Progesterone for Women 35+

What you need to know

I remember turning 35 and thinking, “I’m so far out from menopause, this is a 5-year-from-now worry.”

It’s hard to even fathom menopause when you’re still having babies and coming to terms with not being in your 20s anymore.

But the reality is… we now understand A LOT more about perimenopause and menopause and how we can set ourselves up for a MUCH smoother transition.

One thing we now recognize - progesterone levels naturally decrease starting in your mid-30s.

So let’s take back control over the trajectory of our Queen years. Let’s help future generations learn and thrive from the research and foundation we’re laying.

One simple thing I recommend ALL women consider: Progesterone.

---

What Is Progesterone?

Progesterone is often referred to as “nature’s chill pill.” It’s a primary reproductive hormone that supports your uterine lining (for fertility purposes) and balances estrogen (for overall vitality).

When progesterone and estrogen are out of balance, we can find ourselves in a state of estrogen dominance. This can lead to heavy periods, PMS, skin issues, metabolic dysfunction, and breast/endometrial tissue changes.

Estrogen dominance doesn’t always mean your estrogen levels are high; it may be that your progesterone is too low in comparison, skewing the ratio.

This is becoming increasingly more common with endocrine disruptors in our beauty products/water/food, and other lifestyle factors mentioned below.

---

How Does Progesterone Benefit Me?

Healthy progesterone levels are necessary for:

• Thyroid health

• Brain function

• A balanced mood

• Sleep quality

• Bone health

• Metabolic health

• Cardiovascular health

Progesterone balances your DRIVE to do/be/produce. It helps you feel more at ease, more feminine. Yes, please!

---

What Contributes To Low Levels?

1. Chronic Stress and/or Thyroid Problems

   1. It’s impossible to avoid stress, which is often chronic and unrelenting. The body uses a hormone precursor, pregnenolone, to make cortisol and progesterone. Under stress, the body diverts its resources towards making cortisol over progesterone. Great for survival, not great for feeling your best!

   2. Stress can also shorten the luteal phase (the second part of your cycle after ovulation), which reduces progesterone.

2. Undereating

   1. It’s also very common for women to undereat - in an attempt to lose weight. Significant calorie deficits over long periods of time can suppress GnRH, a hormone that is necessary for ovulation. No ovulation = poor progesterone production.

3. Age-Related Decline

   1. Progesterone production begins declining in the mid-30s, often 10-15 years before menopause. Stress and lifestyle factors compound age-related decline.

Take years of stress and/or dieting, then add aging and the natural rollercoaster of perimenopausal hormone fluctations on top of that - it’s the perfect storm.

---

How Do I Know If I Need It?

I’m a firm believer in pairing labs with symptoms, versus relying on one marker alone.

Let’s start with indicators of low progesterone that you may be feeling or noticing.

Early Indicators (Ages 35-40)

• Premenstrual syndrome (PMS) that’s worsening or new

• Sleep disruption, particularly in the luteal phase

• Increased anxiety or mood swings

• Breast tenderness

• Irregular menstrual cycles

• Weight gain, especially around the midsection

Progressive Symptoms

• Hot flashes or night sweats

• Heavy or irregular periods

• Fatigue despite adequate sleep

• Brain fog and memory issues

• Joint aches

• Decreased libido

  ---

Lab Tests

If you can get lab testing done, here’s what to look for.

Serum Progesterone:

1. Conventional Lab Range:

   1. Luteal Phase (Days 19-21): 0.1-24 ng/mL (varies by cycle phase)

2. Functional Medicine Optimal Ranges:

   • Luteal Phase: 15-30 ng/mL

   • Follicular Phase: <1 ng/mL

   • Postmenopause: <0.5 ng/mL

3. Testing Timing: Day 21 of 28-day cycle (7 days post-ovulation).

Taking oral progesterone? Oral progesterone has a half-life of up to 18 hours, so serum testing can be elevated for 1-2 days post-use. Take note of this when testing.

It’s important to note that progesterone and estrogen levels fluctuate wildly during perimenopause, so while testing can be a helpful indicator, it can be hard to nail down an accurate reading.

You’ll also want to test for the following:

• Estradiol

• FSH

• LH

• SHBG

• Thyroid (TSH, Free T3/T4, Reverse T3, antibodies)

• DHEA-S

These will give you a more comprehensive picture of what’s going on with your thyroid, stress response, and other markers of reproductive health.

Your provider may have you start with estrogen, then add progesterone, or start with progesterone only.

---

---

Can You Increase Levels Naturally?

Yes and no.

Yes - There are diet and lifestyle strategies that support your body’s natural production.

No - Because sometimes those lifestyle adjustments aren’t enough to get your levels where you need them to feel your best. Unfortunately, we cannot offset age or dial in some of our chronic stress.

The Biggest Needle Movers?

