Hardwired for Love
Nurturing yourself to vibrant health
ALSO BY
HELENE B. LEONETTI, M.D.
From Little Lion & the Yggdrassill:
Bridging The Gap: 21st Century Healing for Women (1998)
From Bridger House Publishers:
Menopause A Spiritual Renaissance (2002)
From Insight Publishing:
A Healthier You: Fabulous Ideas to Help You Live a Healthier Life (2005)
From Little Seed Publishing:
Living in Clarity (From the Wake Up…Live The Life You Love Series) (2008)
From Morgan James:
Inspiring Hope: Stories of Hopeful Living for More Success (2009)
Hardwired for Love
Nurturing yourself to vibrant health
HELENE B.LEONETTI, M.D.
Founder of the Self-Esteem Gene™
Phoenix, Arizona
Hardwired for Love
Nurturing yourself to vibrant health
http://www.HardwiredForLove.com
Copyright© 2010 by Helene B. Leonetti, M.D. at Smashwords
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To Ida Louise DeLuca Leonetti
My precious mother, who,
unlike her daughter
did not ever come to know
her enough-ness
or her divinity.
May she reign over the angel realms,
teaching them cooking,
baking, and
crafts,
through which every atom
she wove her love.
Foreword
When I first met Dr. Helene Leonetti some years ago in Pennsylvania, I was immediately impressed by a sense of what might be called mutual harmonies-we seemed to be on the same wave length-as if we'd been friends for years. For someone so petite, she radiated a sense of forthrightness that reminded me of that rare quality called true grit. Over time, I came to realize that her intellectual powers are amazingly well integrated with her heart and soul. She is that rare person who has arrived at a plane of development in which integrity, honesty and love permeates all phases of her life. This wonderful little book is the culmination of her personal character fulfillment. Using candid descriptions of her own pivotal life experiences, she communicates a path of life choices that turns obstacles into opportunities, doubts into convictions, anxieties into confidence, bad health practices into healing forces, and fear into love. Underlying all of this is her faith that, for true health and happiness, one must first love and honor one's own self and all others, since God loves us all despite our shortcomings. We must take charge in honoring that love by adopting healthy life choices: we have the power to be the best that we can be, regardless of circumstances. Her life and her health wisdom provide good direction for all of us to follow. Enjoy the book!
John R. Lee, M.D.
Acknowledgments
Thalia, my Greek soul sister who helped open my soul to true love;
Helen Paulus, my sage sister-in-heart who never let me sell out to my not-enoughness;
Tahya, elegant new friend and business associate who blends my teaching with her magnificent dance to teach self esteem;
Rose Moyer, my wonderful friend, born with the veil, who loves, and loves, and loves some more;
My son, Basil Leonetti, a major star in my firmament, who taught me mother love;
Deepak Chopra, who gave me courage to come out of the closet as a spiritualist;
Diane Cummings, my editor, whose wisdom and courage to know the essence off me created a masterful work in progress;
And on top, beloved Jakob: thank you for waiting.
Introduction
I went to college, medical school, and served a residency for twelve years, and no one ever taught me how to keep my patients healthy.
As a nurse in training in the sixties I was taught that doctors are gods and that we are to believe in their absolute authority. Through those years and the ones that followed when I was studying to become a doctor, I came to realize how disempowering that attitude was. It did no t give room for the individual to rely on his/her own knowledge, understanding and experience.
There is a lot right within the conventional medical community, yet there is a lot wrong too. One has only to look at how we doctors are trained, and that should b e enough to raise eyebrows about our ultimate wisdom. During our medical training and ensuing intern and resident years, we are deprived of the sleep required to adequately carry out our complex duties. And what does the medical establishment do about it? Nothing. It takes the legislature to pass a law requiring residents not to work over a certain number of hours without rest, so that the patients they serve will be protected from our mishaps, misdiagnoses and mistreatments.
We are taught nothing about healthy foods. Instead, we subsist on empty nutrition, high caffeine and sugar diets that ultimately burn out our adrenal glands and lower our immune states. We go from those long hours in the trenches home to study and then to bed, so that we rarely exercise, relax, have fun or smell the roses. Then we are expected to be sensitive, loving and caring with our patients when we have taken no time at all to nurture ourselves. Who has all the wisdom?
Our old conditioning tells us that viruses and bacteria cause disease and that most illnesses are hereditary, so that our ability to stay healthy is not within our grasp. Well, folks, it is time to get rid of that old, worn-out thinking, because we can free ourselves to recreate our destinies with new, healthy, and joyful beliefs.
Some years back, I saw the Light. My journey into true healing came serendipitously when I discovered the physician and author, Deepak Chopra’s, message: that each and every cell in our bodies is connected, that all of our cells are thinking cells, and further, that every word and every thought and every action produces a chemical or biophysical reaction within our bodies. It is pretty awesome, isn’t it, to think about what this means: we control our own destinies.
I have are current dream in which our powerful HMOs will one day give referrals first to the herbalist, the chiropractor, the naturopath, the homoeopathist, the massage therapist and the acupuncturist before prescribing pills or sending patients to surgery. I daresay more of us conventionalists would rapidly learn the tenets of natural healing.
I regularly go to a chiropractor and acupuncturist and receive the blessed healing touch of a therapeutic massage therapist. Through them I have experienced major improvement from a chronic low back ailment. In the past I had also counseled with a psychotherapist who has helped me get in touch with my inner world. Now, I am in a perfect place of knowing, at a deep level, how vital these healing modalities are and how marvelously they interface with what I do as a gynecologist.
I have looked at the exciting role that I play in my patients’ lives, and I realize that it in no way resembles the conventional doctor-patient relationship. Many years ago as a budding nursing student, I was admonished never to address patients by their first names, and to respectfully stand by their bedside, not to sit, and “contaminate” the bed linen. Well, thank God, I never resonated to such prattling, because I have come to learn that it is the intimacy with which we share our stories that brings about healing. I have learned that healing, true healing, takes place not only on the physical level but also more importantly, on our emotional bodies and deep within the soul.
