To Your Health
Medical News Updates

by Paulette Avery, R.N., M.S.N.

Recently I ve come across new medical information pertaining to topics I ve discussed in past columns. I m passing the information on to you with the hope that you will find it helpful.

Natural Progesterone: Some time ago, I devoted a column to the wonders of natural progesterone for use in the treatment of menopausal symptoms. I also touted Dr. John Lee s book, What Your Doctor May Not Tell You About Menopause. Here s some additional information on the topic from a feature article in the January Prevention.

The article agrees with Dr. Lee that there appear to be definite benefits to the use of natural progesterone over synthetic versions. One study found that natural progesterone more effectively preserves the beneficial effects of estrogen on the heart. But Prevention cautions against the use of over-the-counter creams because their effectiveness is unproven and the amount of progesterone in them is often unknown. Instead, they recommend two new products. One is a pill called Prometrium containing micronized progesterone. Unlike other natural progesterones, which are destroyed by the liver when taken orally, this new form can be absorbed by the body.

The other product is Crinone, a gel applied to the vagina. It has the advantage of delivering progesterone directly to the uterus without the messy discharge typical of vaginal creams and suppositories. According to studies, it gave women an emotional boost and was effective in protecting against endometrial cancer. Women taking natural progesterone reported fewer mood swings, less depression, and a lower incidence of headaches compared to women taking just estrogen. Both products have been approved by the FDA, though not yet specifically for use in HRT, and can be prescribed by your doctor.

If you are already using a progesterone cream and find it helpful, discuss it with your doctor. It may be best used in conjunction with estrogen and not alone. Check the label on the cream. It should contain pharmaceutical-grade progesterone listed as "progesterone USP." You need at least 400 mg progesterone per ounce for the cream to be effective. Avoid creams with diosgenin, a precursor to progesterone found in yams. Your body cannot convert it to progesterone.

Stroke Prevention: In a recent column, I reported on tPA, a new clot-busting drug available to treat victims of stroke who seek treatment promptly. In a letter published in the March Prevention, Megan Galloway, manager of the American Heart Association San Antonio Division Task Force, cautions that only a small percentage of patients meet the criteria which make them eligible for the use of tPA. But whether or not tPA can be used, recognition of stroke symptoms and prompt treatment remain important to improve survival rates and decrease disability.

Additionally, a study reported recently in Stroke found that being too diligent about reducing blood cholesterol levels can actually increase your risk for stroke. Although the risk of ischemic stroke, the type caused by a clot or arterial disease, increases with cholesterol levels above 230 milligrams per deciliter of blood, cholesterol levels below 180 mg/dL significantly increased the risk of strokes caused by hemorrhage. Yet another example of the benefits of moderation.

Paulette Avery is a registered nurse and a freelance writer specializing in health issues.