Hormones control every system of the body. Knowledge of how hormones interact gives practitioners an important tool towards achieving wellness in their patients. Those people involved with bio-identical hormones, namely, compound pharmacists, physicians, and nurse practitioners, are already much aware of the importance of progesterone with regards to a woman's gynecological well-being.
However, there seems to be a lack of appreciation for the role progesterone plays in the area of men's health, as well as how progesterone can be utilized to benefit weight control in men, women and children. Please be aware that there are over 300 receptor sites throughout the body for progesterone. It is beyond the scope of this article to delineate all the potential benefits and actions of this hormone. Consider what I discuss here an introduction to the clinical benefits of this hormone.
Let me begin by stating a known fact - men and women have identical hormones. Although this fact seems obvious, it is commonly not appreciated. Progesterone is usually considered a "woman's" hormone, perhaps related to the fact that its role in the male body is never mentioned. Interestingly, I consider it the second most important hormone in men after testosterone.
One of the main roles progesterone plays in males, as well as females, is to control insulin production. Insulin is obviously an important hormone, but excess quantities can be very detrimental. It is the number one cause of obesity in this country, it is perhaps the number one cause of "essential" hypertension, it is the number one cause of type II diabetes and it is probably responsible for most of the complications of diabetes with regard to nerve and blood vessel damage, it raises cholesterol levels and is the number one hormone that speeds up the aging process. If you consider that progesterone is the number one hormone that helps keep insulin levels down you can immediately appreciate the tremendous therapeutic effect this hormone has with regard to treating weight problems, blood pressure problems, diabetes, elevated cholesterol, etc.
I do not consider progesterone alone to be the panacea for all these problems. But used in conjunction with other therapeutic approaches it provides the ability to enhance whatever approach is being utilized. For example, progesterone by itself is very effective for preventing an over-production of insulin. People who start on progesterone cream are very quick to note that they no longer get sleepy in the afternoon between 3PM and 4PM, and they don't get sleepy while driving or after eating. These are the classic times that insulin levels peak. However, progesterone cannot compete with a diet that is high in carbohydrate content - this situation produces an amount of insulin that overwhelms the ability of progesterone to control it. Utilizing certain bio-identical hormones can actually be considered the next step beyond Atkins to maintain weight control.
As men approach the age of 50, hormonal changes start becoming more evident. This is about the time that men stop producing progesterone; accordingly, they start developing weight around the midriff because their insulin levels are now higher. In concert with this drop in progesterone, their testosterone levels continue to drop and their estradiol levels start to rise.
After the menopause, whether surgical or natural, women continue to make estradiol. However, men's level of estradiol is commonly higher than women's after the age of 50. When looking at estradiol, keep in mind that it is a hormone that contributes to six different cancers in women - breast, cervical, vaginal, ovarian, uterine, and colon. It is the only known cause for cancer of the uterus (except for Tamoxifen). The prostate and the uterus embryologically are derived from the same tissue. Therefore, logically it would appear that estradiol is the probable cause of prostate cancer.
Progesterone very likely prevents every known cancer cause by estradiol. Since prostatic cancer mainly occurs in men at a time that their progesterone levels are low or non-existent and that their estradiol levels are high would it not seem logical that giving men natural, bio-identical progesterone cream might prevent prostate cancer?
A classic example of the importance of progesterone in men may be best exemplified by one of my patients who presented himself to me by saying, "Doc, if you don't help me, I'm going to commit suicide". He was 57 years old, obviously depressed, and also complained of severe hypoglycemia, asthma, and he had osteoporosis.
At the time of his visit he was taking a combination of liothyronine (Cytomel) 25mcg, Armour thyroid and Actonel. Review of previous records indicated that he had been on a variety of regimens for depression and asthma including Paxil, Serzone, Effexar, Singular, and Flonase. He had been on a constantly changing thyroid regimen for over 20 years.
