Episode 75 – Progesterone vs. Progestins

What is Progesterone?

• Steroid hormone naturally produced in the body.
• On the ‘WHO model list of Essential Medicines’ – it is considered essential
• Actions: some are direct and some are through metabolites. This is why PO is better.
  • Modulates GABA
  • Induces CYP3A4
  • Prevents mineralocorticoid activity by binding to the MR stronger than aldosterone and glucocorticoids
    • Elevated progesterone reduces Na retaining effects of aldosterone. P withdrawl causes Na retention
  • Effects are amplified in presence of estrogens. Estrogen upregulates the PR.
  • Converts the endometrium to secretory stage to prepare the uterus for implantation. Makes the vaginal and cervical mucus thick and impenetrable to sperm.
  • Mitigates the trophic effects of estrogen.
  • Normal estrogen bleeding is progesterone-withdrawl
  • Decreases smooth muscle contractility of the uterus
  • Importantly involved in sex-drive in females
  • No link to breast CA (unlike progestins – see below). In fact, RR of estrogen with progesterone was 1.00 but 1.69 for estrogen with other progestins. http://link.springer.com/article/10.1007%2Fs10549-007-9523-x
  • Research into possible benefit in TBI
  • Effects on Serotonin receptors. This provides an explanation for why some people resort to substances that enhanceserotonin activity such as nicotine, alcohol, and cannabis when their progesterone levels fall below optimal levels. P may be beneficial in addiction.
  • Other effects:
    • Decreased irritability
    • Suppress immunity during preganancy
    • Raises epidermal growth factor-1 (EGF-1)
    • Increases core temp during ovulation
    • Reduces spasm and relaxes SM
    • Acts as anti-inflammatory
    • Reduces GB activity
    • Normalizes blood clotting and vascular tone, zinc, and copper levels
    • Prevent endometrial cancer
    • Role in signaling insulin release and pancreatic function
  • Metabolites:
    • 5a-dihydroprogesterone & allopregnanolone helps modulate GABA (makes it calming)!
  • Progesterone is great for PMS – but have to use high doses
  • P synergistic with E2 (as opposed to progestins)
    • Modulates effects of excess estrogen: fluid retention, headaches, bloating, bleeding, fibroids
  • ALL menopausal women NEED progesterone! Even if the don’t have a uterus!!
    • Protects against breast CA, CAD, and CVD
  • Side effects:
    • Breast/nipple soreness
    • Somnolence (oral only)

What are Progestins?

• Synthetic chemical with progesterone-like activity
• Actions:
  • Progestins with androgenic effects (MPA, norethisterone acetate, norgestrel, levonorgestrel) have been shown to significantly increase risk of breast CA in postmenopauseal women in combo with E replacement. http://www.sciencedirect.com/science/article/pii/S0960076005001500
• Uses:
  • Hormonal contraception: OCPs, IUD
    • These were the first oral contraceptives, around 1950.
  • Antiandrogens: drospirenone, medrogestone, megestrol acetate, nomegestrol
• Side effects:
  • Bloating, HA, fatigue, weight gain, depression, increased PMS Sxs (stimulates the E receptor), CAD, CVD, DVT, PE, dementia, CA, DM
  • Depression
  • Breast swelling/tenderness
  • Irregular bleeding
  • Weight gain
  • Fluid retention
  • Increased breast CA risk
  • Increased cardiovascular disease risk
  • Stimulates E receptor site
• FDA considers progesterone = with MPA yet MPA is Cat X in pregnancy

Speaker 1: 00:00 This is Dr Chad Edwards and you’re listening to podcast number 75 of against the grain.

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Speaker 3: 01:03 Then Arnold here with Dr. Chad Edwards of revolution health and wellness. How are you doing today, Dr Edwards.

Speaker 1: 01:10 I am excited to be here. You know, I always loved, I love doing this. I love being here and I get so many patients that have come in and say, Hey, I listened to that podcast and I learned so much about this or you know, something like that. It’s just an invaluable tool and I love doing this. Uh, just getting some good information out and try to help as many people as possible.

Speaker 3: 01:26 Absolutely. And there’ve been so many times where I’ve been on the opposite end of this recording session where I was sitting over there and I was recording you and Marshall who used to host with you on the show and I would sit there and I would think this is such great information. Like I’m so glad you’re putting this information out to people and letting them know about all the great topics that you discuss. What specifically are we going to be talking about today? I can’t wait.

Speaker 1: 01:50 Yeah. So today we’re, I don’t, I don’t know if this is something that we always get excited about, but I will tell you that I’m fairly passionate about this because we see a lot of patients that come in, they’ve got problems with some of these issues and, you know, sometimes I’ll make a recommendation and many patients will just accept it. And in some ways maybe that’s a little bit scary. Yeah, they’re just, they’re just doing what their doctor told them to do and some of them will just blindly accepted. Uh, and I would, I would say, uh, you know, that we need to be very cautious, you know, when it comes to our health and you know, I was raised in a very traditional southern Baptist home and one of the things that I remember hearing from the Apostle Paul in one of the, um, one of, one of his writings was work out your salvation in fear and trembling with fear and trembling.

