Progesterone For Mental Health During Menopause: 7 Powerful Ways It Helps

Menopause Matters: Kate Wells

Who remembers those scenes in That 70’s Show where Kitty has her menopause meltdowns? She is alternately furious and weepy, disengaged and hyperactive. Her husband and family never quite know what is coming next. While all they need to do is dodge, and often keep quiet – the internal storm of changing emotions inside Kitty, like many women, can be harrowing to live through for all involved.

Changes in our hormones during menopause can impact our mental health just as much as our physical health. Women may experience feelings of anxiety, stress or even depression. Menopausal mood-related symptoms may include:

• anger and irritability
• anxiety
• forgetfulness
• loss of self-esteem
• loss of confidence
• low mood and feelings of sadness or depression
• poor concentration – often described as ‘brain fog’ and/or lost, umm, words

So, what is it about perimenopause and the menopause changes that seems to have such an impact? Because such a high proportion of women experience variations in their mental health related to menopause, it makes sense to look for some underlying hormone changes that might be at the root of the issue. Hormones are vital chemical messengers acting in multiple ways in the body including those that influence mood.

If you dare, think back to puberty; while you may not remember much, your parents will, because your moods were all over the place. Hormones were just starting to kick in and, in consequence, there was a fair amount of mayhem in your brain. In perimenopause, the first hormone to diminish is progesterone.

Progesterone: From Ovulation To Emotional Regulation:

Most progesterone is found in the corpus luteum, the sac surrounding the ovum (egg). After a couple of decades of ovulating each month and releasing an ovum, women start to have months where they do not ovulate. When a woman does not ovulate, there is no ovum, so no corpus luteum, so no progesterone. A characteristic of perimenopause is more and more cycles where there is no ovum released.

Progesterone is the key for the synthesis of estrogens and androgens, as well as glucocorticoids (e.g. cortisol) and mineralocorticoids (for salt and water balance). Progesterone can easily pass through the blood-brain barrier, and by accumulating in the brain, act on receptors found in brain areas relevant to cognitive and affective processes.

How Progesterone For Mental Health During Menopause Actually Works:

Progesterone influences amygdala reactivity related to processing of emotional stimuli and memory by calming it’s response to stimuli. The amygdala in the limbic system plays a key role in how we assess and respond to environmental threats and challenges by evaluating the emotional importance of sensory information and prompting an appropriate response.

How Progesterone Shapes Emotion And Cognition:

The main job of the amygdala is to regulate emotions, such as fear and aggression. The amygdala is also involved in tying emotional meaning to our memories, reward processing, and decision-making. 

Progesterone and its metabolite allopregnanolone also have the ability to modulate our happy neurotransmitters such as serotonin and dopamine, as well as acetylcholine – the neurotransmitter involved in modulating nerve action.

Serotonin has various roles, mostly in mood balancing, sexual behavior and stress responses. Serotonin’s action related to the nervous system is to modulate mood, cognition, reward, learning and memory. FYI – serotonin receptors also occur outside the nervous system and can modulate other physiological processes such as vomiting, vasoconstriction, sleep, thermoregulation, pain, behavior, sex, feeding, motor activity, biological rhythms and many others.

The Hidden Power Of Progesterone In Perimenopause:

Progesterone can increase the transmission of serotonin, however, it seems like there is a safety switch/feedback loop because too much progesterone appears to decrease serotonin levels. (No bathing in progesterone ladies!).

Dopamine is the key neurotransmitter involved in motor control, learning, motivation, reward, decision-making and working memory. Progesterone (and estradiol) can impact dopaminergic neurotransmission. Estradiol and progesterone have been observed to affect the number of receptors for dopamine. Progesterone acts to modulate dopamine receptors and so reduces the amount of dopamine when levels get too high.  

Progesterone can also regulate local and systemic inflammation and the production of harmful free radicals. Many women begin to report an increase in inflammation during perimenopause, and post menopause, an increase in joint pain is a frequent symptom.  Increased joint pain makes it harder to get a restful night’s sleep and the decline in sleep quality can influence mood still further.

Lastly, progesterone provides negative feedback on the secretion of Luteinizing Hormone (LH).  Spikes in LH can cause spikes in estradiol production which can stimulate hot flashes. As progesterone drops during perimenopause it is important to maintain a steady supply of progesterone to reduce spikes in LH and therefore reduce hot flashes and night sweats. 

Making Sense Of The Terms Progesterone / Progestins / Progestogens:

Even among medical practitioners there is confusion concerning the nomenclature of progesterone forms including natural progesterone, progestagens, gestagens, progestogens and progestins. Progesterone as a term should only refer to the natural hormone produced in the body or the manufactured form qualified as body-identical or bioidentical.

The terms progestogens, gestagens and progestagens refer to natural or synthetic compounds with progestational activity. The term progestins is used for synthetic compounds able to target the progesterone receptors; these substances may have different or even opposite pharmacological properties and modes of action.  

