The Overlooked Importance of Progesterone in Women’s Health

Progesterone, sometimes demonized by traditional health practitioners, may alleviate some symptoms of hormonal imbalance in women.
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Often overshadowed by its hormonal counterpart, estrogen, progesterone may be the unsung hero of women’s health.

This hormone plays a crucial role in regulating estrogen’s effects, potentially alleviating symptoms of menopause, premenstrual syndrome (PMS), and other common health issues. As experts challenge the estrogen-centric approach to women’s wellness, a growing body of research suggests that progesterone deserves more attention.

The Interplay of Estrogen and Progesterone

Progesterone was initially named due to its prevalence during pregnancy because it supports gestation, helping the fertilized egg implant in the uterus, creating a receptive uterine lining for the embryo, and strengthening the pelvic wall muscles. However, that is not the hormone’s only function. One of the primary roles of progesterone is to modulate the mitogenic or proliferative effects of estrogen. Estrogen is responsible for cellular division and growth, which accounts for the development of a young woman’s body as she undergoes puberty, such as widening hips, breast development, and the triggering of menstruation. But too much of it can wreak havoc on a woman’s hormonal balance, resulting in everything from breast cancer to hair loss to acne.

Some experts say that estrogen is the gas pedal and progesterone the brakes. Estrogen is like the lion and progesterone the lion tamer, mainly because without the regulation of progesterone, estrogen can indeed run rampant, with deleterious effects, Kitty Martone, holistic health practitioner and CEO of Ona’s Natural, a company that provides bioidentical hormone replacement therapy (HRT), told The Epoch Times.

Symptoms of excess estrogen include leg cramps, uterine and breast fibroids, accumulation of fat in the hips, thighs, and back of arms, and vaginal bleeding. Progesterone keeps estrogen from going rogue and growing things when it shouldn’t.

“Progesterone and estrogen do this dance together,” Martone said. “It’s really important that no matter what estrogen is doing, progesterone is there to support and regulate it.

“Estrogen dominance, therefore, is not just a case of excess estrogen, but estrogen unregulated by progesterone. No matter how much or how little estrogen a woman produces, unmitigated estrogen can cause this hormonal imbalance.”

Factors such as excess weight, hormonal contraceptives, stress, and lack of sleep can increase estrogen production, making it even more difficult to maintain the balance between progesterone and estrogen. Xenoestrogens, or substances that mimic the effects of estrogen, such as glyphosate, pesticides, and parabens, can also contribute to elevated estrogen levels.

A 2020 study aimed to shift the focus in women’s health from estrogen alone to a more comprehensive view that includes progesterone. The authors emphasized the need for more funding to support research on women’s health throughout all life stages, recognizing the complex, multidimensional relationship between estrogen and progesterone.

Progesterone Versus Progestin

Many doctors have taken a cautious approach to prescribing progesterone due to studies linking excess progesterone to blood clots and thrombosis. Carol Petersen, a registered pharmacist and certified nutritional practitioner, emphasized to The Epoch Times the difference between bioidentical progesterone and its synthetic version, progestin, which is usually prescribed alongside estrogen in HRT.
Progestin, created in a lab, mimics the effects of naturally occurring progesterone but can have different side effects and safety concerns. Synthetic progestins, like those used in birth control products such as pills and intrauterine devices (IUDs), have been found to result in high blood pressure, hair loss, anxiety and depression, and an increased risk of breast cancer.
However, one study found that natural progesterone used with estrogen in HRT doesn’t increase health risks, unlike progestin.
Another study demonstrated that natural progesterone and some of its derivatives do not exert any androgenic effect and, hence, have no negative impact on lipids affecting cardiovascular health. Cardiovascular disease is one of the most significant health risks to older women and was the impetus for the Women’s Health Initiative study in the early 2000s, which was abruptly halted because the researchers found that women taking a combination of estrogen and progestin had an increased risk of breast cancer, heart attack, stroke, and blood clots.

Many women go through life with progesterone deficiency, Petersen told The Epoch Times. She said there is “a lot of ignorance about what a progesterone deficiency looks like” among both practitioners and their patients.

