Low progesterone menopause: Understanding causes, symptoms, and long-term risks

Menopause is the natural end of a female’s reproductive years that usually starts when you are in your 50s. During this stage, your ovarian function ceases, which leads to significant shifts in your body, primarily on the hormonal level. In menopause, your key sex hormones–estrogen and progesterone drop significantly. Although this is a natural process, low progesterone menopause comes with a range of unpleasant symptoms, such as:

• Sleep issues
• Hot flashes
• Mood swings
• Bloating
• Weight gain
• Decreased libido
• Vaginal dryness
• And many others

If not addressed accordingly, low progesterone levels in menopause can increase the risk of long-term health issues, such as osteoporosis, cardiovascular problems, endometrial hyperplasia, adenocarcinoma, cognitive decline, and cancer. Thus, it’s important to diagnose a hormonal imbalance and treat it with hormonal therapy and lifestyle adjustments. 

Menopause is a significant stage in every woman’s life. It’s marked with deep hormonal shifts and, as a result, physical changes in your body. The transformation begins during perimenopause–a transitional stage that leads up to menopause, which can begin as early as your mid-30s or much later, around your mid-50s. During this stage, hormonal changes are still rather mild. However, when you enter menopause, you can experience a significant shift that might require additional management strategies to maintain your physical, mental, and sexual health.

In this guide, we’ll explore the changes that affect one of your essential sex hormones, progesterone, and discuss the causes, symptoms, and health risks associated with low progesterone menopause.

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What Is Progesterone?

Progesterone is an endogenous steroid hormone and one of the essential sex hormones in females. It’s mainly produced in your ovaries. After the ovaries release an egg, the ruptured follicle transforms into the corpus luteum, and it’s the primary source of this hormone. That’s why in a healthy menstrual cycle, progesterone levels are low during menstruation, the follicular phase, and ovulation, and are increased during the luteal phase. Also, progesterone is produced by the adrenal glands and by the placenta during pregnancy. 

Progesterone plays several crucial roles in your body:

• Regulates the menstrual cycle.
• Affects thyroid function and mood.
• Thickens the lining of your uterus to allow implantation of a fertilized egg.
• Protects the uterine lining during pregnancy.
• Prevents subsequent ovulations when you are pregnant.
• Prepares your breasts for lactation.

As you can see, progesterone plays an important part both in your regular menstrual cycle and in pregnancy. That’s why when its levels fluctuate, it can lead to a range of complications, such as irregular periods, reduced fertility, early labor, and others.

Menopause and Hormonal Changes

Although fluctuating progesterone levels can cause certain issues, they also change naturally as you age. And this is something females should be prepared for.

So, what happens during menopause? Menopause is the natural end of a female’s reproductive years. It typically occurs when you are in your 50s, though the time can vary significantly based on different factors, including genetics, lifestyle, and more. You can say you are in menopause when you haven’t had periods for 12 months.

Marking the end of your reproductive years, menopause makes your ovaries stop producing eggs. As a result, you face significant hormonal transformations. In particular, your levels of progesterone and estrogen. This drop causes the majority of the known menopause symptoms, such as:

• Absent periods
• Hot flushes
• Libido decrease
• Mood swings and anxiety
• And others 

Low Progesterone Menopause

Since progesterone is primarily produced by the corpus luteum after ovulation, low progesterone menopause is a natural thing because ovulation doesn't happen anymore. After menopause, your progesterone levels also don’t fluctuate as they are supposed to through the cycle.

Normal progesterone levels in menopause fall within the range of 0-0.5 ng/ml. This is significantly lower compared to the normal levels of this hormone during your reproductive years, which are between 0.1 and 25 ng/ml.

Symptoms of Low Progesterone in Menopause

When your body starts transitioning into this stage of your life, some of the main symptoms of low progesterone in menopause can include:

• Menstrual irregularity - In late perimenopause, when progesterone starts decreasing, you will likely start skipping your periods until they stop completely.
• Sleep difficulties - Many women start noticing issues like night sweats, sleep apnea, and insomnia as they enter menopause.
• Hot flashes - Although it’s commonly associated with estrogen levels, low progesterone menopause also contributes to intense sensations of heat known as hot flashes. This happens because this hormone plays a big role in regulating your body temperature.
• Mood and mind challenges - Progesterone has a significant influence on serotonin metabolism. Thus, when its levels drop, it also causes some changes in your brain, commonly leading to mood swings, irritation, anxiety, and headaches.

These are the primary symptoms you may face. Additional symptoms during menopause can also include:

• Bloating
• Weight gain
• Spotting between periods
• Low libido
• Vaginal dryness

Symptoms of Low Progesterone After Menopause

Menopause is a gradual process that may last for several years until your body fully transitions into the postmenopause stage. When you go past this, some symptoms of menopause may lessen. However, others, especially those linked to hormonal imbalance, may worsen.

