By Elora Gabriel



Osteoporosis is a serious and disabling condition, and it is on the rise among American women. The good news is that we now know more than ever about how to prevent or even reverse this condition. We all know that we should avoid sugar, caffeine, and excess protein in our diets, take a good form of calcium such as calcium hydroxyapatite, and exercise regularly to keep our bones strong. But what is the effect of the different hormones on our bones?

For years, estrogen has been prescribed to protect against osteoporosis. However, little research has been done on the effect of the safer estrogens, such as estriol, tri-estrogen, and phyto-estrogens, upon bone health. It is known, however, that very large amounts of estriol are needed to prevent osteoporosis. This is one reason that I recommend tri-estrogen for most women instead. While we clinical studies are lacking, Dr. Alan Gaby, author of the highly recommended "Preventing and Reversing Osteo-porosis" states that the information we have on tri-estrogen "suggests that it would also be effective for osteoporosis."And according to Dr. Stephen Holt, several studies confirm that phyto-estrogens derived from soybeans "will prevent bone loss" associated with menopause.

However, all foremost authorities on this subject agree that progesterone is far more important for osteoporosis than is estrogen. Progesterone helps to build new bone. Itšs like having a bank balance. Estrogen helps you to spend less, but progesterone puts new cash into your account. Therefore, using progesterone, and deciding what form you want to use, is essential for your bone health.

However, there is considerable confusion about the different types of progesterone. There are three major ways to obtain progesterone effects. First of all would be the commonly prescribed synthetic progesterones, such as Provera. Synthetic progesterones should be avoided, as they have many unpleasant and dangerous side effects and can obliterate the beneficial effect of estrogen on cardiovascular health.

Secondly, we have Progesterone USP, commonly referred to as "natural progesterone". It is converted in a laboratory from wild yams or soybeans and is an exact match for the progesterone produced by the ovaries. And thirdly, many women are now using wild yam extract. The active ingredient in wild yam, called diosgenin, is similar enough to ovarian progesterone that it could be called a "phyto-progesterone". Which of these two substances is better for osteoporosis?

Progesterone USP certainly comes out ahead in terms of clinical results. Most impressive is Dr. John Leešs study of 100 post-menopausal wo-men, many of whom showed symptoms of osteoporosis. The women used a progesterone cream for at least three years. Of the 63 women who had bone density tests, instead of the predicted bone loss that would be expected in this group, every single one had an increase in bone mass. Some women showed an increase of 10% after the first 6 to 12 months of therapy, and others showed a 20-25% increase in the first year. Dr. Lee found that the effects of the therapy were independent of whether the women were receiving estrogen. Progesterone is the standard treatment for osteoporosis in Europe.

The downside of Progesterone USP is that it is possible for excess to build up in the body. While most authorities deny this fact, the laboratory evidence from saliva hormone assays is undeniable. The medical dosage of progesterone is 100-200 mg./day. This is far more than the body ever produces, and several times as much as Dr. Lee used in his study. Women using Progesterone USP generally do not need more than 60 mg./day, even if they are using estrogen. However, even at this dosage, easily obtained from a non-prescription cream, women may develop a toxic excess of progesterone over time.

Those who prefer to go "all natural" tend to like using wild yam. Unlike Progesterone USP, to the best of our knowledge wild yam cannot create any toxic excess in the body and has no side effects. However, to date we have only one clinical study showing that wild yam can increase bone density. Dr. McDonough, an osteopath, reported significant increases in bone density for a 72-year- old woman and a 60-year-old man who were using a topical wild yam product called Nu-Gest. There is also considerable empirical evidence that wild yam has increased bone density. However, it is clear that we need more clinical work with standardized wild yam extract products.

After several years of research, I have come up with the following guidelines for optimal use of progesterone. (1) Healthy peri-menopausal women, who are not at particular risk of osteoporosis in terms of family history, may do fine using wild yam. Do make sure that you find out what percentage of standardized diosgenin extract your wild yam cream has. Good products have at least 8%, and the best are as high as 95%.

(2) Menopausal and post-menopausal women should use the following protocol. If you have not been using progesterone, your levels are probably quite low. Use a combination wild yam and a moderate strength Progesterone USP cream, such as Femarone 17 or Progestone 900, to raise your levels. Go through 3 or 4 jars of such a product. After this, begin to alternate a Progesterone USP product with a pure wild yam product, jar for jar. In other words, you could use a jar of Pro-gestone Ten (a wild yam product with 95% standardized diosgenins) then a jar of Femarone 17, and so on. This method should prevent any excess build-up of progesterone. At the same time, your bones will have the protection of the pharmaceutical progesterone.

If you have been using a Progesterone USP cream (the label will simply list "progesterone") for some time, you should probably switch to wild yam for a couple of months to clear out any excess. Then, begin to alternate as described.

Other hormones which are beneficial for the bones are DHEA and testosterone. Testosterone is a bone-building hormone and is responsible for the lesser incidence of bone loss in men. A 2% natural testosterone gel may be obtained by prescription from compounding pharmacies such as Clarkešs Pharmacy, (800) 480-3432. Synthetic methyl testosterone is not recommended. Testosterone benefits (which also include increased libido and muscle firmness) may also be obtained without a prescription by using a natural hormone called androstenedione. Androstenedione converts directly into testosterone in the body.

DHEA, a non-prescription adrenal hormone, directly increases levels of estrogen and testosterone and indirectly increases progesterone levels. Dr. Gaby describes the case of a wo-man with osteoporosis who was using progesterone and "doing everything right" in terms of lifestyle. Nothing helped her until she began using DHEA. Gaby also comments, "When one looks at the biochemical effects of DHEA, they tend to read like the 'who's who of osteoporosis prevention.'" For most women, 10 mg./day is sufficient, and the micronized form is recommended for better absorption.

With a healthy lifestyle and the proper use of natural hormones, women of any age can prevent bone loss or even increase their bone density. As always, staying informed is a crucial key.

Elora Gabriel is a writer and researcher who has published many articles on natural hormones. Further information is available by contacting Elora at:

Tides of Life
91-A Deer Run Road
Black Mountain, NC 28711
(828) 669-2515

Return to the JANUARY/FEBRUARY Index page