Physician Hormone Therapy Training:
The Neuroprotective Effects of Progesterone on TBIs

When physicians think of prescribing hormone therapy to their patients, no doubt treating perimenopausal and menopausal women first comes to mind. Men with low libido and erectile problems are also common recipients of hormone replacement therapy.

But the active hormone therapy provider will also run into a number of cases in which hormone replacement may be beneficial for conditions unrelated to menopause or sexual health.

Traumatic brain injury is, indeed, one of these applications. Surprising to many, traumatic brain injury is actually the leading cause of morbidity and mortality in young adults. And while progesterone has long been considered exclusively a female reproductive hormone, numerous studies now show that it has wide ranging neuroprotective properties in humans.

SottoPelle is a world leader in provider hormone therapy training. We have trained thousands of doctors in the use of subdermal bioidentical hormone replacement pellets.

An essential component of provider hormone therapy training is remaining on the cutting edge of clinical research in the field of bioidentical hormone replacement therapy (BHRT). Certified SottoPelle trained hormone therapy providers have access to an extensive library of the latest and most advanced BHRT research.

In this article, the hormone therapy training experts at SottoPelle share some revelatory research on the future of progesterone replacement therapy to improve neurological outcome after traumatic brain injury.

Overview of Traumatic Brain Injuries

Traumatic Brain Injuries result in both primary and secondary injuries. Primary injuries immediately result from the initial impact. A secondary brain injury is a delayed response characterized by complex molecular and biochemical events that result in neuro-inflammation, brain edema, and delayed death of the neurons, causing cell death and irreversible brain damage.

Put somewhat simplistically, the primary aim of therapy for TBI is the removal of hematomas, the repair of skull fractures, and supportive therapies aimed at maintaining perfusion and oxygenation to tissues. At this point in time the primary brain injury is considered irreversible, so intervention is aimed at reversing or preventing secondary injuries to help prevent further neurological decline.

This is where progesterone replacement therapy may come into play. Progesterone is a neurosteroid that has many complex properties affecting the mechanisms involved in neuroprotection and repair after various types of brain injury.

A 2013 study published in the medical journal Acta Pharmacologica Sinica reviewed the increasing body of evidence supporting the use of progesterone as a neuroprotective agent to treat traumatic brain injury.

Studies of Progesterone Hormone Therapy in TBI

It was first noted anecdotally that the females tend to recover better than males following TBI.  And there is evidence that the outcome of an ischemic event is worse in older women than in their younger counterparts. But it was the discovery that gender and menstrual cycle had an effect on animals’ response to TBI that finally led to the consideration of progesterone as a neuroprotective agent.

The authors of the study stated that three decades of extensive research there are more than 200 articles on the use of progesterone in TBI. They conclude this evidence makes it clear that progesterone is a neurosteroid that affects multiple mechanisms involved in neuroprotection and repair after various kinds of brain injuries.

Their exhaustive review of that large body of research found that progesterone was shown to reduce neuronal loss, enhance nerve remyelination, improve functional recovery, and decrease cerebral edema^.

In one referenced study, during assessment of TBI patients at 3 months found that the verbal functions and Karnofsky Performance Scale (KPS) scores in the those treated with progesterone were more improved than those in the control group.

And in two randomized, double-blind, placebo-controlled phase II clinical trials the results showed a decrease in mortality rates and improvements in functional outcome in TBI patients following progesterone treatments.

Molecular analysis revealed that progesterone influences the expression of approximately 500 genes that are involved in regulating inflammation, apoptosis and vascular remodeling, and multiple proteins and receptors. This supports the belief that progesterone is a candidate for effective TBI therapies.

