cancer of the ovaries and uterus as well as the lungs.

Progesterone in Men

Men make about half as much progesterone as women. However, it is extremely important for men as well as it is for women. Progesterone gets converted into Testosterone. Most men know that the loss of Testosterone is associated with aging and causes decreased libido and erectile dysfunction. It is also associated with prostate cancer.

Progesterone preserves natural stores of Testosterone by preventing it from being converted into Di-Hydro-Testosterone (DHT), which blocks the prostate and causes Benign Prostate Enlargement and it’s bothersome symptoms including frequent urination, hesitancy, feeble urine stream and night-time urination. Too much DHT also blocks the hair follicles and is the principal cause of male pattern baldness.

A deficiency of Testosterone, in men or women, is associated with a loss of muscle mass, joint pains, heart disease and the tendency to put on excess abdominal fat. Taking supplemental natural progesterone can boost your Testosterone level.

Progesterone and Prostate Cancer

Men typically make a very small amount of Estrogen: about 1/10^th the amount of a woman. If however, the ratio of Estrogen to Progesterone gets out of balance, prostate cancer develops for the same reason breast or uterine cancer develops in a woman. Progesterone protects against cancer growth and Estradiol activates cancer cell growth.

Progesterone Protects the Brain and Nervous System

Progesterone also protects and preserves the nervous system. Progesterone and Testosterone work together to prevent neurodegeneration of the central nervous system. Therefore, any age-related decline in progesterone may have a negative impact on brain, memory and nerve function. Additionally, progesterone and the natural, bio-identical estrogen known as Estriol, help reduce age-associated abnormalities of the myelin sheath that covers the nerves. New research indicates that supplementing these natural hormones could help prevent Multiple Sclerosis.

What is the best form and dose of Progesterone?

The most effective form of progesterone is the oral, sub-lingual form. Transdermal progesterone creams are less effective long term. The skin is designed to be a barrier, not to absorb hormones. It works well for a short while, but eventually progesterone applied to the skin gets shunted into fat cells and begins to build up. Eventually this excess progesterone can cause side-effects including moodiness and irritability.

The mucous membranes of the mouth however, were designed for absorption. When progesterone is absorbed in the mouth, it is absorbed and transported through the blood stream directly to the ovaries, uterus and receptors on the pituitary gland, before it is broken down in the stomach or the liver and excreted from the body. I have found this method to be very effective without any excess buildup over time.

The sublingual form is safe to take for extended periods. The usual sublingual dose is 50 to 100 mg of natural progesterone daily depending on the individual. To determine the correct amount that is right for you, I recommend saliva or blood testing before and after one to three months of natural progesterone therapy. Once the correct dose is found, you should make sure you get your progesterone level tested every twelve months to make sure your levels remain in the optimum range.

Oprah Winfrey, Suzanne Somers and Robin McGraw (Dr. Phil’s wife) all rave about how “bio-identical hormones have rescued them from menopause.

On her website, Oprah writes, “After one day on “bioidentical” estrogen, I felt the veil lift. After three days, the sky was bluer, my brain was no longer fuzzy, my memory was sharper. I was literally singing and had a skip in my step.”

Suzanne Somers has been taking them for years. She believes that the supplements keep her young and feeling sexy and are preventing her breast cancer from coming back.

Robin McGraw says, “I feel better than I ever have in my life,” since starting Bio-Identical Hormone therapy.

What are the Symptoms of Hormone Deficiency?

Hormone deficiencies can cause hot flashes, cold chills, night sweats, sleeplessness, fatigue, lethargy, roller-coaster mood swings, anxiety, irritability, depression, tearfulness, apathy, mental fogginess, difficulty concentrating, confusion, memory loss, vaginal dryness, incontinence, light headedness, weight gain, wrinkles, sagging, thinning skin, osteoporosis and more.

Fortunately, women are now learning that they don’t have to suffer with the symptoms of menopause or resort to taking harmful synthetic hormones. There are safe natural hormone alternatives to the Estrogen-Progestin drugs that are not associated with harmful side effects.

What Are Bio-Identical Hormones?

Bio-Identical Hormones are hormones compounded by pharmacists from natural plant extracts. They are virtually identical to the naturally occurring hormones made by the body, including the three estrogens: estrone, estradiol and estriol, as well as progesterone, pregnenolone, testosterone, DHEA and cortisol.