Recently, I began a new lecture and class: “The Self Esteem Gene: Tapping into your Soul’s Wisdom and Harnessing Your Personal Power.” After discussing my years of dysfunctional relationships, then revealing how grace facilitated my healing, we sit in a circle with a talking stick and share our powerful stories. These sessions are a light that shines like a beacon, nurturing us, healing us, and reminding us that we are indeed magnificent.
Now that I know beyond a doubt the power of the body mind-spirit connection, I can teach my wonderful patient show to empower themselves to find the physician within themselves. We are indeed spiritual beings learning to be human, and the realization of our soul potential is the most exciting part of this magnificent journey.
I want you along as we embark on a most wonderful and exciting journey into self-healing. The secret to health is self-love and empowerment, achieved when knowledge is attained of the multiple and diverse ways to arrive at and maintain a healthy mind, body, and spirit, not one of which can work without the others.
Part I
The
Hormone
Connection
CHAPTER 1
Confessions of a Goddess
Let me tell you a story about someone I know. She was a pretty thing: born an only child to two adoring parents. Mom sewed her clothes from the time she was a wee one. She was voted best dressed in high school and May queen in eighth grade. For as long as she could remember, she was boy crazy. At age eleven, she walked home from school, adoring the boy we shall call Darin who walked on the other side of the street. Darin never spoke to her, never shared a story with her, but she concocted a fantasy that brought them together nonetheless.
The girl’s love life seemed to progress in high school. Freddie, the basketball hero, chose her for his girlfriend. But she wasn’t very reliable and he seemed very arrogant. He might, or might not, show up for their dates together. The girl would sit in her bedroom, peering out the Venetian blinds, most often in vain, for his hotrod. On the occasions he did show, no apologies, no explanations. Freddie liked her mother’s chocolate chip cookies, maybe more than he liked her. But our girl never complained nor did she ask for more in this lopsided relationship. Was she lucky that this fellow, coveted by so many other girls, had chosen her? She must, after all, be someone special.
As high school drew to an end with graduation looming, the girl sought out her guidance counselor querying her about the future. What she could be, as she entered this time when careers were being entertained? The answer she received was stark and terse: you are a woman; you can be a nurse or a teacher.
Being an obedient teen, our girl chose nursing because she felt drawn to the nurturing aspects of caring for the sick. So a registered nurse she became. She looked dashing in her nursing uniforms, with their charming caps and black velvet ribbons certifying her status.
As she grew, so did her beauty. She was wined and dined by many interns and residents. In each relationship—and they followed one after another in swift succession—she gave herself completely, vowing eternal love and commitment. But for all of her devotion, she was regularly dumped. These doctors, after all, were in training. They had hard years ahead with debt piling up. They were looking for distraction, not eternal love.
Around the age of twenty-six, while working in Montefiore Hospital in the Bronx, our girl was reminded by her Italian family that single professional women wound up old maids, and without marriage to a man with a future, her own future would be dire. Obedient girl that she was, she allowed herself to be fixed up with the brother of her cousin’s workmate. Her marriage was expected and “arranged” accordingly.
It was a story book wedding, followed by a magnificent honeymoon in Curacao. Then reality set in and she wasn’t ready for it.
When she fell in love with a towering, intellectual professor at her hospital, her guilt surfaced and the affair was revealed. At home, the physical abuse, which had shown itself subtly during their engagement, exploded into terror-filled days and nights and worsened with the erratic nature of the beatings. Our girl was never sure when the seemingly placid surface would be eroded by uncontrollable anger. She stayed, she was a bad woman, she deserved the beatings.
For a brief time in this eleven-year marriage there was peace, a kind of truce. She was living in Mississippi. She conceived and birthed her beloved son while her husband attended law school. He completed three years. Straight As. All was well. And then a political incursion erupted, and he was expelled, persona non grata, with no hopes of securing entry into another school.
Moving back in defeat to New Jersey, the beatings escalated. Her son was now three years of age and witnessing the abuse. One day, while tending to bacon sizzling on the stovetop, a sobbing overwhelmed her, and tears splashed down, crackling into the bacon drippings. She realized that she did not like what she had become as a result of this marriage.
Deciding finally to leave, she was faced with pleadings to stay, but her need to go to medical school was pressing.
Believing that her son would be better off with his father as she traveled to foreign shores, she was devastated years later to find that her husband’s anger had settled onto his son, who became the focus of his rage.
Fast forward, fast forward: Medical school was complete, and a magnificent Brit entered her life during residency. Her marriage to this adoring man seemed to be the answer to her prayers: she finally felt loved to the extent she craved, and she plotted to leave medicine so that she could spend all her time with him. Alas, the Universe has a wicked sense of humor, for as they made love one night a short time into their marriage, he suffered a massive heart attack and died in her arms.
Stuffing her grief, our girl threw herself into her residency, delivering babies, operating on women with ruptured ectopic pregnancies. Her only solace.
Then enter husband number three. He wooed her, promising a magnificent and wonderful life. She married him with great trepidation because she sensed his controlling ways. But she already had succumbed, and then life catapulted into a black abyss of fear and despair, which one was more consuming, she could not say.
Plotting one’s death with such laser-sharp precision cannot even be given words. But her misery so complete, her joy so entirely lacking, and her consuming need for reprieve from pain muted all that might be pleasurable. She could no longer plan for the future, revel in the song of a bird, be dazzled by the beauty of a rose, or share in the hopes and dreams of her son. Her suicide attempt was thwarted, though, and she awoke in a hospital bed enraged to be viewing a bright sunshiny day and a nurse peering down at her with contempt.
Still asleep, she engaged her fourth husband, this time a spiritualist who taught meditation and engaged her and assisted her in writing her teachings and memoirs. This ten-year odyssey crumbled as she recognized that she was the wind beneath his wings, and not the other way around, as he had told her and she had once thought.
In a fascinating parallel to those many years ago, she found herself cooking bacon, again, weeping uncontrollably, her tears again falling into the sizzling pan.
