Ep. 614 “The Progesterone Conversation We’ve Been Missing” | Menopause, Perimenopause, Progesterone

Welcome to this week’s Midlife Minute.

In this episode, we’re focusing on progesterone, exploring the differences between progesterone and progestins, how progesterone is used in clinical practice, and how individual responses can vary significantly.

IN THIS EPISODE, YOU WILL LEARN:

Why bioidentical progesterone and synthetic progestins are not interchangeable

How early synthetic progestin studies continue to shape how progesterone is viewed

How different routes of progesterone administration produce different effects 

Why do some women experience stronger neurological or physical effects than others on the same progesterone dose

How cyclical versus continuous use can affect how progesterone is used in the body 

Why some women experience sleep or mood changes on oral progesterone

The importance of personalized decision-making

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Resources: 

The pharmacodynamics and safety of progesterone doi:10.1016/j.bpobgyn.2020.06.002

Profiles of plasma estrogens, progesterone and their metabolites after oral or vaginal administration of estradiol or progesterone doi:10.1016/0378-5122(93)90064-O

Pharmacokinetics of progesterone and its metabolites allopregnanolone and pregnanolone after oral administration of low-dose progesterone doi:10.1016/j.maturitas.2005.11.005

Allopregnanolone and mood in the peripartum: a longitudinal assessment in healthy women doi:10.1016/j.psyneuen.2019.104465

Behavior of Male Gamete Fusogen GCS1/HAP2 and the Regulation in Arabidopsis Double Fertilization doi:10.3390/biom13020208

Tolerance to allopregnanolone with focus on the GABA receptor doi:10.1111/j.1476-5381.2010.01059.x

Effects of exercise training on the cardiovascular system: pharmacological approaches doi:10.1016/j.pharmthera.2007.03.010

Sex steroid induced negative mood may be explained by the paradoxical effect mediated by GABA modulators doi:10.1016/j.psyneuen.2009.02.003

Paradoxical effects of GABA modulators may explain sex steroid induced negative mood symptoms in some persons doi:10.1016/j.neuroscience.2011.03.061

Progesterone selectively increases amygdala reactivity in women doi:10.1038/sj.mp.4002030

Progesterone and allopregnanolone neuroprotective effects in the central nervous system doi:10.1016/S0006-8993(02)02366-5

Allopregnanolone and mood disorders doi:10.1016/j.pneurobio.2013.07.005

GABA receptor plasticity and neurosteroid cell withdrawal during the estrous cycle doi:10.1523/JNEUROSCI.2800-09.2009

Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study doi:10.1007/s10549-007-9523-x

Management of Menopausal Symptoms: A Review doi:10.1001/jama.2022.24140

Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis doi:10.1080/13697137.2018.1467611

Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women doi:10.1210/jc.2010-2558