Chapter 27: Cooperative Progesterone and Estrogen Replacement

Hilgers TW

Therapeutics · Hormonal Agents

Chapter 27: Cooperative Progesterone and Estrogen Replacement

Hilgers TW

The Medical and Surgical Practice of NaProTECHNOLOGY, 335-340, 2004

RRM Academy Synopsis

Cooperative progesterone replacement times treatment to the Peak Day

A NaProTECHNOLOGY textbook chapter reports that replacement progesterone and estrogen are given only after ovulation, timed by the Peak Day. The chapter also outlines how the hormones are given and how they affect cycle length.

Key Findings

The chapter names cooperative progesterone replacement therapy (CPRT) and cooperative estrogen replacement therapy (CERT) as the two forms of this treatment.
The chapter judges the dysfunctional luteal phase to be most likely the single most common endocrine disorder of women of childbearing age, with suboptimal progesterone, suboptimal estradiol, or both.
Progesterone or estradiol given before ovulation tends to suppress pulsatile GnRH, estradiol much more strongly, which would then affect FSH, LH and ovulation.
Only 13.5 percent of cycles show ovulation on day 14, whereas the Peak Day estimates ovulation to within 2 days in 95.4 percent of cycles.
A charted example shows shorter mucus cycles and an earlier Peak Day after progesterone, and the chapter describes a strong tendency of CPRT to regulate the cycle.

RRM Context

Restorative reproductive medicine works with the ovulatory cycle. NaProTECHNOLOGY applies that principle to the luteal phase, the span of the cycle after ovulation. Creighton Model charting estimates the timing of ovulation in each woman's own cycle, and replacement hormones follow that timing. The same chart shows how each cycle responds to treatment. Progesterone reaches meaningful levels only after an ovulatory event, so a progesterone-centered approach is also an ovulation-centered one. Timing treatment to the cycle depends on knowing when ovulation occurred.

Our editorial summary of this paper, not the article's abstract.

Abstract

This chapter describes cooperative progesterone replacement therapy (CPRT) and cooperative estrogen replacement therapy (CERT), in which progesterone or estradiol is given only during the postovulatory phase of the menstrual cycle. Hilgers times treatment from the Peak Day of the CREIGHTON MODEL System (CrMS) and states that starting either hormone on a given day of the cycle would have adverse effects because the preovulatory phase is highly variable. The chapter reviews the forms of progesterone support it describes, namely oral and vaginal micronized progesterone capsules, intramuscular progesterone injections and human chorionic gonadotropin (HCG). Hilgers also reports that CPRT has a strong tendency to regulate the menstrual cycle, illustrated by a chart in which the cycles after treatment had shorter mucus cycles and earlier Peak Days.

Topics

Therapeutics › Hormonal Agents › Progesterone and Progestins · Reproductive Endocrinology › Luteal Phase › Progesterone Support · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances

Thomas W Hilgers

Tom Hilgers, T Hilgers

Hilgers et al. 2004, Hilgers 2004

Chapter 27: Cooperative Progesterone and Estrogen Replacement

Cooperative progesterone replacement times treatment to the Peak Day

Key Findings

RRM Context

Abstract

Topics

By this author

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