What should you know about progesterone and menopause?

Before menopause, progesterone is made after ovulation and helps organise the menstrual cycle. As ovulation becomes less predictable, bleeding may change and progesterone exposure can vary. After menopause, the ovaries make much less progesterone. Symptoms such as hot flushes, night sweats, mood changes, vaginal dryness and low sex drive can have several causes, so one hormone result does not explain every symptom.

If someone has a womb and uses systemic oestrogen, a progestogen is commonly considered to reduce stimulation of the womb lining. The choice, route and schedule depend on medical history, bleeding pattern and other medicines. Progesterone is not a universal treatment for every menopause concern.

Write down your periods, symptoms, sleep, migraine history, blood pressure concerns and medicines. Tell your clinician about unexplained bleeding, prior clots, liver disease, breast or womb conditions, and whether you still have a womb. Ask whether local vaginal treatment, non-hormonal options or hormone therapy fits your symptoms and health history.

Arrange medical review for bleeding after menopause, bleeding that is persistent or troublesome after starting or changing treatment, or bleeding with pelvic pain, dizziness or unusual discharge. Seek urgent care for very heavy bleeding with faintness, breathlessness or weakness. New severe headache, chest pain, one-sided leg swelling or sudden breathlessness also needs urgent assessment.

Ask whether you need a progestogen with your oestrogen, how it will be taken, what bleeding pattern is expected, when symptoms should be reviewed, and which warning signs require immediate help.