There is one thing stronger than all the armies in the world,
and that is an idea whose time has come.
-- Victor Hugo
It was an unsettling revelation to me that osteoporosis can begin as early as fifteen years prior to the first signs of menopause -- often around the middle to late thirties. By the time most women reach their postmenopausal years, the majority will suffer from this disease -- a fact that has made it the most common metabolic bone disease in this country.
The gradual loss of bone, perhaps 1 percent each year at first, accelerates to a rate of 3 to 5 percent per year during menopause and then reverts to about 1 to 1.5 percent a year thereafter. This association of accelerated bone loss with menopause, first recognized over fifty years ago, led medical doctors to prescribe estrogen supplements during menopause to reduce these chances. Unfortunately, however, there are some problems with this approach. Of great importance are the significant side effects that start appearing in a woman's body when supplemental estrogen, unopposed by natural progesterone, is introduced. They constitute a long list, ranging from increased blood clotting and water retention to liver dysfunction and greater risk of endometrial and breast cancer.
As if that weren't bad enough, it also turns out that this estrogen therapy doesn't really do very much good. Nevertheless, the standard medical wisdom continues to support this approach and to assume that it is the most effective treatment. There is ample evidence in the medical literature that the therapy is of some limited value, at best, during the menopausal years. However, according to Sandra Cabot, M.D., "when estrogen is discontinued, calcium loss resumes." So we need to look much more closely at the conventional method of treatment.
Dr. John Lee suggests instead that this escalating bone loss is due to decreasing levels of progesterone, caused by failure to ovulate during some menstrual cycles -- for progesterone is mainly produced in the process of ovulation. In nonpregnant ovulating women, the ovaries normally produce 20 to 40 mg of progesterone daily during the second half of the menstrual cycle. During pregnancy the placenta becomes the main producer of progesterone, making ever-increasing amounts, so that by the last three months of pregnancy, it is making 300 to 400 mg a day. Failure to produce these levels of progesterone naturally can lead to trouble. Even though estrogen aids in slowing down bone loss, progesterone could be called proactive, since its stimulatory effect on the osteoblastic cells actually encourages bone growth.'
The Importance of Ovulation
The onset of irregular periods is an indicator that progesterone levels are becoming depleted with respect to estrogen. When menopause is upon us (that is, when we have stopped ovulating), our blood progesterone will decline to almost zero. A reasonable question would be, "Why do some women experience this sooner than others?" Researchers tell us that stress, injury, poor diet, lack of exercise, and trauma, all may play a role in the degree to which ovulation becomes sporadic and then tapers off at menopause.
To these Dr. John Lee would add the damage done to the ovaries by any of the many human-made estrogenic chemicals in the environment. Such exposure to the female fetus or very early in life may damage the ovarian follicles to the extent that in adulthood they can no longer make progesterone as they should. Follicle dysfunction induced by these so-called xenoestrogens may well be the primary cause of the progesterone deficiency that often occurs fifteen years or more before actual menopause.
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In addition, as is widely reported in the press these days, the way you treat your body in general can contribute to premature bone loss. Smoking and excessive consumption of alcohol, caffeine, soft drinks, and meat protein, as well as the use of certain anti-inflammatory or antiseizure medications or thyroid hormone replacements, may all place you at higher risk. And some factors can't be avoided: thin, small-boned women and those of Caucasian descent have a higher risk of osteoporosis.
In the United States, approximately 24 million people are affected by osteoporosis, at a medical cost of over $10 billion and as many as 1.5 million fractures leading to disability, deterioration, and, for too many, death. Today, the annual number of fractures attributable to osteoporosis continues to escalate as our exposure to estrogen from various sources has drastically increased. But, as Dr. Robert Lindsay has said, "The problem is, nobody feels the bone they're losing until it's too late.... Osteoporosis is without symptoms until it becomes disease." According to Dr. Patricia Allen, when the "acceleration of bone loss begins, risks for coronary artery disease start to increase [and] atrophy of breast and genital tissue starts. And so most doctors now believe that a woman who is bothered by menopausal symptoms should be treated before the cessation of her periods."
Progesterone For Healthy Bones
Jerilynn C. Prior, M.D., and her associates, found evidence of progesterone's possible role in countering osteoporosis in a study of sixty-six premenopausal women between twenty-one and forty-one years of age. All these women were long-distance marathon runners. It was observed after twelve months that
The average spinal bone density decreased by about 2% . . . . However, women who developed ovulation disturbances during the study lost 4.2% of their bone mass in one year. While there was no correlation between the rate of bone losses and serum levels of estrogen, there was a close relationship between indicators of progesterone status and bone loss.
