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Natural Progesterone Endo Cream

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NATURAL PROGESTERONE

NATURAL TREATMENTS FOR ENDOMETRIOSIS

by Jeffrey Dach MD:

Comprehensive publication based on scientific studies

Endometriosis is a chronic, incurable gynecological disorder that causes pelvic pain, menstrual irregularities, infertility, and misery that affects 10.6% of women in the United States. (1) (7) The global incidence of endometriosis is estimated to be between 0.1 and 0.3% , or approximately 150 to 200 million women. (17)

Medical treatments are largely ineffective. Surgical treatment with laparoscopy is used as a last resort to restore fertility and relieve pain. (2) In this article we will discuss natural treatments for endometriosis

What is endometriosis?

In this condition, cells from the lining of the uterus called the endometrium are found in distant locations outside the uterus, with deposits of tissue scattered throughout the peritoneal cavity. The mechanism, confirmed in animal experiments, is thought to be the retrograde passage of menstrual endometrium through the fallopian tubes. These cells then seed the surface of the ovaries as well as the entire peritoneal cavity. (3)

“The principal theory of the pathogenesis of endometriosis… (is) the retrograde” regurgitation “of endometrial cells that pass through the oviducts in the peritoneal cavity and proliferate at ectopic sites”. Quote from Dr. Ceccaroni (4)

Abnormalities of host immunity required to allow abnormal implantation of endometrial tissue are also found. (1)

When physicians view the ovaries or peritoneal lining with the laparoscope instrument, they may find small, dark nodules of endometrial tissue implanted (see image below). Microscopic examination of the endometrial implants shows the induction of blood and innervation of the implants,

Above image: Shows laparoscopic view of endometrial implants in the peritoneal cavity (dark spots denoted by red arrows) courtesy of Dr. Yahya Kamal

Shared functions with cancer

Although endometriosis is a benign disease, it shares many of the characteristics of cancer cells, and can be viewed as a neoplastic process. (5) There is extensive clinical, pathological, and molecular evidence suggesting that endometriosis is a neoplastic process with a potential for malignant transformation. (5) Endometriosis can appear on cancer images with PET scans giving a false positive. (6)

Resveratrol and EGCG, fish oil and melatonin

If this is true, that endometriosis is a neoplastic process, then one might expect endometriosis to regress in response to natural substances that have anti-cancer activity, such as resveratrol, ECGC (green tea), fish oil, and melatonin. These have been studied in animal models.

Resveratrol is a natural substance obtained from red wine, which has anti-proliferative and anti-inflammatory properties. (11) EGCG is a green tea extract. A 2013 study by Dr. Riccifound both Resveratrol and EGCG had a potent inhibitory effect on the development of endomeriosis in a mouse model. (7)

A 2011 study by Dr. Brune-Tran showed that resveratrol inhibits the development of experimental endometriosis in vivo and reduces the invasiveness of endometrial stromal cells in vitro. (8) In this study, naked mice were implanted with human endometriosis cells. (8) The authors found that resveratrol reduced the number of endometrial implants by 60% and the decrease in total implant volume by 80%. (8) This is a great result for a naturally occurring supplement.

Fish Oil

The omega-3 fatty acids in fish oil are known to have anti-inflammatory properties. A 2014 study by Dr. Jennifer L. Herington using an experimental mouse model of endometriosis, showed that in mice with a 10% fish oil diet to be completed, adhesion scores and disease burden were significantly reduced. (9) The authors concluded, “an anti-inflammatory diet that includes fish oil supplementation may be a beneficial adjuvant in reducing the development of adhesions in women undergoing surgical treatment of endometriosis. (9)

Melatonin

Melatonin has anti-cancer and anti-inflammatory properties and was studied by Dr. Guney in 2008 in a mouse model of endometriosis. (10) The authors found that melatonin causes regression and atrophy of endometriosis lesions in experimental mice. (10)

Adenomyosis

Adenomyosis is similar to endometriosis with similar ectopic implantation of endometrial tissue, in this case, the ectopic tissue resides inside the uterus itself, in the muscular layer of the uterine wall where no endometrial glandular tissue should be found. Induction of adenomyosis in mice results in progressive hyperalgesia (increased sensitivity to pain), uterine hyperactivity, and the elevated plasma corticosterone levels (stress) that it indicates. (13-14)

