Approximately 75 million women in the US are in perimenopause, menopause, and post menopause. Progesterone deficiency and its imbalance in relationship to estrogen play a major role in these symptoms. These imbalances lead to exhaustion, cognitive issues, workplace stress and burnout. In this blog I discuss progesterone, where it is made, its impact on our brain as we go through menopause, and the consequences of progesterone deficiency. Lastly, I share how you can better maintain your progesterone levels to promote well-being and cognitive health as you age.
Progesterone Acts on the Uterus and the Brain
In women, progesterone is produced during the luteal phase or second half of the menstrual cycle. Progesterone is made in the neurons and glial cells of the nervous system. This hormone is responsible for giving the endometrial lining the nutrients and glycogen needed to prepare for implantation and fertilization of the egg. Progesterone typically stays at elevated levels for another two weeks. If fertilization does not happen within two weeks, its levels fall, triggering the shedding of endometrial lining or menstruation.
Progesterone is also a neuroactive steroid that crosses the blood brain barrier, modulating serotonergic, dopaminergic, and cholinergic neurotransmitter pathways. This is why the levels of progesterone are so critical to a woman’s cognitive well-being. These neurotransmitters affect the hypothalamus, frontal cortex, hippocampus, amygdala, and thalamus. Areas of the brain responsible for mood, sense of well-being, executive functioning and regulating the sympathetic (excitatory) and parasympathetic (inhibitory) nervous systems.
Cognitive Consequences of Progesterone Deficiency
Here is how progesterone deficiency impacts these three neurotransmitters. Serotonin is responsible for memory, sleep, and mood. Progesterone deficiency on serotonergic neurotransmitters leads to brain fog, poor sleep, and even increased moodiness. Dopamine is connected to the reward system in the brain, producing feelings of joy and well-being. Progesterone deficiency on dopaminergic neurotransmitters leads to feeling less joy and less satisfaction. Acetylcholine is responsible for pain control. Progesterone deficiency therefore contributes to unexplained joint pain, unusual cramping, and pain during the menstrual cycle in perimenopause. Long-term progesterone deficiency leads to depression and anxiety in perimenopause and menopause. All-in-all progesterone deficiency is associated with poorer and degenerating cognitive health in women.
Improve Progesterone Deficiency
Laboratory measurement of your progesterone is the first step in evaluating the cause of your symptoms. If progesterone levels are proven low, the most effective way to improve it is with bioidentical natural micronized progesterone taken by mouth. Bioidentical hormones have molecular structures identical to what the body produces naturally. In my almost ten years of experience, I have found this to be the most effective form of progesterone for treating the cognitive aspects of progesterone deficiency. This oral slow-release form of natural micronized progesterone helps improve sleep, anxiety, irritability, lowers anger, lessens pain, and has reliable anti-depressive effects. Although forms such as transdermal and vaginal progesterone have their place depending, they are inferior to oral progesterone for cognitive symptoms. Therefore, avoid the shortcomings of over-the-counter wild yam creams and extracts. These are popular but do not contain progesterone, nor do they increase progesterone levels.
Summary
Progesterone deficiency during perimenopause particularly on the serotonergic, dopaminergic, and cholinergic neurotransmitters has a negative impact for women health and aging. Symptoms include poor memory, anxiety, moodiness, less sleep, feeling less joy, more cramping and even more joint pain. The best recommendation for treating progesterone deficiency is oral slow-release micronized progesterone. Struggling with symptoms of progesterone deficiency in perimenopause is frustrating and can be devasting for your cognitive health. Laboratory measurement of your progesterone is the first step in evaluating the cause of your symptoms.
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Dr. Sasha Blissett is a California State licensed Naturopathic Doctor, who found her passion for naturopathic medicine while battling her own health and skin issues. She specializes in women’s health and takes the time to listen to her patient’s health concerns so she can understand and address the root cause of illnesses. Dr. Blissett is a member of the American Academy of Anti-aging Medicine, Association for the Advancement of Restorative Medicine, the Integrative Dermatology Learnskin, and California Association of Naturopathic Doctors.
