The Importance of Progesterone Replacement in Both Men and Women

By Dr. Melissa (Mel) Irvine, DNP – Clinical Sexologist
Specializes in Sexual Medicine and Beauty

Of the many hormones in the body, a select few are typically categorized as being for one gender or for the other. Many people are often surprised to learn, though, that despite these hormones being more prominent in one gender, they are essential for proper body functioning in both.

One example of these hormones is progesterone, which is often considered for women, although it has many essential roles in men. However, progesterone can decline in both genders for a number of reasons, including with age or due to health conditions. When progesterone levels fall, unpleasant symptoms can occur, which is why progesterone replacement is a crucial treatment for those with unbalanced hormones.

What Is Progesterone?
Progesterone is a hormone most often known to be released by the corpus luteum after a woman has ovulated. Also referred to as the “pregnancy hormone,” progesterone prepares the uterus for pregnancy by thickening the lining and preventing muscle contractions that would expel an egg.

Despite its primary role in preparing the female body for pregnancy, though, progesterone is also vital for men, albeit with different roles.

Let’s further discuss the role of progesterone in both genders and why it is crucial for men and women to have balanced progesterone levels.

The Role of Progesterone in Women
Progesterone varies considerably through a woman’s menstrual cycle, with it being produced in low levels during the first half but rising considerably following ovulation. If a woman becomes pregnant, progesterone remains high throughout the pregnancy and aids in breast milk production upon delivery of the baby.

While the ovaries initially produce progesterone, the placenta begins producing progesterone at a higher rate after 8 or 10 weeks of pregnancy. This increase in progesterone keeps the body from releasing more eggs and prepares the breasts to produce milk.

Despite the role of progesterone in pregnancy, it can also be used to prevent pregnancy. In fact, progesterone is often used by itself or in combination with estrogen in hormonal contraceptives. When in this format, it helps the cervical mucus thicken, making it difficult for sperm to reach and fertilize an egg. It can also cause the uterine lining to thin, or it may stop ovulation entirely.

Because of these extremes in the body, promoting an ideal amount of progesterone is critical for healthy fertility, if pregnancy is a woman’s goal.

Signs Of Low Progesterone in Women
Some signs of low progesterone in women include:
– missing periods or having abnormal periods
– uterine bleeding
– repeated miscarriages
– spotting and pain while pregnant
– infertility

Progesterone and estrogen are also closely related, so if progesterone is too low, it may cause estrogen levels to become high, which can cause weight gain, headaches, or mood swings.

The Role of Progesterone in Men
Despite being considered the “pregnancy hormone,” progesterone is also an essential hormone in men.

In men, progesterone plays a vital role in mood regulation and keeping the mind calm. It also impacts libido and promotes fertility from the man’s side. This is because progesterone influences spermiogenesis, or the creation of sperm; if the amount of progesterone in a man is too low, the body might not be able to produce as much sperm, which can influence a couple’s ability to conceive.

Progesterone is also crucial for the biosynthesis of testosterone, otherwise known as the male sex hormone, which is responsible for the development of secondary sex characteristics such as body hair, muscle growth, and a deeper voice.

Progesterone also plays an essential role in the male body regarding counteracting the effects of estrogen, which can cause testosterone levels to decline. Proper progesterone levels ensure that these sex hormones are in the correct balance.

Signs Of Low Progesterone in Men
Some of the signs of low progesterone in men include:
– hair loss
– low libido
– fatigue
– weight gain
– depression
– breast growth
– muscle loss
– bone loss
– erectile dysfunction

Low progesterone levels can also increase the risk of certain health conditions such as arthritis, osteoporosis, prostate cancer, and prostatism.

Estrogen Dominance and Progesterone
Progesterone is an antagonist to estrogen, giving it an important role in keeping estrogen levels in check. However, this also means that if progesterone levels are too low, estrogen levels can become high without anything to keep them in the correct range, a condition called estrogen dominance.

While estrogen dominance is most often referred to in women, it can affect men as well, with both genders having shared and also different symptoms.

Women with estrogen dominance may have symptoms that include:
– swelling and tenderness in the breasts
– low libido
– bloating
– weight gain
– mood swings
– headaches
– increase premenstrual syndrome symptoms
– fatigue
– cold hands or feet
– memory problems
– anxiety and panic attacks

Men can share some of the above symptoms in addition to experiencing infertility issues, breast tissue growth, or erectile dysfunction.

Normal estrogen levels in adult, menopausal women range from 15 – 350 pg/ml. In adult men, estrogen levels should range from 10 – 40 pg/ml. Estrogen counts higher than these ranges may signify low progesterone.

What Causes Low Progesterone?
There are many causes of low progesterone, some due to a temporary situation, whereas others may be more chronic.

