A little bit about progesterone

This article by Dr Mary Claire Haver talks about Progesterone – the hormone that's supposed to be your friend, but sometimes feels more like that mate who means well but keeps giving you grief.

Here's the situation: if you're on systemic oestrogen ( "systemic oestrogen" simply means oestrogen that travels throughout your entire body via your bloodstream, rather than being delivered locally to just one specific area) and still have your uterus, you need something to protect your uterine lining from thickening up too much. That's where progesterone comes in – it's basically the bouncer keeping things under control. Without it, you could end up with endometrial hyperplasia, which sounds complicated but essentially means your womb lining gets too thick and could potentially become cancerous. Not ideal.

For most women, oral micronised progesterone does the job brilliantly. But some of us get the short straw and experience mood swings that would make a teenager proud, bloating that makes you look six months pregnant, or grogginess that has you feeling like you've been hit by a truck. The mood changes are particularly frustrating – you know something's off, but you can't quite put your finger on what.

The good news? You're not stuck with oral progesterone if it's making your life miserable. The hormonal IUD is becoming a favourite – it delivers a small amount of progestin directly to your uterus, so you get the protection without your whole system being flooded with hormones. Plus, it often reduces or stops periods entirely, which frankly sounds rather lovely.

Vaginal progesterone is another option – yes, the same capsule you'd normally swallow can be used vaginally instead. It reaches its destination more directly, potentially causing fewer side effects. And there's also a newer combination called conjugated oestrogen plus bazedoxifene that doesn't need any progestin at all – it's got a built-in blocker that protects your uterus.

The key takeaway? If oral progesterone is making you feel rubbish, don't suffer in silence. There are alternatives, and the right one for you is out there.

Just a friendly reminder: I'm sharing what I've learned, not prescribing what you should do. Always chat with your GP about what's right for your unique situation!

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