Hormone SERIES Progesterone 1 of 2

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Dr. Aaron Hartman

March 15, 2022

Woman working under stress holding head

When I began studying medicine in 1996, I was told that after a woman had a hysterectomy or went through menopause she no longer needed progesterone. It was thought that estrogen was the only important sex hormone for women. We now know that to be antiquated thinking; progesterone is a key hormone with many functions in women’s health. However, that outdated thinking has remained to this day, and progesterone is still commonly overlooked.


Why is Progesterone So Important?

Let’s start today talking about benefits of progesterone in a healthy female. First and foremost, progesterone has many functions in the body.

  • Promotes healthy sleep
  • Lowers cortisol
  • Helps bone strength
  • Prevents anxiety
  • Supports mood stability
  • Helps with bladder function
  • Lowers breast cancer risk
  • Fights inflammation
  • Thickens hair on the scalp
  • Improves metabolic rate for healthy weight
  • Improves immune function

Progesterone’s role in lowering cortisol is so important for quality sleep and stress management. Bone health, mood support, immune function, hair health and even metabolism rely on healthy levels of progesterone.
Estrone (E1) is converted to a safer, inactive form of E1 sulfur by progesterone. This is important because other metabolites (breakdown products) of estrone can be cancer-causing and inflammatory; progesterone helps prevent the creation of these metabolites.

Progesterone Decline

When women are in their early 30s, progesterone levels begin to decline. In their 40s, progesterone drops further and then falls off sharply after menopause.
Progesterone decline actually begins before estrogen, so many hormonal side effects and symptoms women feel are actually due to progesterone insufficiency – and later deficiency.
In the past, we’ve been hyper-focused on estrogen. However, now we know that estrogen and progesterone must balance each other. Ignoring one and treating the other in isolation will create hormone dysregulation and imbalance.
Lower progesterone levels are a natural part of aging. To keep hormones in a healthy balance as we age, we need to focus on gut health, thyroid health, sugar regulation, stress reduction, and appropriate nutrition. While progesterone, and other sex hormones, will still naturally decrease, all of these health and lifestyle factors will help maintain hormonal balance.
You can have lower levels of hormones, still feel great, and have vibrant health, if your hormones are balanced.

Symptoms of Progesterone Deficiency

These symptoms will sound all too familiar to many women out there who are experiencing hormone imbalance:

  • Anxiety
  • Low libido
  • Heavy periods
  • Insomnia
  • Irritability and hypersensitivity
  • Migraine headaches (especially during a woman’s cycle)
  • Mood swings
  • Nervousness
  • Bone thinning (osteopenia)
  • Weight gain
  • Pain
  • Inflammation

One misconception about hormonal health that I often see is that only estrogen is involved in bone health. However, estrogen and progesterone in balance are both critical for healthy, strong bones.
Low progesterone – not low estrogen – is one of the reasons why women begin experiencing heavier periods either after pregnancy or as they age.

What Causes Low Progesterone?

  • Some pharmaceutical medications
  • Hypothyroidism
  • Nutrient deficiencies
  • High saturated fat intake
  • Stress
  • High sugar diet

Certain medications can cause progesterone deficiency. For example, antidepressants can cause your progesterone to be low. This is unfortunate because antidepressants are often given to woman to help with anxiety, which is induced by low progesterone. So, when we give women an SSRI like Zoloft or Prozac, we can actually cause a feed forward cycle and make a hormone deficiency worse by further lowering progesterone.
Hypothyroidism can cause low progesterone, as well as certain nutrient deficiencies such as vitamin A, vitamin B6, vitamin C, and zinc
In some women, eating too much saturated fat can cause low progesterone. However, I’d like to add a caution here since many of us have been taught for years to avoid fat. We do need some saturated fat in our diet and inadequate amounts can also affect our hormones.

Addressing Low Progesterone or Progesterone Imbalance

The best place to begin in addressing a progesterone imbalance is to work on general health and resilience. We put together multiple resources on these topics on our website including our blog, food plans, and a recommended reading list.
Ultimately, for optimal hormonal health, you need a full-spectrum view of your health with a wider perspective. We can’t just focus on thyroid, or ovaries, or on one specific system in isolation. Each person is a complete whole and more than just the sum of the parts.
Thinking about someone as an individual gives you a better perspective on addressing their health.

Next time

In our next post on progesterone, we’ll take a little deeper dive into current therapies and treatments for progesterone deficiency. We’ll discuss how some popular therapies can actually cause more hormonal harm, and then we’ll talk about some recommendations for longer-term progesterone balance.
Take care and be well.
Since 2010, Richmond Integrative and Functional Medicine has been helping people to restore their health and hope with an integrative approach to conventional and alternative medicine that’s entirely science-backed. We at RIFM believe everyone is made for health. We offer a comprehensive, in-person patient membership program to ensure you get access to the care you need to thrive.


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