Natural Progesterone: What Role in Women's Healthcare? Part 4
by Jane Murray, M.D. (September 1998)
Biochemistry, Physiological Activity,
Injection, Vaginal, Rectal, Sublingual, Intrauterine
Uses, Menopausal HRT,
Disorders, Menstrual-related Allergies,
Natural progesterone appears to be an effective component of postmenopausal
HRT and is preferable to standard progestational agents for women with
worrisome lipid profiles or hypertension. Natural progesterone has fewer
side effects than synthetic agents have, and it protects the uterus from
estrogen-induced endometrial hyperplasia. Given the potential toxicities
of exogenous estrogen, it is reasonable to speculate whether progesterone,
together with a healthy lifestyle, could provide the cardioprotective
effects we want for our patients.
As for osteoporosis prevention and treatment, there are certainly some
promising data regarding the beneficial effect of natural progesterone
on bone formation, particularly in corticosteroid-induced osteoporosis.
We need more research on its effects, but if results are positive, there
may come a day when women take natural progesterone, follow a healthy
diet, exercise and perhaps avoid exogenous estrogen entirely.
In PMS, the data are confusing. We need more information on the proper
route of administration, dosage, and patient selection before we can determine
the appropriate role of natural progesterone. More research is also necessary
concerning the use of natural progesterone for affective disorders or
allergic symptoms. Topical application of progesterone for benign breast
disease appears promising, but again, there are insufficient data to clearly
know its benefit.
We need more good studies that look critically at the questions raised
by existing research. Use of natural progesterone has appealit is
essentially nontoxic, has few side effects, and is less expensive than
synthetic progestins. Perhaps with renewed emphasis on women's health
issues, the National Institutes of Health will make more funding available
for this needed research. Unfortunately, since natural progesterone cannot
be patented, we are not likely to see much corporate support for this
type of research (except for studies investigating patentable delivery
systems), We need to know effective doses and routes of administration
to manage a variety of women's health problems in this arena, as in many
others related to "alternative" and "natural" medicine.
NATURAL PROGESTERONE: PRIMARY POINTS
- Natural progesterone has fewer side effects than
synthetic agents do, and it protects the uterus from estrogen-induced
- It appears to be an effective component of postmenopausal
HRT and is preferable to the standard progestational agents for women
with worrisome lipid profiles or hypertension.
- There is some evidence that progesterone alonewithout
estrogencould have a significant effect on the prevention and
management of osteoporosis. However, more research in this area is clearly
- Whether progesterone is effective for PMS remains
unclear. There are no studies that prove its effectiveness or long-term
safety. However, the treatment is essentially benign, and anecdotal
reports support its use.
- Some intriguing studies suggest a role for progesterone in the management
of affective disorders, allergic symptoms, and benign breast disease.
However, the data are too sparse to support treatment recommendations.