Now this is news! And then Medical Hypotheses claims that the use of natural progesterone is not only safer but less expensive than using its synthetic formulation, Provera (medroxyprogesterone), and that progesterone and not estrogen is the missing factor . . . in reversing osteoporosis.
The journal continues:
The presence or absence of estrogen supplements had no discernible effect on osteoporosis benefits .... Progesterone deficiency rather than estrogen deficiency is a major factor in the pathogenesis of menopausal osteoporosis. Other factors promoting osteoporosis are excess protein intake, lack of exercise, cigarette smoking, and inadequate vitamins A, D, and C.
Dr. Majid Ali says that the use of estrogen to prevent osteoporosis is really quite "frivolous". Osteoporosis is a disease we can do much to prevent. With the knowledge we presently have, it is imperative that women take active steps toward a healthier lifestyle. We must take to heart what author Gail Sheehy says in The Silent Passage: Menopause:
Nearly half of all people over age seventy-five will be affected by porous bones causing the risk of fractures of many kinds. The National Osteoporosis Foundation in the U.S. says that almost a third of women aged sixty-five and over will suffer spinal fractures. And of those who fall and fracture a hip, one in five will not survive a year (usually because of postsurgical complications).
It has been estimated that twice as many serious fractures occur today than thirty years ago. How long will it take us to grasp the truth of the matter, so we can help ourselves and the aging population? "Clearly," says Dr. Alan Gaby, "there is something wrong with our bone health, something that the medical profession has not been able to do much about. There is more to preventing bone loss than calcium supplements, estrogen replacement therapy and exercise."
These reminders about the decline in bone mass as we age make me think of my own family gatherings during the holidays, when we are at long last in the company of several generations of family members. Someone usually says, "Haven't you grown!" In our family we take it a step further: someone stands next to Mom, and then Mom next to Grandma -- and, sure enough, there is a definite change! But it's in the opposite direction. Soon a grandchild will say, "Wait a minute, Grandma, aren't you shrinking?" It seems that these changes start earlier than we may think and are more crippling than we realize.
Is this a topic we can continue to take lightly? Not according to Robert P Heaney, M.D., professor of medicine at Creighton University School of Medicine in Nebraska. In commenting on the medical community's having overlooked the importance of progesterone in osteoporosis, he expressed the hope that research will "galvanize the field into taking the matter seriously." Perhaps statements such as his will begin to reeducate the very doctors who think they know all there is to know about this most vital subject.
The Estrogen Fallacy
It is a mystery that so much focus has been placed on declining estrogen levels; it seems the emphasis has been on the wrong hormone. The October 14, 1993, issue of the New England Journal of Medicine makes it clear that taking estrogen for five or ten years after menopause will not protect a woman from having a hip fracture in her later years. Why should we wait ten to twenty years for the results of the studies that are now in progress? We have already been counseled by many medical experts. Now is the time to make the change from an estrogen replacement program to one based on natural progesterone therapy.
We should ask ourselves, "Why would we use a hormone that has not worked for generations past?" The traditional and often one-sided references to estrogen decline have created a body of misinformation that has sentenced many to poor health and needless distress. It seems irresponsible that the medical world is not doing double-blind studies, along with baseline and follow-up bone mineral density tests, with natural progesterone.
However, we can be grateful to the many doctors who have searched the archives for the truth of the matter. We now have reliable evidence that despite declining estrogen levels, bone loss accelerates when progesterone levels decline, and bone minerals can be restored with natural progesterone replacement therapy. Yet, the message women receive from their medical doctors is that "estrogen is the single most potent factor in prevention of bone loss." This belief has been handed down from one generation to the next. Fortunately, recently published studies and books are now challenging the medical theory and bringing more light to the subject of preventing osteoporosis.
Yes, Osteoporosis Can Be Reversed
A case in point is the book Preventing and Reversing Osteoporosis, written by medical doctor Alan Gaby. I became so absorbed in it that I could not put it down -- nor will you, when you find that, yes, osteoporosis can be reversed. Much of what Dr. Gaby says would be beneficial to many and should be shared. He cautions that despite the preventive measures of calcium supplementation and exercise, and despite medical intervention with estrogen therapy, osteoporosis is getting worse: "At least 1.2 million women suffer fractures each year as a direct result of osteoporosis.... Fractures seem to be increasing.... and this difference cannot be explained by the aging of the population."
