Progesterone for the Pickwickian Syndrome

Obesity hypoventilation syndrome

“…[103–106] Medroxyprogesterone acetate, a synthetic progesterone derivative which effectively stimulates breathing, has been used for long time for managing patients with OHS, with documented positive effects resulting mainly in increasing the ventilatory response to hypercapnia, which ultimately leads to improved ventilation with a drop in PaCO 2 and a rise in PaO 2 . [107–109] Recent work by Saaresranta et al on a group of postmenopausal females with respiratory failure — where study end points were PaCO 2 level, leptin level and neuropeptide Y level — has shown that after 14 days of medroxyprogesterone acetate therapy, there was significant improvement in ventilation and reduction in PaCO 2 without altering serum leptin or neuropeptide Y levels. [110] Obviously this approach of hormonal manipulation is not without side effects, and the risk of inducing a hypercoagulable state should always be considered, particularly in this group of patients who already have underlying predisposing factors like obesity, reduced mobility and heart failure.…”