I think you will agree with me, if you are one of the many women who suffers from progesterone dominance symptoms or think you are having symptoms related to menopause, then getting (relief is vital) the correct information is vital.
The problem is that education on female hormones is limited at best. To compound the matter, doctors are NOT taught ANYTHING about these hormones in medical school nor how to treat them.
Furthermore, pharmaceutical companies with aggressive marketing campaigns – pushing synthetic hormones, have done an excellent job confusing the situation about what is actually safe.
In our clinic I have assisted hundreds of women to work through progesterone dominance, hormonal balance issues, perimenopause, menopause, and hysterectomies, etc. We have helped turn once desperate and frustrated women into happy, loving, productive, sexually active, stress-free women and more.
In this post I am going to teach you what progesterone dominance is, how to diagnose your symptoms, and how to treat them.
#1: High Progesterone dominance side effects:
Women take progesterone for many reasons, like to help restart their menstrual cycles that have stopped, treat severe symptoms of premenstrual syndrome (PMS), treat perimenopause or menopause.
Progesterone is also used to balance the effects of estrogen as part of hormone replacement therapy.
If estrogen is given without progesterone, estrogen increases the risk of uterine cancer. For this reason, they are commonly given together.
However, sometimes too much progesterone can build up in the system causing unwanted symptoms.
Below are some known side effects of progesterone dominance.
❓ Low energy
❓ Upset stomach
❓ Aches & pains
Is it stress or symptoms of a cold or flu?
With the flu season on our doorstep, are we too quick to blame the dreaded office virus?https://t.co/eYdVG5NAWK#HumanResources #MentalHealth #Business #Stress pic.twitter.com/1mTDzGusLw
— Stress Less Work Smarter (@StressLessMgmt) October 26, 2018
Progesterone Dominance side effects
- stomach upset
- changes in appetite
- weight gain
- fluid retention and swelling (edema)
- drowsiness or insomnia
- allergic skin rashes
- breast discomfort or enlargement
- premenstrual syndrome (PMS) – like symptoms dizziness
- weight gain
- water retention
These are just some of high progesterone symptoms.
Progesterone is a hormone that occurs naturally in the body, but it can also be made in a laboratory. Progesterone is a hormone released by the corpus luteum in the ovary. It plays important roles in the menstrual cycle and in maintaining the early stages of pregnancy. It may also be involved in the growth of certain cancers.
Detailed description of progesterone
Progesterone is in a class of steroids called progestogens. It is secreted by the corpus luteum in the ovaries during the second half of the menstrual cycle and in some part by the adrenals.
It is very important during pregnancy to protect the fetus, it stimulates the growth of breast tissue, prevents lactation and strengthens the pelvic wall for labor. Progesterone rises throughout pregnancy until the baby is born.
“Progestin” is a general term for a synthetic substance that causes some or all of the biologic effects of progesterone. The term “progestin” is sometimes used to refer to the progesterone made in the laboratory that is in oral contraceptive and hormone replacement therapy. However, all progesterone and progestin products are made in the laboratory.
The term “natural progesterone” is really a misnomer. Natural progesterones, including the prescription products Crinone and Prometrium, are made from a chemical called diosgenin that is isolated from wild yam or soy.
In the laboratory, this component is converted to pregnenolone and then to progesterone.
The human body is not able to make progesterone from diosgenin, so eating wild yam or soy will not boost your progesterone levels.
Over-the-counter (OTC) progesterone
Over-the-counter progesterone products may not contain the actual progesterone concentrations as labeled. Over the counter progesterone cream is considered a cosmetic.
According to a British report, two-ounce jars of Progest cream used in a clinical trial contained 100 mg progesterone per ounce rather than the 465 mg claimed by the manufacturer.
DYK that most over-the-counter #cosmetics contain very few active ingredients? This is why you’re not getting the results you want. Our skincare was designed for industry professionals, meaning a #higher concentration of active ingredients that provide better and faster results. pic.twitter.com/CyYvUelyUF
— LeTellier Skincare (@LeTellierSkin) June 15, 2018
Topical progesterone products (preparations applied to the skin) marketed as cosmetics require no FDA approval prior to marketing.
There is currently no limit on the amount of progesterone allowed in cosmetic products.
In 1993 the FDA proposed a rule limiting progesterone-containing cosmetic products to a maximum level of 5 mg/oz with the product label instructing users not to exceed 2 oz per month. But this rule was never finalized.
