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Estrogen &Progesterone Imbalances - Natural Progesterone Cream
Estrogen &Progesterone Imbalances - Natural Progesterone Cream
September 30 2006 at 4:07 PM Helen (Login Helen_N)


Imbalances of estrogen and progesterone in female:

1. Progesterone deficiency

Symptoms: Premenstrual Syndrome (PMS), insomnia, early miscarriage, painful or lumpy breast, infertility, unexplained weight gain and anxiety.

Discussion: This is the most common hormone imbalance among women of all ages.

Solution: Estrogen free diet, discontinue birth control pill and use natural progesterone cream to increase the progesterone level.

2. Estrogen deficiency

Symptoms: night sweats, mood swings, depression, hot flashes, sagging breast, vaginal dryness, osteoporosis, fibrocystic lumps, night sweats, painful intercourse and memory problem.

Discussion: This hormone imbalance is most common in menopausal women; especially with petite and/or slim women.

Solution: Progesterone is a biochemical precursor to estrogen. Progesterone cream alone is sufficient to restore estrogen balance and relief of many of the symptoms. If after 3 months of progesterone cream, proper diet, nutritional supplementation of magnesium and B6 do not relive the symptoms, then low-dose natural estrogen may be considered. 2.5 mg of natural tri-estrogen cream ( 10% estrone, 10% estradiol and 80% estriol) provides the equivalent action of 0.625 conjugated estrogen such as Premarin. Herbs like black cohash have weak estrogenic effect. Isoflavone extracts and cruciferous vegetables extracts such as DIM may be considered as well.

3. Excessive estrogen:

Symptoms: bloating, rapid weight gain, heavy bleeding, migraine headache, foggy thinking, insomnia, red flush on face and breast tenderness during the first 2 weeks of menstrual cycle.

Discussion: This often comes about from excessive estrogen intake as part of a hormone replacement therapy program.

Solution: Discontinue estrogen replacement therapy that uses estrogen alone.

4. Excessive androgens (male hormones):

Symptoms: Acne, polycystic ovary syndrome (PCOS), excessive hair on face and arm, thinning hair on the head, infertility and mid-cycle pain.

Discussion: Excessive sugar and simple carbohydrates in the diet often cause this. Excessive sugar stimulates androgen receptors on the outside of the ovary. Androgens also block the release of eggs from the follicle, causing polycystic ovary disease.

Solution: Dietary adjustment to reduce sugar and grains and proper exercise are important. Natural progesterone cream could be used to maintain hormonal balance and discontinued when symptoms are resolved. If progesterone levels rise each month during the leuteal phase of the cycle, a normal synchronal pattern of estrogen and progesterone is maintained and excessive androgen seldom occurs.

5. Estrogen dominance:

Symptoms: Combination of absolute progesterone deficiency and excess estrogen, resulting in a relative increase in estrogen in comparison to progesterone.

Common symptoms include:

· Acceleration of the aging process
· Breast tenderness
· Depression
· Fatigue
· Foggy thinking
· Headaches
· Hypoglycemia
· Memory Loss
· Osteoporosis
· Pre-menopausal bone loss
· Thyroid dysfunction
· Uterine cancer and fibroids
· Water retention
· Fat gain around abdomen, hips and thighs

Discussion: This is the result of low estrogen but even lower progesterone. Up to 50% of western women, especially those who are obese between the ages of 40 and 50 suffer from estrogen dominance.

Solution: Reduce stress, sugar and coffee from diet. Adrenal function is normally compromised in a person with estrogen dominance. Normalization of the adrenal function should be considered first, as well as relief of stressors. Follow a natural whole food diet, application of stress reduction techniques and natural progesterone cream in physiological doses (20 mg a day).

Premenstrual Syndrome (PMS)

In addition to menopausal symptoms commonly blamed on estrogen deficiency instead of relative estrogen dominance, researchers noted that many women suffer a similar set of symptoms associated with estrogen dominance during the menstrual cycle of each month. Dr. Katherine Dalton published the first medical report on PMS in 1953. She observed, that administration of high dose progesterone, by rectal suppository, relieved symptoms of PMS.

