The Essential Role of Progesterone in Perimenopause

And why it’s not just for making Babies

Progesterone is a hormone primarily produced in the ovaries that plays a vital role in the female reproductive system. Once ovulation occurs, the ruptured follicle transforms into a structure known as the corpus luteum, which is responsible for progesterone production. It helps prepare the uterus for pregnancy, supports early pregnancy stages, and prevents the shedding of the uterine lining. Progesterone levels fluctuate throughout the menstrual cycle, regulating menstruation. It also affects breast development, mood, brain function and bone health.

Progesterone production is important during perimenopause for several reasons:

1. Hormonal Balance: Progesterone works in harmony with estrogen to maintain hormonal balance in the female body. During perimenopause, estrogen levels fluctuate, sometimes becoming elevated in relation to progesterone. This hormonal imbalance can lead to various symptoms, such as irregular menstrual cycles, mood swings, hot flashes, and sleep disturbances. Adequate progesterone production helps counterbalance estrogen's effects and maintain body stability.

2. Menstrual Regulation: Progesterone plays a crucial role in regulating the menstrual cycle. It prepares the uterus for pregnancy and helps maintain a regular menstrual pattern. As a woman approaches menopause, her ovaries gradually produce less progesterone, leading to irregular or skipped periods. Promoting its natural production can help regulate the menstrual cycle and reduce associated symptoms.

3. Uterine Health: Progesterone helps maintain the health of the uterine lining, known as the endometrium. It counters the effects of estrogen on the endometrium, preventing its overgrowth, which can increase the risk of abnormal cell growth, such as endometrial hyperplasia or even cancer. In perimenopause, as progesterone levels decline, the unopposed estrogen can cause a thickening of the endometrium. Adequate progesterone production can help protect the uterine lining and reduce the risk of endometrial abnormalities.

4. Nervous System Support: Progesterone has a calming effect on the central nervous system and can help alleviate symptoms such as mood swings, anxiety, and irritability that often accompany perimenopause. It also supports healthy sleep patterns and can aid in reducing insomnia and night sweats.

5. Bone Health: Progesterone stimulates bone formation, balances estrogen levels, protects against bone loss, and enhances calcium absorption. Progesterone works in harmony with estrogen to maintain bone density and strength.

Perimenopause is a time that hormones are fluxing wildly, but some of the common symptoms of low progesterone are:

1. Irregular menstrual cycles: Perimenopause often changes the frequency and duration of menstrual periods. Low progesterone can contribute to irregular or skipped periods.

2. Heavy or prolonged periods: Some women may experience heavier or longer menstrual bleeding due to hormonal imbalances, including low progesterone.

3. Mood swings and irritability: Fluctuating hormone levels, including low progesterone, can contribute to mood swings, increased irritability, anxiety, or even depressive symptoms.

4. Insomnia or disrupted sleep: Hormonal changes can disrupt sleep patterns, leading to difficulty falling asleep or staying asleep throughout the night.

5. Hot flashes and night sweats: While hot flashes and night sweats are commonly associated with declining estrogen levels, low progesterone can also contribute to these symptoms during perimenopause.

6. Vaginal dryness and discomfort: Decreased progesterone levels can lead to changes in vaginal lubrication, resulting in vaginal dryness, itching, or discomfort during intercourse.

7. Decreased libido: Low progesterone levels can contribute to a decrease in sex drive or changes in sexual function.

8. Fatigue and low energy: Some women may experience fatigue, low energy levels, or a general sense of lethargy due to hormonal imbalances during perimenopause.

Perimenopause often brings about many physical and emotional changes, leaving many women seeking relief from symptoms such as heavy bleeding and painful periods. However, it is crucial to challenge the notion that a hysterectomy should be the first line of treatment in such cases and, in many circumstances, what can be suggested if seeing a medical doctor. It may be a viable solution for specific conditions, but it is essential to explore a broader range of options before considering such a drastic measure. It’s important if you are experiencing painful heavy periods that you work with a healthcare practitioner to find the root cause of the problem and treat accordingly, not just refer for a total hysterectomy, job done.

And for the women that are annoyed, irritated or just plain sick of having your monthly bleed, I invite you to view it in a different light. Not to sound too ‘woo-woo’, but we as women are magical creatures, and our hormones ebb and flow like the Luna cycle. OUR CYCLES ARE NOT THE SAME AS MEN'S. So I invite you to stop, rest and prioritise yourself during your bleed, nourish with whole foods, sleep in and don’t even think about vacuuming those floors. Embrace your feminity; it’s what we are designed to do.

Embrace your femininity. it’s what we are designed to do.

Nutrition and progesterone

Nutrition is crucial in supporting progesterone production by providing the necessary building blocks and cofactors for hormone synthesis. One of the best ways to naturally increase progesterone is to focus on diet and lifestyle strategies to support healthy, strong ovulation. Here’s what to include in your diet:

1. Cholesterol: Progesterone is derived from cholesterol, a type of fat. Consuming sufficient amounts of healthy fats, such as avocados, nuts, seeds, olive oil, and fatty fish, ensures an adequate supply of cholesterol for hormone production.

2. Micronutrients: Certain vitamins and minerals are involved in the biochemical pathways that convert cholesterol into progesterone. For example:

   • Vitamin C: Vitamin C is necessary for the enzyme that converts cholesterol to progesterone. Including citrus fruits, strawberries, bell peppers, and broccoli in your diet can provide vitamin C.

   • B vitamins: B vitamins, including vitamin B6, are involved in hormone synthesis. Consuming foods like whole grains, fish, poultry, bananas, and leafy green vegetables provide these essential nutrients.

   • Magnesium: Magnesium is needed to produce and regulate hormones, including progesterone. Dark leafy greens, nuts, seeds, whole grains, and legumes are good sources of magnesium.

3. Blood sugar balance: Blood sugar imbalances can affect hormone production. Consuming a balanced diet that includes complex carbohydrates, lean proteins, and healthy fats helps maintain stable blood sugar levels, which supports overall hormone balance.

4. Phytoestrogens: Some plant-based compounds, known as phytoestrogens, have estrogen-like effects in the body and can indirectly support hormonal balance. Phytoestrogen-rich foods include soy products, flaxseeds, chickpeas, and lentils.

Progesterone will eventually decline, but it’s important to keep producing it for as long as possible for the benefits and protective effects. Nutritional medicine can play a significant role in alleviating perimenopause symptoms, while registered nutritionists can help support you in reducing cardiovascular risk and support you in maintaining metabolic and bone health.

If you need support, you can book a free discovery call here, or if you are ready to dive in, you can look at the services I have here.

References

Serum Antioxidants Are Associated with Serum Reproductive Hormones and Ovulation among Healthy Women PMID: 26581679

The Role of Zinc in Selected Female Reproductive System Disorders https://doi.org/10.3390/nu12082464

The Role of Estrogen in Insulin Resistance: A Review of Clinical and Preclinical Data https://doi.org/10.1016/j.ajpath.2021.05.011

The Relationship Between Bone and Reproductive Hormones Beyond Estrogens and Androgens https://doi.org/10.1210/endrev/bnab024

Menstrual cycle rhythmicity: metabolic patterns in healthy women https://doi.org/10.1017%2FS0007114518000818