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Your Health
During Menopause

What Is Menopause?
What IS A Hot Flash?
34 Signs of Menopause
Meno Survival Tips
Bioidentical Hormones
Revival Soy Protein
About Your Hormones
The HRT Controversy
Testosterone Benefits
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Progesterone and Women's Health

Menopause is not an estrogen-deficiency disease as the media and pharmaceutical companies seem to portray it. In fact, if we were to base our understanding of hormones on the media as opposed to the physiology books, we might think the only hormone a man made was testosterone, and the only hormone a woman made was estrogen. Well, it's time see ourselves as we truly are, hormonally.

Both men and women produce estrogen and testosterone, as well as numerous other hormones that also play important roles in who we are and how we feel. Women however, produce more estrogen, while men produce more testosterone. And then there's progesterone, until recently relatively unheard of by the lay public and wholly under-appreciated next to the media-blitzed estrogen.

Progesterone plays an integral part in a woman's life and the life of the human species as well. When scientists first discovered progesterone at the turn of the century, it was named after its only known action of that time, "pro" meaning in support of, and "gestation" meaning pregnancy. For years to follow, the only recognized role of progesterone was to support pregnancy.

Like all of our steroid hormones, progesterone is formed in the body from cholesterol. It is made predominantly in the ovaries, with small amounts produced by the adrenal cortex and other tissues, such as nerves. In a woman's body the majority of progesterone is secreted by the corpus luteum, which forms in the ovary following ovulation. For half of each monthly cycle, from ovulation until menses, progesterone is designed to be the dominant hormone. Progesterone plays a role in the orchestration of other hormones at ovulation and is linked in some literature to a rise in libido. Other reproductive roles include preparing the environment of the uterus for implantation of the fertilized egg, and enhancing the sperm's ability to reach the egg.

Progesterone and Fertility

Not all women produce sufficient progesterone during the second half of their cycle, leading to symptoms of estrogen dominance, such as bloating, breast tenderness, irritability, PMS mood swings, cravings for sweets, and more. These women may also have difficulty conceiving and maintaining a pregnancy. When a woman becomes pregnant, the placenta, or sac that forms around the fertilized egg, takes over the production of progesterone from the corpus luteum at approximately weeks 8-12, producing steadily more progesterone each month. By the time a woman reaches the third trimester, the placenta is producing upwards to 300 mg of progesterone each day. This is significantly more than the 20-30 mg produced daily by the corpus luteum from ovulation until menses. Progesterone plays a critical role in fetal development as well as in maintaining the pregnancy. Approximately 10% of cases of infertility are associated with luteal phase defect, a condition of too little progesterone during the second half of the menstrual cycle.

PMS and Progesterone

Dr. Katharina Dalton, a British physician, originally coined the term "premenstrual syndrome" (PMS) in 1953 and soon after established the world's first PMS clinic in London. Dalton was one of the first physicians to recognize the pattern of symptoms that occurred for some women one to two weeks before their period started. Far from being "all in her head," PMS can cause mental, emotional, and/or physical symptoms. PMS may be the result of hormonal changes, inadequate nutrition, lack of exercise, and physical and/or emotional stress.

Twenty to ninety-five percent of women experience premenstrual syndrome, with 10-12% severely affected. Some of the more common symptoms associated with PMS include: mood swings, painful menses, food cravings (especially salt and sweets), bloating, abdominal swelling, constipation, frequent urination, breast tenderness, backache, forgetfulness, irritability, and migraines. Many symptoms related to PMS can be attributed to "estrogen dominance," a condition of relative excess estrogen activity in the body. This can be caused by too much estrogen, or by sub-normal levels of progesterone.

Researchers over the last forty years have identified four major types of PMS, determined by a woman's predominant symptoms. Some women have only one group of symptoms, while others suffer with a combination of two or more symptom groups. Of the four PMS types, three may benefit from progesterone supplementation. Clinically, physicians have seen as high as an 80% response rate with the use of supplemental progesterone.

Progesterone has many opposite, balancing activities to those of estrogen. In addition to normalizing blood sugar levels and water metabolism, progesterone also has a calming effect on the central nervous system. Supplemental progesterone during the luteal phase of the reproductive cycle (days 14-28), has been found to address many of the symptoms of PMS listed above.

Progesterone and Menopause

Natural menopause is defined as the cessation of menses as a result of the normal decline in ovarian function. Women may experience a wide range of symptoms in varying degrees of severity, or they may experience no symptoms at all. Some of the signs and symptoms associated with menopause include, but are not limited to: hot flashes, sweating, fatigue, nervousness, irritability, dizziness, numbness, palpitations, insomnia, depression, vaginal dryness and/or pain, nausea, gas, urinary incontinence, pain with urination, constipation, diarrhea, joint pain, and muscle pain. Prior to menopause, as ovarian function wanes, cycles frequently occur where a woman does not ovulate. This period leading up to menopause is referred to as perimenopause.

Anovulatory cycles that begin in the perimenopause can lead to hormone changes that may result in hot flashes, changes in bleeding patterns, PMS-type symptoms, as well as many other menopausal symptoms. Progesterone levels fall close to zero due to anovulatory cycles, while estrogen levels only decline to about 40-60% of pre-menopausal levels. This precipitous drop in progesterone can lead to an imbalance between estrogen and progesterone, causing a relative "estrogen dominance" within the body. Many women report a decrease in hot flashes and other symptoms with progesterone supplementation, which has been supported by recent research evaluating the effectiveness of topically applied progesterone cream.

