Progesterone effects/symptoms in men

[Flyingfool]

Just wondering what symptoms are associated with too high, and too low of progesterone in men.

Also what is the typical “normal” ranges for mens blood test, and what are rhe more realistic ranges for a man to feel well.

Finally how hard is it to convince a standard primary care Dr to test a man for progesterone???  Is a sensitive test required due to the very low amount of progesterone a man has?

Just trying to expand my knowledge and it seems like progesterone in men is little understood or studied in men.

[Cataceous]

Men produce "approximately 5-15 mg of progesterone in their testicles each day"[1]. Another 1 mg or so is produced by the adrenals. Because testicular production is tied to testosterone production, if you're shut down by TRT or aging then progesterone production also suffers[2]. In older men, using hCG may not restore progesterone production[3].

The current NIH reference range for serum progesterone in adult males is 0.2 - 1.4 ng/mL[4]. Lab Corp's standard test has a range of 0.0 - 0.5 ng/mL. It's not clear what level is going to be optimal for any individual. But it's likely that if your value is low or high relative to the reference range then it's not optimal.

There is a sensitive LC/MS-based test for progesterone, but it may not be needed in routine testing, and it's slower and more expensive. There's also a test for free progesterone, which could have the same drawbacks. It's not clear to me how analogous the situation is to that with estradiol. The standard progesterone test does have interference problems with some B vitamins and other things[5].

Most doctors may not consider it worthwhile to test progesterone in men. Fortunately it's an inexpensive test if you want to run it yourself. For example, it's currently $23 through Defy Medical.

Regarding high progesterone, the LiveStrong reference says that it can cause an increase in estradiol production, with associated problems. In addition, high progesterone may lead to sleepiness, depression and digestive problems[6].

Low progesterone may harm libido and erections. It's potentially linked to prostate and bone density issues, and depression[7]. Be sure to look at the list of effects of progesterone in this reference.

I do believe that progesterone needs more attention. Low levels may be responsible for some of the problems seen in men on TRT who otherwise have good numbers. I've been experimenting with supplementation with good results.

[Flyingfool]

Thanks Cat!

It is interesting that the top of the lab corp range is nearly the bottom of the NIH range!  Also interesting that the labcorp range bottom is Zero!  Which would indicate that no progesterone is “normal”. That doesn’t seem logical at all to me.

If the body naturally produces progesterone, how can zero be normal?

That would seem to me to mean that the mass population being tested has sufficient numbers of men showing zero level. But that doesn’t mean they feel well or are not suffering as a result!

At least the NIH range establishes a bottom level that is something other than zero!

I agree that more study is needed. Perhaps low progesterone may be a contributing factor into missing libido in men when free T and E2 are optimized?  Perhaps DHT and or progesterone is the missing link?

Also interesting that HCG can raise T levels but not progesterone.

How are you experimenting with progesterone?  Are you using a cream?  Will progesterone cream also raise DHT?  Can T cream also raise progesterone in addition to DHT?

[Cataceous]

I think "0.0" on that range just means undetectable by that particular test. Probably LC/MS would be different. The resolution is also quite coarse, in that only one significant figure is given. If it were measured in ng/dL, like testosterone, then the numbers would be 100 times bigger, and you'd have a range of 0 - 50.

I agree that DHT and progesterone are going to be the "missing link" in some cases. That's why I'm encouraging guys with continuing problems to test it and experiment.

I initially tried scrotal application of progesterone in oil, available in a couple brands from Amazon. I was applying about 6-8 mg per day. "This took my serum level up to mid-range (LabCorp). I've since switched to injections for more consistency, and am still titrating the dose; 3 mg took me to 2.4 times top-of-range and made me groggy, so I'm trying 1 mg/d."

If anything, progesterone might reduce DHT. I already had low DHT, but raising DHT in the past hasn't helped, while using progesterone has. As far as I know, testosterone cream will not raise progesterone.

[Flyingfool]

Cat,

How has progesterone “helped”?

What symptoms have improved for you?

