Hormone: Progesterone

Progesterone

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Progesterone is the Happy Hormone:

The feel-good/romantic hormone for men & women!

Progesterone is a hormone made primarily by the ovaries at ovulation. From the point of ovulation to the first day of your period (the luteal phase), is when progesterone levels are usually at their highest. When the ovaries are not producing progesterone, the adrenal glands are the primary producers. Progesterone is used by the body to make other hormones such as estrogen and testosterone. Cortisol, the stress hormone, is also formed from progesterone. Dr. Mac states that progesterone is the one and true “Chill Pill.” Progesterone supplementation helps with sleep, anxiety, depression, aging, uterine and prostate problems. Progesterone is also known to help with being in present time and increasing attentiveness. It is the candlelight and music hormone, the hormone for romance.

Estrogen Dominance

Progesterone is needed in hormone replacement therapy for men and women for many reasons, but one of its most important roles is to balance or oppose the effects caused by estrogen dominance. Women who have suffered from PMS and menopausal symptoms will recognize the hallmark symptoms of estrogen dominance: weight gain, bloating, mood swings, irritability, tender breasts, headaches, fatigue, depression, hypoglycemia, uterine fibroids, endometriosis, and fibrocystic breasts. Estrogen dominance is known to cause six different types of cancers including breast, ovary, cervical, uterine and prostate cancers. Estrogen dominance occurs because of menopause, stress and the environment. After menopause, estrogen levels may drop 60% but progesterone levels drop to near zero. The drop in estrogen usually gets the blame for menopause and the stop of menses, but it’s the combined drop of all the sex hormones that causes the symptoms of menopause. Stress causes progesterone levels to be affected. People under stress find progesterone to be very effective in their ability to handle stress. Xeno-estrogens and phyto-estrogens found in the environment are also affecting society. They cause men to be estrogen dominant as they age. They also are being blamed for early puberty now being seen in seven year old girls. Xeno-estrogens are found in plastic bottles, pesticides and fertilizers. Dr. Mac once gave a lecture, where he had the highest estrogen level in the room. There were twenty-seven women in attendance.

Bio-identical Progesterone vs. Synthetic Progesterone

Many patients ask us why they should use bio-identical progesterone instead of the synthetic progesterone such as progestin Provera which traditionally prescribed by physicians. Bio-identical Progesterone is preferable to the synthetic progestins such as Provera, because it is natural to the body and has no undesirable side effects when used as directed. If you have any doubts about how different progesterone is from the progestins, remember that the placenta produces 300-400 mg of progesterone daily during the last few months of pregnancy, so we know that such levels are safe for the developing baby. But progestins, even at fractions of this dose, can cause birth defects. The progestins also cause many other side effects, including partial loss of vision, breast cancer in test dogs, an increased risk of strokes, fluid retention, migraine headaches, asthma, cardiac irregularities and depression.

Premenopausal Woman and Progesterone

In the ten to fifteen years before menopause, many women regularly make enough estrogen to create menstruation, but do not ovulate. Without ovulation progesterone is not produced, thus setting the stage for estrogen dominance. We recommend utilizing progesterone cream during this time to help prevent the symptoms of PMS.

Bio-identical Progesterone is made from plants

Progesterone used for bioidentical hormone replacement comes from plant fats and oils, usually a substance called diosgenin which is extracted from a very specific type of wild yam that grows in Mexico, or from soybeans. In the laboratory diosgenin is chemically synthesized into the identical progesterone made by humans. Some companies sell diosgenin, which they label "wild yam extracts.” There is doubt that the body can actually convert diosgenin into progesterone.

Progesterone cream application

Progesterone is easily absorbed through the skin and into the capillaries. Thus absorption is best where skin is thin: face, neck, chest, breasts, inner arms and palms of the hands. Women with fibrocystic breasts should apply progesterone directly to the breast this will help reduce and in many cases eliminate lumpy breasts. The Mac Protocol usually begins by applying Progesterone cream to the chest and breasts at night. Progesterone will help you sleep. It is always best to use creams after a shower or bath, but in progesterone’s case always use it at night, especially in the beginning. Do not apply on fatty areas of skin. Skin should be clean and dry. Spread a thin layer on a large surface to increase absorption. Rub the cream in thoroughly (approx. 10 times back and forth). As time passes, after a few months we will have you rotate the areas for application of the cream so that individual sites do not become saturated. Cream will dry in 5 to 10 minutes and should not be washed off for approximately 2 hours. Therefore activities such as bathing, swimming, exercising (inducing sweat) can wash the medication off your skin and should be avoided for 2 hours following application.

