5 Dangerous Risks of Low Progesterone (Video)
Low progesterone can have serious risks - learn the dangers and how to fix them
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Below is the transcript of Dr. Kaveh's video on the risks of not checking progesterone levels.
A 53-year-old woman came to me with terrible insomnia and depression. She had failed multiple antidepressants, was stuck on sleep aids, and felt miserable. Three weeks later she was a different person, but it wasn’t because we found the right antidepressant. It was because we replaced one key hormone that no one had checked: progesterone.
Here are five hidden signs of low progesterone that women, and their doctors, often miss. Before getting into the symptoms, it helps to understand what progesterone is and why it matters.
Progesterone is one of the key reproductive hormones in women, and to a much lesser extent in men. It’s different than estrogen, but progesterone and estrogen work together. Like other reproductive hormones, progesterone is derived from cholesterol and produced primarily in the ovaries, with additional production in the adrenal glands. In pregnancy, the placenta produces progesterone. What surprises most people is that the nervous system also produces progesterone, which helps explain why progesterone can strongly influence sleep, anxiety, mood, and cognition.
Progesterone affects more than reproduction. In bones, it supports bone formation and works synergistically with estrogen. In blood vessels, it helps protect the endothelial lining that plays a major role in cardiovascular health. In the nervous system, progesterone has neuroprotective effects and can modulate mood and cognition, with ongoing research into its relationship with neurodegenerative diseases. In the immune system, progesterone has immunomodulatory and anti-inflammatory effects, including immune tolerance during pregnancy. And in the reproductive system, progesterone regulates the menstrual cycle, supports pregnancy, and helps protect against endometrial overgrowth.
Once you understand what progesterone does, the symptom pattern makes sense. Low progesterone can cause breast tenderness, irregular periods, increased appetite, and unexplained aches and pains. It’s associated with higher risk of osteoporosis in postmenopausal women. It’s also associated with higher risk of cardiovascular disease in postmenopausal women. In the nervous system, low progesterone is often linked to depression, anxiety, irritability, sleep disruption, and cognitive changes, especially during the menopause transition. Hormonal fluctuations can also contribute to fatigue in both younger and older women. And because progesterone helps regulate immune activity, low progesterone may contribute to increased inflammation, worsening autoimmune symptoms, or greater susceptibility to infections.
There’s a bigger trend here: many diseases of aging mirror changes in progesterone levels. Bone, heart, brain, and immune system dysfunction increase with age, and progesterone levels decline on a similar timeline. That may not be coincidence.
Low progesterone doesn’t happen in a vacuum. Environmental endocrine disruptors can interfere with progesterone production and signaling and can contribute to chronic inflammation and progesterone resistance. Progesterone resistance means progesterone is present but cannot effectively act at its receptors. Metabolic conditions such as obesity and inflammatory gut conditions can be associated with ovarian inflammation and reduced progesterone production. Stress—emotional, social, illness-related, or financial—can disrupt ovarian function, as can high physical workloads and eating disorders. Early-life factors like food insecurity and poor sanitation have been linked to lower adult progesterone levels and delayed reproductive maturation. Genetics can also influence progesterone signaling and progesterone resistance.
If disrupted progesterone signaling contributes to these symptoms, then restoring progesterone should help. The reality is that progesterone replacement can help, but it requires nuance. The data overall is favorable for many women, particularly when using bioidentical progesterone, which is the same molecule the ovaries produce. This is different from synthetic progestins used in many birth control formulations.
Ovarian hormone fluctuations are clearly linked to mood symptoms in many women. Synthetic hormonal contraception has been associated with worsening depression in some populations. One key reason is that progestins suppress ovulation and disturb the normal luteal-phase endocrine function of the ovary, and their chemical structure prevents their metabolism into neuroactive, mood-supporting derivatives. Natural progesterone can behave differently, and some evidence suggests it may modestly help depression in postmenopausal women. Evidence also supports menopausal hormone therapy during the menopause transition as a way to reduce depressive symptoms in appropriately selected patients.
Sleep is one of the most consistent areas where progesterone can help. Oral micronized progesterone has evidence supporting improved sleep outcomes with generally minimal side effects. At the same time, some women have paradoxical reactions even to natural progesterone and may experience worse mood symptoms. When that happens, it does not always mean progesterone is the wrong therapy; it may mean the dose, timing, or route is wrong. In some cases, changing the route—such as using vaginal progesterone—may improve tolerability, especially in women with nervous system symptoms like tension, mood swings, irritability, anxiety, and feeling out of control.
The main takeaway is that progesterone is a critical hormone for physical and mental health, and multiple internal and external factors can disrupt progesterone signaling. Aging and menopause are major drivers, but environmental exposures, inflammation, metabolic dysfunction, stress physiology, and genetics also matter. Rebalancing progesterone is not one-size-fits-all. It depends on synthetic versus natural formulations, oral versus other routes, and how well other hormones and underlying inflammation are being addressed at the same time.
If you’re dealing with persistent insomnia, mood symptoms, fatigue, brain fog, irregular bleeding, or other signs that cluster around perimenopause or menopause, progesterone deserves to be evaluated in a structured, individualized way.
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Anthony Kaveh MD
Dr. Kaveh is a Stanford and Harvard-trained anesthesiologist and integrative medicine specialist. He has over 1,000,000 followers on social media and has guided hundreds of patients throughout transformative healing experiences. He is an authority on Ketamine, NAD, SGB, and genomics-guided therapies. He is a continuing medical education lecturer in the Bay Area.