1. Eating sufficient calories.

   1. This looks different for everyone; however for most women, this is at least 1800 calories/day.

   2. If or when you diet, stick to a moderate calorie deficit for no more than 12-16 weeks.

   3. Protein should be at least 100 grams/day, fat should be no less than 60 grams/day, and carbohydrates are based on your tolerance and goals.

2. Limit caffeine

   1. You don’t have to avoid it, but stick to less than 200 mgs (no more than 2 cups)

3. Go to bed earlier

   1. Whatever you can do to boost your total number of hours and quality sleep matters!

4. Find ways to manage stress.

   1. Notice how I didn’t say reduce stress? Sometimes it’s nearly impossible to cut out or remove stressors, so your goal is to learn how to manage the ones you have.

   2. A few stress relievers that are fun, free, and more practical that I love.

      1. Music - match music with your mood. Singing/humming can actually support vagus nerve stimulation (calm you down!).

      2. Time outdoors - it’s getting warmer out. Kick off your shoes, get your toes in the grass (or sand if you’re lucky), and take 5 deep belly breaths.

      3. Play with your pup (and/or kids) - That oxytocin boost or few minutes of silliness (think card games, catch, tag, hide and seek) all add up!

---

Key Supplements

Vitamin C, Magnesium, Vitamin D, Omega-3, Zinc, and B6

1. One study showed that those who took 750mg of vitamin C daily increased their progesterone levels by 77%.

2. To make this easy

   1. Take a high-quality multi and omega-3. I recommended Needed.

   2. Dose vitamin D according to your labs (aiming for 50-60 ng/mL)

   3. Consume vitamin C rich foods - like kiwis, citrus, and straberries to compliment what’s in your multi.

Chaste Tree Berry

• This requires at least 3 months to see improvements, but it supports pituitary function, increases LH production, and can help increase progesterone levels.

---

How Do You Supplement Progesterone?

I intentionally use the word “supplement” here, because with bioidentical forms of progesterone, you’re essentially supplementing or replacing what your body is naturally designed to create.

What to expect:

• ~1/3 of women notice life-changing impacts, especially if sleep or mood was the primary concern.

• ~1/3 of women don’t notice any significant changes, especially for the first few months.

• ~1/3 of women find progesterone makes them feel irritable or very sleepy. For these women, topical or other options may be better than oral.

If your provider (or telehealth physician) recommends that you take progesterone due to your age/labs/symptoms, here’s what to look for:

Bioidentical Progesterone vs Synthetic Progestins

There are biodentical forms (what’s now most often recommended) and syntheic forms of progeterone (generally avoided).

• Bioidentical: Look for micronized progesterone in the brand name Prometrium or use compounded versions.

Delivery Methods

• Oral Micronized Progesterone

  • Pros: Convenient, well-studied, good for sleep, systemic

  • Cons: Requires liver metabolism, may cause drowsiness if you take too much

  • Best for: Sleep issues, anxiety, general hormone balance

  • Typical dose: 100-200 mg at bedtime either only during the luteal phase of cycle (after ovulation, before your bleed) or cycle long (depending on your symptoms/age). Start with lower doses.

  Topical Creams/Gels

  • Pros: Avoids first-pass liver metabolism, no capsules to swallow, doesn’t always require a prescription

  • Cons: Variable absorption rates, skin irritation possible, need to be cautious not to transfer the lotion by touching others

  • Best for: Local symptoms, those who can't tolerate oral or want to start at a lower dose (50 or 75 mg cream)

  Vaginal Suppositories

  • Pros: Direct endometrial effects, minimal systemic absorption

  • Cons: Messiness, potential irritation

  • Best for: Heavy bleeding, endometrial protection

I personally use a compounded, oral micronized version of progesterone from the company, Raena. I appreciate that it’s a cleaner version (no peanut oil, titanium dioxide, artifical dyes) and you can easily work with their telehealth providers to get a RX.

Use code STEPHG for 10% off

If your provider is willing to order progesterone capsules for you and you don’t mind the artificial dyes/additives, Prometrium is inexpensive and works well.

---

I hope this has been a helpful primer on why progesterone may be a great place to start, especially if you’re 35+. I’ve noticed a significant difference in my sleep quality and a reduction in my anxiety/racing thoughts. I hope you do too!

---

Medical Disclaimer:

This content is for educational and informational purposes only. The information provided in this publication is not intended to diagnose, treat, cure, or prevent any disease or medical condition. It should not be used as a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.

Always consult with your physician or other qualified healthcare professional before:

• Starting any new supplements, medications, or treatment protocols

• Making changes to existing medical treatments

• Addressing any health concerns or symptoms

Individual results may vary. What works for one person may not work for another. Your healthcare provider is the best source for guidance regarding your specific health circumstances and medical history. The author is not liable for any adverse effects or consequences resulting from the use of any information, suggestions, or procedures discussed in this publication.

Affiliate Disclaimer:

This post contains affiliate links. If you purchase through these links, I may earn a small commission at no additional cost to you. I only recommend products I personally use or believe will add value to my readers. Your support helps keep this content free.