Eps. 20 | The Progesterone Piece: Sleep, Mood, Cycles & Hormone Balance

This video is about progIn this episode of EmpowerND, we’re continuing our conversation with Megan Gietzen, FNP, for The Progesterone Piece: Sleep, Mood, Cycles & Hormone Balance.
Progesterone is often talked about in relation to pregnancy, but its role in women’s health goes far beyond that. This hormone can impact sleep quality, mood changes, anxiety, cycle regularity, PMS symptoms, and the way we feel throughout different phases of the month.
Megan helps us better understand what progesterone does in the body, why hormone balance can feel different from one woman to another, and what signs may point to something being off. We also talk about the importance of tracking symptoms, advocating for yourself, and having informed conversations with your healthcare provider when your cycle, mood, or energy just does not feel right.
Whether you are navigating irregular cycles, mood changes, sleep struggles, perimenopause symptoms, or simply trying to better understand your body, this episode is a helpful place to start.
Learn more about Women Empowering Women and our programs at wewnetwork.org.

The EmpowerND Podcast is hosted by Women Empowering Women, a membership based non-profit organization dedicated to connecting, supporting, and educating women. Through community, events, and resources, Women Empowering Women helps women grow, build confidence, and explore their potential, supporting them every step of the way as they become the best version of themselves. To learn more about Women Empowering Women’s projects or how to become a member, visit wewnetwork.org.

Transcript

SPEAKER_01 0:00

Welcome back to Empower India Podcast. It is a podcast that creates a space for honest conversations about health, well-being, and community resources to help people in southwestern North Dakota live healthy, health lives. The Empower India Podcast is produced by Women Empowering Women, a nonprofit organization dedicated to connecting, supporting, and educating women to help them become the best versions of themselves. To become a member or learn more, visit wewnetwork.org. Today we're continuing the conversation around hormones and focusing on one that doesn't always get as much attention, but plays a huge role in how women feel day-to-day, and that's progesterone. It's often called the calming hormone, and for good reason. Progesterone influences mood, sleep, stress levels, and how grounded or steady we feel, especially in the second half of our cycle. So today we're really breaking down what progesterone does, how it works alongside estrogen, and what women should be paying attention to when something feels off. Today we're joined by Megan. Let's get started. Okay, so to start, can you explain what progesterone is and and what its primary role in the body is?

SPEAKER_00 1:14

Yeah, well, you just kind of summed it up right there, but the primary role of progesterone is our calming agent. It helps um with our uterine lining, right? So like our entire cycle is built up for pregnancy. Um and so that's what estrogen is doing is building up that lining and making it as healthy as it possibly can be. Um and then progesterone comes in and helps it helps form that lining, helps keep it healthy. But then also when um it isn't we have no egg implanted, it helps um shed that lining for us. Um, so it really is just kind of helping keeping that that uterus healthy and not um that that lining not too thick.

SPEAKER_01 1:51

Okay, so how does it work alongside estrogen and why is the balance so important?

SPEAKER_00 1:55

Yeah, so I always kind of describe it like I talked in our last podcast as like estrogen's best friend, right? We need somebody to help calm estrogen down. And that's basically what progesterone is doing, it's counteracting that a little bit so estrogen doesn't wreak havoc on our bodies. Um, and when I say that, I mean it's it's it's almost like a reactive hormone, right? So um, whenever we are moody or irritable and things like that, that's estrogen talking. And so when progesterone comes in, it actually helps calm us down. Um, so a lot of the time in um perimenopause, that progesterone starts to just decline slightly. And that's when we start to feel those, that sudden like I can't sleep at night. I'm always irritable because that estrogen is taking over. Right.

SPEAKER_01 2:41

Yeah. So when in a women's cycle is progesterone highest and why?

SPEAKER_00 2:46

Yeah, so it is highest in that luteal phase. So that is days 12 through 26 for most women, not all women, right? Um, but the the two weeks kind of before um we have that ovulation. Um, so it's that progesterone is peaking and helping, it should be helping, um, calm us down and getting ready for that that ovulation and the implantation. Um, but you know, like I said in perimenopause women, it starts to decline, and that's when we start to notice that. Um, and then menopause it isn't there at all. So um, yeah, that's when we start to notice those symptoms.

