Ladies, how’s your progesterone?
One of the best things for female health is regular ovulation, because if there’s no ovulation there is no progesterone, and progesterone brings many crucial benefits that I expect you will not want to miss out on.
Most are familiar with the role of progesterone in supporting a pregnancy. As the name suggests, it quite literally has a “pro-gest”ation effect. When an egg is released from a mature follicle, the shell that is left behind becomes the corpus luteum, which then pulses out progesterone and estrogen. In this capacity, the progesterone acts to maintain the uterine lining for a developing embryo. If conception happens, this action persists through most of the first trimester, until the placenta is substantial enough to take over. If there is no fertilization, the corpus luteum begins to degrade after 10-12 days, and progesterone levels decline along with it. Without ovulation, there is no corpus luteum and thus our body does not produce progesterone. This means that estrogen—which balances progesterone—is unopposed in the body, resulting in relative estrogen dominance. If left unchecked, estrogen dominance can lead to unpleasant PMS-like symptoms such as bloating, weight gain, mood swings, breast tenderness, fatigue and heavy periods.
Supporting pregnancy is obviously a big deal, but natural progesterone conveys other perks as well. In addition to opposing estrogen, progesterone is a calming hormone with incredible benefits. As part of its monthly role, progesterone enhances thyroid hormone, thereby slightly raising body temperature which is necessary to support a potential pregnancy. As a pro-metabolic hormone, it also helps to metabolize protein and build muscle. It converts to the neurosteroid called allopregnanolone, which acts like GABA in the brain, reducing neuronal excitability and calming the nervous system, enhancing sleep and making it easier to cope with stress. As if that were not enough, progesterone is also known to reduce inflammation, prevent cancer, protect against heart disease, and reduce bone loss, which can be important as we age.
While all of that is pretty wonderful, this is in no way intended to demonize estrogens. Remember that balance is key. Our bodies are designed to cycle through the ups and downs of a harmonious interplay of hormonal messages. Progesterone is best when it plays a regular part in that larger picture. As women, we can reap enduring health benefits if we can support the fullest expression of a natural monthly cycle—and healthy cycles are all about ovulation.
That said, ovulation can be a bit of a mystery. How do you know if you’re ovulating? You might logically assume that your period follows a couple of weeks or so after ovulation, and that if you’re bleeding it means you have ovulated, but this is not always the case. Some women have telltale signs, but for most it can be hard to know unless one is closely tracking symptoms such as temperature and leutenizing hormone—and even then it’s not always certain. There are months when none of the ovarian follicles mature properly for ovulatory release, and yet because a period arrives when expected we may not give much thought to what may or may not have happened at the ovary. It is not uncommon to have an anovulatory cycle, particularly as we creep into peri-menopause, or if the body is overly stressed for a period of time. The body may also skip ovulation if there is a lack of proper nourishment, which is certainly a form of stress, and one that makes sense from an evolutionary point of view. If resources are scarce, then pregnancy might be too challenging to sustain. Whatever the reason, if there is no ovulation, there is no corpus luteum, and thus no progesterone for that month.
That explains why an anovulatory cycle is not a true menstrual cycle—it lacks a corpus luteum and so there is no real luteal phase. Instead, an anovulatory cycle is like a continuous extension of the follicular phase, but with bleeding in between because estrogen alone is not enough to sustain the endometrial lining.
Hormonal birth control is specifically designed to suppress ovulation (and thus pregnancy), so if you are using some form of that then you are also not producing progesterone. While it’s true there may be a form of synthetic progesterone (typically some version of Progestin) in your system if your prescription is formulated to include that. However be aware that synthetic progesterones are vastly inferior with respect to the numerous beneficial roles attributable to the real ones produced by your body and Mother Nature. In some cases, the synthetic form can have the opposite effect—and not in a good way. Progesterone is good for cardiovascular health, stimulates hair growth and is generally positive for sleep and mood. Side effects of Progestin, on the other hand, include high blood pressure, hair loss, anxiety and depression.
Studies show that a woman’s cumulative lifetime exposure to estrogen and progesterone is a relevant factor when it comes to the benefits these hormones confer, and that women with a history of regular, natural menstrual cycles tend to live longer. This is just one more reason to be well informed when making big decisions about birth control and your reproductive goals. Feel free to get in touch with us at Naturna if you’d like to talk more specifically about your own hormone health.
Briden, L. (2021). Hormone Repair Manual. Greenpeak Publishing.
Melcangi, R. C., Giatti, S., Calabrese, D., Pesaresi, M., Cermenati, G., Mitro, N., Viviani, B., Garcia-Segura, L. M., & Caruso, D. (2014). Levels and actions of progesterone and its metabolites in the nervous system during physiological and pathological conditions. Progress in neurobiology, 113, 56–69. https://doi.org/10.1016/j.pneurobio.2013.07.006
Mohammed, H., Russell, I. A., Stark, R., Rueda, O. M., Hickey, T. E., Tarulli, G. A., Serandour, A. A., Birrell, S. N., Bruna, A., Saadi, A., Menon, S., Hadfield, J., Pugh, M., Raj, G. V., Brown, G. D., D’Santos, C., Robinson, J. L., Silva, G., Launchbury, R., Perou, C. M., … Carroll, J. S. (2015). Progesterone receptor modulates ERα action in breast cancer. Nature, 523(7560), 313–317. https://doi.org/10.1038/nature14583
Sathi, P., Kalyan, S., Hitchcock, C. L., Pudek, M., & Prior, J. C. (2013). Progesterone therapy increases free thyroxine levels–data from a randomized placebo-controlled 12-week hot flush trial. Clinical endocrinology, 79(2), 282–287. https://doi.org/10.1111/cen.12128
Wang, Y. X., Arvizu, M., Rich-Edwards, J. W., Stuart, J. J., Manson, J. E., Missmer, S. A., Pan, A., & Chavarro, J. E. (2020). Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: prospective cohort study. BMJ (Clinical research ed.), 371, m3464. https://doi.org/10.1136/bmj.m3464