Along with estrogen and testosterone, progesterone plays an important role in health and well-being. While the hormone is commonly associated with female fertility and reproduction, it is not exclusive to women. It’s produced by both men and women, though in different amounts and for different functions.
A doctor may recommend progesterone replacement therapy for individuals with certain health conditions. This article will cover the uses of progesterone, the benefits of treatment, and the potential side effects.
What is progesterone?
Released by the adrenal cortex, ovaries, and testes, progesterone is a steroid hormone that supports the health of the uterus during pregnancy by regulating blood flow in the organ’s muscular wall as well as helping fight off infection.(1) In the male body, the hormone contributes to the formation of sperm and the process of androgen synthesis, another group of steroid hormones that influence the development of male reproductive and secondary sex characteristics.
The hormone also regulates the menstrual cycle and supports the central nervous, immune, and cardiovascular systems. Additionally, progesterone promotes the development of mammary glands and lactation following childbirth. It also aids in the formation of healthy bones.(1)(2)
A person with low progesterone levels may experience irregular periods, abnormal uterine bleeding, or abdominal pain during pregnancy. Gallbladder issues, weight gain, and decreased libido can also occur if progesterone levels are too low and estrogen levels are too high.(3) A lack of progesterone can also increase the risk of miscarriage and preterm labor. Individuals may also be more susceptible to endometrial hyperplasia, benign prostatic hyperplasia, and osteoporosis.(1)
Progesterone Function: What is progesterone used for?
Patients may be prescribed either synthetic or bioidentical progesterone. Synthetic progesterone is commonly found in progesterone-only birth control, while bioidentical progesterone is typically prescribed alongside estrogen in hormone replacement therapy (HRT). Progesterone-only HRT is rarely used and may only be prescribed under specific circumstances. Synthetic progesterone or bioidentical progesterone combined with estrogen may be prescribed for the following purposes:
1. Menopause Symptom Relief
During the menopause transition, progesterone production starts to decline. As a result, women may experience hot flashes, sleep problems, mood changes, fatigue, and more. Research shows that oral and transdermal progesterone medications reduce vasomotor symptoms associated with menopause, specifically night sweats and hot flashes. Progesterone replacement therapy has also been shown to enhance sleep. This treatment may be recommended for women experiencing symptoms of menopause who do not have osteoporosis.(4)
2. Treatment for Abnormal Uterine Bleeding
Progesterone may be used to treat abnormal uterine bleeding (AUB) in teens, patients diagnosed with polycystic ovary syndrome (PCOS), or women in perimenopause. Examples of abnormal bleeding include irregular periods, heavy menstrual flow, and painful periods. Progesterone or progestins — the synthetic form of progesterone — may be prescribed in combination with estrogen.(2)
3. Birth Control
Progestin oral medications, injections, and IUD implants are commonly used to prevent pregnancy. The synthetic hormones suppress the release of reproductive hormones, thin the uterine lining, block the implantation of embryos, and thicken the lining of the cervix to reduce sperm penetration. Progestin oral medications are also used for emergency contraception.(2)(5)
4. Management of Endometrial Hyperplasia
Certain health conditions can lead to imbalances in the levels of estrogen and progesterone in the body. This can cause the lining of the uterine wall to thicken. This condition, known as endometrial hyperplasia, is usually benign but can increase the risk of endometrial cancer. Progesterone therapy helps thin the uterine lining, thereby reducing the risk of cancer. Various doses and forms of progestins may be prescribed depending on the patient’s needs.(6)
Progesterone Benefits: What does progesterone help with?
Although progesterone agents are used to treat specific medical conditions, the hormone may provide additional health benefits:
1. Improving Mood
Study findings have been mixed, but some research suggests a link between decreased progesterone levels and depression, particularly depression during pregnancy, postpartum depression, and depression associated with premenstrual dysphoric disorder (PMDD). Progesterone supports GABA activity, a neurotransmitter believed to play a role in mood regulation. Increasing progesterone levels may enhance mood and help protect against anxiety and depression.(7)(8)
2. Enhancing Cognitive Function
While synthetic progestins have been associated with negative effects on cognition, one study found that progesterone treatment improved verbal working memory in postmenopausal women who were able to recall more words after completing a verbal task.(9)
3. Lowering Blood Pressure
Progesterone dilates the blood vessels. Although studies have produced varied results, some research indicates that progesterone therapy can reduce blood pressure.(10) Progesterone may also lower the risk of hypertensive disorders of pregnancy like preeclampsia.(11)(12) The hormone’s effects on blood pressure may further support cardiovascular health.
4. Preventing Cancer
Progesterone treatment may reduce the risk of certain gynecological cancers. The therapy has been used to treat endometrial hyperplasia, a condition linked to endometrial cancer. Higher progesterone levels have also been associated with a lower risk of ovarian cancer, suggesting that progesterone may offer protection against it.(1)
5. Protecting Against Osteoporosis
Progesterone supports bone formation. However, age-related decreases in bone mass and density can lead to osteoporosis, particularly during the menopause transition. When used in combination with other medications, progesterone may help reduce the risk of osteoporosis by promoting bone health.(1)(13)
Progesterone Side Effects
Oral progesterone capsules may produce side effects. Individuals should first consult with a healthcare provider to discuss any known allergies, health conditions, or potential drug interactions with other medications or supplements. Possible side effects of progesterone may include the following:(14)
Dizziness
Drowsiness
Headache
Breast tenderness
Mood changes
Upset stomach
Cough
Diarrhea
Constipation
Vaginal discharge
Weight gain
Medical attention may be required for the following severe progesterone side effects:
Rapid heartbeat
Slow speech
Chest pain
Coughing up blood
Trouble breathing
Swelling
Skin rash
Seizures
Lack of coordination
Vision loss
How to Reduce Side Effects of Progesterone
Dizziness and drowsiness may occur at the start of progesterone treatment. Patients are advised to refrain from driving or operating machinery while adjusting to the medication. To reduce the risk of lightheadedness, it’s recommended to sit up slowly after lying down. Staying seated for a few minutes before standing can also help minimize these effects.(14)Some research suggests that synthetic progestins may cause more side effects than oral micronized progesterone, which is made up of smaller particles. Taking bioidentical progesterone may, therefore, help reduce medication side effects.(2)
Progesterone Treatment Options
Progesterone is responsible for more than carrying a pregnancy to term. It also plays a crucial role in the optimal functioning of many different systems in the body.
Progesterone supplementation can come in the synthetic form of progestin, which is commonly used in contraception, or as bioidentical hormones, which are chemically identical to those produced by the body. When used with estrogen, progesterone capsules or body creams may help reduce anxiety, sleep disturbances, and other symptoms of menopause. This therapy may also be recommended for treating certain medical conditions while providing additional health benefits.