Progesterone has a number of important roles relative to menopause. Progesterone is the natural balancer to estrogen, as well as being necessary for optimum estrogen utilization. The presence of progesterone in the body sensitizes both estrogen and thyroid hormone receptor sites, enabling the body to use these hormones more efficiently. Research over the years has also elucidated other protective roles for progesterone in the heart, blood vessels, nerves, and brain.

Progesterone Supplementation

It is important to note that the roles of progesterone differ considerably from those of its synthetic counterparts, such as medroxyprogesterone acetate and others commonly utilized in oral contraceptives and HRT. Synthetic progestins further complicate the issue of hormonal balance as they have been shown to reduce the concentration of natural progesterone in the body. They also compete with natural progesterone for receptor binding, decreasing the body's utilization of progesterone.

Originally, progesterone was only available through suppositories and injections. In 1979, it became available in a cosmetic cream, which allowed for absorption through the skin. Progesterone is well tolerated and absorbed through the skin as is seen with other hormones, such as testosterone, scopolamine, and estrogen. Progesterone is also available in oral, cream and gel micronized forms. Only progesterone creams marketed as cosmetics provide progesterone without a prescription. It's important when purchasing a progesterone cream product that progesterone is listed on the label. Many companies today are producing "wild yam" creams that contain a concentrated extract of wild yam, Dioscorea villosa. Wild yam contains substances that can be converted to natural progesterone in a laboratory; however, the body does not have the ability to convert wild yam extract into progesterone. Because neither oral nor skin applications of wild yam extracts can affect progesterone levels in the body, they are not effective substitutes for natural progesterone supplementation.

Consulting with a naturally-minded physician can often facilitate managing menopause and PMS naturally. Many women have found success on their own through the use of herbs, nutrients, natural hormones, and dietary and lifestyle changes that can markedly affect well being. Use of these approaches for women with serious health conditions should be undertaken with the guidance of a licensed health care provider.

Read more about progesterone and other natural hormones.

Mahesh VB, Brann DW, and Hendry LB. "Diverse modes of action of progesterone and its metabolites." J Steroid Biochem Molec Biol 1996;56(1-6):209-219.
Lee J. Natural Progesterone-Multiple Roles of a Remarkable Hormone. BLL Publ., Sebastopol, CA, 1993.
Speroff L, et al. Clinical Gynecologic Endocrinology and Infertility, 5th Ed. Williams and Wilkins, Baltimore, MD, 1994.
Zarutskie PW et al. "Early luteal progesterone supplementation during in vitro fertilization cycles: a randomized trial." Journal of Reproductive Medicine 1992; 37(3).
Murray MT. "A comprehensive evaluation of premenstrual syndrome." Am J Nat Med 1997;4(2):6-21.
Speroff L et al. Clinical Gynecologic Endocrinology and Infertility, 5th Ed. Williams and Wilkins, Baltimore, MD, 1994.
Jordan J, et al. "Luteal phase defect: the sensitivity and specificity of diagnostic methods in common clinical use." Fert Steril 1994;62(1):54-62.
Zarutskie PW, et al. "Early luteal progesterone supplementation during in vitro fertilization cycles; a randomized trial." Journal of Reproductive Medicine 1992; 37(3).
Dalton K. The Premenstrual Syndrome. Year Book Medical Publ., Inc. Chicago, IL, 1977.
Murray MT. "A comprehensive evaluation of premenstrual syndrome." Am J Nat Med 1997;4(2):6-21.
Lurie S, Borenstein R. "The premenstrual syndrome." Obstet & Gynecol Surv 1990;45(4):220-228.
Lauersen N. "Diagnosis and management of premenstrual syndrome." Hosp Med 1989; March 15:68-80.
Dalton K. The Premenstrual Syndrome. Year Book Medical Publ., Inc. Chicago, IL, 1977.
Leonetti H, et al. "Trandsdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss." Obstet & Gynecol 1999;94(2): 225-228.
Bicikova M, et al. "Serum levels of neurosteroid allopregnanolone in patients with premenstrual syndrome and patients after thyroidectomy." Endocr Regul 1998;32(2):87-92.
Backstrom T, et al. "Effects of intravenous progesterone infusions on the epileptic discharge frequency in women with epilepsy." Acta Neurol Scand 1984:69:240-248.
Lee WS, et al. "Progesterone inhibits arterial smooth muscle cell proliferation." Nat Med 1997;39:1005-8.
Martorano J, Ahlgrimm M, Colbert T. "Differentiating between natural progesterone and synthetic progestins: clinical implications for premenstrual syndrome and perimenopause management." Comp Ther 1998;24(6/7):336-339.
Martorano J, Ahlgrimm M, Colbert T. "Differentiating between natural progesterone and synthetic progestins: clinical implications for premenstrual syndrome and perimenopause management." Comp Ther 1998;24(6/7):336-339.
Kimzey LM, et al. "Absorption of micronized progesterone from a nonliquefying vaginal cream." Fertility and Sterility 1991; 56: 995-996.
Burry K, et al. "Percutaneous absorption of progesterone in postmenopausal women treated with transdermal estrogen." Am J Obstet Gynecol 1999;180(6):1504-1511.

By power-surge.netntributor:
Dr. Deborah Moskowitz





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