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Is Bio-Identical Progesterone Natural

Why do women take bio-identical progesterone? Is it necessary to supplement with this synthetic progesterone if you have menopausal symptoms? Bio-identical progesterone originates from Diosgenin...
Author
Dr. Elizabeth Bright, , DO, ND, MICO
Published on
September 20, 2024

Why do women take bio-identical progesterone? Is it necessary to supplement with this synthetic progesterone if you have menopausal symptoms? Bio-identical progesterone originates from Diosgenin, a steroid saponin found in several plant species. It takes a tremendous amount of chemical processing to turn it into a plant sterol version similar, but still very different from the progesterone we make for our needs from cholesterol. John R. Lee is largely credited with pioneering the use of plant sterol progesterone as a hormone replacement therapy. As John R. Lee wrote in his book on Natural progesterone, the Multiple Roles of a Remarkable Hormone, in 1996, nature did not make a mistake with women and menopause. He wrote the mistake was in our diet.The mistake is in our diet, but it is because women are told not to eat the animal fat from which we synthesize steroid hormones all our lives. John R. Lee, the diet proponent of diosgenin-derived progesterone, proposed a low-fat, vegetarian diet. In my book, Good Fat is Good for Women: Menopause, I explain that John R. Lee claimed that natural progesterone cream, which he started to sell soon after he published his book, would fix the symptoms associated with menopause: hot flashes, osteoporosis, headaches, weight gain, and depression. Like most doctors, his focus was on replacing something, erroneously claiming that it had gone missing because women stop menstruating and are no longer able to get pregnant, completely ignoring the fact that the menopausal symptoms do not have anything to do with the reduced production of estrogen and progesterone, and testosterone, for that matter, as that is also a step in the synthesis of female sex hormones.

The reduced ability of the adrenal glands to synthesize steroid hormones causes menopausal symptoms. Why do women feel the need to take progesterone? Because they are concerned about estrogen dominance and because they are worried about menopausal symptoms. How can they not be? It’s impossible to get away from this fear. It starts when women are in their 30s now —the propaganda of preparation. John R. Lee did mention the possibility of making progesterone from DHEA.

Unfortunately, he made that seem scary, warning that DHEA can be synthesized into androstenedione, a weak androgen hormone. He says, watch out, don’t depend on your adrenals doing it right. He warned that women would have male characteristics like unwanted facial hair and male-pattern baldness. That was a scare tactic. Women are afraid enough of menopause, but will make hormones out of DHEA, which is the way we have done it since women evolved into women, mean they will grow chest hair and a beard?

I find this funny because the estrogen synthesis in the theca cells in the ovaries, when we are supposedly most fertile, follows this pathway—cholesterol to pregnenolone to progesterone to DHEA to Androstenedione to testosterone to estradiol. On the steroid hormone cascade, the progesterone comes right after the pregnenolone in the theca cells in the ovaries. That’s how it’s done from puberty to menopause: before, during, and after, progesterone is derived from cholesterol, following the same pathway in the adrenal cortex.

So, yes, the ovarian production of progesterone declines with menopause because we’re not supposed to use it to line the uterus near the ovaries. It’s a local progesterone production for a particular job—to line the uterus and maintain the placenta. Its job is also just to be ready to do if an egg is fertilized, which results in pregnancy. Without fertilization, estrogen sheds the lining, and the cycle happens again until menopause. Menopause has nothing to do with hot flashes, weight gain, osteoporosis, migraines, etc., or, as John R. Lee wrote, with osteoporosis, cancer, and heart disease.

If there is estrogen dominance or the inability for the estrogens to be synthesized from the earlier synthesis of progesterone at any time in a woman’s life, that has a few causes. Causes include too many xenoestrogens interrupting the normal steroidogenesis pathway and insufficient fat in the diet to give the adrenals and the ovaries the LDL cholesterol necessary to make the hormones. If you don’t eat fat, all of the cholesterol will have to come from the liver, which can only make so much. for the brain, all the cells, and hormones. It can no longer be claimed women run out of progesterone and estrogen at menopause.

This is a remnant of medicine, or our society in general, using women’s reproductive status as the basis of all their health issues. Women are seen this way-fertile, healthy and viable, infertile, unhealthy, and unviable. This is not the case. It never was the case. Now that microscopes have investigated beyond ovarian tissue and discovered the adrenal glands as the powerhouses of steroid hormone production while finding new estrogen and progesterone receptors, the only way to maintain the lie is to make us look the other way. Like John R. Lee did with chest hair and beards. Most endocrine literature does it with the claim that DHEA produced in the ovaries won’t be enough for all the needs of our bodies and that DHEA production in the adrenals goes down with age. However, DHEA only decreases with age if you don’t eat animal fat, make too much cortisol, or have low thyroid function. If you do and are healthy with adequate thyroid function and good adrenal function, don’t swill/chew/paint yourself with hormone disruptors; there is no agerelated decline in DHEA.