“What does bringing home the bacon mean to you?” asked one of her best friends, Helen Paulus.
Hmm... she finally acknowledged that she had financially supported husbands in two of her marriages, stuffing the anger and despair it caused. Finally she left this fourth husband, and at least, so she thought, was at the top of her game. She was a published author, Reiki master, researcher, respected holistic gynecologist. She had it all.
But wait a minute. Did she still have lessons to learn?
The man she had loved throughout medical school and in between all these marriages came strongly into her mind. She remembered with shame that for each of her last three marriages, she had dumped him. It had been almost sixteen years since she had seen or spoken to him, but now she felt an inexplicable urge to reconnect. She knew she could not rest until she moved on her feeling. Her reunion with this man would be her final waterloo and would catapult her toward a showdown with herself.
Despite living sixty-six years on this planet, I can truly say that only in the past two of those years I have learned to love myself unconditionally. What are you talking about, you ask? You, who accomplished great things against obstacles most would have thought too daunting to attempt. Yes, I respond, I know. I went to medical school in Mexico near the age of forty; I entered a competitive surgical subspecialty at forty-five when most are winding down into a kinder, gentler practice. And I studied herbalism, and bio-identical hormones, and spirituality, incorporating them into use with my patients, despite my being called “quack” by many of my colleagues.
During a profound depression, my ego finally gave way, and that would change the way I viewed myself and the world I inhabited. Menopause was the impetus that let me die to my old self and rebirth the new me that has come full circle into self-respect, and self-love.
Beloveds, I am here today, despite forty years of drama, to let you know that healing, that perfect health, continues to be our birthright. We are on a journey to this healing. I want my story to give you the courage to begin yours.
CHAPTER 2
Menopause:
A Spiritual Renaissance
Each person carries his own doctor inside.
Patients come to us not knowing that truth.
We are at our best when we give the doctor
who resides within each patient
a chance to go to work.
—Albert Schweitzer
Do you know of the marvelous work by Clarissa Pinkola Estes called Women Who Run With the Wolves? You know now that if you read the Bluebeard story you will get a picture of me. I was a chief resident when I met my soon to be third husband, the Robert Redford lookalike with a CV from here to Mars, who wined, dined and pursued me relentlessly until I gave up and married him, knowing that it was to be a deadly mismatch. I had lost my identity, and all my joy and spontaneity, which had so attracted me to him, slid into oblivion, as I catapulted deeper and deeper into the abyss of depression. Couple this with a profound sense of my own inferiority at becoming the great white physician after having been the obedient nurse——I was once made to stand when a physician entered the room, add a pathetic total absence of self esteem, and include shouldering the anger and resentment of a sixteen year old son desperate too be accepted by a new stepfather who had no regard for children, and I was, to say the least, vulnerable. What tossed me over the edge was a condition that I would subsequently devote much of my professional life to exploring—Menopause.
My periods were becoming scant and irregular, and finally, feeling rotten from anti-depressant medications, I started to take hormone replacement therapy. I wish I could report that these hormones were making me feel better; perhaps the hot flashes improved, but my overall sense of despair did not. Using my body and my soul as a laboratory lesson, I launched into studying everything I could about menopause and vowed to be the best teacher I could be.
The literature in the industrialized world is replete with allusions to the multiple emotional upheavals associated with menopause and hormone imbalance. Needless to say, this information is fueled by the medical-pharmaceutical industrial complex, which, by their very connection with pathology, take a meaningful transition in a woman's life and transform it into a nightmare of parchment paper-like vaginas, bones that crack and break, and hearts doomed to suffer fatal attacks.
I was never taught in medical school that menopause is a natural life transition, one that signals entry into a magnificent state of wisdom and power. But I have learned on my own that it is.
One of the many areas where we are stuck is in old thinking about menopause. We are led to believe that when we reach our late forties or early fifties beauty fades, our sexual desirability wanes, and we risk multiple chronic illnesses. Nothing could be farther from the truth. Our loving Creator provided us women with this special time in life to recognize the true essence of our being. It is no coincidence, though, that as menopause approaches we do experience some dramatic bodily changes: hot flashes and night sweats, sexual dysfunction, hair loss or unwanted hair growth, constipation, weight gain, bleeding, depression and brain fog. God in His/Her incredible wisdom provided these gifts in order to nudge us into seeking help for our own needs. After all, think just how long we have been nurturing everyone else’s needs instead of our own.
I began some years ago giving monthly lectures called The Good News about Menopause, a seeming oxymoron for many women. I wanted all women to understand that menopause is not the beginning of the end, but indeed is a spiritual renaissance, the beginning of the best time in life. Many women need to be helped through to this attitude, and it is my mission to remind them, and their significant others, of that fact. For seven years, in a monthly healing circle, known as A Menopausal Enrichment Circle for Women, a gathering co-facilitated by a psychotherapist, we set the stage for a safe and sacred space where women could share their dreams, fears, and often-traumatic stories of their journey toward wholeness.
I have sought not to “medicalize” the subject of menopause, where menopausal women become victims of the powerful medical-pharmaceutical complex. Rather, my approach is that menopause is a natural state, not a medical condition, and that it can, indeed must, be considered from a view of wholeness, connecting together the body, mind and spirit. In fact, what I ultimately recognized was that until you put your body, mind and spirit in order, all the pharmaceuticals in creation will not help. And further, promoting dependence on a chemical existence, which has been the basis of our medical philosophy over these last fifty years, continues to keep patients victims and the great white father physicians our saviors. (Our Asian sisters and those in third world nations snicker at our obsession with synthetic pharmaceuticals that we think will save our lives.)
So come along with me, my sisters, and see how we can make menopause a magnificent journey.
Take Home Pearls
•Menopause is not a disease: This change of season signals a time of great power when we complete our fertile years and move into our wise-woman years.
•Symptoms of flashes, insomnia, brain fog, anxiety are our friends, come to remind us of our imbalance
•Self love, taking our needs first, is key!
CHAPTER 3
Estrogen Myths –
Progesterone Magic
Seek not to find out who you are,
seek to determine who you want to be.
