Cyclical Progesterone Therapy for Heavy Menstrual Periods in Perimenopause
Perimenopause is a transitional phase in a woman's life when hormone levels fluctuate as ovarian function declines, leading to various physical and emotional changes. One of the most common concerns I see in naturopathic practice during this phase of life is heavy menstrual bleeding. In this article, I will review the use of cyclical progesterone therapy as an effective option for managing heavy menstrual periods in perimenopause.
Understanding Heavy Menstrual Periods in Perimenopause
Heavy menstrual bleeding, also known as menorrhagia, is characterized by abnormally heavy or prolonged menstrual periods. It can lead to significant inconvenience, discomfort, iron deficiency and even anemia in some cases. Many women in perimenopause may experience menorrhagia when estrogen exceeds the balance of progesterone due to anovulatory or irregular menstrual cycles.
Cyclical Progesterone Therapy to the Rescue! Cyclical progesterone therapy involves taking progesterone during specific phases of the menstrual cycle to regulate the menstrual flow. Progesterone, a hormone produced naturally in the body, plays a crucial role in the menstrual cycle by preparing the uterus for pregnancy, and controlling the shedding of the uterine lining.
If you are not familiar with Dr. Jerylinn Prior’s work at the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) at the University of British Columbia, you should definitely check it out! She has dedicated much of her career to researching the use of progesterone therapy in perimenopause and menopause, and is considered one of the leading experts in this area. Based on her expertise, and what is known about the natural history of menorrhagia, she recommends using cyclical progesterone to reduce both the duration and intensity of menstrual bleeding (1) (2) (3). Her recommendations are what has guided me to use cyclical progesterone therapy in my naturopathic practice to help provide relief for women with menorrhagia.
The optimal dosage and timing of cyclical progesterone therapy can vary depending on an individual's specific needs and medical history. Having said this, it is crucial to consult with a healthcare provider who is familiar with hormone prescribing so they can evaluate your symptoms, determine if further testing is needed, and whether you would be a good candidate for progesterone therapy.
Other Potential Benefits of Progesterone Therapy If you are wondering if there are other benefits of taking progesterone, you might be pleasantly surprised to learn that progesterone may also help to improve your sleep quality, and reduce the severity of hot flashes and night sweats (4) (5) . A recent study published in the Journal of Nature, also found that progesterone therapy significantly reduced emotional and physical interference with daily activity in perimenopausal women (5).
What Can We Take From This Information?
If you are a perimenopausal woman with heavy menstrual bleeding, and no known underlying gynecological disorder, you may be a good candidate for cyclical progesterone therapy. By reducing excessive menstrual bleeding, improving sleep quality, and vasomotor symptoms progesterone can provide much-needed relief for women during the perimenopausal period.
Interested in exploring if you would be a candidate for progesterone therapy? Please contact Juniper Family Health and book a naturopathic consultation. We are here to help!
In health and happiness,
Dr. Meghan van Drimmelen | Naturopath Victoria BC
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