"Progesterone" is given to women who are taking estrogen replacement for several reasons.

One reason is partial protection against uterine (endometrial cancer). Another is its beneficial effect on bones and its effect on sleep. Some women feel much better when on it, but at least as many feel much worse. The effect depends on how each woman’s body metabolizes it (an individual variation).

Only one form of progesterone has been proven dangerous. It is called Provera and is still on the market, a huge black mark against the FDA and pharmaceutical industry.

A new intrauterine device (IUD) called Mirena is now available. It is effective for 5-10 years, but even more exciting than contraception is its potential as part of hormone replacement therapy for perimenopausal women.

Progesterone is given to women who are taking estrogen replacement for two reasons – protection against uterine (endometrial) cancer and prevention of abnormal uterine bleeding. Women who have had hysterectomies do not need to take progesterone unless the surgery was done for endometriosis. The major complaint of women who are on estrogen replacement therapy and progesterone is continued periods.

A dosage of oral or "transcutaneous progesterone" sufficient to suppress periods gives a blood level of progesterone high enough to produce side effects in many women (weight gain, fatigue, mood swings, depression). A progesterone producing IUD (Mirena) stops periods completely by one year in between 80-90% of women by delivering the progesterone directly where it is needed in the uterus, with the production of very low blood levels producing little or no systemic side effects. It has been used in Europe for ten years with excellent results and should decrease markedly the surgery being done in this country (hysterectomies, endometrial ablations, D & C's) for abnormal bleeding in the perimenopausal (35-60) age range. Early investigations indicate the Mirena IUD will also likely benefit patients with endometriosis, adenomyosis, and fibroids.