It’s time to talk about progesterone, the most splendiferous, stupendous hormone around. Ok, I’ve been watching the Tigger Movie with my 2 year old, but progesterone is great. And, it is also probably the most ignored of the bioidentical hormones even though it may be the most important.
What is progesterone? It is the hormone that a woman’s ovaries produce in the second half of her menstrual cycle. Look at the diagram below. In the first 14 days of the cycle, estrogens dominate. Estrogens (like estradiol) grow the cells of the uterus to prepare it for implementation of a fertilized egg. At day 14, presumably when ovulation occurs, estrogens wane and progesterone kicks in. Progesterone’s job is to slow down the growth of the endometrial cells and to develop their function. If a fertilized egg does implant itself, progesterone levels will continue to rise. If not, progesterone drops signaling the start of menstruation and the whole process starts over again.
So, basically progesterone slows the growth of cells stimulated by estrogen and develops their function. But progesterone does a whole lot more. Progesterone receptors have been discovered in the blood vessels , the liver, breast tissue, the bone, and the brain, and has an important influence in the functioning of all those parts of the body.
Now, here’s the key point with regard to menopause. Progesterone is only produced by the ovaries. That means, when your ovaries slowly wind down their functioning through the menopausal years, progesterone production slows down right with it. Estrogens, however can be produced by other cells in the body besides the ovaries, namely adipose cells (or fat cells) that convert testosterone into estrogens. So, during menopause, progesterone is dropping but estrogens may not be, leading to a condition called estrogen dominance. This basically means that you don’t have enough progesterone to balance out the activity of the estrogens still floating around in the blood stream, not to mention the fact that you don’t have as much progesterone to have all of its beneficial effects on the blood vessels, bone, brain, etc.
This can lead to lots of symptoms like hot flashes, sleep disturbances, mood swings, and breast tenderness. Sound familiar? Yeah, these are menopausal symptoms. And, for the past 30 years, what has the medical establishment been giving to women who have these symptoms? Estrogens! Does this make sense – no! We should be giving them progesterone.
I have worked with hundreds of women with menopausal symptoms and I have never seen one who didn’t have some level of estrogen dominance on their hormone tests. So progesterone is the key. And the best part is that bioidentical progesterone is safe, easy to use and often resolves symptoms without the need for much estrogen, if any.
I hope this information is helpful. As always, I welcome your comments and questions.
Live well!
Absolutely loved this article, I plan to send my Holy Hormones! blog readers over to read it! Also loved the picture of Tigger, I am “mother” to two stuffed Eeyores, but I love all the Pooh characters (and firmly believe they all need hormonal balance, Piglet and Pooh are absolutely estrogen dominant—just look at them!)
I agree with Holly, great post. As I try to decide whether or not I want to take bioidenticals, I am reading more about xenoestrogens and the role they play in creating these hormonal imbalances. Before I add something else (progesterone), I want to make sure I am giving my body the best chance possible to balance itself by getting rid of any xenoestrogens in my body. I am reading Dr. John Lee, but also found this article from Women to Women to be pretty helpful Estrogen dominance —
is it real?. If you have any thoughts on this, I would love to read them! Thanks!
I think xenoestrogens are a legitimate concern and, most likely, it is impossible to avoid exposure to them entirely. There are certainly things you can do to limit your exposure to these powerful estrogen-like toxins, for example eating organic fruit and vegetables and avoiding plastic packaging when possible (at least not microwaving anything in plastic).
I’m a big believer in using hormone balancing to treat symptoms and improve quality of life. If you are having symptoms of estrogen dominance (hot flashes, difficulty sleeping, migraines, fluid retention, etc.), progesterone may be very helpful for you. If you are not experiencing these sympotoms, I would recommend keeping your focus on maintaining a healthy lifestyle (good nutrition and exercise).
I hope that’s helpful.
Thanks for the response! I think for right now I am going to go the organic diet/exercise/no plastic packaging route to reduce xenoestrogens. I look forward to keeping up with your blog.
So are the over the counter creams ok? Or do I have to find a dr that will prescribe one?
I think they are OK. The OTC progesterone creams have a low dose of progesterone and do not have micronized progesterone so they may not absorb through the skin as well as the compounded creams. But I have recommended them many times to women who have had symptoms of hormone imbalance, specifically estrogen dominance, and who are not able to afford to see a doctor or aren’t sure that bioidentical hormone replacement is right for them and want to start with something easy and inexpensive.