Because they are identical to what the body makes they are not associated with the severe list of side-effects associated with synthetic hormones.

Because Bio-Identical Hormones come from plants they cannot be patented. In essence, God holds the patent to these plants. That is the only reason drug companies don’t make them. Without a patent, there is no market exclusivity and hence no financial incentive to bring the product to market.

What are Synthetic Hormones?

Synthetic hormones, on the other hand, are altered copies of the body’s naturally occurring hormones. They must be altered in order to qualify for a patent. The chemical structure of these drugs must be altered slightly in order to create a unique chemical not found anywhere else on earth so that it can qualify for a patent.

This altered uniqueness is the distinguishing factor that qualifies them for a patent. The unique chemical structure is similar enough to the original hormone to allow a similar action but unfortunately it is dissimilar enough to cause harmful side-effects.

Balance is the Key to Safe & Effective Bio-Identical Hormone Therapy

There are three types of Estrogen in a woman’s body that work together to safely keep a woman in feminine balance, including Estriol (60-80%), Estrone (10-20%), and Estradiol (10-20%).

Estrone and Estradiol stimulate the cell growth necessary for reproduction. However, when found in too high a level they can induce excess cell growth leading to cancer.

Estriol on the other hand has been found to be anti-carcinogenic and to protect the body from the harmful effects of the Estrone and Estradiol. Estriol has been shown to be anti-carcinogenic.

The correct ratio of Estriol to Estrone and Estradiol as found naturally in a healthy woman’s body is 8:1:1. Taking Estrone, or Estradiol, without Estriol will create a hormonal imbalance that can lead to heart disease, strokes, blood clots and cancer.

Is Natural Always Better?

Just because a hormone is natural, or bio-identical to the body’s own hormones, does not necessarily mean it is safe. Wyeth claims that Premarin is natural. It is extracted from pregnant horse’s urine. It is natural for a horse, but not a woman.

Most importantly, the quantity and balance of the natural hormones prescribed determines whether or not the therapy is safe. Many women get cancer of the breast, ovaries, or uterus from an imbalanced or excessive production of their own Estrone and Estradiol production.

Likewise, the prescription of natural hormones can cause harm if not balanced. Natural, Bio-Identical Estradiol should never be given without also giving natural, Bio-Identical Estriol and Progesterone in order to maintain a woman’s healthy balance.

Drug Companies Copied the wrong Estrogens

The drug companies that made the first estrogen drugs copied the wrong estrogens. They copied the two most concentrated estrogens: Estrone and Estradiol.

This made sense from a production standpoint but not from a safety standpoint. Estrone and Estradiol are 1000 times more potent than Estriol. For this reason Estriol was initially thought of as a weak estrogen.

However, nature puts all three estrogens together for a good reason. Estriol protects the body from developing cancer. If your body has enough Estriol it will prevent the other two more potent estrogens from stimulating the breast and uterus where they tend to cause cancer.

The pharmaceutical scientists made a mistake by underestimating the wisdom of nature’s hormone balance and synergy and ignored Estriol because they considered it a weak estrogen.

Are Bio-Identical Hormones Proven Safe?

There are several good studies on the safety and efficacy of bio-identical hormones, including one large-scale study that compared the risks associated with synthetic and bio-identical hormones. However, even bio-identical hormones can be harmful if they are not prescribed to achieve the appropriate 8:1:1 ratio as it exists in healthy women. For this reason I recommend testing before and after dosing to make sure your levels are optimal. Click here for more information on hormone testing.

In 2005 the Fournier Study published in the International Journal of Cancer followed 54,000 women who took bio-identical estrogen and either bio-identical progesterone or progestin. The women taking the bio-identical progesterone had a 10 percent decrease in the risk of breast cancer while the women taking the synthetic progestin had a 40 percent increase in the risk of breast cancer.

A follow-up article published in 2007 in Breast Cancer and Treatment looked at 80,000 women. Women taking bio-identical estrogen and progesterone had no increase in the rate of breast cancer, while those taking an artificial progestin had an increase of 69% in the risk of breast cancer.

The de Lignieres Study published in 2002 in the journal Climacteric concluded that the risk of breast cancer is not increased with bio-identical hormones but is increased with synthetic progestin.

