Positive Health Online

As you know, women have been bombarded for years and bamboozled about taking HRT and they’ve cottoned on to the fact that it may not be good for them. Recently, there has been a lot of information, including from yourself and John Lee and others about alternative approaches to the Menopause. And there have been a spate of products on the market that are very confusing and I wanted to talk with you about ways that could help women get the right information. First of all, perhaps we should step back one step and ask “what is natural progesterone?”

That’s important. Natural progesterone is not natural. It is what is known as “nature identical” which means that it is exactly the same molecule that is found in your body but it does not exist in nature except in animals, and it does not exist in plants. It is made from diosgenin and diosgenin is a phytochemical that exists in wild yam. The body cannot convert diosgenin into progesterone. Wild yam is a very useful plant for women. Very many women with premenstrual syndrome, with menstrual problems, who can’t conceive, women who tend to miscarry all the time, take wild yam and it sorts them out. But this is not because diosgenin turns into progesterone. We don’t know why it is.

Therefore, wild yam is beneficial to some people with menopausal problems.

Absolutely. Oh yes, one of the most beneficial. It is one of the things, of course, that supports the body’s ability to deal with stress. It strengthens the adrenals and if you look at the best adrenal-strengthening natural products, they all contain wild yam amongst other things. So it is a very good thing, wild yam. But it is not the same thing as natural or “nature identical” progesterone.

What is your opinion about women using natural progesterone cream?

My feeling is that we should never need to use a natural progesterone cream at all and there is something seriously wrong with our society in that I find that there are some women who absolutely need it, definitely need it. The problem is that we have created an environment which is so inimitable to human life – that we are constantly subjected to oestrogenic chemicals – that it is almost impossible for us to overcome the oestrogen dominance that is taking place in a woman’s body without natural progesterone. This is not true of all women, but in some women, with whom I have concluded that there is absolutely no way to go but to use it. But, having said that, I have no real fear of natural progesterone. First of all the level at which it is being used is so low – 1/4000 of what you have in your body when you’re pregnant.

But you started out saying that women should not need to take progesterone.

I think that none of us should need to, but what we have done to our environment is incredible. Last year, about 18 months ago, there was this meeting at the Russian River in California of the world experts in xenobiotics – foreign chemicals. They came to the conclusion that if something is not done to stop what is going on in our environment, then the human race, along with a lot of other animals, could die out within three generations. And that is serious!

Do you think that applying natural progesterone to the skin is safe?

I have no doubts about it whatsoever. The only thing using a progesterone cream might do is, if you are menstruating and you don’t use it by the protocol you are supposed to use it by, namely between day 15 – day 28, it could interfere with your periods. Your periods could be irregular or you can get spotting in the middle of the month.

In our feature there is an extract from Dr John Lee’s book and an extract from Dr Marilyn Glenville’s new book in which she raises some caution about the use of progesterone. And I think that she makes sense in asking “are we going the same route with progesterone that we used to do with HRT”? Which I think is probably a fair question to ask.

Absolutely. And as I say, I have an uneasiness about that too, but I have come to the conclusion that in the world that we have created, for some women it is absolutely essential.

And there is a lot of misconstruing about menopausal products. Women hear about natural progesterone, then they see ads for wild yam.

Yes. I have just come back from Australia and New Zealand where I was doing a series of workshops all over in this area and met some of the people who are selling these creams, who are really sweet people, who are so enthusiastic and really honest, but who are also confused between wild yam and progesterone. In the United States a wild yam cream may or may not contain progesterone. Some of them do, some of them don’t, but they cannot contain more than 5% progesterone. In order to be able to use a proper progesterone cream like Progest, for instance, that contains more than 10%, you have to buy that in the United States at a chemist. It is very important that people understand that wild yam is not progesterone. I was lecturing in Ireland and there was a woman who was selling a yam cream and it said “natural hormone replacement progesterone”. I said to her, “I am really sorry, but are you aware of the fact that what you are selling does not have any progesterone in it”? And she was terrific. I explained it to her, said that there was absolutely no evidence whatsoever that the body can take diosgenin and turn it into progesterone. That is not to say that wild yam is not good for you, but why take a wild yam cream? It might be good for skin, but it is probably better to take it internally if you want wild yam. And she took her sign down that said progesterone.

And there is the opposite thing about people selling cream which is progesterone but thinking that it is wild yam.

I didn’t know that. That surprises me. I have never seen that.

Some progesterone creams have no wild yam in them at all.

