Progesterone

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Progesterone is a steroid hormonal agent belonging to a class of hormones called progestogens. It is produced by the corpus luteum, a short-lived endocrine gland that the female body produces after ovulation during the 2nd half of the menstrual cycle.

Artificial steroid hormonal agents with progesterone-like properties are called progestins. Progestin is frequently integrated with estrogen, another hormone, to establish contraceptives such as contraceptive pill and skin patches. Progestin is likewise useful in dealing with common menopausal symptoms. Comprehending progesterone and progestins will assist women make notified options about their reproductive health. [1]

Where It’s Made

In males and females, a small amount of progesterone is made in the adrenal glands, which release hormonal agents for a range of physical functions.

In females, progesterone is mostly produced by the corpus luteum, a part of the ovary. The corpus luteum develops from the roots that releases an egg from the ovary for ovulation.

In females, progesterone is likewise made by the placenta, an organ that establishes during pregnancy to help support the fetus.

It’s made to a lower degree by the testes of those appointed male a birth.

Recap

Progesterone is produced primarily by the ovary after ovulation and the placenta during pregnancy. It’s likewise made in lower quantities by the adrenal glands and the testes. [2]

Progesterone Levels, Fertility, and Pregnancy

Progesterone is essential for pregnancy since it gets the uterus prepared to accept, implant, and preserve a fertilized egg. The hormone prevents muscle contractions from happening in the uterus that would trigger a lady’s body to reject an egg.

If you become pregnant, the hormone assists produce an environment that nurtures the developing baby.

Your progesterone level will gradually increase between your 9th and 32nd weeks of pregnancy.

The Function of the Placenta in Progesterone Production

The placenta (the structure inside the uterus that offers oxygen and nutrients to a developing infant) will start to produce progesterone after 8 to 10 weeks of pregnancy to assist maintain a healthy environment for the child. At this point, the placenta increases progesterone production to a higher rate than your ovaries were producing. These high levels of progesterone throughout your pregnancy cause the body to stop producing more eggs, as well as prepare your breasts to produce milk.

Fertility Problems and Progesterone Tests

If you’re having a hard time getting pregnant, your doctor might advise a blood test for progesterone to see if you’re ovulating or if your ovaries are healthy.

If your progesterone level is low however you are pregnant, your medical professional may recommend a blood test to inspect whether your pregnancy is at threat for complications, such as miscarriage or preterm shipment.

Symptoms and signs that suggest you might have a low progesterone level include the following:.

  • Uterine bleeding
  • Missing your periods or having abnormal durations
  • Spotting and pain while pregnant
  • Repetitive miscarriages

Not having enough progesterone can also trigger you to have excessive estrogen. A high level of estrogen can reduce your libido, trigger weight gain, and affect your gallbladder.

Progesterone as a Medication and Treatment

Progesterone is part of a class of medications called progestins.

If you’re having difficulty getting pregnant, or if you’re undergoing fertility treatments, your medical professional may advise that you take progesterone hormone treatment.

This can be done for any of the following factors:.

  • To induce menstruation
  • Since your ovaries do not produce adequate progesterone
  • Because medications you take are reducing your progesterone level
  • To change progesterone that’s removed from your ovaries by certain procedures
  • There are numerous various types of progesterone available, so talk to your doctor about which kind is best for you.

Progesterone Treatment Shipment Systems

Progesterone treatments can be found in the list below types:.

  • Vaginal gel that’s typically used once per day
  • Vaginal suppository, which can be intensified at specialty drug stores but is not authorized by the Fda (FDA)
  • Vaginal inserts, which the FDA has actually authorized for progesterone supplements, not replacement
  • Oral capsule that’s inserted vaginally (not approved by the FDA)
  • Injection, the most commonly utilized method, which requires day-to-day injections in the butt [3]

Treatment

Progesterone substances used for medical usages are called progestogens. They are offered in 2 kinds: synthetic versions (progestins) and another variation stemmed from plant sources, which is nearly identical to the body’s own hormone and is frequently called “natural progesterone.”.

In addition to being consisted of in contraceptive pill and hormonal agent replacement therapy, progestogens may be used to deal with a range of conditions, consisting of:.

