Progesterone

Progesterone is one of the hormones in our bodies that stimulates and regulates various functions. Progesterone plays a role in maintaining pregnancy. The hormone is produced in the ovaries, the placenta (when a woman gets pregnant) and the adrenal glands. It helps prepare your body for conception and pregnancy and regulates the monthly menstrual cycle.

Progesterone is one of the steroid hormones. It is secreted by the corpus luteum and by the placenta and is responsible for preparing the body for pregnancy and, if pregnancy occurs, maintaining it until birth.

Corpus luteum

Progesterone secretion by the corpus luteum occurs after ovulation and

• continues the preparation of the endometrium for a possible pregnancy

• inhibits contraction of the uterus

• inhibits development of a new follicle

If pregnancy does not occur, secretion wanes toward the end of the menstrual cycle, and menstruation begins.

Placenta

If pregnancy does occur, the placenta begins to secrete progesterone which supplements that of the corpus luteum. In fact, by the fifth month of pregnancy, the placenta secretes sufficient progesterone by itself that the corpus luteum is no longer essential to maintain pregnancy.

Method of Action

Progesterone, like all steroids, is a small hydrophobic molecule. Thus it diffuses freely through the plasma membrane of all cells. However, in target cells, like those of the endometrium, it

• becomes tightly bound to a cytoplasmic protein the progesterone receptor.

• the complex of receptor and its hormone moves into the nucleus.

• there it binds to a progesterone response element

The progesterone response element is a specific sequence of DNA in the promoters of certain genes that is needed to turn those genes on (or off). Thus, the complex of progesterone with its receptor forms a transcription factor.

The Role of Progesterone in Women

One of progesterone's most important functions is to cause the endometrium to secrete special proteins during the second half of the menstrual cycle, preparing it to receive and nourish an implanted fertilized egg. If implantation does not occur, estrogen and progesterone levels drop, the endometrium breaks down and menstruation occurs.

If a pregnancy occurs, progesterone is produced in the placenta, and levels remain elevated throughout the pregnancy. The combination of high estrogen and progesterone levels suppress further ovulation during pregnancy. Progesterone also encourages the growth of milk-producing glands in the breast during pregnancy.

High progesterone levels are believed to be partly responsible for symptoms of premenstrual syndrome (PMS), such as breast tenderness, feeling bloated and mood swings. When you skip a period, it could be because of failure to ovulate and subsequent low progesterone levels.

Benefits

Progesterone

• is the most protective hormone the body produces

• is not just the hormone of pregnancy

• is the body's natural complement to estrogen

• often makes it unnecessary to use estrogen supplementation

Aging

Since most progesterone in males is created during testicular production of testosterone, and most in females by the ovaries, the shutting down (whether by natural or chemical means), or removal, of those inevitably causes a considerable reduction in progesterone levels. Previous concentration upon the role of progestagens (progesterone and molecules with similar effects) in female reproduction, when progesterone was simply considered a “female hormone”, obscured the significance of progesterone elsewhere in both sexes.

The tendency for progesterone to have a regulatory effect, the presence of progesterone receptors in many types of body tissue, and the pattern of deterioration (or tumor formation) in many of those increasing in later years when progesterone levels have dropped, is prompting widespread research into the potential value of maintaining progesterone levels in both males and females.

Brain damage

Previous studies have shown that progesterone supports the normal development of neurons in the brain, and that the hormone has a protective effect on damaged brain tissue. It has been observed in animal models that females have reduced susceptibility to traumatic brain injury and this protective effect has been hypothesized to be caused by increased circulating levels of estrogen and progesterone in females. A number of additional animal studies have confirmed that progesterone has neuroprotective effects when administered shortly after traumatic brain injury. Encouraging results have also been reported in human clinical trials.

The mechanism of progesterone protective effects may be the reduction of inflammation that follows brain trauma.