While micronized progesterone and especially its metabolite allopregnanolone can modulate GABA receptors and possess the above-mentioned effects in the nervous system, synthetic progestins do not have this potential. Women are often put on birth control pills to manage perimenopause and menopause mood symptoms, however, the synthetic progestins do not have the same beneficial effect on GABA levels as bioidentical progesterone.

Some women have been prescribed anti-depressants to help with the mental health-related symptoms during menopause, but unless you have been diagnosed with depression there are other treatment options that are more appropriate.

Options For Using Progesterone:

• Oral micronized progesterone can be prescribed by a practitioner
• Topical micronized progesterone can be bought over the counter (try Parlor Games’ Vibrant Third Progesterone Cream)
• HRT – medroxyprogesterone (Provera)
• Birth Control pills – progestins

Many women experiencing menopause or perimenopause will experience problems with sleeping. Lack of sleep and tiredness can also make symptoms including irritability, ability to concentrate, or anxiety worse. Addressing problems with sleep may help you manage some of the mental health symptoms you can experience due to menopause. Oral and topical progesterone have all been shown to help with sleep.

Physical Changes And Impacts On How We Feel About Ourselves:

Some of the physical changes that women can experience as they go through menopause can affect the way they feel about themselves, their confidence, and self-esteem.

• Menopause is a big change physically and mentally for many women, so it’s important to give yourself the time and space you need to work through these changes.
• It can be difficult to find time for yourself when you are juggling a busy life, working, and supporting family members, friends or children. If you can, try to remember to take time for yourself too. Finding time for a cup of tea, to read a book, to go outside for a walk, gardening, or enjoying a favorite (not online) hobby is critical.
• Mindful breathing exercises and yoga work to calm your body so you can lean in to the awesomeness of who you are.
• Speaking to other women online or in real life about the physical changes you’re experiencing can also help. Women have sat around in groups to share their experiences and what they have learned since there have been women.  If you are experiencing changes to your mental health – find other women to connect with so you (a) know you are not alone and (b) may learn of new things that will work for you.

The Role Of Vitamins And Minerals In Maintaining Mood And Mental Clarity:

Vitamin B6:

Supports the regulation of hormonal activity. Vitamin B6 is found in: Meat, poultry, fish, fortified breakfast cereals, egg yolk, yeast extract, soya beans, sesame seeds, some fruit and vegetables (such as banana, avocado and green pepper)

Vitamin D:

Helps ensure adequate levels of serotonin, one of our happy chemicals. Vitamin D is found in: Oily fish, eggs, fortified breakfast cereals and fat spreads.

Magnesium:

Contributes to the reduction of tiredness and fatigue. Magnesium is found in: Nuts and seeds (such as Brazil nuts and sunflower seeds), wholegrain breakfast cereals, wholegrain and seeded breads, brown rice and quinoa.

Vitamin B5:

Contributes to normal mental performance. Vitamin B5 is found in: Wholegrains, green vegetables, tomatoes, potatoes and dairy

It’s important to realize that the mental symptoms of menopause are as real as the physical ones, and you should not wait to seek help if you are struggling. Do reach out to your doctor with a list of your new symptoms so they can provide you with the right support and help.

The 7 Ways Progesterone Supports Mental Health During Menopause:

1. Regulates Emotional Reactivity
   
   → Progesterone calms the amygdala, helping reduce anxiety, irritability, and overreaction to stress.

2. Boosts Serotonin and Dopamine Function
   
   → It modulates “feel-good” neurotransmitters, improving mood, motivation, and cognitive clarity.

3. Promotes Restful Sleep
   
   → Through its metabolite allopregnanolone and interaction with GABA, progesterone helps calm the brain and improve sleep quality.

4. Reduces Inflammation and Free Radicals
   
   → By lowering oxidative stress, it protects both physical and mental well-being, especially as estrogen and progesterone decline.

5. Eases Hot Flashes and Night Sweats
   
   → Progesterone regulates luteinizing hormone (LH) to help prevent the hormone spikes that trigger heat and sleep disruptions.

6. Supports Memory and Cognitive Function
   
   → Progesterone acts directly on brain receptors involved in learning, working memory, and executive function.

7. Improves Self-Esteem by Alleviating Physical Symptoms
   
   → By reducing joint pain, anxiety, and brain fog, progesterone indirectly supports confidence, mental clarity, and emotional stability.

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About the Author:

Kate Wells is a hormone expert and true biochem nerd who has been educating practitioners about hormones for many years. Starting out as a High School science teacher, and then pivoting to the business world, Kate new she wanted to combine her passions for science and business and found the perfect match in leadership roles at labs specializing in hormone testing and hormone formulation.

She currently runs her own bioidentical hormone product companies where she writes educational articles and continues to educate practitioners on the role of hormones in optimal longevity. Beyond nerding-out on the latest research, Kate is an avid hiker, regularly putting in 20-mile hikes in the beautiful wilds of Colorado, loves to build stuff, swing dance, and work with fabric to make colorful quilts. Kate is the author of A Forecast for Health and is the CEO and co-founder of Parlor Games LLC. Kate holds a BS, MBA, and has completed a Fellowship in Herbal Medicine.