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Natural Progesterone
Questions and Answers for Men
1 What is progesterone?
Progesterone is a steroid hormone made by both men and women.  In women, it is made the corpus luteum of the ovary and in smaller amounts by the adrenal glands.  In men, is produced in adrenal and testicular tissue.

Simplified pathway for biosynthesis of hormones (graph opens in new window).

Progesterone is produced in the body from cholesterol and is a precursor to most of the other steroid hormones, including cortisol and testosterone.



2 What is progesterone made from?
Progesterone USP used in natural hormone replacement therapy (NHRT) is made from a substance called diosgenin, which is most often extracted from wild yam (Dioscorea villosa).  In a laboratory process, diosgenin is transformed into progesterone, identical with the human hormone.
Some companies are selling diosgenin, which they label as "wild yam extract" claiming that the body will then convert it into hormones as needed.  While this can be done in a laboratory, there is no evidence that this conversion takes place in the human body.



3 What is the role of progesterone in men?
In men, progesterone is produced in adrenal and testicular tissue. It is the precursor to cortisol, testosterone, estrogen and other hormones. All hormone levels drop with age and so does the level of progesterone. This in turn causes additional depletion of other hormones. Prolonged stress further depletes progesterone because it increases the demand for cortisol.



4 What is “estrogen dominance”?
This term coined by Dr. John R. Lee* relates to a condition when there is insufficient progesterone in proportion to estrogen (estrogen is unbalanced or unopposed).



5 What causes excess level of estrogen in men?
Contrary to the popular belief that estrogen is a “female” hormone, it is also present in men, as a result of testosterone conversion - see the diagram Simplified pathway for biosynthesis of hormones (graph opens in new window). Normal serum concentration of estradiol in men is 20 – 50 picograms/ml. 
As well as women, men can also experience the effects of excess estrogen.

Major causes of estrogen dominance in men:
-    environmental estrogens; our food is a significant source of those:  livestock is fed estrogens to grow faster and gain weight by retaining water; crops are sprayed with pesticides that mimic estrogens.
-    impaired liver function
-  prolonged intense stress increases demand for cortisol, which is made from progesterone.  The process leaves less progesterone available for balancing estrogen.



6 What are the symptoms of “estrogen dominance”?
According to John R. Lee, M.D.*, symptoms of estrogen dominance that men can experience include weight gain, bloating, mood swings, irritability, headaches, fatigue, depression and hypoglycemia.  Estrogen dominance is known to contribute to cancer of prostate and the breast.  It may seem paradoxical, but men are not immune to breast cancer.



7
When should men start using natural progesterone?
Men can enjoy many of the non-female-specific benefits of the hormone. Dr. Lee* has recommended progesterone supplementation for men in their late forties and older, when they experience low energy or fatigue, decreased libido, have increased body fat, enlarged prostate or to want to help prevent prostate enlargement.
Progesterone is needed to counter-balance the effects of excess estrogens.  Also, by blocking the enzyme 5a-reductase (see the diagram Simplified pathway for biosynthesis of hormones (graph opens in new window).



8 What is the dose of progesterone for men?
It should not exceed 8 mg per day. Depending on body weight, an average daily dose is 3 - 5 mg. The dose can be single or split between morning and afternoon. Progesterone should be used for 21 to 25 consecutive days in a month and discontinued until the end of the month; the cycle is then repeated.

Excessive long-term use of progesterone (or any other hormones) may lead to hormonal imbalance.



9 Who should not use progesterone?
Persons with active liver disease or severely impaired liver function.

Consult your health care practitioner if you have a chronic medical problem or taking a regularly prescribed medication.



10 How can men benefit from progesterone?
Progesterone is needed for many reasons, but one of its most important roles is to oppose the negative effects of excess estrogen.

