Understanding Progesterone and Progestogens: What You Need to Know
Progesterone is a vital hormone that plays a key role in regulating the menstrual cycle, preparing the body for implantation, and maintaining a healthy pregnancy. During perimenopause, progesterone levels fluctuate, leading to symptoms like irregular periods, mood swings, and sleep disturbances. Understanding these changes and how to manage them is crucial for women's health during this transitional phase. Explore how monitoring progesterone levels can provide insights into your health and guide effective treatment strategies.
Progesterone and the gut
Progesterone, often associated with reproductive health, also plays a crucial role in gut health. It modulates immune responses and gastrointestinal function, influencing conditions like irritable bowel syndrome (IBS). Fluctuations in progesterone levels, particularly during perimenopause and menopause, can exacerbate digestive symptoms such as bloating, abdominal pain, and irregular bowel movements. Understanding this connection is vital for managing gut health during hormonal transitions.
HRT & Weight Loss Injections: What You Need to Know
Combining hormone replacement therapy (HRT) with weight loss injections like semaglutide (Wegovy, Ozempic) or tirzepatide (Mounjaro) is increasingly common. However, recent guidance from the British Menopause Society highlights potential interactions: these medications can slow digestion, possibly reducing the absorption of oral progesterone, a key component of HRT. This may compromise endometrial protection, especially for women with a uterus. Alternative progesterone delivery methods, such as the Mirena coil or combined HRT patches, are recommended. It's crucial to consult with a healthcare provider to adjust your treatment plan accordingly.
Brain Fog in Women: What’s Happening During Pregnancy and Menopause?
Experiencing forgetfulness, difficulty concentrating, or mental fatigue? These are common symptoms of brain fog, particularly during pregnancy and menopause. Hormonal fluctuations, such as changes in estrogen and progesterone levels, can impact brain function, leading to cognitive challenges. While these symptoms are often temporary, they can be managed through lifestyle adjustments, including adequate sleep, stress management, and a balanced diet. In some cases, hormone replacement therapy (HRT) may offer relief. It's important to consult with a healthcare provider to determine the best approach for your individual needs.
Feeling Constantly Tired? Let’s Talk About Fatigue
Fatigue is a common yet often overlooked symptom among women, particularly in their 40s and 50s. It's more than just feeling tired—it's a persistent, overwhelming exhaustion that isn't relieved by sleep. This chronic fatigue can significantly impact daily life and may be linked to various factors such as hormonal changes during perimenopause and menopause, iron deficiency, thyroid dysfunction, psychological stress, sleep disorders, and nutritional deficiencies. Understanding the underlying causes is crucial for effective management and treatment. Explore how addressing these factors can help restore your energy and well-being.
The Non-Contraceptive Benefits of Zoely: What Women in the UK Should Know
Zoely isn’t just a reliable contraceptive — it’s a powerful ally for your overall health. From lighter, more manageable periods to clearer skin and relief from PMS symptoms, this unique estradiol and nomegestrol pill offers benefits far beyond pregnancy prevention. Discover how Zoely can support your menstrual health, boost your well-being during perimenopause, and help you feel more in control of your cycle.
Anti-Mullerian Hormone - AMH
Anti-Müllerian Hormone (AMH) is a key indicator of ovarian reserve, reflecting the quantity of a woman's remaining eggs. While AMH levels naturally decline with age, they can provide valuable insights into reproductive health. In perimenopause and menopause, AMH testing can help assess the timing of ovarian decline and inform decisions about fertility preservation or hormone replacement therapy (HRT). However, AMH levels should be interpreted cautiously, as they do not account for egg quality or guarantee fertility outcomes. It's essential to consult with a healthcare provider to understand what AMH levels mean for your individual health journey.
A Women's Health Doctor's Guide to Preventing Osteoporosis
Osteoporosis affects 1 in 3 women and is often termed a "silent disease" due to its lack of symptoms until a fracture occurs. This condition, characterised by weakened bones, becomes more prevalent around menopause when estrogen levels decline, impacting bone density. Preventive measures include regular weight-bearing and resistance exercises, adequate intake of calcium and vitamin D, hormone replacement therapy (HRT) for eligible women, and maintaining good posture to reduce fall risk. Early intervention and lifestyle modifications play a crucial role in preserving bone health and preventing fractures.
Contraception Choices During Perimenopause
Navigating contraception during perimenopause can be complex, as fertility can persist even with irregular periods. It's essential to continue using reliable contraception until you've been without a period for 12 consecutive months, marking the onset of menopause. Options like hormonal contraceptives—such as combined oral contraceptives, the mini-pill, or hormonal intrauterine devices (IUDs)—not only prevent pregnancy but can also alleviate perimenopausal symptoms like hot flashes and menstrual irregularities. However, considerations regarding age, health history, and potential risks are crucial. Consulting with a healthcare provider ensures the chosen method aligns with your individual health needs and lifestyle.
Periods during the perimenopause … what can happen?
Perimenopause involves complex hormonal fluctuations that impact menstrual cycles. Initially, shorter cycles and heavier periods may occur due to higher FSH and oestrogen levels. As follicle numbers decline further, cycles become more irregular, with missed periods becoming more common.
Progesterone for perimenopausal symptoms
Progesterone plays a crucial role in managing perimenopausal symptoms by balancing estrogen levels and supporting overall hormonal harmony. It helps regulate menstrual cycles, alleviate mood swings, and reduce the risk of endometrial hyperplasia. Incorporating natural progesterone, such as micronized progesterone, can be an effective strategy for women seeking to manage perimenopausal symptoms without synthetic hormones. Consulting with a healthcare provider is essential to determine the most appropriate treatment plan tailored to individual needs.
