Can progesterone cause somnolence (drowsiness)?

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From the Guidelines

Progesterone can cause somnolence (drowsiness) as a side effect, and this is a well-documented effect of the hormone, particularly when taken as a medication. The exact mechanism of this effect is not fully discussed in the provided evidence 1, but it is known that progesterone has sedative properties that affect the central nervous system.

When considering the use of progesterone, particularly in the context of hormone replacement therapy (HRT), it is essential to weigh the potential benefits against the potential risks, including the risk of somnolence. The provided evidence 1 discusses the use of different progestins, including medroxyprogesterone acetate (MPA) and natural micronized progesterone (MP), and their effects on various health outcomes, but it does not specifically address the issue of somnolence.

Some key points to consider when prescribing progesterone include:

  • The dose and timing of the medication, as taking it at bedtime may help minimize the impact of somnolence on daily activities
  • The individual's overall health status and medical history, as certain conditions may increase the risk of somnolence or other adverse effects
  • The potential benefits of progesterone, including its ability to support sleep and reproductive health, which may outweigh the risks for some individuals

It is crucial to consult with a healthcare provider to discuss the potential risks and benefits of progesterone and to determine the best course of treatment for each individual. The evidence 1 highlights the importance of careful consideration and monitoring when prescribing HRT, including the choice of progestin and the regimen of administration.

From the FDA Drug Label

Progesterone capsules are to be taken at bedtime as some women become very drowsy and/or dizzy after taking progesterone capsules. Progesterone capsules may cause transient dizziness and drowsiness and should be used with caution when driving a motor vehicle or operating machinery. Progesterone capsules should be taken as a single daily dose at bedtime. Some women may experience extreme dizziness and/or drowsiness during initial therapy.

Yes, progesterone can cause somnolence (drowsiness).

  • It is recommended to take progesterone capsules at bedtime due to the potential for drowsiness.
  • Women should use caution when driving a motor vehicle or operating machinery due to possible dizziness and drowsiness 2, 2.

From the Research

Progesterone and Somnolence

  • Progesterone has been found to produce sedative-like effects in both men and women, as evidenced by increased feelings of fatigue and impaired smooth eye pursuit 3.
  • The administration of progesterone has been shown to increase the amount of non-rapid eye movement (REM) sleep and decrease the spectral power in the slow wave frequency range, indicating a potential role in regulating sleep architecture 4.
  • Micronized progesterone, a natural form of progesterone with increased bioavailability, has been associated with alleviation of sleep problems and improvement of working memory in peri- and menopausal women, although it may cause more frequent drowsiness and dizziness 5.
  • Progesterone has been found to be effective in improving sleep quality in menopausal women, with one study showing that it caused a greater decrease in vasomotor symptoms and improved deep sleep 6.
  • The effects of progesterone on sleep are thought to be mediated by its neuroactive metabolites, which interact with the gamma-aminobutyric acidA (GABAA) receptor complex, producing sedative-like effects 7, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Progesterone-induced changes in sleep in male subjects.

The American journal of physiology, 1997

Research

Diagnostic and therapeutic use of oral micronized progesterone in endocrinology.

Reviews in endocrine & metabolic disorders, 2024

Research

Progesterone for treatment of symptomatic menopausal women.

Climacteric : the journal of the International Menopause Society, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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