Can progesterone improve COVID-19 outcomes in men?

Can progesterone improve COVID-19 outcomes in men?

Written by Lori Uildriks, Pharm.D., BCPS, BCGP on April 1, 2021 — Fact checked by Catherine Carver, MPH
Share on PinterestCould progesterone protect men from severe COVID-19? Przemyslaw Klos/EyeEm/Getty Images

  • Compared with women, men are more likely to develop severe COVID-19 and die.
  • A small-scale pilot study tested whether injectable progesterone improved outcomes in men hospitalized with moderate-to-severe COVID-19.
  • Participants receiving progesterone had better clinical outcomes after 7 days.
  • The study concludes that further research is required to assess progesterone’s safety and efficacy for the treatment of COVID-19 in a larger, more diverse population.

Overall, men are 2.4 times more likely to die from COVID-19 than women. This disparity may result from a complex interplay of psychosocial, behavioral, and biological factors.

For instance, men tend to engage in higher-risk behaviors at a greater frequency than women, such as increased use of tobacco and alcohol. They also have lower rates of social distancing, hand-washing, and wearing masks.

Men also have a higher incidence of health conditions associated with poorer COVID-19 outcomes and are less likely to seek medical care proactively.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

Immune sex differences

Females tend to mount stronger immune responses than males, which may be due to differences in sex chromosome genes and sex hormones, such as progesterone.

Several immune cell types express progesterone receptors, which can inhibit inflammation in premenopausal females.

Progesterone is a hormone produced by the ovaries in females and the adrenal gland and testes in males. However, it is present in much lower concentrations in males and postmenopausal females.

Earlier research has shown that premenopausal females with COVID-19 tend to spend less time in hospital. They are also less likely to need respiratory support than postmenopausal females.

Progesterone may dampen the exaggerated immune response or “cytokine storm” that causes severe lung injury, which sometimes leads to fatalities in people with a SARS-CoV-2 infection.

Progesterone currently has approval in the United States to treat infertility, the absence of menses or amenorrhea, and abnormal uterine bleeding.

In one study, scientists infected mice with influenza A. When they treated the animals with progesterone, there was less lung inflammation, and they recovered more quickly.

This finding prompted researchers to conduct a randomized controlled pilot trial at Cedars-Sinai Medical Center to assess progesterone’s effectiveness and safety in men hospitalized for COVID-19. Their results appear in the journal Chest.


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