Progesterone in Postmenopausal and Hysterectomized Patients

Progesterone in Postmenopausal and Hysterectomized Patients

Progesterone (P4) helps balance estradiol (E2) in the body, making its use in hormone replacement therapy (HRT) just as important as E2. Conventional HRT wisdom seems to claim that since progesterone’s main role is to protect the uterus from estrogen dominance, no further P4 treatment is needed once a woman completes menopause because estradiol levels significantly decrease. Along with this idea, some believe that progesterone is unnecessary to supplement after women undergo a hysterectomy.

While progesterone is known mostly for its effect on the uterus, P4 receptors are located in other parts of the body outside of the uterus as well, and have various effects on other tissues. Newer studies reveal additional effects of progesterone for bone health, hot flashes, and even sedation with implications for treatment of mood disorders. Progesterone may also be helpful for women who have undergone a hysterectomy.

Clinical evidence suggests that endogenous progesterone plays a role in postmenopausal bone health.

Progesterone therapy alone may have unique individual effects at treating hot flashes. A study using progesterone cream applied on the skin daily for one year improved or resolved hot flashes significantly.

Progesterone can also have significant effects on sleep. One study compared micronized progesterone 100 mg and 400 mg oral capsules to vaginal 400 mg suppositories. The results showed that postmenopausal women given progesterone 100 mg and 400 mg orally induced a hypnotic state. This implies that orally administered progesterone may be effective at promoting sleep in postmenopausal women.

PMS and postpartum depression both can occur from an abrupt dip in progesterone levels. One study found that both conditions were treated effectively with progesterone in some patients, especially as preventive treatment for PMS and postpartum depression.

Adding progesterone to estradiol or using P4 alone for HRT in postmenopausal women with or without an intact uterus may improve your quality of life by mitigating or preventing vasomotor symptoms or postmenopausal bone loss, addressing sleep issues, and potentially improving mood.

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