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Below you will find excerpts from Dr. Pettle's e-book on The Natural Bio-Identical Hormonal Approach to the Treatment of P.M.S., Peri-Menopause, Menopause and Miscellaneous Gynecological Conditions .
This 31 page e-book is a free bonus item when you buy any of the Dr. Pettle videos or audio CDs from our online store.
OR The Roots – Background My Research Revelation – the Dawning of New Direction Associates – Integrative Healers Bi-Est & Tri-Est – Natural Bio-Identical Estrogen Transdermal Cream Prescriptions Learning from Patients – Synthetic Drugs Have Side Effects The Case for Using Bio-Identical Hormones versus Synthetic Drugs Use of Natural Bio-Identical Hormones Natural Bio-Identical Estrogen versus Synthetic Estrogen Dr. Jonathon Wright Balance of the 3 Parts of Estrogen Transdermal Cream Compounds from Natural Bio-Identical Hormones Natural Bio-Identical Progesterone Hormonal Changes and the Effects of Aging in Women Monthly Hormone Balance in Healthy Pre-Menopausal Adult Women Stress Syndrome Resulting from Hormone Imbalances PMS (Pre-Menstrual Syndrome) The PMS Exhaustion, Fatigue, Depression (and other Symptoms) The Forgotten Hormone – Progesterone Women’s Need for Progesterone (NOT Progestin) Progesterone as Mood Elevator, Energy Booster, Fatigue Elevator, Tolerance Enhancer, Libido/Sex Elevator Treatment after Hysterectomy with Natural Bio-Identical Hormones Progesterone as Protection in Human Receptor Sites in the Body Other Gynecological uses For Natural Bio-identical Hormones Treatment of Patients Who Have Had Cancer in the Past, Can be Managed with Natural Bio-Identical Progesterone How Natural Bio-Identical Progesterone Works in the Body Dr. Katherine Dalton Uses of Trans-Vaginal Progesterone in Two Exceptional Conditions Dr. John Lee Oral Progesterone and the Liver Wild Yam Cream for Progesterone Sources Usual Prescribed Dosage for Natural Bio-Identical Progesterone in Compounded Transdermal Cream Patients Attempting Conception Treatment in Spontaneous (Habitual) Abortion Treatment of Osteoporosis, Bone Density with Natural Bio-Identical Hormones Natural Bio-Identical Testosterone Treatment of Reduced Libido. Treatment of Reduced Sex Drive With Natural Bio-Identical Testosterone Usual Doses of Natural Bio-Identical Testosterone SUMMARY AND WRAP-UP – NATURAL BIO-IDENTICAL TRANSDERMAL CREAM HORMONES VERSUS SYNTHETIC ORAL HORMONES Saliva and CA-125 Enzyme Testing versus Blood Tests for Hormonal Level Testing Research – Specific Data Available Sources of Bio-Identical Hormones Natural Bio-Identical Progesterone . . . . .
. . . . . Monthly Hormone Balance in Healthy Pre-Menopausal WomenIn younger years, when estrogen was secreted in the first half of the monthly menstrual cycle (first 2 weeks), natural progesterone met the natural estrogen and instead of estrogen being the dominant hormone, progesterone became the dominant hormone during the second half of the cycle (3rd and 4th weeks). In fact, nature always works in balance. In that natural balance, estrogen is dominant in the first half of the monthly cycle and progesterone in the second half, after the estrogen has prepared the receptor sites. Very often, however, during those cycles, patients do not have enough natural progesterone in their body to counter-balance their estrogen and they then become estrogen dominant for the whole period of the monthly cycle. . . . . . . . . . . Stress Syndrome from Hormone Inbalance What begins to happen in the early to mid-40s, or sometimes late 40s, is that some patients have their threshold of estrogen level rise above the threshhold of individual tolerance that they are comfortable with. The comfort level is surpassed by their own estrogen levels. In other words, once the estrogen threshold is passed, the body begins to chemically panic, since the body does not tolerate well any levels too high or too low. It is that very panic which comes from the secretion of adrenalin and noradrenaline which causes symptoms. This is also closely related to the release of cortisol in the fight-flight-fright response. Another aspect of this cascade is that, in order to produce the required adrenalin and noradrenaline, the body must use up its own usual dopamine and seratonin, natural hormones needed by the brain, and the decrease of which leaves women feeling emotional and weepy at the end of their cycle. . . . . .. . . . . How Natural Bio-Identical Progesterone Works in the BodyThe mechanism of action of the natural bio-identical progesterone is that, once the transdermal cream is placed onto the skin, the natural bio-identical progesterone is absorbed into the body tissue and usually peaks in absorbency between 2 to 3 hours later, with levels now measurable in the blood and saliva. 