Some of the most prominent symptoms of low progesterone after menopause include:

• Vasomotor symptoms, such as hot flashes (often accompanied by increased heart rate and excessive sweating) and night sweats.
• Mood changes and mental issues like anxiety and depression may become more pronounced.
• Sleep issues are also common in postmenopausal women.
• Other symptoms may include decreased libido, urinary tract infections, and vaginal dryness.

It’s important to note that symptoms women face during and post menopause can vary greatly. They depend on numerous individual factors, including genetics, health conditions, and prescribed medication, as well as the specific levels of progesterone and estrogen you have.

Health Implications Associated With Decreased Progesterone Levels in Menopause

A female hormonal balance is the main building block of your physical and mental health, as well as youth. Hence, supporting this balance becomes especially important during menopause, when your progesterone and estrogen levels drop drastically.

If not addressed adequately, low progesterone menopause can potentially lead to several long-term health risks:

Osteoporosis

Osteoporosis is a medical condition that affects your bones. Bones gradually lose tissue, either due to hormonal imbalances or calcium/vitamin D deficiency, and become brittle and fragile. In the long run, this condition can lead to higher risks of injury.

According to studies, low progesterone levels can contribute to the development of this condition. Progesterone therapy, on the other hand, can help you support your bone health.

Cardiovascular Health Issues

According to the American Heart Association, progesterone plays a massive role in cardiovascular health. This hormone is responsible for regulating vascular tone and blood pressure. It can also potentially protect your heart from disease.

When your progesterone is low, it can increase the risk of hypertension and other cardiovascular issues.

Endometrial Hyperplasia and Cancer

Progesterone deficiency has been shown to create unopposed estrogen action. In simple words, estrogen is a hormone that stimulates cell growth in your endometrial lining. Progesterone, on the other hand, is there to inhibit this growth and keep it controlled.

According to studies, when your progesterone is low and estrogen is unopposed, this can increase the risk of the development of endometrial hyperplasia and adenocarcinoma.

Cognitive and Mood Issues

As you already know, hormonal imbalance is generally associated with mood swings. That’s why women often feel moody during different stages of the cycle or when they have hormonal conditions like PCOS. Due to the same reason, the hormonal imbalance and low progesterone in menopause can also cause mood changes, anxiety, and even depression.

What’s more, progesterone is also associated with changes in regional brain activation patterns. Thus, it can potentially lead to cognitive decline.

How to Manage Low Progesterone Menopause

As you now know, low progesterone can lead to a variety of long-term health implications. Not to mention the discomfort it can bring into your life. That’s why managing your hormonal balance is incredibly important in menopause.

Luckily, there are a few strategies you can undertake:

• First of all, if you notice any symptoms, it’s a good idea to take a blood test to have a clinical evaluation of your current hormone levels and diagnose low progesterone.
• Hormone Replacement Therapy (HRT) can help you support your hormones at sufficient levels in the long run.
• Lifestyle approaches can help you improve your balance further and sustain the result. These include following a healthy diet, exercising, and managing stress. Additionally, it’s possible to address imbalances with different herbal teas and supplements.

Important note: Even after you integrate certain management approaches, it’s important that you closely monitor your symptoms of low progesterone after menopause. If they persist or become too severe, you should consider consulting with a healthcare provider.

FAQ

What causes low progesterone levels in menopause?

Its decline is mostly natural. Since progesterone is mainly produced in the ovaries, its production drops significantly after your ovarian function ceases in menopause. Nevertheless, other factors can also contribute to low progesterone, including ongoing stress, underlying health conditions (for example, thyroid problems), and certain medications.

What are the main symptoms of low progesterone in menopause?

When you just enter menopause, low progesterone starts manifesting in menstrual irregularity and the first skipped periods. As its levels decrease, you can face symptoms like:

• Sleep difficulties
• Night sweats
• Hot flashes
• Mood swings
• Headaches
• Bloating
• Weight gain
• Spotting between periods
• Low libido
• Vaginal dryness

In postmenopause, some symptoms may ease. However, vasomotor symptoms, mood swings, and sleep issues may persist.

Is it possible to treat low progesterone menopause?

Yes, there are several ways to increase progesterone balance, regain balance, and improve your symptoms. To do this, you should have a medical screening to assess your hormone levels and, possibly, be prescribed a Hormone Replacement Therapy (HRT). Additionally, you may consider improving your diet, increasing physical activity, and integrating other lifestyle changes to sustain your health.

Conclusion

Low progesterone levels in menopause are natural. Yet, if the hormonal imbalance persists, it can lead to a range of significant health issues.

Now, you should have a better understanding of why progesterone drops in menopause, what implications it has, and how to address it correctly. Use this knowledge to support your health and youth, and improve your quality of life after menopause.

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