The Use of Progesterone Hormone in Medical Practice

The Function of Progesterone

Progesterone’s name comes from “pro” and “gestational” - meaning it facilitates the process of carrying a fetus in the womb from conception to birth. In other words, progesterone’s job is to promote successful pregnancy. Progesterone also plays a critical role in the regulation of the menstrual cycle, signaling when a pregnancy has not occurred and initiating menses. 

While most people know progesterone hormone for its role in female fertility and reproduction, it is produced in both females and males. Similarly, when levels of progesterone are low, many health problems can occur for both sexes^4-6. 

Once a woman hits her mid to late ’30s, progesterone production starts to decline, and perimenopause begins. When she reaches menopause, circulating progesterone levels are so low that they mimic levels seen in men. Low progesterone in women can cause symptoms like:

• Depression, anxiety, or mood swings

• Water retention

• Abdominal pain

• Hot flashes

• Cravings for sweets

• Weight gain 

• Vaginal dryness and infections

• UTIs

• Low libido, loss of sex drive

• Low blood sugar

• Headaches or migraines

• Gallbladder problems

• Breast swelling and tenderness

Benefits of Progesterone Replacement

There has been speculation about the effects of compounded drugs as a treatment for menopausal symptoms. Many are concerned about the safety of these drugs, and progesterone has been given a bad reputation. However, these conclusions were based on reports from outdated research, and more recently, it has been found that progesterone replacement has many benefits.

Progesterone works with estrogen to improve your health and help you feel better in several different ways. It can help relieve hot flashes, brain fog, irregular or heavy periods, vaginal dryness, mood swings, and many other symptoms of perimenopause, menopause, and other conditions that cause hormone deficiency. 

Progesterone acts as a natural antidepressant and can enhance your mood and relieve anxiety. While there are many causes of anxiety, progesterone deficiency is the main factor for women during menopause. Research has shown that progesterone appears to be the most potent anti-anxiety hormone for menopausal women^16-18. Progesterone actually stimulates the brain’s “feel-good” center, earning it nicknames like “the miracle hormone” and “the great sedator”. 

Some experts believe that progesterone can help in preventing ovary, breast, colon, and uterine cancers, and you are eligible to supplement progesterone even if there is a family history of breast or uterine cancer; in this case, it may even be recommended.

Research shows that progesterone supplementation can improve brain function as well as breast, cardiovascular, and nervous system health. If introduced early in the menopause transition, progesterone may also protect against cognitive decline and has been found to improve visual and verbal memory¹⁶. Progesterone can also diminish muscular aches and pains, improve the quality of sleep and libido, and improve skin problems, including acne, seborrhea, rosacea, psoriasis, and kaurosis⁵.

After hot flashes, the next most vexing symptom of menopause is delayed or interrupted sleep. Researchers found that taking progesterone at bedtime improved the quality of deep sleep. Not only will it make you sleepy, but progesterone can reduce the severity of night sweats, which allows for uninterrupted sleep^16-18.

Some women notice increased facial hair growth as they age, especially above the upper lip. This excessive growth of facial and body hair is called “hirsutism.” This is an indication that there is a hormonal imbalance between the three major hormones: estrogen, progesterone, and testosterone. Progesterone treatment can help to regulate the other hormones and correct this condition.

Osteoporosis, or the decrease in bone density incongruent with age-appropriate levels, is a lesser-known, but serious concern for menopausal women. This loss of bone mass can result in increased fractures, loss of height, pain in the hips and back, and spinal curvature. While it might not seem threatening, the effects can be crippling and debilitating if preventive measures are not taken early. Osteoporosis is not only preventable, but it is also reversible in many cases. Good nutrition and exercise are important in the prevention and treatment of osteoporosis, and progesterone therapy can also be very helpful. 

