kathryn

I just came across this again tonight, interesting idea if you are
taking Premarin, to taper off using two different pill strengths.

http://www.cemcor.ubc.ca/articles/hrt/stopping_oht.shtml

Kathryn

terri

Her fourth point - that progesterone is more likely to prevent breast
cancer and heart disease than to cause them based on the "science"
nullifies the rest of what she says as far as I'm concerned. This is a
huge error. There is absolutely no evidence that natural progesterone
prevents breast cancer and considerable evidence that it encourages it
exactly as provera and other artificial progestins do, with or without
estrogen. There is also the matter of progesterone receptor positive
breast cancer which would most certainly grow, spread, and probably
begin in the presence of progesterone alone.

The research for tapering off hormones providing any real benefit in
terms of withdrawal symptoms doesn't exist either. For most women the
withdrawal symptoms will fade over time. If you're tapering off the
drugs you'll think that's what's doing it.

I'm disappointed that Prior seems to have joined the Lee crowd in
encouraging the use of "natural" progesterone after menopause.

cam

Terri <vl-hb001@erols.com> writes:


Yes it does. For example, there is this interesting review which
contains many further references:

----------------------------

Endocrine withdrawal syndromes.

Hochberg Z, Pacak K, Chrousos GP.

Division of Endocrinology (Z.H.), Meyer Children's Hospital, Haifa 31096, Israel.

Hypersecretion of endogenous hormones or chronic administration of
high doses of the same hormones induces varying degrees of tolerance
and dependence. Elimination of hormone hypersecretion or
discontinuation of hormone therapy may result in a mixed picture of
two syndromes: a typical hormone deficiency syndrome and a generic
withdrawal syndrome. Thus, hormones with completely different
physiological effects may produce similar withdrawal syndromes, with
symptoms and signs reminiscent of those observed with drugs of abuse,
suggesting shared mechanisms. This review postulates a unified
endocrine withdrawal syndrome, with changes in the
hypothalamic-pituitary-adrenal axis and the central opioid peptide, in
which noradrenergic and dopaminergic systems of the brain act as
common links in its pathogenesis. Long-term adaptations to hormones
may involve relatively persistent changes in molecular switches,
including common intracellular signaling systems, from membrane
receptors to transcription factors. The goals of therapy are to ease
withdrawal symptoms and to expedite weaning of the patient from the
hormonal excess state. Clinicians should resort to the fundamentals of
tapering hormones down over time, even in the case of abrupt removal
of a hormone-producing tumor. In addition, the prevention of stress
and concurrent administration of antidepressants may ameliorate
symptoms and signs of an endocrine withdrawal syndrome.

PMID: 12920153 [PubMed - in process]

-----------------------------------------------------

The full text of the article at:

http://edrv.endojournals.org/cgi/content/full/24/4/523

contains the following interesting observations:

"Estrogens are potent stimuli to the HPA axis and the LC/NE
system. Postpartum, menopause, and the premenstrual syndrome are all
associated with decreasing estrogen and withdrawal syndrome-like
manifestations (75, 76) (Table 2). These may include hot flushes and
autonomic hyperactivity, but also fatigue, irritability, anxiety and
depression, and even psychosis. Withdrawal symptoms and signs do not
resemble those of estrogen hormonal deficiency, as they manifest in
young women with Turner syndrome or hypogonadotropic hypogonadism."

"B. Menopause as a withdrawal syndrome Women who suffer hot flushes
soon after menopause have lower estrogen levels than those who do not
have hot flushes (82), indicating that this may be a symptom of
estrogen deficiency or withdrawal, and, indeed, it can be ameliorated
by estrogen replacement therapy. Several lines of evidence support a
possible withdrawal syndrome. For example, some postmenopausal
symptoms are self-limited and distinct from those of pure estrogen
deficiency. The more severe withdrawal symptoms of autonomic
hyperactivity, hot flushes, and hyperemic coronary flow occur when
menopause is instituted abruptly by surgery or antiestrogens, such as
clomiphene citrate or tamoxifen (83, 84), but not in congenital forms
of hypogonadism and less so in slowly progressing premature ovarian
failure, when the signs and symptoms of estrogen deficiency include
amenorrhea, endometrial and breast atrophy, and osteoporosis."

"Hormone replacement therapy is often withdrawn abruptly for a variety
of clinical indications, but little attention is given to symptoms and
signs of withdrawal. In addition to physiological dependence, hormone
replacement therapy promotes feelings of well-being, which may
contribute to psychological dependence (85)."


[It will not suprise me in the least to discover that Terri considers
this research to be flawed, the comments bizarre unfounded
speculation, the researchers deranged, bribed, etc., and therefore it
is correct to claim that "research .... showing benefit ... doesn't
exist" because research that Terri disagrees with doesn't count as
being research. She and I have disagreed about this before.]
--
Chris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

kathryn

I was kind of hoping you'd miss that part <grin> Prior does have her
biases, and we need to know that, but she is NOT part of the Lee crowd
ie does not denigrate the use of progestins other than progesterone
for therapy.

She is about to do a study using Prometrium. BTW, I just found this
the other night too.

http://www.bcendocrineresearch.com/news.html

click on the newest 13 October 2003

clilck on Research Study On Progesterone Therapy

I am curious about that blood vessel function part, are they fishing
for benefits, or ruling out harm? What do you think?

And why the diabetes testing? Is that related to blood vessel
function? Or is that another fishing expedition.

Anyway I thought this was interesting.

Kathryn

terri

I think in both cases they are trying to find out whether "natural
progesterone" is less damaging to blood vessels/glucose tolerance than
provera or other synthetic progestins. I doubt anyone thinks it's
actually beneficial in either case.