EGCG, a green tea extract has been found to possess anti-cancer activity (12). Two publications treat EGCG as a natural beneficial treatment for adenomyosis. (13-14) In a 2013 study, Dr. Chen found that EGCG suppressed myometrial infiltration, improved overall hyperalgesia, reduced uterine contractility, and decreased plasma corticosterone levels in experimental adenomiosis-induced mice. (13-14)

Cyclic Natural progesterone for endometriosis

Another natural treatment that has been used successfully in recent years is cyclic progesterone, 20-40 mg twice a day applied as a topical cream for days 8 to 26 of the menstrual cycle. It was started by John R Lee MD and is described in his book, Natural Progesterone: The Multiple Functions of a Remarkable Hormone

Patients have reported good results with this regimen with relief of pain and other symptoms of endometriosis.

Dr. Jeri Lynn previous protocol with oral Prometium 300 mg BID.

Dr. Lam protocol for endometriosis – 20 mg BID topical progesterone days 26.8 .

Women in balance in progesterone cream for endometriosis.

Medicinal Cannabis Beneficial for endometriosis

While it is true that endometriosis is a benign disease that responds to natural substances with anti-cancer activity, then one would expect cannabis sativa extract to have beneficial effects. This is exactly what was found in multiple studies. (15-19) An additional benefit, reduction in pain, was also reported. (15-19)

Pain from the endocannabinoid system and endometriosis

Dr. Dmitrieva studied endocannabinoid involvement in endometriosis and reported her findings in the journal Pain in 2010. He noted that previous studies of endometriosis in mouse models and women showed:. “Sensory and sympathetic nerve fibers sprout branches that innervate” endometriosis implants “In the past, medicinal cannabis has been commonly used for the control of pain associated with endometriosis. Dr. Dmitrieva the theory that the endocannabinoid system is involved in both endometriosis and its associated pain. Using a mouse model of endometriosis, Dr. Dmitrieva found that cannabinoid CB1 receptors are expressed on the sensory and sympathetic nerves to endometriosis implants. (15)

Progesterone and the endometrium

Dioxin Interrupts cannabinoid signaling in the endometrium

In October 2012 Fertility and Sterility, Dr. Kevin G. Osteen, proposed that exposure to environmental endocrine disrupting chemicals, such as dioxin, can trigger changes that promote resistant progesterone endometriosis. He did a molecular study of the CB1 receptor messenger RNA in endometriosis. He analyzed messenger RNA receptor cannabinoids (CB1-R mRNA) in human endometrial tissues before and after exposure to dioxin, (TCDD) or a progesterone receptor antagonist drug, onapristone. (16)

Dr. Osteen found that in vivo exposure to progesterone during the secretory phase (days 12-26 of the cycle) was associated with positive regulation of endocannabinoid receptors in normal women. Dr. Osteen found increased gene expression of endocannabinoid receptor (CB1-R) messenger RNA in endometrial tissue samples harvested from normal healthy women during 12-26 days of the menstrual cycle. However, there was no positive regulation of gene expression in women with endometriosis. They found very little, or reduced, expression of CB1-R gene expression in similar endometrial tissue samples obtained from women with endometriosis.

In vitro studies revealed that acute dioxin exposure to normal endometrial cells produced this same abnormality, resulting in a failure of progesterone to maximally regulate the expression of the endocannabinoid receptor. The same results were obtained with a progesterone antagonist drug.

The authors concluded that the loss of normal progesterone responsiveness, i.e. progesterone resistance, is a striking feature of endometriosis. In addition, the endometrial progesterone-mediated endocannabinoid receptor system was profoundly dysfunctional in women with endometriosis. Exposure to the endocrine disrupting chemical, dioxins, replicated these abnormalities (16)

Endometrial-dependent progesterone regulation Cannabinoid ReceptorLeft Image: Top frame: Green arrow denotes normal increased expression of the endocannabinoid receptor gene in normal patients. The red arrow indicates endometriosis patients with low gene expression during the early phase and there is an increase in the secretory phase. Structure below: Histology slides of endometrial samples show normal brown staining of receptor proteins

Why is natural progesterone so important?

The fact is, in industrialized countries, most men and women have their hormones out of balance. The reason, according to Dr. John Lee, is that there is an overabundance of estrogen and estrogenic substances in the food we eat and in our modern environment. “Estrogen dominance,” as it is called in our time, is a problem in the United States and other industrialized countries. Your body needs natural progesterone to balance the toxic effects of estrogen dominance.

