Progesterone: The Second Domino to Fall after Testosterone
Premenstrual Syndrome
PMS is the butt of many jokes but for those of us who have had this condition, it is no laughing matter. It has been ignored for years by the medical community, and is currently treated by prescribing the treatment of only one of the multiple symptoms, depression. This prescription is one of various anti-depressants, which has minimal effect on most patients with PMS.
Because of the ineffectiveness of the standard, anti-depressant therapy, there are multiple therapies that have partial effect on most patients when they have a very effective treatment at hand—bio-identical progesterone given in the second half of the cycle.
Option for PMS treatment can be any or all of the following:
- Natural progesterone during days 14–28 of the menstrual cycle;
- Progesterone pellets that give a constant low dose of progesterone
- Oral contraceptives;
- Testosterone treatment—non-oral, or pellet
- Antidepressants such as Sarafem, Wellbutrin, Effexor, Prozac
Sidebar: it is amazing to experience the relief that women feel when they are told that there is a natural cause and an effective treatment for this disorder. They are so happy to hear that they are not crazy and that being emotional wrecks is not due to some character flaw in women but rather is due to a chemical or hormonal imbalance that is treatable. Success is beautiful!
Progesterone Therapy with Bioidentical Progesterone
The most effective PMS treatment or progesterone deficiency, treatment is non-oral dosing of bio-identical progesterone. There are several important guidelines that make progesterone more effective and have fewer side-effects.
Premenstrual Syndrome
PMS is the butt of many jokes but for those of us who have had this condition, it is no laughing matter. It has been ignored for years by the medical community, and is currently treated by prescribing the treatment of only one of the multiple symptoms, depression. This prescription is one of various anti-depressants, which has minimal effect on most patients with PMS.
Because of the ineffectiveness of the standard, anti-depressant therapy, there are multiple therapies that have partial effect on most patients when they have a very effective treatment at hand—bio-identical progesterone given in the second half of the cycle.
Option for PMS treatment can be any or all of the following:
Natural progesterone during days 14–28 of the menstrual cycle;
Progesterone pellets that give a constant low dose of progesterone
Oral contraceptives;
Testosterone treatment—non-oral, or pellet
Antidepressants such as Sarafem, Wellbutrin, Effexor, Prozac
Sidebar: it is amazing to experience the relief that women feel when they are told that there is a natural cause and an effective treatment for this disorder. They are so happy to hear that they are not crazy and that being emotional wrecks is not due to some character flaw in women but rather is due to a chemical or hormonal imbalance that is treatable. Success is beautiful!
Progesterone Therapy with Bio-identical Progesterone
The most effective PMS treatment or progesterone deficiency, treatment is non-oral dosing of bio-identical progesterone. There are several important guidelines that make progesterone more effective and have fewer side-effects.
Progesterone Treatment Guidelines
Bio-identical progesterone only
Non-oral delivery of bio-identical progesterone:
Does Everyone Need Progesterone?
I answer the question of whether every woman needs progesterone replacement before and or after menopause, every day in my office. These are really several questions lumped together for which there is no blanket answer.
Progesterone is a hormone that women all have prior to our 40s, and is designed to prepare our uterus for the implantation of an egg, after fertilization and in preparation for pregnancy. That is the primary purpose of progesterone as a hormone when we are young.
A secondary natural purpose of progesterone is to protect the uterus from the stimulation of estradiol. Progesterone is meant to keep the lining stable. Progesterone operates to prevent the estrogen from increasing the thickness of the uterine lining. If left unchecked or unbalanced by progesterone, the uterine lining will become so thick that it vastly increases the likelihood of uterine cancers.
Because of this natural protection for one organ, the uterus, by progesterone, doctors replace progesterone in every woman who possesses a uterus (has not had a hysterectomy), or who has had an ablation.
Mainstream medicine uses a synthetic progesterone-like chemical called a “progestin” that is oral. Unfortunately, these oral pills do not have the same effects on the uterus or PMS as natural progesterone. Oral progestins are transformed in the liver, into several chemicals, the most risky of which is estrone, “old lady estrogen”. Because progestins are so dissimilar from true natural progesterone, even after menopause and TDS, doctors should use non-oral bio-identical progesterones. Natural progesterone protects the uterus, resolves PMS, and has none of the side effects of synthetic progestins, so they are very safe for women who have PMS, heavy bleeding or who take estradiol after menopause.
