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book review of WHAT YOUR DOCTOR MAY NOT TELL YOU ABOUT MENOPAUSE by Dr John Lee |
| Since ovulation produces the corpus luteum
which is the source of all the progesterone _produced_ in the female body
(a very tiny amount of conversion also takes place), someone who is not
ovulating and who is still in her reproductive years will be progesterone
deficient - not estrogen dominant as Lee claims. Natural progesterone or
progestins are indicated in this case where an abnormal condition exists.
However, using progesterone/progestins in these circumstances should be a temporary measure while the underlying problem is addressed. Although progesterone will return your cycles to normal patterns, your failure to ovulate remains. This is actually because of low estrogen levels - estrogen deficiency. The section in Lee's book on anovulatory cycles is one of the most poorly researched sections of a book that is light on substantial research. I refer you to Lee's assertion that anovulatory cycles may result from malnutrition, stress, over-exercise and xenoestrogens. He then asserts that "the most important factor for anovulatory cycles is most likely to be our xenoestrogen exposure." No cite, no evidence, merely his assertion. His failure to explain how xenoestrogens might cause anovulatory cycles is even more disconcerting since if xenoestrogens are actually a problem in the Western world, the result could not possibly be low estrogen leading to anovulation. Yet anovulation is caused by LOW estrogen levels which fail to stimulate the production of lutenizing hormone releasing hormone, which in turn stimulates the pituitary to produce lutenizing hormone which causes ovulation which creates the corpus luteum which produces progesterone. If Lee wishes to argue that xenoestrogens produce a condition similar to that created by oral contraceptives, then there should be a huge population of infertile women who are infertile because they are not ovulating - that's simply not the case. Lee elsewhere makes one further statement about xenoestrogens, claiming that they cause "follicular depletion." This term is never defined, and there are no citations that refer to it. This is the quality of Lee's research and reasoning. He ignores basic endocrine principles, basic laws of biology, and blithely draws totally unsupported conclusions. If you look him up on the internet you will find that more than half of the references to him are links to commercial sites that sell the products he is pushing. Let the buyer beware. One further problem with Lee's book. He reprints a chart on page 45, notes that progesterone levels after menopause are almost zero, and calls this progesterone deficiency. No grounds, no basis. Progesterone is the hormone of pregnancy. It causes the endometrium to thicken in expectation of pregnancy, when pregnancy fails to occur, its production falls and the endometrium is sloughed off. If a pregnancy occurs progesterone is essential in maintaining it. But menopausal women don't get pregnant - they are no longer fertile - they don't need the hormone of pregnancy anymore. The post-meno progesterone level is low/deficient compared to what? Pregnancy levels? levels immediately following ovulation? levels immediately preceding menstruation? Why should these be considered normal for a non-pregnant, non-menstruating, anovulatory post menopausal woman? Terri |