When To Take Progesterone For Perimenopause

Discover the role progesterone plays in your body, what to expect as levels decline, and when to take progesterone for perimenopause.
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Once you hit your forties, you may begin to experience hormonal changes that can impact your physical, emotional, and mental wellbeing. From headaches and irritability to mood swings and night sweats, the symptoms of perimenopause and menopause affect 80% of women.

One of the hormones responsible for perimenopause or menopause symptoms is progesterone.

Discover the role progesterone plays in your body, what symptoms to expect as progesterone declines, and when to take progesterone for perimenopause symptoms.

Side note: you can get free access to this Hormone Restoration Masterclass to reveal what every woman needs to know about hormone restoration but her doctor will never tell her.

Understanding Perimenopause and Menopause

You’ve heard of menopause, the transitioning out of the reproductive years. You officially hit menopause when you’ve gone 12 months without a period. But for years leading up to that day, fluctuating hormones can lead to changes in your menstruation cycle and a myriad of symptoms.

This stage before menopause is known as perimenopause, the first stage of menopause. It’s also referred to as the menopause transition.

Perimenopause, or the menopause transition, can last for years. The average length of perimenopause is 7-14 years.

Race and ethnicity can strongly influence how long women experience perimenopause symptoms. The Study of Women’s Health Across the Nation (SWAN, a multiethnic cohort of 3302 women in midlife in the USA, found that Black women report the longest duration of perimenopause symptoms (10 years) compared with Hispanic women (9 years), non-Hispanic White women (6 years), and Japanese-American women and Chinese-American women (5 years).

For many women, the menopausal transition most often begins between ages 45 and 55.

During perimenopause, levels of two hormones produced in your ovaries, estrogen and progesterone, begin to vary.

What Does Progesterone Do?

Progesterone is a female sex hormone that contributes to menstruation and pregnancy.

Progesterone is released following the release of an egg during the ovulation phase of your menstrual cycle, preparing the body for pregnancy. Progesterone levels will fluctuate during the menstrual cycle. If the egg is fertilized, progesterone levels will remain elevated throughout the pregnancy.

If the egg is not fertilized, progesterone levels will drop, signaling the onset of menstruation.

One of the symptoms of low progesterone is the cessation of menstruation. But this hormone impacts more than just periods and pregnancies—progesterone plays a role in many functions.

Progesterone and Bone Health

Did you know that a pregnant woman has the highest levels of progesterone in the third trimester of her pregnancy, which just happens to be the period when 80% of her baby’s skeleton is mineralized? Progesterone helps with the increased demands of maintaining the bone health of not one but two skeletons during pregnancy: mother and baby.

A growing body of research shows that progesterone protects bone health and density. But as menopause creeps in and progesterone starts its descent, the risk of osteoporosis increases. Progesterone is active in maintaining women’s bone health and osteoporosis prevention.

Progesterone, Brain Function, and Nervous System Health

Progesterone may be known as the pregnancy hormone, but it just as easily could be called the brain and nervous system hormone, as well.

  • Progesterone helps protect your brain from traumatic injury and promotes healing after an injury.
  • Progesterone is essential for optimal fetal brain development.
  • Progesterone protects cognitive function.
  • Progesterone metabolizes into allopregnanolone, which produces calming, anti-anxiety, and possibly enhanced memory effects.

Progesterone and Mood Swings

Your mood can also swing wildly with falling progesterone levels during perimenopause.

Progesterone stimulates the production of GABA, which can help you sleep better, boost your mood, and help you feel relaxed. On the other hand, dropping progesterone levels can lower GABA production, leaving you feeling anxious, sad, or depressed.

Progesterone can also influence emotion processing and is related to the mood symptoms experienced by women with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

Remember that next time you’re feeling inexplicably blue or unusually irritable – it could be the result of declining hormones.

Progesterone, Hot Flashes, and Night Sweats

Female reproductive hormones influence the regulation of your body temperature. Estradiol and progesterone affect thermoregulation, and progesterone plays a role in heat conservation and higher body temperatures.

Changing hormone levels during perimenopause and menopause can cause the part of the brain that controls your body temperature (your hypothalamus) to have trouble regulating body temperature.

Progesterone and Perimenopausal Migraines

Migraines can get really nasty when they strike – like a hammer pounding away inside your skull without mercy. If you’ve been having them frequently after hitting 40s, declining progesterones could be part of the story.

The bad news is this: declining progesterone levels during perimenopause can cause your migraines to increase in both severity and quantity. If you’re having migraines more often than normal, migraines that are more severe than usual, or that are lasting longer, it could be a sign of perimenopause.

The good news is that once you reach menopause and move into the postmenopausal phase, your migraines are likely to lessen in quantity and severity. They may even go away for good.

*While worsening migraines are a sign of perimenopause, changes to your headaches could also signal other medical issues. Please see a medical provider if you have worsening or changing headaches. 

Progesterone and Irregular Bleeding

Irregular bleeding is another telltale sign of waning progesterones during perimenopause. Low progesterone levels have been associated with irregular periods, shortened periods, and spotting.

When to Take Progesterone for Perimenopause

Because progesterone can affect so many systems and processes in your body, the signs of Low progesterone in women who aren’t pregnant can range from:

  • Irregular menstrual periods.
  • Headaches.
  • Mood changes, anxiety or depression.
  • Trouble sleeping.
  • Hot flashes.
  • Bloating or weight gain.

If you are experiencing symptoms that are interrupting with your quality of life, you may want to talk to a healthcare professional about progesterone for perimenopause.

