How Much Progesterone Should I Take After Menopause
The best way to answer this question is to speak with your doctor. Your healthcare provider can review your health history and symptoms to determine the best progesterone dose for your unique concerns and needs.
In general, with hormones like estrogen and progesterone, the goal should be to address your symptoms by taking the lowest dosage for the shortest amount of time possible.
What About Hormone Pellets
Dr. Rebecca is quite adamant in her objection to pellets. Why? Because they can have pretty awful side effects, and once the pellets have been implanted, side effects or no, they cant come out.
Hormone pellets are tiny pellets no larger than a grain of rice that are surgically implanted under a patients skin or in muscle tissue. The pellets are intended to give a slow, continuous release of hormone. DHEA testosterone pellets are particularly popular for women hoping to revive their sexless marriage after menopause.
The problem with pellets is, again, theyre not FDA-regulated, and weve seen that they can give an exceedingly high dose of hormone depending on where and how deeply they were implanted. Many women suffer significant side effects as a result, especially with testosterone. Women think theyll get their libido back, have more energy, feel younger, and they may but they may also grow a beard, develop acne, have clitoromegaly, where the clitoris grows and becomes very like a small phallus, and develop a deeper voice. Those last two dont go away when the testosterone does. The small phallus and the deep voice are forever.
Effect On Glucose Metabolism
Several studies ,, have shown that non-diabetic postmenopausal women have significantly lower fasting blood glucose levels and even lower fasting insulin levels during oral estrogen or estrogen-gestagen treatment compared to placebo groups. The administration of progesterone is not expected to cause any relevant changes to glucose metabolism. The E3N Study also showed that administration of transdermal estrogen with micronized progesterone significantly reduced the risk for diabetes, even over a significant period of exposure. In contrast to synthetic gestagens progesterone has no detrimental effect on glucose balance.
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Why Do Progesterone Creams Work
Now that we know the qualities of progesterone, it makes sense that taking progesterone into the body ameliorates so many symptoms. Heres a quick summary of how progesterone creams work:
Benefits Of Progesterone Therapy During Menopause
There are many benefits of receiving progesterone therapy during menopause for women who are experiencing the unwanted symptoms that often accompany this change of life period. One of the most important reasons for the use of oral progesterone is to stop the effects of night sweats and hot flashes. Although these symptoms are merely annoying for some people, they can interfere with daily life for many others. There have also been studies that have shown the effectiveness of progesterone cream for the reduction of hot flashes, but dosage plays an essential role in this, and that is why treatment must be prescribed by a doctor following blood analysis.
Another benefit of progesterone treatment during menopause is to help a woman stop the more dangerous estrogen therapy without putting her body at risk of increased menopausal symptoms. Progesterone helps to stimulate the formation of new bone cells crucial for the prevention of osteoporosis.
The administration of oral progesterone treatment in menopause should occur before bed as it helps increase deep sleep. Progesterone creams are typically applied both in the morning upon rising, and at night before bed.
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Symptoms Of Low Progesterone After Menopause
The main symptoms of progesterone after menopause deficiency are:
- unreasonable fever and sweating ;
- excessive hair growth ;
- loss of elasticity of the skin;
- dry vagina, pain during sexual intercourse;
- mood swings, aggressiveness, irritability, poor sleep;
- sharp weight gain, swelling;
- nausea, vomiting;
- lowering of blood pressure .
Important! Progesterone hormone deficiency in postmenopausal women can trigger the development of serious gynecological diseases such as uterine myoma and endometriosis . In a neglected form, these pathologies can degenerate into malignant formations.
It is urgent to be attentive to yourself, do not neglect by the systematic visits to the doctor and keep the track of progesterone after menopause.
Scientific Background Of Progesterone Cream
Progesterone is a natural steroid hormone that is found in much higher concentrations in women than men. In women, it operates harmoniously with estrogen and other steroid hormones involved in physiological functions such as the menstrual cycle and preparing the uterine lining for implantation by a fertilized egg. Other essential roles of progesterone include building new bone tissue and countering the tendency of estrogen to cause excess growth in the lining of the uterus, which can lead to endometriosis.
