Progesterone & The Brain: More Than a Reproductive Hormone

by Dr. Mary Knudsen, ND

For decades, progesterone has been boxed into one role: reproduction. It’s been cast as the “pregnancy hormone,” often ignored once fertility is no longer on the table. But here’s the truth—progesterone is so much more than that.

It’s actually a powerful neurosteroid, meaning it plays a direct role in brain health. Yep, your brain has progesterone receptors—and they’re doing a lot more than you’ve been told.

Let’s break down why this hormone matters especially in perimenopause and menopause—and what you can do about it.

GABA – Your Built-In Chill Pill

Ever feel calmer during certain times in your cycle? You can thank progesterone (and its superstar metabolite, allopregnanolone) for that. These compounds enhance GABA-A receptor activity—GABA being the neurotransmitter that helps you relax and unwind.

In menopause, when progesterone drops, many women experience increased anxiety or sleep disruption. Supporting GABA through progesterone therapy (when appropriate) can be a game-changer.

Glutamate – The Brain’s Gas Pedal

While estradiol ramps up glutamate (our brain’s excitatory neurotransmitter), progesterone helps apply the brakes. This balance is key—too much glutamate can contribute to mood swings, anxiety, and even inflammation in the brain.

When progesterone is low (hello, perimenopause), things can start to feel... extra. The right support can help bring back balance.

Noradrenaline – Mood, Motivation & Stress

Progesterone also helps regulate noradrenaline, the hormone that fuels our stress response. Too much noradrenaline can make us feel edgy, irritable, or just plain wired.

This connection helps explain why hormonal shifts can seriously impact mood and stress levels—and why restoring balance can help you feel like yourself again.

Acetylcholine – Brain Fog, Be Gone

If you’ve walked into a room and forgotten why… or struggled to find your words, you’re not alone. That “brain fog” many women describe? Low progesterone could be part of the picture.

This hormone helps regulate acetylcholine, a key player in memory and learning. Supporting brain health during menopause means supporting hormones, too.

So What Does This Mean for Menopause?

As a naturopathic doctor supporting women through menopause, I see it every day: the mood shifts, the anxiety, the disrupted sleep, the foggy brain.

And yet… progesterone is often left out of the conversation.

Personally? Progesterone has been magical for my sleep (and yes, my Oura ring backs me up!). But more importantly, I believe we need to change how we talk about hormones and brain health.

Let’s Rewrite the Narrative

Progesterone isn’t just for fertility. It’s a key part of your mental well-being, your sleep, your clarity, and your resilience.

• We need more research.
• We need more education.
• We need to stop dismissing women’s experiences.

So let’s keep talking about it. Share this with a friend, bring it up with your provider, and advocate for the brain-supporting power of your hormones.

Because thriving through menopause isn’t just possible—it’s your right.

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