Estrogen and Progesterone Facts

Estrogen and progesterone must be in the proper ratio for optimal biological function?

During the luteal phase progesterone must be 20-40 times higher than estrogen in order to avoid symptoms of elevated estrogen. It is the ratio of free estrogen to free progesterone that is must be in the normal range in order to alleviate symptoms.

Elevations in estrogen and decreased progesterone affect the estrogen /progesterone ratio equally. Estrogen and progesterone were designed to function in balance. When estrogen is elevated or progesterone is diminished you will note the following symptoms:

Instability of Mood- Progesterone metabolites bind GABA receptors and exert an antidepressant and anti-anxiety effect. Also, progesterone is a precursor of cortisol. Metabolites of cortisol also bind GABA receptors. GABA receptors are the targets of barbiturates and SSRI's.

Tension Depression

Anxiety Confusion

Mood Swings Crying

Nervousness Forgetfulness

Inability to handle stress

          Poor sleep

Alterations in sodium and fluid balance - Progesterone blocks aldosterone receptors, decreasing sodium and water retention. Women with progesterone deficiency or estrogen excess during the luteal phase will complain of water retention and weight gain.

Weight gain

Bloating

Breast tenderness

Swelling of extremities

Alterations in carbohydrate metabolism- Elevated estrogen levels alter glucose metabolism through alterations in cortisol and corticosteroids. Also estrogen decrease the function of thyroid hormone.

Hypoglycemic episodes

Increased appetite

Headaches

Cravings

Fatigue

Estrogen is known to be the stimulating hormone in these conditions.

Fibroids

Fibrocystic breast

Endometriosis

Endometrial polyps and heavy vaginal bleeding

Breast Cancer

Endometrial Cancer

Progestins (i.e. Provera, norethindrone etc.) Bind the progesterone receptor and exacerbate the symptoms associated with decreased progesterone. Progestins provide contraception and stimulate secretory endometrium. Progestins do not provide the other functions of progesterone.

Indications for Bio-identical Progesterone

Puberty- Anovulatory cycles create excess estrogen and decreased progesterone. This can produce PMS symptoms. Progesterone is effective in relieving these symptoms²⁴

Breast pain- Estrogen increases breast cell proliferation and swelling. Studies show progesterone relieves 96% of mastalgia and 85% of mild to moderate fibrocystic breast.^{24, 40}

PMS- Studies show PMS symptoms are increased in women with elevated luteal phase estradiol levels. Also, women with low levels of a progesterone metabolite have increased symptoms.^1-23

Fibroids- Progesterone can be used to decrease the rate of growth of small (<5cm) fibroids. Very effective for dysmennorrhea associated with fibroids.

Endometriosis- Progesterone is effective in relieving the pain and bleeding associated with endometriosis. Most effective when used from day 7-26 of the menstrual cycle.

Dysmenorrhea- Progesterone is a smooth muscle relaxant and decreases prostaglandin production. Progesterone cream applied to the abdomen will relieve cramping in less than 20 minutes.

Perimenopause - Anovulatory cycles produce a hyperestrogenic state. This produces symptoms of PMS, increases risk of breast cancer, promotes growth of fibroids, and causes heavy vaginal bleeding. The addition of natural progesterone cream will effectively treat all of these symptoms by supplementing the body with the progesterone that is usually produced by the corpus luteum.

Menopausal Symptoms- hot flashes were relieved in 83% of women using transdermal progesterone without any estrogen supplementation. Progesterone is safe in women with a history of breast cancer. Progesterone can be converted into estriol, estrone, and estradiol. Progesterone levels decrease to approximately zero after menopause. Progesterone has many beneficial effects independent of estrogen.

Osteoporosis- Progesterone stimulates osteoblasts, which are involved in bone formation. The addition of progesterone can help in prevention and possibly reversing osteoporosis.

Patient instructions

How to use bio-identical progesterone cream

In this concentration:

1/8 tsp» 10mg

1/4 tsp» 20mg

1/2 tsp» 40mg

Perimenopausal women and women with PMS -

Women with anovulatory bleeding, fibroids, endometriosis

Menopausal Women not on estrogen

Menopausal women on estrogen

Dysmenorrhea

Apply 1/4 to 1/2 tsp. twice a day starting day 12 of menstrual cycle. Continue until day 26. Day 1 is the 1st day of bleeding 

Apply to hands, feet, inner arms, neck, chest, breasts, or abdomen. Rotate the sites.

You may increase the dose to 3 times a day the week prior to your menstrual cycle if symptoms increase during this time.

You may apply as needed to abdomen to relieve menstrual cramps.

If you are menopausal, you may use progesterone for three weeks and either half your dose for one week or stop progesterone for one week.

It is important to discontinue progesterone at least one week a month to achieve the best results