Progesterone is also a key precursor to other steroid hormones, including cortisol, testosterone and certain;estrogens . While a womans estrogen may eventually drop 4060 percent below her baseline level by menopause, her progesterone level can drop even more dramatically. Although the adrenal glands still produce some progesterone, the decline in progesterone upsets the bodys natural hormone balance.
Following menopause, a womans progesterone level drops to nearly zero. Application of progesterone cream is a form of hormone replacement therapy to relieve menopause symptoms.
The many roles;progesterone;plays in the body includes:
- maintains the uterine lining and prevents excess tissue buildup
- inhibits breast tissue overgrowth
- improves libido
A Note From Cleveland Clinic
The decision to take hormone therapy needs to be a very personalized one. Hormone therapy is not for everyone. Discuss the risks and benefits of hormone therapy with your healthcare provider at an office visit specifically dedicated for this conversation. Youll need the time to address all the issues and answer questions in order to arrive at a decision that is best for you. Factors considered should be your age, family history, personal medical history and the severity of your menopausal symptoms.
Be sure to talk about the pros and cons of the different types and forms of HT as well as non-hormonal options such as dietary changes, exercise and weight management, meditation and alternative options.
Types Of Studies Of Hormone Therapy And Cancer Risk
Different types of studies can be used to look at cancer risk from menopausal hormone therapy .
Randomized controlled trials:;In this kind of study, a group of patients get the drug being studied , and another group gets a placebo . Results from this kind of study are powerful because which group a patient is in is based on chance. This helps assure that the groups are similar in all ways, such as risk for cancer, except for the drug thats being studied. This is the best way to see the effects of a drug. These types of studies can also be;double-blinded,;which means neither the people in the study nor their doctors know which group they are in. This lowers the chance that thoughts or opinions about treatment could affect the study results. Unfortunately, these kinds of studies are costly, which limits the number of people in the study, how long the study can continue, and the number of studies done.
A major drawback of observational studies is that the people getting the treatment being studied may have different cancer risk factors than the people who arent. Plus, the treatment can differ between the people being studied. This makes it less clear that the differences seen are only due to the drug being studied and not other factors.
When observational studies and randomized controlled trials have different results, most experts give more weight to the results of the randomized controlled trial.
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Who Might Want To Take Natural Progesterone Cream
Progesterone is a powerful female hormone which can be taken via prescription or in over-the-counter preparations. In general, healthy progesterone levels promote female fertility, helps regulate the menstrual cycle, and can have a profound impact on psychological well-being.
In premenopausal women, progesterone products are sometimes used to reduce the severity of PMS symptoms. Additionally, some women are prescribed progesterone during early pregnancy or when theyre trying to conceive, as low progesterone may contribute to infertility and miscarriage. During perimenopause or menopause, progesterone is commonly used to address a variety of symptoms, including hot flashes and night sweats, and is known to reduce the risk of endometrial cancer in women undergoing estrogen therapy.
Natural progesterone cream might be recommended by a practitioner to help with any of these conditions. Its important to note, however, that progesterone in any form should never be taken without medical counsel. While these products can play a meaningful role in alleviating your symptoms, they arent right for all women in all cases. Its critical that a trained health practitioner evaluates whether progesterone is an appropriate optionand ensure you are using an effective product.
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Abate, A., Perino, M., Abate, F. G., Brigandi, A., Costabile, L., and Manti, F. Intramuscular versus vaginal administration of progesterone for luteal phase support after in vitro fertilization and embryo transfer. A comparative randomized study. Clin.Exp.Obstet.Gynecol. 1999;26:203-206. View abstract.
Abiola, O. O., Checkley, S. A., Campbell, I. C., and Whatley, S. A. Effects of sex steroids on protein synthesis in cultured human lymphocytes. J.Psychiatr.Res. 1996;30:229-238. View abstract.