Dr. Lee, trained at Harvard, reports on his own research as well as other research around the world and the troubling effects of hormones that are out of balance due to a lack of natural progesterone in men and women.

These studies show that PMS, menopausal problems, osteoporosis, breast cancer, fibroids and fibrous breast cysts have a direct correlation in estrogen-dominated women.

Dr. Lee reports that all these problems can be treated through the use of a good natural progesterone cream.

In men, estrogen is responsible for serious prostate problems such as cancer, so common these days and so rare in our grandparents’ time. Equally the low energy and the decrease in sexual desire, the increase of fat, etc.

NATURAL OR BIOIDENTIC HORMONES, Dr. Lee, Harvard University

The need to use hormones is a reality, especially now that women are living much longer and many are going through menopause. Because their ovaries are not fully functioning due to menopause or in cases of total hysterotomy, where both ovaries are removed, these women suffer the unpleasant effects of their hormonal uncontrol. But not only women are affected, the estrogen-filled diet we are consuming produces serious hormonal imbalances in both sexes. Studies on bio-identical hormones have shown that these, which are NATURAL, without chemicals, have spectacular and safe effects on both men and women, as well as preventing the negative effects of excess estrogen on our bodies.

Benefits:

PMS (Premenstrual Stress Syndrome) Symptom Relief
An easier transition to menopause.
Improved libido (increased sexual desire and better response)
Improved mood and humor.
Resolves vaginal and total body dryness.
Restores health to our nails, hair and skin.
Helps to lose weight and eliminate excess fluid from the body.

According to Dr. John Lee who stands out in its use and applications, diosgenin acts in the body as a progesterone and its effects should be rejuvenating and highly beneficial for women in stages of menopause and to improve the symptoms and monthly pain of menstruation in girls and young women.

Scientific studies in general indicate that the estrogens present in many of the foods most consumed by men, women and children are the cause of many of the hormonal, endocrine and reproductive system problems suffered by both men and women.

For this reason, the National Women’s Institute, an entity attached to the National Institute of Health, issued clear and precise guidelines to the nation’s doctors to immediately stop the use of RHT or Hormone Replacement Therapy that has been in use for years. These estrogen-based therapies caused a multitude of health problems and their supposedly good applications were worse than the evil they were intended to correct.

The use of sexual impact skin creams and natural hormone content has been widely accepted by men and women who were experiencing high cholesterol levels and poor sexual response. Because each case may have different responses to the application of a product and contact with new substances that the body is not used to using.

They may be ordered on a progesterone basis to counteract the estrogenic effects of the diet and environment, or on a testosterone basis to increase women’s sexual response and improve men’s sexual potency. For more information on this topic you can read Dr. John Lee’s book: “Hormones and Health” or the artist Susan Sommers’ book: “Ageless” where she clearly states how her breast cancer responded using the transdermal bioidentical creams.

The transdermal creams are to be used through the skin and should not be used internally or ingested by mouth or applied to the eyes. Their beneficial effects should be noticed immediately within two to three days.

These products and their information are not intended to diagnose, treat, cure or prevent any disease. Consult your doctor before using these products if you have a severe medical condition.

MEXICAN WILD YAM EXTRACT WITH NATURAL PROGESTERONE AND LIPOSOME-BASED DHEA

General Description:The skin absorbs nutrients easily, which are taken advantage of by the internal organs. For example, the skin converts daylight into vitamin D, an essential component for good health. Through this process of skin absorption, progesterone, a basic hormone produced by men and women, is assimilated through the skin to give the body benefits including an essential analog for healthy bones. The ENDO formula contains exclusive, natural and totally safe ingredients, making Prosperity Life the only company to launch a progesterone cream that does not cause any harm. Prosperity Life’s Endo cream is made of progesterone with all-natural ingredients that can help relieve symptoms of PMS, menopause and osteoporosis in women. Baldness, elevated testosterone levels and prostate growth problems in men. It can increase energy, stamina and endurance by stimulating the natural production and regulation of other hormones. ENDO’s formula is effective and is made from the highest quality wild yam and dioscorea extracts. In addition, it is enriched with pure progesterone of natural origin:

