Progesterone hormone benefits and progesterone side effects by Ray Sahelian, M.D. Information on progesterone cream and natural alternatives to progesterone hormone treatment

Progesterone is a naturally occurring steroid hormone. In nonpregnant women, the main sites of progesterone synthesis are the ovaries and the adrenal cortices. Because of the poor oral absorption of progesterone and its susceptibility to rapid first-pass metabolism in the liver, a variety of oral, injectable and implantable synthetic analogs, called "progestins," have been developed. Progestational agents have many important clinical functions, including regulation of the menstrual cycle, prevention of endometrial hyperplasia, treatment of abnormal uterine bleeding and contraception.

Some thoughts about natural progesterone
Because of the reported side effects of synthetic analogs called progestins, there has been interest in replicating the natural hormone for clinical use. Natural progesterone is obtained primarily from plant sources and is currently available in intradermal, injectable, intravaginal and oral formulations. An oral micronized progesterone preparation has improved bioavailability and fewer reported side effects compared with synthetic progestins.
  
Natural progesterone is obtained from compounds derived from soybeans and Mexican yam roots, and occasionally from animal ovaries. The hormone is not available from any natural source without extraction and synthesis.
   Oral micronized progesterone is available. Micronizing is a process designed to increase the half-life of progesterone and reduce its destruction in the gastrointestinal tract. Micronization decreases particle size and enhances the dissolution of progesterone. Maximal serum concentrations are achieved more rapidly with orally administered micronized progesterone than with injected progesterone. Absorption of micronized progesterone is enhanced twofold when the hormone is taken with food. However, this may also increase progesterone side effects.

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Source Naturals Eternal Woman Natural Progesterone Cream is intended for women of all ages. It features progesterone USP from soy. Our Progesterone Cream is guaranteed to contain 500 mg of progesterone per ounce and 22 mg per 1/4 teaspoon.

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How's is natural progesterone made?

The human body uses a natural hormone called pregnenolone to convert into progesterone. While oral progesterone is only available by prescription, pregnenolone is sold over the counter. The biological actions of pregnenolone hormone somewhat overlap with that of progesterone hormone.

Alternatives to progesterone hormone
There are several supplements without hormones that could address some of the problems that are sometimes recommended to be solved with progesterone. It is best to limit the use of hormones since they can have serious side effects.

Consider these highly popular all natural products: Mind Power Rx for better mental focus, concentration, and mood; Diet Rx which helps you eat less. It really does curb appetite; Good Night Rx for better sleep; Eyesight Rx for better vision, often within days; MultiVit Rx a daily comprehensive multivitamin for more energy and vitality; Joint Power Rx for healthy joints; and Passion Rx for sexual enhancement, better libido, and stamina in men and women.


Benefit of progesterone cream

Transdermal progesterone cream is promoted as an alternative to hormone replacement therapy for symptoms of menopause. It has been difficult to interpret and make sense of many studies with progesterone cream. Progesterone metabolism is complex, and transdermal skin application in varying dosages and concentrations make interpretations of studies quite difficult. Some women benefit from progesterone cream application, others may not. Various dosages of progesterone cream and concentrations are available over the counter and by prescription. One option is to use a low dosage progesterone cream available over the counter to see if this works for you before resorting to higher potency skin creams available by prescription.

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Uses of progesterone hormone
Progesterone is used as a part of hormone replacement therapy in women who have passed menopause (the change of life) and have not had a hysterectomy (surgery to remove the uterus). Hormone replacement therapy usually includes estrogen, which is used to treat symptoms of menopause and reduce the risk of developing certain diseases. However, estrogen can also cause abnormal thickening of the lining of the uterus and increase the risk of developing uterine cancer. Progesterone helps to prevent this thickening and decreases the risk of developing uterine cancer. Progesterone is also used to bring on menstruation (period) in women of childbearing age who have had normal periods and then stopped menstruating. Progesterone is in a class of medications called progestins (female hormones). It works as part of hormone replacement therapy by decreasing the amount of estrogen in the uterus. It works to bring on menstruation by replacing the natural progesterone that some women are missing.
   Adolescents and perimenopausal women may require progestational agents for the treatment of dysfunctional uterine bleeding resulting from anovulatory cycles. These agents may also be used in women at risk for endometrial hyperplasia because of chronic unopposed estrogen stimulation. Progestin-only contraceptives can be used in women with contraindications to estrogen; however, efficacy requires rigorous compliance. New progestins for use in combination oral contraceptive pills were specifically developed to reduce androgenic symptoms. It is unclear whether these progestins increase the risk of venous thromboembolic disease (blood clots).

