Women’s Hormone Care • Board-Certified Internal Medicine
Progesterone Therapy in Los Angeles
Progesterone is an important reproductive hormone with a central role in the menstrual cycle and the endometrium. In menopausal hormone therapy, progesterone or another progestogen is especially important for many women who have a uterus and use systemic estrogen because adequate progestogen helps protect the endometrium from the effects of unopposed estrogen.
David Nazarian, M.D., Board Certified in Internal Medicine, provides individualized progesterone and hormone-therapy evaluation in Los Angeles and Beverly Hills.
When Progesterone May Be Used
Progesterone may be used with systemic estrogen in women with an intact uterus to help protect the endometrium. It may also be used as part of menopausal and perimenopausal hormone therapy, for secondary amenorrhea, and for cycle regulation when clinically appropriate.
The appropriate indication, formulation and schedule depend on symptoms, menopausal status, uterine status, other hormones being prescribed and individual medical risk factors.
Progesterone and Estrogen Therapy
Endometrial Protection
For women with an intact uterus who use systemic estrogen, an appropriate progestogen regimen is generally used to help reduce the increased risk of endometrial hyperplasia and endometrial cancer associated with unopposed estrogen.
Continuous or Cyclic Use
Progesterone may be prescribed continuously or cyclically depending on the treatment plan, bleeding pattern, menopausal stage and clinical circumstances.
Individualized Selection
The regimen depends on uterine status, route and dose of estrogen, tolerability, medical history, treatment goals and available evidence.
Micronized Progesterone and Other Progestogens
FDA-approved oral micronized progesterone is a bioidentical progesterone option. Other progestogens are also used in hormone therapy. Selection should be individualized according to treatment goals, tolerability, medical history and the overall hormone regimen.
Compounded hormone preparations may be available, but compounded products are not FDA-approved finished products and should not automatically be considered safer or more effective than FDA-approved options.
Potential Benefits, Side Effects and Risks
Potential Benefits
When appropriately prescribed with systemic estrogen in a woman with a uterus, the principal benefit of progesterone or another progestogen is endometrial protection.
Side Effects and Risks
Potential effects can include changes in bleeding patterns, breast tenderness, bloating, headaches, mood changes, dizziness or drowsiness. Risks vary by patient and hormone regimen.
Unexpected or persistent postmenopausal bleeding requires appropriate medical evaluation.
A Comprehensive Progesterone Evaluation
Progesterone should not be prescribed based on a hormone level alone. Evaluation should consider symptoms, menstrual and menopausal history, uterine status, medications, breast and gynecologic history, cardiovascular and thrombotic risk, and the reason hormone therapy is being considered.
Common Questions About Progesterone Therapy
Why is progesterone used with estrogen?
For many women with an intact uterus who use systemic estrogen, progesterone or another progestogen is used to help protect the endometrium.
Is micronized progesterone bioidentical?
FDA-approved oral micronized progesterone is chemically identical to endogenous progesterone and is commonly described as bioidentical progesterone.
Does every woman using hormone therapy need progesterone?
No. The need for progesterone depends in part on whether the uterus is present and on the hormone regimen being used.
Can progesterone be taken continuously?
Some regimens use progesterone continuously and others use it cyclically. The schedule depends on the clinical situation.
Related care: Perimenopause Treatment · Menopause Treatment · Estrogen Therapy
Schedule a Progesterone Therapy Consultation
Discuss your symptoms, medical history, current hormone regimen and treatment goals with David Nazarian, M.D., in Beverly Hills.
