Progesterone and Metabolism

Emily Clarke

Welcome back to the Hormone Restoration and Thyroid Management Podcast Series. I’m Emily Clarke, and as always, I’m joined by Dr. Richard Nkwenti. Today, we’re diving into a hormone that often gets overshadowed by estrogen—progesterone. But, as we’ll see, its influence on metabolism is actually quite profound, isn’t it, Richard?

RICHARD NKWENTI

Absolutely, Emily. Progesterone is usually typecast as the “pregnancy hormone,” but that’s just scratching the surface. Beyond its reproductive roles, it’s a key player in energy balance and how our bodies use nutrients. I like to think of it as a sort of metabolic conductor—quietly orchestrating how we process glucose and respond to insulin, especially as hormone levels fluctuate throughout the menstrual cycle.

Emily Clarke

That’s such a good analogy. And it’s interesting because, for a long time, I just assumed progesterone was only about fertility. But when you look at the research, it’s clear it’s doing a lot more behind the scenes. For example, during the luteal phase—so, after ovulation—progesterone rises, and that actually changes how sensitive we are to insulin, right?

RICHARD NKWENTI

Exactly. During that phase, many women notice shifts in appetite or even cravings, and that’s not just in their heads. Progesterone can reduce insulin sensitivity, which means the body has to work a bit harder to keep blood sugar stable. It’s a subtle but important shift, and if progesterone is out of balance, it can really throw off metabolism and make weight management a challenge.

Emily Clarke

And you’ve seen this firsthand in your practice, haven’t you?

RICHARD NKWENTI

Oh, many times. One patient comes to mind—she’d struggled for years with stubborn weight, despite doing everything “right” with diet and exercise. Her labs showed a clear progesterone deficiency, especially in the second half of her cycle. Once we addressed that imbalance—using a personalized, compounded progesterone protocol—her metabolism seemed to “wake up.” She finally started losing weight, but more importantly, her energy and mood improved. It was a real turning point for her.

Emily Clarke

That’s such a powerful example. And it really highlights how hormones like progesterone can be the missing piece for so many people who feel stuck.

Emily Clarke

So, let’s talk about fat storage, because this is where progesterone gets even more interesting. I remember when I first started researching this for my science communication work, I was genuinely surprised at how much progesterone influences not just where fat is stored, but also things like cholesterol levels.

RICHARD NKWENTI

You’re spot on, Emily. Progesterone doesn’t just sit on the sidelines. It actively shapes lipid metabolism—meaning, it affects how fats are broken down, stored, and even how cholesterol is managed in the body. When progesterone is balanced, it can help keep cholesterol in check. But if it’s too low or too high, you might see shifts in LDL and HDL levels, which can impact cardiovascular risk.

Emily Clarke

And it’s not just progesterone acting alone, is it? There’s this whole interplay with estrogen, insulin, and even cortisol. It’s like a hormonal tug-of-war, and if one side pulls too hard, everything gets out of balance.

RICHARD NKWENTI

That’s a great way to put it. For example, if estrogen is dominant and progesterone is low, you might see more fat stored around the hips and thighs. Add in high cortisol from stress, and suddenly you’re dealing with more abdominal fat and insulin resistance. It’s all interconnected. That’s why, as we discussed in our episode on estrogen dominance, you can’t just look at one hormone in isolation. The whole hormonal “ecosystem” matters.

Emily Clarke

Right, and I think that’s what makes this so tricky for people. You can be doing everything “by the book,” but if your hormones are out of sync, your body just won’t respond the way you expect.

RICHARD NKWENTI

Exactly. And that’s why personalized testing and treatment are so important. No two people have the same hormonal fingerprint, so the solutions have to be just as individualized.

Emily Clarke

Now, if we zoom out a bit, progesterone’s role really comes into focus during big life transitions—like pregnancy and menopause. During pregnancy, progesterone levels skyrocket, and that’s not just for the baby’s sake, is it?

RICHARD NKWENTI

No, not at all. High progesterone in pregnancy helps the body adapt metabolically—ensuring enough nutrients are available for fetal development. It changes how glucose is used, increases fat storage for energy reserves, and even modulates the immune system. But if those levels are abnormal, it can set the stage for issues like gestational diabetes or even long-term insulin resistance.

Emily Clarke

And then, on the other end, menopause brings a sharp drop in progesterone, which can trigger weight gain, changes in fat distribution, and a higher risk of metabolic disorders. It’s like the body has to recalibrate, and sometimes it struggles to find a new balance.

RICHARD NKWENTI

That’s right. And we’re seeing more research now on using progesterone-based therapies to help with these transitions. In my own compounding work, I’ve developed individualized treatments for women dealing with metabolic issues tied to progesterone deficiency—whether it’s post-menopause, after pregnancy, or even in younger women with hormonal imbalances. The key is always personalization—matching the therapy to the person’s unique needs and biochemistry.

Emily Clarke

It’s so encouraging to hear that there are emerging options, especially for people who’ve felt overlooked or frustrated by “one-size-fits-all” approaches. And I think that’s a good place to wrap up for today. Richard, thank you for sharing your insights—and your patient stories, as always.

RICHARD NKWENTI

Thank you, Emily. And thanks to everyone listening. Remember, your hormones are powerful allies when you understand them. We’ll be back soon with more on how to unlock your body’s full potential—one hormone at a time.

Emily Clarke

Take care, everyone. See you next time, Richard!

RICHARD NKWENTI

See you, Emily. Goodbye, everyone.