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.

If you’ve ever thought about hormone therapy but immediately felt a wave of fear—because you were told it causes cancer—you’re not alone. One of the most common things I hear from women is: “I was told I can’t do hormones because of breast cancer,” Or, “My doctor said hormones are dangerous—especially with my family history.”

Progesterone plays a critical role in balancing estrogen’s effects on the uterine lining. In a normal menstrual cycle: Estrogen builds up the uterine lining (called the proliferative endometrium). Progesterone comes in after ovulation and stabilizes and matures that lining, converting it into a secretory endometrium—a plush, nutrient-rich environment ready for a fertilized egg to implant.

Methylation is basically your body adding a small chemical group (one carbon + three hydrogens = a “methyl group”) to another molecule. Sounds tiny. But that little shift can completely change how your body functions.

You’ve probably heard people talk about estrogen like it’s either the hero or the villain when it comes to women’s health, especially breast cancer. The truth is, this area of women’s health is full of complexity, outdated research, and evolving science. But it’s also important. Because the way your body breaks down estrogen—your estrogen metabolism—can influence everything from mood and energy to long-term risks like breast cancer.

80% of women will experience hot flashes, flushing, and night sweats as they transition through the menopausal years. The medical community refers to these symptoms as vasomotor symptoms or VMS.  The hypothalamus triggers hot flashes and night sweats in the brain to release heat built up in the body in response to a surge of adrenaline, one of our stress hormones.  While the sudden drop in estrogen is thought to be the primary trigger of the cascade that causes a hot flash, high cortisol, low cortisol, low progesterone, or low serotonin can also be drivers for hot flashes.  

Estrogen, progesterone, and testosterone modulate different aspects of brain function through several pathways initiated ONLY after hormones bind to receptors on our brain cells.

I'm often asked whether nonhormonal remedies are an effective alternative to hormone replacement therapy (HRT) for women transitioning from perimenopause to menopause (and beyond).