Progesterone Hormone Therapy & Traumatic Brain Injury

In TBI patients, progesterone has been reported to:

• reduce both vasogenic and cytotoxic edema after TBI
• reduce lipid peroxidation, helping to stabilize the blood-brain barrier & improving cell survival
• inhibit inflammation by modulating cytokine release & inhibiting immune cell activation and migration
• limit neuronal apoptosis by stabilizing the mitochondria
• maintain cellular integrity and survival
• promote both central and peripheral remyelination
• attenuate neuronal excitotoxicity by blocking calcium channels

The entire study – The neuroprotective effects of progesterone on traumatic brain injury¹ (available HERE), reveals a large and rapidly growing body of clinical research supporting evidence of progesterone’s neuroprotective properties in patients with TBIs. Read more about SottoPelle Method hormone therapy for traumatic brain injuries HERE.

2023 Research on Progesterone Therapy for TBI

The potential for progesterone’s neuroprotective effects in traumatic brain injuries (TBIs) remains an active area of research and several studies were published in 2023 that explored this topic.

The first relevant study, Evaluating Progesterone Receptors in Neuroprotection², investigated the role of progesterone receptors (PRs) in mediating progesterone’s neuroprotective effects after TBI in ovariectomized rats. Researchers administered progesterone or a placebo after inducing diffuse TBI and measured various parameters like brain water content, oxidative stress markers, and neurological outcomes.

The researchers found that progesterone therapy reduced brain edema, inflammation, and cell death compared to placebo. These beneficial effects were blocked by an antagonist that prevents progesterone from binding to its receptors.

A second 2023 research study, Progesterone After Intensive Lifestyle Intervention for TBI³, evaluated the additional benefit of progesterone compared to placebo after an intensive lifestyle intervention (ILI) in adults with overweight or obesity and TBI. They measured cognitive function, physical performance, and quality of life.

In that study, the subgroup analysis suggested potential benefits for specific cognitive functions in individuals with moderate-to-severe TBI receiving progesterone.

Of course, individual responses to medications can vary significantly. However, these studies offer insights into potential mechanisms of progesterone’s neuroprotective effects, but and further research with robust designs and larger patient populations are expected to determine the true potential of progesterone as a therapeutic strategy for TBIs.

As a SottoPelle Method HRT trained physician you will be better able to evaluate the conditions of your patients’ suffering from traumatic brain injuries and evaluate the potential benefits of progesterone replacement therapy – based on each patient’s specific circumstances to ensure they receive the best, most appropriate care.

Provider Hormone Therapy Training

This emergent use of progesterone hormone therapy to treat TBI is just one of many examples why physicians seeking to offer BHRT to their patients should undergo hormone replacement certification from the SottoPelle Method physician hormone therapy training experts.

With thousands of research articles on the topic of hormone replacement, it is literally impossible for individual hormone therapy providers to keep up on every study. SottoPelle physician hormone therapy training ensures that you and your practice always have the latest and most relevant data at your fingertips to ensure the most accurate and effective hormone dosing and ongoing management.

SottoPelle® physician hormone therapy training is based on science with forty years of HRT expertise, and 30 years of pellet therapy … with proven results! CLICK HERE to learn more about becoming a SottoPelle Certified hormone therapy provider.

Provider Hormone Therapy Training: 323.986.5100 & press 1
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Sources:

1. Jing Wei & Guo-min Xiao (2013). The neuroprotective effects of progesterone on traumatic brain injury: current status and future prospects. Acta Pharmacologica Sinica volume 34, pages 1485–1490.

2. Amirkhosravi, S., Farzaei, M. H., Rezaei-Tavah, K., Hosseini-Sharifzadeh, S., Sadeghi, S., & Samarghandi, H. (2023). Evaluating the neuroprotective effects of progesterone receptors on experimental traumatic brain injury: The PI3K/Akt pathway. Brain and Behavior, 13(6), e2792.

3. Zettergren, R., Aasa, V., Nordström, A., Wennström, M., Ekstrand, Å., & Andersson, T. (2023). Progesterone after intensive lifestyle intervention for traumatic brain injury: a randomized, double-blind, placebo-controlled trial. Journal of Neurotrauma, 40(12), 906-918.