Progesterone, progestogens and psychosomatic health of the climacteric woman

Psychosomatics as a medical perspective and discipline focuses on the interaction of physical and mental health in a specific life situation of a patient, taking into account the physical and emotional wellbeing, role functioning, satisfaction with the partner and family relationship, as well as sexual function and satisfaction. The role of progesterone for the psychosomatic health of the climacteric woman depends on the individual symptom cluster and the pre-existing receptivity of the progesterone receptors which are widely distributed in the body and especially the brain of the woman. The complex action and interaction of progesterone is reflected in controversial empirical results about the impact of progesterone on the physical, mental and sexual health of climacteric women. From biological rationale and clinical experience there are however two important effects of P on the combined physical, mental and sexual wellbeing of climacteric patient: the antiestrogenic effect of progesterone is important on the peripheral physical level not only to protect the endometrium against overstimulation but also to reduce the individual suffering from heavy bleeding, breast tension, bloating and general discomfort. The positive anxiolytic and sedative effects of progesterone on the central nervous system depend on the type of progestogen, the dosage, the timing of application, the combination with estrogen etc. It can be concluded that progesterone and progestogens have an important potential to maintain or improve the psychosomatic health of the climacteric women. Their use must however be tailored to specific symptom clusters and to the individual's pre-existing psychosomatic health status.