Can men benefit from progesterone



by Dr. David Smallbone M.B., Ch. B., L.R.C.P., M.R.C.S., M.F.Hom., F.C.O.H.


It is important to understand that progesterone is not solely a female hormone. Although in women it is responsible for protecting the unborn child from rejection during pregnancy, progesterone performs many other functions in both men and women. Men’s bodies produce progesterone in the adrenal glands and in the testes, although the amount produced is less than that made by women of menstruating age when they ovulate.

Secondly, it is important for men to know that progesterone has no feminising effects on the male body. In fact, progesterone normally increases libido in men (and in women). However, high doses may inhibit sperm production, and progesterone may, therefore, have a relative contraceptive effect.

Prostate Problems

Benign prostate hypertrophy (BPH), the enlargement of the prostate gland, is a common problem in men over 50. It appears to be due to the failure of cells to die off when their useful life is over. Although benign in itself (apart from the inconvenience), prostate enlargement can develop into cancer of the prostate over time.

The male hormone, testosterone, is not itself in a particularly active form. For full action, testosterone needs to be converted into di-hydrotestosterone (DHT), which is some hundred-fold more active. However, any excess DHT needs to be neutralised or damage may follow, including cancer cell production. Progesterone appears to play two distinctly positive rolls in preventing prostate disease. The first is that progesterone inhibits an enzyme called 5-alpha reductase, which governs the conversion of testosterone to DHT, and thus prevents excess DHT from being produced.

Secondly, progesterone plays a role in reducing the risk of cancer in both men and women. All cells have a definite lifespan and upon reaching that degree of maturity, they commit suicide. This event is known as apoptosis (the second “p” is silent). If cells persist beyond their “sell-by” date, they are more prone to become cancerous and when they divide the new cells they produce are more likely to be abnormal and potentially cancerous. Both oestrogen and testosterone are cell growth promoters. This is their role. We now know that oestrogen (when unopposed by progesterone) influences the genetic coding in oestrogen-responsive cells and turns apoptosis off - thus the cells live too long, produce too many ‘daughter’ cells and potentially too many mutant cells. It is probable that testosterone has a similar effect on cells.

It has also been shown that progesterone influences the genetic coding in cells in the opposite way, switching apoptosis back on again. When oestrogen and progesterone (and probably testosterone and progesterone) are in balance, cells should die on time and before they produce abnormal progeny.

Although progesterone almost certainly protects men from excessively active testosterone (i.e. DHT), it will also protect men from the toxic xeno-estrogens, now plentiful in the environment and chemicals commonly used in households. In fact, Dr John Lee believed that today’s near epidemic levels of BPH and prostate cancer are due to excessive exposure to these oestrogens. Sources of xeno-estrogens can include commercially raised beef, chicken and pork, spermicide, detergents, soft plastics, pesticides, herbicides, personal care products and even tap water.

Male pattern baldness

The onset of the male pattern of baldness is often governed by hereditary factors. In these cases, there does not appear to be any response to natural progesterone. However, in cases where there appears to be no hereditary tendency, the baldness may be due to over-conversion of testosterone into DHT. In these cases, progesterone seems to help diminish the rate of loss and, sometimes, may help reverse the process.

Osteoporosis in men

Osteoporosis is a disease of both genders. The process is very gradual and shows few symptoms in the early years of its progress. Often the first sign is a loss of height, very commonly quite dramatically and of a significant degree – up to 3 or 4 inches. The best policy is to pre-empt this occurrence by preventing the onset of osteoporosis.

In women, oestrogens suppress a group of bone cells called osteoclasts, preventing them from re-absorbing bone. A certain amount of re-absorption is necessary, however, because ‘old’ bone becomes brittle and needs replacing, or it is likely to shatter with even a minor impact. Where re-absorption has taken place another group of cells, called osteoblasts, are stimulated to form new bone where the old has been removed. We now also know that osteoblasts have progesterone receptors in their cell walls and that these bone-formers also seem to be stimulated by progesterone. This is why progesterone is thought to be helpful in preventing osteoporosis.

In men, as in women, oestrogen (which men’s bodies also produce) suppresses the osteoclasts, and therefore ultimately also the bone-forming osteoblasts. But testosterone also plays a role in promoting of bone formation, and the laying down of denser bone. It now appears that there are progesterone receptors in men’s osteoblasts too. Thus, in men, when testosterone levels fall later in life, it is possible that bone density can be maintained by the use of progesterone.

As in women, the use of natural progesterone should be started well in advance of potential osteoporosis, for example in late 50s or earlier to prevent onset developing in late 60s and early 70s.

How much progesterone for men?

Men’s bodies produce less progesterone than menstruating women and the dose should therefore be lower. Dr John Lee, who prescribed progesterone for men with BPH and prostate cancer with reported success, recommended that men use 8-12mg of natural progesterone daily.