SPEAKER_01 3:21

I always kind of explain it as like when you're pregnant and you're getting ready to have the baby, you're nesting and you're preparing your space, and progesterone is like nesting your womb. Exactly. Like it's getting it ready. Right. That's a good way of saying it. And it's a little bit. It's making it prepared so it's a safe and calm place so that your embryo can be implanted. Yes, that's perfect. So you kind of explained, you know, how progesterone affects mood anxiety and emotional regulation. So, what role does it play in sleep quality?

SPEAKER_00 3:50

Oh man, it is so big in sleep quality. And I, and it it kind of is in a roundabout way as well. So, although it helps calm us down, helps kind of um just regulate that that nervous system, it helps calm that nervous system down so we can get some sleep. Um, it also helps us sleep all throughout the night because of that. So I hear a lot of the time in perimenopause, you know, those early morning wakenings, so like 3 a.m. to 4 a.m. Um, and that's because our progesterone is so low. Um, it also helps with um this our like regulating that estrogen. So when that estrogen is really high or erratic, we can start to or super low, it just depends on where you're at. Um, we start to get those hot flashes and and that anxiety. And so what progesterone does is counteract that. Um, so it actually helps bring down those hot flashes and bring down that anxiety so we are able to sleep at night. We're not having those, those frequent um nighttime waking up.

SPEAKER_01 4:49

And it really seems like a lot of women in that perimenopause phase are are those are the big symptoms that really affect them. That really does.

SPEAKER_00 4:58

Yes, yeah. And and that's one of the first things that we I always get is my sleep is off. I don't feel good. And then of course, fatigue, right? So if we're not sleeping well at night, then we're just gonna be fatigued all day long. Um, and that has a lot to do with just that progesterone, right? Fixing that sleep, you know, and calming us down.

SPEAKER_01 5:16

So when progesterone levels are healthy and balanced, what might women notice? Oh, just everything, right?

SPEAKER_00 5:22

Like, and I feel like one of the first things that I hear from women as well is I just don't feel like myself, right? And I just don't think we give enough credit to sleep hygiene either. Right. And how important it is to get a good night's sleep, whether, you know, just that six to seven, eight hours that we need, if it's not quality, we're not gonna feel like ourselves during the day. And then that just that cycle perpetuates and just gets worse and worse and worse. Um, so it really does play a role in every system of our body because if we're not getting that good regenerative sleep, we're not gonna have a, you know, we're not all of our systems are gonna be crying out for help.

SPEAKER_01 5:58

Yeah. And that, you know, that kind of explains all the signs of the low progesterone, is how it affects your everyday life and and how some women feel more overwhelmed and reactive.

SPEAKER_00 6:08

Yes, yes. I and I loved that. It's like I love the thought process that estrogen is a reactive hormone and progesterone is just that calming hormone. So, um, and it just kind of explains it perfectly.

SPEAKER_01 6:20

Yeah. So how does low progesterone contribute to PMS symptoms?

SPEAKER_00 6:26

So everything is heightened, right? Because that progesterone isn't there to kind of calm it down. That estrogen then takes over and then we're reactive, right? So, um, so we are irritable and moody and um and the cramping is worse, and because that that uterus isn't healthy, right? It's not being, it's not as healthy. Um, and a lot of the time, too, what I get right off the bat for perimenopause is like their their um cycle comes too early, right? So when that progesterone is really low, we don't have that window, that luteal phase to kind of recover and regenerate and and um smooth everything over. And so then that cycle comes and it's just another hit of estrogen and another hit. Um and so yeah, our body doesn't get that chance to calm down.

SPEAKER_01 7:11

Yeah, I always kind of explain it as well as like, so if your body is your body goes through such turmoil during your cycle that it's like running a half marathon. And it's like every month you have to really, really support your body to get prepared for that next race. And it's like when you have the short cycles, you don't have that time to prepare. Right. So you're just like depleted and you don't have nutrient stores, and then you go right back into it.

SPEAKER_00 7:37

Yeah, it's not fair. No, it's not fair at all. Yeah. And it's not a it's not an easy fix, it's just adding on progesterone. I mean, that's what we try first, of course, but um, you know, sometimes that isn't even even it. We have a lot of work to do on our lifestyle too. You know, like I mentioned as far as sleep hygiene and getting up early and going for a walk and exercising and getting in the right nutrition and food, um, helping balance out those cortisol levels. I mean, all of that alone, you know, will will help balance out that progesterone in the end. But it takes a long.

