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The Link Between Depression Symptoms and Progesterone
08/12/2025

Perimenopause isn’t just about hot flashes and unpredictable cycles — it’s also a time when mood changes can hit hard. New research shows that it’s not simply low hormones causing the problem, but how wildly those hormones fluctuate. In particular, swings in estrogen and a lack of progesterone from missed ovulation may be key drivers behind the irritability, sadness, and brain fog so many women experience.

What they studied

Researchers followed 50 perimenopausal women (average age ~48) experiencing mild-to-moderate depression for eight weeks. Each week, they measured:

  • Estradiol variability (how much estrogen levels were jumping around)
  • Progesterone levels consistent with ovulation
  • Frequency of vasomotor symptoms (hot flashes, night sweats)

What they found

  • Greater fluctuations in estradiol were linked to higher depressive symptoms — even when accounting for BMI, stress history, past depression, etc.
  • Not having progesterone rise to ovulatory levels (suggesting anovulation) was also tied to worse mood.
  • Surprisingly, the frequency of hot flashes/night sweats wasn’t linked to mood swings in this study.

Why it matters
This suggests that unstable estrogen levels and low progesterone — not just visible symptoms like hot flashes — may be the hormonal culprits behind perimenopausal mood problems.

In plain terms
When estrogen is fluctuating and progesterone isn’t being produced normally (because ovulation is failing), women in perimenopause may experience stronger depressive symptoms. These mood changes are driven more by the hormonal instability itself — not necessarily by hot flashes or night sweats.

View the study here: https://academic.oup.com/jcem/article/105/3/e642/5...