Progesterone

Bio-Identical Progesterone

Progesterone is a C-21 steroid hormone involved in the female menstrual cycle, pregnancy (supports gestation) and embryogenesis of humans and other species. Progesterone belongs to a class of hormones called progestogens, and is the major naturally occurring human progestogen.

Progesterone should not be confused with progestins, which are synthetically produced progestogens.

Progesterone is commonly manufactured from the yam family, Dioscorea. Dioscorea produces large amounts of a steroid called diosgenin, which can be converted into progesterone in the laboratory.

Plant Sources
Outside progesterone-producing animals such as humans, progesterone-like steroids are found in Dioscorea mexicana. Dioscorea mexicana is a plant that is part of the yam family and resides in Mexico.[1] It contains a steroid called diosgenin that is taken from the plant and is converted into progesterone.[2] Diosgenin and progesterone are found in other Dioscorea species as well.

Another plant that has been discovered to indirectly contain progesterone is Dioscorea pseudojaponica that resides in Taiwan. Research has showed that the Taiwanese yam contained saponins, steroids, which are converted to diosgenin. From diosgenin, it can produce progesterone.[3]

Another plant that is found to contain these steroids that convert to progesterone is a wild yam called Dioscorea villosa. One study showed that the Dioscorea villosa contains 3.5% of diosgenin.[4] There are many other Dioscorea species of the yam family that contribute to the production of progesterone, but there is one new species found. Dioscorea polygonoides has been researched and found 2.64% of diosgenin that was recognized by testing it with gas chromatography-mass spectrometry.[5] Many of the Dioscorea species that originate from the yam family grow in countries that have tropical and subtropical climates.[6]

Levels
Progesterone levels (black line) during the menstrual cycle

In women, progesterone levels are relatively low during the preovulatory phase of the menstrual cycle, rise after ovulation, and are elevated during the luteal phase. Progesterone levels tend to be < 2 ng/ml prior to ovulation, and > 5 ng/ml after ovulation. If pregnancy occurs, progesterone levels are initially maintained at luteal levels. With the onset of the luteal-placental shift in progesterone support of the pregnancy, levels start to rise further and may reach 100-200 ng/ml at term. Whether a decrease in progesterone levels is critical for the initiation of labor has been argued and may be species-specific. After delivery of the placenta and during lactation, progesterone levels are very low.

Progesterone levels are relatively low in children and postmenopausal women.[18] Adult males have levels similar to those in women during the follicular phase of the menstrual cycle.

Reproductive system
Progesterone is sometimes called the "hormone of pregnancy",[24] and it has many roles relating to the development of the fetus:

Progesterone converts the endometrium to its secretory stage to prepare the uterus for implantation. At the same time progesterone affects the vaginal epithelium and cervical mucus, making the mucus thick and impermeable to sperm. If pregnancy does not occur, progesterone levels will decrease, leading, in the human, to menstruation. Normal menstrual bleeding is progesterone withdrawal bleeding.
During implantation and gestation, progesterone appears to decrease the maternal immune response to allow for the acceptance of the pregnancy.
Progesterone decreases contractility of the uterine smooth muscle.[24]
In addition progesterone inhibits lactation during pregnancy. The fall in progesterone levels following delivery is one of the triggers for milk production.
A drop in progesterone levels is possibly one step that facilitates the onset of labor.
The fetus metabolizes placental progesterone in the production of adrenal steroids.


Bioavailability
Progesterone is poorly absorbed by oral ingestion unless micronised and in oil, or with fatty foods; it does not dissolve in water. Products such as Prometrium, Utrogestan, Minagest and Microgest are therefore capsules containing micronised progesterone in oil - in all three mentioned the oil is peanut oil, which may cause serious allergic reactions in some people, but compounding pharmacies, which have the facilities and licenses to make their own products, can use alternatives. Vaginal and rectal application is also effective, with products such as ENDOMETRIN (progesterone) Vaginal Insert 100 mg, approved by the FDA in June 2007 to support embryo implantation and early pregnancy. Other products are CRINONE and PROCHIEVE bioadhesive progesterone vaginal gels (the first progesterone products FDA-approved for use in infertility and during pregnancy) and Cyclogest, which is progesterone in cocoa butter in the form of pessaries. Progesterone can be given by injection, but because it has a short half-life they need to be daily. Marketing of progesterone phamaceutical products, country to country, varies considerably, with many countries having no oral progesterone products marketed, but they can usually be specially imported by pharmacies through international wholesalers.

"Natural progesterone" products derived from yams, do not require a prescription. Wild yams contain a plant steroid called diosgenin, however there is no evidence that the human body can metabolize diosgenin into progesterone.[28][29] Diosgenin can however be chemically converted into progesterone in the lab.[30]


Source: http://en.wikipedia.org/wiki/Progesterone

Types of Progesterone
Sublingual Liquid - highly absorbable, no toxic tag alongs. Each drop is equivalent to 3 mg of micronized progesterone. Can dilute in a tablespoon of water and hold in mouth.
Sublingual Pellets - highly absorbable, no toxic tag alongs. Progon B 12.5 mg per pellet.
Creams - Use as directed. Creams can bioaccumulate in soft tissue make dosage very hard to keep accurate.

Do You Need Hormones?

• Take our questionnaire
• Contact us for a consultation

Here are general guidelines, each individual varies.

1. It is highly recommended that you do a Test to determine your actual needs then schedule a consultation with Dr. Forrest.
2. Evaluate the need for ProGest using salivary testing
3. Hormonal issues often have to do with Adrenal issues being affected by stress. It is a good idea to test adrenal function and then to support the adrenals. 

• 1. Day 0-15 - no progesterone
  2. Days 16, 17 - 8 drops ProGest 3 times daily; after breakfast, lunch and before bed
  3. Days 18, 19 - 10 drops ProGest 3 times daily; after breakfast, lunch and before bed
  4. Days 20 - 21 - 12 drops ProGest 3 times daily; after breakfast, lunch and before bed
  5. Days 22, 23, 24 - 14 drops ProGest 3 times daily; after breakfast, lunch and before bed
  6. Days 25, 26 - 8 drops ProGest 3 times daily; after breakfast, lunch and before bed
  7. Days 27 - 4 drops ProGest 3 times daily; after breakfast, lunch and before bed
  8. Days 28 - 0 drops Progest
  • Tend to be low in Estrogen and Progesterone
  • Could use PhytoB or PhytoEstrogen products to replace the estrogen
  • Use a graduated cyclical augmentation program for Progesterone. For a standard 28 day cycle, menses is day 1.
  • Can use Pregnenolone and DHEA to prime the hormone pathways.

Cycling Female
Start slowly and build up to full dose.
Adjust dosage if your cycle when you were younger.


Peri-menopause
Still cycling but the cycles are beginning to vary in length and duration

Menopause
Start slowly and max out around 100 mg daily.


Not Certain What To Do Next?
If you are uncertain as to which products or programs to use or which tests to take; or, if you would like additional help: 

• Contact us with a brief question.
• Arrange a phone consultation with Dr. Forrest.
  Call ( 408) 354-4262