What to Know Before Taking Progesterone Without Estrogen

Key Takeaways 

• You can take progesterone without estrogen. You might do this if you can’t take estrogen due to health conditions.

• You might take progesterone-only HRT if you’re in perimenopause and don’t need the additional estrogen. 

• Progesterone-only HRT can improve perimenopause and menopause symptoms like hot flashes, night sweats, sleep problems, and vaginal dryness. 

Hormone replacement therapy (HRT) usually involves taking estrogen and progesterone to help with menopause or perimenopause symptoms. But do you have to take both hormones? And what happens if you take progesterone without estrogen? 

Taking progesterone without estrogen is safe for many women, and it can minimize symptoms like hot sweats, sleep problems, and vaginal dryness. 

Below, we dive into more detail on what happens if you take progesterone without estrogen and the benefits and side effects of progesterone therapy.

If you take progesterone without estrogen, you might see an improvement in perimenopause and menopause symptoms, like: 

• Hot flashes and night sweats (vasomotor symptoms) 

• Mood changes 

• Sleep issues like insomnia 

Most of the time, providers prescribe progesterone alongside estrogen to treat these symptoms. But if estrogen isn’t right for you, a healthcare provider may prescribe progesterone on its own. 

Healthcare providers sometimes also prescribe progesterone alone for perimenopause symptoms. 

A few added perks of progesterone for women in perimenopause are that it can help with:

• Breast pain before periods

• Irregular bleeding

• Heavy periods

What Does the Research Say?

A 2020 review looked at seven clinical trials involving 601 women. Researchers found that many women taking progesterone — especially oral progestin — noticed fewer hot flashes and night sweats.

A 2023 study found that women in perimenopause who took oral progesterone reported:

• Fewer night sweats

• Better sleep 

• Fewer daily disruptions due to symptoms

A healthcare provider can assess your medical history and overall health to see if you’re a good candidate for progesterone-only HRT. 

Micronized progesterone is a form of progesterone that’s identical to what your body makes. It may be safer than synthetic forms of the hormone when it comes to breast cancer risk. It also doesn’t increase your risk of blood clots.

FYI, progesterone pills are made with peanut oil, so they’re not safe for those with a peanut allergy. 

Progesterone is a hormone that regulates your menstrual cycle and prepares your body for a potential pregnancy. Estrogen hormones (yep, there’s more than one type of estrogen!) play a role in puberty, pregnancy, regulating your menstrual cycle, and promoting bone and brain health. 

Progesterone and estrogen drop during perimenopause and menopause, which can cause symptoms like: 

• Trouble sleeping

• Vaginal dryness 

• Hot flashes 

• Night sweats 

• Weight gain 

• Mood swings 

To help, you can take estrogen and progesterone HRT to top up natural levels.

Estrogen can thicken the uterine lining, though, leading to an increased risk of uterine cancer. Progesterone can prevent this thickening — that’s why these hormones are often prescribed together. 

But if you can’t take estrogen due to a health condition — such as estrogen-sensitive breast cancer — a healthcare professional may prescribe progesterone-only HRT, which can still improve some of your symptoms. 

Providers also sometimes prescribe progesterone on its own for perimenopause symptoms. You still produce estrogen during this time, but levels fluctuate a lot.

If you’ve had surgery to remove your uterus (a hysterectomy), a provider may prescribe estrogen alone. That’s because there isn’t a risk of uterine cancer, so you don’t need the anti-thickening effects of progesterone.   

Progesterone can come with a few side effects. These depend on the dose and on the type of progesterone you’re taking.

In general, side effects of progesterone include: 

• Headaches 

• Constipation 

• Tiredness

• Upset stomach  

• Breast tenderness

• Irritability 

• Mood swings 

If you’re in early menopause, you might also experience light bleeding outside of your period when taking progestin. This is known as breakthrough bleeding. 

Reach out to your healthcare provider if any side effects are troubling you. They might suggest adjusting your dose.

You can take progesterone on its own, especially if you can’t use estrogen or you’re in perimenopause. Like any medication, progesterone has side effects, though, so it’s a good idea to talk through the pros and cons of progesterone-only therapy with a healthcare provider.

They can help you decide if taking progesterone without estrogen is a good fit for you. 

Can You Just Take Progesterone Without Estrogen? 

Yes, you can take progesterone without estrogen. A healthcare provider might prescribe progesterone-only hormone replacement therapy if you can’t take estrogen or if you’re in perimenopause. 

What Are the Side Effects of Progesterone-Only HRT? 

The side effects of progesterone-only HRT include headaches, constipation, irritability, tiredness, upset stomach, and breast tenderness. 

Does Progesterone Without Estrogen Cause Weight Gain? 

Weight gain isn’t a side effect of taking progesterone without estrogen. In fact, some experts believe progesterone can help prevent weight gain in perimenopause.