Bio-Identical Hormone Replacement
It is important to compare physiological differences between progesterone and synthetic progestin. While they have a similar effect on endometrial uterine lining in post-menopausal women, they differ in their actions somewhere in the body. Within the nervous system, the neuroprotective and promyelinating effects of progesterone are promising, not only for preventing but also for reversing age-dependent changes and dysfunctions. Progesterone can improve symptoms of PMS by exerting its effects on GABA, while progestin can worsen the symptoms. People who are suffering with headaches related to hormonal imbalances are more likely to get worse on progestins. In the same population progesterone can promote a normal vascular tone to prevent migraines. Synthetic progestins have a negative effect on mineralocorticoid receptors thus causing bloating and weight gain. They can increase insulin resistance, cause depression, worsen lipid profile and cause trombolitic events.
Synthetic progestins and progesterone have a number of differences in their molecular and pharmacological effects on breast tissue. Progesterone inhibits estrogen-stimulated breast epithelial cells. In contrast, synthetic progestins may have a potential antiapoptotic effecs and may increase estrogen-stimulated breast cell mitotic activity and proliferation. Progesterone also downregulates estrogen receptor-1 (ER-1) in the breast and induces breast cancer cell apoptosis.
Current recommendations from American College of Obstetricians and Gynecologist suggest to that estrogens be prescribed alone with estrogen. If a woman had a hysterectomy, progestins are no longer needed to protect a uterus. However, presence of estrogen and progesterone receptors outside of uterus making it of an importance for practitioners, who prescribe bio-identical hormones, to respect the synergy between the two hormones.
Earlier in perimenapuse women tend to experience drop in their progesterone, therefore, supplementing with progesterone alone can help with menopause symptoms. As a woman gets closer to menopause, she may need a combination of both hormones even if she has her uterus removed. Women can produce a significant amount of endogenous estrogen, which occurs through aromatization of estrogens from adrenal androstenedione by the fat cells. Having progesterone can help to offset excess of estrogen and to keep balance in the system.