The Role of Progesterone in Perimenopause: Understanding the First Hormone to Decline
Anna Harrelson • July 8, 2024

How the Decline of Progesterone in Perimenopause Affects Your Body and What You Can Do About It

Estrogen gets so much attention in the conversation of women's hormones, but too often progesterone does not get the attention it deserves!  Today, we’re exploring how progesterone, often the first hormone to decline during perimenopause, affects our bodies and contributes to the symptoms many of us experience during this transition.


Progesterone: The First to Fall

Progesterone is a hormone produced primarily by the ovaries following ovulation each month. Its primary roles include:

  • Regulating the menstrual cycle
  • Supporting early pregnancy
  • Balancing the effects of estrogen

During perimenopause, the process leading up to menopause, progesterone levels begin to decline earlier and more significantly than estrogen. This decline can start as early as the late 30s or early 40s, even if periods remain regular.


Symptoms of Low Progesterone

The decline in progesterone levels can lead to various symptoms, often signaling the beginning of perimenopause. These symptoms include:

  • Irregular Periods: Progesterone helps regulate the menstrual cycle, so its decline can cause irregular periods or changes in menstrual flow.
  • Sleep Disturbances: Progesterone has a calming effect on the brain, promoting restful sleep. Lower levels can lead to insomnia or disturbed sleep patterns.
  • Mood Swings and Anxiety: Reduced progesterone levels can lead to mood swings, irritability, and increased anxiety, as it plays a role in stabilizing mood.
  • PMS-like Symptoms: Women might experience more intense premenstrual symptoms, such as bloating, breast tenderness, and headaches.
  • Hot Flashes and Night Sweats: While commonly associated with estrogen, fluctuating progesterone levels can also contribute to these symptoms.

The Physiology Behind Progesterone Decline

The decline in progesterone is primarily due to fewer ovulations as women age. Without ovulation, the corpus luteum (which produces progesterone) does not form, leading to lower progesterone levels. This imbalance between estrogen and progesterone is often referred to as "estrogen dominance," which can exacerbate symptoms.


Managing Symptoms of Low Progesterone

  • Lifestyle Changes
  • Diet: Eating a balanced diet rich in whole foods can support hormone health. Include plenty of fruits, vegetables, whole grains, and lean proteins.
  • Exercise: Regular physical activity helps balance hormones, reduce stress, and improve sleep.
  • Stress Management
  • Relaxation Techniques: Practices like yoga, meditation, and deep breathing can help manage stress and improve overall well-being.
  • Adequate Sleep: Prioritize good sleep hygiene to support hormone balance.
  • Supplements and Natural Remedies
  • Chasteberry: This herb has been said to help balance progesterone levels and alleviate symptoms.
  • Magnesium and Vitamin B6: These nutrients support hormone balance and can reduce symptoms like irritability and mood swings.
  • Hormone Replacement Therapy (HRT)
  • Bioidentical Progesterone: For some women, supplementing with bioidentical progesterone can help restore balance and alleviate symptoms. Consult with your menopause doctor to see if this option is right for you.


Conclusion

Understanding the role of progesterone and its decline during perimenopause can help you navigate this transition more effectively. By recognizing the symptoms and implementing strategies to manage them, you can maintain your quality of life and well-being during this phase.


Stay informed, take proactive steps, and consult with your healthcare provider to find the best approach for managing your symptoms.

Warm regards,

Dr. Anna


WonderCreek Health Blog

By Anna Harrelson June 13, 2025
You’ve probably seen it popping up in wellness podcasts, health stores, or even your friend's supplement cabinet: bovine colostrum. Marketed for gut health, immune support, and recovery, this early-life nutrient source for calves is now showing up in adult wellness routines. But is it worth your time and money? As a lifestyle medicine physician focused on women’s midlife health and longevity, here’s what I want you to know before you jump on the colostrum bandwagon. Let’s Start With the Basics: What Is Colostrum? Colostrum is the first form of milk produced by mammals (including humans) in the first few days after giving birth. It’s loaded with antibodies, growth factors, and immune-modulating compounds designed to jumpstart a newborn’s immune system and line the gut. Bovine colostrum—from cows—is the form used in most supplements. It's freeze-dried and packaged into powders or capsules, and often promoted for: Gut barrier support ("leaky gut") Immune system priming Exercise recovery Anti-aging benefits But let’s be honest: just because something has growth factors doesn’t mean it belongs in your Amazon cart. Does the Science Support It? Evidence in humans is limited— but not nonexistent. Some small clinical studies have shown potential benefits: Gut health: In people with NSAID-induced intestinal permeability ("leaky gut"), bovine colostrum has been shown to reduce damage and symptoms. Immune function: Some data in athletes suggests reduced upper respiratory infections. Exercise recovery: A few studies report improvements in performance, gut comfort, or muscle soreness—especially in endurance athletes. But these benefits aren’t guaranteed. And the quality and dosage of colostrum varies widely, with no standardized formulation across brands. So Should You Take It? Here’s where my clinical voice kicks in: Before you reach for colostrum, ask yourself: Have you addressed the basics? Are you sleeping? Managing stress? Eating fiber and whole foods? Getting enough protein? Building muscle? Moving your body? Supporting your gut with real food (not just powders)? If the answer is no—then colostrum is not your next step. You’re throwing powdered fuel on an engine that’s missing spark plugs. Do you have dairy sensitivity? Colostrum is a dairy product. Even if it's low in lactose, it may not be tolerated by everyone. Are you already taking quality foundational supplements? Vitamin D, omega-3s, magnesium, creatine, iron (when needed), and probiotics have stronger bodies of evidence for many women in midlife. When Might It Be Worth Trying? Colostrum might be a reasonable add-on if you: Have mild gut symptoms (especially post-infectious or stress-related) Are recovering from illness or antibiotics Train hard and experience frequent upper respiratory issues Want to support your immune system during travel or stress Even then, I recommend: A 2–3 month trial only after dialing in basics Choosing a third-party tested brand Tracking symptoms and benefits Cost, Hype, and the Bigger Picture Many women I work with are overwhelmed by supplement costs. Colostrum can run $50–100/month —and that adds up. So here’s what I tell my patients: Just because something is trending doesn’t mean it’s essential. And just because it works for someone on TikTok doesn’t mean it’s the right tool for your body right now. Your body is an incredible machine. When you give it rest, movement, nourishment, and support—it can do amazing things. Colostrum is not magic. It’s just one tool in a very big toolbox. Bottom Line Colostrum may hality sources. You’re not broken. You might just need a reset—not another powder.
By Anna Harrelson June 12, 2025
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