Clearly, taking an OTC progesterone is not going to give you as comprehensive and customized a treatment as the compounded hormone will, and I do recommend at least taking saliva test to see if you really need the progesterone. Other than that, the OTC creams are certainly safe and if you have mild hormonal imbalance, they can be quite effective. Apply 1/4 teaspoonful to forearm nightly at bedtime for best results.
Hi! I am perimenopausal, 49 and had hormones checked ( by blood). I was told I was estrogen dominant, high testerone, very low progesterone. I was started on low dose of oral progesterone 25mg day 1-14, then 50 mg day 15-period. My periods were 21 days apart ( used to be 28) and very heavy. Was retested after 6 months, progesterone still very low . C/o of anxiety, insomnia, heart palps, hot flashes,insomnia, fatigue and hx of PSVT ( on 12.5mg atenolol), hypothyroid on 37.5 synthyroid).
Dr has increased progesterone to 75 mg day 1-14, 150mg day 15- period. I have been on for 1 1/2 months and still not feeling much better. How long does it take for significant change in symptoms??? And now my breasts seem to be swollen and tender in latter 1/2 of cycle.
If and when should levels be rechecked?? Dr said to call in 2-3 months and discuss it. But I still feel like “crap” and am considering antidepressant or such if this is not going to get better.
Please help!!!!!!!!
Kristi,
I would recommend doing a saliva test sooner rather than later. If your symptoms are getting worse as you continue on the hormones, that’s something you should talk about with your doctor and see about adjusting your dose. Your progesterone dosage doesn’t seem terribly high for an oral dose, but as I’ve mentioned in previous posts, everyone’s needs are very indivudial. What’s normal for one person, may be high for another.
There is another topic that I haven’t talked about much in my blog, but I am planning to discuss more, which is the topic of chronic stress or adrenal fatigue. If the adrenal glands are not functioning properly through chronic stress or environmental contitions (i.e. exposure to pesticides, etc.), the bioidentical hormone replacement therapy will be far less effective that it can be.
Something to think about. If you are not getting the care you need from your regular doctor, it might be a good idea to get a second opinion or talk to a naturopathic doctor.
Take care.
If you haven’t already seen this, you might find this article by Dr. Mercola’s useful regarding progesterone. http://www.mercola.com/article/progesterone/cream.htm
Does progesterone play a role in postmenopausal vaginal dryness, discomfort, and atrophy?
Hi Vicki,
Those symptoms are generally associated with estrogen deficiency although since progesterone influences the activity of estrogens, it is possible that a progesterone deficiency could contribute to those symptoms. The most effective treatment I’ve seen for this is estriol vaginal cream (0.5mg to 2mg inserted vaginally nightly at bedtime for 2 weeks, then 2 to 3 times weekly thereafter).
I hope that helps.
Hi, I am 62 and decided to see a Doctor who prescribes bioidentical creams.
I have been post menopausal for about 5 years. I looked into the bioidentical creams due to sleeplessness, joint pain, weight gain, low libido etc. etc. etc. I eat healthy and exercise at least 1/2 hour a day or walk.
For two months I have been on Progesterone Cream 75Mg/ml (7.5%) – applying 0.2 ML twice a day. Along with Estriol cream ml. One GM inserted daily for 14 days then every other day thereafter. I experienced weight gain, water retention and my breasts were larger and more sensitive.
The doctor reduced me to half the dose of both the above. I am not sleeping again and the water retention is noticeable as per my husband even in my face. I feel much heavier, especially around my middle and rear. I have never been a big person.
I have just seen the Dr. again and he has adjusted after two months and I am now taking Progesterone Cream 50mg(5%) – taking 0.2ml twice daily and he has put me on Biest (80:20) cream 2mg (VC) – taking this intravaginally (0.2 mls) once daily. (have been on this dosage for 2 days so far)
I still have the water retention, but the last two days have notice sweating more – is this normal with the Biest cream added. Should the water retention stop? I am still not sleeping as I would like and feeling drowsy.
Blood tests were done at the beginning and thyroid and others not bad, except Vitamin D very low which will be adjusted through vitamins.
Not sure what to do about the water retention.