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Letter to the Editor
Editor, – The article 'Managing menopausal symptoms' (Aust Prescr 2010;33:171-5) states that transdermal progesterone cream is minimally absorbed through the skin and there is no good evidence for its usefulness in relieving flushes, or in improving mood, libido or lipid profile.
Transdermal progesterone is poorly absorbed, which may explain the poor results obtained. However, if used transvaginally or rectally, absorption is much better.1
Progesterone does not relieve flushes. It is oestrogen which relieves flushes. However, it is an inhibitor of monoamine oxidase,23so it may well improve mood if absorbed in adequate quantities. It also remodels bone,4thus it is useful in counteracting osteoporosis. It has none of the adverse effects of synthetic progestogens, and I found it useful in patients with endometriosis who could not tolerate the synthetic progestins because of weight gain and irritability. Progesterone reversed these adverse effects.
The actions of the synthetic progestogens, apart from the effect on the uterine lining, are different from those of progesterone. Synthetic gestagens have been shown, in fact, to lower the body's production of progesterone.5
Margaret River, WA
- Dalton M, Ambrose CI, Balmer B, Bromham D. Individual variation in absorption of natural progesterone administered by different routes. Br J Fam Plann 1994;19(Suppl):2-3.
- Lin YC, Kono H, Zuspan FP, Lee A, Yajima A. Progesterone as an inhibitor of monoamine oxidase. Br J Fam Plann 1994;19(Suppl):6-8.
- Kono H, Lin YC, Yamaguchi M, Zuspan FP, Furuhashi N, Takayama K, et al. Effects of progesterone and gossypol on monoamine activity in human term placentalexplants. J Exp Med 1991;163:39-45.
- Prior JC, Vigna YM, Kennedy SM. Progesterone's role in bone remodeling. Br J Fam Plann 1994;19(Suppl):13-17.
- Johansson EDB. Depression of the progesterone levels in plasma in women treated with synthetic gestagens after ovulation. Acta Endocrinol 1971;68:779-92.