  • Progesterone cream can provide the following benefits
  • Because it’s transdermal, it’s easily absorbed. But it also contains active ingredients that not only facilitate but also stimulate its rapid absorption, preventing the application from being retained in the subcutaneous lipid layer, which sometimes delays the initial physical reaction. However, the longer a woman uses ENDO cream, the greater its benefits.
  • It reduces the proliferation of breast cancer cells.
  • Decreases emotional stress and other symptoms during PMS or menopause
  • Provides relief for dry, inflamed, sagging and irritated skin.
  • Excellent support for the treatment of osteoporosis, as well as for the prevention of osteoporosis in women.
  • Prevents baldness and regulates testosterone production in men.
  • Supports preventive and therapeutic treatment of prostate problems

Apply from ¼ to 1 teaspoon on a thin part of the skin, for example, the inside of the forearms and thighs, the neck, the chin, the breast, the lower abdomen, and the groin. One area per week is recommended to improve results and should be applied once or twice a day for 21 consecutive days, starting on the eighth day after the first day of menstrual flow and continuing from day 1 to day 7 of the period.

Contraindications and warnings:

Discontinue application if irritation occurs.
This product is not for children. Keep out of reach of children.
Biblographic references:

  1. Women and Natural Progesterone. Dr. John Lee.
  2. What your Doctor may not tell you about Premenopause. Balance your hormones and your life from thirty to fifty. John R. Lee, M.D. Jesse Hanley, M.D. and Virginia Hopkins. Warner Books. 1999.

Synopsis of Natural Progesterone from the book Quick Guide to Vitamins, Minerals and Supplements. Author: Helen Pensanti, M.D. and Barbara A. Hoffman. 2002:

  • In 1936, Japanese scientists used an extraction process and discovered in the Mexican wild yam the dioscorea. It was determined that its chemical configuration was almost identical to that of progesterone excreted by a woman’s ovaries. The United States Pharmacopoeia (USP) then standardized it in the form we know today, natural progesterone or USP progesterone.
  • Progesterone levels decline to near zero as a woman approaches or enters menopause, due to anovulatory cycles. This fact contradicts the belief that a woman’s estrogen levels are reduced to zero, which is nothing more than a myth.
  • Progesterone is the natural estrogen balance in the body, and it is also necessary for the body to make optimal use of estrogen.
  • Millions of women have reported that natural progesterone has relieved them of symptoms of their menopause such as hot flashes, night sweats, insomnia, vaginal dryness, memory lapses and nebulous thinking.
  • It helps relieve the symptoms of premenstrual syndrome (PMS) such as anxiety, irritability, mood swings, breast swelling, depression, colic, and cravings for certain foods.
  • Helps increase libido.
  • It can alleviate depression.
  • Helps relieve and reduce fibrocystic breasts
  • Helps to recreate the bones
  • Can reduce the size of fibroid tumors
  • Helps support thyroid gland function
  • Reduces ovarian cysts
  • Research shows that progesterone plays an important role in the health of the heart, brain and nerves.
  • All women who have PMS, or who are experiencing perimenopause or menopause, should use progesterone cream to balance their hormone levels.
  • It is an excellent treatment for osteoporosis because it helps create new bone. Clinical studies have shown that some women experienced a 10-15% increase in their bone density after using natural progesterone.
  • Recent studies have shown that natural progesterone has a special protective effect against breast cancer as well as other cancers of the reproductive organs. Studies indicate that women who have been diagnosed with breast cancer, but who had high levels of progesterone, had better survival rates.
  • Due to the growing number of studies indicating multiple applications of this remarkable hormone, I anticipate that by 2015 natural progesterone will be listed in all U.S. household medicine cabinets, as aspirin is today.
  • Dr. John R. Lee especially recommends it to men with an enlarged prostate.

Note: You can find more information about natural progesterone in the following books: Natural Progesterone. Author: Dr. Pedro Galo Aguilar (e-book)
All for the woman. Author. Dr. Francisco Contreras Pulido.
Natural Progesterone for Men. Author: Vicente Escobar and Dr. Benjamín del Río (e-book)

Progesterone and Breast Cancer Research

After the factual errors, which cast a shadow over all of Lynne McTaggart and Dr. Grant’s claims, it is the premise that one can declare “progesterone causes breast cancer” based on vitro (test tube) research with a pair of breast cancer cell lines. As Dr. Lee repeatedly pointed out, test tube research is one-dimensional, while the actions of progesterone in the human body are affected and mediated by dozens of other factors, including organs, glands, hormones, the immune system, lifestyle, and genes-to name a few.

