A: These syndromes are not universal. There are cultures in the world where the words for PMS or hot flash do not even exist. Not all postmenopausal women develop osteoporosis!

Q: Physicians now add progesterone to the estrogen they prescribe for menopausal women. Is this an advantage?

A: There is a great deal of confusion surrounding the proper use of the term progesterone. Progesterone or natural progesterone refers to one specific hormone - the one manufactured by your adrenal glands or ovaries. What you need to know is that most of the so-called "progesterone" added to replacement therapy is usually synthetic, resembling the hormone made in your body, but differing in significant ways. Synthetic progestins (a more accurate term for unnatural progesterone) may have serious side effects. Natural progesterone has none.

Q: Then why don't the drug companies use the natural product?

A: A natural hormone (found in humans or anywhere in nature) cannot be patented by a pharmaceutical company. A slight variation of the hormone, however, can be patented! Does this explain the popularity of synthetic hormones promoted by the drug companies?

Q: Just how do the natural and the synthetic progestins differ?

A: The distinction between progestins and natural progesterone is important. The only thing synthetic progestins and natural progesterone have in common is their ability to sustain human secretary endometrium. Among the side effects of synthetic progestin are weight gain, bloating, and cancer. To add to the problem, synthetic progestogins diminish your supply of natural progesterone! (1) Estrogen, by the way, helps to slow down bone loss. Natural progesterone builds bone back!

Q: Do we understand how natural progesterone helps to build bone?

A: We're just beginning to understand the metabolism involved. Natural progesterone affects osteoblasts, our bone-building cells. So natural progesterone is proving to be a valuable agent for the prevention of osteoporsis, and for the management of postmenopausal osteoporosis.

Q: Is it true that hormone residues fed to animals are found in our foods?

A: A mounting body of evidence suggests that other sources of estrogen are contributing to the back-ground level of carcinogens in our food environment.

Q: What are the sources of natural progesterone?

A: A major source is the Mexican yam. A substance from this vegetable is extracted and then converted to the same chemical structure as natural progesterone. It is then usually mixed in a cream base and applied topically. This transdermal route for replacement therapy does not have the adverse effects of synthetic progestins.

Q: How long has natural progesterone been available this way? Has it been used long enough to verify results?

A: Some physicians have been prescribing transdermal progesterone for as long as twelve years. They report fantastic results, quoted in my new book, Hormone Replacement Therapy: Yes or No / How to Make an Informed Decision - not only for relieving PMS symptoms, but also for menopausal problems.

Q: What prompted you to research natural progesterone?

A: My research actually started with estrogen. The information in the medical journals is alarming. For example, there is a 46 percent increase in ischemic stroke risk among nurses using estrogen replacement therapy, despite the fact that the group studied was comprised of women with less diabetes, less cigarette smoking, and less adiposity than those not using estrogen. (2) And very significant, I learned that lack of estrogen does not cause osteoporosis. Here's one example of how we know this: Tamoxifen is an anti-estrogen drug given to breast-cancer prone women. This drug blocks the uptake of estrogen hormones. If lack of estrogen is the cause of osteoporosis, one would expect that tamoxifen would increase bone resorption and cause loss of bone density. Tamoxifen does no such thing!

Q: What about calcium for our bones? Doesn't that work?

A: More than calcium is needed for healthy bones. No published study sheds useful light on the question of how much calcium is necessary for bone health. There is little direct evidence of the effectiveness of calcium intake as a preventive strategy for hip fractures. Iron, zinc and magnesium intake are positively correlated with forearm bone mass content in premenopausal women. This suggests that bone mass is influenced by dietary factors other than or in addition to calcium. Women should know that chlorinated water, especially if consumed on a high fat diet, reduces calcium absorption. Almost all tap water is chlorinated.

Q: How serious is the threat of hip fracture for American women?

A: Adult women face at least a 15 percent lifetime risk of a hip fracture. The annual costs of hip fractures alone are estimated at $7.3 billion in the United States.

Q: What advice would you give to women who are facing menopause?

A: The most important suggestion is to learn the pros and cons of hormone replacement therapy. Learn, too, about the wonderful track record of natural progesterone. Then discuss what you know with your physician, and together you can make a truly informed decision. Just remember that you do NOT have to suffer - with either PMS or menopausal symptoms. There are safe ways to adjust your metabolism. They are neither complicated or expensive, nor are they health-impairing. In fact, you may find that some of your other problems will disappear as you attempt to regulate your hormone metabolism with natural substances such as progesterone.