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Progesterone in Menopause - A Review
11/13/2024

This article discusses the use of progesterone for treating hot flashes and night sweats (vasomotor symptoms, VMS) in menopausal women. It argues that progesterone is an effective and safe alternative to traditional hormone replacement therapy (HRT) with estrogen and progestin.

Key Points:

  • Problem: Many menopausal women experience VMS, which are disruptive and can significantly impact quality of life.
  • Traditional HRT: While effective for VMS, traditional HRT with estrogen and progestin has raised concerns about safety due to findings from the Women's Health Initiative (WHI) trials.
  • Progesterone as an alternative: This review suggests progesterone is a viable alternative for VMS treatment.
    • Effectiveness: Studies show progesterone significantly reduces VMS frequency and intensity compared to placebo.
    • Safety: Available evidence suggests progesterone has a favorable safety profile compared to traditional HRT. It may not increase the risk of cardiovascular disease, blood clots, or breast cancer.
    • Sleep benefits: progesterone may improve sleep quality in addition to reducing VMS.
    • Discontinuation: Stopping progesterone does not appear to cause a rebound increase in VMS.

The passage also addresses concerns about progesterone:

  • Progestins vs. Progesterone: The review clarifies the difference between synthetic progestins used in traditional HRT and natural progesterone.
  • Depression: The review suggests progesterone may not cause depression, a concern sometimes associated with progestins.

Study Recommendation:

The study recommends progesterone as a first-line therapy for VMS, especially for women concerned about the safety of traditional HRT. However, the recommendation may vary depending on individual factors like age of menopause and bone health.

Link: https://www.tandfonline.com/doi/full/10.1080/13697137.2018.1472567#abstract