PROGESTERONE (Hormones and Pregnancy)

[cyberelijah]

Progesterone (Hormones and Pregnancy)

The female reproductive system is full of naturally occurring biochemicals that act as sedatives and benzodiazepines in the brain and central nervous system. These biochemicals include hormones, neuroactive steroids, and their metabolites.
 

They include, but are not limited to:

• Progesterone
• Estrogens
• Neuroactive steroids (allopregnanolone, et al.)
• Metabolites of these

As a result of fluctuations in these biochemicals, a phenomenon known as both a progesterone withdrawal syndrome and a GABA-A receptor desensitization effect occurs, which is similar in nature to the benzodiazepine withdrawal syndrome (BWS). This phenomenon can affect certain women who are affected by premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression or psychosis, menopause, and hysterectomy. It can also occur in individuals experiencing sedative-hypnotic withdrawal syndromes.

Due to fluctuations in neurosteroids and their metabolites, a temporary increase in concentrations of a molecule called alpha-4 occurs. This molecule temporarily blunts the sensitivity of the GABA receptor to GABA (and GABAergic sedatives like benzodiazepines) until hormonal changes or fluctuations occur. This phenomenon can happen in men experiencing physical stress but is more common during specific points in female menstrual and reproductive endocrine cycles.
 

Sudden discontinuation of sedatives like benzodiazepines and ethanol can also cause symptoms similar to PMS withdrawal.

Progesterone, allopregnanolone, and many of their metabolites are cross-tolerant with benzodiazepines. Fluctuating levels of these naturally occurring biochemicals can make the taper and recovery process challenging for women. In individuals not affected by benzodiazepines, these interactions are usually not noticeable. However, they can be evident in women with PMS, PMDD, menopause, postpartum, and post-hysterectomy complications, resembling the benzodiazepine withdrawal syndrome.
 

Irregular Menstrual Periods And Hysterectomy

Benzodiazepines, long documented to cause menstrual irregularities in some patients, are rarely considered in the differential diagnosis of irregular periods by medical providers. Consequently, patients may be prescribed unnecessary hormones or, in severe cases, undergo unnecessary hysterectomies. Many women in benzodiazepine support communities who experienced these irregularities report that tapering off their benzodiazepines led to the resumption of normal menstruation.
 

Pregnancy

Unsurprisingly, babies born to physically dependent mothers are at risk of potential birth defects and complications. Benzodiazepines, like Ativan, Valium, Klonopin, and Xanax, are no exception. These medications can increase the risk of miscarriage, birth defects, and complications during pregnancy and breastfeeding. The risks associated with benzodiazepine use during pregnancy vary across different countries. For instance, the FDA has commonly prescribed benzodiazepines as either D or D+ categories. D categories indicate that studies have been completed on the drug, and it has been proven to carry certain risks. These risks include those to a developing fetus.
 

Discovering that one is pregnant while taking benzodiazepines can be extremely stressful and traumatic, especially if the prescription is long-term (more than 2-4 weeks) and physical dependence has developed. Many women are not provided with accurate and informed consent at the time of prescription and are unaware that benzodiazepines can be highly addictive and difficult to stop.
 

While pregnant women are often encouraged to gradually reduce their benzodiazepine intake, it may be too late to avoid potential damage by the time the pregnancy is discovered. A safer tapering process may take many patients several months to years, and abrupt tapers can be extremely dangerous and challenging for many women. This often leaves women with the difficult task of gradually tapering during pregnancy or with the choice of accepting the risk of fetal exposure to benzodiazepines.

 

From the Ashton Manual:

Benzodiazepines actively cross the placenta and, when taken regularly during pregnancy (even in therapeutic, prescribed doses) can cause neonatal complications. The fetus and neonate metabolize benzodiazepines very slowly, and appreciable concentrations may persist in the infant up to two weeks after birth, resulting in the “floppy infant syndrome” of lax muscles, oversedation, and failure to suckle.

A 2019 study of 1,691,366 pregnancies revealed a 47% higher likelihood of ectopic pregnancy among women taking benzodiazepines. Another study found an increased risk of spontaneous abortion and miscarriage, particularly during the sixth through 19th gestational weeks, for women who started using benzodiazepines in pregnancy.
 

Benzodiazepines have been associated with a significantly higher risk of birth defects and complications for infants, including withdrawal syndrome, floppy infant syndrome, seizures, and others. They also lead to lower birth weight, gestational age at birth, and an increased risk of preterm birth.
 

Mothers and fathers may lose many years with their children to the long-term consequences of benzodiazepine withdrawal syndrome and prolonged withdrawal syndrome. Both syndromes can render a parent too disabled to fully care for their children or spend quality time with them.