Why Progesterone Is the First Hormone to Decline in Perimenopause—and Why That Matters

If you’re in your 40s and noticing heavier periods, intense cramping, sleep disruptions, or feeling more anxious than usual, you’re not imagining it—and you’re not alone. These are some of the most common signs of perimenopause, the transitional phase before menopause. And they’re often linked to a single, powerful hormone: progesterone.

🌿 The First Hormone to Drop

During perimenopause, your body begins to shift hormonally, even if you're still getting regular periods. The first hormone to noticeably decline is progesterone—the calming, soothing hormone that helps balance the effects of estrogen.

When progesterone starts to drop but estrogen remains high or fluctuates erratically, you can experience what’s often called estrogen dominance. This imbalance is a big reason why so many women in their 40s suddenly start dealing with:

• Heavy, prolonged periods

• Severe cramping

• Breast tenderness

• Mood swings or anxiety

• Poor sleep

• PMS that feels worse than it did in your 20s or 30s

  
  

⚠️ The Standard Approach: IUDs

Many women who report these symptoms to their OB-GYN are offered a hormonal IUD (like Mirena) as a solution. These IUDs release synthetic progestins to thin the uterine lining and reduce bleeding.

And while they can offer symptom relief, they don’t address the root cause: your body is low in real, natural progesterone.

Even worse, synthetic progestins do not act like natural progesterone in the body. They don’t support your mood, brain health, bones, or sleep the way real progesterone does. So while the bleeding may stop, the rest of your symptoms often don’t improve—and in some cases, they get worse.

🌿 A Better Way: Replenish What’s Missing

From a functional perspective, it makes far more sense to support your body with bioidentical progesterone, either through topical creams, oral capsules, or even herbal and lifestyle approaches that help encourage your natural production.

When given the right support, progesterone can:

• Lighten and regulate your periods

• Calm the nervous system and reduce anxiety

• Improve sleep quality

• Support bone and brain health

• Balance estrogen levels naturally

  
  

Instead of silencing your symptoms, we listen to them—and use them as a guide to help bring your hormones back into balance.

💬 Wrap Up

Perimenopause is not a disease—it’s a transition. But the symptoms that come with it are your body’s way of asking for support, not suppression. Before jumping to an IUD or birth control, it’s worth exploring whether your body simply needs more of the hormone it’s starting to lose: progesterone.