Women commonly take progesterone to help restart menstrual periods that unexpectedly stopped, treat abnormal uterine bleeding associated with hormonal imbalance, and treat severe symptoms of premenstrual syndrome (PMS).
Progesterone is also used in combination with the hormone estrogen to “balance estrogen” as part of hormone replacement therapy.
If estrogen is given without progesterone, estrogen increases the risk of uterine cancer.
Progesterone cream is sometimes used in hormone replacement therapy and for treating menopausal symptoms such as hot flashes, and premenstrual syndrome (PMS).
Progesterone gel is sometimes used inside the vagina to treat breast pain in women with noncancerous breast disease, prevent and treat abnormal thickening of the lining of the uterus (endometrial hyperplasia), and prevent premature labor.
Progesterone is also used intra-vaginally or by injection for treating infertility and symptoms of (PMS).
Progesterone can also be used for a variety of other conditions not listed above, but there is limited scientific research to support these other uses. Where does progesterone come from?
#3: Progesterone Origins
In 1929 the existence of the corpus luteum hormone was established, was proven to be necessary for successful pregnancy, and thus given the name progesterone (ie “Pro-gestation”)
It wasn’t until 1939 when a scientist learned how to create a natural form of progesterone that could safely be supplemented which was synthesized from the wild yam plant.
From long ago, Native Americans have used wild yam for possible benefits ranging from menopause relief especially hot flashes, treating diverticulosis, gallbladder pain and rheumatoid arthritis.
Wild yam has many purported benefits, but not enough contemporary scientific data… pic.twitter.com/6FslmQQR8Q
— April Danann (@DanannSpl4ces) June 18, 2018
In the 1950’s it was discovered that only wild yams found in tropical regions with the latin name (Dioscorea) could be converted into a laboratory with the exact same molecule as human progesterone yielding – bioidentical progesterone.
Not long after, the pharmaceutical industry realized that large profits could be made from creating their own version an inexpensively synthetic form of progesterone made from soybeans, one which they could patent.
Profiting off of women
Man-made (synthetic) hormones are far more profitable for commercial application because they can be patented.
These patented synthetic progesterones were created in pill and capsule forms that were more effective when taken orally. These same synthetic forms of progesterone, which are prescribed by traditional medical doctors, don’t provide the full spectrum of biological availability (meaning they don’t work as well), nor are they as safe.
Synthetic progesterone grew in popularity due to their ability to prevent pregnancy and their minimal protection of estrogen-induced risk of endometrial cancer.
It’s an alarming fact that corporations’ pursuit of profit over women’s health prevailed.
Pharmaceutical companies could now take perfectly good hormones, that our bodies know and love, and alter them creating synthetic compounds with similar results – but with toxic side effects.
Hormonal research in the last 2 decades has been entirely nonexistent. And the pharmaceutical companies that sell these products have been very successful in confusing doctors about the meaning of ‘progesterone’.
The typical doctor thinks that synthetic progesterone products are actually progesterone.
Since these synthetic progesterones called ‘progestins’ have a long list of undesirable and potentially dangerous side effects, doctors have been leery of prescribing natural progesterone.
Consequently, natural bioidentical progesterone has almost no side effects when supplied in the same doses the body makes naturally in a health woman with healthy function.
This conclusion is probably one of the reasons you are researching using bioidentical progesterone yourself.
Board-certified OB/GYN physician, Dr. Christiane Northrup confirms that “The most physiologic way to take hormones is through the skin—either with a cream or a vaginal gel. That way the hormone goes right into the bloodstream without having to be metabolized by the liver.”
Now that you understand where progesterone comes from there are many uses of progesterone to consider.
#4: Uses for progesterone.
There are many uses for progesterone from hormone replacement therapy, menopause to severe PMS. The following is a more detailed list with brief explanations of each.
Absence of menstrual periods is called amenorrhea. The common effective treatment strategies is to take progesterone by mouth and apply progesterone gel into the vagina for treating absence of menstrual periods in premenopausal women.
Micronized progesterone is FDA-approved for this use, as is intravaginal progesterone gel (Crinone 4%).
Hormone replacement therapy (HRT)
Micronized progesterone (Prometrium) is FDA-approved for use with estrogen as a component of HRT.
Research shows that adding progesterone to HRT protects against side effects of estrogen.
Intravaginal progesterone gel (Crinone 8%) is FDA-approved for use as a part of infertility treatment in women. Some research suggests that applying progesterone intravaginally and injecting it into the muscle may have similar effectiveness for increasing pregnancy rates as giving it by mouth.