These symptoms often occur during the two weeks before menstruation and are associated by unopposed estrogen and progesterone deficiency during this period. The most common complaints are weight gain, bloating, irritability, depression, loss of sex drive, fatigue, breast swelling or tenderness, cravings for sweets and headaches. This is called Pre-menstrual Syndrome (PMS). It is important to note that not all PMS symptoms are caused by progesterone deficiency. Hypothyroid can produce similar symptoms. Stress, leading to adrenal exhaustion and low adrenal reserve, commonly seen in working mothers, for example, can also cause similar symptoms. A low fiber diet can cause estrogen to be reabsorbed and recycled. Excessive intake of xenoestrogen laced beef and poultry also contributes to relative estrogen dominance associated with PMS. Natural Progesterone has been used effectively to treat many PMS patients, according to Dr. Lee and Dr. Hargrove.

Elimination of coffee, sugar and alcohol, together with exercise, refrain from dairy products and natural progesterone replacement, frequently reduces the symptoms of PMS. A diet, high in phyto-estrogen or supplementation of isoflavone extract or DIM, as well as nutritional supplementation with nutrients high in fatty acids, such as evening primrose oil or fish oil, to reduce the inflammatory response, also helps. Avoidance of food, high in a special kind of fatty acid called Arachidonic acid, commonly found in fatty fish like salmon and mahi mahi, should be considered, as Arachidonic acid contains pro-inflammatory prostaglandin.

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EVE MEMBERS The Progesterone Solution September 30 2006, 4:08 PM

Once the concept of estrogen dominance is understood, the cure is simple - reduce estrogen load and or increase progesterone load.

The best way is first through normalization of adrenal function that is commonly compromised in most people with estrogen dominance. When this fails, one can replace the body with physiological doses of progesterone (approximately 20-30 mg./day) to overcome the estrogen dominance and reestablish hormonal balance. Raising the level of progesterone by supplementation (orally, by injection or topically) often provides dramatic relief from PMS, pre-menopausal and menopausal symptoms.

Taking phytoestrogen rich food, such as soy products, is another alternative way of reducing estrogen as these foods contain weak estrogens that competitively take up the estrogen receptor site, making estrogen less available for use. Foods that have estrogenic activities include: oats, peanuts, cashew nuts, wheat, apples and almonds. Interestingly, ginseng also has a weak estrogenic effect. Phytoestrogen also appear in a host of herbs, including black cohash, alfalfa, pomegranate and licorice. While widely promoted as the miracle food in recent years by the soy industry, it should be noted that soy products have their own set of problems. Unfermented soy products, such as tofu, contain acid that, in fact, rob the body of many valuable nutrients and should not be taken in large quantity. Fermented soy products, such as miso, do not have this problem and are the way to go.

Benefits of natural progesterone include:

· Stimulates osteoclast bone building (Osteoporosis Reversal)
· Helps use fat for energy
· Natural Diuretic
· Natural antidepressant
· Restores sex drive (Libido)
· Normalizes zinc and copper levels
· Facilitates thyroid hormone action
· Prevents endometrial and breast cancer
· Protects against fibrocystic breasts
· Normalizes blood sugar levels
· Normalizes blood clotting
· Restores proper oxygen cell levels
· Normalizes Menstrual Cycles

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EVE MEMBERS Natural vs. Synthetic Progesterone September 30 2006, 4:10 PM

The natural form of progesterone is derived from wild yam. It is very different from the synthetic unnatural form made in a laboratory (the widely prescribed Provera). The synthetic version is a chemical compound called "progestin". It is a prescription drug commonly used in small amounts to balance the estrogen effect in a hormone replacement program. Being a drug, progestin is far more powerful than a woman's natural progesterone. It is metabolized in the liver into toxic metabolites which if excessive, can severely interfere with the body's own natural progesterone. This creates other hormone-related health problems and further exacerbating estrogen dominance.

The structural differences between natural and synthetic progesterone is significant with direct bearing on its functionality. Whereas natural progesterone causes a reduction in water and salt retention, synthetic progesterone do the opposite. This is why some women taking synthetic progesterone in their birth control pill or estrogen pill combined with synthetic progesterone during menopause experience bloating and fluid retention. In fact, studies have shown that administration of synthetic progesterone lowers the blood level of the body's natural progesterone.

