Progesterone

Who May Benefit from Progesterone Therapy?

Menstruating women with low progesterone levels

Low levels of progesterone can cause abnormal periods or infertility. Levels of progesterone in premenopausal women at the beginning of their menstrual cycle are typically 1 nanogram per milliliter (ng/mL) or less. Expected levels for women in the middle of their menstrual cycle range from about 5 to 20 ng/mL. Supplementing women with progesterone may help restart menstrual periods that unexpectedly stop (amenorrhea), address abnormal uterine bleeding due to hormonal imbalance, and combat severe symptoms of premenstrual syndrome (PMS). The causes of low progesterone levels can include a natural aging, dietary deficiency of vitamins B and C or zinc, stress, or irregular ovary function.

Perimenopausal and postmenopausal women

Postmenopausal women generally have low progesterone levels of less than 1 ng/ml, an expected result of the ovaries ceasing to function after menopause. Progesterone therapy can help perimenopausal and postmenopausal women experience better sleep outcomes and improved mood stabilization. And progesterone can offer endometrial protection for women initiating hormone replacement in the form of estradiol, estriol, or biest (estriol/estradiol) as well as limit estrogen dominance. Progesterone dosage for menopause will vary depending on individual biology. 

Men with low hormone levels

Progesterone is not considered routine hormone replacement for men, as their typical amount of progesterone is less than 1 ng/mL. However, men need some progesterone to produce testosterone, the hormone necessary for sex drive, sperm production, muscle mass/strength, fat distribution, bone density, and red blood cell production. Testosterone replacement therapy can sometimes cause estrogen dominance in men, because some testosterone is naturally converted to estrogen in the body. Low doses of progesterone may limit the effects of estrogen dominance like fatigue, low sex drive, erectile dysfunction, mood swings, and increased belly fat.

Men and women with central nervous system conditions

Progesterone has been shown to protect nerve and brain function by producing a calmer mood, improving midlife insomnia, and stress tolerance.

What are bioidentical hormones?

Bioidentical hormones, predominantly isolated from plant materials, have the exact chemical and molecular structure as hormones made in the human body. Bioidentical steroid hormones like micronized progesterone are designed to bind to the same receptors and undergo similar enzymatic breakdown. Dose and delivery route are essential to activity, which is why compounded bioidentical hormone replacement therapy (BHRT) offers distinctive options that maximize therapeutic use.   

Synthetic hormones with a different chemical makeup that are structurally similar (but not identical) to those made by the human body can have different downstream effects. For example, progestins are a synthetic version of progesterone that differ chemically and structurally from the endogenous hormone. Because of this, progestins bind to other steroid receptors too, producing different metabolites that can increase the potential for side effects. Bioidentical micronized progesterone behaves like natural progesterone, created to bring out the body’s essential response. The two are not considered interchangeable.

Access clinical studies on Progesterone

• Nolan BJ, Liang B, Cheung AS. Efficacy of Micronized Progesterone for Sleep: A Systematic Review and Meta-analysis of Randomized Controlled Trial Data. J Clin Endocrinol Metab. 2021 Mar 25;106(4):942-951.
• Borozan S, Kamrul-Hasan ABM, Pappachan JM. Hormone replacement therapy for menopausal mood swings and sleep quality: The current evidence. World J Psychiatry. 2024 Oct 19;14(10):1605-1610. 
• Kamp E, Ashraf M, Musbahi E, DeGiovanni C. Menopause, skin and common dermatoses. Part 1: hair disorders. Clin Exp Dermatol. 2022 Dec;47(12):2110-2116. doi: 10.1111/ced.15327. Epub 2022 Oct 28.
• Samaras N, Papadopoulou MA, Samaras D, Ongaro F. Off-label use of hormones as an antiaging strategy: a review. Clin Interv Aging. 2014 Jul 23;9:1175-86. 
• Stefaniak M, Dmoch-Gajzlerska E, Jankowska K, Rogowski A, Kajdy A, Maksym RB. Progesterone and Its Metabolites Play a Beneficial Role in Affect Regulation in the Female Brain. Pharmaceuticals (Basel). 2023 Mar 31;16(4):520. 
• Waghmare PS, Kaushik D, Oz E, Proestos C, Oz F, Kumar M. Unraveling the hormonal approaches for the treatment of rheumatoid arthritis and its complementary interventions. Inflammopharmacology. 2025 Feb;33(2):443-460. 
• Avila M, Bansal A, Culberson J, Peiris AN. The Role of Sex Hormones in Multiple Sclerosis. Eur Neurol. 2018;80(1-2):93-99. 
• Schwartz E, Morelli V, Holtorf K. Hormone replacement therapy in the geriatric patient: current state of the evidence and questions for the future–estrogen, progesterone, testosterone, and thyroid hormone augmentation in geriatric clinical practice: part 2. Clin Geriatr Med. 2011 Nov;27(4):561-75. doi: 10.1016/j.cger.2011.07.004. PMID: 22062441.
• Hurtado MD, Tama E, Fansa S, Ghusn W, Anazco D, Acosta A, Faubion SS, Shufelt CL. Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use. Menopause. 2024 Apr 1;31(4):266-274. doi: 10.1097/GME.0000000000002310.
• Santoro N, Roeca C, Peters BA, Neal-Perry G. The Menopause Transition: Signs, Symptoms, and Management Options. J Clin Endocrinol Metab. 2021 Jan 1;106(1):1-15. 
• Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas). 2019 Oct 1;55(10):668. 
• Vincent C, Bodnaruc AM, Prud’homme D, Olson V, Giroux I. Associations between menopause and body image: A systematic review. Womens Health (Lond). 2023 Jan-Dec;19:17455057231209536.
• Ruiz AD, Daniels KR, Barner JC, Carson JJ, Frei CR. Effectiveness of compounded bioidentical hormone replacement therapy: an observational cohort study. BMC Womens Health. 2011 Jun 8;11:27. 

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