Progesterone helps regulate the menstrual cycle and prepare the lining of the uterus in the uterine cycle to support a fertilized egg and sustain pregnancy. A key aspect of perimenopause is a decline in progesterone, which can trigger the beginning of irregular periods.
Changes in progesterone during perimenopause
During perimenopause, progesterone levels first start to fluctuate, then ultimately decline.
- Fluctuations: As the production of hormones from the ovaries begin to decline from the higher levels of LH and FSH, progesterone will have a cycle where it is really low causing irregular, short, and light periods. There can also be periods where there are high levels of progesterone causing longer and heavier periods. The biggest fluctuation will usually occur before a woman's final menstrual period (FMP).
- Decline: The progression of perimenopause will lead to a decline in the overall levels of progesterone. This occurs with the fall of estrogen as well as the ovaries go through their natural aging process.
- Estrogen Dominance: While estrogen is also decreasing during this time, it might not be decreasing at the same rate of progesterone, causing some symptoms of estrogen dominance.
Symptoms caused by progesterone changes during perimenopause
Symptoms will vary greatly from person to person, and the majority of perimenopausal symptoms are associated with the fluctuations of estrogen. However, high levels of progesterone have been linked to symptoms like:
- Fatigue
- Mood swings
- Breast tenderness
- Abdominal bloating
- Weight gain
- Migraines and Headaches
- Changes in libido (decrease or increase)
Low levels of progesterone have been linked to symptoms like:
- Irregular cycles, including shorter, longer, or inconsistent cycles or a missed period
- Abnormal bleeding, whether heavy or prolonged menstrual bleeding, spotting between periods, or breakthrough bleeding
- Intense PMS symptoms, including mood swings, irritability, anxiety, depression, breast tenderness, bloating, and food cravings
- Infertility or difficulty conceiving
- Irregular fluctuations in basal body temperature
- Fatigue and low energy
- Sleep disturbances, including sleep pattern disruption, difficulty falling asleep, and difficulty staying asleep
- Decreased libido
- Vaginal dryness
- Discomfort during intercourse
- Changes in breast tissue, including swelling, lumps, and tenderness
You can record any or all of these symptoms in the Oova app in the features section.
Managing symptoms from low or high progesterone
A provider might recommend giving you progesterone supplements to tackle the discomfort of some perimenopausal symptoms as well as a form of birth control or to regulate your menstrual cycle.
Progesterone supplementation can be a helpful treatment if you’re experiencing difficult perimenopause or menopause symptoms that interfere with your everyday life. However, it’s important to consult with a healthcare professional to discuss your unique health situation and potential risks.
Oova will still work if you’re taking progesterone supplements. Oova can provide quantitative results on your specific PdG (a progesterone metabolite) levels to help you and your healthcare provider understand your hormones and how they might correspond with your symptoms. The impact of supplements on Oova’s results depends on whether you take oral progesterone or topical. If progesterone is in your body, it may appear on the Oova test as we measure the amount of PdG (a progesterone metabolite) your body excretes daily. Everyone metabolizes these hormones differently, which may or may not significantly impact your PdG readings.
Monitoring your progesterone while on supplements is still helpful to ensure they're working correctly.