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, the late Dr. Lee suggested men 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.

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.

For more information on osteoporosis read our section on ‘Osteoporosis and Progesterone’.

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.”

The more recent article [below] 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.

• Male Contraceptives plus HRT for men

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.