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National Wear Red Day

This Friday is  National Wear Red Day, but the whole month of February is a time to reflect on the important issue of women's heart health. Each year heart disease and stroke cause 1 in 3 deaths among women, killing about one woman every 80 seconds.

This silent killer is caused by a combination of factors including age, lifestyle, overall health, and family history – all of which contribute to raising a woman's risk. While you cannot change such things as age or biological makeup, the good news is that even minor changes to your diet and lifestyle can improve your heart health, and lower your risk by as much as 80%. 

To discuss simple lifestyle changes that help reduce the risk of heart disease contact Dr. Tyuluman of DFW Hormones (DESIGNS FOR WELLNESS™) today: 

Phone: (214) 368-3755

Some areas we can help you with include:

  • Superfoods for your Heart

  • Tips for lowering Cholesterol

  • Healthy Recipes for a Healthy Life

  • Vitamins & Supplements – why they're the perfect complement to any diet



Dating After Breast Cancer…

How one woman battled breast cancer—and the L.A. dating scene—and came out on top.

I'm not a superficial person. But I live in Los Angeles, and I do like to look my best. Especially when I go to therapy or to my gynecologist. So it should come as no surprise that the day before my double mastectomy, I went to get my hair done. I thought it was important to have nice shiny hair while getting my breasts removed. I also had my hair done six months earlier, the day I kicked my husband out of the house. My daughter was two at the time, and I had just found out he was living a dark double life. Clearly, I had a bad year. But this story isn't about him. It's about me: a single mom back in the dating pool who was facing a total breast reconstruction, but with a head of hair that really had its shit together. 

After leaving my ex husband, my friends promised me that things could only get better. And just as I started to pick up the pieces, POW! I’m hit again—this time, with cancer. On the bright side, as the doctor put it, I had the best kind of cancer, Ductal carcinoma in situ (DCIS), caught at the earliest stage. He recommended that I get a single mastectomy, since it was in three different quadrants of my left breast. Even though my right breast was pristine, I opted for the double. I felt like my ex husband was my cancer and I wanted to cut him all out. Honestly, you know you’ve hit rock bottom when cancer is just the icing on the cake. 

The doctor referred me to a wonderful plastic surgeon who showed me pictures of breasts he had done, without revealing their faces of course. I started crying. “I’m a single mom and I just started dating again! I didn’t know there would be these scars going across my breasts! I thought I’d be coming out with a boob job!”

He informed me that on the day of my double, he would just be starting the reconstruction. The whole process would take at least six months, culminating with my cherries on top.

Going Under the Knife
The night before my surgery, I took off my bra, put on my bunny ears and tried my best to squeeze out a smile, as I posed on my bed. I asked my friend to take pictures of me, so I could remember what my real breasts looked like. I always enjoyed my perky B minus cups (as I sometimes fondly called them) and never had the desire to upgrade. My nipples were always a huge erogenous zone for me that I knew I would sadly have to say goodbye to.

The next morning I woke up and watched my beautiful baby girl sleeping. It was so hard knowing that I wasn’t going to see her for a week and that when I got out of the hospital, I wouldn’t be able to lift her. But I couldn’t allow myself to feel the magnitude of this. I just needed to take care of business.

When I arrived at the hospital, I went into pre-op. First my breast surgeon came in to see me, then my plastic surgeon. He told me he liked my blue nail polish. I thanked him and asked if I was going to die. He took my hand and promised me that I would be okay.

The anesthesiologist came in, hooked me up to the IV and told me to count to ten. I closed my eyes, thought of my baby girl, and I was out. 

My first few days in the hospital were a beautiful morphine-colored blur. By day four, I was a little more lucid. A good friend came to visit me, just as my doctor came to check out my breasts. She noticed that when he unbuttoned my gown, I turned my head away. I was terrified to see what would be present where my breasts once were. They both saw what I did and encouraged me to look. There were these two little baby anthills. In the middle of my ant hills, there were lines going across, not as bad as I had imagined them to look. I was mildly fascinated, like these new bumps on my chest were some science experiment. Like these scars were my war wounds.

Getting Back in the Game
I couldn’t let little things like starting reconstructive breast surgery, not having nipples, and having scars, get in the way of my dating life. I needed to date. It truly had become my lifeline in the midst of all the high-stakes drama that was my new reality.

