Progesterone (Pg)

Progesterone is important during childbearing years. If you don’t have enough progesterone, you may have trouble getting or staying pregnant.

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, the egg won’t implant.

Symptoms of low progesterone in women who aren’t pregnant include:

- headaches or migraines
- mood changes, including anxiety or depression
- irregularity in menstrual cycle

Low progesterone may cause abnormal uterine bleeding in women who aren’t pregnant. Irregular or absent periods may indicate poorly functioning ovaries and low progesterone.

If you get pregnant, you still need progesterone to maintain your uterus until your baby is born. Your body will produce this increase in progesterone, which causes some of the symptoms of pregnancy, including breast tenderness and nausea. 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 miscarriage.

Low progesterone may indicate ectopic pregnancy. This can result in miscarriage or fetal death.

Without progesterone to complement it, estrogen may become the dominant hormone.

This may cause symptoms including:

- weight gain
- decreased sex drive, mood swings, and depression
- PMS, irregular menstrual cycle, heavy bleeding
- breast tenderness, fibrocystic breasts
- fibroids
- gallbladder problems

Low progesterone levels when you are trying to get pregnant:

You may not have any symptoms of low progesterone, and you may not need treatment. But if you’re trying to have a baby, hormone therapy could be useful. Hormone therapy increases progesterone levels and may help thicken your uterine lining. This may improve your chances of a healthy pregnancy and carrying to term. 

Hormone therapy:

Menstrual irregularities and abnormal bleeding can improve with hormone therapy. 

For severe symptoms of menopause, hormone therapy usually involves a combination of estrogen and progesterone. Women who take estrogen without progesterone are at increased risk of developing endometrial cancer.

Treatment options for progesterone supplementation include:

- creams and gels, which can be used topically or vaginally
- suppositories, which are commonly used to treat low progesterone that causes fertility problems
- oral medications

Hormone therapy (either estrogen only or a combination of estrogen and progesterone) may help ease symptoms such as:

- hot flashes
- night sweats
- vaginal dryness

For some women, progesterone improves mood. Oral progesterone may provide a calming effect, making it easier to sleep.

Hormone therapy may increase the risk of:

- heart attack and stroke
- blood clots
- gallbladder troubles
- certain types of breast cancer

Your doctor will probably advise against hormone therapy if you have a history of:

- breast cancer
- endometrial cancer
- liver disease
- blood clots
- stroke

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
- controlling stress levels, since your body releases cortisol instead of progesterone when you’re stressed

Progesterone is generally not supplemented in women who are experiencing menopausal symptoms of hormone imbalance. This is because menopausal symptoms are mostly caused by low estrogen levels.

Hormone replacement does carry some risks, so it’s important to discuss them with your doctor. There are prescription medications that are formulated to look the same to your body as your naturally occurring hormones. These are sometimes called “bioidentical hormones.” While these may sound more favorable, they have the same risks as other prescription formulations.

High progesterone in normal premenopausal and postmenopausal women can occur with excessive supplementation, incidental exposure
(e.g., transference from someone using progesterone cream), and/or sluggish metabolism. Transdermal (through the skin) progesterone is well absorbed at physiological levels (10-30 mg/ day). Progesterone results higher than the reference range can occur with topical doses greater than 30 mg.

Note: a significant number of individuals in this range are without adverse symptoms, indicating that a high progesterone level is associated with few side effects. Symptoms of high progesterone are relatively benign and include excessive sleepiness, dizziness, bloating, susceptibility to yeast infections, and functional estrogen deficiency (more problematic when estradiol levels are low/low normal).