Speaker 1: 02:38 And I mean, I think that makes a lot of sense. You know, I accepted what I was taught in, you know, in church growing up. And I just kind of blindly accepted that and later I kind of rationalize, not rationalize, but I kind of worked through everything and kind of got to where I am today with that and that that’s not the topic of what I mean, but it’s that working out you have the issue with fear and spend a lot of time in this because it matters. And so that’s one of the reasons I think this podcast is so important because you need to be a a, a, a skeptic of everything that you’re told, including what I’m saying here now I do the best I can to make sure that I’m providing everything in, in an evidence based fashion with references, with reef resources and all and how I got to where I am on my recommendation.

Speaker 1: 03:23 So today, that was a really long way of saying that today we’re talking about not only progesterone, which is one of the hormones that will often think about is a female hormone, but it’s really. It’s a male hormone as well. Male and female both have progesterone. We just need them on different levels. But really kind of the key to me is progesterone versus progestins, so progestins are synthetic chemicals and they cause a whole host of potential problems and I wanted to get in to a little bit on one versus the other. Why I recommend one, why I don’t recommend the other and kind of work through that. So that’s what we’re, that’s where we’re gonna start.

Speaker 3: 04:06 Awesome. Sounds great. So you were saying progesterone, progesterone versus progestins. Correct. And you said they are synthetic versus naturally occurring. That’s what he said. Men need these. But these also occur for women and women need them in different ways. Yeah. So if we’re going to get into it, like what is a project in, how would I, how would I incur on dealing with this? How would I get this synthetically? Is this things I’m eating? Are they things that I’m taking as far as like if I’m taking aspirin, like what is it?

Speaker 1: 04:40 Yeah. So great question and I’m glad you asked that because I actually didn’t even think through that. You know, you’re already kind of in the middle of it and I just assume everybody knows that. So that’s a great question and basically progesterone is something that our body makes, but you can also take it as a medication or a, you can get it over the counter as a cream and different things like that. Project ends on the other hand are synthesized in the lab and you know, many companies will patent them and use them as a, uh, as a pharmaceutical drug. And so you get them as a prescription from your doctor and you know, a couple of sources. One would be provera, you know, the, you know, my mom was on hormones, you know, for, for several years. And I remember hearing the term prem pro, you know, several years ago had premarin, which we’ve talked about his horse piss basically.

Speaker 1: 05:30 That’s what it is. And then provera is the other half of that because if a woman’s still has her uterus, even the ache, the American College of Obstetrics and gynecology recommends that if you’re on estrogen replacement, that you need to counter a counter balance the estrogen with progesterone. And we’ll talk a little bit more about that. But they weren’t using progesterone. They were using a progestin called medroxyprogesterone acetate and you know, the study came out in 2002 that kind of blew all that out of the water and changed everything as far as hormone replacement, uh, you know, as of that time. And so I wanted to talk a little bit more about that. So basically to answer your question, it’s a prescription that you would get from your doctor. Oh, another form would be the Merina iud intrauterine device. And so it secretes a small amount of progestin. They say locally, meaning inside the uterus, but your body does get some effect.

Speaker 1: 06:29 And I have seen some profound negative effects from these synthetic progestins. Even the small amount that’s in an Iud and I’ve, you know, many women will do very well. And I’ve said before, I’ll say it again, I definitely have a selection bias when it comes to, you know, how many women have a problem with some of these things. Lots of women, hundreds of thousands of women probably are, are on like the marina for example, and don’t have a problem, but the ones that do come to see me. And so all the, I don’t get the ones that do well, I got the ones that are screwed up. So, uh, you know, I’ve got a bias as far as that goes and I readily admit that and I tried to keep it all in perspective.

Speaker 3: 07:07 Oh, awesome. So, I mean, you said the uds, you’re talking to her progesterone, you’re talking about progestins and I’m still a little bit like if you know exactly what we’re talking about here. So if, if I’m a woman, I’m more likely to incur some sort of a treatment or medication from a doctor that is going to cause me to be exposed to suggestions well, distance.

Speaker 1: 07:32 Okay. So, so the progesterone is made naturally in your body. It’s actually manufactured in the adrenal gland and we see some benefit or we see some impact from it. When we look at our labs, we see some impact on the labs when there is a patient with adrenal fatigue. Now I’ll tell a story real quick. So as all this guy, uh, he’s just under 40 years of age, so he was 38. I don’t remember exactly how old he was. And he came into see me fatigued, weak. I’ve probably told this story before on the podcast, but came into see me, see me weak, fatigued, you know, had some of those just tired and fatigued issue. And I checked his labs, his cortisol level looked okay, but it was on the lower side. A Dha levels were a little bit low, progesterone was, was like nondetectable, but his testosterone level looked good.

Speaker 1: 08:24 No is cortisol is low because it’s testosterone looked good. And so frequently we’ll see, you know, I can’t draw it out on the podcast obviously, but there’s this whole hormone cascade and it has to do with, uh, the adrenal hormones, so pregnant alone, which becomes progesterone and then ultimately aldosterone in the outer layer of the adrenal cortex. And then the next layer in ultimately makes cortisol and then the next layer in makes Dah, da Anderson, a diode, testosterone, a, those kinds of things. And so they all work and play together. You change one, it’s going to affect the others. And that’s just the adrenal cortex. So this guy, his cortisol levels were really low. Progesterone levels low. We’re low. Interestingly, his testosterone levels were fine, very fit athlete, these kinds of things, but I was like, man, you got some adrenal problems. You’ve got adrenal fatigue.

