Can progesterone cause dizziness? Understanding the Side Effects

October 8, 2025 •

4 min read

In clinical studies, dizziness is a very common side effect of progesterone, reported by as many as 24% of users [1.8.1]. The question of can progesterone cause dizziness? is a frequent concern for those starting this hormone therapy.

Quick Summary

Yes, progesterone can cause dizziness, drowsiness, and a sensation of spinning [1.2.5]. This is a commonly reported side effect, often resulting from the hormone's influence on the central nervous system and its potential effects on blood pressure and blood vessels [1.4.1, 1.3.1].

Key Points

Dizziness is Common: Dizziness is a very common side effect of progesterone, affecting up to 24% of users in some studies [1.8.1].
CNS Effects: Progesterone's metabolites can have a sedative-like effect on the brain, causing drowsiness and dizziness, which is why it's often taken at bedtime [1.2.4, 1.5.5].
Vestibular Impact: The hormone can influence the inner ear's balance system, leading to feelings of vertigo or unsteadiness [1.3.1, 1.3.2].
Blood Pressure Changes: Progesterone can dilate blood vessels, which may cause a drop in blood pressure and lightheadedness, especially when standing up quickly [1.4.1, 1.5.5].
Route Matters: Oral progesterone is more likely to cause dizziness than vaginal or transdermal forms due to liver metabolism creating sedative byproducts [1.6.1, 1.6.2].
Management is Possible: Strategies like taking the dose at night, staying hydrated, and rising slowly can help manage dizziness [1.5.5, 1.5.4].
Know When to Call a Doctor: Severe dizziness, fainting, or dizziness with other serious symptoms like chest pain or vision changes requires immediate medical attention [1.2.5].

What is Progesterone and Why Is It Used?

Progesterone is a crucial female hormone produced naturally by the body, playing a significant role in the menstrual cycle and in maintaining pregnancy [1.4.3, 1.8.4]. As a medication, it is used for various purposes, including hormone replacement therapy (HRT) for menopausal symptoms, preventing thickening of the uterine lining in women taking estrogen, and treating the absence of menstrual periods (amenorrhea) [1.6.5, 1.8.5]. It comes in several forms, including oral capsules, vaginal gels, injections, and transdermal creams [1.6.6].

The Pharmacological Link: Why Can Progesterone Cause Dizziness?

Dizziness is a well-documented and common side effect of progesterone treatment [1.2.2]. Studies report that a significant percentage of users experience it, along with related symptoms like drowsiness and vertigo [1.8.1, 1.2.3]. The reasons for this are multifaceted and rooted in how progesterone interacts with the body.

Central Nervous System Effects

Progesterone and its metabolites, such as allopregnanolone, act on the central nervous system [1.6.2]. These metabolites can produce sedative-like effects by interacting with GABA-A receptors in the brain, which are the same receptors targeted by some sedative medications [1.2.4]. This interaction can lead to drowsiness, a feeling of being 'drunk', confusion, and dizziness [1.2.3, 1.2.4]. For this reason, it is often recommended to take oral progesterone at bedtime to minimize the impact of these side effects on daily activities [1.5.5].

Influence on the Vestibular System

Hormones like progesterone and estrogen have receptors in the inner ear and influence the vestibular system, which is responsible for balance and spatial orientation [1.3.1, 1.3.2]. Fluctuations in these hormone levels can affect fluid regulation and microcirculation in the inner ear, potentially leading to symptoms of dizziness, vertigo, and imbalance [1.3.2, 1.3.5]. This hormonal influence is also why some women experience dizziness during specific phases of their menstrual cycle, pregnancy, or perimenopause when hormone levels shift dramatically [1.3.1].

Cardiovascular and Blood Pressure Effects

Progesterone can also influence blood pressure and circulation. Research has shown that progesterone can act as a vasodilator, meaning it widens blood vessels [1.4.1]. It can also have a diuretic effect, helping the body lose sodium [1.4.1]. While this can sometimes lead to lower blood pressure, it may also cause dizziness, lightheadedness, or fainting, particularly when getting up too quickly from a lying or sitting position (orthostatic hypotension) [1.5.5, 1.4.4]. This effect is often more common when first starting the medication [1.5.5].

Comparison of Progesterone Side Effects

Different forms of progesterone and its synthetic counterparts (progestins) can have varying side effect profiles.


