Progesterone and Men-Optimizing the Aging Male's Health

Progesterone and Men-Optimizing the Aging Male's Health
Dr Robert G Carlson, MD, FACS

Progesterone – It’s Not Just for Girls!

Every day we see a new article dedicated to explaining how important progesterone is for women in the array of hormones that are key to good health and healthy aging. But what about men? Most men and women along with many doctors would be surprised to find that progesterone is very important to a man’s health!

So Men Produce Progesterone?!
Most men have about seven times lower levels of progesterone than testosterone; but it is actually more abundant than DHT, the primary metabolite of testosterone that makes a man look like a man. Hormones give us our secondary sex characteristics –
curves for a woman, a lower voice etc. for a man. Even though some hormones are more prevalent in men or women, both sexes have all the same hormones just in different levels. Healthy men have more progesterone than the other “female hormones” like estradiol or estrone, 10 times more of it than melatonin, and much more of it than thyroid hormones like free T4 or thyroxin. Progesterone is actually just as important to a man’s health as a woman’s!
We’re Wired for Equality…Most of the Time!
For a short time every month, men and women are equal…in progesterone! The levels of progesterone that men have is equivalent to what women have during the follicular phase each month; this is the first phase of a women’s cycle when progesterone is low, just like a man’s progesterone level.
The reason that men and women will have equal levels of progesterone is because a man creates progesterone in his adrenal glands and the primary source of progesterone for a woman during the first 2 weeks after the onset of the menstrual cycle is from the adrenals as well. In fact, for both men and women the adrenal glands make 1 ½ - 3 mg a day of progesterone.
A woman will have a much higher level of progesterone over the course of each month though because during the second phase of her cycle her ovaries will also produce it. So for two-thirds of every month, men and women will have the same level of progesterone!
Progesterone can also be a precursor of testosterone, aldosterone, and even cortisol. Progesterone is also very important as a base of hormone production; it joins with cholesterol to create””. Progesterone is also a bellweather of how your body is handling stress. During stressful crisis situations, you may have higher levels of progesterone and your body may react by making lots of cortisol (and creating that dreaded spare tire around your waist!) If you are under chronic stressful situations, you can suffer from adrenal fatigue and your body will no longer produce adequate amounts of cortisol.
Our bodies are designed to respond to stress as a self-protective reflex – we either fight, flee or freeze. Crisis triggers cortisol production to help the body manage stress. Cortisol is so important to the body during stress that it becomes the body’s primary focus and the cortisol “sink” is where most of the substrate for other hormone production is often shunted to fortify the body’s arsenal of protection. Remember, we developed in a very unsafe world where we were under constant threat so our bodies are hard-wired for self-preservation by using hormones to respond to stress and keep us alive.

How Much Stress Can You Handle?

Our bodies are designed for a quick, reflexive, self-preservation response to stress but our lives today are one crisis after another. At some point we do “accommodate” to stress, we become more capable of bearing the stress load. But is it healthy? Some stress is good, but too much stress is a killer. One of the key hormones we need for health and longevity – progesterone – falls by the wayside when we are stressed. Everything becomes focused on cortisol production. If you have the typical, chronic stress levels of American daily life, you probably are deficient in progesterone. If you are walking through a crisis event, you may be producing far too much progesterone. In either scenario, you need to support your body’s hormone levels. So, high progesterone levels maybe an indicator of stress, whereas very low levels indicate a serious adrenal fatigue condition.

“You Are Getting Older!” – Bite Me!

Progesterone levels decline with age just like all the adrenal hormones and this affects most of your major organ systems. There are progesterone receptors in your heart an in your major blood vessels such as your arteries and veins. Progesterone is the hormone of calmness. It is nature’s valium, the Feng Sui of hormones. When you have low progesterone levels, some of your organ systems may demonstrate more tenseness or nervousness. The gall bladder has progesterone receptors and a stressed gallbladder with low progesterone may lead to a danger situation like acalculous cholecystitis, which we see in very stressed patients in the ICU. In the prostate, epididymis, and the testicles, there are also progesterone receptors, and there must be a purpose for that? Sperm also has progesterone receptors as well.

Progesterone – What Have You Done for Me Lately?

Progesterone is the peacekeeper hormone that keeps the levels of other hormones in balance and it helps maintain the hormonal symphony resonating in through your body. For instance, estradiol in men is not a good thing; it results in higher stroke rates, increased heart attack rates, and increased prostate cancer. Progesterone keeps your estradiol levels in control.
Progesterone also keeps the levels of Dihydrotestosterone(DHT) in balance. Too much DHT leads to hair loss and increased prostate cancer risks. Progesterone will also keep your aldosterone in balance. You can also blame progesterone if your wife or girlfriend complains that you fall asleep right after sex. Progesterone levels spiral during intercourse and peak after an orgasm; it’s progesterone that creates a calmer, more relaxed state after an orgasm. Many of my male patients like taking progesterone in the evening because it does make everything so much more relaxed and some of them tell me it also increases their deep breathing almost like yoga.

You Gotta Have Heart!

Progesterone has a role to play with regard to cardiovascular disease. Not only are there progesterone receptors in the heart and all the major blood vessels, but it’s also been shown to reduce lipids in the blood. It also helps protect against damage to the arterial system from elevated insulin levels. Too much insulin floating around in your blood can prematurely break down and age the walls of the arteries. Progesterone protects the blood vessels from the effects of insulin.
For people who are progressing into atherosclerosis, there is an overgrowth of smooth muscle cells within the lining of the blood vessels. Progesterone has been shown to stop this out of control growth. And those coronary arteries? The major cause of death from heart disease is the decreasing blood flow to regions of the heart that need it. We call these “ischemic changes” which is the technical term for lack of blood flow. Most doctors have been trained to provide medications that improve blood flow through the coronary arteries like nitroglycerin. But who wants to swallow the poisonous basis of explosives? There are numerous natural compounds throughout the body that do the same thing, including progesterone and testosterone; and they may even help reduce hypertension by helping to relax the muscular walls of arteries and reduce water retention/edema by helping the body excrete sodium.


More to come....