[Noodles913]

Progesterone and Polycystic Ovarian Syndrome (PCOS)


Progesterone is a hormone that affects every tissue in your body, including the uterus, cervix, vagina, the endocrine (hormonal) system, brain cells, fat metabolism, thyroid hormone function, water balance, peripheral nerve myelin sheath synthesis, bone cells, energy production and thermogenesis, the immune system, survival and development of the embryo, and growth and development of the fetus. Though referred to as a sex hormone, it conveys no specific secondary sex characteristics.

Progesterone is essential for life because it is a precursor to aldosterone and cortisol, which are essential for life. It is a precursor to all the steroid hormones, including estrogens and testosterone. Progesterone's chief function is to synergize the actions of estradiol in the female organs, especially in pregnancy. It is necessary for proper uterine and breast development and function.

It is formed primarily by the cyclical rupture of an ovarian follicle (corpus luteum), and secondarily in the adrenal cortex. It is also produced in the placenta in large quantities during pregnancy.

Production is high during the luteal phase (second portion) of the menstrual cycle and is low during the follicular phase (first portion), as well as being low before puberty and after menopause.

Factors that stimulate release of progesterone are: luteinizing hormone (LH), prolactin, nerve impulses (psychic), and estrogen.

Progesterone Deficiency Symptoms

Symptoms of low progesterone include:

Anxiety and irritability
Breast tenderness
Carbohydrate cravings
Early miscarriage
Infertility/not ovulating
Insomnia
Irregular periods
Lower body temperature
Menstrual cramps
Mood swings
Ovarian cysts
Puffiness/bloating
Water retention
Weight gain - hips/middle.

Causes of Low Progesterone

The possible causes of low progesterone in PCOS women are varied and complex. Here are some factors to consider:

Estrogen dominance
Exposure to environmental estrogenic hormone mimics
Liver dysfunction - poor clearance of estrogen and xenobiotics
Insulin resistance
Chronic stress
Diet that causes spikes in blood sugar
Diet deficient in essential nutrients
Lack of exercise
Some medications.

Progesterone and PCOS

PCOS may occur when a woman doesn't ovulate, which causes a disruption in the normal, cyclical interrelationship among her hormones, brain and ovaries.

Normally, the hypothalamus, a regulatory center in the brain, monitors the hormone output of the ovaries and synchronizes the normal menstrual cycle. When monthly bleeding ends, the hypothalamus secretes gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland in the brain to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones direct an ovary to start making estrogen (mostly estradiol), and stimulate the maturation of eggs in about 120 follicles.

The first follicle that ovulates, releasing its egg into the fallopian tube for a journey to the uterus, quickly changes into the corpus luteum, which is a factory for making progesterone, and raises its concentrations to 200 to 300 times higher than that of estradiol. This huge surge of progesterone simultaneously puts the uterine lining in its secretory or ripening phase, and turns off further ovulation by either ovary.

If fertilization does not occur, the ovary stops its elevated production of both estrogen and progesterone. The sudden fall in the concentrations of these hormones causes shedding of the blood-rich uterine lining and bleeding (menstruation). Then, in response to low hormone levels, there is a rise in GnRH and the cycle starts all over again.

But what happens to this cycle if, for some reason, ovulation is unsuccessful? For example, if the follicle migrates to the outside of the ovary, but does not "pop" the egg and release it, the follicle becomes a cyst, and the normal progesterone surge does not occur.

The lack of progesterone is detected by the hypothalamus, which continues to try to stimulate the ovary by increasing its production of GnRH, which increases the pituitary production of FSH and LH. This stimulates the ovary to make more estrogen and androgens, which stimulates more follicles toward ovulation.

If these additional follicles are also unable to produce a matured ovum or make progesterone, the menstrual cycle is dominated by increased estrogen and androgen production without progesterone. This is the fundamental abnormality that creates PCOS.

Treatment of PCOS with Progesterone

Some physicians recommend supplementation of normal physiologic doses of progesterone to treat PCOS. If progesterone levels rise each month during the luteal phase of the cycle, as they are supposed to do, the normal menstrual pattern is maintained each month, and PCOS is less likely to occur. Natural progesterone is a logical component of polycystic ovarian syndrome treatment, along with stress reduction, exercise, nutrition, and supplementation.

Progesterone and Stress

Taking progesterone while ignoring your diet and lifestyle may yield disappointing results. Regular exercise, healthy diet and stress management are essential for success.

When you are under chronic physical or emotional stress, a stress hormone called cortisol is produced by your adrenal glands. Cortisol and progesterone compete for common receptors in your cells. Therefore, cortisol impairs progesterone activity, which reduces the effectiveness of progesterone therapy or may lead to a condition called "estrogen dominance."

