Since my book, From Hormone Hell To Hormone Well, has been released I get frequent calls and emails from women - and men - who are now convinced that they are suffering from estrogen dominance. They want to purchase bio-identical progesterone cream but they face two key challenges. The first is that they are having trouble finding a physician in their area who is knowledgeable about bio-identical hormone replacement. The second is that they have found several "natural" progesterone creams in health foods stores and on line but they aren't sure how to assess the quality of these products.

Because there are several purported "natural" over-the-counter progesterone creams on the market today, I emphasize that it is important for each patient to become an informed consumer before attempting to treat themselves. Most product labels do not specify whether or not they meet the following criteria for product excellence. Key questions to ask before purchasing any progesterone product:

1. Is the progesterone truly bio-identical?
2. Is the concentration of bio-identical progesterone in the product sufficient to foster response?
3. Do the hormones used in the formulation meet the United States Pharmacopoeia gold standards for quality and purity?
4. Was the progesterone product actually compounded under strict guidelines approved by the National Association of Compounding Pharmacists?
5. Is the progesterone incased within a liposomal delivery system? (Note: This is critical because, as the many layers of the liposome melt away like a snowball, the hormones are dispersed continuously through the skin for up to 12 hours.)
6. Can bio-identical progesterone alone alleviate my hormone imbalance or will I need an individualized prescription of more that one hormone?  

Some of my physician colleagues sometimes question my "merchandizing" my own over-the-counter formulation of bio-identical progesterone cream however, once I explain the wide variations in product on the market today, they agree that it is appropriate for me to draw on my expertise as a former compounding pharmacist to insure confidence in the product(s) I recommend and prescribe for my patients. In addition to Dr. Randolph's Natural Progesterone Cream, we also list close to a dozen other over-the-counter progesterone products that I have reviewed and approved in our second edition of From Hormone Hell To Hormone Well.  

When symptoms of hormone imbalance are not alleviated with supplemental progesterone cream alone, then the body is signaling that other hormone levels are shifting, e.g. estrogen and testosterone. Rebalancing these hormone levels will require a more comprehensive approach to bio-identical hormone replacement. Catherine Rollins, Editor of the Natural Progesterone Advisory Network, recently published an excellent article on progesterone cream dosage and uses (http://www.natural-progesterone-advisory- network.com/article050201-1.php). In her article, Ms.Rollins emphasizes that "this 'one size fits all' cookie-cutter approach to synthetic hormone replacement is out-dated, dangerous and invariably short of the mark of patient care and treatment.

At the conclusion of her article, Ms. Rollins suggests guidelines for individualizing a more comprehensive human-identical hormone replacement program. These include:

1. Use saliva testing for a complete and individualized hormone profile.
2. Supplement hormones only when you and your physician have confirmed you are truly deficient in them.
3. Use only bio-identical hormone replacement therapy rather than synthetic hormones.
4. Apply hormone replacement transdermally (through the skin).
5. Supplement hormone according to your unique reproductive cycle.
6. Use only in dosages that provide normal physiologic tissue levels.
7. Take cyclic breaks (from cream) to rest receptor sites and sustain balance.
8. If symptoms of hormone imbalance persist, consult you physician. Your individualized prescription of bio-identical hormone therapies may need to be adjusted.

Again, I tell every patient that I treat that: "It is your body, your responsibility and your hormones that are out of balance. Do your homework and make informed decisions. You can Choose Well!"

*Recommended resources include books such as my book From Hormone Hell To Hormone Well, Dr. Lee's three book series on What Your Doctor May Not Tell You About Menopause, Perimenopause, Breast Cancer, and Christiane Northrup's Women's Bodies, Women's Wisdom.  Recommended websites include www.hormonewell.com; www.natural-progesterone-advisory- network.com; www.salivatest.com; www.womeninbalance.org.

As progesterone begins to decline and estrogen becomes the dominant hormone within a woman's body, symptoms such as PMS, breast swelling, irregular periods, fluid retention, uterine fibroids, reduced libido and migraine headaches can occur. From their mid-thirties on, almost all women are estrogen dominant. In many cases, this condition of estrogen dominance can be neutralized by administering transdermal bio-identical progesterone cream. Once the body's optimum hormonal ratio of estrogen to progesterone is restored, most unpleasant symptoms will be eliminated.

Are you a physician who wants to learn more about bio-identical hormone replacement therapy and/or natural / complimentary medical products?

Livesee offers physicians a simple business mechanism for adding an integrative medicine component into their practice- allowing physicians to more comprehensively support the health and wellness goals of their patients while, also, growing the bottom line revenue of their practice.