Postpartum depression in susceptible women is linked to abrupt postpartum progesterone withdrawal following the high-progesterone state of pregnancy, particularly in those with prior PMS, luteal phase defects, or recurrent miscarriage, and NaProTECHNOLOGY evaluates this through serum progesterone, thyroid function, and prolactin assessment in the postpartum period. Treatment uses bioidentical progesterone -- preferably intramuscular for reliable absorption -- with serum levels monitored every two weeks for dose titration, and once cycles resume, dosing is resynchronized to the CrMS Peak day; Hilgers reports no increase in congenital anomalies in over 2,000 progesterone-supported pregnancies in the Pope Paul VI Institute series.
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Hilgers et al. 2004, Hilgers 2004
Cite this article
Hilgers, T. W. (2004). Chapter 30: Postpartum Depression: Evaluation and Treatment. The Medical and Surgical Practice of NaProTECHNOLOGY, 369-380.
Hilgers TW. Chapter 30: Postpartum Depression: Evaluation and Treatment. The Medical and Surgical Practice of NaProTECHNOLOGY. 2004:369-380.
Hilgers, T. W. "Chapter 30: Postpartum Depression: Evaluation and Treatment." The Medical and Surgical Practice of NaProTECHNOLOGY, 2004, pp. 369-380.
Hilgers TW, 2004·The Medical and Surgical Practice of NaProTECHNOLOGY
Hilgers distinguishes isomolecular hormones -- molecules structurally identical to endogenous estradiol and progesterone -- from heteromolecular artimones, his term for synthetic analogues such as medroxyprogesterone acetate, norethindrone, and ethinyl estradiol, which differ in receptor binding, metabolic pathways, and systemic effects. NaProTECHNOLOGY restricts hormone therapy to isomolecular compounds administered in cycle-synchronized, physiologic doses because artimones suppress the hypothalamic-pituitary-ovarian axis, mask underlying pathology, and produce non-physiologic metabolite profiles incompatible with a restorative reproductive medicine approach.
reproductive-endocrinology/ovarian-hormones/progesteronepcos/treatment/progesterone-supporttherapeutics/hormonal-agents/progesterone-and-progestins
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Chiarella SE et al., 2023·The journal of allergy and clinical immunology. In practice
Progestogen hypersensitivity (PH) is a heterogeneous disease characterized by diverse cutaneous manifestations, bronchospasm, and/or anaphylaxis. Possible triggers include ovarian progesterone and exogenous progestogens. The timing of symptoms is critical to diagnose PH: during the luteal phase of the menstrual cycle for the endogenous form and after exposure to progestins for exogenous PH. Diagnostic modalities such as progesterone skin testing have low sensitivity and specificity for PH. When exogenous PH is suspected, the allergist should consider a progestogen challenge. Treatment strategies should be tailored for each patient, including symptom-directed therapies, ovulation suppression, and progesterone desensitization. Future studies should explore the mechanisms of PH, validation of diagnostic criteria, and standardization of treatment strategies.
perimenopause-menopause/hormone-therapy/benefits-and-riskstherapeutics/hormonal-agents/progesterone-and-progestinsreproductive-endocrinology/ovarian-hormones/progesterone
Open Access
This study tested progesterone for perimenopausal hot flush ± night sweat (vasomotor symptom, VMS) treatment. It was a double-blind, randomized trial of 300 mg oral micronized progesterone@bedtime versus placebo for 3-months (m) after a 1-m untreated baseline during 2012/1-2017/4. We randomized untreated, non-depressed, screenand baseline-eligible by VMS, perimenopausal women (with flow within 1-year), ages 35-58 (n = 189). Participants aged 50 (± SD = 4.6) were mostly White, educated, minimally overweight with 63% in late perimenopause; 93% participated remotely. The 1° outcome was 3rd-m VMS Score difference. Participants recorded VMS number and intensity (0-4 scale)/24 h on a VMS Calendar. Randomization required VMS (intensity 2-4/4) of sufficient frequency and/or ≥ 2/week night sweat awakenings. Baseline total VMS Score (SD) was 12.2 (11.3) without assignment difference. Third-m VMS Score did not differ by therapy (Rate Difference - 1.51). However, the 95% CI [- 3.97, 0.95] P = 0.222, did not exclude 3, a minimal clinically important difference. Women perceived progesterone caused decreased night sweats (P = 0.023) and improved sleep quality (P = 0.005); it decreased perimenopause-related life interference (P = 0.017) without increased depression. No serious adverse events occurred. Perimenopausal night sweats ± hot flushes are variable; this RCT was underpowered but could not exclude a minimal clinically important VMS benefit. Perceived night sweats and sleep quality significantly improved.