But I also knew I would probably have to give a disclosure before I took off my top. So I made the decision that I would tell everyone on the first date: I’m a single mom, and I just had my breasts removed so I’m under reconstruction. My aunt thought I was crazy to disclose so much right away. I just figured, what have I got to lose? There’s a certain kind of freedom that comes from having your world turned upside down.

A week after I left the hospital, I wasn’t able to pull a shirt over my head, but I felt ready to have my first date in my new state. Yes, I was still on vicodin, but that made the date even more pleasant. He was an entrepreneur who owned a hanger company that sold hangers to the stars. After an hour, I realized that even on vicodin, talking about hangers is just as boring as I always imagined it would be. I never need to have a conversation about hangers again, so this was the perfect first person to try my disclosure on. So I just threw it out there.

“I’m a single mom, my ex husband is a sociopath, and I just had a double mastectomy. I got out of the hospital a week ago, and you’re my first date since my surgery!”

Hanger guy looked a bit stunned. I guess this isn’t normal first date banter, even for someone as odd as hanger guy. He said he was sorry I had to go through all this and then asked what I liked to do for fun. I told him I really liked board games.

Then with all the charm of an A-list hanger salesman, he asked me if I ever played naked oil Twister. He said it was a great way to learn about every nook and cranny of a person’s body. I told him that most people’s nooks and crannies I didn’t care to know about. He just laughed and asked if I would join him for a naked pool party.

This was not where I expected the conversation to go. Was I just a nipple-less novelty he wanted to check out, or did it not even phase him? In any case, it didn’t matter. It was such a relief to get everything out in the open. It actually made me feel giddy. So I decided to view my disclosure as an interesting dating experiment.

The first guy I slept with in my reconstructive state was just three days after my implant surgery. When I told him about my situation, he asked me if I had any nipples yet, to which I replied, “No, I'm just like Barbie.”

I showed him my breasts, we had great sex, and were involved for four months. He said to me, “You know what’s so sexy about you? It’s how comfortable you are in your body.” He was right. I felt sexier and more comfortable in my body than I’d ever been!

Look, I don’t have nipples, you think a little cellulite is gonna bring me down? I used to beat myself up and try to hide every imperfection about my body. But the fact that I have scars and no nipples is impossible to hide. There is something so liberating about everything being out in the open. It’s like any ideal of perfection I could have ever hoped for went out the window with my breasts. Everybody has scars, mine are just more visible.

And that's how, in the span of two years, I went on over 70 first dates. I became a player in one of the most superficial cities in the world. Sometimes people ask why it was important for me to date so habitually (sometimes even manically) after my cancer. I think there was a part of me that felt like if I was good enough to put on a little make-up and go out on a date, I wasn’t broken.

It also made me realize how deeply we as women can be so cruel to ourselves and our bodies. Living in L.A. and being an actress, I’ve always struggled with body image. I was bulimic from the time I was in 6th grade until I graduated college, always focusing on every little thing that was wrong with my body, instead of what was right. After getting my double mastectomy, I found new respect for myself and my body. Through this dating experiment, I learned even more about myself than the men I dated. In fact, I feel stronger and more connected to my life than I've ever been.

Reassessing the Damage
I've officially been cancer-free for four years now. My beauftiful daughter is six years old, and I’ve been in a relationship with my awesome boyfriend (who I met on my dating spree) for two years.

Over the years, I've spoken with so many women who were very nervous about dating again after a double mastectomy. I realize now that my unique experience left me with a surprisingly wonderful lesson: Once I accepted my scars and didn't approach them with shame, the men I was dating really didn't care. But I had to accept my body and my life first. That's not the only amazing thing to come out of this experience. I'll be premiering my new solo show, Dating in L.A. With No Nipples, this October for breast cancer awareness month.

Ironically enough, I think that being at such a low point when I was diagnosed allowed me to truly feel like I had nothing to lose. So I guess my advice to all women would be: Don't worry if you marry a sociopath. That way, if you get diagnosed with cancer, it'll pale in comparison.


Lisa Kate David is an actress, writer and voice-over artist hailed by The New York Times as “a major comedic force." For more information about Lisa, you can visit her website. Her new solo show, Dating in L.A. With No Nipples, premieres in Los Angeles this October for Breast Cancer Awareness Month. It truly is a story like no other. Tickets are available (800-838-3006). For more information go



My Corona: The Anatomy Formerly Known as the Hymen

Often known by the established term “hymen,” the vaginal corona is the subject of many myths and misunderstandings. The most important of these is the notion that a person’s vaginal opening is covered by a membrane that ruptures with, or is "broken" by, vaginal sex. This is incorrect. There is no such membrane.