Abou-Saleh, M. T., Ghubash, R., Karim, L., Krymski, M., and Bhai, I. Hormonal aspects of postpartum depression. Psychoneuroendocrinology 1998;23:465-475. View abstract.
Al, Kadri H., Hassan, S., Al-Fozan, H. M., and Hajeer, A. Hormone therapy for endometriosis and surgical menopause. Cochrane.Database.Syst.Rev. 2009;:CD005997. View abstract.
Allen, W. M. Physiology of the corpus luteum, V: the preparation and some chemical properties of progestin, a hormone of the corpus luteum which produces progestational proliferation. 1930;
Aloia, J. F., Vaswani, A., Yeh, J. K., Ross, P. L., Flaster, E., and Dilmanian, F. A. Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss. Ann.Intern.Med. 1-15-1994;120:97-103. View abstract.
Andersch, B. and Hahn, L. Progesterone treatment of premenstrual tension–a double blind study. J.Psychosom.Res. 1985;29:489-493. View abstract.
Berle P, Budenz M Michaelis J.
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Why Progesterone After Menopause Is Important
In the female body, two types of the most important female hormones are produced: estrogen and progesterone. Each type performs its functions, is synthesized in the ovaries, and depends on the level of hormones secreted by the pituitary gland of the brain . FSH activates activity with the advent of menstruation, provides estrogenic synthesis, helps mature follicles in the ovaries. And LH acts in the second half of the cycle, is responsible for the production of progesterone and ovulation. Activation of progesterone synthesis is observed after the rupturing of the follicle, the appearance of a mature egg, the formation of the corpus luteum.
There are periods in a womans life when progesterone deficiency is the norm. These are the first two years of puberty and menopausal hormonal changes. In addition to affecting the reproductive system, progesterone supports the functioning of many-body structures, normalizes the emotional and mental state. That is why progesterone after menopause level is of such great importance.
Progesterone And Lipid Metabolism
Overall, estrogen therapy is associated with positive long-term effects on the lipoprotein profile of postmenopausal women, although it should be noted that this effect was found more commonly for orally administered estrogen.
In contrast to these findings, synthetic gestagens if combined with estrogens reduce HDL-C concentrations. A direct comparison with synthetic gestagens showed that micronized progesterone has fewer negative effects on HDL-C metabolites compared to synthetic gestagens. Saarikoski et al. carried out a study in 80 perimenopausal women treated for functional menometrorrhagia. The women were divided into 2 groups to receive either 300mg/day oral micronized progesterone for 10 days per cycle or 15mg/day norethisterone for 10 days per cycle over 6 consecutive cycles. The study showed that HDL-C levels remained stable with progesterone, but there was marked decrease in HDL-C levels in the norethisterone group . The previously mentioned PEPI trial also showed that, in significant contrast to medroxyprogesterone used in the other arms of the study, progesterone has the least impact on the positive effect on HDL-C caused by estrogens .
Changes in HDL-C levels after estrogen monotherapy, estrogen and progesterone administration, cyclical administration of estrogen with MPA , continuous administration of estrogen with MPA, and placebo . CEE: conjugated equine estrogen.
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Estrogen Therapy And Cancer Risk
In women who still have a uterus, using systemic ET has been shown to increase the risk of;endometrial cancer;. The risk remains higher than average even after ET is no longer used. Although most studies that showed an increased risk were of women taking estrogen as a pill, women using a patch or high-dose vaginal ring can also expect to have an increased risk of endometrial cancer.
Because of this increased cancer risk, women who have gone through menopause and who still have a uterus are given a progestin along with estrogen. Studies have shown that EPT does not increase the risk for endometrial cancer.
Long-term use of vaginal creams, rings, or tablets containing topical estrogen doses may also increase the levels of estrogen in the body. Its not clear if this leads to health risks, but the amounts of hormone are much smaller than systemic therapies.
