Benefits of Progesterone
Progesterone therapy, endothelial function and cardiovascular risk factors: a 3-month randomized, placebo-controlled trial in healthy early postmenopausal women
PLOS ONE, 02/11/2014 Exclusive Author Commentary Clinical Article
Prior JC, et al. – Progesterone is effective treatment for hot flushes/night sweats. The cardiovascular effects of progesterone therapy are unknown but evidence suggests that premenopausal normal estradiol with also normal progesterone levels may provide later cardiovascular protection. The authors compared the effects of progesterone to placebo on endothelial function, weight, blood pressure, metabolism, lipids, inflammation and coagulation. Results indicate that progesterone has short–term cardiovascular safety. Endothelial function, weight, blood pressure, waist circumference, inflammation and coagulation were unchanged as were lipids except for HDL–C. The statistically significant decrease in HDL–C levels was not clinically important (based on lack of Cardiovascular Risk Profile change).
What is important about these RCT data is that they fill a gap in knowledge about the physiological actions of progesterone. Although we carefully screened women enrolled in this study to be early in menopause (1-11 years since their last flow) and to have no cardiovascular risk factors, it may be that the effects of progesterone would be different in women with initial evidence for cardiovascular disease. For example, one study in hypertensive women and men show blood pressure lowering. There is a mechanism for this since in vitro progesterone has vascular smooth muscle relaxation effects. I’m also excited about these data because of my hypothesis that premenopausal normal progesterone and estradiol levels are needed for “women’s cardiovascular protection.” Given that silent (occurring within clinically normal menstrual cycles) ovulatory disturbances (anovulation and short luteal phases) appear to be common in premenopausal women (Li Epidemiologic Reviews 2014), this hypothesis becomes increasingly plausible