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Cycling

The Mac Protocol utilizes a unique and easy cycling method. Since we utilize small doses of bHRT, it is very safe and side effects rarely occur. As for cycling, our unique approach utilizes a woman’s natural cycle. Women with monthly menstrual cycles should apply a minimal dose on days 1-14 and then increase the dose during the days 15-28. (Day 1 is the beginning of your menstrual cycle and may fall on any calendar date). For postmenopausal women, apply cream for the first 28 days of the calendar month than take three days off. But just like estrogen many women prefer to use it on a daily basis. If you experience any skin irritation or allergic reaction, discontinue use and call our office.

The Mac Protocol’s Recommended Progesterone Dosage

For premenopausal women the usual beginning dose is 20 mg/day for days 1-14 and 40-100 mg/day during days 15-28. Progesterone cream will come in 10 ml applicators. 1 ml will usually contain 100 mg of progesterone. Women will usually start with 1/5 of a ml which would be equal to 20 mgs.

For postmenopausal women, we recommend beginning with 20 mg/day than revisiting the dosage monthly and increasing the dosage if necessary until progesterone deficiency symptoms have diminished. There are three protocols for Post menopausal women and to our observance we have not seen much difference between the three, making not one of them better or worse than the other. Protocol 1: utilize the recommended dose for 25 days continuously and discontinue for 3 days. Protocol 2: utilize the recommended dose for 28 days continuously and discontinue for 3 days. Protocol 3: utilize the recommended dose daily. You choose the protocol that you feels make more sense to you.

Progesterone cream risks

During the third trimester of pregnancy, the placenta produces about 300 mg of progesterone daily, so we know that a one-time overdose of the cream is virtually impossible. If you use an entire syringe of cream at once it might make you sleepy. However, we recommend that women avoid using higher than the recommended dosage to avoid hormone imbalances. More is not better when it comes to hormone optimization.

Progesterone pills?

We recommend transdermal cream rather than oral progesterone, because some 80% to 90% of the oral dose is lost through the liver. Thus, at least 200 to 400 mg daily is needed orally to achieve a physiologic dose of 20 to 40 mg daily. Such high doses create undesirable metabolites and unnecessarily overload the liver. In some cases, particularly with women who have sleeping disorders, we may choose an oral application, due to research that indicates it may be more helpful than creams

Men use progesterone?

Our office has certainly received its share of calls from men interested in progesterone to treat hormone imbalance and male menopause, and benign prostatic hypertrophy (enlarged cells in the prostate gland) or hyperplasia (enlarged by an increase in the number of cells in the gland), commonly referred to as BPH. We have found Progesterone in men to be vital for good health. It is the primary precursor of their adrenal cortical hormones and testosterone. Men synthesize progesterone in smaller amounts than women do but it is still important. Both the prostate gland and the uterus develop from the same embryonic cells, and both respond to the same hormones - estrodiol, progesterone, and testosterone. In the same manner, both the ovaries and the testes develop from the same embryonic cells. A fertilized ovum with XX chromosomes develops ovaries and a uterus, while the fertilized ovum with XY chromosomes develops testes and a prostate gland.

Dr John Lee writes, in his publication ‘What Your Doctor May Not Tell You About Prostate Health & Natural Hormone Supplementation ‘ that in the prostate (and in the hair follicles) is an enzyme (5-alpha-reductase) that converts testosterone into dihydrotestosterone (DHT). Higher DHT levels in hair follicles are a primary cause of male pattern baldness. He argues that DHT stimulates proliferation of prostate cells, more so than testosterone does, enlarging the prostate gland and narrowing the urethral channel, leading to urination problems, and speculation that elevated DHT is the cause of prostate cancer. Inhibiting this conversion of testosterone to DHT is often a treatment goal for men with BPH. Since progesterone is a potent inhibitor of 5-alpha-reductase, the decline of progesterone in aging males plays a role in increasing DHT. Adding progesterone back into the body helps restore normal inhibition of 5-alpha-reductase, thus preventing testosterone from changing into (DHT). Basically, Dr. Lee suggested men undergo progesterone replacement therapy using a maintenance dose of 10mg a day to protect against prostate cancer.

Application sites for men

If you have an enlarged prostate or a chronic prostate problem, then we suggest you apply cream directly to the testes. Otherwise, we recommend that the sites of application mirror those adopted by women, inner arms, inner forearms, back of knees, upper chest, neck, etc. Areas where the blood vessels are very close to the skin, avoiding fatty areas like the stomach and buttocks, and avoid hairy areas. We have found that too much cream may cause fluid retention, headaches and other associated symptoms so please use only small doses of 10mg a day. Our Doctors will usually write the prescription for 50 mg per gram/ml. The cream will usually come in 10 ml applicators. You will use one small line or 1/5th a ml.

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