29 Aug 2013

The Power of Progesterone

It’s time to talk about progesterone. This magical hormone is Snow White to the 7 Dwarves of menopause (Itchy, Bitchy, Bloaty, Sleepy, Sweaty, Forgetful and Psycho). She keeps them cool, calm and collected. Despite her role as Best Supporting Actress, she’s probably the most ignored of the bioidentical hormones.

So what’s progesterone?  It is the hormone that a woman’s ovaries produce in the second half of her menstrual cycle.  In the first 14 days of the cycle, estrogens are large and in charge! They grow the cells of the uterus to prepare it for implementation of a fertilized egg.  At day 14, presumably when ovulation occurs, estrogen production wanes and progesterone kicks in.  Progesterone’s job is to slow down the growth of the endometrial cells and to develop their function.  If you become pregnant and a fertilized egg implants itself, progesterone levels will continue to rise.  If not, progesterone drops signaling the start of menstruation and the whole process starts over again.

So, progesterone slows the growth of cells stimulated by estrogen and develops their function.  But progesterone does a whole lot more.  Progesterone receptors are located in the blood vessels, the liver, breast tissue, the bone, and the brain, and the hormone has an important influence in the functioning of all those parts of the body.

But here’s the thing.  Most of your progesterone is produced by the ovaries. That means, when your ovaries slowly wind down their functioning through the menopausal years, progesterone production slows down right with it.  If you’re not ovulating, you’re not making progesterone. Period.

Estrogens, however, can be produced by other cells in the body besides the ovaries, namely fat cells that convert testosterone into estrogens.  Plus, we are all exposed to compounds in the environment that act like estrogen in our bodies (xenoestrogens). You can read about that here.

So, during perimenopause, progesterone is dropping but estrogens may not be, leading to a condition called estrogen dominance.  This basically means that you don’t have enough progesterone to balance out the activity of the estrogens still floating around in the blood stream, not to mention the fact that you don’t have as much progesterone to have all of its beneficial effects on the blood vessels, bone, brain, etc. Estrogen dominance causes all kinds of symptoms such as:

  • Depression
  • Anxiety
  • Panic attacks
  • Aching body and joints
  • Fatigue
  • Breast tenderness
  • Decreased sex drive
  • Mood swings
  • Allergy symptoms
  • Insomnia
  • Weight gain
  • Water retention
  • Hair loss
  • Migraines
  • Heavy periods and bad cramps

Does any of this sound familiar?   Welcome to perimenopause! So what’s the medical community been giving to women who complain of these symptoms since the 1950’s? Estrogen and antidepressants! This makes no sense. They likely need progesterone.

I have worked with dozens of women with perimenopausal and postmenopausal symptoms and 90% of them have some level of estrogen dominance on their hormone tests. So progesterone is the key.  And the best part is that bioidentical progesterone is safe, easy to use and often resolves symptoms without the need for much estrogen, if any.

And p.s…if you don’t have a uterus, you STILL need natural progesterone! You don’t need synthetic progesterone (Provera®) which affects only your uterus, but doesn’t give you all the other goodies that go along with the natural form.

As always, I welcome your comments and questions.

Dr. Anna Garrett


  1. […] don’t let your doctor tell you that you don’t need progesterone. You have progesterone receptors all over your body (not just in your uterus). They need love […]

  2. […] also helps with bloating and many of the mood-related symptoms of perimenopause. You can read more about the power of progesterone […]

  3. Dena Smith Says: November 17, 2017 at 9:02 pm

    I am 63 years old. I had a complete hysterectomy at 50. My PCP won’t give me anything and I’m having terrible symptoms. Hot flashes are killing me. Along with other things. Will natural progesterone help me? Thank you so much.

    • Hi Dena…I know how frustrating that must be! Progesterone may help…worth a try and is available over the counter. You may need estrogen replacement as well. It may be worth scheduling a consultation with me to talk through more specifics.

  4. I am 48 years old, lately my breasts are constantly feel swollen, heavy and painful. What kind of progesterone is the best? How much do use and how do I use it? I had a naturopathic doctor tell me to use it vaginally. Is this the best way?

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