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Which hormone or hormones might you need?

Women are ruled by their hormones, but how do you know if yours are in balance?


Women are ruled principally by two hormones: oestrogen and progesterone and the reality is we need both of them.

Historically at menopause women’s levels of both hormones drop but whereas in the past the balance could be more easily maintained as women continued to produce oestrogen from their fat cells and progesterone in the adrenals, the balance has shifted.

Oestrogen is not a villain, though you may think so based on its bad press in relation to being a risk factor for breast cancer and heart disease. The ‘villain’ is actually the excess oestrogen women have been exposed to over the last 50 years since the advent of synthetic hormones in the Pill/Coil and HRT and the xenoestrogens in our environment and food chain.

This was the situation that led the late Dr Lee to describe what he saw in his female patients as oestrogen dominance. A situation that occurs where progesterone levels are lower than oestrogen and so not able to balance out the effects of their excess.

What is less commonly realised is that women can have low oestrogen levels and still be oestrogen dominant if their progesterone levels are even lower.

Who needs progesterone?

Women need both hormones from puberty to post menopause and there are many conditions identified where progesterone may need to be supplemented.

Again what is not often realised is that a woman can be menstruating regularly but not ovulating, in which case she is not producing progesterone to balance her oestrogen.

These are the most commonly seen conditions where progesterone supplementation is helpful:

  • PMS
  • PCOS
  • Infertility/Miscarriage
  • Baby Blues/Post natal depression
  • Heavy bleeding
  • Endometriosis/Fibroids
  • Menopause: hot flushes, sweats, anxiety, mood swings, weight gain


Who needs oestrogen?

Women with vaginal atrophy or dryness and discomfort all benefit from additional oestrogen as do women who have found that progesterone alone does not fully control severe menopausal symptoms.

Dr Jeffrey Dach in the USA has also found that menopausal women with depression and anxiety benefit from additional oestrogen, but always balanced by progesterone.

How to decide what you need

The key role of progesterone is to protect from the excess oestrogen that can lead to breast cancer, heart disease and more. Essentially its role is to balance out oestrogen so that it:

  • Protects the breast and endometrium
  • Helps break down fat, stabilises blood sugar and is a natural diuretic
  • Anti-depressant and increases libido
  • Helps fertility and women with history of miscarriage
  • Facilitates thyroid function
  • Builds up bone


Generally, menopausal and post menopausal symptoms such as hot flushes, anxiety, weight gain and sleep issues do need progesterone and, if at risk, to protect the bones from osteoporosis.

Younger women also need progesterone to help with the symptoms of PMS, period problems and fertility.

Women who may need a combined cream with both progesterone and oestrogen are those with symptoms such as vaginal dryness or severe symptoms not responding to progesterone alone as well as women with anxiety and depression.

Those on long term HRT – or after a hysterectomy – usually do better on a combined cream when they switch to bioidentical hormones to prevent the symptoms that can occur on withdrawal of either the synthetic hormones or the ceasing of their own production after surgery.

Women with vaginal atrophy always need additional oestrogen in the form of a separate cream until it is under control or improved when they can then use a combination cream.

Helpful information:

I hope this information has helped you be clearer about the role of both hormones, and where you may need a little help.

Whether you need oestrogen, progesterone or both will depend on your symptoms and their severity but this menopause article can be helpful.