Over a decade ago, Dr. John Lee first published his startling conclusions about conventional hormone replacement therapy (HRT): synthetic hormones don’t work as predicted and, worse, they pose a health threat to women. His findings touched off a storm of controversy. But years later, research has proved him right. Now millions of women concerned about aging are looking for alternatives to HRT, and finding them in natural hormones, and Dr. Lee’s effective, commonsense approach to restoring hormone balance.

Although Dr. Lee died in October 2003, his work lives on in his best-selling books, his audio and video tapes, and on his website, where you’ll find a wealth of information about natural hormones, from “Frequently Asked Questions” for beginners, to biochemistry for experts.

Dear Dr. Lee
(Excerpts from The John R. Lee M.D. Medical Letter, by John R. Lee, M.D.)

Q. My psychiatrist said it was estrogen that was the “happy hormone” not progesterone, and too much progesterone can cause depression. I was curious on your viewpoint because I’m hearing the opposite, that progesterone is the “happy pill”. I have bipolar, general anxiety and panic disorders and currently taking meds for these disorders.

 A. There is no such thing as a “happy pill” and the sooner we all figure that out the happier we’ll be! Your psychiatrist is not alone in being so misinformed about estrogen and progesterone. If you’re deficient in estrogen, supplementing it can help perk up your brain function. However, it is equally true that an excess of estrogen can cause anxiety. Progesterone in excess can cause depression in some women. However, the overall effect of progesterone is calming. It is hormone balance that will contribute to mental/emotional balance.

Please read our…PREmenopause book for detailed info on the effects of the various hormones - and you might consider getting a copy for your psychiatrist, too!

 Q. I’ve been on natural hormones for about 10 years now; I use natural progesterone and estrogen (tri-estrogen) and have been doing very well on them. It’s well known that “xenoestrogens” come at us from many sources. Has anyone researched whether the estrogen receptor sites in the body might preferentially take natural estrogens over these xenoestrogens (or synthetic estrogens)? If they do, it would seem logical to supply some natural estrogen too, if only to “discourage” the estrogens we don’t want.

A. There’s no such research that I know of on this topic, but it’s an interesting question. Xenoestrogens are toxic petrochemical compounds that have been found in animal studies to act something like estrogen. They may occupy estrogen receptors but they may also be toxic in ways that are not receptor- related. The chief threat from xenoestrogens is to the embryo, whose differentiating cells are highly sensitive to xenoestrogen toxicity. Xenoestrogens are all fat soluble and very slow to break down in the environment. Over time, our body fat accumulates xenoestrogens. However, the concentrations are really very low and it is difficult to show that any one dose does harm to adults. It is the babies that women are carrying in early pregnancy who are most at risk of damage from xenoestrogens.

Phytoestrogens are plant compounds that have a weak estrogenic effect. It is thought that they can occupy estrogen receptors and therefore protect against one’s own estrogen, if not balanced by progesterone. I believe balancing with progesterone is more beneficial than phytoestrogens but some people seem to do well with phytoestrogens.

The synthetic progestins should never be used. Even the estrogens that we make endogenously (in the body) are dangerous unless properly balanced by progesterone.

Q. I thought perhaps you would want to let your older ladies know that Medicare will pay for saliva tests. The way it is done is that the doctor makes up a prescription with the names of the hormones to be tested ( I tell my doctor which ones I want to test), then the woman sends the prescription along with a front and back copy of her Medicare card in the kit she has used and her doctor is sent the results. She can get a copy for her files from her doctor. My doctor only likes blood tests and I let him take all that he wants but I pay attention to the results of the saliva tests.

A. Thanks for sending on this information. It’s a wonderful example of someone who has educated herself and has found a way to work with her doctor that has a good outcome for both of them.

Q. My husband has prostate cancer and his doctor has recommended that he take a drug that will block all of his hormones because, he says, testosterone causes prostate cancer. But then a friend gave me a 1999 issue of your newsletter, and you recommend taking testosterone. When I asked my doctor about this, he said that all the studies show that testosterone causes prostate cancer. Now I'm confused...

A. Your doctor has read only some of the studies. A thorough search of published studies on prostate cancer and hormones shows no consistency: some show high testosterone in men with prostate cancer, others show normal or low testosterone. Chemical castration usually stops the progression of the cancer for a few years, but it's a temporary fix.

Testosterone levels in men are highest when they are young, and decline slowly with age, and yet prostate cancer is virtually unknown in young men. If testosterone were causing prostate cancer, wouldn't it follow that young men would be getting it at a higher rate? Others blame the conversion of testosterone in older men to dihydrotestosterone, (DaT), but again, this association is not consistent. The latest large study out of Finland (Cancer 1999 Jul 15;86(2):3125) looked at hormone levels in a population of men over a period of 24 years and found no association between prostate cancer and levels of testosterone, other male or hormones or sex hormone-binding globulin (SHBG). The jury is still out.

Q.  I had two mastectomies and just celebrated 20 years free from breast cancer. I had a hysterectomy and my ovaries removed after problems with incontinence and a tailed bladder lift. I've had 13 surgeries since 1981, for many health problems. Then I read your book and threw out the estrogen, motrin, inderal, synthroid, elavil, and the list goes on. All I take now is progesterone cream. Here is a list of my recovery: hot flashes ceased, thyroid returning to normal, fibromyalgia pain greatly reduced, asthma left immediately, not retaining water, blisters in throat are gone, went from three hours of sleep a night to six hours. I'm so grateful for your work helping women.

A.  Thanks for the great letter. I'm sure it will be an inspiration to many other women. It takes courage to drop such an arsenal of drugs, but it sounds like you're doing well. For future reference, I do recommend going off all drugs very gradually!

Q.  I was sent an e-mail saying that antiperspirants cause breast cancer. Is there any research to back this up?

A.  There isn't specific research that I know of linking anti-perspirants and breast cancer, but the link does make common sense. Perspiration is one of your most important avenues of detoxification, and the underarms are located on and around the lymph nodes located around the breast. Lymph nodes are important avenues of detoxification for the breast. Antiperspirants also contain chemicals of dubious safety, and as users of progesterone creams are aware, we readily absorb many substances through the skin. Rubbing chemicals of unknown toxicity on the lymph nodes and next to the breasts every day doesn't seem wise when considered in this context. At the very least, use deodorants, not anti-perspirants. Even better, find an herbal deodorant that works for you. One of the most effective are the "crystal rock" varieties.

Q.  Thanks to the information in your book, my husband and I were able to conceive after three years of unsuccessful attempts. After the second fertility specialist told us to give it up (I was too old, etc.), I started using progesterone cream and the herb Vitex. We conceived less than a month later! I'm due in two days. How much progesterone cream should I use to help with the postpartum emotional roller coaster, and maintain my overall well-being?

A.  My philosophy is that if it isn't broken, don't fix it. If you don't have any symptoms after delivery your body is doing its job. If you do experience post-partum depression it's fine to try a normal physiologic dose of progesterone cream (15 to 20 mg daily) three weeks out of the month, as long as your milk production is adequate for nursing. (See last month's letters - October 1999 - for details on progesterone and prolactin.)