[Cataceous]

Using it has correlated with improvements in libido, sleep and erection quality. I won't go so far as to claim causality for sure; my situation is complicated by the—hopefully—temporary need to use exogenous estradiol to raise otherwise undetectable serum levels, a bizarre situation indeed. However, the first night I tried progesterone the effects seemed dramatic compared to baseline. This and various articles have convinced me that it's another parameter to adjust to achieve the best results from TRT.

[Kierkegaard]

Using it has correlated with improvements in libido, sleep and erection quality. I won't go so far as to claim causality for sure; my situation is complicated by the—hopefully—temporary need to use exogenous estradiol to raise otherwise undetectable serum levels, a bizarre situation indeed. However, the first night I tried progesterone the effects seemed dramatic compared to baseline. This and various articles have convinced me that it's another parameter to adjust to achieve the best results from TRT.

C, what were your experiences when you tried oral progesterone, and how long of a half life do you know or suspect it had? 

Because of issues with progesterone anecdotally getting "trapped" in fat tissue for a while, I'm looking into oral supplementation, and can only find 4 mg drops so far, such as this brand: https://www.amazon.com/BioMatrix-Pro-Adapt-Drop-500-Drops/dp/B07C4MQ7JP/ref=sr_1_5?keywords=progeterone&qid=1568088526&s=gateway&sr=8-5

I'm interested in progesterone balancing estrogen as well as allopregnenolone, which is calming, for sleep.  I'd also like to consider "backfilling" cortisol before trying hydrocortisone given my slightly negative response to T3/NDT.

[Cataceous]

Using it has correlated with improvements in libido, sleep and erection quality. I won't go so far as to claim causality for sure; my situation is complicated by the—hopefully—temporary need to use exogenous estradiol to raise otherwise undetectable serum levels, a bizarre situation indeed. However, the first night I tried progesterone the effects seemed dramatic compared to baseline. This and various articles have convinced me that it's another parameter to adjust to achieve the best results from TRT.

C, what were your experiences when you tried oral progesterone, and how long of a half life do you know or suspect it had? 

Because of issues with progesterone anecdotally getting "trapped" in fat tissue for a while, I'm looking into oral supplementation, and can only find 4 mg drops so far, such as this brand: https://www.amazon.com/BioMatrix-Pro-Adapt-Drop-500-Drops/dp/B07C4MQ7JP/ref=sr_1_5?keywords=progeterone&qid=1568088526&s=gateway&sr=8-5

I'm interested in progesterone balancing estrogen as well as allopregnenolone, which is calming, for sleep.  I'd also like to consider "backfilling" cortisol before trying hydrocortisone given my slightly negative response to T3/NDT.

I never tried the oral route, and I'm a little suspicious of it because of the different way it's metabolized. I started with progesterone in oil applied to the scrotum. There are a couple brands on Amazon, e.g. Progestelle. Then, for greater consistency I switched to an injectable formulation. In either case I apply before going to bed. After a few months of use I believe the persistent benefits are improved mood and sleep. Regarding half lives, I only assume it's on the order of a day, based on what I've read.

Here are my serum progesterone responses, all with LabCorp and the 0.0-0.5 ng/mL reference range:
Baseline: 0.1
7 mg scrotal: 0.3
3 mg subQ: 1.2
1 mg subQ: 0.5

[Flyingfool]

What have you noticed with regard to how you feel and libido? Where there other improvements/benefits of increasing progesterone?  If so, what were they?  Are you able to tellif this was from progesterone only, or also due to getting Estradiol in line?

It appeared your blood levels was 60% of the range with scrotal topical. Have you noticed improvement with higher dose and blood levels at the top of the range cersus middle of range?  It is such a small range that a little seems to go a long way.

Are the ranges of progesterone for men. Or is progesterone a “unisex range?”  I hope it is for men only as women’s progesterone is so variable especially pre-menopause during a woman's cycle.