—Neale Donald Walsch
As a new graduate nurse working in Montefiore Hospital in the Bronx, I was particularly idealistic and fiercely protective of my patients. One day as I cared for Mr. Artusi, a delightful man in his mid thirties, an entourage of physicians and those to be descended into his room like Attila and his forces—all power and business. There, preceding the pack was Dr. Ackerman, chief of Orthopedics. He was followed by his chief resident, his junior residents, his interns, the medical students, and lastly, the premedical observer, a being swooning over the hallowed profession of medicine and praying for admission to the hallowed halls among these godlike beings.
Mr. Artusi had a dangerous infection of his hipbone, called osteomyelitis, and although he was on massive doses of long term antibiotics, the specialists feared he was not healing. As they marched in, they began their medical blathering without even acknowledging this patient’s presence, not even saying hello. The chief resident presented his case to the great Dr. Ackerman, as if the patient were a cadaver. The discourse proceeded through the history of the present illness, past medical history, family’s medical history, social history, the proposed treatment, and finally the prognosis. The patient looked on terrified, as if he was hovering over his own funeral. Finally, the troops turned and marched out, ready to descend on yet another pathology specimen.
I was so incensed that my Italian temper, which rarely surfaced, now rose full force, and I raced down the hall after God … oops … I mean Dr. Ackerman. He was a tall man and I, barely over five feet, had to strain up on tippy toes to look him in the eye.
"You know, you didn't even have the common decency to say hello to this patient or ask him how he felt,” I admonished. “What kind of a doctor are you?"
Dr. Ackerman just stared at me, perplexed. He simply didn’t get it.
I was amazed and disgusted, yet grateful for this experience because it marked a turning point for me. You see, doctors are not—or at least they haven't until recently—been taught the least measure of civility. They have not known to place the sensitivities and emotional well being of a patient on an equal footing with his physical health.
And I now understand so well that healing needs to be invited by several modalities: definitely a look at the patient’s history and prognosis. But incorporated into treatment must come emphasis on many other elements including nutrition.
Since my entry into the caring professions as a nurse in11961, I have been counseled about the benefits of estrogen replacement therapy (ERRT) for the menopause. Estrogen is touted in magazines, medical journals and on TV talk shows. We medical doctors are taught that without estrogen women will sustain life-threatening fracture s, die in great numbers of cardiovascular disease, become old and lose their zest for life.
This view is largely the responsibility of a doctor named Robert Wilson, who wrote a book called Forever Feminine, in which he described women who did not replace their falling estrogen stores in menopause as virtual shadows of their former selves, destined to become dried up, sexless hags with no one willing to love them. A woman with flagging self esteem didn't have to read much of that nonsense before she ran to her physician for some of the magic potion. And indeed, during the sixties and seventies, doctors were prescribing for women large and pervasive doses of estrogen.
We women were given a bum steer for all of those years, and sadly, we bought into it. How fascinating that in spite of the fact that menopause is a universal event, only in our modernized western societies, particularly America, do we pressure women into a mindset that espouses menopause as veering into a decrepit state which only a pill can fix. And sadly, I must remind you, we learn this from the seminars and journals and conferences that are sponsored and subsidized by the mammoth pharmaceutical industry.
A BIG BLUNDER
During the time from the late 1950s through the seventies, while women were given these large estrogen doses, problems developed. It was discovered that about 4 percent of the women taking estrogen developed uterine cancer. Because of that discovery, it was seen that another substance had to be added to protect the uterine lining. That substance, developed by the drug companies was a synthetic progesterone, called progestin (branded Provera). But it had many nasty side effects, and women began refusing to have anything to do with hormone replacement therapy of any kind. Women who suffered erratic bleeding during menopause finally invariably submitted to hysterectomies.
Today we know more, but we’re still behind the times. Synthetic estrogen and synthetic progesterone are still around, and they’re still creating a fair amount of havoc. Although only15percent of American women use estrogen because they fear the increased risk of breast cancer, most doctors persisted in encouraging its application. Even more confounding is the fact that most women experiencing menopausal symptoms, for which estrogen is prescribed, are actually estrogen dominant: their bodies have too much estrogen!
A LITTLE BACKGROUND
To explain as we progress through our thirties into our forties, many of our menstrual cycles are an-ovulatory; that is, they produce no eggs. These an-ovulatory cycles can occur regularly or they can be erratic and heavy, filled with multiple clots and severe cramping. These cycles can also be accompanied by an array of disturbing symptoms that send women streaming to doctors’ offices: water retention and edema, breast swelling, fibrocystic breasts, mood swings, depression, loss of libido, pelvic pain (a sign of possible uterine fibroid tumors), sugar cravings, and weight gain, noticeably at the hips and thighs. The accepted prescription for relief of these symptoms is the synthetic hormone, estrogen. But did you know that all of these symptoms could be indications of too much estrogen? So, there is a good chance that when estrogen is being prescribed to alleviate these symptoms, it is actually acting to elevate them. And the patient’s distress becomes more pronounced.
Now, it is important to understand that during menopause women do in fact lose some estrogen stores, but not all, usually between 40 and 60 percent. Our sumptuous sisters with extra body fat lose less, as estrogen hangs out in our fat cells.
During a woman’s fertile years, she produces three primary hormones: estrogen, progesterone and testosterone. These three work hand-in-hand, synergistically, during these reproductive years, and they maintain a healthy balance.
But during the an-ovulatory cycles, where no eggs are produced, no progesterone is produced either. And estrogen builds relative to the absence of progesterone. So, during the many years between our mid thirties all the way into our late fifties, with erratic ovulation, there is little to no progesterone to balance estrogen; hence, unpleasant symptoms develop.
Here’s my take: no woman will ever be totally deficient in estrogen, because even if her uterus and ovaries are removed, estrogen will still be made through a conversion process in the adrenal glands. Conversely, most women stop making progesterone earlier than we ever dreamed.