John R. Lee, M.D.* lists the following benefits of progesterone:
-    Protects against prostate cancer
-    Helps normalize blood sugar levels
-    Helps use fat for energy
-    Prevents water accumulation (acts as mild diuretic)
-    Helps (normalizes) thyroid hormone function
-    Stimulates new bone formation (osteoporosis protection and even reversal)
-    Improves brain function, has antidepressant properties
-    Improves skin problems including acne, seborrhea, rosacea, psoriasis
-    Diminishes muscular aches and pains, has anti-inflammatory properties
-    Improves sleep pattern
-    Improves libido.



11 If natural progesterone has so many benefits, why don't physicians routinely recommend it to their patients?
Progesterone is a natural substance and as such cannot be patented for sale at high profit margins. That makes pharmaceutical companies uninterested in marketing and promoting natural products such as progesterone.   If pharmaceutical representatives don't market a product to physicians, many physicians are simply unaware of its existence.





The following paragraphs are based on the interview with Katharina Dalton, MD “Progesterone and Related Topics”, published by International Journal of Pharmaceutical Compounding, September/October 1999.

Progesterone receptors are present in men, women and children of all ages.  People should be more aware that progesterone has many important functions: it looks after the smoothness of blood vessels; the myelin sheaths of nerves in men, women and children; and it prevents water retention in the brain of men, women and children.  In other words, it’s needed by men, women and children.
We all need systemic progesterone, which is essentially adrenal progesterone.  Additionally, women have ovarian progesterone that can reach very high levels.  During pregnancy, it can be 1000 times higher than the systemic progesterone that men and children have.

What is the role of progesterone in men?
Progesterone receptors are found, among other sites, in the endothelial lining of blood vessels.  It’s those receptors that keep endothelial lining nice and smooth.  With excess estrogen, the exact opposite happens: the endothelium becomes lumpy and bumpy, therefore excessive estrogen (unbalanced by progesterone) makes us prone to clotting diseases, strokes and angina.  Also, the ability of the blood vessels to relax is related to the presence of progesterone receptors and sufficient progesterone level to stimulate them.  Insufficient progesterone may affect one way or another the many systems of the body, including blood vessels.  Men who do not have sufficient amount of progesterone tend to get cardiovascular diseases in their 40s, whereas women are protected until after their 50s.
In other words, progesterone is necessary to maintain cardiovascular health.

Men also need progesterone for their bones; they tend to get osteoporosis earlier than women because women are protected to a certain extent, particularly with their pregnancies, when they have a high level of progesterone for nine months.

We all need progesterone for the brain, specifically for myelin sheaths of the nerves.

Does the level of progesterone decrease as the result of adrenal stress?
Yes, and you end up with progesterone deficiency at one or more sites in the body.  It might be the blood vessels that get affected.

Does progesterone affect hair growth?
Yes, it certainly affects hair growth in women.  Many women lose some hair shortly after pregnancy.  The reason is that their progesterone level decreases dramatically.  Some unlucky women experience total hair loss.  But with progesterone supplementation their hair regrows amazingly.

Are there any other benefits of progesterone supplementation?
Progesterone facilitates healing process after an injury.  Trauma, including that resulting from cerebral accidents, heals quicker in
pre-menopausal women than in men because they have more progesterone.  Also, they have far less water retention in the brain.  For that reason some neurosurgeons use progesterone injections prior to surgery to prevent swelling due to water retention.


* Information on this page is based on the following books, which offer detailed explanation of women's hormone balance issues, hormone balance programs, as well as detailed descriptions of how to use natural hormones:

John R. Lee, M.D.  What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone

John R. Lee, M.D.  What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Life from Thirty to Fifty

Uzzi Reiss, M.D., O.B.-GYN.  Natural Hormone Balance for Women: Look Younger, Feel Stronger and Live Life with Exuberance

Joseph McWherter, M.D.  Avoiding Breast Cancer While Balancing Your Hormones.  The FEM Centre Breast Cancer Program.  Book available online at www.femcentre.com

Information in this publication is not intended to replace any medical treatment
prescribed by your physician. For those with chronic medical problems
or taking a regularly prescribed medication, please consult your health care practitioner.
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Statements in this publication have not been evaluated by the Food and Drug Administration. The product is not intended to diagnose, treat, cure or prevent any disease.

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