Lexicon
Progesterone
Definition
Menopause is caused by reduced secretion of the ovarian hormones estrogen and progesterone, and the failure of follicle growth at the final menstrual period ends ovarian production of progesterone. [1] Progesterone is a highly lipophilic gonadal hormone that can influence behavior and mental health through its receptors in the brain. [2] Progesterone is important for the process of implantation and early embryonic development, and its deficiency has been proposed as a cause of luteal phase deficiency. [3]
How it works
Progesterone and progestins can influence neural processes such as myelination and neuroprotection, exerting protective effects against stroke. [2] The interaction between progestagens and the systems that regulate stress appears to influence subjective experiences of mood and stress, and progesterone can influence amygdala reactivity related to processing of emotional stimuli and memory. [2] In the reproductive tract progesterone prepares and maintains the endometrium, so postmenopausal women using estrogen therapy require a progestogen to protect the endometrium. [4]
Connected concepts
How it's measured
Serum progesterone is measured to verify menstrual-cycle phase, and a strict luteal-phase verification limit of greater than 16 nmol/L for progesterone has been recommended. [5] Serum luteal progesterone is also measured around the time of frozen embryo transfer, where studies analyzed thresholds below 10 ng/mL. [6]
What levels mean
In frozen embryo transfer cycles using vaginal progesterone and blastocyst embryos, a higher serum progesterone level was associated with increased ongoing pregnancy or live birth and a lower risk of miscarriage, suggesting a minimum clinically important luteal progesterone concentration for implantation. [6] Fluctuations in progesterone across a woman's life are associated with increased susceptibility to mental conditions, and progesterone-receptor modulation can improve premenstrual mood symptoms in premenstrual dysphoric disorder. [2] For endometrial protection, oral micronized progesterone applied sequentially for 12 to 14 days per month at 200 mg per day protects the endometrium for up to 5 years, whereas transdermal micronized progesterone does not provide endometrial protection. [4]
Community knowledge
## Micronized vs Synthetic Progesterone
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- 1.Nelson HD. Menopause. Lancet · 2008
- 2.Bencker C, Gschwandtner L, Nayman S, Grikšienė R, Nguyen B, Nater UM, Guennoun R, Sundström-Poromaa I. Progestagens and progesterone receptor modulation: Effects on the brain, mood, stress, and cognition in females. Front Neuroendocrinol · 2025
- 3.Practice Committees of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility. Diagnosis and treatment of luteal phase deficiency: a committee opinion. Fertil Steril · 2021
- 4.Stute P, Neulen J, Wildt L. The impact of micronized progesterone on the endometrium: a systematic review. Climacteric · 2016
- 5.Janse DE Jonge X, Thompson B, Han A. Methodological Recommendations for Menstrual Cycle Research in Sports and Exercise. Med Sci Sports Exerc · 2019
- 6.
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