Why Progesterone Matters

• Polycystic ovary syndrome (PCOS)
• Endometriosis
• Hypothalamic amenorrhoea (often related to stress, under-eating, or overtraining)

Even in women who ovulate, sometimes the corpus luteum may not produce sufficient progesterone or may break down too early. This can lead to symptoms such as mid-luteal spotting, premenstrual tension (PMT), anxiety, and sleep problems, as the body loses the calming and stabilising influence of progesterone.

It is also worth noting that hormonal contraceptives (the pill, hormonal IUDs, implants) provide a synthetic progestin, not true progesterone. Synthetic progestins do not have the same beneficial effects on the brain, mood, sleep, or anti-inflammatory pathways as the body’s own natural progesterone. They may prevent pregnancy, but they do not replicate the full, protective role of progesterone produced after ovulation.

• Progesterone in Perimenopause and Menopause

As women transition through perimenopause, ovulation becomes increasingly irregular, leading to inconsistent progesterone production. While oestrogen can remain relatively high during this time, falling progesterone levels often create a state of relative oestrogen dominance. This can result in heavy or irregular periods, breast tenderness, mood swings, and sleep disturbances.

In menopause, ovulation ceases completely, and with it, progesterone production from the ovaries stops. While the adrenal glands still produce very small amounts of progesterone precursors, these levels are often not enough to fully replace what was once produced by the ovaries. For many women, this explains some of the sleep difficulties, anxiety, or changes in skin and hair health they experience post-menopause.

However, it is reassuring to know that many of these symptoms often settle down once the body has recalibrated to its new hormonal environment. As the hormonal fluctuations stabilise, women can find a new balance and experience a greater sense of steadiness.

Supporting Healthy Progesterone Levels

If you would like to naturally support progesterone production, focus on these key strategies:

• Prioritise ovulation – A healthy ovulatory cycle is the foundation for progesterone production. Nourish your body with sufficient calories, quality fats, and a balanced, nutrient-rich diet.
• Key nutrients – Ensure adequate intake of magnesium, zinc, vitamin B6, iodine, selenium, vitamin D, and omega-3 fatty acids, all of which are crucial for healthy hormone balance.
• Reduce stress – Chronic stress elevates cortisol production, which can “steal” resources needed for progesterone. Incorporate relaxation practices, prioritise rest, and seek support when needed.
• Support thyroid health – Optimal thyroid function is essential for regular ovulation. If thyroid function is impaired, ovulation (and therefore progesterone production) may suffer.
• Address insulin resistance – High insulin levels can disrupt ovulatory cycles. Balancing blood sugar through diet and lifestyle is key. (See my other blog on PCOS and insulin resistance for more details.)
• Herbal medicine – Botanicals such as Vitex agnus-castus (chaste tree), Paeonia lactiflora (peony), and Glycyrrhiza glabra (licorice) may help support progesterone balance. Always seek professional advice before starting herbal treatments to ensure they are right for your unique needs.