The Wiley Protocol is the most holistic, integrative and natural method of bio-identical hormone replacement therapy (HRT) for menopause of which we are aware. It is the only method of HRT that truly honors and mirrors a woman’s natural biological rhythms. It is the method for menopausal HRT that we prefer our patients follow.

T.S. Wiley has developed a heuristic model for HRT that connects the cosmos to the individual. Her two books “Lights Out” and “Sex, Lies and Menopause” develop and apply her thesis.

Essentially, all of matter moves in certain rhythms and these rhythms are found throughout life as well. Nothing is static or fixed. The daylight cycle represents one of the elemental rhythms we encounter. All life evolved under the influence of light dark periodicity. Pointedly, the menstrual cycle of women, particularly prior to the last 150 years, was highly influenced by the lunar cycles because of the impact that the day night cycles and the moon light cycles have on hormonal balance.

The construct here is really rather attractive. Melatonin suppresses estrogen activity because it blocks the estrogen cell receptor. Light, which blocks the production of melatonin, allows more estrogen activity because when the lights are on melatonin is not available to block estrogen. Prior to artificial lighting, the full moon would be the time of the month that melatonin would be most suppressed and therefore, estrogen activity would be maximized. These would be times of increased fertility. The Wiley protocol recognizes this primordial biological construction and whenever possible applies therapy in coordination with the Lunar Cycle.

The Wiley Protocol also is the only menopausal HRT method developed which specifically addresses the phenomenon of receptor anticipation. This biological function assures that when the hormones are utilized they will be maximally effective and protective.

Receptor anticipation stipulates that one hormone will signal the cells to begin to prepare to receive a second hormone. Receptor anticipation is seen in the relationship between estradiol and progesterone. When estradiol surges at day 12 of a typical 28-day cycle, it signals cells throughout the body to begin to produce progesterone receptors so that the cells can recognize and properly respond to the impending progesterone surge, which reaches a maximum at day 21. This process requires peaking levels of estradiol to work properly. Peaking surges of estradiol naturally occur in a menstrual cycle and is mirrored as well in the Wiley Protocol.
One of the paradoxical implications of this phenomenon is that symptoms like breast tenderness which are typically construed as too much estrogen are more likely to represent estrogen insufficiency. Without an estradiol surge, which is what you happens with fixed dosing of HRT, there will not be enough progesterone receptors to allow progesterone to function effectively. Without enough progesterone activity to modify estrogen function an individual will experience symptoms of estrogen excess i.e. breast tenderness, as a paradoxical result of estrogen insufficiency.

More importantly, however, than a symptomatic hormonal effect from the lack of receptor anticipation for progesterone brought about by the absence or insufficiency of an estrogen surge, is the loss or diminution of the apoptotic function of progesterone. Apoptosis is a progesterone function that protects the body from old cells. Apoptosis, or programmed cell death, is a self healing process that is critical to cancer prevention. This is among the most important functions of progesterone in postmenopausal hormonal treatment and strongly contributes to my recommendation for women to use the Wiley Protocol.