'Natural progesterone: the multiple roles of a remarkable hormone', by John R Lee. Pp viii + 150. Price £8.99. Charlbury, Oxon: Jon Carpenter Publishing, 1999. ISBN 1897766548.
Progesterone is one of two main hormones, the other being oestrogen, made by ovaries of menstruating women. The author of this book, a general practitioner from the United States, claims that natural progesterone (as opposed to synthetic progestogens, which are found in preparations such as oral contraceptives and hormone replacement therapy) is beneficial in a range of menstrual problems such as premenstrual syndrome, and also in the prevention of osteoporosis, coronary heart disease, breast cancer and prostate cancer.
His views contrast with that currently prevailing in that he thinks that many such conditions are caused by oestrogen dominance, not oestrogen deficiency. He says that it is levels of progesterone, rather than oestrogen, that fall around the time of the menopause and that giving oestrogens together with synthetic progestogens in HRT does not prevent this deficiency. Instead of synthetic progestogens, he generally prescribes Progest, a natural progesterone cream.
However, the author's views on natural progesterone are based largely on anecdote and observations and not on evidence from randomised controlled trials, of which there are few in this area. Indeed, researchers from King's College hospital, London, published data last year in the Lancet which call into question how well progesterone is absorbed from the cream formulation, and they concluded that use of this cream would not be likely to protect the endometrium from stimulation by oestrogen and would not conserve bone.
Progest cream is available via mail order in the United Kingdom and in Ireland, and this book, published in the UK for the first time, could well generate interest in this product. However, pharmacists would be best advised not to recommend natural progesterone until sound scientific evidence from clinical trials is obtained.
Reviewer - Pamela Mason. Pamela Mason is is a pharmacist and writer from Sydenham, south London, with a special interest in women's health issues