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Progesterone
Functions:
- Maintenance of the uterine lining during pregnancy
- Prepares the breasts for lactation
- Promotes new bone formation to increase bone mass and density
- Protects against overgrowth of the endometrial lining resulting from estrogen therapy
"Progesterone" is a term that is incorrectly used interchangeably to describe both natural bio-identical progesterone and synthetic substitutes. Synthetic progestins (also called progestogens or progestational agents) are analogues of bio-identical progesterone, and have been developed because they are longer lasting, more potent, and patentable. Bio-identical progesterone has never been shown to have any serious side effects. Progestins can have significant and serious side effects at typical doses, including migraine headache, weight gain, mood swings, depression, irritability, acne, menstrual irregularities, and fluid retention. These side effects are a frequent cause of discontinuation of HRT. Only about 20% of women who start synthetic HRT remain on it two years later.
Medroxyprogesterone acetate (MPA), the most commonly used progestin, was shown in a study by the Oregon Health Sciences University and USC School of Medicine to cause significant lowering of HDL "good" cholesterol, thereby decreasing the cardio protective benefit of estrogen therapy. They compared MPA to natural progesterone and studied the corresponding effect on coronary artery vasospasm. Progesterone plus estradiol protected against vasospasm, but MPA plus estradiol did not. In the past, the choice of MPA over progesterone has been based on familiarity and convenience. Based on these results, formulations of natural bio-identical progesterone would appear to offer the wiser alternative.
Progesterone is commonly prescribed for perimenopausal women to counteract "estrogen dominance". Estrogen dominance occurs when a woman produces smaller amounts of progesterone than normal relative to estrogen levels. Progesterone also builds bone density, promotes glucose utilization, and improves sleep patterns and libido.
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