Speaker 1: 09:18 So often we’ll see testosterone deficiency that will manifest out of that and so we’ll put them on testosterone. This guy did not need testosterone. He didn’t really have symptoms classic for low test. Some of them were there, some overlap, but it’s testosterone levels looked really good and you know, in discussing it with him, it was not worth putting him on testosterone replacement. But we looked at his adrenal function and it just had none, but interestingly has progesterone level was low and that’s ultimately the point here, which was one of the components in the adrenal dysfunction and that can result in a whole host of problems that we’ll, we’ll get into a little bit. So, uh, this chemical is definitely manufactured in the body and both men and women, the, you know, when, when we talk about hormones in the clinic, I’ll talk with women, especially with when they’re thinking about going on estrogen or I’m sorry, a hormone replacement therapy, or if they come in, they have menstrual irregularity, so their periods are irregular, they bleed too long or they’re, the mncs lasts too long or they just spot a little bit or they’ll have two cycles in a month or just really anything in there where their hormones are messed up and we need to get them regulated.

Speaker 1: 10:27 I talk about estrogen being like the fertilizer for the lawn, and you got the lining of the uterus, the lining of the uterus called the endometrium, and it is stimulated to grow by estrogen. Then progesterone comes along as like the lawn mower and mowed the grass so it will kind of trimmed the grass down. So when you look at the female hormones and how they vary throughout their cycle, there’s a rise in estrogen that causes a thickening of that endometrium. And then progesterone levels begin to rise. And the latter half of their cycle when they, after they have avi elated, and then when the progesterone levels decline, then you will have a sloughing of the endometrial lining of that, of the endometrium. And that is their, their menses. That’s there, you know, where they believe because of their period and it’s the withdrawal of progesterone that stimulates that.

Speaker 1: 11:21 But uh, so basically it’s that balance between estrogen and progesterone. So you’ve got to have both. You gotta have balance of both. And if you have a uterus, if a woman has a uterus, if you had a uterus, that’d be really weird, but it would be if, if a, if a woman has a uterus and we are using a bioidentical hormone replacement, or she’s on hormone replacement of be kind, then she needs to be on some kind of progesterone to help offset or balance the estrogen. So you don’t have what’s called unopposed estrogen for a hormone therapy. Now, a lot of physicians, traditionally minded physicians, if you don’t have a uterus, they’ll say, oh, you don’t need progesterone. And I would argue that none of them have ever had or have had a family member with low progesterone when you see it, you know, and you replaced progesterone in those patients and they feel a whole lot better.

Speaker 1: 12:13 So I would argue that absolutely do need progesterone. So if in fact the progesterone is actually on the world health or rural health organizations, a model list of essential medicines. So it’s one of those things that, you know, these societies will say this is a critical medications, a critical hormone. It’s a steroid hormone that’s naturally produced in the body and it has a whole bunch of actions in the body. Some of those actions are direct because of progesterone than itself. Some of them are the metabolites. And this gets into how I, how I will use progesterone, because you can get it as a cream. So like I’ve got a good friend that’s a naturopathic physician and she will recommend some of these natural progesterone creams and progesterone is in wild yams. And so they’ll make this creme with wild yams. My only issue with that is that it’s not really standardized. So you might get varying levels, um, that, that’s one concern that I have.

Speaker 3: 13:18 So if I could interject real quick, is this akin to organic food where it’s like, Whoa, they say something’s organic on the shelf at the grocery store, but you really don’t know how it’s made. It’s not necessarily regulated. So if I go to whole foods or another organic style grocery store where they say these things are organic, but there’s no way of actually telling, is this similar to what you’re talking?

Speaker 1: 13:40 Yeah, absolutely. And to be clear when, when there is a, a claim, if they use the Usda organic label, there are criteria for that. Now you can, there are some claims that you can make and I can’t remember if we did a podcast on this or if I just prepped for it. Uh, you know, sometime I don’t remember. You’re always right. And I guess that makes me a prepper anyway. So, uh, but there are criteria for, you know, the organic term. Now in regards to your question. Yes. I think you’re spot on with the way you’re thinking about this because supplements are controlled by the FDA. But they’re controlled as food’s not as medications, which means, you know, in one of the things that I talk about in my book, um, know revolutionize your health was because of my supplements is the quality of supplements out there.

Speaker 1: 14:32 And if you haven’t read that book, it’s just a real simple read and you can go download it on the revolution health.org website under supplements tab or somewhere you can just go download that book. And I, I will go through some of the research on the supplements that are available and how some of it is just pure crap. I mean, it’s awful quality stuff in some cases. So you just don’t know. So yes, exactly what you’re saying. It’s not regulated in the same way that medications are regulated. So you are just trusting that they’ve got a standardized amount in there. And I’ve got a lot of question, a lot of concern on is this good quality stuff we just don’t know. So I don’t use that. I’ve got better, better weapons in my arsenal so to speak. Absolutely. So, uh, the second concern that I have about it is that is a topical cream.

