Posted on Jul 11, 2023, 3 p.m.
By Carol Petersen RPh, CNP
Too much progesterone, how much is too much? During the last trimester of pregnancy, women can reach levels of progesterone in the serum as high as 200-300 ng/ml and more. During the luteal phase, getting to a level of 20 to 30 ng/ml is usual. Most women feel amazing during the last three months of pregnancy. For those, labeled with PMDD (premenstrual dysphoric disorder) or PMS (premenstrual syndrome), pregnancy gives them their only relief.
If sky-high progesterone levels are so dangerous, why do both male and female fetuses thrive under these generous levels? Yes, there are those who suffer from nausea and vomiting during pregnancy. Perhaps this is also in response to high estrogen levels without enough mitigating progesterone Dr. Katharina Dalton, a pioneer in recognizing the importance of progesterone during the female cycle, during pregnancy, and even postpartum-treated women with PMS who became pregnant with extra progesterone during the pregnancy. The women thrived and so did their children who she followed some years later. (1)
Dr. John Lee wrote a book entitled “Natural Progesterone, The Multiple Roles of a Remarkable Hormone”. (2) It is a great primer on progesterone, and we owe him a debt of gratitude for our heightened awareness of this hormone. We owe Dr. Ray Peat an even greater thank you because his research inspired Dr. Lee to use progesterone for his patients. Unfortunately, Dr. Lee also taught us that women only made 20 mg of progesterone per day. There is no reference to this number. Dr. Ray Peat provided a reference for 100 mg of progesterone in the ovarian vein. (3) Dr. Lee also embraced using saliva testing to monitor hormone treatments.
Unfortunately, progesterone supplied in cream for application to the skin provides extraordinary levels in the saliva. We have no good explanation for this. Saliva testing is purported to somehow reflect the hormone status of the body although tissue concentrations can vary widely and the idea of a “composite” number is questionable. Labs have resorted to creating “normal” treatment levels for progesterone in the saliva which is higher than untreated normal. The consequences of Dr. Lee’s suggested supplementation and the saliva testing of progesterone have created a cadre of healthcare practitioners who are trained to treat the saliva tests rather than the patient. This, in turn, has many women so miserable that they are convinced that they cannot tolerate progesterone.
Unsung Progesterone Heroes
There are two women who are unsung heroes in the story of progesterone. One is Ona Green who started Ona’s Natural (4) to provide non-prescription progesterone products because she herself depended upon generous progesterone to treat catamenial epilepsy. Another is Doris King, who saved herself and now coaches others to use progesterone for bipolar disease and schizophrenia. (5). These women found the answers for their progesterone deficiency health problems and in turn try to help others in significant ways.
Estrogen Dominance and Estrogen Kickback
Kitty Martone who is the current CEO of Ona’s Natural hosts a Facebook page called the Estrogen Dominance Support Group. Estrogen dominance is not exactly a medical term but is a good description of the symptoms that occur when progesterone is deficient relative to estrogen. This concept was introduced by Dr. Lee. “Estrogen” includes all the xenoestrogens, heavy metals, glyphosate, and all the chemicals that have estrogen-mimicking activity and occupy estrogen receptors.
This group uses another term “estrogen kickback” to describe enhanced estrogen effects when women or their healthcare practitioners timidly start small doses of progesterone. The symptoms of estrogen excess: anxiety, palpitations, breast enlargement and tenderness, headache, and sleeplessness suddenly magnify and even send women to emergency rooms. The resolution is more progesterone and more very quickly until these symptoms easily abate. However, the term “estrogen kickback” and this phenomenon never appears in conventional medicine or even functional medicine though it is predictable and frequent.
Practitioners give their patients the wrong advice – stop or decrease the progesterone. The first denies the very hormone those women need for many of their health problems and the second can cause reactions even worse than the first small dose. Conventional medicine often teaches with drugs to start low and go slow but it is the wrong advice when using too much.
Progesterone, What People Claim
Here is a list of symptoms that various people have posted on social media to warn women of using too much progesterone:
Most frequently this occurs in the estrogen kickback zone when estrogen promotes fat storage and fluid retention. The remedy is more progesterone.
Another estrogen kickback symptom. Thyroid activity is inhibited when estrogen dominates. Adding more progesterone will help support thyroid conversion to active thyroid which is the main driver for our energy-producing mitochondria.