A Truly Remarkable Hormone

It turns out progesterone is a truly remarkable hormone. Progesterone is necessary for the creation of all the other hormones - the precursor function and it is necessary for pregnancy and the survival of the fetus - the procreation function. Then progesterone has numerous intrinsic effects - things we know are benefits of progesterone even though we don't know how it happens.

Up in your hypothalamus in your brain you have controllers, you have nifty little computers up there that are keeping track of the bodies need and the production of all the hormones. It tells the pituitary we need a little bit more progesterone, we need a little bit less of this and a little bit more of that and all of these things can happen. And the ovary carries them out and the adrenal glands carry them out and the pituitary does its show and it is a constant shifting changing scene and the progesterone is at the bottom of it all. Imagine if the progesterone is gone, these things can't happen. So all sorts of things can happen when progesterone is deficient.

Procreation effects

Progesterone is necessary for the uterus to develop a nice bloody lining as a nest to be able to nourish the fertilized egg and to sustain it. If you have a fall off of progesterone at that point you will initiate a shedding, like a monthly shedding, and you will lose the pregnancy. So the ovary is very important, it has to make more progesterone at that point. By the 3rd month the placenta is making the majority of the progesterone, as much as 400mg per day. So progesterone is critical for the survival and development of the embryo, development of the fetus throughout gestation. Those are the procreation effects.

Some more benefits and uses of Progesterone

• Progesterone is used to control persistent anovulatory bleeding. It is also used to prepare uterine lining in infertility therapy and to support early pregnancy. Patients with recurrent pregnancy loss due to inadequate progesterone production may receive progesterone.

• Progesterone is also used in non-pregnant women with a delayed menstruation of one or more weeks, in order to allow the thickened endometrial lining to slough off. This process is termed a progesterone withdrawal bleed. The progesterone is taken orally for a short time (usually one week), after which the progesterone is discontinued and bleeding should occur.

• Progesterone is being investigated as potentially beneficial in treating multiple sclerosis, since the characteristic deterioration of nerve myelin insulation halts during pregnancy, when progesterone levels are raised; deterioration commences again when the levels drop.

• Progesterone also has a role in skin elasticity and bone strength, in respiration and in nerve tissue.

• Progesterone is starting to be used in the treatment of the skin condition hidradenitis suppurativa.

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction to progesterone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• sudden numbness or weakness, especially on one side of the body;

• sudden headache, confusion, pain behind the eyes, problems with vision, speech, or balance;

• fast or pounding heartbeats;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• unusual or unexpected vaginal bleeding;

• migraine headache;

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• swelling in your hands, ankles, or feet;

• fever, chills, body aches, flu symptoms;

• a breast lump; or

• symptoms of depression (sleep problems, weakness, mood changes).

Less serious progesterone side effects may include:

• mild nausea, diarrhea, bloating, stomach cramps;

• dizziness, spinning sensation;

• hot flashes;

• mild headache;

• joint pain;

• breast pain or tenderness;

• cough;

• acne or increased hair growth;

• changes in weight; or

• vaginal itching, dryness, or discharge.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What special precautions should I follow?

Before taking progesterone,

• tell your doctor and pharmacist if you are allergic to progesterone, any other medications, or peanuts.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Samdimmune); danazol (Danocrine); delaviridine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac); erythromycin (E.E.S, E-Mycin, Erythrocin); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); HIV protease inhibitors such as indinavir (Crixivan), ritonavir (Norvir), and saquinavir (Fortovase); isoniazid (INH, Nydrazid); lansoprazole (Prevacid, Prevpac); metronidazole (Flagyl); nefazodone (Serzone); omeprazole (Prilosec); ticlopidine (Ticlid); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor what herbal products you are taking, especially St. John's wort.

• tell your doctor if you have or have ever had unexplained vaginal bleeding between periods; a miscarriage in which some tissue was left in the uterus; cancer of the breasts or female organs; seizures; migraine headaches; asthma; diabetes; depression; blood clots in the legs, lungs, eyes, brain, or anywhere in the body; stroke or ministroke; vision problems; or liver, kidney, heart, or gallbladder disease.

• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking progesterone.