SPEAKER_01 8:08

I think that women really kind of were given a disservice when when like low-fat diets came out and things like that because they're not getting those good fat, healthy fats that help support their hormones. And then that's not setting them up for us either.

SPEAKER_00 8:23

Right. Well, that and then, you know, just the whole push for statins and lipid control. Um, we need a little bit of cholesterol to move those hormones around, you know? And so I think we kind of do a driver surface with that too. Yeah. Yeah.

SPEAKER_01 8:35

Okay. So what happens when estrogen is high relative to the progesterone?

SPEAKER_00 8:40

Yeah, everything is off balance, right? So again, ever all of those reactive emotions and um and physical complaints come out and um and yeah, you're just not, you're not you're feeling yourself again, right? You're always on edge and it's always just one more thing, you know, and and you never have that ability to just, you know, take a deep breath, basically.

SPEAKER_01 9:03

And it's a vicious cycle because the more you feel like that, the less you do self-care. Yeah. So then the more you do you more, you know, the less you do self-care, the more you feel like that because you're not getting adequate sleep or nutrition, exactly exercise.

SPEAKER_00 9:14

And so then you just end up in this vicious cycle where you don't spiral, really, you know, and then that and that's where where I see a lot of patients that come to me. It's like, I have not been myself for, you know, six months to a year. What is going on of years really? Like, what is going on with me? How can I start? Where can we start? You know? Yeah.

SPEAKER_01 9:34

And then it actually starts to really kind of you see them kind of come back to life.

SPEAKER_00 9:40

Oh, I love saying of them at their three-month appointment. Like when I follow up with them for a couple more blood works. It's like, I mean, I'll even give emails in between, and like my life has changed in three days. Like, why it took me so long to just come here, get the help. I don't know, but yeah, life has dramatically changed. Yeah. And it is that that simple sometimes.

SPEAKER_01 10:02

Uh so can you explain the concept of estrogen dominance in a simple way?

SPEAKER_00 10:06

Yeah. Okay. So I actually really don't love the term estrogen dominance. It just depends on how you look at it, right? Like I think we're women and we need estrogen, and it we also need to counterbalance that. So I look at it more as just low progesterone, right? So, like it, which it makes sense. It's the same thing, but I look at it as like, okay, when you don't have progesterone on board, everything is gonna be out of whack and you're gonna be irritable. Right. And it's you're gonna be, everything is gonna tip you off, and um, you're gonna have those estrogen dominant symptoms or the low progesterone symptoms like irregularity of menstrual cycles and um and uh issues sleeping and um not being calm and being reactive and the breast tenderness and all of the PMS symptoms that we get when our progesterone is too low.

SPEAKER_01 10:54

So, what would some natural ways to support progesterone levels be?

SPEAKER_00 10:59

That is, yeah, that's that's a good one. So, really, like we talked about with the sleep hygiene, with the cortisol balancing, with um blood sugar regulation, with eating appropriately, with getting up and moving our bodies, all of those things are gonna lay that healthy foundation where we can hopefully I mean you can probably get away with a lot of not having any supplementation or anything like that. Um, but I mean eventually it I recommend some supplementation just because it is the the best course for most women.

unknown 11:28

Okay.

SPEAKER_00 11:29

So when should someone consider testing their hormone levels? I this may be controversial, but I think all of the time. I I really my one of my biggest pet peeves is that um people don't have access to their labs and they go to, you know, their PCP or their primary, their OBGYN, and they're told no, you're you're too young, or no, it doesn't matter because you're in this part of your cycle. Okay, but this is your body and you get to decide right when you what baseline labs you want, or whenever you want, you know, and I think that um that is one of the things that I push for is that you can come in and get those labs whenever you want, you know, that it isn't something that you have to beg for. Um, and I I think that's a lot of um gatekeeping and gaslighting in the medical industry, is that yes, we they may not, you may not do anything with them, but it's okay to have that level.

SPEAKER_01 12:23

Well, and I think that honestly, if if I'm being honest as a primary care provider, prior prior, you know, prior to being out of the corporate world, I wasn't comfortable doing them or interpreting them.