GETTING IT WRONG
When in the sixties, doctors got that progesterone was needed to balance estrogen and the synthetic progesterone(progestin) was developed and widely prescribed for menopausal women, there came with it one big problem. Progestins don’t work. Synthetic progesterone can make one and only one claim to fame: it controls the stimulatory effects of estrogen on the uterine lining and prevents the risk of cancer. But at a steep price: it inhibits the body's utilization of the natural hormone, progesterone; additionally, the synthetic progestins, such as the well-known Provera, can cause numerous conditions:
•breast tenderness with a milky discharge
•breakthrough bleeding and menstrual irregularities
•depression
•acne
•hair loss or hirsutism (hairy face, body)
•headaches
•PMS
•high blood pressure
•nervousness
What we have done in the past, and continue to do under the influence of our pharmaceutical industry, is to tout the benefits of synthetic progestins as if they were identical to natural progesterone. Friends, the synthetic progestin is no more like natural progesterone than apples are to bananas.
The case for natural progesterone is strong. Even the pharmaceutical industry is paying some attention to the press that natural progesterone is receiving and has introduced an oral medication, Prometrium. This certainly is better than the synthetic progestin, medroxyprogesterone (Provera) or aygestin, but because the oral progesterone gets rerouted through our intestinal tract, approximately 90 per cent of it is converted by the liver into metabolic byproducts that make us sleepy, dizzy, fatigued. Such side effects are, however, desired for insomniac women who get help by taking it before bedtime.
SO WHAT’S THE ANSWER?
There is another version of the hormone progesterone with many more compelling benefits and virtually no side effects: it is natural transdermal progesterone, a cream that is rubbed onto the skin.
Our skin is the most efficient organ for absorption. It boasts a significant attraction to the membrane of the red blood cell onto which it will piggyback as it absorbs.
I prescribe transdermal, or skin, progesterone cream, and the vast majority of my patients receive many benefits from it. The variety I prefer incorporates aloe and Vitamin E, which dry, craggy skin finds delicious and soaks up. And the other rewards are countless: natural transdermal progesterone can improve osteoporosis and cardiac function; it enhances thyroid function—you estrogen-only users may well suffer from hypo-thyroidism because estrogen locks up thyroid function, making it less efficient, while progesterone unlocks it, enhancing thyroid function; it protects against breast and uterine cancer and, because it has a cortisone-like action, it is an anti-inflammatory and helps with aches and pains. The bonus factor is that it revs up the sex drive.
I would like to caution you right now that not all natural progesterone creams are created equal. When buying, you should look for a product that contains between nine hundred and one thousand milligrams of progesterone for every two ounces of cream (¼ tsp = 20 mgs).
Do I ever prescribe ERT? Yes. Most women in peri-menopause who are still mensing but not producing progesterone will do beautifully on progesterone alone. For other women, lean and healthy women, who have gone one year without menstruating or who have had hysterectomies, and who may suffer symptoms—hot flashes, brain fog, decreased libido—for which progesterone alone will not be enough for relief, I prescribe estrogen. Usually I prescribe those made from natural soybean substances and delivered by patch, gel, spray or pill, though I am using less and less by mouth because of the initial metabolism through the liver which is already taxed with so many detoxifying jobs.
TESTOSTERONE FOR WOMEN?
Testosterone recently has been given attention as a hormone that needs to be replaced in menopausal women, particularly women who have lost their ovaries, because that is where, along with the adrenal glands, testosterone is produced. While women make much less testosterone than do men, still it is an important ingredient for maintaining well being and a lively libido. The pharmaceutical companies have come up with a replacement synthetic testosterone, but unfortunately it contains a methyl group, which has been shown to lower good cholesterol and to adversely affect the liver.
I prescribe a 2 percent natural testosterone cream and instruct my patients to use a lentil pea-size amount on the clitoris nightly. For women with vaginal dryness, weak bladders and decreased sexual desire, I order from a compound pharmacy a mixture of estriol—the safer estrogen made primarily when we are pregnant—and testosterone. I instruct patients to massage a garden-sized pea amount of cream into their vaginas nightly. This is usually 0.5 milligrams of each/1gram.
I have particular appreciation for pharmacists, such as my friend, Pete Hueseman, who speak of the difference between synthetic and natural progesterone and who have additional training to make compounds of natural, bio identical hormones. While I am certainly no fan of large doses of pharmaceutical estrogens, particularly those made from horse urine because of the cruelty suffered by our animal friends, I do prescribe plant estrogens—pharmaceutical and herbal—but never without natural progesterone.
You may wonder why many doctors seem to know nothing of the natural hormone, progesterone, which is often all we need during the challenging years before, during and after menopause, and persist in prescribing synthetic progestins, which have many side effects, especially in light of the fact that the Women’s Health Initiative (WHI) crashed three years prematurely in 2002 because of an unacceptably high amount of breast cancer, strokes, blood clots to the lungs, and heart attacks. WHI consisted of a set of clinical trials designed to test the effects of postmenopausal hormone therapy. What actually was solidified is that synthetic progesterone is more risky than estrogen.
I believe that much of the impasse surrounding physicians’ refusal to get on board with the latest research results lies in the concept of what I term old wisdom: it is easier and safer to continue espousing common, conventional practice than to spend time and effort considering a diametrically opposing one, thus risking criticism, even ostracism, from one’s colleagues.
There are some who support these “far out” theories, though. My pharmacist friend, Pete, writes in his article, “A Pharmacist Explores Some Differences Between Natural Progesterone and Synthetic Progestin:”
We live in an era when more and more emphasis is being placed on the importance of natural substances. Natural food supplements and herbal formulations are in demand. Homeopathic physicians and caregivers are regaining popularity. Everyone seems to be asking, "What can we do to help the body repair itself in a more natural fashion?"
Many women who take hormone replacement therapy are also asking the "natural vs. synthetic" question. Is natural always better? What is the difference between the natural progesterone and the synthetic progestin, medroxyprogesterone, also commonly prescribed as Provera?
