Naturally this makes me despise the whole product, even though I have been looking for one of the creams listed as being over 400 mg/oz. by the Aeron lab - wanting to try Dr. John Lee's hypothesis. He is considered a maverick or a quack, along with the handful of others who wrote books about it - Dalton, Wright, Kamen, etc., and yet their published results with patients don't include cancer, blood clots, strokes, or other negative side effects which Premarin, Prempro, Provera and other pharmaceuticals admit to. I know that some posters here have said the theories and research don't hold water but I am not far enough along in my research to be able to see exactly where the errors lie). 

I did find out, from one article after about 25 pages of scanning the Alta vista results,  why I can't find Pro-Gest in any health food store in a 40 mile radius. The Canadian government banned "two progesterone creams" a while ago. All the stores I went to made it clear "we don't have it, we're not going to get it, we can't get it, we used to carry it." The reason the government banned them was that the manufacturers could not offer any proof that their creams worked. 

I searched in vain for anti-wild yam cream sites; I found only TWO. The more I read the more I saw that the various promises of the wild yam cream has made it a field day for small-time entrepreneurs and it has become just as much a money making scheme for its promoters as Premarin is for its creator. Any truth about the substance(s) found in a genuinely useful cream are lost in the overblown hype, making me want to learn to love my hot flashes etc. etc. rather than participate in this exploitation of women's suffering. I am not being ironic here. I mean it. 

The one hope I recently had in my "real life" (as opposed to my reading, which comes under "self-doctoring"), the C.E.S., a conjugated estrogen made from plant sources only, which my G.P. said he could prescribe if I needed it (the only plant-based one he had in his huge book of drugs), turns out to be of the same unnatural formula as Premarin, even though it is from plants not horses. It does not contain estriol, the one estrogen that is said to protect against rather than foster breast cancer, and contains estrogens that are not native to the human body, in the wrong proportion. So I have no interest in it anymore. 

Lest you think I am confusing apples and oranges here (estrogen versus progesterone), I am not - I am looking into the mystery of the conflicting claims of estrogen starvation/estrogen dominance as opposed to the "maverick" theory that low progesterone is what causes pms and perimenopausal symptoms. 

Back to wild yam cream, if it is such a harmful and/or useless product, a cosmetic at best or a dangerous drug at worst, why are there not more sites denouncing it? When I say "it" I mean the whole "wild yam cream" concept - anyone can put one out with little more than cosmetic ingredients and offer it as a panacea for hot flashes, etc. , or worse, market it irresponsibly containing possibly excessive amounts of "synthetic progesterone", as one of the two anti-wild yam cream sites accused. 

I could not believe any of the testimonials by women who had used it for years and were very happy with it, since these testimonials were on marketing web sites. All of them sounded suspect, and the huge bulk of posts on various interactive (non-marketing) forums was from women with questions about the creams, not results. And the questions seemed to be answered by people promoting their own cream, so that ruled it out for me immediately. I don't see any testimonials for the joys of Provera or Prempro or anything else, either, so it's clear I am not going to find much more help with my research on the Internet. It's just a jungle out there. 

See, I'm not going to rely on something that reeks so strongly of quackery, which the medical establishment sees as a placebo. Every fibre of my being revolts against that. I was willing to try the various herbs my naturopath gave me, as some were used centuries ago, apparently - black cohosh, for example; then there's the whole "increase the soy intake" like Japanese women who have no hot flashes, but I get a bad reaction to soy. 

I find it interesting that my naturopath, the most sympathetic of the practitioners I have consulted, did not recommend the cream with progesterone synthesized from the wild yam; and interesting that no "real" doctor I've asked knows what it is, and therefore, it's like there are two camps and you have to choose one like in the short story, "The Lady or the Tiger". OR - just ignore the books by Wright, Dalton, Lee, Kamen, Gittleman, etc. However, when there are different sides of the question out there I cannot precipitously choose one. It's in my nature to study and come to a conclusion. 

When I'm feeling well, my old self - you know the story - all of this is moot. I don't need anything extra. However, apart from wanting to feel consistently better, the deadline for my article in my sister's magazine is approaching in August and I dread the idea I will end up with the same heartrending storyline as every other article. "Nothing is known." "There are no proofs." "You have to choose." 

Yet I know this will be the result. Even if I started on Premarin, Estrace, C.E.S., Pro-Gest or what have you and had a thrilling end to all my symptoms, I could not in fairness do a glowing testimonial. It COULD BE a placebo effect; a simple remission due to my own natural cycles.

When I am at my worst, I have symptoms that make me worry I have some terrible disease - and yet all my symptoms are on the list of menopausal symptoms, albeit a little more severe (i.e. attacks of nausea and cramps and shaking that last 3 days) and many other women write in to forums with even worse symptoms, and what's more, they are exacerbated by some type of estrogen prescribed to them. I see my suffering magnified by a thousand on the Internet, and promises to relieve our suffering, with no reason to believe those promises because they come from mavericks or self-promoting "natural product" companies, who also hawk St. John's Wort and other must-have herbs of the moment. 

I hope I have not annoyed readers here, but I wanted to share my current state of mind - even when in the well part of my cycle, it feels like swimming upstream. When I come out the other side will I be rigidly "for" one remedy and "against" the others? Never. I will know that something worked for me and would not necessarily work for the next woman. And yet, I am not satisfied with that. 

