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Does a woman need progesterone if she doesn’t have a uterus?

Myth Busters - Menopause Edition!

This is a question that comes up a lot, and it stems from an old belief that clung on after the results of the Women’s Health Initiative were first published…over twenty years ago.

You read that right. TWENTY YEAR old info.

The Origin Story

The myth begins with the continued confusion of the hormone progesterone that the body makes and the synthetic progestins – like medroxyprogesterone acetate (MPA) that pharmaceutical companies make. Natural body-made progesterone is used in hundreds of places throughout the body – for good things! In fact, you can read about those things here! The synthetic progestins ONLY work like natural progesterone inside the uterus. Progestins have the exact opposite effect of progesterone everywhere elsewhere in the body. This is a big part of why synthetic progestins are a problem…we don’t want them running amok elsewhere and wreaking havoc on unsuspecting cells.

It's because of this havoc that doctors don’t give progestins OR progesterone. They lump the two together, thinking they are the same thing, but they are not. Because of this confusion, doctors don’t get the chance to see how progesterone CAN have a positive effect in many areas of the body. Trapped by faulty thinking they were taught in medical school, many doctors still think that all progesterone is not needed for women after menopause, especially if she has had a hysterectomy.

What Can Progesterone Do?

Limiting the use of progesterone to women who have a uterus ignores the science that progesterone has beneficial effects outside of the uterus. Progesterone receptors have been identified in almost every cell in the body; therefore, progesterone has functions throughout the entire body. A quick look at the evidence shows many favorable effects of progesterone, whereas MPA produces unwanted side effects or risks - which are the exact opposite of the actions of progesterone.

Boobs, Hearts, Bones, & Brains

When it comes to breast cancer, we know that the synthetic progestins do increase risk. Good news, bioidentical progesterone has been shown to reduce the risk. Bioidentical progesterone has anti-proliferative (growth) and anti-cancer properties. Woo hoo! We also know that low progesterone levels are associated with an increased risk of breast cancer. Clinical studies suggest progesterone therapy protects against breast cancer. Some studies have even shown a decreased risk of breast cancer when natural progesterone is added to estrogen therapy.

Sadly, the number one killer of women over 50 is cardiovascular disease of some form. Progesterone works in partnership with estrogen to manage healthy fat levels and cardiovascular health. Other major health concerns for post-menopausal women are the development of osteoporosis and dementia. Progesterone works together with estrogen to provide better bone remodeling through stimulation of bone growth, while synthetic progestins do not. While progesterone provides neuroprotective benefits for the nervous system including the brain, side effects of synthetic progestins are the opposite.

Additional evidence continues to demonstrate the opposite effects of progesterone vs. the synthetic substitutes. MPA is proliferative (grows cells) and is inflammatory; progesterone has been demonstrated to be neutral or slightly anti-inflammatory and anti-proliferative in its actions. Progesterone is used by doctors for protection from further damage in traumatic brain injuries, and in at least two small studies progesterone has been shown to help reverse the debilitating effects of brain injury. MPA causes degenerative changes in the liver, while progesterone does not. Having the right amount of progesterone can increase the release of insulin from the pancreas which helps with weight management, while synthetic progestins do the opposite and can actually increase insulin resistance.

Myth… Busted!

As we mentioned earlier, doctors still confuse progesterone and progestins and so the myth persists that progesterone is not needed if you don’t have a uterus!

It is clear that bioidentical progesterone provides a number of protective and useful benefits that synthetic progestins do not. Synthetic progestins instead increase risks for a number of health conditions. A woman won’t need progesterone to protect a uterus if she doesn’t have one, but she does need progesterone when her levels become low if she wants to continue to provide protection of her breasts, heart, blood vessels, bones, nervous system muscles, liver, skin, and perhaps much more yet to be discovered.