woman-holding-calendar-to-show-progesterone-cycle

Progesterone: What is it and what does it do to your body in menopause?

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…

Anything else?

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:

  • headaches
  • migraines
  • mood changes
  • anxiety
  • depression
  • 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.

Sounds horrendous…

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 womens healthcare.

Does progesterone affect you? I’d love to hear your experiences. Please leave a comment below.

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14 thoughts on “Progesterone: What is it and what does it do to your body in menopause?”

  1. I never see any discussion of if a patient can only take progesterone due to contraindications for estrogen. I wondered how changing the progesterone levels affect the estrogen levels. Thoughts?

    1. That’s a really good question. My understanding is that the two work together but separately, but I could be wrong. Most menopause symptoms are the result of low oestrogen, but the two have such a role to play and with such a delicate balance. I’m going to investigate further!!!! Thanks Tracy x

  2. Christine Hannigan

    Can i ask when you started to notice your progesterone sensitivity please?
    I am on week 4 of HRT Oestrogen and progesterone combined and just want to be mindful of this. Loved the article thank you so much

    1. Hi Christine and thank you! I noticed after about three months of my first HRT patches. I noticed a cycle occurring and realised I had some problem with progesterone but had never heard of sensitivity then. When you say oestrogen and progesterone combined, is that a patch with them continously being fed into your body? Mine were two weeks oestrogen, two weeks progesterone. When I was accidentally put on a continuous HRT, it was great. I had no problem with the progesterone – but I did bleed a lot so the GPs realised I shouldn’t have been on that one! That was Evorel Conti, by the way.

      Track your progress to see if you have any cycles recurring. If you do, the tracking will help your GP x

  3. Elouise Jaymes

    At age 37 I began having uncontrolled anxiety, particularly at the end of the month towards a period. I went to GP and said I think it’s hormonal. I was told it was not as I was too young for menopause and was prescribed anti depressants and cognitive therapy. In my gut I knew this wasn’t quite right. After years of sprialling I saw a locum GP accidently who said it’s very likley you are experiencing perimenopausal hormone shifts which may settle after a while and said I may be progesterone sensitive. JUST THIS conversation allowed me to become less fearful of the anxiety and I have been anti-depressant free for 6 years as I now understand and manage the pre period anxiety. I have still never had any investigation into sensitivity (don’t even know if they can test it) and am fast approaching average age of menopause proper. Deep breathing through anxiety has been my way of coping but having a reason was a life saver. It is crimminal that this major event in women’s lives is so under researched and misunderstood.

    1. Hi Elouise. It is so true – just knowing there is a reason behind how you feel helps and lets you manage the emotions. That is why I’m fighting so hard for better menopause awareness in GP offices. Women need to know what is happening to their bodies. Thank you so much for your message xxx

  4. I’m so glad I’ve found this site! There certainly is not enough info for women to make informed choices and for those around us to understand what is happening to us. Because we are female. It feels so wrong.
    I think I’m progesterone sensitive, I had a mirena coil about 5 years ago and i could not tolerate it, I felt awful, so depressed and felt like i just couldn’t live that way. I feel the same now as I’ve started HRT Oestrogen gel and 14 day progesterone. I’m waiting for the end of 14 days to log and reflect how i feel when i stop taking them. It’s horrible. Just feel so awful, can’t stop eating, feel exhausted, irritable, cross, tearful, hopeless.
    I will definitely be a regular visitor to this site.
    I feel strongly about the lack of open conversation about something so natural and the lack of specialist clinics. I don’t have a menopause specialist clinic in my locality or a specialist menopause GP at my surgery. Surely this should be standard?
    We need to lobby to make this a priority for every woman to receive advice and treatment, FREE treatment, to ensure we can live our lives as balanced as possible.

  5. I am sure I have suffered from PMDD all my adult life. I am taking antidepressants and have done most of my adult life. When pregnant I was great! I think I am sensitive to progesterone I tried hormone replacement therapy last year I couldn’t stomach the progesterone part wax extremely anxious depressed and nauseous with 24 hours of taking it. Going through peri menopause is difficult I have just finished periods 2 months but my mood is all over the place nausea hot sweats everything they list almost!! Glad to find this site and the support xx

  6. Thanks for sharing. I am 52 and have been in perimenopause for 5 years. I was on 50m estrogen (estradot) and 100 mg progesterone (prometrium) continuously. Because I’ve had a lot of difficulties with insomnia my doctor suggested I up the dose of prometrium to 200mg daily. Initially my sleep improved but within 3 weeks my insomnia returned along with a marked increase in anxiety and depression. I have felt really low and tired beyond belief. I’m going to reduce the prometrium to 100mg and see if I feel better. I find the support and information doctors provide to be so random and casual. I know everyone responds differently but the care I’ve had is just so haphazard. I do feel super alone with all this. And perhaps due to the 200mg daily progesterone spike I have had 4 monthly periods after years of irregularity. What a waste of energy and nuisance. I wonder if this return to the monthly cycles with weeks of sore breasts is due to the progesterone 200mg? All the best to everyone going through this journey.

    1. Hey Em. Have a word with your GP. It might be that the progesterone is too strong for your body and you need to reduce to 150. But please, persevere and ask x

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