Breast cancer researcher Dr. David Zava, our co-author of “What Your Doctor Can’t Tell You About Breast Cancer,” and a great friend and colleague of Dr. Lee, spent thousands of hours studying these same lines of breast cancer. He explains: “It is absurd to extrapolate this research to humans without a thorough understanding of biochemistry and physiology. The reality of how progesterone affects breast tissue is much more complex than progesterone is just one piece of the puzzle. The research Dr. Grant cites is good, solid scientific work, and very interesting, but it is not even close to enough information to declare that progesterone is carcinogenic. In fact, there is much more research showing the opposite: that progesterone has a protective effect against breast cancer, and also that there is no clinical data, done with real women showing that it is protective. “

As for the test tube studies, there are dozens, if not hundreds, showing that progesterone reduces cell proliferation, stimulates apoptosis (cell death), and stimulates cell differentiation-all important factors in breast cancer prevention. There’s a rumor going around in the research community now about the possibilities of the p53 gene in the prevention and treatment of breast cancer, and guess what? Progesterone upregulates the p53 gene, a nice little piece of test tube research done about a decade ago that pointed the way for a lot of other research on progesterone and p53.

Research Real progesterone with real women

Let’s briefly review some of the research data intended for clinical use with women-actual, live human progesterone and breast cancer. For details and more research, please read What Your Doctor Can’t Tell You About Breast Cancer.

1) The oldest known clinical study of progesterone and breast cancer was conducted at Johns Hopkins University in 1981 (Cowan et al, American Journal of Epidemiology). They measured estrogen and progesterone in a group of women, then divided them into two groups: those with normal progesterone levels and those with low progesterone levels. They followed these women for 20 years and found that in women with low progesterone levels, the incidence of breast cancer was more than 80 percent higher than those with normal progesterone and the incidence of all cancers was 10 times higher than in women with normal progesterone.

2) In 1996, the researchers measured the womens progesterone before breast cancer surgery and found that those with normal progesterone levels had a doubled survival rate of 18 years than women with low progesterone levels at the time of surgery. (Mohr et al, British Journal of Cancer)

3) Three studies in particular have demonstrated the effect of progesterone on breast cells. One, by Foidart et al and published in the journal Fertility and Sterility, in 1998 concluded, “Exposure to progesterone for 14 days reduced oestradiol-induced proliferation of normal breast epithelial cells in vivo. Another, by Malet et al and published in the Journal of Steroid Biochemistry and Molecular Biology, in 2000 concluded, “The cells showed a proliferative appearance after E2 [estradiol] treatment, and returned to a resting appearance when P [rogesterone] was added for E2. P [rogesterone] appears(s) predominantly to inhibit cell growth, both in the presence and in the absence of E2”.

The third study examined the effects of transdermal (skin rubbing) hormones on healthy young women planning to undergo minor breast surgery for cosmetic reasons or benign breast disease. Ten to 13 days before surgery, four groups of women apply either estradiol cream, progesterone cream, an estradiol and progesterone combination, or a placebo cream (with no hormones in it). In surgery, biopsies were performed to measure estrogen and progesterone levels, and the level of cell proliferation rates. (High levels of cell proliferation is a marker for breast cancer). The study showed that both hormones were well absorbed through the skin into the breast tissue. But more importantly, estradiol increased cell proliferation by 230 percent, while progesterone decreased by more than 400 percent. The combination of estradiol-progesterone maintains the normal proliferation rate (Chang et al, Fertility and Sterility)

4) In 2002, a French study of HRT in 3175 women was released. This was particularly interesting because it was a large-scale study, and because, to quote the study, “… the main specificity of the French cohort is that 83% of the users of combined HRT were receiving a mainly or exclusively transdermal estradiol gel formulation, and the progestin was oral micronized progesterone in 58%, while the users of MPAs were less than 3%. “Oral micronized progesterone is bioidentical, natural progesterone, which is what most French women use, rather than synthetic progestins. The study conclusion was that, “When both duration of use and last period of use were analyzed together, no significant increase in the incidence of breast cancer was observed in any of the four subgroups considered,” and “Based on internal analysis, there was no significant increase in the risk of breast cancer related to the use of the specific type of HRT most prescribed in France.