Speaker 1: 15:21 Now, not that I think that’s necessarily bad. I, if all we’re trying to do are balanced hormones, then using a progesterone cream, not a bad idea at all, but all you’re going to get is, or most of what you’re going to get as the direct effect of the progesterone. And I think some of the important actions of progesterone which we’re going to go into right now are because of the metabolites of progesterone. So when you take a progesterone capsule, an oral pill or capsule, and generally those are the ones that I usually use are compounded and there’s reasons that we do then a commercial or a brand name, progesterone is called [inaudible]. And it’s a micronized. Progesterone works pretty well. The absorption and effectiveness is a little bit variable, but, uh, and it’s, uh, it’s an immediate release, not a sustained release. And so there’s, there’s benefits both ways, but insurance may cover that, that standard prescription that can get at Walgreens, Walmart, you know, Billy Bob’s pharmacy, any of you know, you can get it, just your standard pharmacy kind of thing.

Speaker 1: 16:23 But I’ll often it’s only available in two doses, 100 milligrams and 200 milligrams and I might, I’ve got some patients that are on 25 milligrams of progesterone and I’ve got some that are on 400 and so it’s extremely variable. And what dose do I need? And the only having 100 and 200 milligrams. What if the patient needs 1:50, you know, you’re just stuck. So I will often use a compounded progesterone because I can get it in whatever dose we need and it works great. But when you take that capsule, it goes to the liver first is what we call first pass metabolism just has to do with the way the blood flow from your gut goes to the liver and the liver gets first crack at metabolizing that thing. And some of the effects of oral progesterone are because of the metabolites. Some of them will actually bind to and work with the Gaba receptor, which volume works on the same receptor, so it can be a very calming hormone and most of the time patients will come in, especially female patients, they’ll come in, they’ll have some anxiety and maybe not like they’re crazy and having panic attacks, but they’re just a little bit on edge and other hormones a little bit messed up.

Speaker 1: 17:39 And uh, you know, they’ve got a little more pms symptoms and you know, they’re more irritable around that time of the month and those kinds of things. Not Sleeping as well. Progesterone is one of the first things I’m going to try and so often heard it today here at almost every day in my clinic, a woman will come in and they’ll say, you know, I’ve got these issues. Went to my doctor and got some labs. I say everything, it looks normal. And they’ll say, well, why am I feeling like this? And the answer though, the patient I saw today, the answer that she was told was, well, you know, you’re almost 40, you’re just another year, another year older.

Speaker 3: 18:12 And how does that make you feel when you hear your patients being told these things?

Speaker 1: 18:16 Uh, angry. I mean, seriously, that’s, that’s actually I could do a whole podcast on how I got into functional medicine. How did I get from traditional minded stuff to where I am today. And certainly some of it comes out as we do these podcasts, but it, it’s maddening that your best answer to your patient as well. You’re just another year older. So does that mean I’m 40 and I, I should feel like crap.

Speaker 3: 18:43 That’s terrible. I don’t, I don’t honestly,

Speaker 1: 18:46 my, my patients don’t generally feel like crap. Right? So why is it okay that you just tell a patient you will, you know, you’re just another year older. It means you don’t have any idea what you’re talking about.

Speaker 3: 19:00 Right? Not It’s too far off topic, but I am thankful for doctors like yourself, physicians like yourself who were out there inspiring people through the change that you’re trying to bring because it’s like you’re the person telling your, the person telling the kid who came from the wrong side of town, like, hey, you can be somebody in this world. You’re, you’re the doctor, you’re the physician saying this is not true and I can help you. I believe I can help you and you’ve helped many people. I know you have. I deal with you a lot outside of the podcast and I know that I’ve, I’ve seen, I’ve seen firsthand that you help numerous people with the, the, the things that you offer, you know, your, your bio replacement hormones, you know, everything that you are about. I am thankful for people like you because maybe some day I’ll need that, but if you weren’t out there, what would I do? You know, but like I said, I don’t want to get too far off topic. I just wanted to brag, brag on you a little bit. I appreciate

Speaker 1: 19:56 that. You know, I haven’t even paid you yet today. That’s awesome. Thanks. Seriously, I appreciate that. That’s, and I mean we’ve, you know, for some of our patients that have been around a long time since we opened. I mean we’ve gone through embezzlements. We’ve gone through major staff changes when we’ve had, you know, there’s been a lot of bumps in the road and we’ve had some, some rough times just because of some of the junk we’ve been through and you know, it’s kind of at some points I’m like, Okay God, am I supposed to be doing this? And then the very next day I’ll have a patient come in just in tears because of how much better they feel because of something that we did. And I don’t mean in a traditional medical sense, it was something that we did and every single time it’s happened in this where I was kind of asking that, am I, should I be doing this and these, these, the very next day something specific we’ll come in and like one for example, was a patient on Ivy Gludethyon and that’s something that I, I’m, I’m not saying I couldn’t have done it, but boy, it would have been very difficult when I was at, you know, the large clinic that I was at in Tulsa, it would have been very, very difficult to get that done just because of the logistics and systems and you know, they, they don’t get the way I do it.

Speaker 1: 21:11 And a patient came in because of that and just in tears and we changed their life. And then same thing would happen, you know, the next time because I did something different that I didn’t have the opportunity to do any other way. And you know, some testing that I didn’t have available through the traditional channels and realms. And just so it just kind of, you know, really solidifies that. Yeah, I’m on, I’m on the right track here. At least you know, as I feel, you know, I’ve been called to do so, um, you know, that the progesterone, I mean, it can be a very, very calming thing and you know, progesterone can be a great, great tool. And so for those patients that think that, you know, they feel bad that you know, just another year older, all that whole nonsense progesterone may be a great tool. And, and I’ll often do that.

