Progesterone is a hormone that is naturally produced, and it works by binding to receptors throughout the body. These receptors are found in the brain, uterus, ovaries, and breasts.
When progesterone binds to these receptors, it helps to regulate the menstrual cycle and prepare the body for pregnancy. Progesterone also plays a role in maintaining pregnancy. During pregnancy, progesterone levels increase in order to help sustain the pregnancy.
Progesterone levels fluctuate throughout a woman’s life but decline during menopause. This can lead to a variety of uncomfortable symptoms.
Progesterone is the drug of choice to treat PMS and postpartum depression as it enhances all of estradiol’s positive effects and minimizes estradiol’s negative effects such as: breast tenderness, irritability, cramping, heavy menstrual periods, and migraine headaches.
A lack of progesterone can cause irregular menstrual cycles, infertility, miscarriages, and other health problems. Progesterone helps to thicken the lining of the uterus, which is necessary for implantation and pregnancy. Without enough progesterone, the lining of the uterus remains thin, making it difficult for a fertilized egg to implant.
During perimenopause, women experience a loss of progesterone. This can cause irregular periods, heavy cycles, hot flashes, night sweats, mood swings, and other symptoms. A sudden drop in progesterone levels can also occur if a woman has her ovaries removed or goes through chemotherapy.
Women that suffer from Postpartum depression are experiencing sudden withdrawal from this feel good hormone. Women with PPD need progesterone supplementation in order to treat the cause of their disorder rather than an antidepressant that only addresses the symptoms that they are experiencing.
There are a lot of recommendations on how to increase Progesterone levels naturally. But no matter what you do, it’s rarely enough to raise your levels to a therapeutic range where you’ll receive the maximum benefits.
In addition to its reproductive functions, progesterone also has a number of other health benefits for women.
- Progesterone works synergistically with estradiol to maintain bone density and reduce the risk of osteoporosis.
- Progesterone protects against breast cancer.
- Progesterone is the drug of choice to treat premenstrual syndrome (PMS). PMS is caused by inadequate amounts of progesterone to oppose the negative effects of estradiol. Symptoms of PMS are breast tenderness, irritability, pelvic cramps, mood swings, and heavy cycles.
- Progesterone can help to regulate menstruation: Progesterone helps to reduce thickening of the uterine lining, which can increase the risk of endometrial cancer.
- Progesterone is an effective treatment for migraine and cluster headaches as well as menstrual (catamenial) seizures.
All women need progesterone whether peri or post menopausal, whether they have a uterus or not. It’s a common misconception that if women don’t have a uterus they don’t need progesterone. But we need for bone health, to protect against breast cancer, and for the calming mood stabilizing effect it provides.
Pregnant women need high levels of progesterone in order to sustain pregnancy. A lack of progesterone during pregnancy will often result in a miscarriage. Women sometimes report feeling the best that they have ever felt during pregnancy due to the high levels of progesterone. Once these women deliver, they often suffer severe depression due to the rapid loss of progesterone. Women that suffer from Postpartum Depression are experiencing sudden withdrawal from this feel good hormone. Women with PPD need progesterone supplementation in order to treat the cause of their disorder rather than an antidepressant that only addresses the symptoms that they are experiencing.
Progesterone can benefit women who suffer from the following conditions:
- Irregular menstrual cycles: Progesterone is very effective in treating several of the symptoms of PCOS including irregular cycles, heavy menstrual cycles, mood swings, and others.
- Endometriosis: Women with endometriosis often have low levels of progesterone and higher levels of estrogen. This can cause pain and heavy bleeding during periods. Taking progesterone can help alleviate these symptoms.
- Recurrent miscarriages: Some research suggests that taking a progesterone supplement may reduce the risk of miscarrying in women who have had two or more previous miscarriages.
- Hormone replacement therapy during menopause: Progesterone should be taken along with estradiol replacement because it enhances everything that’s great about estrogen and counteracts the negatives.
|Route of administration||Absorption||Drowsiness||Effectiveness|
|Sublingual (under the tongue)||Best absorption rate by far||No drowsiness||Very effective at reaching therapeutic levels|
|Oral||Only 40% absorption rate||Causes drowsiness||Rarely reaches therapeutic levels when used alone, but may be useful in improving sleep|
|Topical Cream||Poorly absorbed||No drowsiness||Worthless-provides no protection
Progesterone treatment is used to supplement the body’s natural production of progesterone. There are several different types of progesterone treatment available, each with its own advantages and disadvantages. Your doctor can help you decide which type of treatment is right for you.
The method of delivery is extremely important in order to achieve therapeutic levels. Progesterone applied topically is not well absorbed, and will not provide adequate levels to relieve symptoms or protect against breast or uterine cancer. Patients taking oral progesterone only absorb about 40% of the hormone. Oral progesterone causes drowsiness therefore must be taken at bedtime. It can be helpful for women with sleep disturbances to take progesterone orally to enhance sleep. Taking oral progesterone in combination with oral estradiol lowers the amount of estradiol absorbed. Therefore, consideration to maintaining adequate estradiol levels must be given to women taking oral progesterone. It is imperative for practitioners prescribing HRT to have an understanding of the pharmacodynamics of each hormone and the various delivery systems as well as the interaction between hormones in order to optimize each hormone.
This is a small round, waxy disc called a troche that is placed under the tongue and allowed to dissolve. It provides the maximum rate of absorption and is our preferred method of delivery. Women may take this any time of day because it doesn’t cause drowsiness. This allows for administration several times per day if needed when they experience an increase in symptoms such as anxiety, PMS symptoms, and others.
Progesterone suppositories are small, cylindrical pieces of medication that are inserted into the vagina. They are made from a plant-based form of progesterone and are bioidentical to what women produce. They are typically used once or twice daily, starting on the day after ovulation and continuing until 10 weeks gestation. The drawback with suppositories is that they are messy and inconvenient.
Oral Progesterone Pills:
Oral progesterone pills come in both pill and capsule form. We utilize the oral micronized progesterone that is compounded into an oral capsule because we can compound the dosage that is most effective for each individual woman, which may not be commercially available. Oral progesterone pills are available by prescription only and must be taken at bedtime because they will cause drowsiness.
Progesterone injections are given intramuscularly (into the muscle) or subcutaneously (under the skin.) They contain a synthetic form of progesterone that is similar to the progesterone naturally produced by the body. It’s best to get a consistent daily dosage. On days you need more, it’s easy to get that sublingually. But it’s difficult to get several injections. The only time we might use progesterone injections is if a woman was suffering from heavy postpartum depression due to the rapid loss of progesterone that occurs immediately after delivery.
Micronized progesterone can cause drowsiness. Some women say taking progesterone cause them nausea but this can be alleviated by changing delivery methods. Some medical textbooks say if you have too much progesterone you can develop solemnance, which is a lack of emotional response.
Bioidentical progesterone, which is what we use exclusively at Tier1 Health & Wellness, does not interact with other medications. This is because it is produced by your body. Synthetic progesterone on the other hand can have interactions with medications like birth control pills, blood thinners and antidepressants.