The most outstanding difference between the two is that medroxyprogesterone is an analog, a look-alike of progesterone, not truly a progesterone at all, but rather a progestin. The chemical structure of medroxyprogesterone closely resembles the chemical structure of progesterone as it is produced naturally in the human body. But even a slight difference in the molecular configuration of a compound can produce a totally different response from its natural counterpart.
Progesterone is the oldest steroid hormone-some 500 million years old on the evolutionary scale. All vertebrates produce progesterone although it is only in higher vertebrates that this hormone is instrumental in the reproductive cycle. In lower vertebrates progesterone functions in relation to glucose metabolism, the development of intelligence, and bone formation.
The process of producing natural progesterone, which is made from yams and soybeans, was discovered by Russell Marker, a Pennsylvania State College chemistry professor. While experimenting with sapogenins, a group of plant steroids, in the jungles of Mexico in the 1930's, Marker realized that progesterone could be transformed by chemical process from a sapogenin, diosgenin, which is found naturally in yam.
Unlike medroxyprogesterone, natural progesterone is an exact chemical duplicate of the progesterone that is produced by the human body. Another immediate difference between medroxyprogesterone and natural progesterone is that the synthetic hormone can actually lower a patient's blood level of progesterone. Some women who take medroxyprogesterone to combat PMS or oppose estrogen in menopause, report headaches, mood swings, and fluid retention.
On the other hand, women who take natural progesterone often say that their mood swings diminish. Women who suffer from migraines as their main complaint with PMS also find that this situation may be corrected by natural progesterone. In its natural form, progesterone acts as a diuretic, which means that women who take these supplements may have to go to the bathroom more frequently, but they are spared the fluid retention and weight gain experienced by women on synthetic progestin.
Prescribed doses also differ in regard to natural and synthetic progesterone. Synthetic progestin is ten to one hundred times as potent as the natural progesterone. This appears to be a tremendous range, but the doses fall well within those limits.
Synthetic progestins were developed with the advent of the birth control pill. The half-life of natural progesterone was very short and researchers were looking for an agent that would give a longer half-life and yet produce or mimic the effect of progesterone. Birth control pills contain, in most cases, a synthetic progestin and a synthetic estrogen. The very potent synthetic progestins prevent ovulation in a very low dose and, therefore, accomplish their function of birth control.
Conversely, natural progesterone has been used for many years in pregnancy, luteal phase defect, and postpartum depression. When a woman is pregnant, her progesterone levels are thirty to fifty times higher than normal. A nursing mother should not be concerned that taking natural progesterone for postpartum depression will affect the baby. After all, the baby has been exposed to tremendous levels of progesterone during pregnancy.
Significant difference exists between synthetic and natural progesterone. Natural progesterone duplicates the body's progesterone exactly, causes fewer side effects and can be more consistently utilized by the body. In the case of natural progesterone versus the synthetic progestins in hormone replacement, natural does appear to be better.
SAFE AND SANE
Obviously, you are asking, is natural progesterone safe? After all, my doctor doesn't know a thing about it; there is little on the subject in the medical journals, especially about the transdermal type, so why should I believe you? Healthy skepticism is a wonderful virtue, a first step in your exciting journey to healing—never take anything at face value. But let me now help assuage your doubts. The first breakthrough in acknowledging the benefits of natural progesterone shows up in an important study called PEPI. (1)
Five different arms of hormone replacement therapy were used to evaluate how hormones protect the cardiovascular system. Four of the study arms used synthetic progestin and/or estrogen. The fifth arm used estrogen along with natural progesterone. The results surprised everyone, because the “fifth arm” women who used natural progesterone showed an improved lipid profile: good cholesterol (HDL) numbers went up; bad cholesterol figures (LDL) went down. In addition, no excessive bleeding occurred, and the uterine lining was equally protected against an overgrowth of estrogen dominant tissue. Use of the synthetic progesterone (medroxyprogesterone, showed that the positive effects of estrogen on HDLs, or high-density lipoproteins, were muted, or lessened. In fact, in many instances LDLs, or low-density lipoproteins, actually rose.
A magnificent study performed at the Primate Center in Oregon further demonstrates this. (2) In this study, menopausal rhesus monkeys were divided into two groups: one group was put on the synthetic progesterone, Provera, while the other group was given natural progesterone. Then both groups of monkeys were dosed with a drug known to cause arteries to squeeze close. In the case of the monkeys given natural progesterone, the arteries stayed open. The monkeys with Provera suffered blocked arteries.
I call synthetic progesterone the look-alike drug that women love to hate, as it promotes severe PMS symptoms—anxiety, headaches and bloating, conditions most often absent with natural progesterone.
Additional benefits make natural progesterone truly remarkable: it enhances thyroid function, acts as a natural anti-depressant, is a natural diuretic, protects against breast fibrocysts, breast cancer, and uterine cancer and is a stabilizer for metabolism of copper and zinc, whose balance is key to the brain’s regulation of our mood swings and responses to stress. It also protects our bones against osteoporosis.
For skeptics concerned that transdermal progesterone is not systemically absorbed, my two published studies confirm that it is. (3),(4)
Take Home Pearls
•Natural plant estrogens are ‘bioidentical’ to what the body makes, whereas synthetic estrogens (horse urine) are not smart enough to trick the body into thinking they belong there. Horse urine is natural for horses, not humans.
•Estrogens are indicated for women who, despite natural progesterone, continue having symptoms of brain fog, anxiety, vaginal dryness; but they must be used cautiously in women with breast, uterine cancers.
•All women, regardless of whether they have had hysterectomy, with or without removal of ovaries, need natural progesterone to balance the estrogen they are given.
•Estriol is a very safe form of estrogen and needs to be provided by a compounding pharmacy.
•Natural progesterone used transdermally enhances thyroid function, protects our breast, heart, and bones, and assists with our sex drive.
•Testosterone in small amounts revs up our libido and used with estriol vaginally helps with dryness and bladder issues.
•Self love, taking our needs first, is key!
CHAPTER 4
Science and the Yam
Let the love you have be what you do.
