Can progesterone help relieve menopause symptoms?

Can progesterone help relieve menopause symptoms? Why can’t you lose weight on a ketogenic diet? And can keto help with neurodegenerative conditions?

Get the answer to these questions in this week’s Q&A with fertility specialist Dr. Fox:

Can progesterone help relieve menopause symptoms?

I am 60 years old, and I had a partial hysterectomy at age 29. I suffered from migraines from age 18 to 50, and they stopped when I began topical progesterone. Later, I took topical estrogen cream, but it didn’t help the hot flashes at all. You don’t recommend progesterone, but what if the saliva tests show I am low in it?

Thank you,
Bobbie

 
Dr. Fox:

Good questions, Bobbie.

Progesterone is not needed except to prepare the uterus for pregnancy. It’s absent in menopause and the first two weeks of every cycle during the reproductive years. If it were necessary, women would be in trouble.

If I measure progesterone in any menopausal patient, it will be extremely low. That is normal and does not require replacement. Progesterone does cover up symptoms such as headaches, hot flashes, night sweats, etc., so women “feel better” when they are on it and thus think that they are healthier. Without needed estrogen, the hormone that genuinely treats the problem, deterioration can continue despite the progesterone “cover-up.”

Saliva testing for progesterone and estrogen is very inconsistent and vastly less accurate than blood testing.

Estrogen topical cream is inconsistent in delivering adequate and consistent serum levels of estradiol. Many creams are mostly estriol and estrone, 1000X and 100X LESS effective than estradiol in controlling symptoms. You need estrogen delivered consistently with blood monitoring of the estradiol levels (make sure it’s estradiol). The appropriate range is 60-200 or so depending on age.

Thanks.  

Can’t lose weight in ketosis

Please help me.

Wildangel72

 
Dr. Fox:

Don’t be discouraged! Focus on staying the course and consider that you may feel better with a TSH <1.5. If you are working nights or have a rotating schedule, this can be extremely stressful and raise cortisol, the stress hormone. I would ask for an am cortisol test. Healthy values are <10. Another sleep disturbance, such as sleep apnea, is also a huge issue. I would recommend not cutting calories. In women, this sometimes produces stress and foils the efforts. My general recommendations based on my clinical experience are the following: Start a trial of no aerobic exercise (resistance training is OK), no coffee, sleep for seven to eight hours per night, 200+ calorie meals every three hours (this can help if high cortisol is an issue), check and replace vitamin D levels, and replace iodine and magnesium through supplements. You may not need this pattern for life, but it may be worth an experiment to see how you respond. Sometimes life is a series of experiments. You can also see the diet doctor guide on weight loss stalls to see if that information helps.

Will the keto diet help with neurodegenerative conditions?

I have been told that the keto diet will help prevent neurodegenerative conditions from worsening. However, most of what’s on this site is information about weight loss. I’m wondering will this website help me in the neurodegenerative condition area, and if so, is it the same approach to the recipes?

Niamh

 
Dr. Fox:

Yes, the brain is very sensitive and responsive to ketosis. In certain situations, the recovery may be slow.

Diet Doctor has a few posts on Alzheimer’s disease, discussions of case reports, and a discussion on Parkinson’s disease. Hopefully some of those resources will help.
 

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