Well that doesn’t matter. I don’t think Progest has wild yam in it. It is not illegal for you to order natural progesterone from abroad, for your own use, it is perfectly legal. Without a doctor’s prescription, it is perfectly legal to order 1-2 jars for yourself from Ireland or from the United States with no problem whatsoever.

That’s right. But a legal problem has arisen because the Medicine Control Agency here classifies progesterone as a medicinal product, and therefore you need to buy it on prescription from the doctor, or you need to order it through America or Ireland. It is also forbidden to advertise it in the UK, so it is very difficult.

It is very difficult. It is a problem in the United States. In 1962 a law was passed in the United States that said that any substance which had been sold over the counter for a certain period of years could still be sold over the counter. Natural progesterone, together with things like natural thyroid, whole thyroid and adrenal hormone had all been used quite widely to treat all kind of things until about 1948 or 1949 until drug companies began to develop the pill. At that point all of the research into the use of natural hormones stopped and it was focussed on researching specific drugs. So legally you have to be able to buy those over the counter, it was guaranteed by this act of 1962, which the FDA brought in to try to control a lot of other things from proliferating. But you cannot advertise it in the United States for what it is and consequently these creams are sold under the title “cosmetics”. This is so stupid because of course there is no way to be able to regulate it properly and say this contains this much progesterone, this contains no progesterone, but it is pure extract of wild yam in a lanolin base or whatever. And this highlights how meaningless a lot of the regulations are.

It makes it very difficult to inform people as well.

It does indeed.

And they are breaking the law if they are selling it unless by prescription.

But to return to the other thing, “are we doing with natural progesterone what people were doing with HRT”, the answer is no and the reason lies in the amount of money that goes behind hyping HRT. If you look at all these organisations, ask where they get their money from? And they disseminate information. Who is disseminating information about natural progesterone? Celia Wright a bit, John Lee has written a book.

I guess there may be the potential that drug companies could market progesterone as a drug as they have done with HRT? Because progesterone is another hormone.

No, because the oestrogen that we are actually using is not exactly the same chemical that is in a woman’s body. And none of the progestogens are, they are all end-product molecules, which means that the body doesn’t have the enzymes to be able to turn it into other things. That is what is so wonderful about natural progesterone. If you happen to get more than you needed, which is extremely unlikely, because we are dealing with such low quantities in the creams, but say you got more than you needed, your body has the enzymes to turn it into thirteen other steroid hormones that you might make use of, including – guess what – the oestrogens. I had never figured out why drugs had such nasty side effects. And the reason they do is because they are end product molecules, and they have to be because they have to be something not found in nature in order to be patentable, in order to be used as drugs and the body doesn’t have the enzymes either to turn it into anything else that is useful and doesn’t even have the enzymes to eliminate it effectively from the body. So of course you get side effects. Therefore you are dealing with a totally different thing here. It is nothing like the oestrogen that people are using and oestrogen replacement therapy.

I presume that there must be some non-natural progesterones that are being sold as well.

That are not the identical molecule?

Yes. By drug companies?

By drug companies – yes, all of the progestogens are these end-product molecules. And do you know how the first ones were made? They were made from wild yam. They extracted the diosgenin, and they turned it into progesterone. And then, they turned it into all of these different end-product molecules that they were able to research and identify as being unique so that they could be patented and then they sold them as drugs.

I guess that if there were a problem of anyone hyping progestogens or progesterones that would be the drug companies.

Yes: there is a danger there and it is a serious one. When I was researching Passage to Power I would be reading abstracts of research papers and I would come upon an abstract that says that progesterone causes cancer and I would say “that’s very interesting” and I would go back to the original paper and I would find that it was not progesterone, it was a progestogen. But you know the way we say “we are going to hoover the living room” instead of “vacuum the living room” doctors say “I’ll not only give you a little oestrogen, I will give you a little ‘progesterone’ to balance it, so that you don’t have any problems developing cancer of the womb.” The progesterone in these cases is in reality a progestogen. And this is a major source of confusion.

Marilyn Glenville’s book sounds like a good book – I will take a look at it. I think that the idea that natural progesterone is the answer to everything is nonsense. There isn’t an answer to everything, but that is one of the things that can be useful to a woman. Then she can see how she feels, take up weight training, change her diet and in a year’s time she probably won’t need it.

If you were advising, say, your own daughters when they were approaching menopause about the approach they could use in the first instance, what approaches would you suggest?

