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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• Purchase Cynthia’s book, The Menopause Gut.
• Cynthia’s Intermittent Fasting Transformation Book
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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