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Natural progesterone for premenstrual syndrome (PMS)

IHN logoNEW YORK, NY. Progesterone is the hormone of pregnancy. It is produced by the ovaries and prepares the lining of the uterus for the fertilized egg. Progesterone analogues, the socalled progestins, are chemically synthesized and are used in birth control pills and in the treatment of endometriosis (Depo-Provera or medroxyprogesterone acetate). Natural progesterone is chemically identical to the hormone produced by the body and is derived from extracts of yams or soybeans. Dr. Joseph Martorano, MD of the PMS Medical Center and Marla Ahlgrimm of the Madison Pharmacy Associates have just released a comprehensive report discussing the differences between natural progesterone and synthetic progestins. They suggest that the synthetic hormones compete with natural progesterone in the body. The resulting decrease in the level of the natural hormone can lead to a worsening of premenstrual symptoms such as depression, headaches, and water retention. The authors recommend that women suffering from PMS not be treated with synthetic progestins, but be weaned off them and started on therapy with natural progesterone. The "wash-out" period should be one to two months, but may be shortened if the condition is serious. Normal dosages of natural progesterone are 100 mg of oral micronized capsules two to four times daily, two 200-300 mg "Even Release" tablets daily or 200-400 mg suppositories two times daily. Creams, gels or lotions may also be effective if they provide 10-30 mg of progesterone per twice daily applications. Natural progesterone is usually taken only during the second half of the menstrual cycle (from ovulation until beginning of menstruation). For mild cases of PMS taking progesterone for a few days prior to menstruation may be sufficient.
Martorano, Joseph T., et al. Differentiating between natural progesterone and synthetic progestins: clinical implications for premenstrual syndrome and perimenopause management. Comprehensive Therapy, Vol. 24, June/July 1998, pp. 336-39

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