In recent years, the common use of pharmaceutical Hormone Replacement Therapy or HRT, for perimenopausal and menopausal symptoms has been called into question by some experts. According to American Family Physician, this overall departure from the use of HRT is based in concerns about increased risk of breast and ovarian cancers, gallbladder disease and thromboembolism. Progesterone, an important female hormone associated with pregnancy, is commonly used as part of HRT. In light of concerns over conventional HRT, progesterone is now being marketed in "natural" over-the-counter creams, which are harvested from plants and micronized to ensure bioavailability.
Misconceptions
According to a study published in the "Journal of General and Internal Medicine," the concept that hormone creams marketed as "natural" are safer is erroneous. The researchers, led by Adriane Hugh-Berman, state in this study that natural hormones, including progesterone, are likely to have the same side effects as conventional HRT. The researchers also suggested that the U.S. Food and Drug Administration classify transdermal hormone creams as drugs, since they are absorbed quickly into the skin.
Function
According to American Family Physician, progesterone cream is typically used to decrease vasomotor symptoms, more commonly known as "hot flashes." While the use of synthetic progesterone has shown a decrease in hot flashes in clinical studies, it has been scrutinized due to its effects on cholesterol levels. American Family Physician notes that "natural" progesterone cream demonstrated no effect on cholesterol. The study published in the "Journal of General and Internal Medicine" notes that progesterone is also used to prevent estrogen-based endometrial hyperplasia, a thickening of the wall of the uterus that can lead to cancer. The study reports, however, that there is no evidence that topical progesterone has any effect on endometrial hyperplasia.
Effects
According to the authors of the "Journal of General and Internal Medicine" study, which was conducted at Georgetown University School of Medicine, the long-term effects of progesterone cream are not yet fully understood. The researchers of this study cite prior data from a large French study called E3N EPIC, which followed 98,997 women for 5.8 years. This study reported a potentially decreased breast cancer risk among women who used micronized progesterone cream versus other types of progestens. The researchers emphasized that these findings are not conclusive and that further studies are needed.
Significance
The use of over-the-counter, "natural" hormone creams appears to have gained momentum and cultural significance in recent years. According to the study published in the "Journal of General and Internal Medicine," these bioidentical hormones have been made popular through books aimed at consumers. The study made reference to pop culture influences such as actress Suzanne Somers, who has authored three books on the subject in three years. The study states that several popular books may be contributing to misconceptions about hormones.
Considerations
The "Journal of General and Internal Medicine" study cautions that the use of any hormones, whether "natural" or not, aren't intended for use by people with no symptoms. The study cautions that several companies currently market salivary hormone tests, which are designed to determine any possible hormone imbalances. The authors of the study caution that these tests may prompt women with no symptoms to begin taking hormones without cause. Talk to your doctor if you feel you have a hormone imbalance.