Reported side effects of synthetic progesterone include an increased risk of cancer, increased risk of birth defects if taken during the first four months of pregnancy, fluid retention, abnormal menstrual flow, nausea, acne, hirsutism, mental depression, nausea, insomnia, masculinization, and depression. It is contraindicated in those with thrombophlebitis, liver dysfunction, known or suspected malignancy of breast and genital organs. One of the metabolites have an anesthetic effect on brain cells. A woman on high doses of synthetic progesterone is often lethargic and depressed and cannot be cured with anti-depressants such as Prozac.

Natural progesterone is obtained by extracting diosgenin from wild yams and then converting this component into natural progesterone in the laboratory. Natural progesterone is referred to as natural because it is the identical molecule to that which the human body manufactures. Such yam-derived natural progesterone should not be confused with "yam extracts" that are commonly sold in health food stores. Our body easily converts natural progesterone into the identical molecule made by the body. It cannot convert the "yam extracts" into progesterone. There is no evidence that such "wild yam extract" is converted into progesterone once it enters into the human body and unlike natural progesterone, no conclusive formal studies have ever been conducted that identifies any particular benefits from "wild yam extracts".

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EVE MEMBERS Side effects of Natural Progesterone September 30 2006, 4:11 PM

No known side effects exist when using natural progesterone in physiological amounts (20 - 30 mg a day for women and 6-10 mg a day for men) under normal conditions. It is therefore very safe. But as with most substances, too much can cause problems. Too much progesterone is actually counterproductive, as chronically high dose of progesterone over many months eventually causes progesterone receptors to turn off, reducing its effectiveness and may lead to toxic side effects, Some possible side effects include:

* An anesthetic and intoxicating effect such as slight sleepiness. Excess progesterone down-regulates estrogen receptors, and the brain's response to estrogen is needed for serotonin production. Simply reduce the dose until the sleepiness goes away.
* Some women report paradoxical estrogen dominance symptoms for the first week or two after starting progesterone. It is also common for those who have been deficient in progesterone for years, in the initial application of progesterone, to experience some water retention, headaches, and swollen breasts. These are symptoms of estrogen dominance, but paradoxically exhibited in the initial stages of progesterone application, as the estrogen receptors are being re-sensitized by the progesterone and "waking up". This usually goes away by itself and is not a sign of toxicity.
* Edema (water retention). This is likely to be caused by excess conversion to deoxycortisone, a mineralcorticoid made in the adrenal glands that causes water retention.
* Candida. Excess progesterone can inhibit anti-Candida white blood cells, which can lead to bloating and gas. Systemic candidiasis can be treated with a grain-free diet for 2 weeks, followed by 40 mg of progesterone ( using3% progesterone cream) a day applied vaginally and to the breast. More is applied gradually elsewhere to areas such as the neck, face, brow , and inner aspects of the arms. If side effects worsen, reduce progesterone dosage.
* Lowered libido. Excess progesterone block the conversion of testosterone to DHT. This primarily happens to men.
* Excessive progesterone can also lead to the increase in androgen production and ultimately increase in estrogen production within the adrenal hormonal synthesis pathway as the body shunts the excessive progesterone to these other hormones.

Excessive progesterone is normally caused by the excessive built up of progesterone in the body. This is more commonly seen in those who are self-administering topical progesterone cream in the wrong area. Progesterone cream should be applied to areas of the body that have good circulation but not high in fat. These areas include the wrist, back of the neck, and under part of the upper arm. Areas such as the abdomen, buttock and breast are high in fat and will retain progesterone faster than other parts of the body.

Absorption of progesterone from topical application is about 20-30% for the first day. A residual amount is left behind at the site of application, and this can accumulate in the subcutaneous fat tissue over time.

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EVE MEMBERS Low vs. High Dose Progesterone Cream September 30 2006, 4:14 PM

Progesterone cream comes in a variety of concentrations. Which is best? According to Dr Lee, low dose cream costs a little bit more, but it is the better way to go. There are two important reasons.

First, excessive progesterone in high dose (10%) cream is metabolized in the liver and some of the metabolite may have anesthetic properties on the brain, causing lethargy and depression.