Progesterone balance
Progesterone plays an important role in postovulatory regulation of the menstrual cycle. Under the influence of luteinizing hormone, the corpus luteum secretes progesterone, which stimulates the endometrium to develop secretory glands. The corpus luteum produces progesterone for approximately 10 to 12 days of the cycle. If a fertilized ovum is not implanted, progesterone and estrogen levels decline sharply, resulting in menstrual bleeding. If fertilization occurs, progesterone supports implantation of the ovum and maintains the pregnancy.

Progesterone side effects
Progesterone may cause side effects if the blood progesterone level is too high. Some of these side effect symptoms Include: headache, breast tenderness or pain, irritability, gastrointestinal symptoms, tiredness, muscle, joint, or bone pain, insomnia, and mood swings.

Q. I wanted to comment that natural progesterone is not the best thing for everyone. I am 45, in perimenopause and have had a hysterectomy. A doctor prescribed oral micronized progesterone (starting at 100mg then up to 400mg) every night, telling me that it would help me sleep. It did give me a very drunk feeling after I would take it but it never really helped me to sleep better. After a few weeks I started having trouble with insomnia, anxiety every morning, acne, nervousness. The doctor suggested this was because I needed even more progesterone and to up the dose, which I did. It just made everything worse. I stopped the progesterone and after several weeks the anxiety went away and I was finally able to sleep OK again. I then found out that one of the major metabolites of oral progesterone is allopregnanolone which is a potent natural benzodiazepine. Some studies I read suggest that chronic exposure to too much allopregenanolone causes anxiety. This was my experience. I had a rough several weeks after stopping the progesterone – just like one might after taking a benzodiazepine. I was not aware that for some people progesterone can have such a negative affect until it actually happened to me. There is so much hype on the internet about progesterone with no mention that for some women it apparently can have a negative and not positive affect. Previous to trying the oral progesterone, I had tried the progesterone cream (30mg a day). It was also not helpful. As I understand it, the reason oral progesterone is “supposed” to help you sleep is not because of the progesterone but because of the allopregnanolone produced when it is metabolized in the liver. I wish I had been more aware of some of the potential downsides of oral progesterone before I took it so that I would have realized sooner than it was not for me.
   A. Thanks for sharing your progesterone side effect experience. Hormones are very powerful, and low dosages can sometimes be helpful while high dosages cause side effects. In my opinion, 100 mg is a very high dose, and sometimes a lower dosage of 10 mg or so can help women while higher amounts cause side effects. This may be true of sleep. Low progesterone dosage may help with sleep while higher amounts can cause insomnia.
      Q. Thank you so much for the response and the comment about a lower dose. I have recently increased my estradiol (Vivelle patch) and am sleeping much better for now. Since I have a history of endometriosis I do have a concern that the increased estradiol will reactivate the problem/pain that I had for so long… time will tell. I hope it doesn’t end up being a trade of one (disturbed sleep) for the other (endo pain). I will very much keep in mind the idea of a much smaller dose of progesterone and really appreciate your comment. The doctor who prescribed it to me has patients on 800-1000mg of progesterone to help them sleep! Anyway, I never expected to receive a response so it was a nice surprise. I definitely have found over the last two years that for me, more of a good thing is not always better… in fact, more of a good thing has often been worse… so I agree with Dr. Sahelian’s methods of supplementing in small doses and appreciate him being realistic amid all the “hype” about supplements.

Q. I feel it important to mention that there are many more side effects of topical progesterone cream than those listed on your web site. Namely, progesterone withdrawal can lead to severe side effects similar to those experienced when withdrawing from a benzodiazepine. Also, hair loss is a major problem as well, although full recovery is expected when progesterone is stopped.
   A. Thanks for letting us know your personal progesterone use experience.

How is progesterone available?
Progesterone is sold as an injection, cream, progesterone pill ( capsule, tablet ), and as progesterone suppository.

Absorption of progesterone cream
Women who use over-the-counter progesterone creams could be exposed to hormone levels comparable to those used in a form of hormone replacement therapy. A study compared one brand of progesterone cream with a prescription oral progesterone that, like the cream, is derived from plant sources and provides a hormone that is structurally identical to the natural progesterone in a woman's body. The prescription product, Prometrium, is used as part of hormone replacement therapy after menopause, and for restoring menstruation in younger women whose periods have stopped because of another illness. The study found that the over-the-counter progesterone cream, when taken as the label directs, exposed study volunteers to as much hormone as the prescription did. The potential problem stems from the fact that these creams are categorized as herbal beauty products and women use them without medical supervision -- for a range of conditions the products purportedly aid, from PMS to hot flashes to osteoporosis. Due to the imprecise nature of using a progesterone cream means there is a high probability of taking more than the intended or ideal dose.

