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Progesteron a pryszcze - Prawda czy mit?
Progesterone and progestin: How do they work?
Progesterone is the main pro-gestational steroid hormone secreted by the female reproductive system. It is linked to the menstrual cycle, pregnancy, and development of an embryo. Progestin is an artificial form of progesterone that is used for medical purposes.
The ovaries, placenta, and adrenal glands produce progesterone to regulate the condition of the endometrium, which is the inner lining of the uterus.
Progesterone is a steroid and a hormone. It has some important roles, particularly in the process of reproduction.
The corpus luteum is a temporary endocrine, or hormone-producing, gland that forms from the empty ovarian follicle after ovulation.
If fertilization does not occur, the corpus luteum breaks down, less progesterone is produced, and the levels of progesterone are too low to promote the growth of the uterine wall. As the lining of the womb is no longer maintained by progesterone from the corpus luteum, the lining breaks away, resulting in menstrual bleeding.
If conception occurs, progesterone stimulates the further development of blood vessels in the endometrium, and it stimulates glands in the endometrium to secrete nutrients that nourish the fertilized egg.
Progesterone prepares the tissue lining of the uterus to so that the fertilized egg can be implanted. Progesterone also helps to preserve the endometrium throughout pregnancy.
After conception, the placenta forms. The placenta begins to secrete progesterone to supplement, and surpass, the progesterone already secreted by the corpus luteum.
Levels of progesterone from the placenta remain high during pregnancy. This prevents other eggs from maturing, and it promotes changes in breast tissue to prepare for lactation.
Progesterone levels drop consistently just before the menopause. This is thought to be the major cause of symptoms experienced around the menopause.
Causes of High Progesterone
High progesterone is a sign that something is elevating your levels.
Hormone Replacement
Your healthcare provider may recommend a combination of estrogen and progesterone hormone therapy if you are experiencing the symptoms of perimenopause, such as hot flashes and night sweats. Hormone replacement therapy increases your progesterone levels.
Hormone Contraceptives
Some types of hormonal birth control can cause an increase in progesterone over time. Studies have found that the second-generation progestins levonorgestrel and norgestrel are more likely to have this effect.
First-generation progestins such as norethindrone and third-generation progestins such as norgestodene are less likely to increase progesterone levels.
Pregnancy
During pregnancy, your body will produce around 10 times as much progesterone as it does when you are not pregnant.
Ovarian Cysts
High progesterone may also be a sign that you have an ovarian cyst. Some ovarian cysts can produce progesterone and estrogen, which can lead to an increase in these hormones.
Congenital Adrenal Hyperplasia
CAH throws off the balance of hormone production (under- or overproduction) and can cause greater male trait expression.
Girls with severe CAH can be born with ambiguous genitalia. For example, the clitoris may be larger than usual and looks like a small penis while the labia fuses look like a scrotum.
People with milder forms of the condition may have early signs of puberty or fertility problems.
How Common Is Congenital Adrenal Hyperplasia?
Molar Pregnancy
Another condition associated with high progesterone is a molar pregnancy. This happens when the embryo doesn't form correctly and the placenta grows into a noncancerous tumor.
Low Progesterone
By your 30s, you’re more likely to worry about having low progesterone than having high progesterone. That’s because your levels naturally decline over time, which can cause high estrogen levels.
Progesterone Supplements
Supplemental progesterone that's made from natural or synthetic sources can be prescribed for a variety of reasons ranging from pregnancy support to contraception.
Methods for supplementing progesterone include:
- Tablets that are taken by mouth
- Shots into a muscle, known as intramuscular injections
- Vaginal gels or suppositories (medication inserted into the vagina)
Progesterone is rapidly cleared from the body when given by mouth, which makes it difficult to use progesterone this way, especially if it is needed only in smaller doses.
Micronized progesterone, which is decreased in particle size for longer effect, can be taken in some instances. It may be prescribed as part of a menopausal hormone replacement regime or to restore periods if you stopped getting periods before menopause.
Progestins, medications that have similar properties to progesterone, provide an option that can be effective when taken by mouth.
For Pregnancy After IVF
For some women, it may be necessary to take supplemental progesterone during pregnancy.
If you conceived with the help of in vitro fertilization (IVF), you might not ovulate naturally and your corpus luteum may not produce enough progesterone.
Your healthcare provider may recommend some type of progesterone support either in the form of a vaginal gel or suppository, tablet, or injections until about 10 to 12 weeks of pregnancy.
Supplemental progesterone may also be used during IVF or intrauterine insemination (IUI) to help promote pregnancy.
For Preterm Labor Prevention
If you have a history of preterm delivery and/or preterm premature rupture of membranes in a previous pregnancy, you may be a candidate to use progesterone injections to try to prevent another preterm birth.
These are weekly injections of a specific type of progesterone that usually begin at 16 to 24 weeks and continue through 36 weeks of pregnancy.
High Progesterone Symptoms and Side Effects
High progesterone symptoms include breast swelling and tenderness, bloating, and other symptoms like anxiety, agitation, or depression. Your progesterone levels naturally rise during pregnancy and after ovulation, the release of an egg from the ovaries.
Conditions like ovarian cysts or a disorder of the adrenal glands can cause you to have too much progesterone. It can also be a sign of a molar pregnancy, where abnormal cells grow in the placenta.
This article discusses the symptoms of high progesterone and when to see a healthcare provider.
Kontroverze oko hormonske terapije
Početkom 2000-ih, ljudi su počeli da brinu o rizicima hormonske terapije. U to vreme, studija „Inicijative za zdravlje žena“ (WHI) pokazala je da postoji veza između kombinovane terapije estrogenom i progestinom i povećanog rizika od raka dojke i kardiovaskularnih bolesti.
Studija je takođe pokazala da je hormonska terapija više štetna za žene u postmenopauzi nego što je bila korisna, navodeći da je estrogen sam po sebi povezan sa povećanim rizikom od moždanog udara, kao i da nije od pomoći za bolest koronarne arterije.
WHI je objavio rezultate studije u „JAMA-i“, najavljujući da su, uprkos praćenju učesnika u proseku pet godina, istraživači studije prekinuli davanje estrogena plus progestina u studiji pre prvobitnog datuma prekida. Razlog za iznenadni kraj je to što se smatralo neetičkim nastaviti studiju, jer je otkriveno da je povećan rizik od raka dojke kod žena koje su uzimale lekove.
Zatim dve godine nakon ove objave, „WHI“ je takođe ranije prekinuo studiju samo o estrogenu, navodeći da je otkriven povećan rizik od pojave krvnih ugrušaka kod žena koje su uzimale lek. Međutim, ove žene se nisu suočile sa značajnim povećanjem rizika od raka dojke.
Uz to, aktuelnije analize ne pokazuju da su ovi rizici očigledni kod hormonske terapije. Uzmite u obzir naknadnu studiju objavljenu u septembru 2017. u „JAMA-i“, koja je objavila da ni estrogen plus progestin koji se uzimaju u proseku od 5,6 godina niti sam estrogen uzet u proseku od 7,2 godine nisu povezani sa povećanim rizikom od: smrti iz bilo kog uzroka, kardiovaskularnih problema ili raka tokom kumulativnog praćenja od 18 godina.
Iako postoje različita mišljenja o hormonskoj terapiji, vaš lekar vam može pomoći da utvrdi da li je to odgovarajući tretman za vas. Uvek je najbolje rešenje da se obratite stručnjaku u koga imate poverenje.
