Progesterone replacement in perimenopause

Sleep, cycle, peace of mind.

1. What happens hormonally in perimenopause?

• Estrogen levels can fluctuate strongly and are sometimes elevated
• Progesterone decreases

This happens because ovulation becomes irregular or sometimes doesn't occur at all. Without ovulation, little progesterone is produced. Progesterone usually declines earlier than estrogen.

2. Why would you take progesterone?

Protection of the uterine lining

If estrogen continues to work without sufficient progesterone, the uterine lining can become too thick. This can lead to:

• Heavy or irregular bleeding
• In the longer term, an increased risk of abnormalities of the uterine lining

Progesterone helps to keep the uterine lining balanced and protected.

A calmer bleeding pattern

Progesterone replacement can contribute to:

• Less heavy or unpredictable bleeding
• More regularity in the cycle
• Fewer breakthrough bleedings

Effect on mood and mental state

Progesterone works not only in the uterus but also in the brain. It can:

• Reduce anxiety and inner restlessness
• Make stress more manageable
• Have a mood-improving effect in some women

Improvement of sleep

One of the most valued effects of progesterone is its influence on sleep:

• Falling asleep faster
• Less waking up at night
• Deeper, more restorative sleep

Reduction of breast tension

Progesterone can also help with:

• Reducing estrogen-related breast tension
• Less "swollen" or painful feeling in the breasts

3. Progesterone without estrogen?

In early perimenopause, progesterone can often provide sufficient support, without directly adding estrogen.

It can be used as the sole therapy for:

• Sleep problems
• Anxiety or inner restlessness
• Heavy or irregular bleeding

Sometimes estrogen actually worsens symptoms during this phase. Progesterone can then help to first restore calm and stability.

Progesterone can be used:

• Cyclically (two weeks per month)
• Or continuously

This information is intended solely for educational and informational purposes. It does not replace medical advice, diagnosis, or treatment by a doctor or other qualified healthcare provider. Always consult your (family) doctor if you have questions or concerns about your health or treatment.