First of all, a lot of symptoms that are associated with menopause are not necessarily menopausal at all. It is just that we come to mid-life and we find that certain things are going on with our bodies and it’s basically a sign that the lifestyle that we are living is not one to support our energy and our health at the highest level. So it’s a good time to examine some pretty fundamental things, such as the question “am I leading my life or somebody else’s?” Also, “am I really eating the kind of foods that will support me at the highest level of energy?” This is interesting because a lot of women find that they don’t want meat any more at menopause whereas other women who may have been vegetarian find that they really need more protein. So it’s a very individual thing. And what I like to see is women in touch with themselves enough that they actually trust what their bodies are telling them. Rather like pregnancy. You know when you want baked potatoes in the middle of the night? That type of thing. Then, “am I using my body enough?” The body is a living organic system and like every living organic system the more movement it gets the stronger it becomes. It is the total opposite of a machine, which of course wears out when you use it. And then ask “what is not working here?” and begin to give thanks for any symptoms that you have and say “great, they are telling me that I need to readjust some things. Let me learn how to readjust them.”

A major thing to look at is the kind of fats that you are eating. People are eating all these trans fatty acids. They have read all the ads and they think that margarines are the way to go because they are full of polyunsaturated fats and they don’t know that the way that they process polyunsaturated fats changes them from cis fatty acids – which the body can make use of to make prostaglandins, build cell walls and help regulate hormones – into trans fatty acids, which the body cannot use and which can actually block the uptake of cis fatty acids which may be present in the diet. Hence you have the situation where in the western world almost 40% of the calories we eat come in the form of fat, and people are wandering around all over with fatty acid deficiencies. So the fat thing is really important. There is still very little known, I think, by people. So I would look at that.

If you are awakening in the middle of the night, which is the single most common symptom that women get around menopause, that and hot flushes which usually go together, it is important to do two things. One is to say “ah, this is interesting. Maybe I need to detoxify my system in some way” and two “ah, this is interesting, what do I want to do in the middle of the night when I wake up?” Because it is my experience that at menopause whatever part of a woman’s soul has not been lived out tends to rise up from underneath. Like a child, who grabs hold of your clothes and pulls on you to pay attention. Very often, if a woman wakes up at 3 am, and many menopausal women do – if she finally allows herself to get up at 3 am in the morning, she may find that she can do her most creative work and have the most creative ideas that she has ever had in her life. Because if you think about it, at menopause something remarkable is happening. The creativity which until then has basically belonged to the procreation of the species and has been biologically oriented, suddenly is no longer biologically oriented, it is handed to a woman and it is for her to use in any way that she wishes. This is enormously exciting but also very frightening to women because we like and feel comfortable with whatever roles we have been playing for a long time. Menopause is a time where you say “wait a minute, what roles are still appropriate for me and what roles are not? What do I really want out of my life?” And it is my experience that a lot of this waking up in the night is at a time when throughout every religious tradition all the monks and the nuns get up to pray because it is the time that is most creative, the time when the energies of the earth are very silent, the dark time when things are brought to birth.

Hot flushes are very interesting from the point of view of natural medicine. They are believed to be a way that the body cleanses and detoxifies itself. I think that there is a lot in this because it is like having a sauna or getting lots of exercise and the sweat cleanses your system, but I think that there is something too from a spiritual point of view. When a hot flush comes what is happening is that the creativity which is no longer being used biologically rises up in you and asks you to direct it in some other way. I worked with a woman about three years ago who was having terrible hot flushes, was panicked and didn’t know what to do. I suggested that she begin to work with herself to try to find out any – even trivial – little things about what she wants to do, how she wants to direct them, and as I recall, I can’t remember whether she took up pottery, it was something like that, a fairly hefty craft, and the hot flushes completely disappeared without any medication whatsoever within about 6 weeks.

Have you also found that other approaches like flower essences, or aromatherapy essential oils have been helpful?

Yes, and I find homeopathic remedies like Folliculinum and Carcinosin very helpful. The Carcinosin remedy is used for cancer, but I find it so useful for menopausal women. One of the major things psychologically that you need to do with people with cancer is find an outlet for them to be able to express the truth of who they are and this is major, major if they are to eliminate the disease from their bodies. And with women who feel that they have lost their soul, don’t know who they are and completely lost and don’t know what to do with their lives, one dose of Carcinosin 1M often changes their whole view of reality. And I think that is wonderful. And Folliculinum, of course, is a more traditional remedy that is used homoeopathically to treat hot flushes and is very effective for a lot of women.

