I'm not sure - I stayed on the pill, which is a whole load of progestogen, until I was 49 and bypassed a lot of stuff, and felt good on it. Wondered what the fuss was about.
However, I still had a period of depression and anxiety at about 38/39 when my night sweats started. From 45, I had very definite changes that would go with oestrogen deficiency - very little bleeding, oestrogen withdrawal headaches, vaginal dryness/itching/pube loss and constant night sweats. But my skin was amazing - no spots for the only time I can remember!
When I came off it, I discovered libido
and felt like a lid had been lifted - there were obvious downsides, but I had lived with them for years.
I tried progestogen only pill (which is a much smaller amount of progestogen and no oestrogen) but I had genitourinal/vaginal dryness problems which ramped up and, having no week off, the constipation was constant and I felt rubbish. I thought this would have helped me having read about oestrogen dominance but it didn't. I then went on to have loads of periods (no ovulation, therefore no progestogen to help regulate the bleeding) and bad joint pains (this also started in a smaller way when I was late 30's
) and went onto hrt. I have lots of brain fog and feel detached from my body when I am not on it - this gradually crept up on me in the time between stopping pop and starting hrt. Spotty again though
Some women sail through happily on mirena or pop and are happy with it, so expect a small amount of progesterone must work for some. For others, it is like permanent pms.