Men and Progesterone Use

Why would men need to take progesterone?

Our website has certainly received it’s share of calls from men interested to learn how progesterone can be incorporated in the treatment of male-related illnesses that are linked to hormone imbalance and male menopause, i.e., benign prothetic hypertrophy (enlarged cells in the prostate gland) or hyperplasia (enlarged by an increase in the number of cells in the gland), commonly referred to as BPH.

Progesterone in men is vital to good health. It is the primary precursor of their adrenal cortical hormones and testosterone. Men synthesise progesterone in smaller amounts than women do but it is still important.

The metabolic actions of the prostate gland are determined in large part by hormones, especially estradiol, progesterone, and testosterone, which are made by the testes. These, in turn, are mediated by pituitary hormones, especially FSH and LH, just as ovarian function is women is.

Both the prostate gland and the uterus develop from the same embryonic cells, and both respond to the same hormones - estrodiol, progesterone, and testosterone.

In the same manner, both the ovaries and the testes develop from the same embryonic cells. A fertilised ovum with XX chromosomes develops ovaries and a uterus, while the fertilised ovum with XY chromosomes develops testes and a prostate gland.

Dr John Lee writes, in his latest publication ‘What Your Doctor May Not Tell You About Prostate Health & Natural Hormone Supplementation’ that in the prostate (and in the hair follicles) is an enzyme (5-alpha-reductase) that converts testosterone into dihydrotestosterone (DHT). Higher DHT levels in hair follicles is a primary cause of male pattern baldness.

He argues that DHT stimulates proliferation of prostate cells, more so than testosterone does, enlarging the prostate gland and narrowing the urethral channel, leading to urination problems, and speculation that elevated DHT is the cause of prostate cancer.

Inhibiting this conversion of testosterone to DHT is often a treatment goal for men with BPH.

Since progesterone is a potent inhibitor of 5-alpha-reductase, the decline of progesterone in aging males plays a role in increasing the conversation rate of testosterone to DHT.

Adding progesterone back into the body helps restore normal inhibition of 5-alpha-reductase, thus preventing testosterone from changing into dihydrotestosterone (DHT), which stimulates proliferation of prostate cells.

Basically, Dr. Lee suggestsmen undergo progesterone replacement therapy using a maintenance dose of 8-10mg a day and 1-2mg per day of testosterone to protect against prostate cancer.

Rate of prostate cancer on the increase

Prostate problems are the fastest-growing health concern among men in Western countries, and the rate of prostate cancer is increasing steadily.

The initiation of normal cells turning into cancer cells is the same for both the breast or uterus and the prostate gland. In these organs, cancer initiation is due primarily to estrogen dominance combined with lifestyle factors and/or toxic insults that predispose estrogen to become oxidised.

The incidence of prostate cancer increases with age. The majority of men in the US will acquire prostate cancer if they live beyond 65. It is a slow-growing cancer (more rapidly growing in younger men, however). For men over 65, the doubling time of a prostate cancer nodule is usually about 5 years. Compare this with the doubling time of a breast cancer nodule, which is about 3 to 4 months. If left untreated, prostate cancer tends to eventually metastasize to bones.

A case of estrogen dominance

Men are often wary of taking progesterone supplementation for fear it will induce female characteristics. This couldn’t be further from the truth. It is the hormone estrogen that is responsible for the characteristics of the female body.

In men, estrogen gradually rises with age, while saliva levels of progesteorne and testosterone gradually fall with age. Thus, with aging, estrogen dominance occurs.

A clear sign of estrogen dominance in aging men is their tendency to develop breasts. This indicates these men are low in progesterone and testosterone.

We know that the prostate gland responds to the hormones estrodiol, progesterone, and testosterone, and that a man’s progesterone and testosterone levels fall as he ages. If, however, his estradiol levels continue to remain high he should consider himself in a state of ‘estrogen dominance’. And research right now is pointing an accusing finger at estradiol as an initiator and promoter of cancer.

Excess testosterone can spill over and become estrogen, causing water retention, prostate enlargement, atrophy of the genitals, decrease in libido, and cancer.

Being overweight is another factor to consider since fat cells convert into estrogens which then stimulates prostate growth.

As we know from breast cancer research, insulin resistance leads to estrogen dominance and an increased risk of breast cancer. It seems to be that the same pattern occurs in prostate cancer.

Regular exposure to xenoestrogens such as pesticides like home and garden sprays only add to the problem.

Middle aged men are not immune to estrogen dominance that can lead to symptoms such as weight gain, large-than-normal breasts, gall bladder problems, anxiety and insomnia, and prostate enlargement that leads to urinary problems.

Check testosterone levels

Regular FAI (Free Androgen Index) blood assay readings to check testosterone levels is recommended. Your doctor would be very familiar in interpreting this test as opposed to saliva readings.

Our advice to women holds true for men … take full responsibility for any hormone treatment, move away from compliance and ignorance, undertake your own research, carefully track your symptoms, get regular saliva hormone levels tests, and at every opportunity work closely with a collaborative health care professional.

Will progesterone help men with osteoporosis?

Yes, it will. The same principle applies because progesterone will help build new bone for men in much the same way it does for women.

Does progesterone increase the risk of prostate cancer?

According to Dr Lee, two studies published in the American Journal of Pathology in 1999 show that estrogen increases prostate cancer, and that progesterone receptors in the prostate are more abundant in cases of more agressive prostate cancer. Misinterpretation of this type of result is common.

Conventional interpretation suggests that this might indicate that progesterone causes the more aggressive breast and prostate cancers. The truth is that progesterone receptors are made by estrogen. The higher the estradiol/progesterone ratio, the greater are the number of progesterone receptors that will emerge.

This is the tissue’s effort to restore proper progesterone function in situations where estrogen dominance is present. thus, increase of progesterone receptors is evidence of estrogen dominance, and not evidence that progesterone increases the risk of cancer.

Can progesterone be used as a contraceptive in men?

In Dr John Lee’s earlier publication ‘What Your Doctor May Not Tell You About Menopause’ first published in 1996 he wrote, “In a study in the Medical Tribune fifteen years ago, progesterone was given to college age men which resulted in no change to general stamina, vigor or sex drive. However, sperm maturation was inhibited. Since many testosterone receptors also accept progesterone (and with similar results), it is likely that a biofeedback mechanism in the brain reduces testosterone production when high levels of progesterone are present. Thus it appears that pharmacologic doses of progesterone in men act only as a contraceptive.”

A recent article, “Male Contraceptives plus HRT for Men”, explains this theory in pretty thorough detail. Please note the words ‘progesterone’ and ‘progestin’ referred to throughout this interview with the good Professor David Handelsman are actually the same synthetic progestins found in conventional HRT. More recently the Women’s Health Initiative study was stopped short one year ago when it became clear that estrogen-progestin increased the risk of breast cancer, heart attack, and strokes.

Suggested application sites

If there is a cyst or lump in the testes that has been tested and found to be benign then we suggest you apply cream directly to the testes. A similar approach is adopted by women with fibrocystic breasts, and progesterone has certainly helped reduce if not eliminate lumpy breasts.

We recommend that the sites of application mirror those adopted by women. Areas where the blood vessels are very close to the skin, avoiding fatty areas like the stomach and buttocks, and avoid areas where there are more than a few hair follicles.

Suggested areas for men where there is good blood supply is inside the groin, behind the knees, ankles, wrists, inside under your arms (not armpit), on the temples, forehead, neck, upper chest. It’s not necessary to apply progesterone cream directly to the penis.

Too much cream may cause fluid retention, headaches and other associated symptoms so please use only small maintenance dose of 8-10mg a day.