Introduction - Progesterone

Question 1

Where does it come from?

Answer 1

Synthesised by the overies and by the adrenals
Comes after a surge of LH
More than one kind - three types

Question 2

What is the role of progesterone?

Answer 2

Main Role for progesterone is to prepare for pregnancy If fertilisation has occured, the corpus luteum still plays a role for several weeks creating progesterone and oestrogen.

Role in the Uterus - Generates production of blood vessels: it also stimulates production of glandular structures eg stimulates boob growth

So Progesterone can affect:
* Glandular changes in the breast
* Competes with androgens
* Prevention of cancer
* Pregnenolone; precursor of other steroid hormones
* Allopregnenolone acts as a brain neurotransmitter
* Stimulates aldosterone secretion - might explain water retention before periods

Conjugated and extreted like oestrogen through liver, bile/urine

Question 3

What is a lack of progesterone associated with?

Answer 3

• PMT
• Dysfunctional bleeding patterns
• Cyclic breast disorders
• Endometriosis, fibroids
• PCOD - lack of ovulation so lack of progesterone
• Infertility
• Repeated miscarriage - if corpeus lutuem is not fullly functioning this can be the fault

Question 4

What are the causes of progesterone deficiency?

Answer 4

Causes of progesterone deficiency
* No ovulation: no corpus luteum. This is found in
* PCOS
* Hypothalamic amenorrhoea
* Hyperprolactinaemia

It is normal at times - eg menopause

Question 5

What does reduced progesterone production lead to?

Answer 5

Sometimes the corpus luteum does not secrete enough progesterone - this can come from
* Hypothalamic-pituitary axis failure (not
enough FSH, LH)
* Excessive prolactin: abnormal cycle, and
shorter luteal phase
* Also, can be problems can be faulty hormone receptors which are influenced by prolactin.

Question 6

How do you test for progesterone
deficiency/ insensitivity?

Answer 6

• Menstrual diary; symptoms recording
• Basal temperature
• Length of luteal phase
• Time T rise to onset menstruation, fewer then 11 days; luteal defect.
• Blood Test (taken 7-9 days after ovulation)
• Endometrial biopsy

Herbs which may