Women seeking relief from symptoms associated with peri-menopause and menopause often reach for the progesterone cream. If you’re going through it, no pun intended, you know the symptoms. In case you’re unfamiliar, here are some of them: hot flashes, vaginal dryness, decreased libido, night sweats, mood swings, fatigue, difficulty concentrating, weight gain, increased pain, digestive disturbances, depression, memory lapses and more. Although bio-identical hormone replacement therapy might be appropriate for some people, the use of transdermal (through the skin) creams should be avoided.The purpose of using a cream is for seamless delivery of the hormone into the bloodstream. This delivery method prevents the complications associated with oral hormone replacement which gets processed through the gastrointestinal (GI) tract and liver. The GI tract and liver will break down the hormone into metabolites that differ from the original hormone and thus not produce the desired results. Avoiding this unwanted effect via the use of a cream won’t cut it however.
When a hormone cream is administered through the skin, not only does some of it go straight into the bloodstream, but the hormone also builds up in the sub-cutaneous (under the skin) fat. With consistent, prolonged application, the level of that hormone becomes elevated past normal physiological levels. And this can easily be seen on saliva testing of someone using a cream. When this happens, down-regulation of that hormone’s receptors is the result. Essentially, down-regulation means that there is a decrease in the number and sensitivity of the target cell’s receptors for that hormone. This prevents the hormone from working on the cells and producing the desired outcome that was originally intended. Down-regulation can be seen as a defense mechanism to prevent over-stimulation, but unfortunately it can lead to symptoms of deficiency because the hormone’s message(s) aren’t received.
Down-regulation of receptors isn’t the only complication. When the hormone builds in the subcutaneous fat, it can get released at random intervals and in random amounts unrelated to when or how much of the cream is applied. This is certainly a problem when the intention is to provide a specific dose during specific times of the day or month. Also, liver function becomes hampered because it now has the burden of having to metabolize and detoxify the excessive amount of that hormone. And when dealing with progesterone specifically, other hormones can become imbalanced as well. Progesterone is a precursor (meaning it eventually can get converted into another hormone) to many other hormones. These include the likes of estrogen, testosterone, androstenedione, DHEA, aldosterone, and cortisol. An artificial rise in any of these hormones due to the conversion of excess progesterone results in its own complications.
So now what? What are the best alternatives? Personally, I prefer sublingual liquids. These are absorbed through the mucosa of the mouth and go straight into the bloodstream avoiding immediate metabolism by the GI tract and liver. Additionally, people have success with creams or gels that are only applied through the vaginal or rectal mucous membranes, not the skin.
If you, or someone you know has been or is currently taking progesterone cream transdermally, (or other hormones transdermally), you should encourage them to have their levels checked via saliva to see how it’s affecting them. Chances are, their levels will be “off the charts”.
Dr. Rob D’Aquila – NYC Chiropractor – Diplomate of the International Board of Applied Kinesiology