Moderation and common sense are the keys to optimal health

One of the aspects of Dr. Lee’s character that I most admired was his willingness to change course and moderate his message when new evidence was brought to his attention. He was first drawn to progesterone when he realized that the conventional hormone replacement therapy he had been prescribing for years had probably hurt many women. He had the courage to admit this first to himself, and then to his patients, and then he set about solving the puzzle of how to help women balance their hormones safely and effectively. The discovery of progesterone as a forgotten piece of the hormone balancing puzzle was exciting and yes, he was a man on a mission to help women balance their hormones and to help undo the damage of conventional HRT. As a result of his courage and zeal, millions of women are healthier and happier.

From the outset, Dr. Lee recommends no more than 15 to 30 mg of progesterone daily for most women, and for pre-menopausal women for only two weeks per cycle. This is a very moderate dose that approximates what the ovary would decide in a normal pre-menopausal woman. In addition, he advocated splitting the dose and taking half in the morning and half in the afternoon

There is no doubt that this is not a good idea for most women who take large doses of progesterone in any form over a long period of time. That’s not good medicine, it’s not balanced, it’s not common sense, and it’s bound to cause problems sooner or later. In his first book published by doctors, Dr. Lee compared the “dance of steroids” to an orchestra, where each player creates beautiful music by being in harmony and rhythm with the others. Large doses of progesterone will drown out the other players and create chaos.

As jealous as Dr. Lee was about to progesterone, his message was not just a hormone. He always strongly advocated a healthy diet, moderate exercise, good sleep, stress management, healthy relationships with others, and the importance of making time for fun and for contemplation.

The quest for optimal health is never-ending and always changing, and is best addressed on all levels: physical, emotional, mental, and spiritual. There is no magic potion or lotion. Optimal health is an evolving, continuous journey of discovery.

Please pass this on

Dr. Ellen Grant – Lynne McTaggart article has created quite a stir, as it was widely disseminated around on the internet, and as I said before, it sounds pretty convincing if you are not familiar with the research. However, the information on breast cancer, as well as the additional information on progesterone and the immune system, is not accurate or convincing once you have the facts in hand.

There is a great deal of misinformation about progesterone that is widespread at this time. It’s probably no coincidence that this well-funded and well-orchestrated campaign coincides with Wyeth-Ayerst’s petition to the FDA demanding that capitalized pharmacists will not be allowed to dispense with natural hormones. (Wyeth-Ayerst is the manufacturer of PremPro.) If they are successful in lobbying the FDA on manufacturing the single prescription, branded drug, it will be interesting to see how quickly they come up with a progesterone cream, patch or pill themselves.

This is a free author article

The Best Way to Use Progesterone Cream

The key mistake that many knowledgeable and well-meaning doctors, including myself, advised using the cream on the skin. While this certainly offers better results than swallowing hormones, there is still room for improvement.

There is one relatively minor trick, which I could do with the creams, which avoids almost all of the side effects of applying the cream to the skin.

If you apply the cream to the mucous membranes of your epithelial membranes lining the uterus and vagina, you will get a virtually ideal delivery system. Not only is absorption more complete through these membranes than through your skin, but the hormones that are absorbed through your vaginal membranes enter the same pelvic venous plexus where your ovaries normally flow.

From here the hormones are carried to your heart and lungs and distributed to the tissues as if your ovary had actually produced them.

Men also require hormones. Obviously men do not have a vagina to use, but we do have a rectum that has a similar epithelial mucosal surface and could be used to administer the hormones in an ideal way and without any of the complications described above.

Time and Dosage of Progesterone Cream

For most pre-menopausal women the usual dose is 15-24 mg per day for 14 days before their period, stopping one day before their period. So use the cream for 12 days and then stop. Normally this would mean that you will start on day 12 of your cycle and stop on day 26.

The sudden drop in your progesterone level is the main trigger for your period to start. Hopefully, when any premenstrual symptoms start, painful periods will be dramatically reduced.

When a woman is in menopause she may only need 15 mg but she must take them during the first 25 days of the month, then she will take 5 or 6 days off and restart on the first day of the month.

For most women, just one application per day will work. However, because the half-life is relatively short, some women find that they get a more satisfactory response by dividing the daily dose in half, half in the morning and half in the afternoon. If you’re only taking the hormones in the morning and start feeling symptoms later, dividing the dose in half should solve the problem.

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