RFSU (the Swedish Association for Sexuality Education) wishes to dispel the myths and promote knowledge of the true facts. Our aim is to give you a more accurate idea of what you will find just inside the vaginal opening.

Where is the vaginal corona located and what does it look like?

The vaginal corona is located 1–2 centimeters just inside the vaginal opening, not deep inside the vagina. Every corona looks different – just like ear lobes, noses and labia – and differs in size, color and shape. It consists of thin folds of mucous tissue, which may be tightly or more loosely folded. It is slightly pink, almost transparent, but if it’s thicker it may look a little paler or whitish. It may resemble the petals of a rose or other flower, it may be carnation-shaped, or it may look like a jigsaw piece or a half-moon. In the vast majority of cases, it is elastic and stretchy.

Sometimes, albeit very rarely, the mucous tissue folds may cover the entire vaginal opening. In this case, you may need to see a gynecologist and have the vaginal corona opened to release menstrualblood and enable you to insert a tampon or have intercourse or other insertive sex. Giving birth through the vagina changes the vaginal corona appearance, smoothing or stretching it out and making it less visible. Nobody knows the vaginal corona’s real function, but it is probably a remnant of fetal development.

Does it hurt “the first time”?

Since the vaginal corona isn’t a brittle membrane the sensation when you first stretch out the mucous tissue folds – whether you’re inserting a tampon, masturbating or having insertive sex – is a highly individual experience. Some people feel no pain at all, while others, with a thicker vaginal corona, have reported some pains. There may be minor ruptures in the mucous folds that hurt, and sometimes there may be a little bleeding.

For a person with a vagina to enjoy vaginal intercourse – regardless of how many times they have done it and what is being inserted in the vagina – they need to be aroused and lubricated (wet). If they're tense and have difficulties relaxing, it may hurt more. It doesn’t matter whether it’s the first, second or tenth time. It’s important to recognize the key role played by a person’s mind, whole body and clitoris in sexual arousal and enjoyment. The clitoral glans, for instance, contains thousands of sensory nerve endings – more than any other part of the human body. This sensitivity is the reason why so many people enjoy clitoral stimulation.

Do you bleed “the first time”?

The vast majority of people with vaginas don’t bleed. No matter what their vaginal corona looks like, fewer than half of all people with one bleed when they have intercourse for the first time. Of those who do bleed, few do because the corona was tight; instead, there are usually other reasons. If you were not sexually aroused, but rather tense, nervous and too dry, minor ruptures may develop in vaginal corona and may bleed. But this has nothing to do with how many times you’ve had sex.


Can the vaginal corona "break" when you ride a bike or a horse?

No. Since the vaginal corona isn’t a brittle membrane, physical exercise doesn’t break it. The vaginal corona is located 1–2 cm inside the vaginal opening – in other words, entirely within the vestibule. A whole bunch of things (vaginal discharges, hormonal changes, mensesmasturbation, sex) can wear the corona away more over time, living your life among them, but that's not about breaking anything.

What is meant by "breaking the hymen?" Does penis length make a difference?

The various myths and the incorrect assumption that there is a covering membrane have given rise to expressions such as "breaking the hymen" and "deflowering." These usually refer to a person having their vagina entered for the first time, either by themselves or by having sex with a partner. What’s actually there is the vaginal corona, consisting of elastic folds of mucous tissue, which can’t be ruptured or broken in one fell swoop by a penis or any other object inserted into the vagina. When the mucous tissue is stretched, minor ruptures sometimes develop and may smart a little. These soon heal, usually within 24 hours. The folds of the vaginal corona are located 1–2 cm inside the vaginal opening, so penis length is irrelevant.

If you or a partner have tried to enter your vagina without success, a simple gynecological examination can tell you whether the vaginal corona is an obstacle.

Virginity – what does it mean?

Discussion of virginity revolves around whether a personhas ever had sex. In most people’s minds, the main question is whether or not someone has had vaginal intercourse.

Virginity is a vague concept based on perceptions and myths, chiefly concerning female sexuality, that RFSU (or Scarleteen!) would not wish to endorse. For one thing, virginity is often associated with a heteronormative view of sex restricted to vaginal intercourse between man and woman (in other words, insertion of the penis into the vagina). For another, in many languages and cultures, virginity is synonymous with innocence, the opposite of which is guilt. There is no guilt involved in having sex, and no need to feel guilty about it. What’s more, such myths are used against women in particular; for instance as an excuse for spreading rumors and committing sexual assaults.