Progesterone danger with Depo Provera
Contraception with depot medroxyprogesterone acetate is associated with an increase in the risk of diabetes in some Latino women with prior pregnancy-related or "gestational" diabetes. Depot medroxyprogesterone (DMPA) contraceptives are given by monthly injections, and are often referred to by one brand name, Depo Provera.

Using the contraceptive Depo-Provera ( brand name for medroxyprogesterone acetate) is associated with bone loss. Depo-Provera, also known as DMPA, is a long-lasting contraceptive hormone that is injected every three months. Dr. M. Kathleen Clark and colleagues at the University of Iowa in Iowa City compared changes in bone mineral density in 178 women starting on Depo-Provera for the first time and 145 women not using hormonal contraception. Average bone density at the hip fell 2.8 percent one year after starting Depo-Provera and 5.8 percent after two years. Loss of bone density in the spine was similar. In contrast, average bone loss at the hip and spine was less than 0.9 percent among the comparison group of women, the team reports in the medical journal Fertility and Sterility. The U.S. Food and Drug Administration has issued a black box warning on Depo-Provera stating, in essence, that bone density is lost and may not be regained, particularly when it is used for more than two years.

Progesterone Research Update
Progesterone: the forgotten hormone in men?
Aging Male. 2004 Sep;7(3):236-57. Oettel M, Mukhopadhyay AK.
'Classical' genomic progesterone receptors appear relatively late in phylogenesis, i.e. it is only in birds and mammals that they are detectable. In the different species, they mediate manifold effects regarding the differentiation of target organ functions, mainly in the reproductive system. Surprisingly, we know little about the physiology, endocrinology, and pharmacology of progesterone and progestins in male gender or men respectively, despite the fact that, as to progesterone secretion and serum progesterone levels, there are no great quantitative differences between men and women (at least outside the luteal phase). In a prospective cohort study of 1026 men with and without cardiovascular disease, we were not able to demonstrate any age-dependent change in serum progesterone concentrations. Progesterone influences spermiogenesis and testosterone biosynthesis in the Leydig cells. Other progesterone effects in men include those on the central nervous system (CNS) (mainly mediated by 5alpha-reduced progesterone metabolites as so-called neurosteroids), including blocking of gonadotropin secretion, sleep improvement, and effects on tumors in the CNS (meningioma, fibroma), as well as effects on the immune system, cardiovascular system, kidney function, adipose tissue, behavior, and respiratory system. A progestin may stimulate weight gain and appetite in men as well as in women. The detection of progesterone receptor isoforms would have a highly diagnostic value in prostate pathology (benign prostatic hypertrophy and prostate cancer). The modulation of progesterone effects on typical male targets is connected with a great pharmacodynamic variability. The reason for this is that, in men, some important effects of progesterone are mediated non-genomically through different molecular biological modes of action. Therefore, the precise therapeutic manipulation of progesterone actions in the male requires completely new endocrine-pharmacological approaches.

Soymilk or progesterone for prevention of bone loss--a 2 year randomized, placebo-controlled trial.
 Eur J Nutr. 2004 Aug;43(4):246-57. Epub 2004 Apr 14.
Given concerns over the use of hormone replacement therapy (HRT), women are seeking natural alternatives to cope with the symptoms and effects of menopause. The bone sparing effects of soy protein and its isoflavones is well established in animal studies, while 5 previous human studies on soy and bone have yielded variable outcomes due in part to their short duration of study. Progesterone has been suggested as a bone-trophic hormone, but the effect of long-term, low dose transdermal progesterone is unknown. AIM: The aim of the study was to compare for the first time the long-term effects of soymilk, with or without isoflavones with natural transdermal progesterone, or the combination, on bone mineral density in the lumbar spine and hip. METHODS: Postmenopausal, Caucasian women with established osteoporosis or at least 3 risk-factors for osteoporosis, were randomly assigned, double-blind to one of four treatment-groups: soymilk containing isoflavones (soy+, n = 23), transdermal progesterone (TPD+, n = 22), or the combination of soy+ and TDP+,(n = 22) or placebo (isoflavone-poor soymilk, soy/ and progesterone-free-cream TDP/, n = 22). All subjects received comparable intakes of calcium, minerals and vitamins. Bone mineral content (BMC) and density (BMD) were measured in lumbar spine and hip by using dual-energy X-ray absorptiometry (DEXA) at baseline and after 2 years. The percentage change in lumbar spine BMD and BMC respectively, did not differ from zero in the soy+ group and TDP+ group but significant bone loss occurred in the control group and the combined treatment group. No significant changes occurred for femoral neck BMD or BMC. Daily intake of two glasses of soymilk containing 76 mg isoflavones prevents lumbar spine bone loss in postmenopausal women. Transdermal progesterone had bone-sparing effects but when combined with soy milk a negative interaction between the two treatments occurs resulting in bone-loss to a greater extent than either treatment alone.

