Benefits of Progesterone During and After Menopause

Menopause is a natural phase of life, but it can be challenging due to changes in hormone levels that can create intense symptoms. In hormone replacement therapy (HRT), estrogen is the primary hormone used to treat menopause symptoms, while progesterone is usually added to help balance estrogen. For women with a uterus, a combination of estrogen and progesterone is prescribed to maintain uterine health and prevent endometrial hyperplasia — an overgrowth of cells in the lining of the uterus, which can lead to cancer. 

Using progesterone by itself is uncommon and typically not needed without estrogen. However, some women are unable to receive estrogen therapy and, in specific cases, may be candidates for progesterone supplementation on its own.

Progesterone Levels & Menopause

Progesterone’s main job is to prepare the body for a possible pregnancy during the reproductive years. But that’s not all progesterone does; it also regulates numerous hormonal events in the body and is key to balancing estrogen.⁽¹⁾⁽²⁾

Progesterone During Perimenopause

During perimenopause, the body drastically reduces the production of both estrogen and progesterone. Eventually, menstrual periods stop entirely. While some women may appreciate the absence of periods, other side effects, like hot flashes and vaginal dryness, can be less welcome.⁽²⁾

Progesterone After Menopause

As the menopause transition progresses and eventually completes, hormone levels remain low, leading to various issues like sleep disturbances, mood changes, and memory loss. Combined progesterone and estrogen HRT can help manage these symptoms and improve overall well-being.⁽²⁾

Symptoms of Low Progesterone Levels in Menopause

During the menopause transition, the ovaries reduce the production of reproductive hormones. This causes women to experience a wide variety of changes due to low levels of estrogen and progesterone. These symptoms may include the following:⁽²⁾⁽⁴⁾

• Migraines

• Weight gain

• Cognitive decline

• Hot flashes and night sweats

• Vaginal dryness and changes 

• Sleep disturbances and disorders

• Mood changes, anxiety, and depression

Benefits of Progesterone Therapy in Menopause

Progesterone replacement therapy offers several benefits for women during and after menopause, including the following:

• Mood Improvement & Anxiety Relief: Progesterone acts as a natural antidepressant and anti-anxiety hormone. Restoring progesterone levels can help reduce irritability, nervous tension, and panic attacks.⁽⁴⁾⁽⁵⁾

• Better Sleep: Progesterone helps improve the quality of deep sleep and reduces night sweats.

• Increased Longevity: By addressing hormonal

  imbalances, combined estrogen and progesterone HRT may help slow the aging process by protecting the skin from signs of aging and maintaining bone density, muscle mass, and cognitive function.^(1)(4)(6)(9)

• Disease Prevention: Bioidentical progesterone may lower the risk of certain cancers (e.g., uterine and colon) and support long-term cognitive health, though more research is still needed.^{(1)(2)(3)(4)(9)(10)}

When to Take Progesterone for Perimenopause

Progesterone therapy, along with estrogen, should ideally start at the beginning of the menopause transition. For women with a uterus, progesterone is prescribed together with estrogen to prevent excessive growth of the uterine lining. While progesterone is an important part of hormone balance, it’s rarely used alone. 

The benefits of combining progesterone with estrogen before, during, and after menopause may vary. However, in most cases, women start to feel better soon after starting HRT. For women over 60 years old or those who have been menopausal for more than 10 years, it’s advisable to weigh the pros and cons with a healthcare provider, as progesterone therapy may not be suitable.⁽¹⁾⁽⁴⁾ 

Are there side effects of progesterone treatment?

Side effects from progesterone HRT are rare, but some women may experience these symptoms:⁽⁴⁾⁽⁷⁾

• Fatigue

• Weight gain

• Nausea

• Fluid retention

• Vaginal bleeding

• Headaches and dizziness 

• Allergic reactions (in extreme cases)

• Breast cancer (in rare cases)

These side effects are highly unlikely at the doses prescribed by healthcare professionals, but it’s always wise to consult a doctor before starting any new treatment.

Balancing Progesterone

Understanding when progesterone might be appropriate and how progesterone levels fluctuate during menopause is crucial for managing symptoms effectively. Hormone replacement therapy remains a widely recommended approach, especially for those experiencing symptoms of low estrogen and progesterone during the menopause transition. 

Starting HRT early in menopause, when appropriate, can help alleviate common issues linked to hormonal changes. However, progesterone levels can vary from perimenopause to the end of menopause, and personalized treatment is important to address individual needs. It's always essential to consult with a healthcare provider to determine the best course of action, especially if there are factors like age, time since menopause onset, and medical history to consider.