50% of the bio-identical hormone is eliminated from the body within 12 hours. This is why natural bio-identical hormones are prescribed to be used twice a day. This timing allows for the patient to have the full effect of the natural bio-identical hormones throughout the full 24 hours of the day. . . . . . . . Usual Prescribed Dosage of Natural Bio-Identical Progesterone in Compounded Transdermal CreamI prefer to prescribe actual natural bio-identical progesterone transdermal cream, derived from wild yam, made in a compounding pharmacy. The cream is applied to and absorbed through the skin very well (even scientific journals, which were initially skeptical, have now shown that it is truly absorbed). The big advantage of this form of prescription over synthetic drugs is that it is possible to specify the exact amount of natural bio-identical progesterone that is contained in the prescription of transdermal cream. An equally major advantage over the oral drug is that the patient can adjust the amount needed by altering the quantity of the cream used. The patient can also alter the frequency of the cream used. The doctor can guide the patient in altering the dose of the cream per application. Tubes, jars or syringes, which are quite neat, can all be used to deliver the natural bio-identical hormones through the very talented efforts of compounding pharmacies (such as York Downs Pharmacy, North York, Ontario, Canada -- 1-800-564-5020) . . . . . .. . . . . In my practice, therapy usually starts with use of a 2% to 3% progesterone cream,¼ tsp. twice a day, both for PMS and peri-menopausal patients. I realize this is a slightly higher dose than first suggested by Dr. Lee. I have found that this dosage has worked very well for most of my patients. 3% natural bio-identical progesterone cream provides 37 mgm. of progesterone transdermally on each application, provided that you apply ¼ tsp. at each given dose.. . . . . . . . . . Treatment of Menopausal Flushes With Natural Bio-Identical Transdermal Creams The late Dr. John Lee stated, and I agree, that approximately 2 out of 3 patients can be treated for their menopausal flushes with natural bio-identical progesterone transdermal cream alone. . . . . . . . . Treatment of Migraine HeadachesPatients who suffer from menstrual migraine headaches do very well to take the natural bio-identical progesterone transdermal cream on to the first and second day of their menses. Most of my patients stop their natural bio-identical progesterone with the onset of their menstruation and this appears to be the most balanced physiological way to use the natural bio-identical progesterone transdermal cream. . . . . . The Forgotten Hormone – Progesterone . . . . .. . . . . The fascinating thing about natural progesterone is that it has been forgotten and remained unused by many gynecologists for many years.Progesterone use has actually been removed from the standard practice of treatment of patients who have had hysterectomies. The reasoning used by doctors in the past was that patients do not need progesterone because they no longer have a uterus and therefore do not require progesterone to protect the uterus. Following standard medical practice, when I carried out hysterectomies on patients 15 to 20 years ago, I would place patients on (synthetic) estrogen alone, without taking into account the fact that, as in all women, their naturally produced progesterone had always been present in their bodies (and dominant for 2 weeks) and followed estrogen in dominance in natural balance in their bodies during their monthly cycle (2 weeks estrogen dominant, 2 weeks progesterone dominant) for the whole of their adult lives. . . . . . . . Many patients will literally say, "I feel as if I’m in a fog," or they will say, "My brain feels like it’s under water." These patients are actually describing the water-logged brain that occurs with the secretion of hormones from the adrenals such as aldosterone, which cause a retention of water within the brain. . . . . . OTHER GYNECOLOGICAL USES FOR NATURAL BIO-IDENTICAL HORMONES Treatment of Patients Who Have Had Cancer in the Past Can be Managed with Natural Bio-Identical Progesterone . . . . . One of the most controversial areas for decision-making in my medical practice is the use or non-use of natural bio-identical progesterone in breast cancer patients. At the present time I am reviewing all literature that I can obtain. I invite anyone, physicians, other professionals or researchers who may read this who may have any documented evidence that will help me to analyze this all-important question as to whether or not natural bio-identical progesterone can be safely used for breast cancer patients. (Recent studies by Chang suggest that progesterone application to the breast actually decreases mitosis, or decreases the growth of cells, compared to patients using placebo or no cream at all.) In other words, patients are protected from the effects of estrogen by the use of natural progesterone.. . . . .