Progesterone emails
Q. Can DHEA convert to progesterone in some women, rather than estrogen and testosterone?
   A. Pregnenolone converts into DHEA and progesterone. DHEA does not convert into progesterone, rather it converts into estrogen and testosterone.

Q. After reading about progesterone, pregnenolone and DHEA is there any way to stimulate the body to make it's own progesterone? Or what is the best way? It's all rather confusing.
  A. We're not aware of a way to stimulate progesterone by itself.


Q. Natural Progesterone:  The Multiple Roles of a Remarkable Hormone" (written for doctors by Dr. John R. Lee (a brilliant man who wrote this to enlighten all doctors for themselves and their patients).  He saved me as I had a horrific time with PMS and then Pre-Menopause and learned through his groundbreaking book (for we lay-people), "What Your Doctor May NOT Tell You About Menopause" the VALUE of natural progesterone cream (the best delivery system to replenish what naturally dissipates with age (NO not the estrogens, the progesterone hormone--not the SAM-e in one of the latter comments here in these recommendations--the progesterone is what needs to be replaced to feel completely normal again.  The lie of using estrogen goes back about 80 years when the discovery of the tropical oils to make bio-identical progesterone (by Russell E. Marker Ph.D.--a biochemist at Pennsylvania State U. in the 1920s) was a discovery that Dr. Marker gave to society (No Prescription Needed).  To make the billions that the pharmaceutical industry has been raking in for years, they had to push and promote the use of estrogen (which does require a prescription).  You know the problems that have ensued as women DO NOT need more estrogen.  And certainly not the synthetic kind either (that will kill us).  So many problems exist for women now as the estrogen has been accepted as the hormone to replace.

Q. What is your opinion regarding taking oral progesterone for individual with candida over growth, candida infection, or food allergy?
   A. Firstly, I am skeptical of a candida diagnosis. Second, I have not seen studies regarding the use of progesterone in relation to real candida overgrowth.

Q. I love your newsletters. Do want to comment as a 55 year old who is finally through menopause, that besides the black cohosh (I didn't use the St. John's Wort), I found progesterone cream, pharmaceutical grade, very helpful for moods, and hot flashes.

Q. When I'm not on any birth control, my sex drive was normal, and my husband and I had sex 5-7 times a week. Now that I'm back on my progesterone depo shots again, my sex drive has decreased and we haven't had sex in two weeks. I feel horrible, because I'm just not interested in sex. I love him and our life together is great overall, but when I'm on the shot, my drive just isn't there. But, I don't know if Passion Rx would be right for me. I don't have any heart conditions, and the only medication I'm on is the depo. I have a medical condition, but it's orthopedic, so I don't think this supplement would affect it at all. I guess I just want to know if Passion Rx would help a decreased sex drive due to birth control.
   A. It's very difficult to predict whether an aphrodisiac herb or a sex formula will help any particular individual. It's like asking if Viagra will help a man. It can in 60 to 70 percent of cases, but one cannot say any medicine or herbal supplement will help a person for certain. The only way to tell is by trial and error.

Q. I was on natural progesterone cream for thr previous 2 months and I was seeing a great difference in my PMS (which I wasn't having until about 6 months ago) and my libido was getting better. I went to see my gynecologist who by the way pooh pooh's natural progesterone cream, regardless I've read Dr. Lee's book (which she rolls her eyes at as well). I can't seem to find a Dr. that doesn't. My problem is that I am going to go in and have the "Essure" procedure done for my sterilization method and my gyno said I had to be on Depo-Provera for at least 2 months prior to the procedure as it cleans and slicks out my uterus so she has a clear path for the Essure implants. My question is: can I continue the natural progesterone cream safely while I am on the Depo-Provera shots? Please any help with this would be greatly appreciated as no one here in Canada is really familiar with using both at the same time. By the way Depo is driving me bonkers, can't wait to get off of it.
   A. This is a type of personal question are not in a position to respond to.