Speaker 1: 22:04 It’s generally very safe. I mean, you got to watch it and control it. There’s nuances to it needs to be, you need to get with a physician that knows what they’re doing in regards to progesterone and uh, be able to follow that and, and, uh, gesture levels. So one of the many things that progesterone can do. Another thing that it does, there’s a, you know, we’ve got detoxification. In fact, the very next podcast we’re going to do is going to be on some toxins, toxic load, things like that last podcast was on a BPA or bisphenol a. If you miss that, when I, one of my favorite ones that I’ve done just because of how shocking some of that information was as I did the preparation for that podcast. But, uh, we have, uh, some phases of detoxification and phase one detoxification involves what are called the cytochrome p 4:50 enzymes.

Speaker 1: 22:53 Now these are a series of chemicals in your liver that break down certain kinds of medications. They perform certain biochemical reactions and you’ve got different enzymes that will break down certain things. Well, progesterone. So let me give you an example and why it matters and we’ll do a podcast one day on nutrogenomix and getting your DNA tested for your, uh, for your, or I should say nutrogenomix pharmacogenomics. It’s how your body breaks down certain medications, you know, based on those genetics and the enzymes. And one of them is the Cyp three, a four enzyme, and it has certain actions, certain activities, and progesterone induces that enzyme meaning meaning that it, it makes more of that enzyme. So if you’re trucking along and you metabolize, you got five chemicals and you metabolite five clinical chemicals in an hour, well when you get progesterone in the mix, you may metabolize five chemicals in 30 minutes.

Speaker 1: 23:54 Well, you know, so inducing means you’re going to chew through it faster. And so there’s other medications and you know, uh, for, for those of the listeners that haven’t gone back and listened to some of the other podcast where I talk about medication, they’re on the role of medications. The number four cause of death in projected cause of death in 1996 was properly prescribed medications. And when I, you know, I work in the emergency room and I’ll get patients that it’s Kinda funny. You can get these patients that come in and you can see their list of medications and you can almost pick who their doctor was in town because here’s your problem, here’s your pill, here’s the problem, here’s your bill. You’ve got 17 problems, you got 17 pills and patient feels like crap. But by Golly, we got their numbers looking good in the labs just like that in the military too.

Speaker 1: 24:39 It was like absolutely go to sick call. It would always be like, okay, we’ll take some Ibuprofen for that ranger candy. Just take some Ibuprofen. That’s right. Exactly. So I know exactly what you’re saying right now. Yeah, and I was thinking, you know, you were talking about how the person came in today, did the eye, the Ivy Gluten? Yeah, treatment. Yeah, and I was thinking how cool it would have been if you had someone here who could testify to the impact that this treatment has had. Having the project a little tongue tied progesterone treatment and how it really did impact them and from their own personal perspective to tell the listeners like, listen, this is what I was dealing with. These are the effects that I was having. These are the things I was dealing with in my hormones and after I had the progesterone treatment, this is how I felt.

Speaker 1: 25:27 Right. And it’s because of the treatments that you offer. You know that. I’m glad you said that and I’ll just use this as a. not a plea, but I call out any of our patients that have gotten a hormone replacement therapy. Know specifically pellets, but any of the hormones, if you wouldn’t mind giving a testimonial about your experience, uh, we would appreciate it. It’s not necessarily for us, it’s the other patient that’s thinking about doing it or that would benefit from your story. And you know, with prolotherapy we have no problem getting testimonials for that. It’s the people are excited to do that. No problem with hormones. It’s a different story and nobody wants to tell their story. Why do you think that is? And I think it’s because it’s hormones and you know, for men it’s testosterone and I mean it’s just, it, it, it is a different ballgame now.

Speaker 1: 26:16 I’ve had some that, you know, no, no big deal, but, so if you’re, if you’re listening and you’ve been to our clinic and you’ve had a great experience with hormones and you wouldn’t mind doing a testimonial, we would appreciate it. Our listeners are. Other patients would appreciate it. You may benefit someone and that’s why we want to do it. So I just thought I’d say that. Um, so the, uh, I got off track. Well I was. Oh, you were kind of talking about the effects and you know, the things that it helps with and I was thinking

Speaker 3: 26:44 like you didn’t really talk about like how does somebody know if they need this progesterone treatment? Like are there telltale signs or is it one of those things where it’s like, I don’t know what’s wrong, so I come in, you check me out, you go through a series, a battery of tests, and then you determine based off your results.

Speaker 1: 27:03 Yeah, so there’s a whole slew of reasons that you, that a patient may need progesterone nod. I don’t routinely give it to men, but for women, great tool and any woman on project, on hormone replacement therapy, we need to evaluate their, their progesterone. I’m not saying every single one of you, but most women I would argue need it. Just because you don’t have a uterus doesn’t mean you don’t need or wouldn’t benefit from progesterone replacement. If you’ve got adrenal fatigue, you may need it. If you’re on estrogen replacement, you probably need it. If you’re weak, fatigued, probably need it. If you have night sweats, you probably need it. And if you have difficulty going to sleep, feel a little more on edge, have project a premenstrual syndrome, uh, you know, things like that. You probably needed a multiple different things. In fact, they will use progesterone to help maintain a pregnancy very early if you’ve had multiple miscarriages.