Secondly, progesterone is rapidly absorbed from the skin and there is a danger that the release of progesterone into the blood stream is not smooth. Since progesterone has a half-life of only 5 minutes, once in the blood, its effectiveness is limited.

Other physicians favor a higher potency cream ( up to 10%) because they have better results. Regardless of whether it is high or low dose, the key is that your progress is being monitored by a qualified health care professional.

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EVE MEMBERS How to apply Progesterone Cream September 30 2006, 4:17 PM

It is important to be as accurate as possible when applying progesterone. The best low dose progesterone cream should contain 1.7% of progesterone and yielding 20 mg of progesterone per application. The simplest application method is through the use of metered pump that measures the exact amount (20 mg), each time the pump is pressed.

Progesterone is best absorbed where the skin is relatively thin and well supplied with capillary blood flow. Areas such as face, neck, upper chest, and inner arms are good areas. Spread out to as big an area as possible for maximum absorption and allow as much time for absorption as possible. Therefore, bedtime application is best if you are applying it once a day. Twice a day application is best but it may be too troublesome for most. Rotate to different areas to avoid saturation in any one particular site.

Here is a sample rotational application protocol:

Day 1 morning: Apply to the right side of the back of the neck.

Day 1 before bed: Apply to the left side of the back of the neck.

Day 2 morning: Apply to the right wrist area, with palm facing up.

Day 2 before bed: Apply to the left wrist area , with palm facing up.

Day 3 morning: Apply to the underside of the right upper arm.

Day 3 before bed: Apply to the underside of the left upper arm.

Repeat this cycle from day 4 onwards. In other words, day 4 will be the same as day 1, and day 5 will be the same as day 2 , etc.

Practically speaking, the best gauge for the ideal dose should not be determined by any laboratory test alone. It is important to rely on relief of symptoms when figuring out the ideal dose. The right dose is the dose that works.

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EVE MEMBERS Women in pre-menopause - still ovulating September 30 2006, 4:19 PM

Women in pre-menopause - still ovulating:

· Use: Progesterone cream can be used to relieve PMS, painful cramps with periods, menstrual irregularities, prevent cancer and to protect against osteoporosis later in life.

· Direction for those on no hormonal supplementation: Count the day the period begins as the first day. Apply 20mg (one full pump when properly dosed) of natural progesterone every day from day 12 to day 26. Those with longer cycles may wish to use from day 10 to day 28. Begin the cream after ovulation that usually occurs about 10 to 12 days after your period begins. If bleeding starts before day 26, stop the progesterone and start counting up to day 12, and start again.

· Direction for those on synthetic progesterone (progestin) supplementation: Taper off the synthetic progesterone gradually and replace with natural progesterone over a 3-6 month period. Synthetic progesterone can be reduced to every other day and then further taper off.

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EVE MEMBERS Women in peri-menopause September 30 2006, 4:20 PM

Women in peri-menopause (still menstruating with menopausal symptoms and/or PMS but not ovulating):

· Use: Progesterone cream can be used to relieve PMS symptoms and prevent osteoporosis.

· Directions: Count the day the period begins as the first day. Apply 20 mg of natural progesterone (one full pump when properly dosed) from day 7 to day 27. If your period begins early, stop using Progesterone cream while you are bleeding.

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EVE MEMBERS Women in menopause September 30 2006, 4:21 PM

Women in menopause (not menstruating):

· Use: For prevention or reversal of osteoporosis and relief of menopausal symptoms.

· Directions for those who are not on estrogen replacement therapy: Choose a calendar day, such as the first day of the month. Apply 20 mg of natural progesterone (one full pump when properly dosed) of natural progesterone daily from day 1 to 25. Let the body rest the rest of the month. If a woman has not been making progesterone for a number of years, the body-fat progesterone is probably low. In this case, double up on the application for the first 2 months, and return to normal physiological dose thereafter.

· Directions for those who are on estrogen replacement therapy: reduce the dosage of estrogen supplement to half when starting the progesterone. If not, the woman would likely experience symptoms of estrogen dominance during the first one to two months of progesterone. Every two to three months, reduce the estrogen supplement again by half. Estrogen and progesterone can be used together during a three-week cycle each month, leaving a rest period of 7 days without either hormone. The estrogen dose should be low enough that monthly bleeding does not occur but high enough to prevent vaginal dryness or hot flashes.