Endocrine ‘disruptors’ - xenoestrogens
Xenoestrogens are synthetic chemicals that mimic estrogen in the body, potentially disrupting hormonal balance. Common sources include plastics (e.g., BPA), pesticides (e.g., DDT), and personal care products containing parabens. Exposure to these substances has been linked to various health issues, including hormone-related cancers and reproductive health problems. To minimise exposure, consider reducing plastic use, choosing organic foods, and selecting personal care products with natural ingredients. Being mindful of these factors can help protect your health from the potential effects of xenoestrogens.
Bleeding on HRT - information for women who still have a womb
Experiencing vaginal bleeding while on hormone replacement therapy (HRT) is common, especially for women who still have a uterus. The type and timing of bleeding can vary depending on the HRT regimen—continuous or sequential. While light, short-duration bleeding is often considered normal, especially with sequential HRT, unscheduled or prolonged bleeding may indicate underlying issues such as endometrial hyperplasia or cancer. It's crucial to monitor bleeding patterns and consult with a healthcare provider if irregularities occur. Early detection and appropriate adjustments to HRT can help manage symptoms and reduce risks.
Long term safety of HRT
Hormone Replacement Therapy (HRT) remains a cornerstone in managing menopausal symptoms, offering relief from hot flushes, night sweats, and mood changes. While HRT is generally safe for women under 60, especially when initiated close to menopause onset, long-term use carries certain risks. These include a slightly increased risk of breast and ovarian cancers, as well as potential cardiovascular concerns if started many years post-menopause. However, for many women, the benefits—such as reduced risk of osteoporosis and improved quality of life—outweigh the risks. It's crucial to have a personalised discussion with a healthcare provider to weigh the pros and cons based on individual health profiles.
Progesterones and meningiomas
Recent studies have highlighted a potential link between certain progesterone-based medications and an increased risk of meningiomas, which are typically benign brain tumors. While these tumors are more common in women and often asymptomatic, some high-dose progestogens—such as medroxyprogesterone acetate (found in Depo-Provera), cyproterone acetate (found in Dianette), and nomegestrol acetate (found in Zoely)—have been associated with a higher risk of developing meningiomas. Notably, the risk appears to be dose-dependent, with prolonged use increasing the likelihood of tumor development. It's important to note that while these associations exist, the overall risk remains low, and more research is needed to fully understand the relationship between progesterone use and meningioma development. Women using these medications should consult with their healthcare providers to discuss potential risks and consider alternative options if necessary.
Diagnosing the perimenopause
Diagnosing perimenopause can be complex due to the absence of a definitive test. According to the British Menopause Society, perimenopause is characterized by changes in menstrual cycle patterns, such as infrequent periods and cycles becoming slightly longer, e.g., 6–7 weeks apart. Common symptoms include hot flushes, night sweats, cognitive changes, mood swings, sleep disturbances, and urogenital symptoms like vaginal dryness. In some cases, a trial of hormone replacement therapy (HRT) may be used to assess symptom improvement. It's essential to consult with a healthcare provider to evaluate symptoms and consider appropriate treatment options.
Cycle mapping - how best to monitor your menstrual cycle
Cycle mapping involves tracking key female hormones—LH, FSH, estradiol, and progesterone—throughout your menstrual cycle to assess ovulation and hormone patterns. Unlike traditional single-point blood tests, cycle mapping provides a comprehensive view, especially beneficial for those with irregular cycles, perimenopausal symptoms, or fertility concerns. Utilizing advanced tools like the Mira hormone monitor, which offers real-time, quantitative data, can enhance accuracy in tracking hormonal fluctuations. This approach aids in identifying ovulation timing, luteal phase length, and menopausal progression, facilitating informed healthcare decisions.
Hormones and sleep during the menopause
Menopause brings about significant hormonal changes that can disrupt sleep patterns. Declining levels of estrogen and progesterone, along with reduced melatonin production, often lead to symptoms like night sweats, insomnia, and early morning awakenings. These disturbances can contribute to anxiety and depression, creating a challenging cycle. Hormone Replacement Therapy (HRT), particularly when combined with progesterone, has been shown to improve sleep quality by reducing night sweats and promoting deeper, more restorative sleep. Unlike sleeping tablets, HRT addresses the underlying hormonal causes of sleep disturbances, offering a more sustainable solution. For women in perimenopause, micronized progesterone can alleviate both sleep issues and heavy periods. Consulting with a healthcare provider can help determine the most appropriate treatment tailored to individual needs.
The role of the microbiome in phytoestrogens
The gut microbiome plays a crucial role in metabolising phytoestrogens—plant-derived compounds found in foods like soy, flaxseeds, and legumes. These compounds can mimic estrogen in the body, potentially alleviating menopausal symptoms and supporting hormonal balance. However, their effectiveness depends on the composition of an individual's gut bacteria. Certain gut microbes are better equipped to convert phytoestrogens into bioactive forms that the body can utilise. A diverse and healthy microbiome enhances this conversion, while an imbalanced microbiome may reduce efficacy. Factors such as diet, antibiotic use, and lifestyle choices can influence gut health and, consequently, the benefits derived from phytoestrogens. Maintaining a balanced microbiome through a fiber-rich diet, probiotics, and prebiotics may optimise the health benefits of phytoestrogens.
Non-steroidal painkillers and the ‘pill’ - new evidence of blood clot risk
Taking NSAIDs like ibuprofen with combined oral contraceptives (the pill) may increase the risk of blood clots (VTE). Studies suggest this combination can raise the risk significantly. If you’re on the pill, it’s safer to use paracetamol for pain relief and consult your healthcare provider before using NSAIDs—especially if you have additional risk factors like obesity or a history of clots.