I’d like to address two questions regarding progesterone which are asked frequently when I am discussing
Bioidentical hormone replacement with patients and with other physicians. I have patients who’ve been told, and colleagues who tell them, that “you don’t need progesterone because you don’t have a uterus” following a hysterectomy. Patients suffering from progesterone deficiency symptoms who haven’t had a hysterectomy are sometimes told not to go on progesterone because it will increase their risk of breast cancer.
On the first point, the hormone progesterone has many functions in the body outside the uterus. The “top three” symptoms my patients have at their initial consult attributable to progesterone deficiency are 1. poor sleep (including trouble falling asleep, trouble staying asleep, inability to fall back to sleep after waking up during the night, and waking up feeling tired regardless of how many hours they have slept) 2. Anxiety (not necessarily related to any increased stress, and often described as “waves of anxiety or panic”). 3. Problems with short-term memory (“I go downstairs and forget what I went to get”. “I have more trouble remembering names and thinking of words”. “I am getting embarrassed when speaking in meetings at work”)
These are just the top three issues with low progesterone levels. Another huge impact of low progesterone in patients with or without their uterus is weight gain. Estrogen not adequately balanced with progesterone leads to bloating and weight gain in the abdomen and hips.
Clearly, progesterone deficiency is a diagnosis which merits treatment with Bioidentical hormone replacement in patients with uterus intact as well as those status post hysterectomy.
Next it is important to make the distinction between Bioidentical progesterone and progestin hormone preparations. Bioidentical progesterone is identical to the progesterone our bodies produce and may be used safely to correct progesterone deficiency and relieve the above symptoms. In contrast, progestins are different in structure from Bioidentical progesterone. They have some, but not all,of the benefits of Bioidentical progesterone but also some different functions and risks unique to progestins. Clinical trials have linked progestins to increased breast cancer risk. Research has shown that Bioidentical progesterone does not affect risk of breast cancer or decreases risk. This distinction is sometimes left out in the media and is so important to understand when deciding whether to seek relief from perimenopausal and menopausal symptoms of progesterone deficiency.
Once my patients and their other treating physicians discuss and understand the role of progesterone and the research behind the safety of bioidentical progesterone, we can agree on a treatment plan, achieving great, restorative sleep, relief from anxiety, sharp short-term memory and maintaining a healthy goal weight. That’s our goal at BODYLOGICMD: Living better. Longer.