Redditors Recommend Progesterone for Menopause Sleep Issues: Does it Work?

Some Reddit users transitioning through menopause claim that progesterone is the key to getting a good night's sleep. According to one expert, progesterone can help, but specific formulations may be more effective than others.

Though menopause is a natural transition into a woman's post-reproductive years, its onset can trigger a host of challenging symptoms. During the period leading up to menopause and after, a person can experience decreased libido, mood swings, vaginal dryness, and hot flashes.

In addition to hot flashes, sleep, or lack thereof, is another menopause-related symptom that has become a hot topic of discussion on social media platforms like Reddit.

Some Redditors suggested sleeping alone or with a cat. Others said eating oatmeal before bed helped them sleep better. Getting enough exercise was another strategy recommended by Reddit users.

Still, several commenters mentioned that progesterone was the ultimate solution for their insomnia woes. Progesterone is a hormone that, along with estrogen and testosterone, wanes during the menopause transition.

A sentiment echoed by other social media users.

However, not all Redditors are sold on progesterone as a game-changing tool for restorative sleep, as some claimed it didn't help at all.

Can progesterone help improve sleep during menopause?

During the transition to menopause, the body slowly begins to produce fewer female hormones, such as estrogen and progesterone. The drop in these and other hormones leads to uncomfortable symptoms, including hot flashes, vaginal dryness, mood swings, and insomnia.

Hormone therapy, or hormone replacement therapy, can help alleviate these symptoms. Recent research has even found evidence that hormone replacement can reduce biological age in postmenopausal women.

However, the type of therapy differs depending on whether the individual has a uterus.

For example, women who have had a hysterectomy and no longer have a uterus are typically prescribed estrogen-only therapy. In contrast, those with a uterus need a combination therapy of estrogen and progesterone. Progesterone is necessary to prevent the overgrowth of cells in the uterine lining, which can increase the risk of uterine cancer.

For example, a 2018 research review found that progesterone (300 mg daily at bedtime) can improve deep sleep.

Dr. Bruce Dorr, an OBGYN and Senior Medical Advisor for Biote, an educator of hormone optimization and therapeutic wellness company, tells Healthnews that progesterone breaks down into pregnanolone and allopregnanolone which have sedating and anxiety-reducing properties.

Moreover, some individuals convert more progesterone into this compound, so they experience more sedation than others.

"Progesterone decreases estrogen receptors — meaning the way that estrogen binds in cells and creates its effect," Dorr explains. "Many patients before menopause don't ovulate and make progesterone, leaving estrogen unopposed or 'dominant.'"

Dorr says that progesterone helps decrease this condition, which can lessen uncomfortable symptoms that may interrupt sleep, like headaches, bloating, weight gain, and breast tenderness.

"Many women can get relief from classic menopause symptoms like night sweats and hot flashes that interrupt sleep with progesterone — just like estrogen," Dorr adds.

Side effects of progesterone

While progesterone can help alleviate insomnia issues, some women may experience side effects, including:

• Breast tenderness
• Nausea
• Mood swings
• Headache
• Digestive disturbances
• Tiredness

According to Dorr, while progesterone is generally well tolerated, the tiredness associated with the hormone can be extreme.

"For people who convert more progesterone into the sedating breakdown compound, the sedating effects can be very exaggerated to the point of severe dizziness or lightheadedness," Dorr says. "I've had some women go to the ER because it is so dramatic."

What types of progesterone therapy are most effective?

Estrogen, progesterone, and combination hormone therapy come in several forms, including pills, vaginal rings, patches applied to the skin, and creams. However, Dorr tells Healthnews that the body may absorb some types better than others.

"The best-studied form is oral micronized progesterone — meaning that it comes in a small [easily] absorbed form — because it is hard to absorb in general," Dorr explains. "The original formulation was placed in peanut oil for better absorption. However, that can pose problems for those with peanut allergies."

Dorr notes that vaginal progesterone cream is another option, but it can be expensive. Moreover, progesterone is also available in a cream form, but it is poorly absorbed and isn't enough to help counteract the uterine effects of estrogen replacement therapy.

"There are compounded forms taken sublingually or in a ready-dissolving tablet on the tongue," Dorr says. "These have not been extensively studied."

Non-hormonal options for menopause insomnia

Some individuals transitioning through menopause might not wish to take hormones, or hormone therapy is not an option due to specific medical conditions.

However, there are several alternatives to hormones, like progesterone, that can help promote restful sleep.

"Anything that has a sedating side effect can work for sleep," Dorr tells Healthnews. "That's why a majority of sleeping aids used are antihistamines like Benadryl, Zyrtec, or Claritin."

In addition, magnesium, melatonin, or supplements containing tryptophan derivatives can also promote restorative sleep. Tryptophan can positively impact sleep quality because it helps the body make melatonin.

Dorr says that phosphatidylserine, a type of phospholipid found in brain cell membranes, also has effective sleep properties. The compound is found naturally in soybeans, eggs, fish, and liver, and is also available as a supplement.

However, since these options can cause side effects or potentially interact with prescription or over-the-counter medications, it's best to consult with a healthcare provider before taking them for menopause-related insomnia.