· Directions for those taking an estrogen and synthetic progesterone (such as Provera) combination: Stop the synthetic progesterone immediately when progesterone cream is added. Estrogen should be tapped off slowly.

· Low dose natural estrogen (estriol) may be added for 3 weeks out of the month in cases of menopausal symptoms such as vaginal dryness and hot flashes unrelieved by progesterone cream alone.

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EVE MEMBERS Other Special Uses September 30 2006, 4:27 PM

Other Special Uses:

· Osteoporosis: apply 20 mg daily from day 1 to day 25 of the menstrual cycle. Baseline bone mineral density (BMD) test should be obtained. If after 1 year, if the bone density increased, the amount can be reduced by half. If BMD does not increase, other factors such as exercise, diet and optimization of nutrition should be undertaken together with a full medical workup to identify other underlying causes.

· Severe PMS or endometriosis : apply 20 mg from day 12 to day 26.

· Uterine cramps: apply above the pubic area at onset of cramps.

· Hormone related headaches: apply creams to the sides of the neck just behind the earlobe at onset of headache. Do not use on day 28.

· During hot flashes: apply a small dab to the inside of the wrist at the onset of hot flashes.

· Premenstrual migraine headaches: Apply 20 mg progesterone cream during the 10 days before the period begins. Be alert to aura that usually precedes these headaches. You can apply a small glob (1/4 to 1/2 teaspoon) every 3 to 4 hours till symptoms subside.

· Polycystic ovary disease: Apply 20 mg of progesterone cream during day 14 to 28 of the menstrual cycle. Adjust accordingly if for longer or shorter cycle. As the hormonal balance is regained, facial hair and acne, two commonly associated symptoms, will disappear.

· Progesterone cream and pregnancy: According to Dr. Lee, one of the chief causes of early pregnancy loss is the failure of the body to increase progesterone production sufficiently during the first several weeks after fertilization. Women who are having difficulty conceiving or who may be at risk of a miscarriage may wish to discuss with their physician to begin natural progesterone supplementation after ovulation.

· Breast cancer prevention: Breast cancer occurs most often during estrogen dominance. Dr. Graham Colditz of Harvard postulated that unopposed estrogen is responsible for 30% of breast cancer. Preventive low-dose progesterone supplementation (12-15 mg per day) can be used 24 to 25 days a month should be considered, especially for those at risk.

· Breast cancer patient: Progesterone supplementation should be maintained for life with all breast cancer patients, before, during and after surgery.

· Uterine fibroids: 20 mg of progesterone cream can be used from day 12 to day 26. You can start as early as day 8 and go through day 30. Ultrasound tests can be obtained initially as baseline and after 3 to 6 months of use. A 10-15% reduction in size is generally expected or at least the size should not increase further. Continue this treatment until menopause if it is successful. At menopause, progesterone application can be reduced. Fibroids normally atrophy after menopause as estrogen level reduces.

· Breast Fibrocysts: Apply 20 mg of progesterone cream from ovulation ( day 12 to 14) until the day or two before the period starts. Normal breast tissue will return within 3 to 4 months. Also take 400 IU of vitamin E at bedtime, 600 mg of magnesium and 50 mg of vitamin B6 a day. Do also refrain from coffee and reduce sugar and fat intake.

· PMS: Apply 20 mg of progesterone cream from days 10 to 12 to days 26 to 30. This is best done in two divided doses, with a small dab at night starting on days 10 to 12 and gradually increasing to two dabs per day morning and night. Finish off the last 3 or 4 days with bigger dabs. Each day total should not exceed 20 mg.

· Pre-menopausal women with hysterectomy or ovaries removed: Apply 20 mg of progesterone for 25 days of the calendar month and rest from day 26 to the end of the month.

· Menstrual Migraine: Apply 20 mg of progesterone cream during the 10 days before your period (days 16 to 26). Apply a small amount every 3 to 4 hours when you sense the "aura" coming until symptoms ceases.

