Is there a place for progesterone replacement?

Is there a place for progesterone replacement?

Ovarian failure at the menopause is associated with cessation of progesterone production as well as oestrogen deficiency. An American physician, Dr Lee, has described and publicised his experience with ‘natural progesterone cream – ‘Progest’ - which is applied to the skin. The progesterone is produced in the laboratory from diosgenin by extraction from the Mexican Yam. Many other reproductive hormones are similarly extracted from the Mexican Yam. A variety of clinical benefits have been claimed including increased bone density, relief of benign breast disease symptoms, enhanced libido (sex driveQ 28.18) and relief of premenstrual syndrome. Dr Lee recognises the fact that others have used progesterone in capsule form or rectal suppositories (Cyclogest) but he found that the transdermal route was more acceptable for his patients. There is some evidence that progesterone may have benefit on the heart. Controlled studies are required to confirm the possible advantages of Progest. One recent study, at King’s College Hospital inLondon , found that Progest resulted in only a small increase in plasma progesterone levels and the authors commented that they were not convinced that this was likely to achieve a biological effect.

Several patients have come to me wishing to continue Progest having commenced it under the supervision of others. There have been many occasions when patients have not had their symptoms ade quately controlled by oestrogen replacement therapy and Progest has apparently helped a few of them.

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