Hypothyroidism
Many of the hormones in the body interact, which is evident between the thyroid hormones, T3 and T4, and progesterone. With hypothyroidism, the thyroid does not produce enough hormones, and since the thyroid is responsible for regulating the endocrine system, this can then influence how well the body is able to produce progesterone.

It is also possible for low progesterone to lead to hypothyroidism, so this connection is bi-directional.

Low Cholesterol
Cholesterol is needed by the body in order to make progesterone. So, if your cholesterol is low, your body does not have enough of the building blocks required to produce enough progesterone.

Stress
Stress contributes to many health conditions, and low progesterone is one of them. This is because the hormone secreted by the body when in a perceived stressful situation, cortisol, utilizes the resources needed to make progesterone.

Essentially, when the body is stressed, it halts progesterone production in order to increase the amount of cortisol produced. For those experiencing chronic stress, this means that cortisol continually interferes with progesterone production.

Anovulatory Cycle
An anovulatory cycle is a menstrual cycle where ovulation does not occur. Since a rise in progesterone is triggered by the release of an egg and the empty follicle it leaves behind called the corpus luteum, an anovulatory cycle results in no increase in progesterone.

Anovulatory cycles are common in those on certain types of birth control or with PCOS.

Abnormal Bodyweight
Your body weight can play a prominent role in progesterone production because of its impact on the menstrual cycle. This is because women need a certain amount of body fat in order to have a regular cycle, which leads to ovulation and a rise in progesterone. Because of this, low body weight may impede ovulation, leading to no progesterone production.

Problems can occur at the other end of the spectrum as well, though. This is because fat cells produce estrogen, so high body fat can result in an overproduction of estrogen, which can lead to low progesterone. Studies have shown this correlation between obesity and low progesterone in men as well.

Prolactin Disorder
Prolactin is a hormone produced by the pituitary, and it negatively affects the production of sex hormone precursors. Those with hyperprolactinemia produce too much prolactin, which can disrupt the menstrual cycle, keeping progesterone from being produced.

Correcting Low Progesterone
Progesterone replacement therapy involves progestins, which are synthetic compounds mimicking the effects of progesterone on the body.

Some reasons why someone may be treated with progesterone hormone therapy are to:
– correct a low amount of progesterone due to underproduction
– bring on menstruation
– reverse low progesterone resulting from certain
medications
– replace progesterone that is limited due to specific
medical procedures

There are many different forms of progesterone hormone therapy, such as:
– injections
– oral capsules
– vaginal gels
– vaginal inserts
– vaginal suppositories

The ideal method of progesterone replacement will depend on gender, symptoms, and personal preferences.

The Importance of Progesterone Replacement
Besides helping to address problems with fertility, progesterone replacement can also be essential for a healthy pregnancy in women. For example, women who are pregnant, but have low progesterone, may be at a greater risk of preterm delivery or miscarriage. Replacing progesterone can help prevent these complications from occurring.

Progesterone replacement produces similar benefits in men regarding improving fertility due to its role in spermatogenesis and the fact that low progesterone can lead to erectile dysfunction.

Progesterone can also help with other symptoms affecting well-being, including those that appear in men with low progesterone. These benefits can include an improvement in mood, better sleep, and stronger bones.

Some cases of low progesterone are temporary, but for those suffering significantly from low progesterone, it is likely due to a chronic cause, and the only way to find relief is by addressing the hormonal imbalance.

Progesterone can be supplemented in many forms, such as injections, pills, or creams, which help raise progesterone levels and assist the body in functioning correctly, reversing unpleasant symptoms. Working with a doctor who specializes in hormones can also ensure that you get just the right amount of progesterone, as too much can also cause problems, especially for those looking to conceive.

By adequately balancing progesterone, all other hormones in the body can work in balance again, significantly improving your quality of life.

References
Taraborrelli S. (2015). Physiology, production and action of progesterone. Acta obstetricia et gynecologica Scandinavica, 94 Suppl 161, 8–16. https://doi.org/10.1111/aogs.12771

Druckmann, R., & Druckmann, M. (2005). Progesterone and the immunology of pregnancy. The Journal Of Steroid Biochemistry And Molecular Biology, 97(5), 389-396. doi: 10.1016/j.jsbmb.2005.08.010

Blanchette, S., Marceau, P., Biron, S., Brochu, G., & Tchernof, A. (2006). Circulating Progesterone and Obesity in Men. Hormone And Metabolic Research, 38(5), 330-335. doi: 10.1055/s-2006-925392

Sanchez, E. G., Giviziez, C. R., Sanchez, H. M., Agostinho, P. L., Barros, P. S., & Approbato, M. S. (2016). Low progesterone levels and ovulation by ultrasound assessment in infertile patients. JBRA assisted reproduction, 20(1), 13–16. https://doi.org/10.5935/1518-0557.20160004

 

Dr. Mel Irvine

9250 Corkscrew Rd. STE 5, Estero, FL 33982
239-351-5663
info@sextys.com | drmelirvine.com