Estrogen, Progesterone & BPD

Estrogen and progesterone are 2 of the major hormones that are involved in the menstrual cycle and pregnancy. They are also present in many of the types of contraception available, together or just progesterone alone. As well as having their various functions and uses in the female reproductive system, these hormones also influence your mood, emotions and behaviour.

Estrogen is capable of regulating your mood through its ability to increase serotonin and the number of serotonin receptors in the central nervous system (CNS). As the levels of estrogen fluctuate during your monthly menstrual cycle, the levels of serotonin fluctuate too. This is why many women have greater mood stability when the levels of estrogen rise, and less stability when the levels are low.

However when the levels of both estrogen and progesterone rise, progesterone can interfere with the levels of serotonin in the CNS, thus interfering with the mood stability induced by estrogen. Progesterone also can enhance your emotional responses through its ability to stimulate the reactivity of the part of the brain responsible for processing emotional arousal (the amygdala). When the levels of progesterone rise during the 1-2 weeks before menstruation, your emotional responses are generally intensified. This is why many women are rather sensitive before they start their period.

As for us women with borderline personality disorder, the effects of estrogen and progesterone can differ due to our abnormal brain activity. A 2003 study concluded that women’s BPD symptoms worsened when their levels of estrogen were high. It has been suggested that this may be because of estrogens role in increasing serotonin and the no. of serotonin receptors in the CNS. Problems within the serotonin system (in the CNS) have been identified in people with BPD, so the influence of estrogen on the serotonin system may be the cause of worsened BPD symptoms.

Progesterones role in stimulating the amygdala could be another factor that worsens women’s BPD symptoms. While there haven’t been any studies on this factor (as far as I’m aware), there have been studies confirming that the amygdala is hyperactive in people with BPD. So estrogens effect of increasing the amygdala reactivity (during the 1-2 weeks before menstruation) could further intensify its hyperactivity, and result in incredibly intense and overwhelming emotions in comparison to the usual intense emotions caused by BPD.

I decided to conduct a survey for women with borderline personality disorder to review the effects of estrogen and progesterone. The survey consisted of questions regarding contraception, the 1-2 weeks before menstruation, and pregnancy; and how each of these variables affected each womans BPD symptoms.

58 women answered my question about their BPD symptoms during the 1-2 weeks before menstruation (when the levels of estrogen and progesterone rise). 27 of these women are not on any form of contraception, and the other 31 are using a type of contraceptive or have undergone a procedure that stops them from conceiving.

  • 25 of the 27 women not using contraception (93%) stated that their BPD symptoms worsened during this time.
  • woman did not notice any difference in her BPD symptoms.
  • 1 woman was unsure due to irregular periods.

After I reviewed the answers of the women who are currently using a type of contraceptive (oral, implant, IUD or DMPA), or undergone a procedure that stops them from conceiving (hysterectomy or tubal ligation), I separated the results into 3 categories.

Contraceptives containing estrogen and progestin – The Pill.

  • of the 11 women on the pill stated that the severity of their BPD symptoms decreased throughout their menstrual cycle, except for the 1-2 weeks before menstruation when they would worsen.
  • woman stated that the severity of her BPD symptoms worsened throughout her menstrual cycle, especially during the week(s) before menstruation.
  • woman did not notice any difference in her BPD symptoms at all.
  • woman did not notice any difference in her BPD symptoms, except for the week(s) before menstruation when the severity would decrease.
  • women (54.5%) did not notice any difference in their BPD symptoms, except for the week(s) before menstruation when they would worsen.

Contraceptives containing only progestin – IUD, Implant, Mini Pill, DMPA.

  • of the 16 women (37.5%) using progestin only contraceptives stated that the severity of their BPD symptoms worsened throughout their menstrual cycle, especially during the week(s) before menstruation. [IUD x1, Implant x1, Mini Pill x4]
  • women did not notice a difference in their BPD symptoms at all. [IUD x4, Implant x1, DMPA x1]
  • women did not notice a difference in their BPD symptoms, except for the week(s) before menstruation when they would worsen. [IUD x2, Implant x1, Mini Pill x1]

Non hormonal contraceptive procedures – Tubal Ligation, Hysterectomy.

  • women have had their tubes tied or cut (tubal ligation), and stated that they did not notice any difference in their BPD symptoms, except for the week(s) before menstruation when they worsened.
  • woman had a hysterectomy, and did not notice any difference in her BPD symptoms since the procedure.

40 women answered my question about their BPD symptoms during pregnancy. 33 of these women had a succesful pregnancy, 3 unfortunately suffered a miscarriage, and 4 were pregnant before being diagnosed with BPD.

  • 6 of the 33 women who were pregnant stated that they felt calmer, and that the severity of their BPD symptoms decreased to a manageable level.
  • 13 women states that the severity of their BPD symptoms increased.
  • 12 women did not notice any difference in their BPD symptoms.
  • 1 woman stated that the severity of her BPD symptoms varied (some were better, some were worse).
  • 1 woman stated that the severity of her BPD symptoms varied with each pregnancy.
  • The 3 women who miscarried did not notice any difference in their BPD symptoms.
  • 2 of the women who were pregnant before being diagnosed with BPD stated that they noticed no difference in their symptoms.
  • The other 2 women were unsure because they were not diagnosed with BPD yet.

In conclusion, the majority of women with borderline personality disorder suffer from worse BPD symptoms during the 1-2 weeks before menstruation when the levels of both estrogen and progesterone fluctuate (regardless of whether they are on contraception or not).

Of those who are using contraceptives, it seems that the women taking the progestin only pill (mini pill) suffer from worse BPD symptoms all the time. The increase in progesterone levels throughout their menstrual cycle, due to the daily intake of progestin, most likely intensifies their already heightened emotions due to its effect on the amygdala.

As for BPD symptoms during pregnancy, the severity of the symptoms seem to vary. This could be because the levels of estrogen and progesterone steadily increase up until the 3rd trimester when they reach their peak.

Ultimately, both estrogen and progesterone have an effect on the symptoms of many women with borderline personality disorder. The way each hormone influences their BPD symptoms can differ, which may be due to the levels of each hormone in every individuals system. Some may have higher levels, while some may not have enough. All in all, progesterone generally has a negative effect on women’s emotional states, while estrogen can have a positive or negative effect.


A total of 63 women participated in the survey created for this blog post. The statistics shown have been taken from the results of 60 of these women (ages 16-52). The results of the other 3 women have been omitted due to unusable/irrelevant answers.

Please be aware that the survey was a non-scientific study, and the results shown in this blog post have not been backed by any health professionals.

Thank you to all of the women who took part in the survey!

3 Comments Add yours

  1. Rayne says:

    Wow! This was so interesting to read! Thanks for doing this survey and sharing the results with us. 🙂

    Liked by 1 person

    1. S. K. Bosak says:

      You’re welcome 🙂

      Liked by 1 person

  2. Informative study. There is so little research on this stuff. It’s inspiring to see someone creating data where there is none.

    Liked by 1 person

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