A small percentage of women need those same progesterone benefits after menopause even if they do not have a uterus. Because these women suffer from depression and mood swings, I call these women “progesterone women”. they generally are replaced to pre-menopausal levels with testosterone and estradiol, but unlike other patients, they will continue to have trouble sleeping, and continue to feel irritable. This is a diagnosis by exclusion. We evaluate symptoms as they respond to testosterone and estradiol in order to determine accurate dosages of replacement hormone balances. Every woman is a unique medical puzzle. This is one of the strongest arguments we can make for individualized medicine over mass consumption medicine.
When a low dose of natural progesterone is added their neurotransmitters (brain hormones) are stabilized and they receive the full effects of testosterone and estradiol replacement.
Summary of Progesterone Replacement
Progesterone is not needed after menopause by every woman
Progesterone for treatment of PMS may be given daily, or just day 14-28
Non-oral Progesterone is necessary to treat PMS, to receive all the benefits, and avoid side effects
Progesterone should be taken at bedtime because it is relaxing and can make you sleepy
Progesterone in bio-identical form is the safest and most effective treatment for progesterone deficit.
There is no evidence that Progesterone should be given to men, or is needed if estradiol is not replaced.
Does Everyone Need Progesterone?
I answer the question of whether every woman needs progesterone replacement before and or after menopause, every day in my office. These are really several questions lumped together for which there is no blanket answer.
Progesterone is a hormone that women all have prior to our 40s, and is designed to prepare our uterus for the implantation of an egg, after fertilization and in preparation for pregnancy. That is the primary purpose of progesterone as a hormone when we are young.
A secondary natural purpose of progesterone is to protect the uterus from the stimulation of estradiol. Progesterone is meant to keep the lining stable. Progesterone operates to prevent the estrogen from increasing the thickness of the uterine lining. If left unchecked or unbalanced by progesterone, the uterine lining will become so thick that it vastly increases the likelihood of uterine cancers.
Because of this natural protection for one organ, the uterus, by progesterone, doctors replace progesterone in every woman who possesses a uterus (has not had a hysterectomy), or who has had an ablation.
Mainstream medicine uses a synthetic progesterone-like chemical called a “progestin” that is oral. Unfortunately, these oral pills do not have the same effects on the uterus or PMS as natural progesterone. Oral progestins are transformed in the liver, into several chemicals, the most risky of which is estrone, “old lady estrogen.” Because progestins are so dissimilar from true natural progesterone, even after menopause and TDS, doctors should use non-oral bio-identical progesterones. Natural progesterone protects the uterus, resolves PMS, and has none of the side effects of synthetic progestins, so they are very safe for women who have PMS, heavy bleeding or who take estradiol after menopause.
A small percentage of women need those same progesterone benefits after menopause even if they do not have a uterus. Because these women suffer from depression and mood swings, I call these women “progesterone women”. they generally are replaced to pre-menopausal levels with testosterone and estradiol, but unlike other patients, they will continue to have trouble sleeping, and continue to feel irritable. This is a diagnosis by exclusion. We evaluate symptoms as they respond to testosterone and estradiol in order to determine accurate dosages of replacement hormone balances. Every woman is a unique medical puzzle. This is one of the strongest arguments we can make for individualized medicine over mass consumption medicine.
When a low dose of natural progesterone is added their neurotransmitters (brain hormones) are stabilized and they receive the full effects of testosterone and estradiol replacement.
Summary of Progesterone Replacement
- Progesterone is not needed after menopause by every woman
- Progesterone for treatment of PMS may be given daily, or just day 14-28
- Non-oral Progesterone is necessary to treat PMS, to receive all the benefits, and avoid side effects
- Progesterone should be taken at bedtime because it is relaxing and can make you sleepy
- Progesterone in bio-identical form is the safest and most effective treatment for progesterone deficit.
- There is no evidence that Progesterone should be given to men, or is needed if estradiol is not replaced.
Dr. Maupin on KMBC in Kansas City on Monday, May 9, in a story about the benefits of bioidentical hormone pellets.















Recent Comments