—Rumi
During my nursing days in the sixties, the wards at Jersey City Medical Center were huge, housing some sixty patients. The female unit on one side of this medicinal environment, replete with peeling lead based painted walls and without the cheery prints and potted plants of today, was lined with manual crank metal frame beds, with mattresses that to my fading memory were four to five inches thick. They were nothing like what we see today, those splendid beauty rest varieties with endless position changing possibilities. While you can easily relate to the private and semiprivate rooms of contemporary day hospitals, when I say wards, I mean just that fourteen or so sparse beds separated only by muslin curtains. The travails, painful moans, and fearful tears were shared communally.
Katie was one of my favorite patients. She was all of four feet eight inches tall, eighty eight pounds, and stooped with the ravages of osteoporosis. She was gorgeous, nonetheless, all seventy eight years of her: she possessed a thick white mane, long and lustrous, which II often combed and braided, using for ribbons the gauze that served in hospitals as wash cloths. Katie's soul shone through her large crystal clear blue eyes.
"Ah, Girl, l," she would say, (however many times I told her my name, she preferred calling me girl), "I am so scared: my cat and my television are alone in my apartment and I am afraid my cat will starve and the vandals will steal my TV. What am I to do?"
Katie lived in a rent controlled apartment in a once opulent area since gone shabby by the influx of people not loving themselves and their environment enough to treat their neighborhoods with respect.
Well, I did what any loving nurse would do: one day after my seven to three shift ended, I drove over to Katie’s apartment and found the landlord, who generously took Katie's cat and TV set into his own apartment until she was discharged.
I was happy to help Katie, even though she had not directly asked me to. Then I wondered, why is it so difficult to ask for? The Bible says ask and it shall be given. I think that too often we are afraid to ask because we feel so unworthy that we can’t believe anyone else would be interested incoming to our aid.
What we must remember always is that we are mirror images of each other: when we feel lower than low about ourselves, so also do others view us. I think about Katie when I feel a need to empower myself with self-love.
FOUR STUDIES
Plenty of evidentiary research exists to support the claims about natural progesterone, the miraculous hormone drawn from the humble yam.
The first study I share comes from Upsala, Sweden. 5 The study followed a group of 128 postmenopausal women with cancer of their uterine lining. Each patient underwent a procedure called D and C, where a portion of the uterine lining was scraped off, then analyzed to determine stages of disease. Also measured in the tumor mass and blood was S-phase fraction (SPF, which correlates the growth activity to the prognosis or prediction for the specific uterine cancer. Finally, the various hormones—progesterone, testosterone, and and rostenedione, (a metabolic by-product of estrogen)—were measured. The latter two had no effect on the prognosis of the cancer. But, in the patients who maintained a certain level of progesterone concentration in their blood, there was a decrease in the tumor’s proliferative, or spreading, ability: an indication of a possible healthier outcome.
For the next study, a brief crash course on the menstrual cycle will be helpful. In women with the average twenty-eight to thirty day cycle, the first fourteen days(approximately) are known as the proliferative or estrogenic phase; after this first phase comes mid-cycle, when we make an egg, or ovulate, and the uterine lining then converts to a predominantly secretory or progestational phase, dominated by progesterone production. If her consort, the sperm, does not meet the egg that bursts forth from the ovary, conception does not occur, and the uterine lining bleeds off, with day one beginning a new cycle. If we do not ovulate, we do not produce progesterone, period. Estrogen production, remember, never goes to zero, even when we have stopped our menses or if our ovaries have been removed. Estrogen continues to be made by our adrenal glands and is stored in our fat cells.
Jerilynn C. Prior, M.D., of Vancouver, British Columbia, performed an exquisite and thorough study that furthers the case for the benefits of progesterone. It was called “Spinal Bone Loss and Ovulatory Disturbances.” (6)
Originally, it was taught that only menopausal women and marathon runners of any age lose bone after estrogen begins to decrease. This very important study may have disproved this concept. Using three groups of premenopausal women, marathon runners, moderate exercisers, and women of regular activity between the ages of twenty-one and forty-two, Dr. Prior demonstrated that it is not a lack of estrogen that accounts for bone loss but rather the lack of progesterone. And she did so by revealing an ovulatory cycles (remember: no ovulation, no progesterone) at least 29 percent of the time, in all three groups, regardless of their activity levels.
Very importantly, for those many women fearing the use of hormones because of the specter of breast cancer—good news! A skillfully done study from Taiwan and Paris (7) explored the effects of various hormones on cell growth in normal breast tissue. Forty women scheduled for removal of benign breast lumps were randomized into four groups and wore on the affected breast for two weeks prior to surgery a gel containing one of the following:
•Estrogen and progesterone
•Estrogen alone
•Progesterone alone
•Placebo
After the breast lumps were removed, each was examined for cellular growth. As was expected, the estrogen lump showed an increase in the number of cycling cells. The mass under the influence of estrogen and progesterone revealed no change over the placebo group. But the most exciting finding was the progesterone group: there was an inhibition of the growth of cycling cells: this study strongly suggests that progesterone acts to protect the breast.
Lastly, molecular biologist and friend, Bent Formby, Ph.D., has carried out an excellent study worthy of the Nobel Prize.(8) Using human DNA breast cancer cell strains, he demonstrated that progesterone inhibits the growth of these cancer cells, while estrogen fuels this growth. He also found that progesterone fosters a phenomenon called apoptosis, or programmed cell death, which prevents conversion of normal cells into cancer cells. Additionally, he discovered that estrogen prevents apoptosis.
THE NATURAL WAY
I would not have stepped into this “natural healing” arena without the man I credit, most thankfully, for my enlightenment: the late John R. Lee, M.D. I knew him as an affable, formidable healer, a man far advanced in his thinking, who became my mentor as well as a blessed friend.
Dr. Lee began his journey as a family practitioner in Mill Valley, California. As he grew with his practice, his forty year-old patients turned sixty, and with the progression of years came the recognition that their stooped shoulders were more than just world-weariness. The well-known dowager’s hump, named after the late British Queen Mum, was discovered not to have as much to do with old age so much as it did with compression fractures of the thoracic spine caused by osteoporosis.