Speaker 1: 28:00 Now that this is not what I do in my clinics, I’m going to be clear about this. I’ve done this in the past. I don’t do it in my clinic. I did it in the military when I was doing a lot of women’s health, but I don’t do this in my clinic. So don’t, don’t call us and say, Hey, can you give us progesterone, you know, while I’m pregnant and no, no, no, you need your ob happy to work with them, but you need to go to your ob because that’s the most appropriate thing. So, but we will absolutely work with your doctor if they’re willing to work with us. Um, but so all of those things are things that I would consider a progesterone replacement for. And then we’ll get into the progestin piece here in just a minute. And let me go over some more of the, uh, the actions of estrogen.

Speaker 1: 28:46 For example, you know, we talked about, you know, I said estrogen, progesterone, we talked about, you know, estrogen is, is trophic, it’s growth related at builds tissue, like the lining of the uterus. And so a progesterone kind of mitigates that or counteract some of that, a decrease of smooth muscle contractility in the uterus. It’s important in sex drive and females, if you have no progesterone, your sex drive could be a little bit lower. Interestingly, there is some research into the possible benefit of progesterone in traumatic brain injury. There’s some ongoing research about that. This, this is another really interesting part because estrogen has an effect on the serotonin receptor. When we talk about depression, you know, people will often go on Ssri or selective serotonin reuptake inhibitors. A progesterone has an on the serotonin receptor and I think there’s, it gives an explanation as to why some people have,

Speaker 1: 29:50 they resort to several substances that enhance Serotonin, like, you know, with the Ssri I’m activity, but other things do that, such as nicotine, alcohol, cannabis, or marijuana, and when their, when their progesterone levels fall, they often will resort to some of those things they go because they need some higher levels. So in those patients, progesterone can be beneficial in dealing with their addiction. Again, I don’t do addiction medicine, but you know, we try to be as functional as we can. So, uh, if you’ve got a drug problem, we’re, we’re probably not the clinic for you. If you are working with someone addiction specialist and you want some additional help, we may be able to help in that regard.

Speaker 4: 30:36 The, uh,

Speaker 1: 30:38 the progesterone can help the endometrium converted into the secretary stage, which prepares the uterus for implantation of a fertilized egg. Uh, I mean, it’s just got all kinds of effects. Some quick other things decreases. Our ability, suppresses immunity during pregnancy. It raises the epidermal growth factor, one increases core temp during ovulation, reduce the spasms and relaxes smooth muscles, acts as an anti inflammatory and reduces gallbladder, gallbladder activity, normalizes blood clotting and vascular tone and helps with zinc and copper levels, prevents or helps in preventing a endometrial cancer. It’s got a role in signaling insulin release and pancreatic function. So if you have diabetes, you’ve got some insulin problems, prediabetes, those kinds of things. Then hormones play a role in that as well. So progesterone has a lot of effect in the body. It’s synergistic in its effect with Estrodiol, the primary estrogen,

Speaker 1: 31:39 uh, you know, some of the metabolites that we talked about a pregnant alone, uh, and uh, five Alpha Dihydro progesterone. Both of those interact with Gabba, which we talked about, which makes it very calming, great for pms. If women have premenstrual syndrome, then progesterone may be very beneficial and some women need very high doses. We talked about that 400 milligrams. You may need two to 400 milligrams, so if you’ve tried 50 milligrams, didn’t get any benefit, you may need to go much higher than that. But again, we have to work through that. Um, progesterone has been shown to a possibly be protective against breast cancer, coronary artery disease, cardiovascular disease, those kinds of things. The biggest side effects that we see when we give progesterone, if we give too much, you can have some breast or a nipple soreness. Uh, and then the other thing that we’ll see is we’ll call somnolence or sleepiness, which that really only occurs when we give it orally. And that’s because of those metabolites that with the Gabba. Uh, so after we come back from the break, let’s talk a little bit about the project ends and why I like one versus the other. I cannot wait. Awesome.

Speaker 2: 32:49 Are you tired and fatigued? Are you frustrated with doctors because they just don’t seem to listen. Do you want to fix your pain without surgery? If you answered yes to any of these questions and we are the clinic for you, we offer prolotherapy prp or platelet rich plasma therapy and stem cell injections, ivy nutritional therapies, bioidentical hormone replacement therapy, and functional medicine to get you back on track to optimal health. Call our clinic at nine one eight, nine three, five, three, six, three, six or visit our website@wwwdotrevolutionhealth.org to schedule your appointment today. It’s one versus the other. It’s Alpha versus Beta, Beta versus outfit. Same. Same. And so we haven’t talked about progestins yet. Like what exactly are progestins and why do I need to know about them if I’m a woman or a man or anybody?

Speaker 1: 33:32 Yeah. Right. And the reason that I would say that most that we need to know about progestins is because I see them as a real problem in many of my patients. And again, I will readily admit I have a selection bias, but I had, I know I’ve told this story before. I had a patient that came into my clinic. Uh, she was in her mid thirties and came in, had been feeling bad for years. Literally she started feeling bad and this was probably six months ago that she came in and this patient had started feeling bad and November of 2012. So she had been to multiple doctors, has been to her ob, ob Gyn. She had been to a gastroenterologist, been to a general surgeon, been in primary care, and that was probably our seventh or eighth doctor that she came to see came in and sat down and I started talking with her and you know, the Sir William Osler, one of the physicians that I just have tremendous respect for.

