Natural Progesterone: What Role in Women's Health Care?
Whether it's right for your patient depends on the specific setting
JANE L. MURRAY, MD
"The 1998 Physicians' Desk Reference indicates that medroxyprogesterone acetate should be used cautiously in patients with a history of depression; if the depression recurs or worsens, the progestin should be stopped."
"Estrogen/Progestin Interventions trial, high-density lipoprotein levels increased 3.5 times more in the group using micronized progesterone than in those receiving medroxyprogesterone acetate. Micronized progesterone appears to achieve this effect without producing any adverse effects on hemostasis, blood pressure, or levels of other lipids, probably because it has virtually no androgenic side effects."
"Many of them bind to receptors for glucocorticoids, androgens, and mineralocorticoids, as well as those for progesterone, thus explaining the diverse side effects many women experience while taking progestins: acne, menstrual irregularities, migraines, striae, and weight gain. Emotional side effects can include depression, mood swings, and irritability."
"Synthetic progestins, on the other hand, often cause androgenic side effects (acne, body and facial hair), depression, and weight gain."
Experimental and Clinical Psychopharmacology
2007, Vol. 15, No. 5, 427–444
Progesterone: Review of Safety for Clinical Studies
"Synthetic progestins marketed as Provera, PremPro, and Cycrin are widely used but may produce a number of significant side effects, such as fatigue, fluid retention, lipid level alterations, dysphoria, hypercoagulant states, and increased androgenicity. Natural progesterones are reported to have milder adverse effects, depending on the route of administration. Micronized natural progesterone is available for oral administration, has better bioavailability and fewer side effects than natural progesterone, and is convenient to administer. Therefore, micronized natural progesterone appears to be a safe and effective alternative to synthetic and natural progesterone formulations for variety of clinical and research applications."
CLINICAL THERAPEUTIC VOL. 21, NO. 1, 1999
Oral Micronized Progesterone
""the most commonly used synthetic progestins, norethisterone and medroxyprogesterone acetate, have been associated with metabolic and vascular side effects (eg, suppression of the vasodilating effect of estrogens) in both experimental and human controlled studies.All comparative studies to date conclude that the side effects of synthetic progestins can be minimized or eliminated through the use of natural progesterone, which is identical to the steroid produced by the corpus luteum."
And on and on...
Micronized progesterone is also available as Utrogestan, Cyclogest (suppositories), Progestan.