SPEAKER_00 12:39

And so that made it right is that if we get that level, we have to do something and it's abnormal. We have to do something about it.

SPEAKER_01 12:46

Also taught that we need to send them to a specialist. Yes, yes. And so to you, for you to do that, it means even though you're it's in your scope and you're it's perfectly okay for you to do it and to order it, yeah. It feels like it's not.

SPEAKER_00 12:58

Well, and there's so many variables with that too, because you know, in the modern medicine world and the in the corporate medicine world, you are only allowed so much time. Right. So you're not allowed the time to look into that lab, which is a very easy thing.

SPEAKER_01 13:13

If you learn how to interpret them if you don't have the time to do the correct, yeah.

SPEAKER_00 13:17

So I think it is just that that they're so limited, right? Which I understand, but I also believe that like that's a simple conversation you can have with your client, you know, like I or your patient, I don't have the time to kind of look into all of this. I would love to, I can get it for you, but I can't necessarily do anything about it, you know. And I think that most people would be fine with that. Yeah. Um, because there are such, you know, there's crazy things out there like the Chat GPT and AI. And I mean, there's so many different routes that these people can go with. Um, they can also just come down the street to some people who are understand how these things work um or have a different mindset on it. But um, yeah, I just I have a a big pet peeve that if a patient wants something, um, you know, why are we why are we gatekeeping that from them just because insurance says something? You know, that that doesn't matter.

SPEAKER_01 14:06

Yeah, I think a lot of those things all play a factor in it. And it's not necessarily that anyone is, you know, purposely not giving them the importance of the shot. Yeah. Yeah. It's more of they just don't either know how to interpret it, don't have time to interpret it, or yeah, or you know, I hear it a lot. I hear it. Or also are worried that insurance won't cover it because they don't know how to properly code. Right, right. Yes. So that's part of it too.

SPEAKER_00 14:29

Yeah, and limitations from from having insurance over your head, you know. I mean, that's a that's a big deal. But yeah, I hear it, I hear it all the time, and it and it's um, you know, there's ways around it. Right. Mm-hmm.

SPEAKER_01 14:39

Yep, it's count us. Exactly. Okay. Why do you think progesterone doesn't get as much attention as estrogen?

SPEAKER_00 14:48

Yeah, right. I think I I think it's because it's not the loud one, right? Like it doesn't get that that reaction from from everybody. It's not doing, it's not, it's not our main one. And it I always think of it like estrogen is the is the main actress, you know, and progesterone is kind of the supporting actress. So yeah, like it doesn't get all of that attention. Um, but I think it's underrated. I really do. I mean, it is our first hormone that we that we regulate in that perimenopause cycle or phase of when people are starting to complain the most. That's like my first go-to. Um, and then estrogen comes a little bit behind that. And um, but as women, like we produce a lot of estrogen, right? Most of the time. We produce a lot of estrogen, but we need that progesterone to counteract it. Um, and that's where like that balance is so like it's just it's so um iffy because you you need to make sure that you have that balance, you know, before before you move on. So yeah, I do think it's an underrated hormone.

SPEAKER_01 15:45

Okay, so what are some treatment options or support options if progesterone's low?

SPEAKER_00 15:50

Yeah, I think for is just really understanding your cycle first, right? So I really love how some of my women do like the natural family planning and they know they know exactly what is going on in their cycle and they know exactly where they're low. And that is so helpful. I think just to understand your body, you know, um, first and foremost. And then you can go and find out what's going on. Because I mean, yeah, labs are helpful, right? They help us all day long, but really your symptoms are one I'm going off of. Yeah. And I can tell you what's probably low based on your symptoms and where you're at in your cycle, and if you even have that cycle, you know, there's all these kinds of variables. But um, I think that a lot of what we can do to help ourselves is just to monitor ourselves, you know, like watch ourselves and and see where those changes are at. And honestly, that helps us too.

unknown 16:39

Yep.

SPEAKER_01 16:41

Such a helpful conversation and one that really brings more clarity to something a lot of women experience but don't always understand. Gesterone plays a key role in how we feel day to day, and recognizing those patterns can make a big difference in how we support our bodies. Thank you so much for being here and sharing your insight with us. Until next time, stay informed, stay empowered, and we'll see you on the next Empower Indie podcast.