Known as the “pregnancy hormone”, progesterone is rarely mentioned in menopause beyond discussions about HRT. We hear about oestrogen a lot, which is why I wrote a guide to oestrogen first, but thinking about it, it has been progesterone that has most influenced my menopause.
So, here comes the science bit…
What is progesterone?
Progesterone is one of women’s sex hormones, together with oestrogen and testosterone (men have small amounts of oestrogen and progesterone in their bodies, too).
While there’s production in your adrenal glands, like oestrogen, it’s mainly made inside your ovaries, in the follicles, which are minute sacs of fluid each containing an egg. During the first two weeks of your cycle, your hormones trigger some of the follicles to grow and the eggs inside them to mature – around 15-20. One follicle goes on to become dominant and the one that releases its egg that month, leaving behind an empty sac known as the corpus luteum.
However, the work of the sac isn’t done yet. It begins to secrete progesterone to prepare the womb (aka uterus) for a possible pregnancy. These hormones help maintain the lining of your womb (which has been built up by oestrogen) ready for a fertilised egg to embed itself and get cosy for the next nine months. Hence the name: “for/supporting gestation”.
If conception doesn’t happen, the corpus luteum breaks down, your progesterone levels drop and all that juicy lining is discarded – aka your period.
Then we begin all over again…
Progesterone is also responsible for getting your breasts ready to make milk. If your boobs hurt and feel full in the last two weeks of your cycle, this is the hormone to curse.
It’s not all bad news, however. Progesterone helps keep your brain healthy, especially after any brain injury. Doctors think it could help in cases of brain damage.
What about if you’re pregnant?
When you conceive, hormones send a message to the corpus luteum to keep working and continue producing progesterone until the placenta is formed to take over – about 7-10 weeks. The progesterone keeps the lining of the womb intact for a healthy pregnancy.
But it can also cause some of the not-so-nice bits of pregnancy, such as nausea and breast tenderness.
If you have low progesterone, you may have trouble getting or staying pregnant. (It can also cause irregular periods, or even no period, if you’re not pregnant.)
Low levels can also cause:
- mood changes
- irregular periods
What about the eggs that don’t make it?
Prepare yourself – they die. Well, they get reabsorbed back into your body, if you want to be nice about it. But basically, they die and as you’re born with all the eggs you’ll ever have, that’s the number going down around 15-20 every cycle just through this process.
Plus with natural cell degradation, it’s estimated we lose about 1,000 more follicles each month, too.
Oh, and this speeds up as we get older and then along comes perimenopause and all the good times with that. On my last scan, I was told my left ovary has “gone to sleep”. Yeah, I’m cheering too.
What happens with progesterone during menopause?
When the follicles die, our reproductive system starts shutting down, which means no more messages to produce progesterone. Levels decline until they’re very similar to those of men.
It’s these fluctuations in production that are responsible for any changes to your periods in the run-up to menopause, so they can become longer, heavier and/or irregular. Most menopause symptoms are caused by falling oestrogen levels.
After menopause – that’s exactly 12 months after you have a period – your ovaries no longer produce progesterone.
If you’re on HRT and you still have a womb, you’ll need to take a combined form: oestrogen and progesterone. If you’ve had your womb removed, then you only take oestrogen. This is because oestrogen alone can cause the womb lining to thicken and this can increase the risks of endometrial cancer. Progesterone balances this out.
When progesterone goes bad
Well, that’s all well and good, I hear you say, so what’s all this about progesterone being so influential on your menopause?
Everything I have described is the ideal biological workings of a woman, where things run exactly as they should. Unfortunately, real life isn’t like that.
My first lots of HRT were sequential, which meant I was taking 14 days of oestrogen and then 14 days of progesterone. After a few months, I noticed that when I was on the progesterone, my mood would drop. And by that, I mean plummet. Plummet like your heart when you realise Chris Hemsworth will never leave beautiful Spanish model Elsa Pataky for you.
Turns out I was progesterone sensitive and have suffered from PMDD (premenstrual dysphoric disorder) throughout most of my menstruating life. Changing hormone levels has been like opening up myself to Harry Potter’s dementors. If this sounds like you, you can read more about progesterone sensitivity and my experiences of it here.
It was. But that was because I didn’t know enough, which is why I share my experience with others. By understanding the impact progesterone has on our bodies, you can take action when it’s not working correctly. I’m on anti-depressants with HRT and that is working well for me. Others have gone for a Mirena coil or take progesterone vaginally, so it is getting to the parts of the body it should be. I’ve heard of some women who gave up HRT completely because of progesterone sensitivity.
As ever, my clarion call is to do the research and find out what is best for you. Then lobby your MP for better women’s healthcare.
Does progesterone affect you? I’d love to hear your experiences. Please leave a comment below.
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