  • menstrual or bleeding problems
  • endometriosis
  • breast, kidney or uterine cancer
  • appetite and weight reduction in AIDS and cancer clients

They are likewise utilized as a diagnostic help to determine estrogen’s impact in the uterine lining, and in their natural state may be utilized to deal with infertility.

If you are thinking about a progestogen item, go over with your healthcare expert any medical conditions you might have, particularly asthma, epilepsy, cardiovascular or bleeding conditions, high cholesterol, history of blood clots or stroke, kidney or liver disorders, migraines, breast problems, depression or diabetes. Also share information about any medications you are taking.

Common side effects of progestins include:

  • development bleeding
  • menstrual cramps
  • bloating triggered by water weight gain
  • dizziness
  • moodiness
  • dry mouth
  • queasiness
  • tiredness
  • irritability

Many of these adverse effects imitate PMS, which is not surprising since PMS usually happens when progesterone levels peak. Some women experience rarer side effects like anxiety, fainting, breast inflammation, trouble sleeping, extreme headaches or vision issues.

Speak with your healthcare expert if you experience adverse effects. Much of these adverse effects subside with continued usage. If not, changing to a different progestin-based item may assist.

Uses of Progestin Products

Unusual uterine bleeding: Because of their ability to hinder bleeding, progestins are frequently utilized to manage excessive or abnormal uterine bleeding (AUB).

Endometriosis: Endometriosis may be treated with a progestin or with an estrogen-progestin birth control pill. The objective is to reduce estrogen production, hence keeping endometrial tissue from growing.

Irregular periods and polycystic ovary syndrome (PCOS): The shedding of the uterine lining that occurs with menstruation each month lowers the risk of endometrial cancer; therefore, keeping menstruations is important throughout childbearing years. If you frequently skip periods due to PCOS, being overweight or underweight, or because of another condition, your health care expert might advise birth control pills containing estrogen and progestin to ensure regular cycles. If you can’t or will not take contraceptive pill, you may require an occasional prescription for an oral progestin to help you balance unopposed estrogen and shed the uterine lining.

Birth control: Contraceptive pills normally include estrogen and progestin. Combination tablets suppress ovulation (the release of an egg) monthly. The progestin in these tablets also reduces the danger of pregnancy by modifying the mucous in your cervix, making it harder for the sperm to move and connect with an egg. Constant progestins in mix contraceptive pill also avoid the development of the endometrium and change uterine secretions to reduce the opportunity that a fertilized egg could implant in the uterine lining.

Combination pills been available in various formulas. Some are based on a 28-day regimen (21 days of active tablets which contain the same amount of estrogen and progestin followed by 7 days of placebo tablets or no tablets at all), called monophasic contraceptive pill. Others differ the dose of estrogen and/or progestin that a woman gets throughout her cycle and are called multiphasic contraceptive pill.

There is a 91-day oral contraceptive regimen (Seasonale and generics) that, offers women with contraception and less durations each year. Tablets containing the active hormonal agents progestin (levonorgestrel) and an estrogen (ethinyl estradiol) are taken for 12 weeks (84 days), followed by one week of placebo tablets, so you just have 4 periods a year.

The FDA also has actually approved continuous-use contraceptive pill which contain ethinyl estradiol and levonorgestrel. Brand names include Lybrel, Alesse, Lessina, Nordette, Triphasil-28, Triphasil-21, and others. These are monophasic tablet (consisting of the exact same levels of estrogen and progestin throughout the whole pill-taking schedule) that are available in a 28- or 21-day pack and are designed to be taken constantly, with no break in between pill packets. That indicates you will not have a period. You might have some identifying or breakthrough bleeding, particularly when you first begin using continuous birth control pills. However the majority of ladies will have no bleeding (or hardly any) by the end of a year.

Estrogen-progestin contraceptive pill have some anti-cancer benefits in addition to contraception. They might reduce ovarian cancer threat, in addition to uterine and colon cancer danger. Nevertheless, mix pills are not recommended for females who have actually had breast cancer.

It is essential to comprehend that not all of the questions surrounding combined HRT and breast cancer threat have actually been answered. If you’ve had breast cancer or have a history of it in your household, discuss your threat with your health care specialist.