We sometimes receive questions about how to know whether or not you are a “virgin.” You are the only person who can decide that. Different people have different ideas about which sexual acts constitute a “loss of virginity.” Some people restrict it to vaginal intercourse, while others count other activities as well.

Is it possible to see or feel whether a woman has ever had sex?

No. Looking at a penis or a vagina, it’s equally impossible to tell whether that person has ever had sex. Neither a gynecologist nor a sex partner can tell whether you’ve had vaginal, oral, anal or manual sex (unless you have become pregnant or contracted a sexually transmittedinfection). No one else can detect whether you’ve had sex.

Can the corona be stitched up?

Surgery on the vaginal corona rarely solves any problems, first because outcomes vary, and second because it helps to maintain patriarchal structures and a prejudiced view of women and their sexuality. Some women face the demand that they should have an intact “hymen” when they get married, as a guarantee that they haven’t had premarital sex with anyone else. Surgery on the vaginal corona is unusual (some private clinics will perform procedures, but they are expensive and offer no guarantees regarding bleeding upon penetration), mainly because the outcome is uncertain. Usually the patient can instead be helped through non-surgical therapy. This involves sessions with a gynecologist, counselor and physiotherapist intended to validate the patient’s concerns, strengthen her self-confidence and reduce her self-inflicted guilt.

What happens if the procedure is still performed?

If one still decides to perform the procedure, which is highly unusual, a couple of stitches are inserted on each side of the vaginal corona. The stitches should have dissolved by the time of the patient’s wedding and shouldn’t be detectable by anyone else. However, it is not possible to sew a membrane in place, to recreate something that never existed. Doctors say it’s like “stitching butter” because the tissue is soft and elastic. The stitches themselves rarely cause bleeding and may be discovered if the woman is forced to undergo a gynecological examination prior to her wedding. The stitches may also fall out as soon as the patient leaves hospital.

So, a procedure helps the patient more on a psychological level than on a physical one. Bleeding upon insertion cannot be guaranteed.

Can you tell from a person's corona if they have suffered a sexual assault?

Although you can’t tell from looking at a vaginal corona whether it has been entered, if you’ve been the victim of a sexual assault it’s possible to find traces of your attacker or evidence of an assault. It’s therefore critical to seek medical care as soon as possible after any rape, and not to wash yourself. The injuries that doctors record and the samples they take can be used as evidence in court. Equally important is the need to talk to someone and get counseling and support to help you deal with what has happened.

Reprinted and adapted with permission from the RSFU, Anna Knöfel Magnusson, Lena Marions, Jonas Hartelius with illustrations by Eva Fallström. RFSU is a member of IPPF.



5 Signs Your Hormones Are Out Of Whack! #DFWhormones


Raise your hand if, in the last few weeks, you've felt tired, bloated or cranky. Sound familiar? Then you know the drill: Every month, your hormones -- the body's itty-bitty secret weapon -- come out to play, wreaking havoc on your mood, skin and mind. While levels generally stabilize after your period, various factors, like stress (yup, keep those hands raised) and anxiety can throw them off balance. So how can you tell if your symptoms require an office visit? Alyssa Dweck, M.D., an OB-GYN at the Mount Kisco Medical Group in New York, shares the five red flags that might merit a doctor's note.

Exhaustion is one of the most, well, exhausting symptoms to a doc, since it has so many possible causes. "If you're tired after a week of final exams or late nights at work, then you're probably fine," says Dweck. "But if you constantly feel worn out and notice weight gain, appetite fluctuations and a change in bowel movements, it could be a sign of an underactive thyroid." Yes, fatigue happens to everyone, but if yours doesn't feel logical, then it's worth getting it checked out.

Skin Changes
You're breaking out -- again. While those sudden zits could be caused by one too many nights of going to bed without washing your face, they may be indicative of something more. "Adult acne or cystic acne around the lower half of your face could suggest a high level of testosterone," says Dweck. Although not a life-threatening problem, breakouts can take a toll on your psyche. Luckily, your doc can prescribe you medication to stabilize your hormone levels and clear up skin.

