Low progesterone is one of the primary hormone imbalances affecting women in the western world. This can be especially troubling when you consider that about 1 in every 8 couples has difficulty getting or staying pregnant, and progesterone is the hormone of pregnancy.
Progesterone and infertility
Progesterone helps to maintain the uterine lining so that the newly fertilized embryo is able to implant and the pregnancy is able to progress. Low progesterone often results in something called Luteal Phase Defect, which means that the phase in which the uterine lining is maintained by progesterone decreases to less than 9-10 days. This results in the shedding of the uterine lining, aka the period, before the embryo has a chance to implant in the uterus.
If pregnancy occurs, the body rapidly ramps up its progesterone production, which remains high throughout the duration of the pregnancy. Without adequate progesterone, pregnancy cannot be sustained.
What about those of us who aren’t trying to conceive? Low progesterone is still a problem for us, too.
Symptoms of low progesterone
In our Know Your Flow piece, we described some of the symptoms associated with low progesterone: brown spotting before or after your period, anxiety, PMS, and cyclical breast tenderness. Other symptoms include breakthrough bleeding in the second half of your cycle, menstrual migraines, bloating, and irregular cycles.
Low progesterone can also be the culprit behind issues like hair loss and acne. Progesterone helps to prevent the conversion of testosterone into a derivative known as DHT. DHT is believed to damage hair follicles, resulting in accelerated shedding. So, if your progesterone is low, your DHT and other androgens (typically male-sex hormones like testosterone) may be elevated. These elevated androgens also tend to be the culprit behind many instances of adult acne.
Causes of low progesterone
Low progesterone can be caused by a number of things including stress, high cortisol levels, hypothyroidism, lack of ovulation, and oral contraceptives.
Prolonged periods of stress go hand-in-hand with high cortisol levels, and can also impair adrenal and thyroid function. During times of increased stress, a phenomenon called “pregnenolone steal” occurs. Pregnenolone is a precursor hormone needs to make both progesterone and the stress hormone cortisol. During high stress times your body diverts the pregnenolone it would typically be using for progesterone production and uses it to make cortisol instead.
Hypothyroidism in itself has numerous causes, including stress, and nutrient and mineral deficiencies. Like pregnenolone, thyroid hormone is a needed component for our bodies to make progesterone. In fact, thyroid hormone is required in order for the body to make pregnenolone from cholesterol. A major cause of both hypothyroidism and low progesterone is low vitamin D levels, and it’s estimated that about 40% of Americans are deficient in this vitamin.
Progesterone is made in the ovaries after ovulation. The little sack from which the egg is released forms the corpus luteum, which produces progesterone. If you’re not ovulating regularly, then the predominant source of progesterone in the body is never formed. Again, there are many different causes behind anovulation (lack of ovulation). One reason is the birth control pill and other hormonal contraceptives. Depending on the time of pill or hormone combination you are on, you probably still receive a synthetic variant of progesterone, but it may not be enough to combat the symptoms of low-progesterone for some women.
Other reasons for anovulation include PCOS, hypothalamic amenorrhea, low estrogen and stress.
Diet and lifestyle tweaks to correct low progesterone
As with most hormonal imbalances and health issues, the best place to start is with optimal nutrition. Try to get greens into every meal, focus on a whole foods regimen, and make sure to chew your food thoroughly. Your stomach doesn’t have teeth! It’s difficult to extract all the nutrients from our food when we do not digest it properly.
Stress management is also critical because of the reasons mentioned above. Take a look at your stress and pay attention to how your stress levels change throughout the day and note any triggers. Try to develop a de-stress list, including things like simple breathing exercises, a 5 minute walk outside, and anything you can think of to help yourself decompress. Cultivating a morning routine and an evening wind-down routine can also be helpful. Removing biological stressors like caffeine, sugar and alcohol is also recommended.
I believe in using supplements therapeutically for a period of time and then reducing to a maintenance regimen. Its best to consult with a health professional before incorporating multiple new supplements into your wellness plan. Basic supplements recommended for a healthy cycle are B vitamins, fish or cod liver oil, and magnesium. In addition, vitamin D3 and vitamin C (approximately 1,000 IU per day) are recommended for low progesterone. Additionally, vitex chasteberry is an herbal supplement proven to help regulate ovulation and boost progesterone levels.
These are the brands that I personally use and recommend to my clients*:
If you suspect you may have a thyroid issue, it’s best to see your doctor to have your thyroid hormone levels, as well as Vitamin D and iron levels, tested. This can help determine the appropriate supplementation regimen. A minor tweak most of us can all benefit from is adding some trace minerals to our water once or twice a day. These minerals help to nourish our thyroid and are not adequately present in our food or water due to soil depletion.
A little self care can go a long way!
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Kara DeDonato is a fertility health expert who works with women to troubleshoot their monthly cycles and digestion so that they can feel their best and be their best selves. Read her full bio here.