Progesterone
Progesterone is a steroid hormone used clinically in various forms (most commonly oral micronized progesterone, but also transdermal and vaginal preparations). It is not a neutral supplement: progesterone meaningfully alters endocrine and neurosteroid signaling, with effects on mood, sleep, stress tolerance, and sedation. Because it is a hormone with systemic activity, responses are highly dose-dependent and individual-specific, and use typically requires clinician oversight.
In PFS/PSSD/PAS discussions, progesterone comes up primarily because it is the precursor to allopregnanolone, a powerful neurosteroid that positively modulates GABA-A receptors. Allopregnanolone is synthesized from progesterone via 5-alpha-reductase (5AR) and 3α-HSD, and disruptions in neurosteroid signaling (rather than classic GABA deficiency) are a commonly discussed theory in these syndromes. The hypothesis some people explore is that, in certain individuals, progesterone might increase downstream allopregnanolone availability and improve symptoms related to anxiety, sleep, stress response, or emotional range. At the same time, this pathway introduces complexity and risk, particularly in androgen-sensitive conditions.
Anecdotes (Community Reports):
https://www.reddit.com/r/FinasterideSyndrome/comments/1m5ta5z/progesterone/
https://www.reddit.com/r/PSSD/comments/1l5ji56/very_solid_theory_progesterone_destroy_us/
https://forum.propeciahelp.com/t/progesterone-treatment/5573/931
https://www.reddit.com/r/DrWillPowers/comments/1mq6wso/post_finasteride_syndrome_major_progress/
How to Interpret This Page
This page summarizes anecdotal reports and community observations, not medical evidence. “Risk” here refers to how frequently severe or prolonged symptom worsening is reported, not to proven causation or population-wide probability. Individual responses vary widely, and absence of issues in some users does not rule out significant reactions in others.
Community Reports: Mixed Outcomes & Variable Risk Signal
Across community anecdotes, progesterone shows mixed and highly variable outcomes. Some individuals report partial improvement in areas such as sleep quality, anxiety reduction, emotional regulation, or stress tolerance. A smaller number describe more noticeable improvement windows, often framed as neurocalming rather than true resolution of sexual or motivational symptoms. Many others report no meaningful benefit.
Importantly, there are also reports of worsening or destabilization, including increased emotional blunting, fatigue, libido suppression, sexual numbness, or feeling hormonally “off.” A key concern raised in PFS communities is that progesterone is often described as a functional 5-alpha-reductase inhibitor, meaning it can reduce conversion of testosterone to DHT. For individuals whose condition was triggered by 5AR inhibition (e.g., finasteride), this introduces a plausible mechanism for flares or regression rather than recovery. As with many hormone-active substances in this space, outcomes appear to cluster toward variability rather than consistency.
Reported Risks / Reasons for Caution
Progesterone is not low-impact. Potential effects include sedation, dizziness, fatigue, mood changes, libido suppression, and hormonal imbalance. Because it interacts with the HPG axis and neurosteroid pathways, it can be destabilizing in already-sensitized individuals. In men especially, progesterone can suppress aspects of androgen signaling, and inappropriate dosing or prolonged use may worsen sexual or motivational symptoms.
Another key risk is mechanistic ambiguity: while progesterone is upstream of allopregnanolone (a potentially beneficial neurosteroid), it also sits upstream of the same 5AR pathway implicated in PFS. That means the same intervention could plausibly help one person and worsen another, depending on where the underlying dysfunction lies (neurosteroid synthesis vs. androgen signaling vs. receptor sensitivity).
Because of these factors, progesterone is generally treated as a high-complexity, clinician-supervised option, not a casual experiment.
Reported Risks / Reasons for Caution
Progesterone is not low-impact. Potential effects include sedation, dizziness, fatigue, mood changes, libido suppression, and hormonal imbalance. Because it interacts with the HPG axis and neurosteroid pathways, it can be destabilizing in already-sensitized individuals. In men especially, progesterone can suppress aspects of androgen signaling, and inappropriate dosing or prolonged use may worsen sexual or motivational symptoms.
Another key risk is mechanistic ambiguity: while progesterone is upstream of allopregnanolone (a potentially beneficial neurosteroid), it also sits upstream of the same 5AR pathway implicated in PFS. That means the same intervention could plausibly help one person and worsen another, depending on where the underlying dysfunction lies (neurosteroid synthesis vs. androgen signaling vs. receptor sensitivity).
Because of these factors, progesterone is generally treated as a high-complexity, clinician-supervised option, not a casual experiment.