How Is Low Progesterone Treated?

Progesterone is available in a few different forms:

  • Topical creams or gels
  • Cream or gel suppositories
  • Oral pills
  • Injections

Progesterone supplements are low-risk; however, each treatment has side effects and risks. Talk to your healthcare provider to make sure you understand the risks and benefits of progesterone treatment.

Hormone Replacement Therapy for Perimenopause

Many women are turning to hormone replacement therapy (HRT) to help ease the symptoms of perimenopause and menopause. Hormone replacement therapy utilizes synthetic or bioidentical forms of progesterone, estrogen, and testosterone to help restore balance through the menopausal transition.

Synthetic vs Bioidentical Hormones

If you and your healthcare provider determine that hormone replacement therapy could help ease your perimenopause symptoms, you could be prescribed either bioidentical or synthetic hormones.

Bioidentical hormones (such as estradiol, estriol, and progesterone) are made from plant sources and have the same molecular structure as the hormones made by your body.

Synthetic hormones (such as Premarin and Provera) synthetic hormones are made from man-made chemical compounds, like many medications, but do not have the same molecular structure as the hormones in your body. Your body converts synthetic hormones into a usable form.

Proponents of bioidentical hormones claim that they are safer than comparable synthetic versions, while the US Food and Drug Administration and The Endocrine Society say little evidence supports claims that bioidentical hormones are safer or more effective.

One review of published studies found patients reported greater satisfaction with bioidentical hormone replacement with progesterone compared with HRT containing a synthetic progestin. The review concluded that physiological data and clinical outcomes suggest that bioidentical hormones are associated with lower risks and are more effective than their synthetic counterparts.

Talk to your healthcare provider about the pros and cons of bioidentical vs. synthetic hormones to find the right hormone replacement protocol for you.

How Can I Increase My Progesterone Levels Naturally?

You may be able to support healthy progesterone levels naturally by:

  • Eating a healthy diet rich in vitamin C, zinc, magnesium and vitamin B
  • Getting enough sleep
  • Reducing your stress levels and finding ways to stay calm
  • Exercising

Can Progesterone Help with Hot Flashes and Night Sweats?

More than 80% of women in menopause experience hot flashes and night sweats, which are hot flashes that occur at night while you’re sleeping.

study published in the journal Menopause by the Centre for Menstrual Cycle and Ovulation Research found that women taking progesterone for three months found hot flash and night sweat symptoms improved significantly compared to a placebo group.

Can Progesterone Help You Sleep Better During Perimenopause?

You survived the all-nighters of your youth and the years of disrupted sleep that came with parenting babies and young children. Just as you get into the groove of sleeping a full 8 hours a night and enjoying the benefits of feeling rested and energized…

Perimenopause hits and messes with your sleep cycle.

Sleep issues can be frequent during perimenopause and menopause because of changes in hormones. Studies have detected a direct correlation between progesterone and deep sleep. When estrogen and progesterone levels drop, so does the quality of our sleep.

Progesterone has a relaxing, mildly sedative effect. Decreased levels of progesterone in perimenopause can be one reason why your sleep quality suffers during this time. In addition, night sweats and nighttime hot flashes can further disturb your sleep, leaving you feeling chronically exhausted during the day.

Studies suggest that progesterone supplementation can help restore normal sleep patterns when sleep is disturbed.

Safety Considerations for Progesterone Use

Progesterone and other hormone replacement therapy is a medical intervention for menopause. It is not without risk and HRT should be undertaken with the guidance of a licensed medical provider. HRT and progesterone supplementation have been linked to tumors in animal studies and abnormal blood clotting.

Progesterone may make you dizzy or drowsy. It may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position.

Possible Side Effects of Progesterone

The possible side effects of progesterone include:

  • headache
  • breast tenderness or pain
  • upset stomach
  • vomiting
  • diarrhea
  • constipation
  • tiredness
  • muscle, joint, or bone pain
  • mood swings
  • irritability
  • excessive worrying
  • runny nose
  • sneezing
  • cough
  • vaginal discharge
  • problems urinating

Learn more about the possible side effects of progesterone, including severe side effects.


What is progesterone?

Progesterone is an important hormone in your body. It helps regulate menstruation and supports a pregnancy.

What does progesterone do?

Progesterone supports healthy menstruation and pregnancy. It also plays a role in bone health, brain and nervous system function, mood, temperature regulation, and sleep.

What happens to progesterone levels during menopause?

Progesterone levels begin to decline during menopause.

What are the symptoms of low progesterone?

Low levels of progesterone can cause irregular menstrual periods, spotting, headaches, hot flashes, night sweats, mood swings, and disturbances to sleep.

How can I increase my progesterone levels?

Hormone replacement therapy can help restore progesterone levels, as can eating a healthy diet rich in vitamin C, zinc, magnesium and vitamin B, getting enough sleep, exercising, and reducing stress levels.

For an all-encompassing solution to hormone restoration, Dr. Michelle Sands also has an ebook that you can grab for FREE: Hormone Harmony Over 35


Melissa Zimmerman
Melissa Zimmerman is a founding editor at GloWell, a content marketing strategist and wellness writer, and a natural-momma obsessed with nontoxic and natural alternatives to conventional products. When she's not researching, writing, and editing wellness content, she can be found in Northern CA reading a book on the sidelines of her son's soccer games. If you need wellness writing services for your brand, connect with Melissa at www.proseandpurpose.com