Let us hope that more medical doctors are getting away from the mainstream of drug therapy and are discovering natural remedies that seem to work more efficiently for such problems in the long run. Dr. Gaby, for instance, with twenty years of medical research and thirteen years of clinical practice, writes that many of the most significant advances and effective treatments have been those discovered or administered outside the auspices of the traditional medical community.
Dr. John Lee comments that modern medicine "strangely persists in the single-minded belief that estrogen is the mainstay of osteoporosis treatment for women." Strange, indeed, that doctors should think like this, when even medical textbooks such as Harrison's Principles of Internal Medicine (12th edition, 1991) and Cecil Textbook of Medicine (18th edition, 1988) don't back up this theory. Along the same lines, Dr. Lee also quotes the 1991 Scientific American Medicine:
"Estrogens decrease bone resorption" but "associated with the decrease in bone resorption is a decrease in bone formation. Therefore, estrogens should not be expected to increase bone mass." The authors also discuss estrogen side effects including the risk of endometrial cancer which "is increased six-fold in women who receive estrogen therapy for up to five years; the risk is increased 15-fold in long-term users."
Progesterone Cream for Osteoporosis
Although there are many forms and ways to take natural progesterone, Dr. Lee acquaints us with the transdermal method. By carefully observing his patients over the course of fifteen years, he proved the effectiveness of transdermal progesterone cream. His work confirmed its safety and its remarkable benefits to his osteoporotic patients who had a history of cancer of the uterus or breast and to those who had diabetes, vascular disorders, and other conditions.
Dr. Lee had hoped that the progesterone would strengthen his patients' bones. To his surprise, it did; their bone mineral density tests showed progressive improvement and the number of his patients suffering osteoporotic fracture dropped nearly to zero.
Dr. Lee is perplexed at "the reluctance of contemporary medicine to adopt the use of natural progesterone." It's his impression, however, that "the news is spreading and change is on the way". In the publication Natural Solutions, Dr. Lee voices true dismay with his orthopedic colleagues who chose not to use the progesterone cream in their patients' care "but did put their own wives on the cream."
Dr. Lee points out that the "conventional treatment of osteoporosis with estrogen, with or without supplemental calcium and vitamin D, tends to delay bone mass loss, but not reverse it." His investigation into using transdermal progesterone cream instead of a synthetic estrogen replacement treatment demonstrates that "osteoporosis subsided, musculoskeletal strength and mobility increased, and monthly vaginal bleeding did not occur." Most striking were the results of the dual-photon densitometry test, which measured a 10 to 15 percent increase in bone mineral density, even in women who had experienced menopause twenty-five years earlier.
After years of researching transdermal progesterone supplementation, Dr. Lee observed in his patients "a progressive increase in bone mineral density and definite clinical improvement including fracture prevention..." He concluded that "osteoporosis reversal is a clinical reality using a natural form of progesterone derived from yams that is safe, uncomplicated, and inexpensive." Unfortunately, by the time many of us are ready to deal with the impact of osteoporosis it has already done considerable damage, as it is symptomless until the fractures begin. If you think that you can deal with brittle bones after you get through the inconvenience of hot flashes and night sweats, you need to think again.
It is an enigma to me that our nation's supposedly up-to-date medical researchers continue to be oblivious to the evidence that progesterone stimulates new bone formation by the osteoblasts, the bone-building cells. Think of the many aging women who could benefit from this information and be freed from unnecessary pain and spared their disability. As Gail Sheehy observes, osteoporosis "often leaves older women frail, susceptible to falls and broken bones .... [It] makes it painful merely to sit." Many elderly osteoporotic women die of secondary infections following hip surgery. These infections are what makes osteoporosis victims subject to death, not the osteoporosis itself.
Reading about this reminded me again of my mother's fragile condition as her hip bones grew so weak she could hardly get out of a chair. The longer she sat in one place, the more pain she felt. Before long she had to depend on a wheelchair to get around, and in an even shorter time she yielded to a hospital bed in our home. We felt blessed that she at least did not have to enter a nursing home, as so many do.
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About The Authors
Raquel Martin suffered for years after the left side of her body was temporarily paralyzed from a blood clot in her brain in the early 1970s. She went to many specialists and tried many drugs which caused further chaos in her body. Eventually she learned to do her own research and make her own decisions. She discovered the cause of her disorders and took control of her health. She has recovered, and her life is now dedicated to spreading information about the need for safe natural alternative therapies. Her other works include Today's Health Alternative & Preventing and Reversing Arthritis Naturally. Visit her website at http://www.healthcare-alternatives.info/.
Judi Gerstung, D.C., is a chiropractor and radiologist with special interest in the detection and prevention of osteoporosis. She lives in Colorado.