79. What Happened When I Ran Out of Progesterone (and Why It Matters After 40)
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What happens when you stop taking progesterone, even for just a few weeks? In this quick episode, I’m sharing my personal story of running out of progesterone, how my symptoms came rushing back, and why this hormone is so important for women in perimenopause.
You’ll learn why dosing and delivery methods matter, common signs of low progesterone, and how we help clients find a provider who actually understands women’s hormones. I covered:
- My story of running out of progesterone and the symptoms that returned
- How progesterone is the first hormone to decline after 35
- Common signs of low progesterone: mood swings, anxiety, poor sleep, heavy periods
- The pros and cons of oral, vaginal/rectal, and topical progesterone
- Why dosing matters (too low can trigger “estrogen kickback”)
- Why it’s vital to find a hormone-savvy provider who listens and prescribes appropriately
A Personal Wake-Up Call
Hey, today I want to share a personal story with you. I think it’s really important because it highlights just how much our hormones matter, especially progesterone.
Recently, I ran out of my progesterone prescription. I didn’t think much of it at first, but let me tell you: it ended up being a big reminder of why progesterone is so critical in perimenopause.
What Happened When I Ran Out
o here’s what happened. I hadn’t been feeling my best — I was more irritable than usual, more emotional, and my sleep wasn’t as good as it normally has been. So I asked my doctor to increase my dose. The problem was, she was away. She travels a ton in the summer, teaches at a university, bought a house with her partner, so she’s not always available – which I can totally respect. And in hindsight, I should have just refilled my normal prescription while I waited, but because it was a 90-day supply, I didn’t.
Then there was miscommunication with her team, and long story short, I went several weeks without progesterone. And during that time, my symptoms came back with a vengeance — anxiety, overwhelm, major irritability (poor Mike), more emotional, I had a pretty heavy period, and crappy sleep. Basically, all the things progesterone had been helping to keep in check.
And since I’m also on estrogen, being without progesterone meant I had unopposed estrogen for several weeks. That’s not ideal, because estrogen always needs to be balanced with progesterone to protect the uterine lining but also estrogen’s more stimulatory effects. So I had to lower my estrogen dose temporarily, until I could get my progesterone back on board.
The Challenge of Finding the Right Provider
And here’s the other annoying thing — I have to change doctors. My current doctor is a Naturopath with integrative health experience and hormone experience, so she’s kind of a unicorn. So I’m a bit bummed because she’s based in DC, and because of some malpractice insurance restrictions, she can no longer prescribe to patients in other states unless they go in person. And I have zero interest in going to DC several times per year. During COVID, things were more lenient with telehealth, but now it seems for some doctors, regulations are tightening.
Anyway, I know firsthand how frustrating it can be to find a good, hormone-savvy provider. That’s one of the reasons we help our clients navigate this. We actually give you access to an HRT directory, organized by state, plus vetted telehealth companies we like. And if there are none in your state listed, we give you the steps to find someone with proper training. We also walk you through the right questions to ask so you don’t go into an appointment — whether in person or online — blindly. The worst thing you can do is show up for a consult and not be prepared – you really do have to learn how to advocate for yourself and be confident doing so.
The good news is, I do have someone in mind for my new provider. She seems very accommodating, open to running the labs I want, and willing to prescribe both FDA-approved and compounded formulations – which is important to me as I take both.
Why Progesterone Matters in Perimenopause
So let’s talk about progesterone. It’s usually the first hormone to decline after 35, and that drop can show up as anxiety, irritability, mood swings, trouble sleeping, heavier periods, even feeling more overwhelmed than usual.
Here’s why this hormone is so important:
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Progesterone has a calming effect on the brain.
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It helps balance estrogen, so when it’s low, estrogen can feel even more dominant.
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It supports lighter, more manageable cycles.
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It’s often the missing piece in poor sleep and unpredictable moods.
Why Dosing and Delivery Methods Matter
Now, dosing matters. Too low of a dose can actually cause what’s called an “estrogen kickback”…
The delivery method matters too:
- Oral progesterone converts into a metabolite called allopregnanolone, which is very calming to the brain. For some women, this feels amazing. But for others, it can cause grogginess or even more depression. Plus, oral progesterone has to go through the liver first, which changes how much your body actually uses.
- Vaginal or rectal applications – yes, you stick the pill up your vagina or your anus – I know – fun times in perimenopause – this bypasses the first liver pass and can deliver a more steady effect, often without as much grogginess.
- Topical creams can work, but only at the right dose. Many over-the-counter creams are too weak to actually protect the uterine lining; they are quite low dose. So at the time of this recording, the brand that I recommend is Ona’s Natural. I’ll link to it in the show notes, as it comes in 50 mg, 100 mg, even 200 mg. Which is usually the sweet spot for many women. You can obviously start with 100 and increase if needed.
And one more thing: the FDA-approved formulation, known as Prometrium, which you need a prescription for, contains inactive ingredients like peanut oil or yellow dye which some women react to. This is where compounded formulations can be very helpful — they can be tailored to the right dose and avoid unnecessary fillers. I used to take Prometrium but didn’t love how I felt with it, so I switched to a compounded, slow release progesterone. I take it orally and feel good with it.
Resources for Learning More About Progesterone
If you want to dig deeper into this, I recommend checking out the work of Phyllis Bronson. She’s a research scientist, biochemist and clinician who’s studied women’s hormones and HRT extensively. Her book Moods, Emotions, and Aging, is excellent. I’ll link to it in the show notes.
I’ll also link to an episode I did last year with Carol Petersen, a Registered Compounding Pharmacist and expert in women’s hormones, who shared so much valuable insight about progesterone – it is my most viewed video on YouTube.
By the way, if you’re watching this on YT, please subscribe to my channel, give the video a like and comment below! That really helps the algorithm put my videos in front of more women who need this education. And if you’re listening on Apple, Spotify or other platforms, please leave a rating and review. That’s so incredibly helpful to us and all the work we put into the show and it only take 1 minute of your time. Thank you!
How We Support Women With Hormones
OK, so if you’re listening and thinking, “This is me… I need help with this,” that’s exactly what we do in my health coaching practice. My teammate Tonya and I help women understand their labs, explore their options for HRT, and connect with providers who actually get it. If you’re ready for that kind of support, you can learn more about my 4-month program, The Perimenopause Method. Links are in the show notes.
The Takeaway: Don’t Underestimate Progesterone
So, the takeaway: don’t underestimate progesterone. If you’ve been struggling with mood swings, anxiety, irritability, poor sleep, or heavy periods, it could be a big sign that your body is running low…
Most importantly, don’t settle for a provider who dismisses your symptoms. There are good doctors and nurse practitioners out there who will listen and work with you.
Thanks for listening, and I’ll see you next time!
Link Mentioned:
Ona’s Natural Progesterone Cream
Moods, Emotions, and Aging: Hormones and the Mind-Body Connection by Phyllis Bronson
Episode 32: Progesterone: The Miracle Hormone w/ Carol Petersen (Registered Pharmacist)
Claudia Petrilli is a Functional Health Coach, Integrative Nutrition Coach, Women’s Health Educator, and creator of The Perimenopause Method program. Having experienced debilitating periods, digestive issues, a sluggish thyroid, a pituitary tumor, and perimenopause symptoms in her late 30s, she knows exactly what it’s like to get dismissed by doctors and spend years searching for answers.
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