Below is a summary of the many benefits of progesterone, including those already discussed, and more:

• Eases anxiety & stress - has a calming effect on both the mind and the body

• Improves mood 

• Promotes memory - stimulates brain processes and the nervous system

• Enhances sleep - has a sedative effect

• Helps regulate estrogen 

• Helps prevent diabetes an imbalance of progesterone and estrogen can dysregulate the release of insulin, increasing the risk for insulin resistance or Diabetes

• Protects from cancer - specifically breast and uterine cancers

• Reduces weight gain - helps the metabolism by contributing to the use of fat for energy

• Prevents heart disease - assists in preventing plaque from forming on arterial walls

• Bone formation - essential for bone growth and maintaining healthy calcium levels

• Thyroid gland - assists in the proper function of the thyroid gland

• Anti-aging - can help slow the aging process

• Improves libido/sex drive

• Reduces migraines

• Reduces inflammation & joint pain

Progesterone Therapy for Women

For many women, Progesterone Replacement Therapy (PRT) is introduced alongside estrogen replacement, and the combination of the two therapies can be very effective to mitigate common symptoms. Taking estrogen alone can cause the lining of the uterus to thicken, which in turn may raise the risk of uterine cancer. However, taking progesterone alongside estrogen as part of an overall Hormone Replacement Therapy (HRT) treatment plan can reverse the risk and be protective^4-9.

While estrogen without progesterone is not recommended, some believe that progesterone should only be prescribed alongside estrogen if a woman still has her uterus. However, the protective benefits of progesterone are not localized to the uterus alone, and they actually extend throughout the entire body. Progestogens have relatively few side effects at typical dosage.

Progesterone vs Progestin

Progesterone hormones are made naturally by your body and are commonly associated with fertility, menstruation, and contraception. Progestins are the synthetic form of progesterone that are used mostly for contraception. Although these synthetic progestins can be used in HRT, bioidentical progesterone is a better choice. HRT progesterone is offered in a micronized (smaller particle) form that allows for easier absorption. It also lasts longer in your body than progestins, due to their different chemical structures.

While progestin is used in birth control, it can also be used for the treatment of dysfunctional uterine bleeding or issues with your menstrual cycle. If you have low progesterone levels and are still in your reproductive years, irregular and heavy menstrual bleeding can occur. Low progesterone can mean the ovary has failed to release an egg at ovulation or that a woman has polycystic ovary syndrome.

Types of Progesterone Agents

When using progesterone for birth control you will most often see it combined with estrogen. There are many ways your physician may have prescribed progestin for hormonal birth control including pills, patches, injections, implants, and IUDs^7,8.

When using progesterone for anti-aging and menopausal symptoms you will be prescribed bioidentical hormones. This bioidentical HRT is most commonly provided as oral tablets, transdermal patches, and creams. Using progesterone as a cream allows for absorption through the skin and direction to the blood. This allows for the progesterone to bypass the liver and go to the specific receptor sites where it is needed. Any excess progesterone is excreted. Natural, bioidentical progesterone cream can be applied to your face, hands, chest, torso, inner arms, and inner thighs. Progesterone cream absorbs quickly and does not leave a residue. 

Based on your symptoms, you may require more progesterone to help alleviate your symptoms, while others will use less. Talk with your Winona provider to determine which form and dosage is right for you. 

Summary

Progesterone hormone is responsible for more than just carrying a pregnancy to term, and women of all ages rely on it for healthy and optimal function of different systems. When progesterone levels drop as a woman begins her menopause transition, she is likely to feel the uncomfortable symptoms that result from hormone imbalance. Supplementing with progesterone as part of an HRT program can provide relief from symptoms, as well as offering preventive care in areas like cancer, osteoporosis, and cardiovascular disease.

While progesterone supplementation can come in the synthetic form of progestin - commonly associated with contraception - Winona uses bioidentical progesterone derived from plants for our HRT. Most of the symptoms you are experiencing can be tamed with a bioidentical HRT plan designed specifically for you. As your hormone levels balance, you’ll start feeling better in just a few weeks.

At Winona, your health and comfort are our top priorities, and we are eager to work with you to create a health plan that is right for you. Our patient intake form is easy, and we are happy to talk to you about the options available for bioidentical HRT and other menopause treatments. Make an appointment online to discuss your symptoms with our medical team, and look forward to putting your days of discomfort behind you. 

Visit Winona for your online health assessment today.