Bio-identical hormones have been used in Europe for almost fifty years. Since bio-identical hormones are available in relatively inexpensive generic forms that can be applied using non-patentable formulations by a compounding pharmacist, American drug companies have no interest in sponsoring studies on the safety and efficacy of bio-identical hormones.

Estriol is the Key Estrogen

Estriol is a mild estrogen that has been used in Europe for 30 years. Its safety and effectiveness are well established. Many doctors in the U.S. who use natural hormones prescribe estriol plus natural progesterone to balance the hormones and stop the symptoms of menopause.

Here’s what the medical literature states about Ovestin, a natural, Bio-Identical Estriol made in Europe: “Ovestin contains the natural hormone Estriol, which is a weak estrogen. Unlike other estrogens, estriol is short-acting since it has only a short retention time in the nuclei of endometrial cells.

Estriol prevents hot flashes, bone loss, thinning of the skin and vaginal membranes yet it is 1000 times less stimulating to the breast tissue than is Estradiol. Not only does it NOT promote breast cancer, but considerable evidence indicates that it may protect against and reverses breast cancer.

According to an unpublished study by Lemon, Foley, and Kessinger, “2.5 to 5 mg and occasionally 15 mg of estriol, equivalent to a little more than 0.625 to 1.25 mg of conjugated estrogens and estradiol) was used, with the informed consent of patients, in postmenopausal women with breast carcinoma and metasiases. Thirty-seven percent receiving this small dosage had remission or arrest of metastatic lesions.”

Estriol does not induce excessive build-up of the endometrial lining of the uterus. Hence it does not cause a risk of uterine cancer or withdrawal bleedings.

In addition to treatment of hot flashes, mood swings, and other common symptoms of menopause, Estriol is particularly effective in the treatment of vaginal and urinary symptoms.

In case of atrophy of the vaginal tissue Estriol induces the normalization of the urogenital epithelium and helps to restore the normal microflora and the physiological pH in the vagina.

As a result, it increases the resistance of the urogenital epithelial cells to infection and inflammation reducing vaginal complaints such as painful intercourse, dryness, itching, vaginal and urinary infections, pain on urination and mild urinary incontinence.

What does Dr. Hansen Prescribe to his Patients for Menopause?

The first thing that I do for my patients with symptoms of menopause is to test their individual hormone levels. Balance is the key to optimal health and vitality.

We need to know the starting level of all of the key hormones including Estrone, Estradiol, and Estriol, as well as Progesterone, Pregnenolone, Testosterone, DHEA, Cortisol and Thyroid.

For moderate or severe symptoms of menopause, I recommend Hormone Augmentation with a combination of natural Bio-Identical Estriol and natural Progesterone determined by the individual hormone testing of each individual patient.
Click here for more information on hormone testing

Natural Progesterone

Taking natural Progesterone helps to prevent uterine cancer and increases Bone Mineral Density by as much as 10-15% within 6 months and 20-25% in 3 years (Clinical Nutrition Review, 1990, 10:384-391). The natural bio-identical hormones are safe and effective alternatives to synthetic drugs, providing all of the benefits and more, without the negatives.

Black Cohosh is an Effective Herbal Remedy for Milder Menopause Symptoms

For mild symptoms of menopause, Dr. Hansen formulated a product that he named Esprogen, which contains five of the best hormone balancing herbs nature has to offer.

The key herb for menopause is known as Black Cohosh (Cimicifuga racemosa). It has been shown to be effective in the treatment of the most aggravating menopausal symptoms, including hot flashes, profuse sweating, sleep disturbances and depressive moods. In a review of eight human studies, it was shown to be a safe, effective alternative to estrogen replacement therapy.

U.S. and European Clinical studies documenting the safety and effectiveness of Black cohosh root extracts for the treatment of menopause are impressive. These studies show good therapeutic efficacy and safety profiles for Black Cohosh root. In addition, clinical and experimental investigations indicate that Black Cohosh root does not show hormone-like activity and may possess anti-cancer activity. (SOURCE: Adv Ther 1998 Jan-Feb;15(1):45-53; Planta Med 1991 Oct;57(5):420-4; J Womens Health 1998 Jun;7(5):525-9, University of Bridgeport, Connecticut, USA)

September 11, 2008

Dear Senator McCain,

I am strongly opposed to the FDA’s policy to eliminate the access of compounded hormone medications that contain estriol to doctors and their patients.  This is an intrusion into the doctor-patient relationship. Doctors should decide on a case-by-case basis if compounded hormones with estriol are right for their patients. Even the FDA admits that safety is not an issue, and they cannot document a single adverse event in the decades that estriol has been prescribed to patients.  It would be disastrous for doctors and patients if the FDA banned the use of estriol.

