QUESTION: Is there such thing as progesterone receptor resistance? What might cause the resistance? Patient’s progesterone wnl, but PMDD symptoms nearly went away with progesterone supplementation.
ANSWER: Great question. As there can be many causes I’ll summarize as best possible.
- First is that the serum Progesterone (although usually representative of CNS levels) may be higher than that in the CNS. This happens. [Question of “then how do you test and treat?? – Answer is you do a therapeutic trial (of the Neurosteroid Rx) and see, just as you did.]
- Second is I find toxicity very common in “normal lab, low activity hormone cases? I’d screen diet and environment for chemical exposures and do heavy metal assessment. In a sample of people with the progesterone receptor resistance I checked over 80% had actionable toxic metal levels.
- Next is related to the first: Peripheral demand for high order steroids (Pregnenolone and Progesterone) causing “normal serum levels” and low CNS levels. Most common are chronic inflammatory conditions (Infection, Autoimmune, Nervous system disorders…), Reproductive organ dysregulation and Adrenal stress – dysfunction.
- And finally, all the above.
Best to treat with what works (Progesterone) and look at other cause areas and treat them. 60-70% can eventually taper off or down on the Rx Progesterone if underlying causes are found and treated. This can take 1 to 3 years however. But in the mean time the Rx is very safe.