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Progesterone
Michael Lam, MD, MPH
www.DrLam.com
Contents
Hormone
Basics
Functions
of Progesterone
Hormone
Replacement Therapy (HRT)
Dr.
John Lee - Pioneer on Natural Progesterone
Why
is estrogen and progesterone out of Balance?
Hormones
and Lifestyle
Imbalances
of estrogen and progesterone in females
Estrogen
Dominance - Key to the Puzzle
Premenstrual
Syndrome (PMS)
Pre-menopause
Syndrome
The
Progesterone Solution
Benefits
of Natural Progesterone
Natural
vs. Synthetic Progesterone
Side
effects of Natural Progesterone
Routes
of Progesterone Delivery
Delivery
Systems of Topical Progesterone
Progesterone
and Adrenal Gland Optimization
Progesterone
and Osteoporosis
Progesterone
or Estrogen and Cancer
How
Much Progesterone Cream To Use?
Low
vs. High Dose Progesterone Cream
Laboratory
Measurement
How
to apply Progesterone Cream
Progesterone
and Men
Male
Hormonal Imbalances
Progesterone
and Prostate
Summary
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Hormone Basics
 The
two main sexual hormones in women are estrogen and progesterone. Both
are produced in men and women, although in different quantities. Progesterone
is made from pregnenolone, which in turn comes from cholesterol.
Production of progesterone occurs at several places. In women, it
is primarily produced in the ovaries just before ovulation and increase
rapidly after ovulation. It is also produced in the adrenal glands
in both sexes and in the testes in males. Its level is highest during the ovulation
period (day 13-15 of the menstrual cycle). If fertilization does not
take place, the secretion of progesterone decreases and menstruation occurs.
If fertilization does occur, progesterone is secreted during pregnancy by
the placenta and acts to prevent spontaneous abortion. About 20-25 mg of progesterone is produced
per day during a woman's monthly cycle.Up to 300-400
mg are produced daily during pregnancy. During
menopause, the total amount of progesterone produced declined to less than
1% of the pre-menopausal level. This drop is extreme.
Progesterone occupies an important position in the pathway of hormonal synthesis.
In addition to being the precursor to estrogen, it is also the
precursor of testosterone and the all-important adrenal cortical hormone
cortisol. Cortisol is essential for stress response, sugar and
electrolyte balance, blood pressure and general survival. In short,
progesterone serves to promote survival and development of the embryo and
fetus. It acts as a precursor to many important steroid hormones and
helps to regulate a broad range of biological and metabolic effects in the
body. During chronic stress, progesterone
production is reduced as the body favors cortisol production to reduce stress.
This is an important point which we will look into later.
Estrogen is produced in the ovaries. It regulates the menstrual cycle,
promotes cell division and is largely responsible for the development of
secondary female characteristics during puberty. In non-pregnant,
pre-menopausal women, only 100-200 micrograms of estrogen is secreted daily.
But during pregnancy, much more is secreted. Estrogen is produced in the ovaries, adrenal
and fat tissues. During menopause, the
amount of estrogen in the body declines by about 50 to 60 percent.
Production , however, is augmented in the adrenals and in the fat cells.
Estrogen and progesterone work in synchronization
with each other. They oppose each other in their actions and work
as checks and balances to achieve hormonal harmony in both sexes.
Functions of Progesterone
Progesterone acts primarily as an antagonist (opposite
to) to estrogen in our body. For example, estrogen can
cause breast cysts while progesterone protects against breast cysts.
Estrogen enhances salt and water retention while progesterone is a natural
diuretic. Estrogen has been associated with breast and endometrial
cancer, while progesterone has cancer preventive effect.
Some of the functions
of progesterone include:
-
It protects the
breast, uterus, and ovaries from cancer
-
It acts as a natural
diuretic
-
It produces a
calming, anti-anxiety effect
-
It contributes
to formation of new bone tissue
Most significantly, it is known that high
amounts of estrogen can induce a host of metabolic disturbances, and
the body's way of counterbalancing estrogen is progesterone. When
this balancing mechanism is dysfunctional, a multitude of health related
problems can arise.
Hormone Replacement Therapy (HRT)
Menopause is often a time when the hormonal balance between estrogen and
progesterone is off.
Symptoms of such imbalance include hot flashes,
vaginal dryness, water retention, weight gain, insomnia, mood swings, short-term
memory loss, wrinkly skin and osteoporosis.The breakthrough in
treatment of menopausal symptoms came in 1964, when Dr. Wilson first reported
that the lack of estrogen causes menopause. Pharmaceutical companies
introduced a synthetic estrogen hormone called Premarin. With this
drug, symptoms of menopause such as hot flashes were greatly reduced.
There was little doubt then that menopause was solely due to estrogen deficiency.
Few doctors knew then that estrogen deficiency alone did not explain many
of the symptoms of menopause.
For example,
How does one explain
the fact that women who are post-menopausal but cannot be started on HRT
can have relief of their menopausal symptoms when using progesterone replacement
alone? Clearly there is more to the menopausal picture than deficiency of
In fact, many women on HRT with estrogen alone are unhappy with fat accumulating
at their hips and abdomen, osteoporosis, loss of sex drive and often swollen
breasts. The common perception is that estrogen is the primary regulator
of libido, but in reality estrogen replacement often does not restore their
previous sex drive. What is needed is progesterone and in some cases,
testosterone is also needed. While the exact mechanism is not known,
it is postulated that estrogen "prime" the brain cells but progesterone
"turns on" the sex drive. This has been studied and clinically observed
in laboratory rats whose ovaries are removed. Supplementing with estrogen
alone does not increase sex drive, but supplementing with progesterone together
with low dose estrogen does.
During menopause, the absolute level of estrogen decreased by 50 percent
to a level below what is needed for pregnancy and enough for other normal
body functions through the golden years. This is the way nature
intended it to be. Menopause is therefore a normal physiological adjustment
that does not produce any undesirable symptoms. It is not a disease.
The current menopausal problem is an abnormality resulting from the relentless
insult on the body's hormonal system from industrialized cultures' and deviation
from a wholesome and healthy lifestyle. We shall examine this in more
detail.
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