Progesterone is a female sex hormone produced mainly in the ovaries following ovulation each month. It’s a crucial part of the menstrual cycle and maintenance of pregnancy.
Progesterone helps to regulate your cycle, but its main job is to get your uterus ready for pregnancy. After you ovulate each month, progesterone helps thicken the lining of the uterus in preparation for a fertilized egg. If there is no fertilized egg, progesterone levels drop again and menstruation begins. If a fertilized egg does implant in the uterine wall, progesterone helps to maintain the uterine lining throughout pregnancy.
Progesterone is necessary for breast development and breast-feeding as well. It complements some of the effects of estrogen, another female hormone. It also plays an important role with testosterone, as it is the precursor for adrenal hormones.
Men produce a small amount of progesterone to aid in the development of sperm.
Progesterone is especially important in your childbearing years. If you don’t have enough progesterone, you may have trouble getting or staying pregnant. Each month, after one of your ovaries releases an egg, your progesterone levels should rise. Progesterone helps the uterus thicken in anticipation of receiving a fertilized egg. If it’s not thick enough, implantation doesn’t occur.
Symptoms of low progesterone in women who aren’t pregnant include:
- headaches or migraines
- mood changes, including anxiety or depression
- low sex drive
- hot flashes
- irregularity in your menstrual cycle
For women who aren’t pregnant, low progesterone may cause abnormal uterine bleeding. Irregular or absent periods may indicate poorly functioning ovaries and low progesterone.
If you do get pregnant, you still need progesterone to maintain your uterus until your baby is born. If your progesterone levels are too low, your uterus may not be able to carry the baby to term.
During pregnancy, symptoms of low progesterone include spotting and abdominal pain. Other symptoms of low progesterone in women who are pregnant may include:
- constant breast tenderness
- unrelenting fatigue
- frequent low blood sugar
- vaginal dryness
Low progesterone may indicate toxemia or ectopic pregnancy. This can sometimes result in miscarriage or fetal death.
Without progesterone to complement it, estrogen may become the dominant hormone. This may lead to a variety of symptoms, including:
- weight gain
- decreased sex drive, mood swings, and depression
- PMS, irregular menstrual cycle, heavy bleeding
- breast tenderness, fibrocystic breasts
- fibroids, endometriosis
- gallbladder problems
- thyroid dysfunction
A progesterone test (PGSN) can help your doctor determine if your progesterone levels are too low. This is a simple blood test that doesn’t require any preparation.
The test can offer clues as to why you’re having trouble getting pregnant. It can also confirm whether or not you’ve ovulated. The PGSN test can be used to monitor hormone replacement therapy or the health of a high-risk pregnancy.
Progesterone levels fluctuate throughout the menstrual cycle. They peak about seven days before your period, and can even vary in the course of a single day. Progesterone levels are usually higher than normal during pregnancy. They’re even higher if you’re expecting more than one baby.
Poorly functioning ovaries can result in poor progesterone production. During menopause, it’s natural for estrogen and progesterone levels to fall.
Men, children, and postmenopausal women all have lower progesterone levels than women in their childbearing years.
What is considered a “normal” progesterone level depends on a person’s age and gender. In women, additional factors include whether she’s pregnant and where she is in her menstrual cycle.
Having low progesterone may not have any symptoms for you, and you may not need to treat it. However, if you’re trying to have a baby, hormone therapy to increase progesterone may help thicken your uterine lining. This may improve your chances of having a healthy pregnancy and carrying to term.
Menstrual irregularities and abnormal bleeding can also be improved through hormone therapy.
For severe symptoms of menopause, hormone therapy usually consists of a combination of estrogen and progesterone. Women who take estrogen without progesterone are at increased risk of developing endometrial cancer.
Treatment options include:
- creams and gels, which can be used topically or, in women, vaginally
- suppositories, which are commonly used when treating low progesterone that is causing fertility problems
- vaginal rings, which offer slower releases of hormones than oral medications
- oral medications, like Provera
Hormone therapy may help ease symptoms such as hot flashes, night sweats, and vaginal dryness. For some women, it improves mood and state of mind. It may also lower your risk of osteoporosis and diabetes. Oral progesterone may provide a calming effect, making it easier to sleep.
Hormone therapy may increase the risk of stroke, blood clots, and gallbladder troubles. If you’ve had breast cancer or endometrial cancer, your doctor will probably advise against hormone therapy. Women with a history of liver disease, blood clots, or stroke shouldn’t undergo hormone therapy.
Natural remedies for raising low progesterone levels include:
- increasing your intake of vitamins B and C, which are necessary for maintaining progesterone levels
- eating more foods with zinc, like shellfish
- controlling stress levels, as cortisol is released instead of progesterone in high periods of stress and it reduces progesterone levels
Progesterone is still important in women who have had hysterectomies. Women who have had hysterectomies and are not on progesterone replacement are more likely to die from heart disease and have increased risk for both brain and bone diseases.
Because women with hysterectomies are also more likely to have strokes or cancer while on conventional hormone therapies, undergoing bioidentical hormone therapy is essential. In bioidentical hormone therapy, the hormones you’re receiving are biologically identical to your natural hormones. Women on this type of hormone therapy have no increased risk of disease.
Low progesterone can cause a number of different problems for both men and women. However, there are several different types of treatments that can help resolve low progesterone, allowing you and your doctor to choose which solution is best for you. It may take a few weeks before you see results from hormone therapy.
Hormone therapy may be a long-term solution for some, particularly postmenopausal women. You can work with your doctor to re-evaluate your treatment plan each year.