Reviewed By Blake Gilliam, CRNP
Reading Time: 3 minutes
As women approach their late 30s and 40s, their bodies begin a natural transition into perimenopause—the years leading up to menopause.
This life stage is marked by fluctuating hormone levels, particularly estrogen and progesterone, which can disrupt everything from your menstrual cycle to your emotional well-being.
At Madison Integrative Medicine, we understand how these shifts can impact your quality of life, and we are here to shed light on one important question: Can low progesterone during perimenopause cause anxiety?
Table of Contents
Key Takeaway
Low progesterone during perimenopause can contribute to heightened anxiety, disrupted sleep, and emotional instability due to its role in calming the nervous system. Reduced GABA activity from low progesterone intensifies the body’s stress response.
Your Body Through the Years
In your reproductive years, estrogen and progesterone work in harmony to regulate your menstrual period, support pregnancy, and maintain overall health.
Estrogen thickens the uterine lining, while progesterone stabilizes it.
Around your mid-30s/early 40’s, ovarian function begins to decline, leading to shorter or irregular cycles and eventually irregular periods.
By perimenopause, progesterone production drops more sharply than estrogen, creating an imbalance between estrogen and progesterone—a state often called estrogen dominance.
Progesterone 101: The Calming Hormone
Progesterone isn’t just a female sex hormone; it’s a cornerstone of emotional and physical balance.
It supports bone health, stabilizes blood sugar, promotes deep sleep, and counterbalances the effects of estrogen.
Progesterone enhances the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that calms the nervous system. When progesterone levels fall, GABA activity drops, leaving many women feeling wired, irritable, or anxious.
Why Does Progesterone Decline in Perimenopause?
- Ovarian aging: The ovaries produce less progesterone after ovulation becomes irregular.
- Stress: Chronic stress taxes the adrenal glands, which help produce progesterone post-menopause.
- Estrogen dominance: With less progesterone to balance it, the effects of estrogen—like breast tenderness and water retention—intensify.
Symptoms of Low Progesterone in Perimenopause
The signs of progesterone deficiency extend beyond missed periods. Watch for:
- Anxiety, mood swings, or depression (due to reduced GABA support)
- Sleep disturbances (trouble falling asleep or wakefulness in sleep)
- Heavy bleeding or abnormal bleeding during cycles
- Breast tenderness, shorter cycles, or hot flushes
- Low sex drive and bone density concerns
If these common symptoms sound familiar, you’re not alone. Many women in perimenopause struggle silently, unaware that hormonal imbalances are to blame.
The Anxiety Connection: When Hormones Hijack Your Inner Peace
Without adequate progesterone, the brain loses the soothing effects of GABA, making stressors feel overwhelming. Add sleep deprivation from night sweats or insomnia, and it’s easy to see why anxiety spikes during this phase.
Restoring Balance: How to Address Low Progesterone
- Hormone testing: A healthcare provider can assess your hormone health through blood or saliva tests.
- Lifestyle adjustments: Prioritize stress management, balanced nutrition, and sleep hygiene.
- Bioidentical hormone replacement therapy (BHRT): At our wellness clinic in Madison, AL, we offer personalized BHRT using a natural, body-identical form that mimics your own hormones.
BHRT at Madison Integrative Medicine: A Path to Renewed Vitality
Bioidentical hormones are tailored to your unique needs. Unlike synthetic hormones, they are derived from plant sources and match your body’s molecular structure, minimizing side effects. Benefits include:
- Reduced anxiety and improved mood
- Better sleep quality and restful sleep
- Protection against endometrial cancer and support for bone formation
- Stabilized menstrual bleeding and relief from premenstrual symptoms
Take Charge of Your Hormone Health
If perimenopause symptoms—like anxiety, heavy periods, or emotional symptoms—are disrupting your life, consider BHRT.
At Madison Integrative Medicine, we are committed to helping you navigate this transition with compassion and science-backed care.
To book a consultation at our wellness center in Madison, AL, call (256) 325-0955 or visit us at 1230 Slaughter Rd Suite C, Madison, AL.