These products likewise have side effects, the most common of which are nausea, breast inflammation and advancement bleeding. Many negative effects decrease or disappear after three months of continuous usage. Switching to another kind of birth control pill can also ease adverse effects. Nausea might differ depending on when you take the pills and whether you take them on a full or empty stomach.

Mix contraceptive pill are generally not a proper treatment option if you are over 35 and smoke, have high blood pressure, have a history of migraine with aura or blood clots in your lungs or you are extremely sensitive to adverse effects of this medication, such as headaches. Cigarette smoking while taking mix birth control pills considerably increases your threat of cardiovascular disease and stroke.

Estrogen-progestin contraceptives are available as a spot (Ortho Evra) and as a ring (Nuvaring).

Ortho Evra is a weekly prescription spot that releases norelgestromin (a progestin hormonal agent) and ethinyl estradiol (an estrogen hormonal agent) through the skin into the blood stream to prevent pregnancy. Each spot is worn for one week. On the same day of the week you start the spot, replace it with another. After three weeks (and three new spots) you have a week that is patch-free, throughout which you get your period. Ortho Evra includes greater levels of estrogen than lower dosage contraceptive pill, and the FDA authorized additions to the spot’s label addressing an increased risk of embolism associated with its usage. You need to discuss this and other potential threats with your healthcare specialist.

Adverse effects might include breast tenderness, headache, a response at the application site, nausea and emotional changes. Other dangers are similar to those from utilizing contraceptive pill, such as an increased danger of cardiac arrest, embolism and stroke, particularly in females who smoke and/or have a history of these conditions.

Another contraceptive which contains progesterone is Nuvaring, which consists of a soft, versatile, transparent, ring about 2 inches in size. It consists of a mix of estrogen and progestin hormonal agents (ethinyl estradiol and levonorgestrel). After it is placed into the vaginal area, these hormones are slowly released on a consistent basis. You require to insert a brand-new ring every month for continuous birth control, removing it after three weeks, at which time you have your period.

Adverse effects are very little however may consist of vaginal discharge, vaginitis and inflammation. Like contraceptive pills, Nuvaring might increase the danger of embolism, cardiac arrest and stroke. Ladies who utilize Nuvaring are strongly recommended not to smoke, as it might increase the threat of heart-related adverse effects.

Some ladies pick to take a progestin-only pill. Called the “mini-pill,” progestin-only pills permit ladies to prevent a few of the worst side effects of estrogen, while enhancing regular menstrual cycles and avoiding pregnancy. If you are breast-feeding, you may wish to think about the mini-pill, considering that mix items might dry up your milk supply.

Progestin-based mini-pills are extremely reliable for preventing pregnancy (about 97 percent), but missing out on a tablet or taking it at a different time of day is riskier than with combination estrogen-progestin tablets. That’s because the mini-pill’s results can subside after a day, making you susceptible to pregnancy. Women on mini-pills might also ovulate, even when they take the pills properly. And if you miss a day, the possible schedule of an egg makes getting pregnant more likely.

Longer-acting progestins may be a great birth control alternative if you desire trustworthy protection without needing to remember to take a pill each day. Injected medroxyprogesterone (Depo-Provera) lasts three months. The Mirena IUD, which provides progesterone straight and continuously into the uterine lining for as much as five years, is an additional longer-term option. Both are extremely reliable. Discuss the risks and advantages with your doctor before choosing the approach that’s best for you.

Progestin-Only Contraceptive Products At-A-Glance

Levonorgestrel (tablets and implants); marketed as emergency contraception tablets (Fallback One-Step and Next Option) and the Mirena levonorgestrel-releasing intrauterine system.

Ulipristal acetate; a progesterone agonist/antagonist that is marketed as the “ella” tablet.

Medroxyprogesterone (injected); marketed as Depo-Provera contraceptive injection.

Norethindrone (tablets); marketed as Ortho Micronor and Nor-Q-D.

Emergency situation birth control: Tablets consisting of levonorgestrel (Fallback One-Step and Next Option) can be utilized for emergency situation birth control within 72 to 120 hours of unprotected sex. With Plan B One-Step, you take one tablet within 72 hours after unprotected sex to help prevent pregnancy. It can be taken up to 120 hours after sex but is less reliable the more time lapses. Next Option works likewise but includes taking one pill within 72 hours of vulnerable sex and another 12 hours later on. ella tablets cut the possibilities of becoming pregnant by about two-thirds for at least 120 hours after unprotected sex by delaying or hindering ovulation. You can buy the levonorgestrel emergency contraceptive pills over-the-counter without a prescription. You must request for them at the pharmacy counter. ella is available just by prescription, however you could keep a supply in your home.