Speaker 1: 34:25 Uh, obviously he’s dead, but a help. He founded Johns Hopkins and he said, listen to your patient, they’re telling you the diagnosis and when we do that, the patients will tell us so much and when we take a good history that will give us so much information. So I’m sitting here and talking to this girl. Hadn’t laid a hand on her yet, hadn’t done a single lab and then anything. She’s just telling me her story. And I said, well, when did you start feeling bad? And she said, November of 2012. And I was like, wow, that’s a pretty specific date. What happened? And she was like, I don’t know. I was like, oh, she went through a divorce. But that was like a year or two before it was all these different things. Then I was like, what the world happened? I mean, that’s a very specific.

Speaker 1: 35:06 There’s something around that period of time. Okay. Couldn’t really elicit a, you know, why she was feeling the way she felt and so, you know, we’d, okay, we’ll just keep looking. We’ll keep digging. I said, well, tell me about your periods. And she’s like, oh, I don’t have, I don’t have periods. And I was like, well, why? Why don’t you have periods? And she said, well, I had this. I had this thing planet in my arm right here. I was like, okay, well when did you have that thing planted in your arm? She said, October of 2012, I, I think we’re done here being the led bulb. And that thing is a little device that slowly secretes a progestin. Right? Similar to progesterone but is not the same thing. So we’re, we’re, we’re talking about here is a birth control device. Exactly. Exactly. So I said, well why don’t we get that thing out?

Speaker 1: 35:51 So we took her into the procedure room, cut that thing out, came back to see me three weeks later in tears. And her fiance was mad and I was like, what, why, why are you so upset? And he said, because we went to seven different doctors and nobody even thought to ask the question. So what, he wasn’t mad at you? He was mad at the other doctors? Yes. Wow. What? I mean, he was like, why wouldn’t they even ask the question? And I think they had even talked about it with, with a couple of them saw. He was like, oh no, that’s not it. Sometimes the most simple answers are the hardest to come across. It’s like sometimes you overthink everything, right? Like working in a studio. There’s sometimes we have a equipment and we’ll literally sit here and try to trace everything and it will come back to.

Speaker 1: 36:39 Did I turn the power on? Right? Yeah. Yeah. Is that power strip plugged in? Is it switched or anything like that? Luckily. Um, so anyway. Um, okay. So that is just an example of how the project ends. Can cause a problem. I’ve seen the same thing with Iud is a severity similar case. I’ve got some that are on progesterone progestin only a birth control pills. I’m not just case after case after case after case. That’s just how it is. So, um, these progestins w there, they are considered to be the same according to, um, according to the FDA, they’re basically considered to be the same as progesterone. Well, but they’re not. In fact a [inaudible] progesterone Acetate, which is a Progestin, not progesterone is a category, excuse me, category x medication in pregnancy, category x that sounded dire. It’s bad, its contra indicated. Do not use.

Speaker 1: 37:48 Wow. So it’s almost like that label that they used to have with the skull and crossbones where. Exactly. Exactly. Wow. So yet it’s considered the same thing. And we routinely use, I say routinely in certain cases we’ll, we will use progesterone. Your body kicks out, progesterone in, in response to um, you know, pregnancy. I mean your progesterone levels go up. That’s part of that pregnancy process. Medroxyprogesterone Acetate is contra indicated. These are not the same chemical. They’re not the same. Your body handles and processes of them differently. So again, synthetic have progesterone like activity, the projections, and some of them they’ve got different actions because there’s different kinds of them. Some of them have androgenic effects, like, uh, the [inaudible] progesterone acetate that we mentioned or MPA, um, nor a nor ethicists Jeroen acetate nor gestural level nor gestural. They’ve all been shown to significantly increase the risk of breast cancer in postmenopausal women in combination with estrogen replacement.

Speaker 1: 38:53 So, you know, we, we will often talk about hormones and oh, there’s an increased risk of breast cancer. Well, I would, and I’ve got podcast where we’re talking about the different kinds of estrogen. So estrogen versus estrodiol. And then the different detoxification. We talked, we talked a little bit about that here. Uh, the different detoxification pathways the estrogens can go through, which is again, a topic of a different podcasts. We’ve already done that when you look through and find that, if you want to listen to it. Um, but the [inaudible] progesterone Acetate, I’m sorry, the, the, these ends have been shown to increase breast cancer. So patients will come in and they say, I’ve heard hormones increased risk of breast cancer. Yes, it was, it’s been demonstrated, uh, but the biggest effect was actually with progestins, they’re common, these are commonly used in birth control, which we’ve talked a little bit about oral contraceptives and Iud is in fact it was the very first oral contraceptive, uh, around 1950 was a progesterone only pill.

Speaker 1: 39:54 Um, the, uh, but the difference is they have a whole host of side effects that progesterone does not have. Things like bloating, headache, fatigue, weight gain, depression, increased premenstrual syndrome symptoms because it stimulates the estrogen receptor, a increased risk of coronary artery disease, cardiovascular disease, deep vein thrombosis, pulmonary embolism dementia, cancer, diabetes, depression, breast swelling and tenderness. That one, it shares with progesterone, a irregular bleeding weight gain, fluid retention, increased breast cancer risk, increased cardiovascular disease risk. Uh, you know, the list goes on and on and on and on and on. All these things sound extremely terrible. Why would anybody do this to themselves? Because I would argue because of the, the impact of progesterone, the, uh, um, let me rephrase that. Of the pharmaceutical industry on physician education, we’ve got studies on these things that we can patent, you know, we can’t patent a natural chemical and so we don’t do as many studies on natural chemicals.

