Progesterone and bone health

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By Jeff Behr

Bone mass in women is highest during their early to mid-30s, after which a gradual decline occurs until menopause. At menopause, this bone loss accelerates for three to five years, then decreases at a steady rate of about 1 percent per year. This menopausal acceleration of bone loss strongly suggests that a decline in a sex hormone is the cause of it. But which one?

Osteoporosis and estrogen

The late Dr. John R. Lee, MD—Harvard trained physician and highly respected book author and lecturer—writes, “Mainstream medicine strangely persists in the belief that estrogen supplementation is the best treatment for osteoporosis in women. Yet the most authoritative medical textbooks do not support this contention.” Example: Harrison’s Principles of Internal Medicine, “Estrogens may decrease the rate of bone resorption [bone mineral loss], but bone formation usually does not increase and eventually decreases. [Although] estrogens retard bone loss ... restoration of bone mass is minimal.” Or, Scientific American, 1991: “Estrogens decrease bone resorption [and] associated with the decrease in bone resorption is a decrease in bone formation. Therefore, estrogens should not be expected to increase bone mass.” These authors also discuss estrogen’s side effects, including the risk of endometrial cancer, which “is increased six-fold in women who receive estrogen therapy for up to five years; the risk is increased 15-fold in long-term users.”

Conversely, when progesterone levels increase, osteoblast activity increases, thus stimulating new bone formation sufficiently enough to prevent Bone Mass Density (BMD) loss. In fact, research shows that women more than seven years postmenopausal will gain new bone and higher BMD from progesterone therapy whether or not they take estrogen.

Dr. Lee’s clinical studies clearly demonstrate that a majority of women do not need supplemental estrogen in order to have strong bones. Let’s now talk about natural progesterone’s role.

Osteoporosis and natural, bio-identical progesterone

We know that significant bone loss occurs during the 10 to 15 years before menopause, when estrogen levels are still normal but progesterone levels are dropping. Dr. Lee points out that, “The more important factor in osteoporosis is the lack of progesterone, which causes a decrease in new bone formation. In women with low bone density, adding progesterone can actively increase bone mass and density and may reverse osteoporosis.”

Dr. Lee cites several examples to illustrate progesterone’s bone benefits. “…In 1982, a 72-year-old woman came to see me after she had fractured her arm lifting her ill husband, and had been found to have severe osteoporosis. Until then, she had followed a good diet and had considered herself in good health. Her doctor had recommended a fluoride treatment, but she refused and came to me to try the progesterone skin cream therapy. After the first six months, [the] persistent pain in her “healed” fractured arm disappeared. Subsequent bone mineral density results, while treated with transdermal progesterone, [showed] a 29-percent increase in bone mineral density in less than three years of progesterone therapy. This is not at all unusual. When I originally wrote about this in my first book, this woman was 85 years old and continued to do well using progesterone cream. She recently died at home in her mid-90s. …” Dr. Lee continues, “…More recently, I received a phone call from a 72-year-old woman from Pennsylvania who had developed a very painful back due to a spinal fracture. Bone density measurements showed she had advanced osteoporosis. [She] prided herself on her youthful looks, good diet and other good health practices. She was appalled that despite all her good habits she had developed such severe osteoporosis. She had heard of my work with natural progesterone and was asking my advice. Her husband and son were both physicians. They and her own doctor told her that my ideas about progesterone and bone building were totally unsubstantiated.

“I sent her a copy of my treatment protocol and suggested she give it a try, under the care of her physician. Sixteen months later she sent me copies of her bone mineral density tests, performed initially after 8 months and again after 16 months. They showed a progressive BMD increase of 23 percent in 16 months. Of course, she was very pleased and was happy to report that her husband, her son, her own doctor and the radiologist were amazed, and they were all now using natural progesterone in their own practices…”

Clearly the more important hormone is natural, bio-identical progesterone because it stimulates osteoblast activity. Studies by Jerilynn Prior, MD, prove that osteoblasts do have progesterone receptors. When progesterone is present, osteoblasts are ‘turned-on’ and go to work building new bone formation.

(NOTE: synthetic progestins do not offer the same benefits and are linked to serious health risks.)

The evidence is undeniable—natural progesterone is essential to healthy, strong bones. Dr. Lee reports in his book, “Approximately 40 percent of the progesterone-treated patients in my study had been on estrogen supplements prior to starting progesterone, and most discontinued their estrogen. Those with the lowest bone density readings at the beginning showed the greatest response to progesterone. Further, patients who are now well up in their 80s continue to enjoy strong bones without evident bone loss while continuing their use of natural progesterone. Age is not the cause of osteoporosis; poor nutrition, lack of exercise and progesterone deficiency are the major factors.”

Natural progesterone supplementation alone won’t ‘cure’ osteoporosis, but it is a major factor in reducing its occurrence and reversing it, should it happen.

Physician John R. Lee sums it up quite well, “It is very clear that progesterone can be of great benefit to women with measurable bone loss. In most such cases, progesterone will rapidly and impressively build bone, along with proper diet, weight-bearing exercise and some vitamin and mineral supplements.”

Science reporter Jeff Behr based this article upon personal discussions with, and published works of, the late Dr. John R. Lee, MD—Harvard trained physician and highly respected book author and lecturer.

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