. . . . . Studies by Chang have shown that if you place estrogen on the breast, it increases the growth of the breast dramatically. If you then place natural bio-identical progesterone onto that same breast, it will decrease the growth that was caused by the estrogen literally by one half. In other words, as compared to estrogen alone, the effect is diminished by 50% when the application of progesterone is with the estrogen. However, the most remarkable outcome of the study was the fact that when a patient had the application of progesterone only on the breast, the mitotic (growth) activity of the breast with progesterone on it alone actually showed a decrease below the level of the breasts that received no cream at all. . . . . . . . . . Natural Bio-Identical Testosterone. . . . . One other hormone should be seriously considered in the discussion of replacing natural bio-identical hormones for menopausal patients. That hormone is natural bio-identical testosterone. . . . . .Treatment of Reduced Libido, Treatment of Reduced Sex Drive with Natural Bio-Identical Testosterone . . . . . The hormone testosterone does occur naturally in the bodies of women (although at about one sixth the level naturally occurring in men). As in all things in nature’s balance, testosterone has a number of uses in women’s bodies. One of the fascinating uses of natural bio-identical progesterone is to help benefit the libido (sex drive). Current medical opinion is recognizing that the libido in women seems to be driven by testosterone to a far greater degree than we ever previously believed. The natural bio-identical progesterone, being a 21-carbon product, can provide a precursor to make the 19-carbon product of testosterone within the body’s cascade. However, if the natural bio-identical progesterone does not provide enough of an increase in libido, patients are now very comfortable with the use of natural bio-identical testosterone prescribed in a transdermal cream that is applied below their waist. It is interesting that many people believe that testosterone is only a male hormone when in fact it is also a very important female hormone that occurs naturally within the reproductive cycle, but the level of testosterone is only about 1/6th the level found in the male. . . . . .Usual Dosages of Natural Bio-Identical Testosterone . . . . . When I prescribe natural bio-identical transdermal testosterone, I order testosterone in the order of 2.5 mgm. twice a day and increase it up to 5 mgm twice a day, usually using ¼ tsp. in the lower part of the abdomen, applied on the inner thighs and on the clitoris. The only patient with whom I will consider prescribing a more synthetic testosterone is in the case of a cancer patient who wants to increase her sex drive. If the patient has had breast cancer and I do not want to prescribe for her testosterone that can be transformed into natural estrogen, then I will use methyl-testosterone 0.25 mgm twice a day, as this is not as readily converted into estrogen by the body. (Please see CD Window, Scientific Basis of Bio-Identical Hormones.) . . . . .SUMMARY – WRAP-UP - NATURAL BIO-IDENTICAL TRANSDERMAL CREAM HORMONES VERSUS SYNTHETIC ORAL HORMONES Saliva and CA-125 Enzyme Testing versus Blood Tests for Hormonal Level Testing . . . . . In this author’s opinion, Canada should and hopefully very soon will, seriously consider the possibility of covering the cost of saliva hormone and CA-125 tests under public health care provisions.
. . . . . Before finishing the discussion of blood tests, however, I should add that there is one particular blood test I think every menopausal women who has ovaries should have done. The enzyme test is called a CA-125, which I believe is equivalent to a man having a PSA. Where pelvic genital cancers, ovarian and uterine cancers exist in menopause, an elevated CA-125 is often found. Patients who have a base line CA-125 that has stayed steady over the last 2 years and now appear to have suddenly rising levels, should definitely raise the red flag to their physician to aggressively investigate why this enzyme has increased. . . . . .. . . . . In Ontario, Canada, the universal government health insurance plan, OHIP (Ontario Hospital Insurance Plan) does not pay for saliva or CA-125 tests,. Dr. Gilson does do these tests in his laboratory in Calgary, Alberta. Wouldn’t it make more sense to choose a simple non-intrusive, more economical saliva test which gives excellent definitive non-ambiguous results of hormone level testing versus a blood test which is not as accurate? The test results of hormonal blood testing are not completely accurate because hormone blood levels are constantly fluctuating hour to hour in women. . . . . .Research – Scientific Data Available . . . . . My patients kept coming to me and saying, "My doctor says that there are no scientific papers that show that natural bio-identical hormones are better for the body than synthetic drugs." Dr. George Gilson, Dr. T. Zava and many other doctors whom I quote in my study have shown that there are, of course, many, many studies and articles written by world authorities to show that natural bio-identical hormones have been, and will always be, better accepted by the human body than synthetic drugs. . . . . .. . . . . One of the suggestions I have made is to place the patient immediately on transdermal estrogen in the form of estrogel (which is made from soy) and along with it, give the patient 1 oral tablet of progesterone such as Prometrium (100 mgm) or, if they are allergic to peanuts, give them 100 mg. of progesterone in safflower. This will allow the patient to stop the synthetic drug immediately and go onto a more natural based hormonal replacement therapy. If the patient remains comfortable on this hormone replacement, then I would suggest that you leave the patient on this regime for a short time that can be negotiated between physician and the patient. Later, I transfer the patient to a natural bio-identical hormone approach where estrogen is now divided into a more balanced ratio such as Bi-Est. This can be done over a few months or a few years, depending on the patient’s reaction. . . . . .. . . . . Prescription by transdermal cream, prepared in a compounding pharmacy, allows a doctor to prescribe natural bio-identical estrogen in its natural ratio (80% estriol, 10% estrone and 10% estradiol) as in Tri-Est, or in the use of Bi-Est (ratio of 90% estriol, 10% estradiol). Physicians can become very comfortable with the prescription of natural bio-identical progesterone, natural bio-identical estrogen and now, natural bio-identical testosterone. The physician will be able to change the strength and the timing of the creams depending on the patients’ needs. It is also hoped that the changing levels of patients' hormones can be followed scientifically by the use of saliva hormone testing. . . . . .
I look forward to writing you in the future and perhaps one day, we will meet. Thank you, my patients, for sharing your light and your wisdom with me. Sincerely,
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Copyright © 2005-2008 Ruth Pettle Wellness
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