Speaker 1: 41:03 If I’m a pharmaceutical manufacturer, I want to make a chemical that is going to make me money and you know, in some would argue that they want to help patients and would argue they don’t want to help patients. It’s just about the Almighty dollar. But ultimately they are in business. You know, you, you can, you can have a stock holder meeting and say we felt $5, million people, but if you didn’t make any money, the stock holder may not care. Right? And so it’s still a business. I’m not vilifying that Ashley, I am a capitalist. I support that. But we have to understand what it is and just call it what it is. Um, this is economics. And so I’m, I can’t patent a natural chemical. I have to alter it and make it mine. Then I can do studies and you know, God willing, the studies show benefit, which is what they’ve done for years until the women’s health study, women’s health initiative came out in 2002 and that study was stopped early, especially in the progesterone arm because of the detrimental effects of cardiovascular disease and increased risk of breast cancer.

Speaker 1: 42:08 So again, having to do with the project ends, progesterone is not the same as progestin and in many ways they’re anti hormones. You know, we, progesterone has got some suggestion that it’s anticancer, but progestins are pro cancer. In fact, a progesterones never been shown to have an increased risk of breast cancer. In fact, in one study, uh, there was a relative risk of estrogen or relative risk of breast cancer when estrogen was used with progesterone. The relative risk was one, meaning it was the same, you know, it’s, it’s a net wash, not higher, not lower, but it was one point six, nine for estrogen used with other progestins. So you were one point six, nine times more likely to get breast cancer if you used an estrogen with progestin. So, very interesting. Um, you know, it was, you weren’t high or low likelihood, lower likelihood with progesterone, but almost not quite double for estrogen with Progestin.

Speaker 3: 43:13 So how, I mean, you say like one point six, nine times more likely to incur breast cancer, right? If you’re talking to someone who doesn’t understand the magnitude of that, like how could you describe this in a way that the average person who didn’t go to medical school for 30, 40 years like yourself feels like it’s. How would you describe that in a way that would be easily understandable?

Speaker 1: 43:40 You want, you want the lowest risk for rest, you want the lowest risk you can get for cancer. Correct? Right. Okay. But you have some symptoms you want, you don’t feel well, all of those kinds of things. We want to fix that, but with the lowest risk possible. Right? Right. Okay. So in many cases we want to use hormone replacement to help you feel better. And so let’s do something that doesn’t raise your risk of breast cancer. So let’s use progesterone or an estrogen replacement with progesterone. Or I can use this synthetic chemical that increases your risk. Sixty nine percent, not quite double, but it increases your risk for getting breast cancer by 69 percent. Wow, that’s huge.

Speaker 3: 44:25 I was going to try to play devil’s advocate, but when you said 69 percent, I was like, that’s a pretty high percentage there. That’s, that’s

Speaker 1: 44:32 what’s been shown. And you know, we’ve got multiple studies showing correlations to that effect. So, uh, I don’t think there’s any real significant benefit to progestins unless you are looking for an oral birth control pill. I can’t do that in a bio identical way, right? It’s, you got to use the synthetic ones in your bio identical way. How would you be able to facilitate birth control? The one that I recommend is an enter uterine device called pair regard. There’s no hormones involved. It’s got a copper lining or the copper coils on it. A very simple procedure. We actually do it in our clinic. It takes a few minutes. Most women tolerate it very well. You can have some cramping associated with that. So any woman considering getting a paraguard, I asked them to take ibuprofen before they come in because it can help with some of that cramping, got to get a pregnancy test within 24 hours if of had a test done and sometimes using a certain medication can help soften the cervix and make the procedure a little bit easier.

Speaker 1: 45:37 But I mean I did them all the time in the military, got a great record in, in, uh, in our clinic, uh, and we certainly do them there as well. So if you need birth control and that’s generally what I recommend. It’s not for every woman and we, I try to offer as many options as I can. If you’re not having any problem with your oral birth control pill and you know, stay with it. Uh, I, we don’t use them at our house, you know, but um, you know, that’s my thought. But if you could have a psa to women who are listening to this podcast right now, pro progestins, what would your message be? Don’t use them so full, but so effective. They, I’m in this, the studies, the studies are out there suggesting that, that, uh, you know, if you want to lower your risk of disease and optimize your health, use bioidentical hormones.

Speaker 1: 46:31 Okay. And if anybody is interested in progesterone treatment, how can they get in touch with you? Our website, revolution health.org. Uh, certainly we’ve got information out there, obviously the podcast, which you’re obviously listening to right now if you’ve got it. And, uh, or you can give our clinic a call at nine. One, eight, nine, three, five, three, six, three, six. Oh, right. Well, is there any final messages you want to put out there? I’m glad it’s Friday. That’s it. Thank you so much for joining us, Dr Edwards. This has been highly educational. Thank you. Thanks guys. We’ll see you next time. All right, bye.

Speaker 2: 47:05 Thanks for listening to this week’s podcast with Dr Chad Edwards. Tune in next week where we’ll be going against the grain.

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