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One of the beautiful things about naturopathic medicine is how versatile we can be with treatment options for various conditions. In British Columbia, many Naturopathic Doctors practice with a blended style of Western medicine and alternative treatments such as nutrition and botanical medicines. One of the treatments that Dr. Hartman offers for women with irregular cycles, PCOS, or overall low progesterone levels is something called Cyclic Progesterone Therapy.

What is Progesterone?

Progesterone is a steroid hormone produced both in men and women in the adrenal glands and in the ovaries in women. Large amounts of progesterone are produced after ovulation and during pregnancy. The name progesterone was given to this hormone because of it’s ability to help sustain a pregnancy (“pro-gestation”). Beyond the fertility actions, progesterone also provides the body with many other benefits when it comes to the health of the bones, breast, heart, and uterus.

When a women is not ovulating regularly, there will be an overall decreased level of progesterone in the body resulting in symptoms such as irregular/absent menstrual cycles, infertility, and PMS. Long-term, the risk of breast cancer, uterine cancer, uterine hyperplasia, heart disease and osteoporosis will all increase.

Symptoms of Low Progesterone

  • Premenstrual anxiety, depression or mood swings
  • Painful or fibrocystic breasts
  • Water retention or bloating
  • Weight gain
  • Premenstrual headaches or migraines
  • Heavy menstrual flow
  • Clotting
  • Low libido
  • Amenorrhea (lack of a period)
  • Acne
  • Fatigue
  • Infertility
  • Hot flashes

What is Cyclic Progesterone Therapy

Cyclic Progesterone Therapy (CPT) was developed by Dr. Jerilynn Prior, a medical doctor and professor of endocrinology and metabolism at the UBC School of Medicine. She is also the Scientific Director for the Center of Menstrual Cycle and Ovulation Research in Vancouver, BC. CPT involves using bioidentical progesterone in cycling women in a way that mimics a normal pattern (i.e. for two weeks in the last half of the menstrual cycle).

Benefits in PCOS

One of the mechanisms that causes polycystic ovarian syndrome (PCOS) is a disordered release of a hormone called Luteinizing Hormone (LH) from the pituitary gland. Oftentimes, women with PCOS have LH levels that are double or triple where they should be which results in a lack of ovulation and high levels of both androgens and estrogens. Cyclic Progesterone Therapy has the ability to regulate the LH production and release which can promote ovulation, a reduction in the high androgen symptoms (abnormal hair growth, acne, female pattern hair loss), and regulation of the menstrual cycle.

Side Effects and Risks

The best part of this therapy is that there are no serious side effects to taking bioidentical progesterone. In fact, there are numerous benefits including reduced risk of endometrial cancer and promotion of sleep (drowsiness can occur so it’s often dosed at bedtime).

In contrast to treatment with supplemental estrogen, progesterone does NOT increase the risk of blood clots, migraines or breast cancer. Progestin, a synthetic progestogen, does carry an increased risk of breast cancer when taken alongside estrogen. However, progestin acts very differently in the body than progesterone and is not the same as progesterone.

Occasionally with the first cycle of progesterone therapy, some women will experience some breast tenderness, moodiness, or water retention. This is due to a sensitizing effect of the progesterone on estrogen receptors and these symptoms will improve after the first cycle.

Dr. Nicole Hartman

About Dr. Nicole Hartman

Dr. Nicole Hartman is a naturopathic physician, a world traveler, a hiker, and a blogger. She focuses her practice in fertility and women's health and takes an integrative, evidence-based approach to healthcare.