Hair Growth
We're talking really fast hair growth. "If you all of a sudden grow a beard within a month or notice coarse, dark hair popping up on your chest, back or arms, that could be indicative of a testosterone-secreting tumor," explains Dweck. But don't freak out: Tumors are rare, she notes, and can often be treated with drugs or surgery.

Weird Periods
Just like fatigue, a messed-up menstrual cycle can be the result of many factors, like stress, thyroid issues, low estrogen or polycystic ovary syndrome (PCOS). "The hallmark of PCOS is irregular or absent periods, but it could also present with difficulty losing weight or strange hair growth," says Dweck. Generally, PCOS is managed through diet, exercise and birth control pills, but your doctor will work with you to develop a multi-faceted plan if she finds this to be the cause of your period problems.

Night Sweats
Unless it's unusually warm in your bedroom, waking up feeling overheated and sweaty could be the result of lower estrogen levels and infrequent ovulation -- a.k.a. perimenopause. "Perimenopause can occur up to 10 years before you're even near the age of menopause," says Dweck, "so unless you're having major menstrual issues before age 40, there's a good chance your phantom sweating could actually be early menopause." Either way, Dweck recommends making an appointment with your doc to make sure it's nothing more serious.

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How To Make Sex Coffee (Yes, It's A Real Thing!)


You already have a morning cup of coffee. Why not make it count?

Wake up your vroom-vroom with this suprisingly simple recipe: a cup of java, maca, cacao, and cinnamon. That's it! These raw foods have been used since ancient times to support your sexdrive and if you're not mixing these bad boys into your daily diet, you're missing out on some seriously sexy benefits.

Here's what each ingredient may do for you:

  • MACA: an Aztec root, usually ground into a powder.  An adaptogen, it supports your body in creating the enzymes it needs to balance hormones and enhance fertility. It's often touted as an aphrodisiac, which can increase libido.
  • CACAO: Raw cacao is a stimulant. It gets your blood pumping and triggers your body to release seratonin, which enhances mood. The Journal of Sexual Medicine published astudy that found women who ate chocolate daily scored slightly higher on the Female Sexual Index, aka the chart that measures female sexual function.
  • CINNAMON: Cinnamon promotes vital energy, keeping your body from that desire-sucking lag that can come after a busy day. 
  • HONEY: Honey may increase stamina, and has been shown to increase virility and fertility
  • COCONUT MILK: Many cultures have used coconut milk to naturally balance hormones and to increase sex drive. Full of healthy fats, coconut milk will give you energy for sex, without a nasty aftercrash. 

This coffee takes all five of these superfoods, and whips them into a gorgeous latte. To make it, you'll need a hand blender, and about five minutes from start to finish. Try making this coffee once a week, especially when you have time to sip slowly and really enjoy your day. You'll get your regular dose of caffeine, plus added boost from the world's most ancient sex-related superfoods. 


Try to make this coffee once or twice a week, when you want the added benefits of superfoods said to support sex drive. It tastes like a delicious, Aztec-spiced drink. If you've ever enjoyed Mexican Hot Chocolate, the flavor is very similar: dark chocolate, cinnamon, and just a touch of sweetness.

Makes 1. 

  • 2/3 cup hot coffee
  • 1 tablespoon raw cacao
  • 2 tablespoons coconut milk
  • 1 tablespoon honey
  • 1/2 teaspoon cinnamon
  • 1 teaspoon maca

Pour coffee into a medium bowl. Add cacao, coconut milk, honey, and cinnamon. Whip with hand blender until frothy. Add the maca, whip once more, and serve immediately. Enjoy - and happy sexing! 

DISCLAIMER: This recipe makes no health-related promises. It simply offers a delicious way to enjoy superfoods said to support a number of health benefits. Consult with your doctor before adding any new or unfamiliar ingredients to your diet, especially if you're on medication. 





I turned 35 four months ago.  For about a year I saw this number coming like a dark shadow from the sky.  Every few months the panic of my narrowing fertile years crept in.  Will I have a baby?  When will I have a baby?  Do I even want to have a baby?  How much time will I have to figure this all out?

Like most American women I grew up with the notion that marriage and family would be an inherent part of my future–signposts of a successful transition into adulthood.  In my later twenties, as my first live-in relationship dissolved, it dawned on me that I could choose a life of being single and child-free and that that life could be pretty damn good.  I envisioned my free, spontaneous life writing at small cafes in France and hiking in Argentina.