[Cataceous]

When I first started with progesterone there was a perceptible increase in libido and nocturnal erections, but these returned to baseline over time. As noted, the improvements in mood and sleep have persisted. With mood, I'd made improvements over the years, but there were still lingering irritability and some really blah days. These seem to have gone away, correlating with the progesterone treatment. With respect to sleep, I now average almost an extra hour of uninterrupted sleep, which is really nice. These changes have appeared to be independent of estradiol, which has been all over the place during this period.

Regarding doses, I mainly noticed morning grogginess when I was at higher levels. Not much difference otherwise.

I'd like to know how the LabCorp serum reference range for progesterone (0.0-0.5 ng/mL) ties into the higher NIH range (both for men) of 0.2-1.2 ng/mL. As you suggest, women have different ranges depending on where in the cycle they are.

A guy over at ExcelMale is reporting that progesterone seems to have solved his problems with fluid retention on TRT.

[Kierkegaard]

Thanks C, really useful info.

What do you mean wrt metabolism issues with oral progesterone?

I also have questions about the range, seeing how Labcorp 's range is .2-1.4 ng/mL for males.

[Rumtoto]

Progesterone seems potentially risky for men:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332976/

Men absorb low but significant levels of progesterone after intercourse with a female partner using vaginal progesterone. Male exposure to progesterone during the typical 8–12 weeks used during early pregnancy could cause adverse effects such as decreased libido. When progesterone (medroxyprogesterone) was used for treatment of male sex offenders starting in the 1960s, men were noted to have reduced sexual thoughts and fantasies, frequency and pleasure of masturbation, and frequency of early morning erections on awakening [6]. Although vaginal progesterone gel is not similar to medroxyprogesterone, the effects of vaginal progesterone gel have not been directly studied in men and therefore are not known.

But its role is not well understood: https://www.ncbi.nlm.nih.gov/pubmed/15669543

Surprisingly, we know little about the physiology, endocrinology, and pharmacology of progesterone and progestins in male gender or men respectively, despite the fact that, as to progesterone secretion and serum progesterone levels, there are no great quantitative differences between men and women (at least outside the luteal phase). In a prospective cohort study of 1026 men with and without cardiovascular disease, we were not able to demonstrate any age-dependent change in serum progesterone concentrations. Progesterone influences spermiogenesis, sperm capacitation/acrosome reaction and testosterone biosynthesis in the Leydig cells. Other progesterone effects in men include those on the central nervous system (CNS) (mainly mediated by 5alpha-reduced progesterone metabolites as so-called neurosteroids), including blocking of gonadotropin secretion, sleep improvement, and effects on tumors in the CNS (meningioma, fibroma), as well as effects on the immune system, cardiovascular system, kidney function, adipose tissue, behavior, and respiratory system. A progestin may stimulate weight gain and appetite in men as well as in women. The detection of progesterone receptor isoforms would have a highly diagnostic value in prostate pathology (benign prostatic hypertrophy and prostate cancer). The modulation of progesterone effects on typical male targets is connected with a great pharmacodynamic variability. The reason for this is that, in men, some important effects of progesterone are mediated non-genomically through different molecular biological modes of action. Therefore, the precise therapeutic manipulation of progesterone actions in the male requires completely new endocrine-pharmacological approaches.

[Cataceous]

Progesterone seems potentially risky for men:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332976/
...

This study says only that men can absorb some progesterone from parters using vaginal gel. The background statement notes that supra-physioolgical amounts are problematic, which is true of virtually anything. View the situation as comparable to the one with testosterone: low levels also carry risks, and we're looking to regain normal levels after experiencing reductions caused by aging and/or TRT.

[Cataceous]

...
What do you mean wrt metabolism issues with oral progesterone?
...

I mean you may get excessive byproducts. The Wiki entry notes:

When progesterone is taken orally, due to first-pass metabolism, very high levels of its metabolites occur. ... Conversely, the same issues are not applicable to parenteral routes of progesterone such as vaginal administration and intramuscular injection, because these routes are not subject to a first pass and relatively low levels of progesterone metabolites are formed.

[Kierkegaard]

That would only apply if you swallow, eh? Not with sublingual use?