Doctors and patients alike rely on compounded hormone  medications, many of which contain estriol.  Without access to individualized compounded prescriptions, both patients and healthcare providers will suffer.  This policy restricts access to vital compounded medications that have been deemed to enhance or even save the lives of patients because of conditions that cannot be treated by off-the-shelf pharmaceuticals.

The FDA has overstepped their boundaries with this new policy.

I support H.Con.Res.342 and S.Con.Res.88, bipartisan resolutions which declares FDA’s policy “not in the public interest.”

As your constituent, I strongly urge you to send the FDA a clear signal that this policy must be reversed, and ask you to co-sponsor H.Con.Res.342 and S.Con.Res.88.

Overview
Hormones exert a powerful influence over a woman’s health. Estrogens protect a woman from cardiovascular disease and osteoporosis and are vital for fertility. Progesterone levels affect mood, and balance the tissue proliferative effect of Estrogen. Testosterone increases energy, libido, and muscle.

A comprehensive assessment of your hormonal balance can be made by measuring Estrone, Estradiol, Estriol, DHEA, Progesterone, and Testosterone. Informed decisions regarding the need to initiate Bio-Identical Hormone Replacement Therapy (BHRT), or how to individualize therapy can then be made to maximize the health benefits of BHRT. Individual differences in hormone metabolism make monitored therapy the best choice for long term health.

Careful monitoring and individualization of BHRT can provide women with the benefits of supplemented natural Estrogen while reducing the risk of uterine, ovarian and breast cancer. (An increased cancer risk has been associated with conjugated Estrogen or synthetically modified hormone use. This is not the case with bio-identical or natural hormone use.)

Estrogen

With advancing age, a woman’s ovarian function declines, leading to a decline in the production of Estrogen. This decline leads to vasomotor instability that causes hot flashes. It also causes decreased muscle mass, which is then replaced by fibrous tissue. Thinning skin is due to a loss of connective tissue support and elasticity. Vaginal mucous membranes also become thin and dry and breast tissue begins to sag. Supplementing natural Estriol (E3) can help stop many of these undesirable effects associated with menopause.

Progesterone
Progesterone is also produced by the ovaries from cholesterol. It has its own unique hormonal functions, but a certain amount is also converted into Estrogen. Progesterone increases uterine secretions and stimulates calcium deposits into bone tissue. It also helps regulate salt, control blood sugar, calms the nervous system and promote a healthy thymus gland. Supplementing natural Progesterone can help maintain these healthful benefits. You should have approximately ten times more Progesterone than Estriol for optimal balance.

Testosterone
When a woman’s ovarian function declines in the years before and during natural menopause, so does the amount of Testosterone she produces. Between a woman’s 20s and 40s the amount of Testosterone circulating in her blood declines about 50%. If a woman starts synthetic Estrogen Replacement Therapy at menopause, her blood levels of Testosterone drop even further due to a biochemical reaction.

Symptoms such as fatigue, muscle wasting, low sex drive, decreased sexual stimulation, and diminished sense of well-being can be due to a Testosterone deficiency. These symptoms may be significantly improved with natural Testosterone replacement.

DHEA
DHEA is the most abundant steroid in the body. DHEA is a steroid precursor produced by the adrenal gland and converted to Testosterone and the Estrogens. DHEA levels decrease dramatically with age. Adequate DHEA levels give the body the building blocks necessary to produce these hormones. Low levels of DHEA are associated with and increase in coronary artery disease, muscle wasting, abdominal fat and osteoporosis. Taking DHEA reverses these processes and may also increase the sense of well-being.

Hormone levels affect health and well-being.
Monitoring hormone therapy increases therapy benefits while reducing side effects.
Due to individual differences in hormone absorption and metabolism, the hormone dosage required to attain physiologic levels will vary by patient and method of administration.