For almost 10 years now, the pendulum has swung fully in both directions from an aching inner call to experience the rite of motherhood to a near certainty that I don’t want to be a mother in this lifetime.

As a modern maiden there are endless possibilities for how I can live my life.  I can travel, pursue my PhD, spend time on personal development, create art, dedicate myself to activism, start a business or climb the corporate ladder.  I can choose to live with a partner, in community or all by myself.  I have the opportunity to be really focused and pour myself into one thing or be completely spontaneous.  While I have no illusions about women having equal access and privilege–there’s still plenty of healing to do there–there is a lot of fun and freedom for the child-free American woman to enjoy.

As I move through my mid thirties I feel as if I’m just finally coming into the full expression of being a woman.  I feel more confident, empowered, healthy, sexy and feminine than ever before.  I feel at home in myself.  I have learned how to relax and I am also ready to do really big things in the world.

I could go on reveling in this stage of my life for quite some time and, well, most of the time I do.

Then, there are the subtle–and not so subtle–reminders that my eggs have an expiration date.

I went for my annual exam just after my birthday and suddenly, just because I hit the magical number of 35, there was a sudden grave concern about breast cancer and the inevitable fatality of my fertile years.  “Well, 37 would be fine but 36 even better than 37,” she said about my chances for conceiving.”  The pressure is on.

It’s funny how often such a personal and profound decision becomes casual conversation with just about anyone.  I’ve been in a committed partnership for over three years now so for many the logical next steps are marriage and children and invariably those questions come up.  However, I think the covert cultural expectations for women in all scenarios can be overwhelming.  I’m constantly given a range of encouragement and advice from, “You’d be the best mother,” to flat out warnings “don’t do it.”  I’ve even received several unwarranted suggestions that I might consider freezing my eggs.

Then, there is the often heartbreaking and very real journeys of friends and the women that I work with that are struggling with their fertility.  Indeed there seems to be an epidemic of “infertility” (which is a loaded word that I think gets used more often than it should).  Certainly a record number of women are having miscarriages and difficulty conceiving.  There is a long discussion to be had about why this is happening but some of the major factors are 1) health and nutrition, 2) exposure to toxins, 3) stress and anxiety, 4) an imbalance in masculine energy and 5) age.  Even with all of our medical advancements once a woman hits a “certain age” (which can’t be predetermined and is slightly different for all women) it can become harder and eventually impossible to conceive and grow a baby.

So we have the dilemma of the modern maiden.  How long do we remain in ambiguity?     How long do we relish our freedom or give everything to careers?  And, if we really consider it a choice, is motherhood something we wholeheartedly want for ourselves?

I’ve found peace in acceptance that I am a whole woman whether or not I give birth.  While I’m frolicking in all of the possibilities I am preparing my body and my life the best I can for the possibility of pregnancy.   I lean into my faith that my path will continue to unfold exactly how it is supposed to and that cycles of creation are the most beautiful mystery of all.


Lara Catone teaches classes on how to understand and optimize your fertility cycle.  Check out her schedule and online course here.


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Progesterone: What you NEED to know! #dfwhormones

What Is It?
Progesterone is a hormone that stimulates and regulates important functions, playing a role in maintaining pregnancy, preparing the body for conception and regulating the monthly menstrual cycle.

Progesterone is one of the hormones in our bodies that stimulates and regulates various functions. Progesterone plays a role in maintaining pregnancy. The hormone is produced in the ovaries, the placenta (when a woman gets pregnant) and the adrenal glands. It helps prepare your body for conception and pregnancy and regulates the monthly menstrual cycle. It also plays a role in sexual desire.

During the reproductive years, the pituitary gland in the brain generates hormones (follicle-stimulating hormone [FSH] and luteinizing hormone [LH]) that cause a new egg to mature and be released from its ovarian follicle each month. As the follicle develops, it produces the sex hormones estrogen and progesterone, which thicken the lining of the uterus. Progesterone levels rise in the second half of the menstrual cycle, and following the release of the egg (ovulation), the ovarian tissue that replaces the follicle (the corpus luteum) continues to produce estrogen and progesterone.

Estrogen is the hormone that stimulates growth of the uterine lining (endometrium), causing it to thicken during the pre-ovulatory phase of the cycle.

The Role of Progesterone in Women
One of progesterone's most important functions is to cause the endometrium to secrete special proteins during the second half of the menstrual cycle, preparing it to receive and nourish an implanted fertilized egg. If implantation does not occur, estrogen and progesterone levels drop, the endometrium breaks down and menstruation occurs.

