Perimenopause \u00b7 HRT
Progesterone in perimenopause: cyclical vs continuous
Progesterone declines earlier and more steeply than estrogen. Cyclical micronized progesterone in the luteal phase can improve sleep, PMDD-like symptoms, and heavy bleeding before estrogen therapy is warranted.
Key points
- 100–200mg oral at bedtime
- Cyclical vs continuous based on cycles
- Monitor bleeding pattern
Frequently asked questions
Do I need progesterone in perimenopause?
Many benefit before formal HRT — especially for sleep and cycle regulation.
Cyclical or continuous?
Cyclical (days 15–26 of a 28-day pattern) is typical in perimenopause.
Bedtime or morning?
Bedtime — for sleep and to avoid daytime sedation.
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Medically reviewed by Kindr Health Clinical Team · Last reviewed 2026-06-19. Compounded medications are prepared by FDA-registered 503A pharmacies and are not FDA-approved drug products.