Ask your health care expert or pharmacist for more details about how and when to use these items, if you wish to keep them on hand. Mix birth control pills can likewise be used for emergency situation birth control if you already have a prescription for them, but talk with your healthcare company about proper dosage and timing for usage as an emergency situation contraceptive.

Perimenopause and menopause: For perimenopausal females with irregular or absent periods, the low-dose estrogen/progestin combination found in contraceptive pills often eases symptoms and assists keep routine menstruations.

Additionally, postmenopausal hormonal agent treatment using either estrogen alone (ET) or an estrogen-progestin mix (HT) is sometimes recommended to treat moderate to serious perimenopausal or postmenopausal signs. Estrogen-only treatment is prescribed only if you’ve had a hysterectomy. If you still have your uterus, you’ll require to take some progestin with the estrogen (unless you use the estrogen-SERM mix, Duavee) due to the fact that the progestin helps offset estrogen’s stimulating impacts on the endometrium, which might increase your threat of endometrial cancer.

Some postmenopausal hormone therapy products provide the exact same dosage of progestin in each daily dose (called constant treatment). Others are developed with progestin added throughout part of a monthly cycle and then stopped (called cyclic treatment). Females on the intermittent-progestin program report more bleeding issues than ladies on continuous treatment regimens.

Estrogen-progestin mixes might need cyclic treatment, throughout which you take different pills on various days, leading to month-to-month bleeding similar to menstruation, or continuous treatment, during which you take estrogen and progestin together every day. Numerous ladies choose the constant combination therapy so they can avoid monthly bleeding. If bleeding persists more than three months, consult your healthcare expert.

Progestin-Only Products at a Glance

Progestins

Kinds of progestins readily available include intramuscular, oral, and cream. They include:.

Hydroxyprogesterone (injected); marketed under the names Hylutin, Makena and Prodrox. It is prescribed for irregular uterine bleeding, amenorrhea and readying the uterus for menstruation.

Medroxyprogesterone (tablets and injection); marketed under the names Curretab, Depo-Provera (injection) and Provera. Tablets are prescribed for unusual uterine bleeding, amenorrhea, to get the uterus prepared for menstruation and as part of menopausal hormonal agent treatment with estrogen. Injections are prescribed for kidney or uterine cancer.

Megestrol (liquid and tablets); marketed as Megace. Liquid is prescribed for appetite or weight loss associated with AIDS. Tablets are recommended for breast or uterine cancer or for cravings or weight-loss connected to cancer.

Norethisterone acetate (tablets); marketed as Nor– Q-D and Aygestin. It is prescribed for irregular uterine bleeding, amenorrhea or endometriosis.

Progesterone

Progesterone products consist of:.

Micronized oral progesterone (Prometrium). It is recommended for menopausal symptoms, infertility, unusual uterine bleeding, endometriosis and amenorrhea (absence of a menstrual duration).

Progesterone vaginal gel (Crinone). It is used to deal with infertility and amenorrhea.

Avoidance

Numerous conditions for which progestin or progestin-estrogen mixes are prescribed can not be prevented. Menopause, for instance, is a normal stage of life. However while the changes in hormone levels can not be avoided, the intense signs these changes might trigger can often be relieved through medication and/or way of life changes.

As your body modifications, it is extremely important to communicate honestly with both your partner and your healthcare professional. Tell both about your symptoms and the physical and emotional changes you might experience. Your health care professional will be able to help you find how to better manage and treat those signs, including how to maintain a healthy sex life. And your partner should know what’s occurring to you, specifically if the symptoms are triggering distress and are affecting your sex life.

