PROGESTERONE

A silver sea, Soothing, like Progesterone.
Tranquility

PROGESTERONE CHANGES INTO ALLOPREGNANOLONE

The hormonal action of progesterone was discovered in 1929, following the discovery of estrogen in 1923. It was named thus: PRO – (meaning for, or supportive of) – GEST (short for “gestation”, meaning “pregnancy”) – ERONE (hormone).
The name tells you that progesterone is the pregnancy hormone.
In the brain, Progesterone changes into Allopregnanolone, which actually produces much of Progesterone’s effects.

Progesterone must not be confused with “progestins”.
Progestins are synthetic pharmaceutical chemicals, which possess properties similar to those of progesterone but which are known for their propensity to promote breast and uterine cancers, large vein blood clots, heart attacks and strokes.
Do check the link above, to have a look at the Wikipedia page on Progestins: the interesting thing about this Wiki page is that it avoids making a clear statement regarding the reasons why doctors don’t want to deal with “hormones” (see “NON-HUMAN PROGESTERONE”, below)..
Several pages down the article, you will find these two interesting statements:
[1] “the risk of coronary heart disease was greater with the combination of estrogen plus a progestin (specifically, Equine Oestrogen, plus medroxyprogesterone acetate) than with estrogen alone” …….and …….. “strong evidence that the treatment of post-menopausal women with (synthetic) hormone therapy for cardiovascular disease had little if any effect (on the heart) and increased the risk of stroke and venous thromboembolic events.
[2] “With 20 years of use, breast cancer incidence is about 1.5-fold higher with estrogen alone and about 2.5-fold higher with estrogen plus progestogen therapy.[151] The increase in breast cancer risk was shown to be due to the estrogen plus progestogen therapy (conjugated estrogens plus medroxyprogesterone acetate) in the Women’s Health Initiative randomized controlled trials

In the human body, progesterone is produced from pregnenolone, which is made by conversion of cholesterol.
The progesterone is then converted into Allopregnanolone, the “king of the hormones” (crowned king, by me).

This human hormone, progesterone, is produced in very large quantity by the ovaries, the placenta and even the brain, but bioidentical progesterone (a substance with a precisely identical chemical structure) can be produced pharmaceutically, from “diosgenin”, a chemical found in wild yam which can also be processed into the entire sequence of other human “neurosteroid” hormones.

PROGESTERONE IS ACTIVE IN MANY HUMAN BODY SYSTEMS

Progesterone is in many ways the body’s most interesting hormone.
Certainly, it is the most surprising hormone.
Progesterone normalizes the menstrual cycle and is necessary for pregnancy, so we have always thought of it as the pregnancy hormone, but:
It’s great for sleep.
It improves memory.
It supports kidney function.
It acts to prevent breast cancer.
It opposes the natural tendency of oestrogens to produce weight gain, so it is sometimes prescribed to improve the progesterone/oestrogen balance, to help with weight loss.
In the brain Progesterone changes into Allopregnanolone, so the effect of taking it is immediate improvement of all the functions of that amazing, indispensable king of the hormone family. (Allopregnanolone promotes normal sleep patterns, does brain maintenance, repairs demyelinated nerves, helps to control pain, enhances self-image, and improves cognition and memory. It is antianxiety, prosocial and antidepressant, thereby cancelling the effects of stress and preventing high blood pressure and the problems it causes).

Males produce little progesterone, which perhaps is the reason for women’s advantage in the memory department.
Importantly, neither men nor women make enough progesterone after menopause/andropause,

PROGESTERONE DEFICIENCY

Low Progesterone can start at any age, even in the teenage years, in both females and males.
Progesterone deficiency causes menstrual irregularity, PMS and infertility in women, and in both sexes it is a cause of insomnia, poor self-image and a loss of “tranquility”.
Especially when combined with other deficiencies, progesterone deficiency is a cause of anxiety, depression, fuzzy thinking, memory loss, confusion and possibly, Alzheimer’s disease.

THERAPY FOR PROGESTERONE DEFICIENCY

A nightly dose of progesterone, taken with melatonin *, maintains levels of progesterone in the brain, to take advantage of the benefits of the hormone itself and of Allopregnanolone, especially in brain maintenance and repair.**
Some practitioners believe, as I do, that maintaining progesterone at adequate levels will prevent, or retard, development of Alzheimer’s and other neurological diseases.

* Melatonin is hypnotic, chronobiotic, antidepressant, pro-cognitive, anxiolytic and analgesic.
It scavenges reactive oxygen and nitrogen species and increases antioxidant defenses, so it clears brain inflammation and makes it easier for Allopregnanolone to do its work.
** Progesterone, if administered quickly after a stroke, concussion or brain/spinal-cord injury, minimises nerve cell damage (this, again, is a function of the Progesterone/Allopregnanolone/Melatonin combination, the “three musketeers” of the brain) ***.
*** The three musketeers need help from DHEA, Testosterone, Oestrogen, T3, Vitamin D and the essential vitamins and minerals, but the title sounds great, doesn’t it?

PROGESTERONE IN THE MENSTRUAL CYCLE AND IN PREGNANCY

A relatively small amount of Progesterone is continuously made in the adrenals and ovaries.
The ovaries’ output begins to rise on the 13th-14th day of the menstrual cycle, to prepare the lining of the uterus (the endometrium) for implantation of an egg.
The progesterone level peaks on the 21st day and if no fertilised egg has been implanted in the uterus by then, the corpus luteum stops working and shrinks.
So the blood progesterone level falls to baseline by the 28th day.
Without enough Progesterone, the endometrium can’t keep going and menstruation begins.
If an egg is produced, fertilised and implanted, the corpus luteum (the original egg pod) makes enough progesterone to keep the endometrium fertile until the baby’s placenta takes over production, at about 8-12 weeks of pregnancy.

