There are two main sexual hormones which help with managing reproductive function in women- progesterone and oestrogen. In this article, we’ll be focusing a little on progesterone.
What is Progesterone and why is it important?
Progesterone plays a very essential role in regulating ovulation, facilitating implantation and maintaining a healthy pregnancy1. It affects every stage of the fertility cycle, from conception to delivery. During ovulation, progesterone prepares the body for pregnancy. It causes the uterine lining to thicken and create a conducive environment for fertilization to occur.
Progesterone also has a host of non-reproductive functions, some of which include regulating your mood and cognition.
How do your progesterone levels affect you?
Throughout your menstrual cycle, your progesterone levels will fall and rise. For you to know whether your progesterone level is too high or too low, you have to know what stage of your menstrual cycle your body is in.
Your progesterone levels will rise during the second half of your menstrual cycle, just after you’ve ovulated. This is called the luteal phase. This rise is to prepare your body for the implantation of an egg if fertilization occurs. If pregnancy doesn’t occur, progesterone levels fall. The drop in progesterone levels is what triggers your next menstrual period.
During pregnancy, it’s natural for your progesterone levels to increase. The progesterone is responsible for your uterus expanding to accommodate your baby and preventing preterm labour. It is also responsible for preventing lactation until the baby is born. And strengthening the pelvic muscles as the body nears labour during pregnancy.
It’s important to monitor your progesterone levels to determine if they could be adversely affecting you. A simple blood test or a saliva test can help with this.
Can progesterone affect your mental health?
Your body’s two sexual hormones – progesterone and oestrogen complement each other. The right balance needs to be maintained between the two for optimal well being. When your progesterone levels are low, oestrogen dominates which may lead to a myriad of problems. This could affect your mental health.
A 2012 study showed that increased levels of progesterone you experience in the luteal phase of your menstrual cycle is usually accompanied by lower levels of aggression, irritability and fatigue.
When fertilization doesn’t occur your progesterone levels drop resulting in an imbalance of your sexual hormones. During this period you are likely to feel more irritable, anxious and experience mood swings. You might recognize this imbalance as Premenstrual Syndrome (PMS). PMS symptoms vary in severity from woman to woman. While some women may only experience a slight change in their moods other women experience symptoms severe enough to affect their daily lives. This form of PMS is called premenstrual dysphoric disorder (PMDD). Symptoms of PMDD include depression, mood swings, anger and anxiety.
Research shows a link between women who experience severe PMS which is brought on by low progesterone levels being at risk of developing postpartum depression after a pregnancy. About one in five pregnant women will likely develop postpartum depression (PPD). PPD is usually characterized by fatigue, irritability, loss of appetite and even suicidal thoughts. Factors such as age, education and family history are related to PPD.
Lower progesterone levels are one of the many changes your body will experience during menopause. With this comes symptoms such as hot flashes and night sweats. There is research linking peri-menopause which is the period before menopause, to a heightened risk of depressive symptoms. Studies also show that the drop in hormonal levels of oestrogen and progesterone contribute to the risk of depression.
Certain medical conditions such as PCOS (Polycystic Ovary Syndrome) a condition which causes women to have higher than normal levels of male hormones, also lowers progesterone levels. Though the connection isn’t fully understood, PCOS has been linked with depression and anxiety.
Progestin and your mental health
Progestin is a synthetic hormone created from progesterone. It’s mostly used in hormonal therapy drugs for menopausal women and in some contraceptive pills. There have been some studies which link progestin use with depression and anxiety. Especially when used in contraceptive pills.
This doesn’t happen with all women. While some women might experience drastic mood swings and increase in anxiety levels, some women will not experience any of these side effects. If you are on progestin-only contraceptive pills it is recommended you be on the lookout for any changes, good or bad in your mental health and discuss it with your doctor.
It’s important to know that a lot of the studies linking hormonal therapy to mental health problems are speculative and a lot more research needs to be done.
If you’ve noticed you have irregular periods, really bad PMS or have experienced early miscarriages in the past, you may have a low progesterone problem. The most important thing is to know your progesterone levels not just for pregnancy health but for your overall well being. To do this you can go see your doctor for a blood test or take a simple saliva test with the inne mini lab.
- R.Sitruk-Ware (2018), Climacteric, Non-clinical Studies of Progesterone, Article consulted on March 18, 2020, https://www.tandfonline.com/doi/abs/10.1080/13697137.2018.1463982?journalCode=icmt20
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- Pratap, K. & Navneet, M. (2012), Nigerian Medical Journal, Hormones in Pregnancy, Article consulted on March 18, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640235/
- MedlinePlus, Serum Progesterone, Article consulted on March 18, 2020, https://medlineplus.gov/ency/article/003714.htm
- Chutima, R., Andre, F.C., Frank, C., & Michael, M.(2019), Frontiers in Psychology, Lowered Plasma Steady-State Levels of Progesterone Combined With Declining Progesterone Levels During the Luteal Phase Predict Peri-Menstrual Syndrome and Its Major Subdomains, Article consulted on March 18, 2020, https://www.frontiersin.org/articles/10.3389/fpsyg.2019.02446/full
- Torbjörn, B., Marie, B. & Jessica, S.(2015), Current Psychiatry Reports, GABAA Receptor-Modulating Steroids in Relation to Women’s Behavioral Health, Article consulted on March 18, 2020, https://www.researchgate.net/publication/282129888_GABAA_Receptor-Modulating_Steroids_in_Relation_to_Women’s_Behavioral_Health
- Mayo Clinic, Premenstrual syndrome (PMS), Article consulted on March 18, 2020, https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/symptoms-causes/syc-20376780
- Melissa, B., Sarah, L.M., Teri, P., Scott, S., Caron, Z. & Michael, W.O. (2013), Archives of Women’s Mental Health, Examination of Premenstrual Symptoms as a Risk Factor for Depression in Postpartum Women”, Article consulted on March 18, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663927/
- Gavin, N.I., Gaynes, B.N., Lohr, K.N., Meltzer-Brody, S., Gartiehner, G. & Swinson, T. (2005), Obstetrics and Gynecology, Perinatal Depression: A Systematic Review of Prevalence and Incidence”, Article consulted on March 18, 2020, https://www.ncbi.nlm.nih.gov/pubmed/16260528
- Joyce, T.B. & Howard, M.K. (2011), Obstetrics and Gynecology Clinics of North America, Mood and Menopause: Findings from the Study of Women’s Health Across the Nation (SWAN) Over Ten Years”, Article consulted on March 18, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197240/
- Centers for Diseases Control & Prevention, PCOS (Polycystic Ovary Syndrome) and Diabetes, Article consulted on March 18, 2020, https://www.cdc.gov/diabetes/basics/pcos.html
- Keisha, S., Sanket, N., Tanu, R., Anthony, E.A., Kimberly, R.L. & Tultul, N. (2018), International Journal of Environmental Research and Public Health, Do Progestin-Only Contraceptives Contribute to the Risk of Developing Depression as Implied by Beta-Arrestin 1 Levels in Leukocytes? A Pilot Study, Article consulted on March 18, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163405/