If candida is overgrowing in the gastrointestinal tract, progesterone will allow more overgrowing in the same way progesterone protects the alien baby from the mom. Treat candida first and retry progesterone. A feeling of bloating can also occur as the estrogen-induced endometrial buildup increases the size of the vagina.
Discomfort or Pain in the Legs
Progesterone is an anti-inflammatory. Pain and inflammation will disappear when progesterone is dosed adequately. Check on vitamin D levels for this one too. Make sure minerals are adequate.
Progesterone is a diuretic. When water retention occurs, it is a sure sign that the estrogen kickback is in full swing, and more progesterone is needed. It is very common to have generous peeing occur as progesterone relieves this.
This is one of the easiest symptoms to resolve with more progesterone. Anxiety is a wonderful symptom to monitor because it responds so quickly to progesterone. Use progesterone every 15 to 20 minutes till calm prevails.
This is another estrogen kickback sign along with breast enlargement, an increase in fibrotic tissue in the breast. Progesterone may be applied directly to the breasts. Iodine is a great addition to relieving fibrotic tissue in breasts.
Estrogen dominance suppresses thyroid function leading to depression. This can be helped with additional progesterone but investigate thyroid function as well.
Loss of Libido
Underdosing progesterone leads to estrogen dominance. This has the consequence of inducing sex hormone binding globulin, a carrier protein, which binds up testosterone and DHEA preferentially and affects libido. The answer is again to increase the progesterone and perhaps give some help to the androgenic hormones too.
Doris King’s books are a great reference to describe how progesterone can relieve the misery of some misdiagnosed mental illnesses. Dr. Phyllis Bronson’s book is also a good reference about hormones and moods. (6) Progesterone has a positive effect when treating mood disorders.
Progesterone can help with producing the hormone relaxin at delivery to soften the cervix. This required the very high progesterone levels of third-trimester pregnancy. Check for thyroid issues as mentioned above. Ligament laxity is a low thyroid symptom. Androgens like testosterone and DHEA should be monitored in the case of muscle weakness.
Progesterone enables estrogen to be more active. This is not a progesterone excess but perhaps not enough estrogen activity dependent upon progesterone.
Progesterone has been used in the treatment of acne successfully. Look for issues like constipation or yeast overgrowth forcing the skin to become a main organ of excretion. Vitamin A has also been helpful to convert cholesterol into the rest of the steroid hormones and has been used to treat acne.
Headaches can be a common monthly occurrence for some women during the luteal phase. Progesterone can relieve them. Use a topical to the back of the neck and the temples. Women have reported new onset of headaches with progesterone which is likely when in the low progesterone zone.
This wonderful study by Dr. Jerilynn Prior is just published and demonstrates that vasomotor symptoms can be relieved by progesterone. When those tiny doses of progesterone are used, instability of the adrenals, insulin/glucose, and varying estrogen levels worsen vasomotor activity. Dr. Prior’s study used 300mg of oral progesterone. (7)
The urinary tract is especially rich with receptors for estriol and testosterone. Incontinence can be reversed with these hormones. Progesterone can also ease incontinence so this symptom may come up in the estrogen dominance zone.
Progesterone does not create infections, but tissues depleted of estriol and testosterone are vulnerable to infections.
There are many women and practitioners that believe that women can use too much progesterone and interpret the signs of too little progesterone as an indication that progesterone is in excess or ignore other deficiencies. None of these complaints are correlated with progesterone levels that must be more than third-trimester pregnancy levels to legitimately exceed normal human levels.
Although generous amounts of progesterone can bring relief, we now know there are many ways to mitigate the estrogen burden to also bring relief.
Carol Petersen RPh, CNP
This article was written by Carol Petersen RPh, CNP an accomplished compounding pharmacist with decades of experience helping patients improve their quality of life through bio-identical hormone replacement therapy. She graduated from the University of Wisconsin School of Pharmacy and is a Certified Nutritional Practitioner. Her passion to optimize health and commitment to compounding is evident in her involvement with organizations including the International College of Integrated Medicine and the American College of Apothecaries, the American Pharmacists Association, and the Alliance for Pharmacy Compounding. She was also the founder and first chair for the Compounding Special Interest Group with the American Pharmacists Association. She serves as chair for the Integrated Medicine Consortium. She co-hosts a radio program “Take Charge of Your Health” in the greater New York area. She is on the Medical Advisory Board for the Centre for Menstrual Cycle and Ovulation Research (CeMCOR.ca). To contact Carol click here.
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