Understanding Progesterone Side Effects and Progesterone Intolerance

Understanding Progesterone Side Effects and Progesterone Intolerance

Introduction

Progesterone plays an essential role throughout a woman’s reproductive life, including during perimenopause and menopause. Despite its benefits, some women experience side effects that range from mild to severe. This post dives into these issues, with a focus on both progesterone side effects and progesterone intolerance.

What is Progesterone?

Progesterone is a key hormone in regulating menstrual cycles and maintaining pregnancies. It is also critical for protecting the uterus when taking estradiol or after a hysterectomy. However, it can cause various side effects, affecting women’s quality of life.

Common Side Effects of Progesterone

While progesterone is beneficial, it comes with side effects such as:

  • Gastrointestinal issues like acid reflux and nausea.

  • Drowsiness, which can be beneficial for those struggling with sleep.

  • Mild dizziness and bloating.

  • Mood fluctuations and occasional headaches.

These symptoms generally improve as the body adjusts to the hormone.

Understanding Progesterone Intolerance

Progesterone intolerance extends beyond typical side effects, manifesting as severe mood changes, intense depression, and symptoms akin to pre-menstrual dysphoric disorder (PMDD). My conversations with women who have experienced both PMDD and menopausal progesterone intolerance led to an interesting discovery. It seems plausible that a biochemical mechanism connects both of these severe hormonal issues. The connection appears to be a progesterone metabolite called allopregnanolone. This metabolite usually aids in sleep but can adversely affect GABA-A receptors, exacerbating anxiety and depression.

Managing Progesterone Side Effects

Most women can manage progesterone’s side effects with lifestyle adjustments and medical guidance. Tips include:

  • Timing progesterone intake to coincide with bedtime to use drowsiness to your advantage.

  • Dietary adjustments to help manage gastrointestinal symptoms.

  • Regular consultation with healthcare providers to adjust dosages as necessary.

Severe Cases and Specialist Consultation

For those experiencing severe side effects, consulting with a hormone optimization specialist is crucial. Customized treatment plans can significantly improve symptoms and enhance quality of life. Most of the hormone optimization specialists I’ve talked with emphasize a “start low and go slow” approach to progesterone intolerance. Some experienced providers have used doses five or ten times lower than those normally prescribed to women in menopause, gradually increasing over weeks or months. Other providers have actually increased progesterone dosage, believing intolerance is a matter of inadequate progesterone. Still others use sublingual or transdermal dosage forms to overcome progesterone side effects.

Conclusion

While essential, progesterone’s side effects can range from manageable to severe. Understanding these can help women navigate their hormonal health more effectively. If progesterone therapy is impacting your life, don’t hesitate to seek professional advice. Progesterone intolerance is very rare but also very real. This is one a situation that requires the experience and training of a hormone optimization specialist who knows how to help women overcome it.

Experiencing Menopause Miseries?

Are you experiencing side effects from progesterone? Have you found unique ways to manage them? Share your experiences in the comments below. If you’re considering hormone replacement therapy but you’re feeling uncertain or hesitant, check out my course “The Menopause Solution.” Easy-to-understand video lessons provide the clarity and confidence needed to make an informed decision about whether HRT is right for your menopause or not.

Adela Hunt

Florida Autonomous Nurse Practitioner

9 个月

.... but mirena has progestin....? its not the same as progesterone

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Jennifer Paulson DNP, FNP-BC, IFMCP

Nurse Practitioner, Hormone Specialist, Integrative & Functional Medicine

9 个月

Yes, yes, yes! I have these patients and they will do better with transdermal or PV progesterone, which can be worrisome for uterine protection. Surely closer surveillance needed. I also find these same women report they felt miserable in pregnancy with excess weight gain, hunger, edema.

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Jeffrey Blake, MD, FACOG, FPMRS

Advanced Gynecology & Pelvic Health Specialists, LLC 14540 Prairie Lakes Blvd N, Suite 110 Noblesville, IN 46060 317 982 5222

9 个月

Going to throw this out there. (Read all the comments and replies in this post, too). I feel it's appropriate to perform a hysterectomy in someone who is progesterone intolerant but wants/needs ERT . With the minimally invasive options available, quick recovery and minimal risks, the benefit of being able to continue with an improved QoL and mitigate the risks of future hip fracture or cardiovascular event far outweighs any downside. I'd rather see my patient undergo a hysterectomy than a hip fracture (bigger surgery and 20% mortality rate over 6 months after) or heart attack later in years. Obviously a proper workup and conservative options are trialed prior, but when push comes to shove.... besides, many of these progesterone intolerant women have adenomyosis and/or endometriosis and feel substantially better post-hyst. Win-win.

Steve Goldring RPh

Teaching 1 BILLION Women About HRT for Menopause - 1 course at a time

9 个月

I’d be curious to know if any of you hormone optimization practitioners have seen the overlap between PMDD and progesterone intolerance?

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Jeffrey Blake, MD, FACOG, FPMRS

Advanced Gynecology & Pelvic Health Specialists, LLC 14540 Prairie Lakes Blvd N, Suite 110 Noblesville, IN 46060 317 982 5222

9 个月

A nice reminder. It's also important to differentiate between progesterone ("bio-identical") and progestins (synthetics).... kinda alike but not really. ??

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