As fate would have it, much that was to follow started in 1978 after he heard a lecture by Professor Ray Peat, Ph.D., of Blake College in Eugene, Oregon, about the various attributes of progesterone. It was from him that Dr. Lee learned about a skin cream, originally sold as a moisturizer, which contained among other ingredients, progesterone. He began recommending this cream to his aging women patients, and to his surprise, besides making them feel measurably better, their bone mineral density improved.
Dr. Lee noted that this gentle cream, delivered through the skin, has the distinct advantage of bypassing conjugation through the liver, which all oral medications have to do. Rubbing the cream into the skin directly delivers and circulates active progesterone into the system.
And remember, how much less of the cream we have to use. When taken orally, the traditional dose is one hundred to two hundred milligrams. When applied to the skin, transdermally, we only require twenty to forty milligrams (one-quarter to one-half teaspoon), five to ten times less!
My friend, David Zava, Ph.D., a biochemist and breast cancer researcher, has quantified these dosages. He analyzes the amounts of progesterone (as well as the steroid hormones: estrogen, testosterone, cortisol and DHEA, in saliva fluid that accurately reflects the active portion of progesterone in the body. Through this method, he has been able to assure the accuracy of the progesterone doses.
DOUBTING DOCTORS
The physicians who doubt the veracity of natural transdermal progesterone come to their conclusions through measurements of progesterone in blood serum. But, truly, looking for progesterone in this way is somewhat like looking outside for the car keys you dropped in the house. Transdermal progesterone is lipophilic, or lipid loving; it latches onto the fatty membrane of the red blood cells, hitching a ride in the blood, so to speak. Well, when conventional levels of progesterone are measured in the blood serum, the count is inaccurate because we have effectively spun down the blood, throwing the red blood cells away and using instead the straw-colored fluid to measure levels. But our detractors gleefully plot to discredit the skin cream by condescendingly pointing out that transdermal progesterone is not absorbed. “See,” they taunt, “we told you it doesn’t work: you cannot measure it in the blood!” The arrogance of ignorance keeps our blinders on to prevent us from seeing a new truth.
Dr. Lee entered one hundred women into a study 9 over three years and was astonished to see how much increase in bone density these women experienced after using transdermal progesterone cream. The average increase in bone density was close to 15 percent. The fascinating point is that he has disproved conventional medical teachings that insist that once bone is lost, it is gone forever.
Now, gentle readers, you can imagine the raucous behavior on the part of my conformist colleagues after reading this piece of news. Digging in their heels, they arrogantly reminded that the journal publishing this finding is truly insignificant, not prestigious, as is the New England Journal of Medicine or the Journal of the American Medical Association, or Lancet. Secondly, they were quick to point out that this was not a randomized, double-blinded, placebo-controlled study.
Very importantly (and sadly), no major pharmaceutical company sponsored the study, so it got little press, thus, little attention. Unfortunately, doctors learn how to use medications from the detail people who work for these megalithic pharmaceutical corporations. Natural transdermal progesterone gets little attention, because the pharmaceutical companies don’t manufacture it.
The bottom line is that the miracle of natural progesterone is no longer hush-hush. For all the scientists out there, it is important to remember that progesterone is the master hormone. In the biochemical cascade, after cholesterol and pregnenolone, progesterone is the hormone from which testosterone, estrogen, and cortisolare made. In the human body, a small amount of estrogen and testosterone can be made from progesterone, but not the other way around.
THE WORK GOES ON
From the outset, I was excited about how natural progesterone was assisting so many women, and I felt motivated to carry on with what had gone before. In order to further mainstream credibility and give even more sober attention to the benefits of this “wonder cream,” I constructed a randomized, double blind, placebo-controlled test. Along with my distinguished colleague, James Anasti, M.D., a brilliant reproductive endocrinologist who has done innumerable studies for the National Institutes of Health, I recruited 107 eligible women to participate in this most important study.
One remarkable finding was that after one year of research, we were able to show that 83 percent of the women using natural transdermal progesterone experienced relief from their hot flashes, while only19 percent using the placebo cream did. These impressive statistics were published in the prestigious journal, Obstetrics and Gynecology in August 1999.
And this was just the beginning. We then studied sixty women, again in a randomized, double-blinded, placebo-controlled test, to find out whether the addition of natural progesterone for women using estrogen would protect the uterine lining against cancer. I’m pleased to say that our study was awarded third prize out of four hundred research projects submitted to the American College of Obstetrics and Gynecology, and our positive findings were presented at the College’s May 2001 national convention.
Our third trial also received Third Prize for original research by ACOG and was published in 2005 Alternative Therapies. This definitive research followed twenty-six women, each of whom received a baseline endometrial biopsy and began a six-month course of Premarin and Provera. This was followed by another biopsy, a two week wash out period, then a six month course of Premarin (estrogen) and natural transdermal progesterone cream. Then a final biopsy of the uterine lining was done. The magnificent findings affirm that the natural progesterone cream gave as much protection to the uterine lining when used with estrogen as did the progestin. The pathologists were blinded to which women were on which arm of the study, so no prejudice could be rendered.
On a personal note, of course, I do not use Premarin my practice: it is made of the horse urine obtained from a pregnant mare whose life is made hell with the cruel methods used to collect the urine. My decision to use Premarin in this study was a political one, since most conventional practitioners know only of Premarin and would have cast aside our findings if we had failed to use it.
As I stated in Chapter 3, I regularly prescribe estrogen, bio-identical estrogen, but I use the smallest doses I can, and always with the transdermal progesterone cream, which mutes the risk of cancer by the estrogen. I regularly use the safest form of estrogen, estriol, which has been used for decades in Europe, but which is not patented here in America. I recently learned that this is made here in America and sold in Europe, but our FDA has threatened to close down the companies that provide the hormone powder to our compounding pharmacies to make estriol. It could not be the giant pharmaceutical company, Wyeth, the makers of Premarin, influencing the FDA because of their great financial loss, could it be?