As an experienced physician in women’s health now practicing functional medicine, I frequently hear misconceptions about hormone therapy, one of the most common beings: “My doctor said I don’t need progesterone because I don’t have a uterus.”
This outdated belief has left countless women suffering from unnecessary symptoms and missing out on the full benefits of hormone balance.
Progesterone is not just about pregnancy or uterine health; it is an essential hormone that affects nearly every system in a woman’s body. Yet, many conventional practitioners overlook its importance in menopause and bioidentical hormone replacement therapy (BHRT).
Let’s debunk the myths surrounding progesterone, highlight its critical role in women’s health, and explore the scientific evidence supporting its use in BHRT.
Myth #1: “You Only Need Progesterone If You Have a Uterus”
This is one of the most pervasive myths about hormone health. While it’s true that progesterone helps maintain the uterine lining, it has far-reaching effects beyond the reproductive system.
The Science Says:
- Progesterone is crucial for brain health. Studies have shown that progesterone has neuroprotective properties, supporting cognitive function and reducing the risk of neurodegenerative diseases.
- It helps regulate mood and sleep. Progesterone has natural calming effects due to its ability to interact with GABA receptors in the brain, promoting relaxation and improving sleep quality.
- It supports cardiovascular health. Research has found that bioidentical progesterone (unlike synthetic progestins) helps maintain healthy blood vessels and reduces the risk of hypertension and cardiovascular disease.
Myth #2: “Estrogen Alone is Enough for Hormone Therapy”
Many women are prescribed estrogen-only therapy, especially after a hysterectomy, with the assumption that progesterone isn’t necessary. However, this approach ignores progesterone’s balancing effects on estrogen and its broader role in metabolic and neurological health.
The Science Says:
- Progesterone helps prevent estrogen dominance. When estrogen is unopposed, it can lead to symptoms like weight gain, anxiety, breast tenderness, and an increased risk of estrogen-related cancers.
- It plays a role in bone health. While estrogen slows bone loss, progesterone actively stimulates new bone formation.
- It reduces inflammation. Progesterone has anti-inflammatory properties that help protect against autoimmune conditions and chronic disease.
Myth #3: “All Forms of Progesterone Are the Same”
A common mistake in hormone therapy is confusing bioidentical progesterone with synthetic progestins. Many of the risks associated with hormone therapy stem from synthetic progestins, not bioidentical progesterone.
The Science Says:
- Bioidentical progesterone is safer than synthetic progestins. Studies show that synthetic progestins, like those used in conventional hormone therapy (e.g., medroxyprogesterone acetate), can increase the risk of blood clots, stroke, and breast cancer. In contrast, bioidentical progesterone has been found to be protective.
- It supports metabolic health. Bioidentical progesterone has been shown to improve insulin sensitivity and help prevent metabolic syndrome.
Myth #4: “Progesterone Causes Weight Gain”
Many women fear that taking progesterone will lead to weight gain, but this concern is largely based on misinformation.
The Science Says:
- Progesterone helps with fluid balance. Unlike synthetic progestins, which can cause bloating and water retention, bioidentical progesterone has a natural diuretic effect, helping to reduce puffiness and bloating.
- It supports metabolic function. Progesterone plays a role in fat metabolism and can actually help maintain a healthy weight when used correctly.
Myth #5: “Progesterone is Only for Menopause”
While progesterone therapy is commonly associated with menopause, its benefits extend to women at various life stages.
The Science Says:
- It helps women with irregular cycles. Women with polycystic ovary syndrome (PCOS) or irregular cycles often have progesterone deficiencies that contribute to infertility and hormonal imbalance.
- It is beneficial during perimenopause. Many of the early symptoms of perimenopause, such as anxiety, insomnia, and mood swings, are due to progesterone deficiency long before estrogen levels significantly decline.
The Future of Women’s Hormone Health
It’s time to move beyond outdated beliefs and embrace the full potential of bioidentical hormone therapy for women.
Progesterone is not just about the uterus, it’s about brain function, metabolic health, cardiovascular protection, and overall well-being.
If you’ve been told that you don’t need progesterone, I encourage you to seek out a physician who specializes in functional and longevity medicine. The right balance of hormones can be life-changing, helping you reclaim energy, vitality, and overall health.
Take Action:
- Find a knowledgeable provider. Work with a physician who understands the role of progesterone in women’s health.
- Get comprehensive hormone testing. Blood, saliva, or urine testing can help determine your progesterone levels and overall hormonal balance.
- Educate yourself. Don’t settle for misinformation—stay informed and advocate for your health.
Women deserve better than outdated myths and incomplete hormone therapy. Progesterone is a vital part of the equation, and it’s time we start treating it that way.
Dr. Sadia Ali attended FIU in her hometown of Miami, Florida, and received her Bachelor of Arts in Biochemistry. She attended medical school at USF Morsani College of Medicine in Tampa, Florida, and completed her Family Medicine Residency Training at Atrium Health in Concord, North Carolina.
Dr. Ali completed her medical training in Winter Park, Florida, where she was a Junior Faculty and became fellowship-trained in Women’s Health & Obstetrics. Dr. Ali is also trained in functional, aesthetic & obesity medicine.