Q. Could you please tell me if this cream put out by Dr. Helen Pensanti natural progesterone cream / red clover/ wild yams would be causing tingly sensations around my eyes and nose been using this for a wk. and 4 days didn't have this till then.
   A. You may wish to ask Dr. Helen Pensanti since we are not familiar with this progesterone cream product.

Q. Is there any need for progesterone cream if a pregnenolone supplement is taken?
   A. It depends on the amounts used since progesterone cream and pregnenolone have overlapping functions.

Q. Can progesterone cream be applied the same day as taking a resveratrol pill?
   A. Probably but there is no research combining the two.

Q. Q. I have comment on the hormone replacement therapy section of Dr. Sahelian's newsletter 2007 January. I am assuming one of the bioidentical hormone supplements mentioned would be progesterone cream, derived from yam. For sometime, as a premenopausal woman, and now a postmenopausal woman, I have used this progesterone cream supplement with excellent results. First, I used Dr. Lee's (His well known book about what women should know about menopause is excellent) recommendations, but of late, have been using it under the direction of both an MD, and a nutritionist / chiropractor with years of experience in holistic health. This last physician has carefully measured the levels of progesterone in my body, and prescribed the dose accordingly. The point I want to make is that given the role of progesterone in the body, and it's amazing ability to counteract the deleterious effect of estrogen like compounds that we are subject to (i.e. plastics , pesticides, herbicides and numerous other things ) my doctors, and a number of others I know are giving women like me great relief from the symptoms of excess estrogen in the body. These symptoms include hot flashes, sleeplessness, heart palpitations, fatigue, depression, propensity to low blood sugar just to name a few. Because the progesterone cream bypasses the liver, small doses can be used, and adjusted to comfort levels. Then, saliva testing done regularly to ascertain levels helps to ensure adequate, but not excess therapeutic levels. I am sure not many studies have been done using progesterone cream, because it is cheap, and no one stands to make a fortune (i.e. a drug company) selling it. But results are all that counts with me, especially when I can measure by the saliva test just how much I need. Just wanted to give this input, as have not seen much about it in your letters. I know lots of women personally who have achieved results with this progesterone cream method. Thanks for all your excellent letters.
   A. Thank you for your email. The field of hormone replacement therapy is very complicated and each woman has to find out for herself the best way to achieve this and you seem to have done so for yourself. Congratulations. As to progesterone cream, I think there is good potential here that is not being taken advantage of by many doctors, and with time I will evaluate more studies on this topic.

Q. Re: Progesterone cream side effects. I have been using natural progesterone cream. It is somewhat helpful with hot flashes. However, the downside for me is that it causes depressive moods. Since my use of other HRT was discontinued abruptly, I need to be able to continue using this progesterone cream to treat menopausal symptoms, while finding a supplement to remedy the depressive mood effects. Which of Dr. Sahelian mood remedies would be best to help counteract the depressive effects of the natural progesterone?
   A. We can't give any specific advice on specific supplements, but we can refer you to the page on depression that you could look over with your doctor.

Q. I have found a cream (800mg of bioidentical progesterone USP) that has both progesterone and pregnenolone in the formulation. What are the benefits to using a pregnenolone and progesterone cream and what are the possible disadvantages if any? My personal experience with the combination cream has been good to relieve foggy thinking that happens around day 14-16. Now I'm feeling better then all of a sudden now around day 22 I'm dealing with swollen hurting breasts and sleeplessness. I thought progesterone cream was suppose to take away swollen breasts and help you to be calm and sleep better.
   A. The dosage of any medicine has an enormous influence on the effects. A medicine can be beneficial or harmful depending on how much of it is used and how often. High doses of many hormones, particularly pregnenolone, lead to to insomnia. I am not familiar with the use of a combination pregnenolone and progesterone cream.

Q. I have read the article on progesterone. I am a 27 year old man who suffers benign prostatic hyperplasia (BPH) and Male pattern hair loss. I have read Dr. John Lee article, He said that progesterone was found to be a natural and significant 5aR inhibitor. I started to use about 10mg progesterone cream per night. It reduce oily on my scalp obviously, my prostate also improve. I believe that the level of my DHT decrease. I feel comfortable during intercourse. (I don't want to use Proscar because of the side effect of impotence). I feel very well after using the cream. However, After 10 days, I noted that my breast is being enlarge.

See a list of hormones 

Additional links
Cordyceps mushroom, libido herbs gaba has been marketed for stress, kava is useful for anxiety ahcc for immune carnosine as an antioxidant

This progesterone page was last updated February 2008.