References

1. Samsioe G. The endometrium: effects of estrogen and estrogen-progestogen replacement therapy. Int J Fertil Menopausal Stud 1994;39 Suppl 2:84-92
2. Davis S. Androgen replacement in women: a commentary. J Clin Endocrinol Metab 1999 Jun;84(6):1886-91
3. Watts NB. Hulka BS. Epidemilogical analysis of breast and gynecological cancers. Prog Clin Biol Res. 1997;396:17-29.
4. Rosano GM, Panina G. Cardiovascular pharmacology of hormone replacement therapy. Drugs Aging 1999 Sep;15(3):219-34

To understand Menopause, you need to know a little about your hormones estrogen and progesterone. Starting in a woman’s 30s, blood levels of estrogen and progesterone gradually decline. This is what nature intended.

Estrogen is necessary for the monthly production of new endometrial cells to line the uterus in preparation for a baby. Progesterone increases the vascular development of the uterus and breasts. When the child bearing years are over, the hormone levels decrease dramatically.

The use of synthetic estrogens, first isolated in the 1920s, did not become popular until the 1960s, when it was touted in Feminine Forever, by Robert Wilson, as the antidote to aging in women by preventing the otherwise inevitable thinning and wrinkling of the skin, drying of the vaginal membranes, and thinning of the bones that caused stooping of the shoulders.

By 1975 more than half of the 30 million postmenopausal women in the United States were being prescribed estrogen. However, about that same time, studies began showing that these women were five times more likely to develop uterine cancer than women who did not take this Estrogen Replacement Therapy. More recent studies have shown that estrogen also increases the incidence of breast cancer.

There are three types of estrogen in a woman’s body that work together to safely produce the desired effects. The three types of estrogen are Estrone (E1), Estradiol (E2), and Estriol (E3). Estrone and Estradiol have now been shown to be carcinogenic when given by themselves, while Estriol has been found to be anticarcinogenic and therefore protect the body from the harmful effects of the other two.

However, all of the current estrogen drugs used in this country are combinations of synthetic copies of estrone and estradiol.Rather than admit they were wrong and open themselves up to millions of dollars in law suits, doctors and pharmaceutical companies in the U.S. continue to make the synthetic copies of the forms of estrogen that are known to be carcinogenic, although the safe estrogen, Estriol, has been prescribed in Europe for a number of years.

Doctors and pharmaceutical companies in the U.S. are either afraid to learn the truth and therefore don’t investigate it, or they are involved in a horrible cover-up that is killing thousands of women every year.

Estriol is considered the “forgotten” estrogen. Is has been labeled historically in the US as a weak or ineffective estrogen, while in Europe Estriol has been recognized for its benefits and has been used for years.

With recent articles and studies stating that women using traditional estrogen therapy for five or more years have a 30 to 40% increased risk of cancer, the need to use a safer form of estrogen seems crucial. Estriol is the best choice. It has never been associated with cancer activity in the female body, but has been shown to prevent or even reverse Breast Cancer.

BENEFITS OF ESTRIOL

Estriol has a much less stimulating effect on the breast and uterine lining than estradiol and estrone. Estradiol is 1000 times more stimulating to the breast tissue than is Estriol.

One of the most exciting things about Estriol is the fact that not only does it not promote breast cancer, but considerable evidence exists to show that it protects against this disease.

In 1978, A. H. Follingstad, M.D. of Albuquerque, NM, wrote as article for the Journal of the American Medical Association, calling for the use of Estriol instead of estrone and estradiol. In support of his position, he cited a group of post menopausal women with metastatic breast cancer. When given small doses of Estriol, 37% of the women experienced either a remission or a complete arrest of the metastasized lesions.

In 1966, H. M. Lemon, M.D. demonstrated that women with breast cancer have lower Estriol levels. Later he showed that women without breast cancer had naturally higher Estriol levels (compared to estrone and estradiol) than those with breast cancer.

Doses of 2-4 mg. Estriol is considered to be the equivalent of .625 and 1.25mg conjugated estrogen respectively.

Dr. Julian Whitaker, Publisher of the “Health and Healing ” newsletter, says that Estriol’s anti-cancer effect is thought to be due to its anti-estrone characteristics. It apparently blocks the stimulatory effect of estrone on the breast.

Estriol as an estrogen supplement does not lose its unique identity when given orally as does estradiol. It remains Estriol.