· Increase Libido: Progesterone and testosterone are both important factors in libido. Testosterone is much more potent. Natural progesterone is the preferred choice.

· Hair Loss: When progesterone level drops due to ovarian follicle failure (lack of ovulation), the body responds by increasing the synthesis of androstenedione, an adrenal cortical steroid. This has some androgenic properties, resulting in male pattern hair loss. Natural progesterone supplementation for 6 months may be helpful to reduce the androstenedione level, at which time normal hair growth will resume.

· Hypothyroid: Thyroid hormones and estrogen have opposing actions. Progesterone also opposes estrogen. Symptoms of hypothyroid occurring in patients with unopposed estrogen or estrogen dominance (progesterone deficiency) become less symptomatic when progesterone is replaced.
Thank you for your post on this subject.

I have followed Dr. Lees guidelines, with his less cream is best approach.

At that point I was able to use the over the counter cream with great results. That was at age 49, when the only symptom was excruciatingly painful breasts and an instense sweat (hot flash) about 2 x week. Taking the cream 2x day at just a fraction of the recommended dose, quieted those symptoms.

Turn the page and I am now 52 and truly entering menopause.. I had a total of 6 monthly periods last year, my last being 3 months ago. I am seeing a physician who upon seeing I had no progesterone/blood workout results, placed me on a bioidentical progesterone cream from a NJ compounding pharmacy. Starting point dose being 50 mg in the quanity of 1 millimeter of cream, to be applied once a day at bedtime, on the lower arms.

This is a major change from the rotation application I have done. Also is a change to 1x a day. Now on the 5th day I am not sure this is bringing on a headache or if that headache is one of those pre menstrual ones I get prior to monthly.

And the last change that I am not too keen on is that there is no cycling (I still do get my period on occasion and have read even if you don't it is wise to cycle 3 weeks on and 1 week off). I will be cycling in spite of the initial recommendations. I did read Dr Lees book and it does make sense to cycle.

I decided to reduce the dose to 20 mg eve (approx) and 10 mg morning (approx) and go back to a rotation approach, following the specifics you gave on your post. I would rather come up short in progesterone and have to increase it, than to overdo and get a negative system response.

This Dr is very cooperative and easy to deal with, so there will not be any negativity regarding changes made to his directions.

The Dr plans to add other hormonal doses to this after he sees what the blood workup reads from this dosing with progesterone.

I also am taking 1 mg of melatonin nightly, in accordance with not just this Drs advice, but with the author of Melatonin Miracle. It makes perfect sense, and offers hormonal balance/support.

I veggie juice daily and am working ground flax seed into my diet.

I am reviewing ionic trace minerals just in case there is any validity to their use.

Blood work up read complete deficit in progesterone.
Fixing the progesterone first to see if the other lower areas are boosted naturally, for the others are on the low side, with the exception of high testosterone (which may be due to contamination by husband doing Testosterone cream/he now washes all off before coming near bed or me) Re test on blood levels should show the testosterone down if indeed he was a contaminating source!

Blood tests:
Estradiol 21
Cortisol AM 10.4
Testosterone 50
FSH 43.4

All bases covered or are they? Do you have any suggestions? Open to all resources and thank you for your time.
Hello Sensuwolf,

I would like to chime in if that's OK.

The levels depend on what cycle day it is. Measuring during several intervals during the same month would also be a good idea. But it could be an expensive idea.

Generally speaking....
PROGESTERONE <0.5 = Very low.
Estradiol 21 = Low
Testosterone 50 = Within normal range.
DHEA 54 = High if measured in nmol/L, low if measured in ng/dl.
FSH 43.4 = Normal for postmenopausal, very low otherwise.
TSH 3RD GENERATION 4.02 = meaningless without T4, T3. TBG would be helpful.
Cortisol AM 10.4 = Within normal range.
SHBG would also be good to know.

How would you like to attack this?

a) From a simulation of hormone levels using exogenous means, such as progesterone cream and/or herbs at appropriate times in a simulated cycle, or

b) From attempting to restore natural hormone levels using the ovaries and ovulation, so that there would be natural estrogen and progesterone (endogenous). The problem with this option is that perimenopause symptoms could return as could the cycle. I doubt it, but it could be a result.




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