Progesterone for Women
Function, Deficiency, and Hormone Support
Progesterone is a critical hormone produced primarily by the ovaries after ovulation (corpus luteum), and in smaller amounts by the adrenal glands and during pregnancy by the placenta. It plays a key role in regulating the menstrual cycle, supporting pregnancy, and balancing the effects of estrogen.
How Progesterone Is Made in the Female Body
- Produced from cholesterol, through conversion to pregnenolone, then progesterone
- Synthesized in the corpus luteum after ovulation in the second half of the menstrual cycle
- Also secreted by the adrenal glands during stress and by the placenta during pregnancy
Progesterone in Perimenopause & Menopause
- Ovulation becomes irregular, leading to insufficient progesterone production
- Estrogen may remain high or fluctuate, creating "estrogen dominance" relative to low progesterone
- In menopause, progesterone production drops to near zero unless supplemented
Effects of Low Progesterone-System Effect of Deficiency
Brain & Sleep - poor sleep quality, insomnia, increased anxiety or worry
Mood & Anxiety - Increased risk of depression, irritability, mood swings
Reproductive System - Irregular periods, heavy bleeding, PMS, infertility
Uterus - Higher risk of endometrial hyperplasia (if unopposed estrogen)
Post-hysterectomy - Still beneficial for sleep, mood, and breast protection
Progesterone Metabolism: Key Pathways
- Pregnenolone → Progesterone →Allopregnanolone:
Neuroactive metabolite that enhances GABA, promoting calm, sleep, and reduced anxiety
- Other pathways include cortisol and aldosterone synthesis
Optimal Dosing & Forms of Progesterone
Oral micronized (bioidentical) - Best for sleep, converts to allopregnanolone in liver
Topical cream - Useful for mood/PMS, bypasses liver metabolism
Vaginal (capsules/gel) - Local uterine effect, fertility support
Typical Dose for Menopausal Support:
- Oral: 100–200 mg at bedtime (micronized, bioidentical)
- Topical: 20–40 mg/day (adjust based on labs and symptoms)
Risks of High Progesterone (Uncommon but Possible)
- Sedation, fatigue
- Dizziness or brain fog
- Breast tenderness
- Bloating
- Depressed mood (rare)
These are usually dose-related or due to metabolic sensitivity and resolve with dosage adjustment.
Summary
Progesterone is a cornerstone hormone in women's health, supporting mood, sleep, cognition, menstrual regulation, and cancer protection. Its decline in perimenopause and menopause can trigger a cascade of symptoms—but when restored safely through bioidentical hormone replacement, it can dramatically improve quality of life.
Even post-hysterectomy, progesterone offers neurological, psychological, and metabolic benefits, making it a key component of balanced hormone therapy when used thoughtfully and monitored with labs.
