Why Progesterone Deserves More Respect
If you've ever been told that progesterone “doesn’t matter” unless you have a uterus, or that your symptoms after starting progesterone HRT must mean “your dose is too high,” or that transdermal progesterone doesn’t work, then this article is for you.
Let’s bust through the confusion with what decades of science and real-world experience actually tell us about progesterone, one of the most powerful yet misunderstood hormones in a woman’s body.
Hormones Are About Individuality.
In science, the best evidence is measurable and repeatable. And when it comes to progesterone, we now have 30+ years of measurable outcomes, clinical experience, and molecular data showing how bioidentical progesterone can truly change lives when used in the right form and dose.
But here's the catch: One size never fits all. There is no “perfect number” or holy grail hormone level. Every woman’s body has its own needs, rhythms, and sensitivities.
So if you're feeling off, even if your labs look “normal”, that’s not your imagination. It’s your body asking for more support.
Mood Swings? Anxiety? Feeling Flat or Foggy?
That could be low estrogen. Or low progesterone. Or both.
Dr. Phyllis Bronson, a biochemist and researcher who’s studied these molecules for decades, reminds us that progesterone is the molecule of calm. It helps us feel emotionally stable, sleep better, and soften the stress response that’s often mistaken for “just aging.”
Many women are labeled “anxious” or “depressed” and put on SSRIs (antidepressants), when what they really need is to replace the hormones their body no longer makes.
Especially progesterone.
Progestins ≠ Progesterone
This is critical: Not all "progestogens" are created equal.
Bioidentical progesterone is the natural hormone your body knows how to use.
Progestins are synthetic imposters—molecularly different and often water-retaining, inflammatory, and mood-destabilizing.
What does the research show?
Bioidentical progesterone is a natural diuretic.
Progestins retain water and alter mood chemistry.
Bioidentical progesterone activates calming receptors in the brain (GABA-A)—synthetics do not.
The bottom line is that form matters, language matters, and bucketing all progestogens into one category is bad science and bad medicine.
Why “Low Progesterone” Is More Common Than You Think
Here’s the truth most women are never told: In your 30s, progesterone starts to quietly decline. By perimenopause, estrogen may still be cycling wildly, but progesterone is already fading.
That imbalance, called "relative estrogen dominance," can trigger:
Anxiety, mood swings
Irritability
Sleep disturbances
Breast tenderness
Heavy or irregular bleeding
And yes… even relationship strain
And it often gets misdiagnosed as “depression,” “PMS,” or “just stress.”
Why Most Women Aren’t Getting Enough Progesterone
Most conventional providers prescribe 100 mg oral progesterone (if any at all). But here's the kicker: Your body will prioritize that progesterone to make cortisol, your stress hormone, before it ever reaches your brain to calm anxiety or help you sleep.
That’s why many women almost never feel better on low doses.
I recently hosted a community chat with Dr. Bronson to pick her brain on all things progesterone and get our most pressing questions answered (you can watch the replay here!). One key takeaway? According to Dr. Bronson, giving just a little progesterone can actually be worse than giving none at all. That small dose can get shunted into other pathways, leaving your symptoms unresolved.
So What’s the Solution?
It’s not just the dose, but also the delivery method that matters.
Transdermal progesterone (creams or gels)—absorbed through the skin- is highly effective when used in sufficient amounts. And it's the preferred route for many women who want to avoid upper GI metabolites from oral progesterone (which can feel sedating or “loopy” to some).
Vaginal or rectal suppositories—particularly helpful at night for sleep and mood. Some women find they stay in better when used rectally, and absorption is excellent.
Oral progesterone—a great tool for women struggling with insomnia or who need a stronger sedative effect at night.
The key? Enough hormone, in the right form, that works for your unique body.
No Uterus? You Still Need Progesterone.
If you've been told you “don’t need progesterone” because you had a hysterectomy, please know: that’s outdated advice. Progesterone isn’t just about protecting the uterine lining.
It’s about:
Mood
Sleep
Stress regulation
Breast health
Cognitive clarity
Libido
And so much more!
And in the words of Dr. Bronson: “Progesterone is the most important molecule across the board for women.”
Women Deserve More Than Hormone Soundbites
Many influencers and even some providers are promoting hormone protocols that sound scientific but lack nuance and clinical wisdom. Dr. Bronson’s message is clear: Don’t be afraid to increase your dose if you’re still not feeling better.
And no, transdermal progesterone is not “useless,” despite the persistent myth that it doesn’t get absorbed. It absolutely does. And it works beautifully for many women.
Here’s What You Should Know:
You might need more of the right hormone in a form your body can use.
Symptoms, not just lab numbers, should guide your treatment.
Progesterone deserves a fresh look. With the right dose, form, and support, it can be a game-changer for many women navigating midlife.
For a deep dive into my conversation with Dr. Phyllis Bronson, click here to watch the recording. To learn more about Dr. Bronson, click here. To purchase her book, Moods, Emotion and Aging: Hormones and Mind-Body Connection, click here.
Phyllis Bronson, Ph.D. holds a doctorate in biochemistry. Her ongoing research involves studying the biological impact of molecules on mood and emotion. Dr. Bronson works with women who have hormone-based mood disorders utilizing her original research on human identical hormones.
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