How Do I Know If It’s Time For Progesterone?
Hormone replacement therapy is all over social media - with good reason! Which might leave you wondering, “Is progesterone right for me?” But first, what is progesterone? It’s your “pro-gestation” hormone as it plays a huge role in fertility. However, it also helps you feel calm, sleep better, have easier periods, and reduces PMS. It’s made in the second half of your cycle ONLY after you ovulate (or release the egg). Unfortunately, as we hit perimenopause, we make less and less progesterone. It’s even worse if you’ve gone through menopause or had your ovaries removed!
This means, if you’ve gone through surgical menopause, expected menopause, or are in perimenopause, you can strongly consider supporting your progesterone.
As I mentioned, common symptoms of low progesterone include:
Heavy periods
Clots with periods
Premenstrual syndrome (PMS)
Irritability
Anxiety
Insomnia (can’t fall asleep, can’t stay asleep)
Do you need to test your progesterone first? You can, especially if you’re early in your perimenopausal journey and still have regularly cycles. For example, my own cycles are still regular AND I do still ovulate however on testing I can see my progesterone production over time is declining. That information coupled with the above symptoms are the reason I started progesterone replacement in my luteal phase.
As you move through perimenopause, you might find your cycles become more irregular and therefore it’s not indicated to test progesterone and just go on it based on symptoms alone.
What about more “natural” treatments to support progesterone?
I hear this a lot. Remember, progesterone replacement is considered bio-identical (or body-identical) as it looks like the progesterone you make in your body. The most common pharmaceutical brand is called, Prometrium. It’s a capsule that comes in 100 or 200mg taken at night before bed. There are also various progesterone creams or vaginal progesterone options.
This is different from a progestin. A progestin is a synthetic progesterone. Progestin and progesterone are NOT the same.
However, if you’re thinking about natural supplements for progesterone production, the most common ones are Chaste Tree Berry (Vitex), Evening Primrose Oil, Wild Yam, and Maca Root. While I love many of these products and find they can be extremely helpful, especially in early perimenopause, they don’t seem to work in having the ovaries actually MAKE progesterone as you move further through the perimenopausal transition. Therefore, I often found my patients eventually went on progesterone replacement since ovulation was just not happening anymore.
I have a number of resources to help with this further:
If you want to know what phase of perimenopause you’re in, I have an article here and a youtube video here.
And if you want to know your progesterone options, I have an article here and a youtube video here.