High cortisol also causes an increase in your blood sugar level, which may in turn cause an over-production of insulin. High insulin levels may lead to insulin resistance and production of androgens (male hormones) and thus worsen PCOS symptoms.


Disclaimer: The information in this website is not intended to treat, diagnose, cure or prevent any disease. All material provided in the pcos forum via the 3FC website is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health program.

[SeekInnerThinChick]

Thanks, Noodles! That was interesting, but I'm not sure what to do with the info...

Is it just me, or what? The more I learn about PCOS, the more confused I get. Does this mean I should be taking progesterone, even though I have a regular period? And if I did take it, how would that affect the menopause? Would it make me more at risk of becoming pregnant?

And if my diet, exercise, and stress levels are all o.k., with good blood numbers, just what is the progesterone supposed to do for me? I've heard of people rubbing themselves with progesterone creams to stop menopause symptoms, but mine are minimal anyway, usually just a mild hot flash about 5:30 in the a.m., like clockwork.

Does it stop the excess hair from growing? Or maybe make my bustline more perky? That would be useful, lol!

I can see how someone who was young and wanting to start a family would want to regulate the hormone balance closely, but what's the advantage in medicating myself at my age? It seems to me that science doesn't yet have a lot of good data on PCOS women at midlife, and doctors for sure don't have a clue.

[Noodles913]

Originally Posted by SeekInnerThinChick

Thanks, Noodles! That was interesting, but I'm not sure what to do with the info...

Is it just me, or what? The more I learn about PCOS, the more confused I get. Does this mean I should be taking progesterone, even though I have a regular period? And if I did take it, how would that affect the menopause? Would it make me more at risk of becoming pregnant?

I wouldn't take it if your periods are normal. They give it to you if you have abnormal periods. There were times when I wouldn't have a period for 6 months! When they would give it to me I would bleed for 5-6 weeks straight from the progestrone. Hence why I had a hysterectomy.

Originally Posted by SeekInnerThinChick

And if my diet, exercise, and stress levels are all o.k., with good blood numbers, just what is the progesterone supposed to do for me? I've heard of people rubbing themselves with progesterone creams to stop menopause symptoms, but mine are minimal anyway, usually just a mild hot flash about 5:30 in the a.m., like clockwork.

I use to use the cream. I honestly didn't see a difference in anything it did...but it might work for others. Just it didn't work for me.

Originally Posted by SeekInnerThinChick

Does it stop the excess hair from growing? Or maybe make my bustline more perky? That would be useful, lol!

I wish!! Even when I was using the cream and/or prescription progestrone pills, I still grew hair in places I didn't want it. I have been taking saw palmetto now though, and I have noticed a difference in how fast it grows and the color. It isn't dark black anymore. Yay! Someday though, I will just get Lazer. I hate being a hairy italian to begin with.

Originally Posted by SeekInnerThinChick

I can see how someone who was young and wanting to start a family would want to regulate the hormone balance closely, but what's the advantage in medicating myself at my age? It seems to me that science doesn't yet have a lot of good data on PCOS women at midlife, and doctors for sure don't have a clue.

My philosophy, if it isn't broke, and if it works for you and you're happy & feel right, then don't fix it. Just MHO though. I've tried all sorts of medications, pills, creams, etc...for this rotten disease and the only thing that finally worked for me was to have my ovaries cauterized. Then after that I did a major diet change...and this helped everything else along. I feel better right now than I have in the past 10+ years...and I put that surgery off for 5!! I could slap myself now for waiting so long. *wack wack*

[SeekInnerThinChick]

....slap myself now for waiting so long. *wack wack*

Lol! My father would say "as long as it doesn't leave a mark on the wall. Might knock some sense in."

I had a big cyst removed from my left ovary back in the mid 'eighties. I was the size of an orange, and extremely painful. When it lasted more than one cycle, my ob/gyn and I both wanted that thing out pronto. We were both scared it was ovarian cancer.

Turned out to be just an ordinary cyst, with a big ball of watery fluid attached. (Sorry if that's gross!) She "scraped" the surfaces of both ovaries, they weren't that cysty, just a little "crusted." And no sign of endometriosis at all. Maybe scraping them clean helped my system regulate itself. Not enough to send a mature egg into the tube, otherwise I'd have gotten preggers by now.

I'd just as soon not medicate myself any more than I absolutely have to, but my oh my! the doctors who have tried to almost force me to take BCP or HRT! Huge pressure to conform to the norm. And you know they make a lot of money over the long run if they get you into it.

I've gotten to the point where I tell them to p!$$ off. My new doc is not an ob/gyn and isn't a pill pusher type.

[Noodles913]

Cant argue with ya there... I am just glad I finally found a doctor who knows what he's doing...and an endocrinologist who knows what she's doing. AMEN For good non-vulture type Doctors in this world!!