What role does progesterone play during menopause?

The sex hormone progesterone, oestrogen's sister hormone, begins to decline even before perimenopause, the first stage of menopause. This drop can cause all kinds of changes in the female body. Understanding progesterone's role, the symptoms of low progesterone and the benefits of progesterone hormone therapy, can help make menopause less overwhelming.

What does progesterone do?

Progesterone is produced by the ovaries, the adrenal glands and, during pregnancy, the placenta. During your childbearing years, progesterone's main task is to help maintain a healthy pregnancy and create a good environment for a fertilised egg to implant by thickening the uterine lining.  

But progesterone does more than that. It also plays a role in balancing oestrogen levels, helps your thyroid to work optimally, keeps your body warm, has a soothing effect and helps to remove excess fluid from your body.  

How do progesterone and oestrogen work together?

Progesterone and oestrogen work together during your cycle to keep everything in balance. Oestrogen stimulates the uterus to build up extra tissue. After ovulation, the ovaries also produce progesterone to further thicken the lining of your uterus to prepare it for pregnancy. If pregnancy does not occur, progesterone levels fall and the menstrual cycle begins.  

Did you experience PMS symptoms during your childbearing years? Then you're probably familiar with the effects of oestrogen and progesterone imbalances. Before menstruation, progesterone levels drop sharply, which causes typical PMS symptoms such as mood swings, irritability and fluid retention, or causes these symptoms to get worse. Low levels of progesterone can also cause weight gain, sore breasts or breast swelling. Read more here about oestrogen's role during menopause. 

Progesterone and the stages of menopause

As you know, the production of oestrogen and progesterone decreases during the transition time before menopause. Progesterone levels begin declining when a woman is in her late 30s or early 40s. As perimenopause progresses, this decline triggers the menstrual cycle to become irregular.  

Once your period has been absent for more than one year, you are in postmenopause. By now progesterone production from the ovaries has almost stopped completely and is taken over by other organs, such as the adrenal glands and fat tissue, albeit in smaller amounts. During this stage, the body reaches a new hormonal balance and progesterone levels are consistently low. The female body still needs progesterone, but not as much as before menopause. 

What are the symptoms of low progesterone?

During perimenopause, progesterone levels drop faster than oestrogen levels, causing an oestrogen dominance effect in the body. This can cause various symptoms, the most common ones being hot flashes, mood swings and weight gain.  

As the body reaches menopause the ovaries stop producing progesterone. Progesterone production is then solely relegated to the adrenal glands. The adrenal glands also secrete other hormones, including the stress hormone cortisol. Cortisol has priority over everything. This is because, from an evolutionary perspective, raising cortisol (in response to stress) enabled us to escape danger. This mechanism is still intact: when you're stressed, the adrenal glands will 'steal' progesterone to make the stress hormone cortisol. This can make menopause symptoms worse. 

What are signs you may have low progesterone?

When produced in sufficient amounts, progesterone's effect on the brain is to increase a sense of calm, relaxation and positivity. Signs of low progesterone during menopause are: 

• Mood swings 
• Low mood 
• Shorter menstrual cycles 
• Restlessness 
• Sleep problems  
• Anxiety 
• Night sweats 

What can you do?

Making adjustment to your diet and lifestyle and including daily exercise into your routine can help alleviate menopausal symptoms. Here are some tips to get you started. 

• Eat a balanced diet. Eat plenty of fruit, vegetables, whole grains, healthy fats (such as avocados, nuts, and seeds), and protein to support hormonal balance.  
• Keep your cortisol levels low. Reduce stress so your adrenal glands can focus on producing progesterone. Relaxation techniques, such as yoga, meditation or breathing exercises, have a proven positive effect on reducing tension, stress and anxiety. Take breaks more often, and carve out time for relaxation and leisure activities.  
• Exercise daily. Be active each day, even if that just means taking a short walk or using the stairs instead of the elevator. Our advice? Make sure you get at least 30 minutes of physical activity a day. Exercise not only reduces stress, but it also stimulates the production of various hormones, including ‘happy hormones’ called endorphins.  
• Consider taking a herbal supplement for extra support. Monk's pepper, in supplements like Solgar® Herbal Female Complex, can support menopausal health. It's especially beneficial for women who still have periods. 

* Health claim pending approval by the European Commission. 

Can hormone therapy help?

Hormone therapy is an effective treatment for the relief of mild to severe symptoms of menopause. Which form of hormone therapy (composition and dosage form) is right for you depends on your symptoms, medical history and what menopause stage you are in. Read more about hormone therapy.  

Progesterone hormone therapy can be helpful in women with: 

• Progesterone deficiency. Progesterone-only HRT can help with symptoms such as irregular periods, sleep problems and mood swings, especially in perimenopause and postmenopause, when progesterone levels decline naturally or are consistently low. If progesterone (e.g., Utrogestan) is used to treat sleep problems, it's best to take it an hour before bedtime.  
• An intact uterus. In women with an intact uterus, hormone therapy comprising oestrogen and progesterone is desirable to minimise the risk of endometrial hyperplasia (a condition where the lining of the uterus is abnormally thick). Oestrogen stimulates the mucous membrane that lines the uterus, while progesterone helps to maintain balance.  
• Irregular cycles. Progesterone can help regulate the menstrual cycle and treat unusual stopping of menstrual periods. 

Via SeeMe-nopause, you can get medical help from the comfort of your home. Simply choose your preferred medication and a doctor will review your order to ensure the medication you want to order meets your needs. 

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