Progesterone for Women
Progesterone for Women
Progesterone is a key hormone produced by the ovaries after ovulation. While it plays a major role in the menstrual cycle and pregnancy, it also supports mood, sleep, and brain function.
Medically reviewed by Dr Eloise Elphinstone
BMS Accredited Menopause Doctor
Reviewed: 24/09/2026 Published: 18/03/2025
An Introduction to Progesterone
If you have a womb and are starting oestrogen HRT, you will also need to take progesterone. This is because oestrogen stimulates the womb lining, and without progesterone to keep it in balance, there’s a risk of it thickening over time. As part of HRT, progesterone is responsible for regulating the lining of the womb, preventing the development of irregular cells. Provided progesterone is prescribed appropriately there is no increase in risk of this when taking HRT. Some women also notice that progesterone may have a calming effect.
If you do not have a womb, due to a hysterectomy, you do not need to take the progesterone part of HRT.
In HRT, progesterone is taken as a tablet, included in combined patches or provided by the mirena coil. The right type of progesterone for you will depend on your health history and preferences, and can be decided when you speak with a clinician.
Progesterone treatments we prescribe
There are many options for progesterone provision as part of HRT. These include body identical micronised progesterone and a larger group of synthetic types of progestogen. There are benefits and side effects associated with all types, and tailoring both the dose and type of progesterone is an important part of prescribing HRT.
Many women will come to us with a mirena coil fitted, which also provides the progesterone part of HRT.
At Menopause Care, we prescribe a range of progesterone options including but not limited to the below options.
Benefits of Progesterone
Progesterone plays an important role in HRT. For women with an intact uterus who use systemic oestrogen, a progestogen is needed to protect the womb lining from the effects of oestrogen.
Progesterone effects:
- Protects the womb: When used alongside oestrogen, progesterone helps prevent the womb lining from becoming excessively thick, reducing the increased risk of endometrial hyperplasia and cancer associated with unopposed oestrogen.
- May support sleep: Oral micronised progesterone can have a sedating effect and may cause drowsiness, which is why it is usually taken at bedtime. Some women report improvements in sleep when taking micronised progesterone.
- May influence mood: Some women report feeling calmer or experiencing changes in mood when taking micronised progesterone. However, the evidence for using progesterone specifically to treat anxiety or mood symptoms is less established.
- Potential effects on the brain: Progesterone and its metabolites have effects within the brain, and research is exploring their potential role in cognition and neurological health. However, there is currently insufficient evidence to recommend progesterone specifically for the prevention or treatment of cognitive decline.
The type of progesterone, dose and route of administration can affect how it is experienced, so your clinician can discuss the most appropriate option for you.
Yes, micronised progesterone (Utrogestan) can have a calming effect and may improve sleep quality, especially for women struggling with night-time wake-ups. It has a mild sedative effect, so it's often taken at bedtime. However, not everyone finds it beneficial, and other factors like stress, routine, and lifestyle also play a role in sleep quality.
There is no strong evidence that progesterone HRT directly causes weight gain. Some women experience bloating or fluid retention, especially when starting treatment, but this often settles over time. Hormonal changes during menopause can affect body composition, but lifestyle factors like diet, activity levels, and sleep play a much bigger role in weight changes.
Key information about Progesterone
The main types of progesterone used in HRT are:
- Micronised progesterone (body identical) – Micronised progesterone is a body-identical form of progesterone used in some HRT regimens. Individual suitability and tolerability vary.
- Synthetic progestogens (progestins) – These are lab-made versions of progesterone, used in some forms of HRT and contraception. They include norethisterone, medroxyprogesterone acetate (MPA), and dydrogesterone. While effective, they may carry a slightly higher risk of side effects compared to body-identical progesterone.
Not everyone experiences side effects, but some women notice:
- Fatigue or drowsiness (especially with micronised progesterone)
- Bloating
- Breast tenderness
- Mood changes (some progestogens can cause low mood in sensitive individuals)
- Spotting or irregular bleeding (particularly when adjusting to a new regimen)
If side effects persist, adjusting the dose or switching the type of progesterone can often help.
There is no strong evidence that progesterone HRT directly causes weight gain. Some women experience bloating or fluid retention, especially when starting treatment, but this often settles over time. Hormonal changes during menopause can affect body composition, but lifestyle factors like diet, activity levels, and sleep play a much bigger role in weight changes.
Micronised progesterone is a form of progesterone that has been processed into tiny particles, making it easier for the body to absorb. It’s considered the safest form of progesterone for HRT and is often better tolerated than synthetic progestogens.
Body-identical progesterone refers to progesterone that has the same molecular structure as the hormone naturally produced in your body. It’s derived from plant sources and is available as micronised progesterone (Utrogestan) in the UK. This form is preferred in HRT due to its safety profile and lower risk of side effects.
Taking progesterone cyclically means using it for part of the month rather than every day. This approach is usually for women who are still perimenopausal or on sequential HRT, meaning they take oestrogen daily and progesterone for 12–14 days per month. This mimics a natural menstrual cycle and often results in a monthly withdrawal bleed.
Taking progesterone continuously means taking it every day without a break. This is typically used in continuous combined HRT, which is suitable for women who are postmenopausal (12 months without a period). This approach helps to prevent a withdrawal bleed and keeps hormone levels steady.
Progesterone is usually prescribed alongside oestrogen to protect the uterus from overgrowth.
Progesterone is not easily boosted through lifestyle alone. However, certain factors may support healthy progesterone levels, including:
- Managing stress – High cortisol (stress hormone) can reduce progesterone levels.
- Supporting ovulation – If you are still ovulating, ensuring a well-balanced diet, regular exercise, and good sleep can help maintain progesterone production.
- Including magnesium and vitamin B6 – These nutrients support hormone balance and progesterone metabolism.