ET is not linked to a higher risk of;breast cancer. In fact, certain groups of women taking ET, such as women who had no family history of breast cancer and those who had no history of benign breast disease, had a slightly lower risk of breast cancer.
The WHI study of ET did not report any results about;ovarian cancer.
To put the risk into numbers, if 1,000 women who were 50 years old took estrogen for menopause for 5 years, one extra ovarian cancer would be expected to develop.
ET does not seem to have any effect on the risk of;lung cancer.
Endometrial Effects Of Transdermal Progesterone Creams And Estriol
Women with intact uteri are prescribed estrogen with a progestogen to oppose estrogen-induced endometrial hyperplasia and cancer. Bioidentical hormone proponents sometimes recommend topical progesterone cream instead of oral progestin for this purpose. However, it is unclear whether topical progesterone can effectively mitigate estrogen-induced endometrial stimulation. Three studies have examined the ability of progesterone to oppose estrogenic stimulation. The longest study, which lasted for 48;weeks, found that transdermal cream containing 40;mg of progesterone could not effectively oppose estradiol-induced endometrial stimulation. A 12-week study of a cream containing up to 64;mg of progesterone found similar effects. The only study that found that progesterone cream effectively opposed estrogen lasted only 28;days, too short a time to assess estrogenic effects. Five studies that measured serum or plasma levels after topical progesterone treatment have found progesterone levels <5;ng/mL . Only one study found a progesterone cream equivalent to oral progesterone after measuring progesterone concentration in whole blood .
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Supplements To Boost Progesterone
In many cases, women will benefit from the concurrent use of progesterone cream and certain supplements.;
While low progesterone is a problem for many, this issue is often accompanied by high estrogen.;
The use of progesterone cream can help “balance” out the ratio of progesterone to estrogen in the body, but it may not be the ultimate treatment to the high estrogen.;
In cases such as these, you may benefit from the use of supplements designed to help clear out estrogen which can also make more effective your dose of progesterone.;
Supplements that help reduce estrogen include:;
- DIM or Indole 3 Carbinol – DIM is a special compound that helps increase the metabolism of estrogen in the body. This compound is found in brassica vegetables and can help alleviate the symptoms of excess estrogen. Take 100 to 300mg per day for best results.;
- Calcium D glucarate – Calcium D glucarate also helps directly increase estrogen metabolism by increasing glucuronidation in the liver. It can be combined with DIM. Use up to 3,000mg per day .;
- Maca root – Maca root is a plant based powder that has long been used for menstrual and sexual related issues. Many people find great benefit while using maca even though studies show that it doesn’t alter serum levels of sex hormones. Use 1-2 tablespoons per day.;
- Ashwagandha – Ashwaganda is an adrenal adaptogen that has been shown to help balance estrogen levels by down-regulating estrogen receptors. Use up to 500mg per day.;
Indications For Progesterone Administration
There are currently a number of well-known indications for progesterone administration, both in gynecology and obstetrics. These include
primary or secondary amenorrhea
infertility due to known corpus luteum insufficiency
treatment of endometriosis ,
treatment of fibrocystic mastopathy
treatment of premenstrual syndrome
supporting the luteal phase during IVF treatment
prevention of pregnancy loss
protection of the endometrium during HT with estrogen ,,,,,,,,,,
Several studies have recently shown that micronized progesterone is tolerated better than synthetic gestagens ,,.
Progesterone plays a very important role for the endometrium, primarily in the implantation and development of the fertilized ovum. It is significantly involved in the proliferative to secretory transition of the endometrium, the decidualization of the endometrium, in triggering the synthesis of PAPP-A , PP14 and uteroglobin, the development of PIBF , the switch from Th1 to Th2 cells , the stimulation of prostaglandin E2 production and suppression of the matrix metalloproteinases MMP3 and MMP9 . All these factors are essential parts of normal development during pregnancy.
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