Many women in my office experience menopausal mood changes. As women approach their forties, they often find themselves grappling with heightened stress levels and mood swings. The culprit? Fluctuating progesterone levels during perimenopause. Recent studies have shed light on the intriguing connection between progesterone and mood changes in women going through this transitional phase. In this blog post, we’ll explore whether progesterone could be the key to alleviating mood problems during menopause.

Understanding the Link between menopause, progesterone and mood:

Perimenopause, the transitional period leading up to menopause, has been associated with an increased risk of anxiety, sadness, and sleep disturbances. Scientific research, such as a study in the National Center for Biotechnology Information [1], reveals that progesterone, a crucial brain chemical, plays a pivotal role in how the brain deals with stress. The conversion of progesterone into allopregnanolone has a calming effect on GABA receptors, stabilizing the adrenal system and promoting neurogenesis, the growth of new nerve cells.

As menopause approaches, progesterone levels decline before estrogen levels, marking a significant shift in how medical professionals perceive perimenopause. During this time, women begin complaining about menopausal mood changes. Dr. Jerilynn Prior, a renowned Canadian health researcher, emphasizes the importance of regular ovulation and progesterone levels in reducing the risk of heart disease, osteoporosis, and breast cancer [3].

The Vicious Cycle of Stress and Progesterone:

Stress exacerbates the drop in progesterone levels during perimenopause, creating a detrimental cycle. Once progesterone loses its positive impact on mood, sleep, and metabolism after ovulation, women may experience a decline in overall well-being. The study titled “Estradiol and Progesterone as Resilience Markers” [4] indicates that lower progesterone levels during perimenopause are linked to decreased life satisfaction, increased stress, and a higher likelihood of developing depression and anxiety.

Distinguishing Between Progesterone and Progestins:

It’s crucial to differentiate between bio-identical progesterone and synthetic progestins, the latter commonly found in oral contraception. Unlike progestins, which have been associated with mood disturbances, progesterone offers unique benefits. Unfortunately, misconceptions persist, leading to the inaccurate belief that “progesterone negatively impacts mood,” when it’s actually progestins that may have this effect.

Choosing the Right Progesterone:

Naturopathic doctors in Ontario are well informed about hormone management. Progesterone, available as oral micronized progesterone or cream, requires a prescription. Brands like Prometrium are prevalent options. While progesterone cream is available without a prescription in some countries, its efficacy may vary compared to progesterone pills.

Progesterone’s Impact on the Brain:

Research suggests that for most women, progesterone positively influences mood by transforming into allopregnanolone, a neurosteroid with calming effects on GABA receptors [5]. Unlike hormonal birth control drugs containing progestin, progesterone can enhance mood.

Tailoring Progesterone Treatment for Mood in Perimenopause:

For women experiencing premenstrual dysphoric disorder (PMDD), higher doses of progesterone may be necessary to improve mood. Starting with a moderate dosage or a cream applied every few days allows for careful monitoring of therapeutic reactions. It’s essential to avoid doses exceeding 400 mg, as higher amounts may lead to signs of depression [8].

Progesterone is emerging as a potential ally for women navigating the challenges of mood changes during perimenopause. By understanding the nuances of progesterone’s role and differentiating it from progestins, women can make informed decisions about their well-being during this transformative phase of life. Always consult with a healthcare professional to determine the most suitable progesterone treatment for individual needs.

References

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513660/
2: https://www.tandfonline.com/doi/abs/10.1080/02646830600974071#:~:text=Ordinary%20women%20and%20official%20statements,stable%20estrogen%20levels%20of%20menopause.
3:(http://www.cemcor.ubc.ca/sites/default/files/uploads/1_What_is_Ovulation.pdf)
4: (https://pubmed.ncbi.nlm.nih.gov/33676150/)
5:(https://pubmed.ncbi.nlm.nih.gov/31693131/)
6: https://www.youtube.com/watch?v=7BmlbTsNt2A&t=2s
7: https://www.ncbi.nlm.nih.gov/pubmed/19272715
8: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1415816/