Hormone SERIES Progesterone 2 of 2

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Dr. Aaron Hartman

March 22, 2022


Today I’d like to talk a little about progesterone treatment beyond the diet and lifestyle factors we discussed last week, as well as some of the unintended consequences of conventional progesterone treatment.
Most hormonal treatments currently used today are oral forms of progestin (e.g. medroxyprogesterone), which are synthetic forms of progesterone.
There are two main reasons to be very cautious in the use of progestins. First, when taking an oral progestin, the dose is about 8 to 10 times what is needed to get the right physiologic levels in your blood. These high doses can stress your liver and cause your liver to make metabolic byproducts that can be pro-inflammatory and cancer-causing.
The second reason for caution is that progestins (such as medroxyprogesterone) are synthetic, as opposed to bioidentical progesterone. Synthetic “equivalents” are supposed to be equivalent biologically, but ultimately they are not. The byproducts of these synthetic hormones can be harmful a person’s health.

Side Effects of Progestins (Synthetic Progesterone)

  • Acne
  • Bloating
  • Breakthrough bleeding and spotting
  • Breast tenderness
  • Low energy
  • Low libido
  • Headaches
  • Insomnia
  • Irritability
  • Mood issues
  • Fluid retention
  • Hair loss
  • Weight gain

Progesterone is important for breast health and stimulates breast growth. Bioidentical progesterone is breast-protective, while synthetic progestins can actually promote cancer.
As we talked about in our last post, progesterone can thicken your hair, however, progestins can actually cause hair loss. This is how birth control pills and some other oral hormones cause hair loss. Conversely, bioidentical progesterone, if done correctly, can actually help decrease insomnia and irritability. Again, the nuances of medicine are tricky. The devil is always in the details.

Addressing Low Progesterone

How do we address low progesterone levels? There are three important concepts to consider:
First and foremost, testing is so important before treating. Progesterone needs to be considered alongside estrogen, thyroid, insulin, and other factors to gain perspective.
It’s important to use a bioidentical hormone, not a synthetic progestin, for the best long-term health results.
Finally, testing afterward and periodically is important to make sure you’re not overdosing.

Signs of Progesterone or Progestin Overdose

Whether you’re taking bioidentical progesterone or synthetic progestins, it’s possible to take too much. What are some of the signs that you might be taking too much progesterone or progestin? You might notice:

  • Back pain
  • Body aches (especially in the legs)
  • Bladder issues
  • Elevated sugars
  • Increased appetite
  • Carbohydrate cravings
  • Anxiety
  • Weight gain
  • Increased risk for gall stones

These side effects can be mitigated if we test hormone levels after treatment and periodically. It’s so important, so I’ll say it again: test don’t guess!

Benefits of Progesterone Treatment

Even given the pitfalls we’ve discussed today, there are many therapeutic advantages of using progesterone. If treatment is done correctly, the benefits can significantly improve a woman’s health and well-being by:

  • Reducing the risk of breast cancer
  • Supporting mood
  • Reducing anxiety
  • Improving sleep
  • Thickening hair
  • Reducing the risk of heart disease
  • Aiding weight loss
  • Reducing inflammation
  • Lowering blood pressure
  • Improving bone health

Progesterone treatment does actually lower your risk of breast cancer if balanced appropriately with estrogen. It can reduce anxiety and treat insomnia. It can also lower your risk for heart disease, help with weight loss, and thicken your hair. Progesterone is anti-inflammatory, It can lower blood pressure, and improve bone health. There are even some interesting studies looking at progesterone and its role in improving myelination in multiple sclerosis.
Again, these are some benefits of progesterone treatment when done appropriately, with the right kind of progesterone, balanced properly with other hormones.


Today’s topic of progesterone treatment should be considered only after the other foundational concepts of functional medicine have been addressed. For optimal hormonal health, we must consider the thyroid, sugar and insulin levels, pancreatic function, cortisol levels, as well as gut function. All these plane to a beautifully complex web of hormone balance, and can result in longevity, vibrant health and optimal function.
As we think about the treatment of progesterone, there are three important concepts to remember. First, we want to consider progesterone in relation to other hormones. Second, we should use bioidentical hormones, not synthetic progestins. Finally, it is so important to test before and after treatment.
Hopefully this series is helpful to you as we continue to discuss various hormones and how they interconnect. We’d love some feedback if these have been helpful to you. Follow us on social media and leave a comment to let us know!
Stay tuned for next week’s post when we begin a series on thyroid hormones and function.
Thanks a lot, take care and be well.
Since 2010, Richmond Integrative and Functional Medicine has been helping people to restore their health and hope with an integrative approach to conventional and alternative medicine that’s entirely science-backed. We at RIFM believe everyone is made for health. We offer a comprehensive, in-person patient membership program to ensure you get access to the care you need to thrive.


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