I maintain there must be a logical answer that would hold true for scientific reasons, with adaptation to each woman's particular circumstances.  There has to be one scientific answer - the body works according to recognized biological facts - or else each woman is playing Russian roulette, or throwing money away, with whatever remedy she accepts in her body. 

If progesterone cream (properly made in a laboratory) works to relieve the symptoms of menopause, it should be commonly known and available to be prescribed by doctors. Otherwise we are living in a looking-glass world; every woman should not have to be a detective and re-invent the wheel when she has debilitating symptoms.  If it is a placebo or a dangerous drug, there should be more warnings against it. 

Just my current opinion. 
later opinion below

First you mention that the OTC cremes are not available in Canada because they have not been tested. This is not true and shouldn't be mixed up with the other controversies about herbal remedies that do not have DIN (drug identification numbers). Progesterone, like melatonin and DHEA are all hormones and in Canada hormones are only available by prescription. I believe that this is the reason the cremes are not available in the UK as well. The creme products are not available by prescription because doctors have no way of knowing what is in these products, the labeling and inspection regulations apply to cosmetics not medications. 

The  warning by Health Canada last May 1, 1997 about the marketing of these cremes in Canada can be read at: http://www.hc-sc.gc.ca/english/archives/warnings/1997/97_31e.htm

Your post is a very timely one, The Lancet has just published a  study comparing Pro-Gest® to placebo and also comparing both to Uterogestan, an oral natural progesterone known as Prometrium in Canada. The findings were that progesterone levels from Pro-Gest® were much much lower than the levels from the oral progesterone, though they were higher than placebo. The levels found were not high enough to use to oppose estrogen and protect the endometrium as a part of HRT nor were they considered high enough to conserve bone density.

A Cooper, C Spencer, M I Whitehead, D Ross, G J R Barnard, W P Collins

Systemic absorption of progesterone from Pro-Gest® cream in postmenopausal women 
The Lancet Volume 351, Number 9111 25 April 1998 

The URL for The Lancet ishttp://www.thelancet.com
Kathryn
[Update July 1999:Theresa wrote:  I contacted the British National Formulary  Drug Information Line and was told that Pro-Gest® is theoretically available on private prescription, although most Local Authorities have "blacklisted" it, (ie GP's aren't allowed to prescribe it at all) because there's no evidence of its effectiveness. The man on the info line also had a mini rant about the manufacturers (Hynature), and the way they've been promoting an ineffective drug as natural, safe, etc.]

It's been more than a month and I stopped using it today. I suffered somewhat less of my usual symptoms while using it, after a few weeks. In the last 3 days I was getting the symptoms of progesterone overdose - sleepiness, super calmness (as opposed to my usual hyper state, this is not a bad thing, just odd). I was also using more than the 1/8 tsp twice a day recommended, because I never believed such a tiny amount would do anything. I never had dramatic results right after using it, but in the last 3 weeks I have noticed increased libido (from zero to normal), a lack of my usual depression and despair, no edema in the ankles - that is, less water retention; no hot flashes to speak of, thicker and shinier skin and hair (they were dry and thin before; now appear healthier), but it didn't help with my intolerance to the heat wave we had recently, or my anxiety attacks from the heat.  It also didn't prevent a recent and current recurrence of my chronic cystitis.  But I can tell it affected me. I was not doing anything else differently, diet has not changed, life situation is the same, and am not using any other hormones. I don't care for the cramps, bloating and pain I experienced today after I stopped using it - but I have no way of knowing whether it was responsible, or stopping it was responsible, or it was unrelated. 

I do not like the idea of using hormones my doctors tell me are unnecessary - I did this despite their insistence on estrogen. I didn't like the effects of the CES pills (plant estrogen) and I stopped them. I was less afraid of the natural progesterone, as there were no known toxic or dangerous side effects. But I still don't like it. This was an experiment. 

I also don't like the cost - after paying shipping and handling and witth the conversion from Canadian to US $ I am paying $50 to $60 per tiny jar. So I am not going to get any more for a while at least. I may go back to it if I notice I am not maintaining at least the health I have right now. But once again I hate doing things in the dark - completely based on doctors I never met (Dr. Lee et al) who are not accepted by my own doctors. Dr. Lee is coming to my city next month and I am going to his lecture in hopes of asking him some questions of my own. 

I hate having to defend myself to my health practitioners who have their ideas and expect me to kowtow. I didn't like the way I felt using the C.E.S. and I stopped it. (This was before trying the progesterone) My gynecologist, a most unsympathetic person, is going to give me a hard time for not using it for the full 3 months he told me to. 

I would like to take nothing and feel normal, the way I did for the first 45 years of my life; however, that is apparently not going to happen. I've tried that and it leads to NO quality of life. So I'll continue at least some experimenting with remedies. I still feel the only way to know what to take (if anything) is to measure one's hormonal levels (all of them) frequently, but my doctors will NOT do this. EVER. 

Life goes on, symptoms rise and fall; I am not an advocate of wild yam cream yet. 

Suzanne

Wild (Mexican) Yam
Dioscorea spp.
Note· This is a widely misrepresented product whose entire modern use is founded on a misconception. Because Mexican yam is virtually never used as an herb per se, this section is devoted entirely to debunking the misconception.