Estriol is thought to help prevent or stabilize the conversion of estradiol to estrone. Estrone being labeled by many researchers as the “villain” estrogen in the female body.

Estriol seems to be well tolerated when given orally.

It is also remarkable that Estriol, different from estradiol, does not provoke endometrial proliferation and shedding when given in one dose a day. Thus, Estriol is characteristically suitable for postmenopausal women who no longer want to have uterine bleeding and who have comparatively higher risk of endometrial hyperplasia.

A Taiwan study concluded that Estriol was very effective in the improvement of major subjective climacteric complaints in 86% of patients, especially hot flush and insomnia within 3 months. The atrophic genital thinning caused by estrogen deficiency were also improved satisfactorily. This study was not able to show that Estriol will prevent bone loss.

Receptor binding studies have indicated that Estriol has only low relative binding affinity to endometrial estrogen receptors (about 10% of Estradiol), whereas it has a relatively strong binding affinity to vaginal estrogen receptors (equal to Estradiol). This means that after a single dose of Estriol, the binding to the endometrial estrogen receptor is too short to induce true proliferation, while its binding to the vaginal estrogen receptor is sufficient to exert a full vaginotropic effect. Because of Estriol’s strong vaginotropic effect it is thought to be the estrogen most beneficial to the vagina, cervix, and vulva. In cases of postmenopausal vaginal drynes and atrophy, which predisposes a woman to vaginitis and cystitis, Estriol supplementation would theoretically be the most effective (and safest) estrogen to use.

Of all the estrogens, Estriol has the shortest receptor occupancy. Therefore providing a short duration of action in certain estrogen receptor tissue. A consequence of the short duration of action of Estriol at the receptor level is that there are hardly any systemic effects. Studies indicate absence of effects on: blood pressure, body weight, liver function and blood clot formation.

Current studies do not show Estriol to have any cardioprotective effects through changes in lipid metabolism.

Literature searches produced only one study which showed that Estriol had a positive effect on Bone Mineral Density. A Japanese study. Seventy -five natural postmenopausal women with a BMD of more that 10% below the peak bone density were treated for 50 weeks with 2mg/ day Estriol cyclically (4 weeks on / 1 week off) and .8gm / day calcium lactate continuously. The BMD increased by 1.79% (p<0.01 vs. pretreatment) after 50 weeks.

The Japanese study also concluded that the parameters of lipid metabolism in their study showed no significant changes after 50 weeks.

The intravaginal administration of Estriol prevents recurrent urinary tract infections in postmenopausal women, probably by modifying the vaginal flora.

It is suggested that Vitamin E administered daily with Estriol therapy will improve Estriols activity in the body.

Oral doses of up to 16mg per day have been documented. The most common oral dosage range is 1-4mg per day.

Mode of Administration

Dr. Hansen recommends the oral, sub-lingual (under the tongue) route for Estriol. Dosing Estriol under the tongue allows the hormone to be absorbed directly into the blood stream from the mouth. This route allows the hormone to directly to work without being partially removed by the liver and eliminated from the body too quickly. Because it is taken orally, the dose can be changed as needed, and excesses do not build up, whereas the SottoPelle® implants cannot be changed for 4-6 months, unless they are surgically removed.

References

1. John R. Lee, M.D. with Virginia Hopkins. What your Doctor may not tell you about

menopause. The breakthrough book on natural progesterone. Warner Books, Inc 1996

2. Tzay-Shing Yang M.D. et al., Efficacy and safety of Estriol replacement therapy for climacteric women. Chin Med J (Taipei) 1995;55:386-91

3. A. H. Follingstad M.D. Estriol, the forgotten estrogen. JAMA, Jan. 2 1978 Vol 239 No.1

4. Hiroshi Minaguchi M.D. et al, Yokohama City University, School of Medicine, Yokohama, Japan. J. Obstet. Gynaecol. Res. Vol 22, No. 3: 259-265 1996

5. Raul Raz, M.D., Walter E. Stamm, M.D. A controlled trial of intravaginal Estriol in postmenopausal women with recurrent urinary tract infections. N. England J. Med. 1993;329:753-6

6. G. P. Vooijs, T. B. P. Geurts, Review of the endometrial safety during intravaginal treatment with Estriol. European Journal of Obstet. and Gynec. and Reprod. Biology 62 (1995) 101-106