If a pregnancy occurs, progesterone is produced in the placenta, and levels remain elevated throughout the pregnancy. The combination of high estrogen and progesterone levels suppress further ovulation during pregnancy. Progesterone also encourages the growth of milk-producing glands in the breast during pregnancy.

High progesterone levels are believed to be partly responsible for symptoms of premenstrual syndrome (PMS), such as breast tenderness, feeling bloated and mood swings. When you skip a period, it could be because of failure to ovulate and subsequent low progesterone levels.

Progestogen Treatments
The word "progestogen" refers to any hormone product that affects the uterus in much the same way as our natural progesterone. Effective synthetic versions of progesterone, called progestins, have been around since the 1950s. A micronized capsule version of natural progesterone (derived from wild yams) was developed more recently.

Progestogens are included along with estrogen in combination oral contraceptives and in menopausal hormone therapy. Progestins are also used alone for birth control and for treatment of a variety of other conditions, including abnormal uterine bleeding and amenorrhea (absence of periods); endometriosis; breast, kidney or uterine cancer; and loss of appetite and weight related to AIDS and cancer. Progestins may also be used as a diagnostic aid to check the effects of estrogen.

Birth Control Pills 
Combination birth control pills (pills that contain both estrogen and progestin) block ovulation and make the body less receptive to a fertilized egg during ovulation. The pills typically have to be taken in a specified order. When the hormones are stopped during the placebo or "dummy" pills, a withdrawal bleed occurs.

Some birth control pills, called mini-pills, contain only progestin. These pills do not always suppress ovulation, but make the cervical mucus thick and unwelcoming to sperm, preventing entry to the uterus. They also thin the endometrial lining, making it less receptive to a fertilized egg. Mini-pills are slightly less effective than combination pills but are still a very effective form of contraception when used properly.

Progestin is also the active ingredient in the long-acting injected contraceptive Depo Provera (medroxyprogesterone) and the intrauterine device (IUD) Mirena.

Maintaining menstrual cycles, a function of progestins, is important during childbearing years because unopposed estrogen without progesterone increases the risk of endometrial cancer. If you frequently skip periods due to polycystic ovary syndrome (PCOS), being overweight or underweight, or another disorder, your health care professional may recommend birth control pills to regulate your cycle.

If you miss periods and can't take either combination or progestin-only birth control pills, or would simply prefer not to take them, you may need an occasional progestin prescription to balance the unopposed estrogen. This will also result in the shedding of the uterine lining at least four times a year.

As you grow older and enter perimenopause (the menopause transition phase, which can last six years or more and ends one year after your final menstrual period), your hormone levels fluctuate and decrease, causing irregular ovulation and menstruation, as well as bothersome symptoms like hot flashes. Some women find that low-dose birth control pills can help control perimenopausal symptoms and keep periods regular.

After menopause (which occurs at an average age of 51), you will probably produce only a fraction of the amount of estrogen as you did before menopause.

Latest News on Hormone Therapy and Estrogen Therapy
Supplemental menopausal hormone therapy (either estrogen therapy [ET] alone or a combination of estrogen-progestin therapy, known as hormone therapy [HT] or menopausal hormone therapy [MHT]) has long been recommended as one option for women to consider for relief of menopausal symptoms and to prevent bone loss. The progestin in HT is included primarily to protect the uterine lining. Estrogen stimulates growth of the endometrium (the uterine lining), creating a risk for uterine precancers and cancer, and should be taken alone, or "unopposed," only if you have had a hysterectomy.

The U.S. Food and Drug Administration (FDA) now advises health care professionals to prescribe menopausal hormone therapies at the lowest possible dose and for the shortest possible length of time to achieve treatment goals. If you are taking hormones, you should re-evaluate your treatment with your health care professional every six months.

Ask your health care professional for more information about the latest research on ET and HT, and how the risks and benefits of using these therapies apply to your personal health needs.

There now are lower-dose hormone therapies available. These include Prempro 0.3/1.5 and Prempro 0.45/1.5 with lower doses of estrogen and progestin, as well as Climara PRO, femhrt, Activella and Angeliq. These medications are lower-dose products than the Prempro product used in the Women's Health Initiative, which suggested increased risks of some health conditions like breast cancer and heart disease for certain women taking one particular type of hormone therapy.