Realities To Know

  • Progestogen describes any hormonal agent replacement item that produces similar results on the uterus as progesterone, the naturally occurring form of the hormone produced in a woman’s body. Progestins are artificial versions of progesterone.
  • Progesterone helps secure the lining of the uterus, likewise called the endometrium.
  • Progestogens are consisted of in mix hormonal therapies with estrogen to prevent endometrial accumulation, which can lead to cancer.
  • After menopause, you will not produce any considerable progesterone.
  • Progesterone is believed to be partly responsible for symptoms of premenstrual syndrome (PMS), such as breast inflammation, feeling bloated and mood swings.
  • In addition to menopausal hormone therapy and contraception, progestogens might be used to treat a range of conditions, consisting of menstrual irregularities and endometriosis; breast, kidney or uterine cancer; and hunger and weight-loss in help clients. Progesterone, the natural hormone, might also be used to prevent pregnancy loss and preterm labor.
  • Progestin-only contraceptive products might be a great option if you are unable to take a mix product with estrogen or are worried about estrogen’s side effects. They are appropriate for older ladies, specifically smokers who want to utilize an oral hormonal contraceptive method, and postpartum and/or breast-feeding ladies.
  • Progestin-only mini-pills are extremely reliable for avoiding pregnancy (about 97 percent) if taken correctly. They need to be taken at the same time every day to be reliable.
  • Progestogens are sometimes used as a diagnostic aid to determine whether estrogen is being produced. In a “progestin obstacle” test, a woman takes progestin pills for five or more days. When the progestin is stopped, bleeding takes place if sufficient estrogen exists.
  • Hormone-based therapies are not the only alternative for birth control or for alleviating menopausal symptoms. Inquire about and go over all the alternatives with your healthcare company. [3]

How is progesterone managed?

The formation of the corpus luteum (which produces the majority of progesterone) is set off by a surge in luteinising hormonal agent production by the anterior pituitary gland. This normally occurs at roughly day 14 of the menstrual cycle and it promotes the release of an egg from the ovary (ovulation) and the formation of the corpus luteum from the remnant of the follicle. The corpus luteum then produces progesterone, which prepares the body for pregnancy. If the egg is not fertilised and no embryo is conceived, the corpus luteum breaks down and the production of progesterone decreases. As the lining of the womb is no longer kept by progesterone from the corpus luteum, it breaks away and menstrual bleeding takes place, marking the start of a brand-new menstruation.

However, if the ovulated egg is fertilised and triggers an embryo, the cells that surround this early embryo (which are destined to form the placenta) will secrete human chorionic gonadotrophin’ data-content=’ 1392′ >> human chorionic gonadotrophin. This hormone has a very comparable chemical structure to luteinising hormonal agent. This indicates it can bind to and trigger the very same receptors as luteinising hormonal agent, implying that the corpus luteum does not break down and rather keeps producing progesterone till the placenta is developed. [4]

Progesterone in males

Progesterone is called a female hormone, but males need progesterone to produce testosterone. The adrenal glands and testes in males produce progesterone.

Progesterone levels in males resemble those of females in the follicular stage of the menstruation, when the egg hair follicle on an ovary is preparing to launch an egg.

Signs of low progesterone in males include:.

  • Low progesterone levels in males can lead to loss of hair.
  • Low sex drive
  • Loss of hair
  • Weight gain
  • Tiredness
  • Depression
  • Gynecomastia, which is breast development in males
  • Impotence
  • Impotence
  • Bone loss
  • Muscle loss

Men with low progesterone levels have a greater danger of developing:.

  • Osteoporosis
  • Arthritis
  • Prostate cancer
  • Prostatism, an obstruction of the bladder neck, normally connected with a bigger prostate gland

As males age, testosterone begins to decline, estrogen levels rise, and progesterone levels fall drastically. [5]

Adverse effects

When taken by mouth: The progesterone prescription items that have been approved by the Food and Drug Administration (FDA) are LIKELY SAFE for many people when used by mouth with the advice and care of a healthcare expert.

When applied to the skin: The progesterone prescription items that have been authorized by the Food and Drug Administration (FDA) are LIKELY SAFE for most people when applied to the skin with the guidance and care of a healthcare professional.

When given as a shot: The progesterone prescription items that have actually been authorized by the Food and Drug Administration (FDA) are LIKELY SAFE for the majority of people when injected into the muscle with the recommendations and care of a health care professional.