For example, women are often told that estrogen is the cure for hot flashes. An article on the Harvard Health Publishing website about perimenopause states that “the most effective treatment for severe hot flashes and night sweats is estrogen.”
Petersen deviates from this popular opinion. She cited research from Jerilynn Prior, a professor of endocrinology and metabolism at the University of British Columbia in Vancouver, British Columbia, who has spent her career studying the effects of the menstrual cycle’s changing estrogen and progesterone hormone levels on women’s health. Prior’s research states that progesterone effectively treats vasomotor symptoms such as hot flashes and night sweats, improves sleep, and “may be the only therapy that symptomatic women, who are menopausal at a normal age and without osteoporosis, need.”
Prior’s studies also demonstrate that along with estradiol, a pivotal female sex hormone, progesterone is crucial for increased bone formation through progesterone-specific osteoblast receptors. Women often experience a decrease in bone density during menopause, which may result in a heightened risk of fractures and breakage.

Still, Martone said she continues to see a stigma against progesterone among the medical community given its conflation with progestin and emphasizes the small but crucial difference: Progestins are one molecule off, which can make a difference between breast cancer and no breast cancer.

“It’s a big, big deal,” she said.

How Much Progesterone Is Enough?

According to Petersen, progesterone receptors are all over the body, and it’s a crucial hormone that performs many different functions that create a high demand for it. Therefore, she advises against the orthodoxy of starting with a lower dosage and incrementally increasing it. She often recommends her patients “start high and go higher” until symptoms find resolution. If progesterone is underdosed, she said, patients could be in a worse situation than when they started.

Unlike estrogen, Petersen said, one could “literally bathe in progesterone” with no serious side effects. Women often have to experiment with various methods of intake, including oral, transdermal, and suppository, to find the dosage and delivery method that works best for them to alleviate symptoms.

“Sometimes it can take hundreds of milligrams for patients to reach calm,” she said.

However, Petersen noted one caveat of higher progesterone dosages: candida, a fungal infection caused by an overgrowth of yeast that occurs in a woman’s vagina mainly during pregnancy or the luteal phase of her menstrual cycle. She recommends clearing all symptomology of candida before embarking on a progesterone supplement regimen, as progesterone can exacerbate the condition. Some find success relieving candida symptoms through diet and lifestyle changes, while others may require over-the-counter solutions, including boric acid suppositories or medication. More severe cases may call for a prescription to treat infection and symptoms.

How to Boost Production of Progesterone

Progesterone is synthesized from a chemical called diosgenin, which comes from wild yam or soy. However, the human body cannot make progesterone from diosgenin, so eating wild yam or soy will not boost progesterone levels. Zinc-rich foods such as oysters, beef, egg yolks, liver, nuts, and seeds can help increase progesterone production.

A healthy diet, exercise regimen, proper sleep hygiene, and stress management also keep hormone balance in check. Martone often recommends supplementing with magnesium, as its deficiency can disrupt hormone balance and reduce progesterone production.

Most women, however, require supplemental progesterone to boost levels, and both Petersen and Martone recommend bioidentical progesterone over its synthetic counterpart.

Many of Martone’s and Petersen’s patients have found relief with the types of protocols they suggest. Both recommend seeking a doctor, most likely a functional medicine doctor or specialist, who uses accurate testing methodologies and understands the complexity of hormonal fluctuations and how to prescribe bioidentical replacement therapies to maintain hormonal balance.

Petersen noted that progesterone can help a woman who feels like a victim of unknown forces to regain control of her life.

“She’s got the knowledge and she’s got the tools to bring her to calm and to bring back her normal personality,” she said.

This is a promising and hopeful message for women who often feel like their bodies are subject to the daily tribulations of fluctuating hormones.

Jennifer Galardi
Author
Jennifer Galardi spent decades as a health and wellness expert before receiving a masters in Public Policy from Pepperdine University. She writes about health, culture, and policy and her work can be seen in The New York Sun, The Blaze, and The American Spectator, along with countless health outlets.
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