Progesterone: More Than Just a Reproductive Hormone

When we talk about hormones during perimenopause, oestrogen often gets most of the attention. But progesterone deserves a much bigger part of the conversation.

Progesterone is often one of the first hormones to become less reliable during perimenopause. This is largely because progesterone is produced after ovulation. As ovulation becomes less consistent, progesterone production can become less consistent too — sometimes years before periods finally stop… at 42 I’m already noticing changes.

And the crux is - progesterone does far more than simply balance oestrogen.

Why progesterone matters

Progesterone has a calming influence on the brain and nervous system. One of its metabolites, allopregnanolone, interacts with GABA receptors in the brain, which can influence feelings of calm, relaxation and sleep.

This is one reason lower or fluctuating progesterone during perimenopause may be associated with symptoms such as:

• Anxiety or feeling more on edge

• Irritability

• Difficulty switching off

• Poor sleep

• Waking during the night

• Increased premenstrual symptoms

Progesterone also has important interactions with the immune system.

This becomes particularly interesting during perimenopause and menopause, when we can see changes in immune regulation and, in some women, the emergence or worsening of autoimmune conditions.

Progesterone generally has immune-modulating and anti-inflammatory effects. While low progesterone isn't the cause of autoimmune disease, supporting healthy hormone balance may be one piece of the puzzle when we're looking at inflammation, immune regulation and conditions such as Hashimoto's.

Can we naturally support progesterone?

We can't stop the natural hormonal transition of perimenopause, but there is often plenty we can do to support and preserve the progesterone your body is still capable of producing.

Because progesterone depends on ovulation, supporting healthy ovulatory cycles while they're still occurring is important.

That may mean looking at multiple areas in the body that is contributing to inflammation in particular…

Stress is particularly important. Your reproductive system doesn't operate separately from the rest of your body. When the body is under significant or prolonged physiological stress, reproductive hormone signalling can be affected.

Sometimes the best way to support hormones isn't to chase the hormone itself — it's to improve the environment in which those hormones are being produced.

And sometimes natural support isn't enough

I'm a naturopath, but that doesn't mean I believe everything needs to be managed naturally at all costs.

Progesterone isn't appropriate for every woman, and individual medical history and symptoms always matter.

For the right woman, it can be a very useful option, similarly in the wrong body it can cause or worsen symptoms.

The goal isn't to choose between "natural" and "medical" care.

It's to understand what your body is doing, support what we can naturally, and use additional options when they're genuinely needed.

Perimenopause doesn't have to be about simply putting up with changing hormones. Sometimes a little more support — in the right places — can make this transition feel very different.

Natasha Gedrim (BHSc Nat)

Thyroid and Hormone Naturopath