Also, research suggests that intravaginal progesterone seems to be as effective for pregnancy rates as human chorionic gonadotropin (HCG).
Further information has been written on the subject of conceiving using progesterone cream (ttc) while trying to conceive. It’s worth reviewing in detail if you are considering having a baby and/or have been having trouble conceiving.
Abnormal thickening of the endometrium (endometrial hyperplasia)
Some research suggests that applying progesterone (Crinone) into the vagina prevents endometrial hyperplasia in women with an intact uterus that are taking estrogen replacement therapy.
Other early research shows that a specific intravaginal progesterone cream may help reverse abnormal thickening of the endometrium and decrease vaginal bleeding in premenopausal women with non-cancerous endometrial hyperplasia.
Breast pain (mastodynia)
There is also further research that suggests that applying progesterone (Crinone) into the vagina seems to reduce breast pain and tenderness in women with non-cancerous breast disease.
And more research suggests that applying a specific progesterone cream (Progest) to the skin reduces symptoms such as hot flashes in menopausal women. There have been countless articles written on the power of using progesterone cream to aid women in menopausal symptoms.
Most research suggests that applying progesterone gel into the vagina, alone or along with therapy to delay labor (tocolytic therapy), reduces the risk of premature delivery in some women at high risk of premature birth.
However, other research suggests that intravaginal progesterone gel does not decrease the frequency of premature birth in women with a history of premature birth.
With all the uses of progesterone out of the way let’s consider what actually causes high progesterone.
#5: What Causes High Progesterone?
Believe it or not, women have more progesterone than they have estrogen (in absolute concentration). What this means is, that progesterone is incredibly important to the female body because it directly counteracts the effects of estrogen.
You probably think of estrogen as the “female” sex hormone, responsible for the majority of sexual characteristics that females have like breast development, etc. But, like many things, too much of a good thing isn’t always better.
This principle is true of both estrogen AND progesterone; these two hormones live in balance with one another. Now let’s take a look at estrogen in depth to get a greater understanding of this balance.
Estrogen is often considered a growth hormone which makes things bigger, progesterone as the exact opposite. Estrogen causes breast tissue to grow, it causes endometrial tissue to grow and it causes fat cells to grow. Not exactly what most women want.
Progesterone, on the other hand, causes the exact opposite. Progesterone helps regulate breast tissue growth, it helps regulate your menstrual cycle and it can help with weight loss.
Balance is key in order to maintain a healthy system.
But what is most important to understand is that you need to balance these hormones.
It’s not as easy as simply increasing progesterone for weight loss, for instance, it’s the imbalance (lack of balance) of these two hormones which cause significant negative symptoms in many women.
To be fair, the majority of women nowadays have excess estrogen and too little progesterone.
This is commonly referred to as estrogen dominance, however some women still suffer from the symptoms of excess progesterone.
How to Know If You Have Estrogen Dominance and What To Do About It
Most women suffer from low progesterone, however there are quite a few that have excess progesterone. And this bring me to the most common causes of high progesterone in women.
#7: Most common causes of high progesterone in women
The following are the most common causes of high progesterone in women that you may avoid with proper care and a little attention to detail.
- Changes in your menstrual cycle (elongation of the luteal phase)
- A reduction in estrogen levels in the body
- Too much supplementation with progesterone (either oral or transdermal progesterone)
- Excess supplementation with pregnenolone or other progesterone precursors
- Adrenal related problems (overproduction of adrenal hormones or improper adrenal enzyme signaling)
As with other hormone imbalances, it’s always important to correctly identify what is causing the problem in your body.
Once you have identified the issue that is causing your symptoms then can you properly target them with the required treatment.
Before we talk about treatment let’s discuss the many symptoms of progesterone dominance.
#8: Symptoms of progesterone dominance
Here are the progesterone dominance symptoms that are most common. These symptoms arise from too much progesterone in the body. This is usually the result of taking too much over the counter progesterone, pregnenolone or during the luteal phase of your menstrual cycle (last 2 weeks)
Most common symptoms of high progesterone:
- Weight fluctuations (usually mild weight gain of 5-10 pounds)
- Depressed feeling but not overt depression
- Slight dizziness
- Waking up groggy or “on edge”
- Sense of physical instability
- Spinning sensation
- Discomfort or pain in the legs
- Water retention
- Anxiety or just feeling “tense”
- Changes to libido (usually decreased sex drive)
- Not feeling like yourself
Less common symptoms of high progesterone:
The following is a list of less common symptoms which are usually the result of taking much higher levels of progesterone or having much higher concentrations of progesterone in the body.