And there are quite a lot of herbal remedies.

And they are great. Agnus Castus, Black Cohosh, Dong Quai which is Angelica and wild yam, they are the four major ones.

And are they helpful?

Enormously. Very good. The difference between using one of those and using oestrogen in order to treat hot flushes is that if you give oestrogen to treat hot flushes, it will take them away instantaneously and the reason it is taking them away is that the hypothalamus, which is the control centre for a lot of hormonal activity related to menstruation and the cycle a woman goes through, is also the control centre for temperature in the body. When the ovaries shut down, you get these feedback loops between the hormones that actually regulate, telling the ovaries “come on, make some more oestrogen or I stop, etc.” and for a time you get a very active hypothalamus saying “where’s the oestrogen, come on, come on, make more oestrogen.” And as that happens, the hypothalamus becomes hyperactive and it triggers this temperature phenomenon and so the moment you put oestrogen in, the hypothalamus says, “oh, that’s nice – oestrogen – just relax” and the hot flushes stop. The only problem is when you stop and take away the HRT, the oestrogen, whether it is in 6 months or in 10 years, then the hot flushes flood back. When you use a herb, it is much slower acting, it usually takes about 6 weeks, and can take up to 3 months to clear the hot flushes; however, once you have cleared them, then in another 2 or 3 months you can taper off and you may never need it again. You may have to experiment to find which one is best for you. After a while you get to be intuitive with women and you can say, I think I would try Black Cohosh first or I think I would try Agnus Castus first. Agnus Castus is from the European tradition, Black Cohosh is the American Indian tradition and Dong Quai is from the Chinese and nowadays they are available to all of us all over the world.

Could these herbs be regulating these changes in a similar way to the mechanism by which the hypothalamus regulates hormones in the body?

Possibly. But these different herbs contain such a vast amount of phytochemicals and we are only beginning to scratch the surface of phytochemicals. With the flavonoids, for instance, there are 4000 that have now been isolated, but there are probably 20,000 altogether that have not been studied. And these have powerful antioxidant properties, much more powerful than Vitamin A, C and E and there are many types of other plant-regulating chemicals to be discovered and studied.

What would you suggest to women if and when they start having menopausal symptoms? Of course, they should see their ordinary doctor who may not be aware of natural practices.

It is very unlikely that they are aware.

Should they try to seek out a natural practitioner who can help them through this or do you suggest that they experiment on their own?

I don’t think that there is much danger with what we have been talking about. I think that you really need a homoeopath to prescribe homoeopathic remedies, not because there is danger, but just because you need to get the right potency and you need the right remedy.

Do you feel the same way about herbs?

No, I don’t. Suppose you decide that you want to take some wild yam and you have hot flushes and you know that that is one of the herbs that can be useful for that. So you take some wild yam and you take it for 3 months and you find that it really doesn’t do much for your hot flushes. What you are going to find is that it strengthens your body as a whole anyway, that it helps you to deal better with stress, it makes your libido better, you just feel better. Wild yam is one of the things that makes people feel very good, really great. No, it is not going to damage you.

You obviously know a tremendous amount about many natural approaches. However, what would you recommend for someone who is not familiar and is very confused and bewildered and possibly upset and distressed over symptoms and doesn’t know where to go to get information and to get help? I imagine that there are many of these women.

Yes, there are many of them. The problem here is that in an ideal world, yes, of course, you should go and see a doctor who understands the use of natural hormones, the use of herbs, or a nutritionist or a naturopath. The problem that I find is that just as 90% of lawyers are reasonably mediocre and 10% are brilliant, the same thing is true of doctors, naturopaths, nutritionists, etc. and the problem is finding a good one, the same is for a book, for that matter.

But of course the other problem is, how many times have you tried something that someone else has said is wonderful for them, makes them jump over the moon but it hasn’t done anything for you?

Well, that’s absolutely true. And how many times has the doctor or the naturopath or the nutritionist suggested something that you tried that didn’t work?

That’s the problem. I have become very sceptical.

Exactly. Because in fact to be a good practitioner you really have to be good. You have to really know your stuff. But I think that the thing that is important to realise is that you are dealing with things that are not dangerous. It is like suggesting to someone that they drink more water, eat more soybeans, because that will help balance their system. I think that in this world it is not easy to become informed and one has to be, because otherwise ultimately it is only you that you can trust.

It has been lovely speaking with you. Thank you Leslie.

Further Information

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