Feature	Bioidentical Progesterone (Micronized)	Synthetic Progestins
Molecular Structure	Chemically identical to the progesterone produced by the human body [1.7.1].	Laboratory-created with a different molecular structure than natural progesterone [1.7.1].
Common Side Effects	Drowsiness, dizziness, breast tenderness, bloating [1.7.2]. Often considered better tolerated [1.7.1].	Headaches, mood changes, bloating, weight gain, irregular bleeding [1.7.1, 1.7.2].
Cardiovascular Risk	Not associated with an increased risk of blood clots or heart disease [1.7.6]. May help lower blood pressure [1.7.6].	Some synthetic progestins have been linked to an increased risk of cardiovascular events and breast cancer [1.7.5].
Mental Health Impact	Has a natural calming effect and can promote sleep [1.7.3].	May cause mood swings, anxiety, or depression in some individuals [1.7.5].

Oral progesterone is more likely to cause drowsiness and dizziness compared to vaginal or transdermal routes [1.6.1]. This is due to the first-pass metabolism in the liver after oral ingestion, which produces high levels of sedative metabolites [1.6.2].

How to Manage Progesterone-Related Dizziness

If you experience dizziness while taking progesterone, there are several strategies that may help manage the symptom:

Take it at Bedtime: Since progesterone can cause drowsiness and dizziness, taking the daily dose at bedtime is a common recommendation to minimize its impact during the day [1.5.5].
Stay Hydrated: Drinking plenty of water is essential, as dehydration can cause or worsen lightheadedness [1.5.4].
Rise Slowly: To avoid dizziness from sudden changes in blood pressure, get out of bed or stand up from a sitting position slowly. Rest your feet on the floor for a few minutes before standing up completely [1.5.5].
Maintain Stable Blood Sugar: Eat regular, balanced meals and snacks to prevent low blood sugar, which can contribute to dizziness [1.5.4].
Avoid Driving Until You Know How It Affects You: Do not drive a car or operate heavy machinery until you understand how progesterone affects your alertness [1.2.1].

When to Contact a Doctor

While mild dizziness can be a common and manageable side effect, you should contact your doctor immediately if you experience [1.2.1, 1.2.5]:

Sudden, severe dizziness or a spinning sensation (vertigo).
Dizziness accompanied by a severe headache, vision changes, or speech problems.
Fainting or loss of consciousness.
Weakness or numbness in an arm or leg.
Chest pain or shortness of breath.

These could be signs of a more serious condition, such as a blood clot or stroke [1.2.5].

Conclusion

In conclusion, the answer to 'Can progesterone cause dizziness?' is a definitive yes. It is a frequent side effect resulting from the hormone's action on the central nervous system, vestibular system, and blood pressure. The likelihood and intensity can vary based on the dosage, route of administration, and individual sensitivity. Managing this side effect often involves simple adjustments like taking the medication at night. However, severe or accompanied symptoms warrant immediate medical attention to rule out more serious complications.

For more information on progesterone, consult the MedlinePlus drug information page provided by the U.S. National Library of Medicine.

Frequently Asked Questions

Mild dizziness is a common and usually manageable side effect [1.2.2]. However, if it is severe, sudden, or accompanied by other symptoms like severe headache, vision problems, or chest pain, you should seek immediate medical attention as it could indicate a more serious condition [1.2.1, 1.2.5].

Yes, it is frequently recommended to take oral progesterone at bedtime. This helps to minimize the impact of side effects like dizziness and drowsiness on your daily activities [1.5.5].

Yes. Oral progesterone is more likely to cause dizziness compared to transdermal (cream) or vaginal routes. This is because oral administration leads to high levels of sedative metabolites after being processed by the liver [1.6.1, 1.6.2].

Progesterone can cause dizziness by affecting the central nervous system (producing sedative effects), influencing the inner ear's balance system, and by dilating blood vessels, which can lead to a drop in blood pressure [1.2.4, 1.3.1, 1.4.1].

You should use caution. Progesterone may make you dizzy or drowsy. It is advised not to drive or operate machinery until you know how the medication affects you [1.2.1].

Bioidentical progesterone is chemically identical to what your body makes and tends to be better tolerated, though it can still cause dizziness [1.7.1]. Synthetic progestins have a different structure and may carry a higher risk of side effects like mood changes, weight gain, and in some cases, cardiovascular issues [1.7.1, 1.7.5].

To prevent dizziness or fainting when changing positions, you should get up slowly from a lying or sitting position. It helps to rest your feet on the floor for a few minutes before standing up completely [1.5.5].