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Progesterone is a hormone produced after ovulation and has a calming effect on the nervous system. In addition to its role in the menstrual cycle and fertility, progesterone also affects sleep, recovery and stress regulation.
At low or fluctuating progesterone levels, the calming effect can decrease, which can lead to difficulty falling asleep, shallow sleep, nighttime restlessness and early awakening. These problems are particularly common in premenopause, as progesterone production often decreases earlier than estrogen production.
Sleep problems can therefore be an early sign of hormonal imbalance. Through correct hormonal investigation and interpretation of progesterone in the right part of the menstrual cycle, it is often possible to identify underlying causes of long-term sleep problems.
For many women, sleep problems are not about being “too stressed” or having bad sleep habits, but about the body no longer receiving the hormonal signal it needs to unwind. Progesterone is one of the most important hormones for just this – creating calm, security and the biological conditions for sleep.
Progesterone is produced after ovulation by the corpus luteum in the ovaries. In addition to its central role in the menstrual cycle and fertility, progesterone has a direct and significant impact on the nervous system and the brain’s regulation of stress and rest.
In the body, progesterone is partially converted into active metabolites that affect GABA receptors in the brain. GABA is a signaling system with a calming and anti-anxiety effect and plays a crucial role in relaxation, falling asleep and deeper sleep. When progesterone levels drop, this calming signal decreases, which can make it more difficult to fall asleep and to sleep undisturbed during the night.
How low progesterone levels affect your sleep
When progesterone levels are low, the calming and stabilizing effect on the nervous system decreases. Progesterone normally helps to dampen the stress response and signal to the body that it is time to rest. With a lack of progesterone, this signal may be absent, which means that the body remains in a more active or alert state, despite physical fatigue.
This means that the nervous system has more difficulty switching from wakefulness to recovery. Especially in the evening and at night, when progesterone's calming effect normally plays a greater role, the imbalance can become clear. The result is often that thoughts, worries or internal stress take over when the body really needs to unwind.
Low progesterone levels can therefore affect sleep in several ways:
- Difficulty falling asleep despite feeling tired, because the nervous system is overactivated.
- Shallow or restless sleep with frequent awakenings.
- Early awakening in the morning without feeling rested.
- Nocturnal restlessness or anxiety, sometimes without a clear external cause.
- Feeling of lack of recovery despite sufficient sleep.
For many women, these problems occur cyclically or gradually in connection with hormonal changes, for example in premenopause. Sleep problems can then be an early sign that progesterone production after ovulation has become insufficient.
Progesterone, sleep and the menstrual cycle
During the menstrual cycle, progesterone levels vary greatly. In the follicular phase, before ovulation, levels are naturally low. After ovulation, in the luteal phase, progesterone should rise significantly.
Many women find that their sleep is at its best during the early luteal phase when progesterone is at its highest. If progesterone production is insufficient after ovulation, sleep problems can instead worsen during this part of the cycle, often in connection with PMS.
Why are sleep problems common in premenopause?
In premenopause, ovulation becomes more irregular. This leads to progesterone production varying greatly from cycle to cycle and often decreasing earlier than estrogen production.
This imbalance can contribute to many premenopausal women experiencing:
- New onset sleep problems
- Increased stress sensitivity in the evening
- Anxiety or inner turmoil at night
- Poor recovery despite adequate sleep
Sleep problems can therefore be one of the earliest signs of hormonal changes in this phase of life.
Progesterone, stress and cortisol
Stress and sleep are closely linked. In the event of prolonged stress, the body prioritizes the production of cortisol, which can inhibit progesterone synthesis. Low progesterone in combination with elevated cortisol can create a vicious cycle of increased alertness, inner stress and poor sleep quality.
When might it be relevant to test progesterone for sleep problems?
If sleep problems are recurrent and particularly pronounced during certain parts of the menstrual cycle, hormonal testing may be relevant. Progesterone is measured in a blood test and should be taken in the luteal phase, usually about 7 days after ovulation, to give an accurate result. In premenopausal women, repeated measurements may sometimes be needed for an accurate assessment.
Can you improve sleep with low progesterone levels?
Measures depend on the underlying cause and symptom picture. In some cases, sleep can be improved by supporting the body's natural hormonal balance.
- Reduced physical and mental stress
- Regular circadian rhythm and good sleep hygiene
- Sufficient energy and nutritional intake
- Treatment of underlying hormonal disorders
In cases of severe symptoms, medical treatment with progesterone may be appropriate after individual assessment and correct hormonal testing.