Do I Need Progesterone for Hormonal Balance and Health Concerns?

Do I need to take progesterone?

Hello Doctor, since last year I have been experiencing symptoms of frequent urination and have started using Premarin cream in the gynecology department.
However, I am a bit concerned about the risks associated with using estrogen alone.
Should I consider using progesterone to achieve balance? Additionally, based on some health checks I had this year, I found that my saliva hormone E3 level is 47.4 pg/ml, which is elevated, while my progesterone level is 39 pg/ml, which is low.
There is also an indication of elevated phthalates in my serum.
I am worried whether it is appropriate to continue using Premarin under these conditions.
Should I seek further evaluation or treatment? Thank you.

Guo Xiaojie, 60~69 year old female. Ask Date: 2023/03/23

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if used long-term, it is recommended to use progesterone.
Wishing you good health.

Reply Date: 2023/03/23

More Info

When considering the use of progesterone for hormonal balance and addressing health concerns, it's essential to understand the role of hormones in the body, particularly estrogen and progesterone. Progesterone is a crucial hormone that helps regulate the menstrual cycle, supports pregnancy, and balances the effects of estrogen. An imbalance between these hormones can lead to various health issues, including menstrual irregularities, mood swings, and increased risk of certain health conditions.

In your case, you mentioned using a topical estrogen product (普力馬林) due to symptoms of frequent urination. While estrogen can be beneficial for alleviating menopausal symptoms and improving vaginal health, relying solely on estrogen without progesterone can pose risks, especially if you have a uterus. This is because unopposed estrogen can lead to endometrial hyperplasia (thickening of the uterine lining) and increase the risk of endometrial cancer.

Your recent health check indicated elevated levels of estriol (E3) and low levels of progesterone. Elevated estriol can be a concern, particularly if it is significantly higher than normal, as it may indicate an imbalance in your hormonal levels. Low progesterone levels can lead to symptoms such as irregular periods, mood changes, and difficulty in achieving hormonal balance.
Given these findings, it may be prudent to consider the following steps:
1. Consult with Your Healthcare Provider: Discuss your hormonal levels and symptoms with your healthcare provider. They can provide a comprehensive evaluation of your hormonal health and determine whether you need progesterone supplementation.
2. Consider Hormonal Therapy: If your healthcare provider deems it necessary, they may recommend a combination of estrogen and progesterone therapy. This approach can help balance your hormones and mitigate the risks associated with unopposed estrogen.

3. Further Testing: Since you mentioned concerns about plasticizers in your serum, it may be beneficial to investigate this further. Hormonal imbalances can sometimes be influenced by environmental factors, including exposure to endocrine disruptors. Your healthcare provider may suggest additional tests to assess your overall hormonal health and the potential impact of these substances.

4. Lifestyle Modifications: In addition to medical interventions, consider lifestyle changes that can support hormonal balance. This includes a balanced diet rich in whole foods, regular physical activity, stress management techniques, and adequate sleep. These factors can significantly influence hormone levels and overall health.

5. Monitoring: If you start progesterone therapy or any other hormonal treatment, regular monitoring of your hormone levels and symptoms will be essential. This will help ensure that the treatment is effective and that any adjustments can be made as needed.

In summary, while estrogen can provide relief for certain symptoms, the potential risks of using it without progesterone should not be overlooked. Given your hormonal levels and health concerns, it would be wise to have a detailed discussion with your healthcare provider about the necessity of progesterone and any further evaluations or treatments that may be appropriate for you. Your health and well-being are paramount, and a tailored approach to your hormonal health will be the most beneficial.

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