Q Dear Dr. V,
Is it enough to use natural progesterone cream alone, or is it important to take Premarin® with it? I have been taking these two together for quite a few years, always with a great deal of worry. I am 59 and healthy. Are you an advocate of taking estrogen, meaning Premarin, in addition to natural progesterone cream?


A Dear NB,
I am an advocate of people learning as much as they can and then deciding what's best for themselves. This can be difficult with all the information available about supplements today - not to mention that information from different sources is often conflicting or contradictory. It seems you have to become an expert yourself, or at least find out who the trustworthy experts are.

Life Enhancement's natural progesterone cream (Progesterone-Transdermal) has many benefits, including strengthening bone, which is especially important because osteoporosis progresses with age. It also enhances the levels of HDL ("good" cholesterol), which has protective effects on the cardiovascular system. Natural progesterone can alleviate many PMS and postmenopausal symptoms in many women.

Natural progesterone can be used with or without estrogen replacement, depending on which camp of hormone replacement therapy you subscribe to. Most mainstream doctors recommend the prescription drugs Premarin (an estrogen) and Provera® (a progestin, also commonly and generically referred to as progesterone). The molecules contained in these products are variations of their natural human molecular counterpart. Whereas natural estrogens are made up of molecules identical to the estrogen molecules in the body, Premarin and Provera are not.

Furthermore, some alternative doctors, such as the well-known nutrient physician Jonathan Wright, M.D. (see his book, Natural Hormone Replacement for Women Over Forty), believe in taking all three of the natural estrogens (estrone, estradiol, and estriol) in the same proportions as are produced in the body. Other experts, such as John Lee, M.D., and Ray Peat, Ph.D., support the use of progesterone replacement therapy but are usually not in favor of estrogen replacement; they subscribe to the "estrogen dominance" theory. You can learn more about this in Dr. Lee's book, What Your Doctor May Not Tell You About Menopause, or in Dr. Peat's monthly newsletter (see

All the best to you.
Dr. V

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