A to Z Facts About Progesterone and Perimenopause
15 Jan 2020

A to Z Facts About Progesterone and Perimenopause

Progesterone is a sex hormone that is produced when you ovulate. It is the first hormone level to fall as you enter perimenopause since ovulation becomes more and more sporadic. Because of this, estrogen is allowed to run the show all month, creating perimenopause symptoms like breast tenderness, heavy periods, insomnia, fatigue, mood swings, and anxiety.

Progesterone is typically thought of when it comes to maintaining pregnancy or for protection against uterine cancer when supplemental estrogen is used for hormone replacement. At least that’s how most conventional physicians file it in their mental database.

But there’s more to it than that. What you may not realize is that it has benefits FAR beyond uterine protection and pregnancy maintenance. I get loads of questions about progesterone because there is so much confusion floating around.

There are a lot of myths and misunderstandings about progesterone, so I put together this A to Z list that’s all about the power of this hormone.

A: Anxiety is helped tremendously by progesterone supplementation (unless cortisol is low). It’s a calming hormone and can keep those racing thoughts and worries at bay. 

B: Progesterone has been shown in clinical studies to have a protective effect against breast cancer.

C: Progesterone can be turned into cortisol if your body needs more. This is why some women feel even more agitated and wired after starting progesterone. 

D: Progesterone comes in a number of dosage forms. These include capsules, creams, troches, and oil. Cream and oil are available over-the-counter. Capsules and troches require a prescription.

E: Progesterone increases energy by stimulating the thyroid and increasing metabolism.

F: Progesterone is your “feel-good” hormone. When it drops so does your mood and energy.

G: Natural progesterone can be beneficial with regard to the gut’s healing process. It has anti-inflammatory and anti-stress properties and has been shown to work as a natural relaxant in the GI tract.

H: Many doctors still believe that progesterone isn’t necessary after a hysterectomy. That’s old-school thinking. Progesterone isn’t just about uterine protection, it’s good for a host of other organ systems (as you can see from this list).

I: IUDs don’t contain PROGESTERONE. They contain synthetic PROGESTIN. These products (Mirena and Skylar) do not provide the positive benefits of progesterone and have been associated with a small increase in breast cancer risk.

J: Studies have shown that progesterone replacement has significantly improved pain and other symptoms in patients with bone and joint conditions.

K: Progesterone keeps estrogen under control. Estrogen stimulates growth and progesterone keeps that growth from getting out of control. When ovulation is irregular, estrogen runs the show which results in symptoms of overload (breast tenderness, heavy periods, etc).

L: Progesterone lightens bleeding and can be used to stop flooding periods.

M: The estrogen dominance that is so common during perimenopause can trigger a migraine, due to estrogen’s excitatory nature. Often, progesterone cream is all you need to relieve premenstrual or menopausal migraines.

N: Nerve health. Progesterone improves the integrity and function of cell membranes. In the brain, progesterone receptors help protect nerve tissue.

O: Progesterone is made when you ovulate. No ovulation=very low progesterone and increased symptoms of estrogen dominance.

P: PROGESTIN is not progesterone. It is a fake progesterone and is synthetic. It does not have the positive benefits of progesterone. It WILL slow down heavy bleeding but will not do all of the other awesome things on this list!

Q: Because it gets into the brain, progesterone helps quiet anxiety.

R: Low progesterone can cause a rapid heartbeat. Any heart rhythm abnormalities should be checked out to make sure it’s not something serious, but supplementing progesterone may kick palpitations to the curb.

S: Progesterone has few side effects and is very safe. The most common side effect is drowsiness and occasionally, depression.

T: Progesterone therapy is best tested using blood spot. It will not show up accurately in blood tests, urine or saliva. 

U: Uterine protection. Progesterone is used to counteract the effects of estrogen therapy in women who still have a uterus. This decreases the risk of uterine cancer. 

V: Vaginal dosing of progesterone is another alternative to oral or topical forms. It’s very well absorbed using this route.

W: Because progesterone raises body temperature slightly, it can be helpful for weight loss.

X: Xenoestrogens. These are fake estrogens found in the environment (think plastics and pesticides). Progesterone can help counteract the effects of these compounds.

Y: Yams (as in wild). Diosgenin is a substance found in wild yams and it is the starting compound for USP progesterone. The conversion to progesterone cannot be done by the body, so it’s done in a lab. The resulting hormone is bioidentical, which means it is the exact chemical structure as progesterone from the ovaries.

Z: ZZZs! Insomnia is a very common sign of low progesterone. Supplementing with oral progesterone capsules is very helpful for many women who struggle with lack of sleep.

What you may not realize is that Progesterone has benefits FAR beyond uterine protection and pregnancy maintenance. #progesterone #perimenopause #hormones #anxiety #insomnia #estrogen #BHRT #BioidenticalHormoneReplacementTherapy Click To Tweet

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at www.perimenopausebook.com.

Dr. Anna is available for 1-1 consultations. Find out more at www.drannagarrett.com/lets-talk

Dr. Anna Garrett


  1. Fantastic information Anna! I also recently learned that Progesterone helps with managing mast cell production for women with Interstitial Cystitis. It really has so many benefits!

  2. Amber Stout Says: January 16, 2020 at 8:54 am

    Is it ok to supplement without a dr permission? I have all the symptoms of low progesterone but no dr will acknowledge it.

    • Hi, I generally recommend knowing where your levels are since many symptoms can overlap. For example, fatigue can be from low progesterone, low cortisol or hypothyroidism. And BTW, it is good to let your doctor know what you’re doing…but you don’t need permission.

  3. Can progesterone be acquired over the counter? And what is a blood spot test?

  4. Thank you for this article! Are there any particular natural creams you would recommend or suggest trying?

    • There are a number of brands available. As long as the label says USP progesterone, it should be fine. It really boils down to the consistency of the cream and whether it rubs in effectively on your skin.

  5. Julianne PAULI Says: January 23, 2020 at 11:44 pm

    I had a complete hysterectomy and I suffer from from hot flushes and insomnia. My question is which would be better for me progesterone cream or pill

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