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Are there benefits of progesterone therapy after hysterectomy

#bioidenticalhormones #progesterone #hormonereplacementherapy

Progesterone is a steroid hormone involved in the female menstrual cycle, pregnancy (supports gestation ), and embryogenesis of humans and other species.

In menopausal women on hormone replacement therapy (HRT), progesterone (P4) helps the body to equate estradiol (E2). Since progesterone's main role is to protect the uterine lining against estrogen prevailing, medical professionals used to assume that a woman does not need any further P4 treatment since estradiol levels decrease significantly. This led the medical world to think that progesterone is unnecessary after hysterectomy among women.

But progesterone has effects on the body outside of the uterus. We can find progesterone receptors in breast tissue, in bones and in the brain. In breast tissue, progesterone promotes milk-producing structures in the lactating mammary gland. When stimulated by tumor growth factors, progesterone can also stimulate abnormal breast tissue growth and be involved in progesterone receptor positive breast cancer. That doesn't mean the progesterone therapy in menopause will lead to breast cancer. The development of cancer cells is usually dependent on multiple different cellular mechanisms including abnormal function of tumor suppressor genes and severe oncogenes and cancer promoting factors in the environment. In studies, it was mostly the synthetic progesterone that was associated with increased breast cancer risk and not bioidentical micronized progesterone.

Outside of the breast, progesterone has protective effects on brain and bone health.

Progesterone and Brain Health

Progesterone has been deemed a neurosteroid because of the crucial role it plays in many vital functions of the brain, such as neurogenesis (the growth and development of nervous system tissue), regeneration (repairing damaged brain cells), cognition and mood and myelination of nerve cells in the central nervous system. It also lowers neuroinflammation in the brain.

Progesterone has a sedative/hypnotic effect resulting from metabolites that are produced by the liver after progesterone is taken by mouth. It therefore can work as a great sleep aid in women suffering from progesterone deficiency (perimenopause and menopause, PMS, postpartum).

Progesterone and Bone Health

Progesterone appears to have complementary bone actions with estrogen and antiresorptive therapies. Invitro publications have documented progesterone's ability to increase osteoblast numbers as well as its effects to promote osteoblast maturation and differentiation. Progesterone appears to play a differing but also physiological role in partnership with estrogen in achieving optimal peak bone mass.

Given the benefits of progesterone for bone and brain health, it is my recommendation to supplement women with both estradiol and progesterone in menopause, even after a hysterectomy.

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