Prior lab studies showed a persistently low T4 and usually elevated T3 levels. TSH levels were always around the 0.01 range. This latter fact exemplifies a classic error done by most doctors who evaluate thyroid studies. They consider a low TSH as an indication of too much thyroid being given. They are perhaps unaware that there are several different types of hypothyroidism. The most common is primary hypothyroidism where the thyroid itself is unable to produce enough thyroid. The most common cause of this is a result of Hashimoto's thyroiditis.
However, there is also an entity called secondary hypothyroidism. This occurs when the pituitary fails to produce enough thyroid stimulating hormone and results in a hypofunctioning thyroid that is frequently misinterpreted as being hyperfunctioning.
In any event, the reams of old records he brought with him were virtually worthless. He told me that he had spent over $200,000 in the two years prior to his seeing me; he had been all over the country consulting with the "top" doctors in the most prestigious medical centers. In addition to their failing to figure out what was wrong with him, they neglected to realize he had adult ADHD, fibromyalgia, and restless leg syndrome.
Initial lab studies showed:
Free T4 0.8 [0.8-1.8] NG/DL
Free T3 816 [230-420] PG/DL
TSH
The proximal cause of all this man's problems was a deficiency of progesterone. When I told him this he was, of course, skeptical. But I was his last resort. I gave him a prescription for progesterone cream 100 mg/ ¼ tsp, at a dosage of ¼ tsp TID applied to the wrist/forearm area. I also prescribed T3 S/R 7.5 mcg BID along with levoxyl 0.125 mg. Three days after starting on this regimen he ran into my office and stated, "Doc, in my entire life I have never felt this good!"
Please note: The dosage of progesterone utilized for this patient is higher than the usual dose I would recommend for men. This is the dosage specifically utilized for those with ADHD and is continued until symptoms of hypoglycemia are gone. At that point I lower the dose to 100mg to 200mg/ day.
Over the years I've had the opportunity to have utilized progesterone in hundreds of men. I am very much aware of what this hormone is capable of achieving. Therefore, I was not surprised by the effect that it had on his particular patient. Much of his depression was related to the fact that he was internalizing anger. He was a type A personality, workaholic, successful, and had a short fuse. In other words, he produced a lot of adrenaline. He was a classic adult ADHD. On this basis alone I knew that progesterone would help him. In addition, progesterone affects many of the neurotransmitters in the brain, also helping to alleviate depression.
Progesterone helps to prevent hypoglycemia by preventing a rise in insulin. It has a powerful effect on asthma − partly because it breaks down into cortisone and also because it blocks estradiol, a known cause of asthma. His osteoporosis was also most likely related to a lack of progesterone; it is a hormone that both prevents osteoporosis as well as treats it.
Delineating all the benefits of progesterone for men is beyond the scope of this article. Suffice it to say a major benefit is related its ability to keep insulin levels down. This helps to prevent weight gain, lower blood pressure and prevent diabetes. This tendency to lower insulin leads to the elimination or helps to alleviate a number of conditions felt to be incurable by the medical community. This includes disorders such as ADHD (attention deficit hyperactivity disorder), restless leg syndrome, fibromyalgia, and type II diabetes. Of course these types of benefits relate to women as well as men.
In summary, this article provides a small overview of the potential of bio-identical progesterone for men, as well as the importance of progesterone in helping both men and women to control their weight. Please note that the benefits mentioned are based on utilization of progesterone in a transdermal form thereby allowing for its uptake by progesterone receptor sites.
You will notice at the end of this article there will be no references made to other articles in other journals or publications. The reason is that what I am writing is based on my own personal clinical observations. There is some intuition and logic involved, but primarily I rely on feedback I get from patients rather than relying on the dubious findings of "double-blind studies".
©2006. Dr. Michael E. Platt/All Rights Reserved. This article is copyrighted, but you have permission to share it through any medium as long as the proper copyright and credit line is included.
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