Re: Is progesterone therapy still used for some PFS patients?
u/drwillpowers
r/DrWillPowers2026-10-05T18:43:55Z
Dr Will Powers’ own statements and theorizing
Mentions treatments or doses — not guidance
Summary (paraphrased)
Powers said his progesterone/pregnenolone use is now phenotype-specific: he reserves it for patients with an apparent low-neurosteroid-production picture — chronic anxiety, tremors, paranoia, signs of the GABA system being disrupted in the negative direction — and for the acute crash phase, when a patient presents days after onset and needs stabilization. He cautioned against retrospective criticism of earlier practice, noting the best available evidence at the time was the Melcangi data showing decreased allopregnanolone. He said it is now evident that neurosteroid disruption runs in many directions and each case needs precise handling, which is why he is pursuing CSF taps with mass spectrometry to read out each patient's exact disruption and target therapy accordingly. His blind (pre-CSF) guidance: pregnenolone/progesterone for anxiety, paranoia, and benzo-withdrawal-like signs — but not for low libido or anhedonia.
Key points (paraphrased)
- Progesterone/pregnenolone reserved for low-neurosteroid phenotype (anxiety, tremors, paranoia) and acute post-crash stabilization.
- Earlier use defended in context: Melcangi's decreased-allopregnanolone data was the best available evidence then.
- Current view: multidirectional neurosteroid disruption requiring per-patient precision.
- CSF taps + mass spec sought as the targeting tool.
- Explicit non-indication: low libido / anhedonia (neurosteroid-excess picture).
Why it’s in the corpus
Captures Powers' current treatment algorithm — progesterone for the low-neurosteroid phenotype, contraindicated for the anhedonic/excess phenotype — and his rationale for phenotype-specific prescribing. Relevant to the corpus's treatment-observation thread and to tracking how his recommendations evolved from his early progesterone work (cf. DWP-001).
Context — the post Powers was replying toVerbatim third-party text, shown for context only — not Powers’ statement. Usernames removed.ShowHide
Powers' comment replies to the original post "Is progesterone therapy still used for some PFS patients?" by [username removed]:
(Im post AI) I personally never crash and just have sexual side effects, my only bad reactions to any intervention is slightly lower libido that is already super low let’s say from 5% to 1%. HCG (all my libido,random erections, pleasure all symptoms resolved within 3h post injection but stoped working after 4months)worked perfect and 2years later my erections are still improved from it. steroids or supplements don’t do shit so my guess is that I’m neurosteroid deficient since no other stuff even changes how I feel. (except cdg which I used for 80days at 3g a day but it only gave me a bit better libido for 2 weeks). My question is, is progesterone therapy worth trying with Sommer or is it out of the window with the new model?
(Parent context recovered from the r.genit.al mirror on 2026-10-07; Powers' comment text itself is from John's user-provided export.)
Some fields on this page come from the release’s Markdown edition, which carries text the JSON edition omits.
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