When applied into the vagina: The progesterone prescription items that have been authorized by the Fda (FDA) are LIKELY SAFE for most people when applied into the vaginal area with the suggestions and care of a health care professional.

Nevertheless, progesterone can trigger many negative effects including stomach upset, changes in appetite, weight gain, fluid retention and swelling (edema), tiredness, acne, sleepiness or sleeping disorders, allergic skin rashes, hives, fever, headache, depression, breast pain or enhancement, premenstrual syndrome (PMS)- like symptoms, modified menstrual cycles, irregular bleeding, and other side effects. [6]

Should I be worried about low progesterone?

Progesterone is necessary during childbearing years. If you don’t have adequate progesterone, you might have difficulty getting or remaining pregnant.

After among your ovaries launches an egg, your progesterone levels must increase. Progesterone assists the uterus thicken in anticipation of getting a fertilized egg. If it’s not thick enough, the egg will not implant.

Signs of low progesterone in ladies who aren’t pregnant include:.

  • headaches or migraines
  • mood modifications, including anxiety or anxiety
  • abnormality in menstruation

Low progesterone might cause unusual uterine bleeding in ladies who aren’t pregnant. Irregular or missing periods may suggest inadequately operating ovaries and low progesterone.

If you get pregnant, you still require progesterone to preserve your uterus up until your child is born. Your body will produce this boost in progesterone, which causes some of the signs of pregnancy, consisting of breast inflammation and nausea. If your progesterone levels are too low, your uterus might not be able to carry the child to term.

During pregnancy, symptoms of low progesterone consist of spotting and miscarriage.

Low progesterone might indicate ectopic pregnancy. This can result in miscarriage or fetal death.

Without progesterone to complement it, estrogen might become the dominant hormone. This might trigger symptoms including:.

  • weight gain
  • decreased libido, mood swings, and anxiety
  • PMS, irregular menstrual cycle, heavy bleeding
  • breast tenderness, fibrocystic breasts
  • fibroids
  • gallbladder issues [7]

Drug Interactions

Although particular medications must not be utilized together at all, in other cases 2 different medications may be used together even if an interaction might occur. In these cases, your medical professional may wish to alter the dosage, or other precautions might be required. When you are taking this medication, it is particularly crucial that your health care expert understand if you are taking any of the medicines listed below. The following interactions have actually been selected on the basis of their prospective significance and are not always extensive.

Utilizing this medicine with any of the following medicines is usually not recommended, but might be needed in many cases. If both medicines are prescribed together, your medical professional may change the dose or how often you use one or both of the medicines.

  • Abametapir
  • Conivaptan
  • Eslicarbazepine Acetate
  • Fedratinib
  • Fexinidazole
  • Fosnetupitant
  • Netupitant [8]

This information ought to not be analyzed without the aid of a healthcare provider. If you think you are experiencing an interaction, get in touch with a healthcare provider immediately. The absence of an interaction does not necessarily suggest no interactions exist. [9]

Conclusion

Keep all consultations with your medical professional.

Before having any laboratory test or biopsy (removal of tissue for screening), inform your doctor and the laboratory personnel that you are taking progesterone.

Do not let anybody else take your medication. Ask your pharmacist any concerns you have about refilling your prescription.

It is important for you to keep a composed list of all of the prescription and nonprescription (non-prescription) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You need to bring this list with you each time you go to a medical professional or if you are confessed to a health center. It is also crucial information to bring with you in case of emergency situations. [10]

Referrals

  1. https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/reproductive-hormones
  2. https://www.verywellhealth.com/progesterone-understanding-the-other-female-sex-hormone-4142780#toc-where-its-made
  3. https://www.healthywomen.org/your-health/progesterone/questions-to-ask
  4. https://www.yourhormones.info/hormones/progesterone/
  5. https://www.medicalnewstoday.com/articles/277737#progesterone-in-men
  6. https://www.webmd.com/vitamins/ai/ingredientmono-760/progesterone
  7. https://www.healthline.com/health/womens-health/low-progesterone#low-progesterone
  8. https://www.mayoclinic.org/drugs-supplements/progesterone-oral-route/side-effects/drg-20075298?p=1
  9. https://go.drugbank.com/drugs/DB00396
  10. https://medlineplus.gov/druginfo/meds/a604017.html
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