Progesterone, a crucial hormone in the female reproductive system, plays a vital role in regulating the menstrual cycle, pregnancy, and overall hormonal balance. Many women, especially those experiencing hormonal imbalances or menopausal symptoms, turn to progesterone supplementation. But, a common question arises: Should progesterone be cycled, or should it be taken continuously?

Understanding Progesterone’s Role

Progesterone works in harmony with estrogen to maintain hormonal balance. During the menstrual cycle, progesterone levels rise after ovulation to prepare the uterine lining for potential pregnancy. If pregnancy doesn’t occur, progesterone levels decline, leading to menstruation. Progesterone also falls as ovulation becomes more irregular in perimenopause. This leads to symptoms like anxiety, insomnia, heavy periods, weight gain, and mood swings.

We also now know that progesterone is made the first 2 weeks of the cycle by enzymes throughout the body, especially in the adrenal gland.

The Case for Cycling Progesterone

Some experts advocate for cycling progesterone to mimic the natural fluctuations of the hormone cycle. This approach involves taking progesterone for a specific period (generally, days 14-26 of the cycle) followed by a hormone-free interval until the next luteal phase.

Benefits of Cycling Progesterone

• Reduced Risk of Side Effects: Cycling progesterone may help minimize potential side effects like mood swings, breast tenderness, and weight gain, which can sometimes occur with continuous use.
• Enhanced Natural Hormone Production: By allowing the body’s natural hormone production to take over during hormone-free periods, cycling may stimulate the body’s own hormone production.
• Improved Ovulation: In some cases, cycling progesterone can help regulate ovulation and improve fertility.

The Case for Continuous Progesterone

Other experts recommend continuous progesterone use, particularly for women experiencing menopausal symptoms like hot flashes, night sweats, or insomnia.

Benefits of Continuous Progesterone

• Consistent Symptom Relief: Continuous use can provide consistent relief from menopausal symptoms, leading to better sleep quality and overall well-being.
• Reduced Risk of Endometrial Cancer: Progesterone helps protect the uterine lining, reducing the risk of endometrial cancer, especially when combined with estrogen therapy.

Factors to Consider

The decision to cycle or use progesterone continuously depends on various factors, including:

• Age: Younger women may benefit from cycling to mimic natural hormone fluctuations, while older women, especially those postmenopausal, may prefer continuous use for consistent symptom relief.
• Symptoms: The severity and type of symptoms can influence the choice of regimen. For example, women with severe hot flashes may benefit from continuous use.
• Medical History: Underlying health conditions, such as uterine fibroids or endometriosis, may impact the decision.
• Individual Response: Each woman’s body responds differently to progesterone, so it’s important to work with a healthcare provider to determine the best approach.

The Bottom Line

Cycling vs. not cycling progesterone is a topic of hot debate. Ultimately, the decision on how to dose this hormone depends on the individual woman. I took progesterone continuously when I was perimenopausal because I needed it for sleep. And sleeping only 2 weeks out of the month was unacceptable to me!

Science and our understanding of hormones continue to evolve. If your prescriber says there’s only one way to do it, look for a more informed healthcare provider.

References

• National Institute on Aging: https://www.nia.nih.gov/health/menopause
• Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401

Remember, this information is intended for educational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional for personalized guidance.