• you should know that progesterone may make you dizzy or drowsy. Do not drive a car or operate machinery until you know how this medication affects you. If progesterone does make you dizzy or drowsy, take your daily dose at bedtime.

• you should know that progesterone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking progesterone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

Adverse effects

The convenient pill form of “progesterone” (whether it is actually progesterone, or is instead a synthetic, patented progestin), needs to be taken at unnaturally high doses; and, this can have a dramatic health impact. For example, 400 mg can cause increased fluid retention, which may result in epilepsy, migraine, asthma, cardiac or renal dysfunction. Blood clots that can result in strokes and heart attacks, which may lead to death or long-term disability, may develop; pulmonary embolus or breast cancer can also develop as a result of [current practices in] progesterone therapy. [High-dose] progesterone is associated with an increased risk of thrombotic disorders such as thrombophlebitis, cerebrovascular disorders, pulmonary embolism, and retinal thrombosis.

Common adverse effects include cramps, abdominal pain, skeletal pain, perineal pain, headache, arthralgia, constipation, dyspareunia, nocturia, diarrhea, nausea, vomiting, breast enlargement, joint pain, flatulence, hot flushes, thirst, increased appetite, nervousness, drowsiness, excessive urination at night.

Psychiatric effects including depression, mood swings, emotional instability, aggression, abnormal crying, insomnia, forgetfulness, sleep disorders.

Reviews

Review by skrumm: User Rating: 9.0

... (progesterone) for Progesterone Insufficiency: I'm 48, and found that this nicely balanced the issues I'm having with estrogen dominance. I've had no side effects that I can tell, but a real clearing up of the fuzzy brain, night sweats, and trouble sleeping. I love it!

Review by zoda: User Rating: 10

... (progesterone) for Seizures: This ... says it's not known what happens with overdose of ... but I can tell you do not take 2 doses at once. I normally take 800mg/day for last 1/2 of my cycle to suppress catamenial seizures. It works great with no negative side effects. I take 200mg every 6 hours. I recently missed a 200mg dose so I took 400mg at once. I was completely anesthesized for a couple of hours. Body went jelly-like. Everything slowed way down to the point that words came too slowly, if at all. Family opted to take me to the ER. Later was determined I was likely not in danger of dying but was clearly knocked out for a while. Memory of much of those 2 hours is totally lost to me. Family says I was pleasant and cooperative but out of it.

Review by ACE24: User Rating: 8.0

... (progesterone) for Uterine Bleeding: My doctor is having me take this medication because I have excessive bleeding. So far the bleeding has stopped but I'm on day 10 and the side effects are kicking in. I have breast tenderness, stomach cramps and I makes me very tired. Overall so far it has done what it needs to do. I go off of it in 2 days I'm hoping that my body will regulate.

Review by kbehunin: User Rating: 7.0

... (progesterone) for Perimenopausal Symptoms: Taking it at 100 mg. Didn't like the dizzy feeling. Started taking it at night, much better but I feel it building up in my system over time. I wish I could take half or 3/4 as much but it is not available in those doses. I have absorption issues and the liquid form is great except I can't cut it in half. I do like what it does for my thinking, digestion, emotions etc but over time irritability, heavy-dreaming, pregnant-like feeling build-up. I am a small woman about 110lbs, 5 feet and wish smaller doses were available. A little bit goes a long way.

Review by Dawn in NJ: User Rating: 8.0

... (progesterone) for Amenorrhea: Prescribed by my gynecologist to treat amenorrhea and long, heavy periods as a result of anovulation (I have polycystic ovarian syndrome which causes anovulation). Due to the anovulation, I would go several months without a period only to eventually have a period which would last anywhere from 14-35 days. The period would be much heavier than the norm, especially for the first 7-10 days. I would also have very large clot-like discharge. I take ... for 21 days, then off for 7 days(which brings on my period). The only significant side effect has been hot flashes during the day, usually in the late morning I will have one bad one with profuse sweating. Then usually one in the afternoon but it's not as bad.