Interestingly enough these symptoms can actually mimic excess estrogen in the body.
Symptoms of excess estrogen
- Hot flashes (due to an overload of estrogen receptors)
- Increased appetite
- Overt anxiety or panic attacks
- Significant weight gain
As you might have noticed some of these symptoms are very subtle or very general. Therefore, this can make the diagnosis difficult. For this reason, it’s important to remember that each person will have different individual symptoms.
You know your body better than anyone, therefore it’s very likely that you will know when something is not right. If you feel you are having any of the symptoms above, have your progesterone levels checked.
You can check your progesterone levels through a blood serum test by checking serum progesterone.
#9: Things you should realize before you get tested:
There are 4 things you should consider before getting tested for progesterone dominance. You will want to evaluate progesterone and estradiol at the same time. Also, notice when you are menstruating as this matters, serum levels can fluctuate and may not be the most accurate, and progesterone levels change with age.
There are 4 things to know before you get tested
#1. You must evaluate progesterone AND estradiol at the same time.
Dealing with hormones is a delicate balance one in which you will want to balance estrogen and progesterone at the same time. Therefore, you will want to test and monitor both at the same time through serum blood tests or with a saliva test. Most physicians know how to test for these however it’s always a good idea to remind them to test for both just in case.
#2. The time of the month matters (if you are still menstruating)
If you are menstruating, then it’s important to check your progesterone and estradiol levels during days 19-21 of your cycle. At this point in your cycle progesterone most likely will be the highest and the ratio above applies.
I would suggest that you check your progesterone and estrogen levels multiple times per month. It’s very difficult to get an accurate reading if you randomly check your progesterone levels, with the exception after menopause. In menopause you are not ovulating and its ok to check progesterone and estrogen any time.
#3. Serum levels may not be the most accurate way to test your progesterone levels
Much like other hormones in your body, serum levels may not be the absolute best way to check what is really happening in your body. I generally recommend you start with serum levels first because they are easy to order and insurance will almost always cover the test. However, you may need to make sure that you doctor codes the forms correctly for insurance purposes.
If you continue to have symptoms or your serum levels are not helpful, you may need more advanced testing. In some cases, you can get a more accurate reading of progesterone by checking for urinary metabolites of pregnanediol. Checking urinary levels of sex hormones also allows you to get a better idea of what is happening to your estrogen levels (as there are at least 3 primary estrogen metabolites that are not regularly checked in the serum).
This process is somewhat more advanced than serum testing, so make sure you find a Doctor who understands this process and can help you interpret your tests.
#4. Progesterone levels change as you age.
Progesterone levels and progesterone metabolism change with age, in addition to your menstrual cycle. As women age progesterone levels tend to decrease and estrogen tends to rise which cause progesterone dominance. This usually starts around age 35 but this is just an average and does not mean it will happen to you. It’s a great idea to check progesterone levels every time, perhaps with yearly physicals.
#10: Treating High Progesterone
Treating of high progesterone largely depends on what the cause is. By far the most common cause of high progesterone and therefore high progesterone symptoms are due to over supplementation.
Usually the main culprit with high progesterone is over supplementing with progesterone. Treatment varies based on what the cause is. Below are 4 explanations you should know about.
#1. Treating high progesterone – from supplementing with too much progesterone:
Consider dropping your dose if you notice any of the symptoms above, however its best to check your serum progesterone levels before and after starting progesterone supplementation.
#2. Another common cause of high progesterone is due to adrenal overstimulation, which results in overproduction of progesterone in the adrenal glands:
Due to the high levels of stress in women’s lives their adrenal glands are often taxed to the extreme. Excess levels of fatigue and stress cause abnormal hormone production or enzyme metabolism which can also affect cortisol levels. Studies have shown this to be the case. Stressing the adrenals combined with high cortisol levels may cause weight gain and other symptoms.
Here are some basic recommendations to get your started:
- Cut caffeine usage completely
- Manage and reduce your stress (if possible), try yoga, thai chi, meditate
- If you are an exerciser, try reducing your exercise a little – see if that helps
- Take the right supplements designed to help balance cortisol levels
- Check your serum cortisol level and DHEA level
- Exclude refined carbs and sugars from your diet
This is just some basic information to get you started, however all these steps are helpful as a yearly reset. If you feel you have adrenal issues its best to consult your medical provider and get tested.