Just like there isn’t for men, who need the testosterone that comes from the DHEA as much as we need estrogens all our lives, progesterone is synthesized before DHEA. The issue here would be too much cortisol synthesis and not enough progesterone. Your endocrine system is very good at walking and chewing gum simultaneously. But sprinting and chewing gum at the same time is harder. If you are under too much stress, running too many marathons, fasting too often, dancing all night too many nights, consuming inflammatory food and drink, putting lots of chemicals in your body, bathing in antiseptic liquids, etc., what would be synthesized into progesterone and swim happily through your bloodstream to the progesterone receptors in different tissues all over your body, will be instead turned into cortisol, to address the above stress.

One of the new ways of looking at progesterone as more than a sex hormone is that it is also a neurosteroid and synthesized peripherally in nerve cells to regenerate myelin sheaths, protect the brain from injury, and restore it after injury. The same enzymes responsible for turning cholesterol into pregnenolone and progesterone are in glial cells in the brain. The myelin sheaths are made out of fat, and the progesterone, made out of fat, is not just an endocrine signaling hormone but also stimulates the repair and regeneration of nerve tissue. Without it, you get demyelination, which is what happens in multiple sclerosis.

This is really good news. We can ignore the fact that one of the products of this research was the synthetic production of allopregnanolone. Allopregnanolone, a progesterone metabolite, has been seen to act on GABA receptors, the nervous system’s calming neurotransmitter. The pharmaceutical industry now sells Allopregnanolone as Zulresso, supposedly a naturally produced steroid injected to treat depression in women. Specifically postpartum depression because, as we know, progesterone is high during pregnancy but lower with birth. Which is natural, but the level of ovarian progesterone goes down naturally, or the baby will never come out. Not the progesterone in the brain. This progesterone is produced in the adrenals, brain, and other tissues.

They had a hard time using “natural” oral progesterone as therapy for brain injuries because it degraded in the digestive tract. They developed nasal progesterone, which seems to make it to the brain. It’s wonderful if they can use it to heal damaged brain tissue, but it’s not natural. It is derived in the same way as the cream women apply vaginally from plant sterols found in yams, but it’s not as natural as the one we make ourselves out of the fat we eat. The adrenals cannot make steroid hormones out of plant sterols. Neither can the brain. The same industry telling us to avoid fat, from which we make progesterone, is also telling us we run out of progesterone when we are in menopause, or indeed before if we are depressed. And that we need to take theirs because we aren’t making our own. Does that make sense to you? I hope it makes you wonder.

References:

Bright E. Good Fat Is Good For Women: Menopause.

Pinna G. Allopregnanolone, the Neuromodulator Turned Therapeutic Agent: Thank You, Next? Front Endocrinol (Lausanne). 2020 May 14;11:236. doi: 10.3389/fendo.2020.00236. Erratum in: Front Endocrinol (Lausanne). 2020 Jul 30;11:507.

https://www.acs.org/education/whatischemistry/landmarks/progesteronesynthesis.html. Accessed February 26, 2024.

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Replacement Therapy; Jackson LM, Parker RM, Mattison DR, editors. The Clinical Utility of Compounded Bioidentical Hormone Therapy: A Review of Safety, Effectiveness, and Use. Washington (DC): National Academies Press (US); 2020 Jul 1. 4, Reproductive Steroid Hormones: Synthesis, Structure, and Biochemistry.

Marker RE, Tsukamoto T, Turner DL. Pennsylvania State College, USA and Kanazawa University, Japan

Sterols. C. Diosgenin.

J. Am. Chem. Soc. 1940;

62: 2525-2532

https://www.pbs.org/wgbh/americanexperience/features/pill-development-synthetic-hormones/. Accessed December 13, 2024.

Semwal P, Painuli S, Abu-Izneid T, Rauf A, Sharma A, Daştan SD, Kumar M, Alshehri MM, Taheri Y, Das R, Mitra S, Emran TB, Sharifi-Rad J, Calina D, Cho WC. Diosgenin: An Updated Pharmacological Review and Therapeutic Perspectives. Oxid Med Cell Longev. 2022 May 29;2022:1035441.

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