Graph of Progesterone in the menstrual cycle

NORMAL PROGESTERONE LEVELS

In men, and in women during the first 7 to 10 days of the menstrual cycle, the progesterone level is low (< 6 ng/ml) *.  
In women of childbearing age, progesterone production begins to rise at day 14 of the menstrual cycle and after ovulation it rises rapidly to 30 – 50 ng/mL
If pregnancy begins, a hormone called human chorionic gonadotropin (“HCG”) is released by the fertilised egg.
HCG converts the egg sac in the ovary into a “corpus luteum”, which produces progesterone, to maintain the pregnancy until the placenta begins to produce its own progesterone at 8–12 weeks.
The placenta keeps producing large quantities of progesterone (100–200 ng/ml) until a day or two before the baby is born. ** Then the blood progesterone level falls to its baseline level *** and stays down while the mother is breastfeeding.

* It has been suggested that women have better memories than men do because they make more progesterone.
** The sudden drop in Progesterone availability is the trigger for “parturition” (birth).
*** If the progesterone goes low enough to cause Allopregnanolone deficiency, serious postpartum depression may ensue, needing treatment with Allopregnanolone
(of course, treatment with progesterone will also work).

PROGESTERONE DEFICIENCY

Progesterone deficiency does not usually begin until menopause or andropause. However it can begin at any age, perhaps as a sequel to PTSD in childhood.
Any woman who suffers from PMS, menstrual irregularity, oligomenorrhoea (abnormally light menstruation) or menorrhagia (abnormally heavy menstruation) may be progesterone deficient and should have her “peak” blood progesterone levels checked between the 20th and 22nd day of her cycle. If low progesterone is confirmed, supplementation with progesterone pills, * or cream, can be very helpful.

* Some Progesterone deficient women do well with 100mg of Progesterone each night (many need 200 or 300mg)…… Doctors often suggest taking the Progesterone supplement from the 15th to the 25th day of the menstrual cycle, in young women.
However postmenopausal people with insomnia do better by taking it every night.

PROGESTERONE PREPARATIONS

Progesterone can be prepared as a cream, sublingual tablets or troches. Some practitioners prefer creams, but usually it is prescribed as pills, which are more convenient to take, are guaranteed to be of uniform dosage and are not liable to transfer to a partner, as a skin cream is.

The usual dose of pills is 100 – 300 mg for woman and 50 mg for men.
The dose of cream is usually only 1/3 of the oral dose, because progesterone absorbed transdermally enters the circulation immediately, while material absorbed from the bowel passes through the liver, which destroys perhaps 60 % of the dose.

Progesterone is taken an hour before bedtime, with 3 – 10 mg of melatonin.
Of the two, progesterone is the better sleep promoter because Allopregnanolone, made from progesterone, is what puts you to sleep.
Melatonin is prescribed for its multiple functions, which include assisting Allopregnanolone with brain maintenance.

PROGESTERONE (PILLS) SIDE EFFECTS

BIOIDENTICAL PROGESTERONE: reportedly, progesterone side effects include stomach upset, changes in appetite, weight gain, fluid retention and swelling (edema), fatigue, acne, drowsiness or insomnia, allergic skin rashes, hives, fever, headache, depression, breast discomfort or enlargement, premenstrual syndrome (PMS)-like symptoms, altered menstrual cycles, irregular bleeding, and other side effects.
However in my practice, 100mg – 300 mg of progesterone every night for menopausal women and 50 mg nightly for men has not to date produced any of these side effects.
Occasionally some sensitive subject has complained of feeling groggy on waking, but that difficulty has uniformly stopped if the dose is taken earlier in the evening, or if the dosage is reduced.

NON-HUMAN PROGESTERONE: There are many synthetic and animal-derived “progestins” *, which were prescribed in the twentieth century. They were prescribed along with synthetic Oestrogens, or “CEE” (Conjugated Equine Estrogen) and the combination produced such a range of lethal and sublethal side effects , including cancers, blood clots, strokes and heart attacks, that the very word “hormone” fell into disrepute.
Nowadays our doctors are beginning to recover and to recognise that apart from the question of hormone-dependent tumours, human hormones do not present a problem. However the guilt response of the medical profession as a whole was overwhelming.
Even now, thirty years later, doctors are still reluctant to embrace the principles of hormone therapy. Many MDs still get so upset by the mention of hormone therapy that they refuse even to discuss the subject and getting a regular MD to prescribe hormone restoration is almost impossible.

* Some progestins are still supplied, as birth-control pills. The link below is to a listing of currently available progestins.

PROGESTERONE (CREAM) SIDE EFFECTS

Skin irritation: Rare. it usually occurs when the cream is applied to the same area, repeatedly.
Skin-to-skin transfer to an intimate partner or to a baby: This is a possibility, but the probability of side-effect generation is tiny

ABOUT THIS MONOGRAPH

This very brief “paper” on progesterone is a condensation of a lot of information, especially regarding the activities and functions of progesterone in the human body.
It is intended to provide “lay” persons with the basic information they need to understand the hormone, cooperate with their functional medicine practitioner and make more confident decisions about their own healthcare.

If you need further information, or need a deeper understanding of your hormonal imbalances, please see “you and your hormones” ( https://www.yourhormones.info/hormones/). This is an amazingly detailed, in-depth, all–encompassing review of all the human hormones, much too complicated for the casual reader, but useful if you need it.

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