#3. Treating high progesterone related to elongation of your cycle or the luteal phase.
We have already stressed the importance of balance however I think it’s good to point out that balancing your stress, thus managing your luteal phase (menstrual cycle) is also important as well. Managing your lifestyle by removing stresses, eating a balanced diet, exercising, etc. is a great way to manage your menstrual cycle. The less stress you have, the less likely you will have a longer menstrual cycle therefore the less progesterone your body will produce.
Things you can do to manage your menstrual cycle:
- Eating a real whole food diet without excessive caloric restriction
- Managing stress levels by taking certain supplements or partaking in certain activities which improve your natural stress response
- Making sure you sleep at least 8 hours each night
- Regulating your exercise so you aren’t exercising too much or too little
- Managing your weight (this means making sure you don’t gain too much weight or lose too much)
If you follow these recommendations you should be well on your way to managing your menstrual cycle and your luteal phase which can help level your progesterone levels.
#4. Get your thyroid evaluated (and other hormones!)
By now you will have a good understanding of how important balancing hormones are. Therefore, if you take into consideration how important thyroid function is, how it can affect both progesterone and cortisol levels, (8) and how stress can alter them and their effects on obesity, you are well on your way to a healthy life.
Slight changes in any of the hormones could affect progesterone levels. It’s a great idea to check your thyroid status and other hormones such as leptin, insulin and testosterone if you notice you have high progesterone symptoms. A good doctor can run a hormone blood serum panel easily.
#11: Treating High Progesterone from Birth Control Medications
Another important consideration is birth control medications and how they can affect hormones and progesterone levels. Birth control medication can trick the body by acting as fake progesterone (synthetic) and can reduce or block your body’s normal production of endogenous progesterone.
This may cause the symptoms of high progesterone even though your serum progesterone levels may be “low” or “normal”. And this is also why so many women who start birth control medications end up with symptoms such as weight gain, swelling or mood swings (all symptoms of excess progesterone).
But does that mean it’s normal? Not by a long shot. So what do you do about it? Obviously, if you are reacting negatively to birth control medications your next step should be to go off of them (assuming that is an option for you).
Since birth control is a synthetic (known as progestin or progestogen) and acts like progesterone it may trigger incorrect messages to the brain. Therefore, these signals make your body think that it has excess progesterone, which may cause the symptoms of high progesterone – even though your serum progesterone levels may be ‘low’ or ‘normal’ when checked.
Furthermore, this can be the reason many women who begin taking birth control experience weight gain, swelling or mood swings (all symptoms of excess progesterone).
If you are interested in the possibility of getting pregnant and you are having any of the symptoms or problems listed in this article you may want to consider the effects birth control and progesterone can have on pregnancy.
As a side note many women who take birth control for an extended period of time who then later experience trouble getting pregnant may want to consider the long term effects of taking birth control when trying to conceive.
Having these negative reactions to birth control should not be considered normal. If you are reacting negatively to birth control medications your next step should be to go to the doctor and discuss getting off birth control or alternatives to synthetic birth control.
However, stopping birth control medication may not be enough to restore normal progesterone and estrogen function, you may need to properly eliminate and restore the metabolism of these hormones through the liver, and this can be achieved in a few ways.
In order to increase liver metabolism and phase I and phase II elimination pathways you can take the supplement calcium-d-glucarate.
This supplement has been shown to increase glucuronidation (which is an elimination pathway in the liver). Taking milk thistle, or MSM for instance, may also help improve liver function
Controlling (normalizing) your body weight and removing excess fat cells that you may have gained from taking birth control pills should help normalize your hormones and is a major concern. Fat can act as a storage device to fat-soluble substances which includes hormones, like progesterone, endocrine disruptors and fat-soluble vitamins.
If you think you are suffering from high progesterone, you may want to spend the time researching and educating yourself on what is causing the problem. This article is a great first step. Once you have figured out the root cause of your hormone imbalance you will have come a long way towards targeting the treatment to REVERSE the issue.
Most doctors don’t have enough training and education on the subject of hormones in order to assist you balancing your body.
In fact, during medical school there are no classes on hormones related to treating women with these issues. Only doctors that practice functional medicine or who have learned and educated themselves will be able to assist you on your journey towards treatment.
Your ob-gyn may not even know what to do as well.
I would be glad to discuss your symptoms and anything you would like to discuss and would love to hear from you. If you have any questions, please don’t hesitate to comment below!