Maybe you’re aware of progesterone’s importance for pregnancy, or perhaps you’re taking the progesterone-only contraceptive pill…but are you aware how important it is for female health? It’s an incredibly important part of the female balance of hormones and one that’s often overlooked!
In this article we cover everything you need to know about progesterone including its role in the body, symptoms of low progesterone, what happens to progesterone in perimenopause and menopause and how you can best support your progesterone levels naturally. Â
What is progesterone?
Progesterone is a hormone known for its calming, soothing effects, making us feel relaxed and balanced throughout the second half of our cycle, as well as also helping to improve memory, maintain the endometrial lining and more.Â
Although progesterone helps the body in many ways and is greatly beneficial for our health, it is only made in the body once you ovulate.
Ovulation is the star of the menstrual cycle and it occurs when estrogen levels peak. This peak sends a signal to the brain to release a surge of luteinising hormone, and once this happens the egg is released and ovulation has occurred. Once the egg has been released during ovulation the follicle then turns into the corpus luteum.Â
The corpus luteum is responsible for producing progesterone (pro-gestation), which supports a pregnancy until the placenta can take over the production of progesterone.Â
Progesterone reaches its highest levels during the luteal phase (second phase of the menstrual cycle).Â
Why do we need progesterone?
We need progesterone for a healthy pregnancy, as progesterone helps to prepare the body for implantation, as well as maintenance of early pregnancy. Â
But this is not progesterone’s only function!Â
- It has amazing calming effects on the body and the brain.
- It’s a natural antihistamine.
- It reduces inflammation and regulates immune function.
- It supports the thyroid.
- It supports a healthy brain, bones and breasts.
- It promotes a healthy menstrual cycle by providing important hormonal feedback. to the hypothalamus in the brain.
Estrogen and progesterone: The dream team
Physiologically, estrogen and progesterone work as a team. For example, a pre-ovulatory surge of estrogen is necessary for ovulation and therefore the manufacture of progesterone. Estrogen also works in every tissue to facilitate the production of progesterone receptors in those same tissues.
In turn, progesterone counterbalances estrogen:
- It thins the lining of the uterus, while estrogen thickens it.
- It calms the brain, while estrogen is stimulating.
- It helps to slow cell division in the breasts, while estrogen increases cell division.
- It acts like a natural anti-histamine, while estrogen can stimulate histamine.
Symptoms of low progesterone
When progesterone is low you will probably know about it! Here are some signs and symptoms your progesterone may be low:
- Anxiety
- Short cycles
- Acne
- Spotting before your period
- Headaches
- Fertility issues
- Low sex drive
- Irregular cycles
- Poor sleepÂ
- PMS symptoms
There are many reasons why progesterone may be low, including perimenopause and menopause as ovarian function declines and ovulation stops. But there are many other reasons why progesterone levels may not be optimal during your reproductive years too.Â
Some possible causes may be hypothalamic amenorrhea, poor blood flow to the ovaries, estrogen dominance, stress, under eating, overexercising, high testosterone, PCOS, insulin resistance and thyroid imbalances.Â
Progesterone and hormonal contraception
Hormonal contraception suppresses progesterone by preventing ovulation.
The only type of hormonal contraception where ovulation can occur is the hormonal IUD (e.g. the Mirena Coil). However studies show that ovulation is less likely in the first 1-2 years of use, and many women never ovulate while using the coil. Where ovulation does occur, progesterone levels still tend to be lower, often leading to estrogen dominance.Â
It is important to note that progestins are NOT the same as progesterone. While progestins perform a similar role to progesterone inside the uterus (by thinning the uterine lining), the don’t come with all the other full body effects of progesterone. In fact, progestins are molecularly more similar to androgens (often incorrectly referred to as male hormones), leading to symptoms such as hair loss, body hair growth and acne.Â
Progesterone in perimenopause
Progesterone is usually the first hormone level to decline in the early stages of perimenopause. This can cause a number of symptoms including:
- Poor sleep
- Poor memory
- Increased anxiety or loss of confidence
- Increased weight gain
- Irregular periods
Progesterone and menopause
Once you are through menopause (defined as the point in time when you have gone 12 months without a period) then progesterone levels will have dropped significantly due to the cessation of ovulation and the menstrual period. This can cause many of the same symptoms as listed above in perimenopause.Â
The adrenal glands continue to produce small amounts of progesterone after menopause.Â
How do I know if I’m making enough progesterone?
Clinical research indicates optimal progesterone levels in our reproductive years should range between 6-20 ng/mL, but at FUTURE WOMAN we believe levels of 8 ng/mL or more are optimal.Â
The amount of time you produce progesterone for is also important. A luteal phase (the length of time between ovulation and when your period begins) should be 11-16 days long.Â
Finally, progesterone levels should always be evaluated alongside estrogen levels to check that your ratio is optimal. In a healthy luteal phase, we should be making 100x more progesterone than estrogen.
How to test progesterone levels
There are a few important things to keep in mind when testing progesterone levels:
- Testing day: Progesterone is only made after ovulation and levels peak 5-7 days after ovulation has occurred. This is therefore the best time to test progesterone.
- Testing accuracy: Progesterone levels have been shown in research to fluctuate dramatically throughout the day, so a single blood test cannot provide an accurate reading. We collect multiple dried urine samples across the day and take an average – this significantly improves the accuracy.
- Testing metabolites: An assessment of progesterone metabolites is also important and this is only detectable in urine. 5a-pregnanediol is the preferred metabolite as it can cross the blood brain barrier and up-regulate GABA activity. It’s therefore more commonly associated with progesterone’s beneficial effects.
- Other key markers: Alongside progesterone it’s useful to also test estrogen, androgens, stress hormones like cortisol and oxidative stress to evaluate potential drivers of low progesterone.
Reasons for low progesterone
The main reasons for low progesterone are:
- You don’t ovulate – anovulation
- You do ovulate, but not every cycle
- The quality of ovulation is poorÂ
Some of the causes of anovulation, sporadic ovulation and poor-quality ovulation include:Â Â Â Â
- PCOSÂ (or polycystic ovarian syndrome)
- Blood sugar issues
- Inflammation – which can impact brain signalling to the ovaries as well as affect hormone receptors
- Thyroid issues
- Chronic stress
- Nutrient deficiencies
- Under eating or over exercising
- Hormonal birth control
- Regularly taking NSAIDs or other medications like opioids
- Perimenopause
- High levels of oxidative stress
How to boost progesterone levels
Our Advanced Hormone Test includes a personalised plan to help boost your progesterone levels (if testing reveals them to be low). One of our expert practitioners will review your results alongside your symptoms, history, diet and lifestyle habits to prepare a tailored set of recommendations for you.Â
These will include:
- Tailored supplement recommendations
- Diet changes
- Lifestyle suggestions
