I read a poster shared by a private menopause clinic on their social media channel. It confused me because I had thought that reduced oestrogen was the main cause of symptoms, not reduced progesterone.
I headed off to do some research and most of what I read seems to suggest that reduced oestrogen is the biggest devil.
More about oestrogen
Following puberty, it’s oestrogen that helps to release eggs from the ovaries. It also regulates our periods and helps with conception if we want to have children.
Oestrogen also plays a role in controlling other functions, including bone density, skin and body temperature and keeping the vagina moist. Thus, a reduction in oestrogen causes many symptoms associated with the menopause, such as irregular or absent period, hot flushes, night sweats, mood swings, vaginal dryness, reduced libido (sex drive), stress incontinence, joint pains and a thinning of the bones, which can lead to osteoporosis.
Other reported symptoms are an increase in urinary tract infections (UTIs) due to a thinning of the urethra, breast tenderness, headaches or accentuation of pre-existing migraines, depression, trouble concentrating, fatigue and anxiety.
More about progesterone
Progesterone helps to regulate your cycle but its main job is to get your uterus ready for pregnancy. After ovulation each month, progesterone helps thicken the lining of the uterus to prepare for a fertilised egg.
If there is no fertilised egg, progesterone levels drop and menstruation begins. If a fertilised egg implants in the uterine wall, progesterone helps maintain the uterine lining throughout pregnancy.
A decrease in progesterone levels do not affect the body in the same way as reduced oestrogen (as far as I can ascertain), however if women are taking HRT they need oestrogen as well as progesterone so as to make the body flush out the womb lining (a period). If this doesn’t happen there is a greater chance of cancer in the lining of the womb.
A synthetic form of progesterone, called progestogen, is usually used in combination with oestrogen in HRT. (However, if you have had a hysterectomy, you do not need progesterone and can take oestrogen-only HRT.)
I had read of far fewer effects of low progesterone during my research but these are indicated as including, headaches or migraines; mood changes, including anxiety or depression; and irregular periods.
Further to this, because I was curious about the poster, I have also asked for more information from a menopause counsellor. She reported: “Lower levels of progesterone contribute towards some symptoms, eg anxiety. It’s known as the calming hormone.” This is interesting and not something I had realised.
The counsellor added: “Oestrogen gets more bad press as progesterone tends to fall more evenly, while oestrogen has more ups and downs.”
In addition, women can suffer reduced testosterone and this has side effects such as hair loss, fatigue and also an impact on libido.
Still, it’s complicated
It’s more complicated than the poster shared by the Menopause Clinic suggested and a spokesperson did eventually agree with me that all hormones play a role in the peri menopause and the menopause.
I just felt that if you read their poster you would be worrying about whether your GP had issued you with enough progesterone replacement, as well as the oestrogen.
A better poster
This poster is far more accurate, in my opinion, because it’s a combination of changing hormones that lead to a range of symptoms. This would lead me to my GP. I felt that the other poster was aimed at sending people to a private clinic.