Low progesterone: All you need to know

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Low progesterone is a concern that many women have either while trying to get pregnant or early in pregnancy. This isn’t a common problem. 

However, women who do have low progesterone levels may have difficulty with getting or staying pregnant.

So, what exactly is progesterone and what is it needed for? And how do you know if you have low progesterone? Read on for more information about this important pregnancy hormone.

What is progesterone?

Progesterone is a special type of steroid hormone that is important in the female menstrual cycle and in pregnancy.

Progesterone is primarily made by the empty egg follicle (also known as the corpus luteum) after ovulation. 

It is also made by the placenta and the adrenal glands. Believe it or not, progesterone is also produced in very small amounts by the testicles in a man’s body.

Why is progesterone important?

When it comes to getting and staying pregnant, progesterone is very important.

The Menstrual Cycle

Progesterone levels are normally pretty low. However, after ovulation, the empty egg follicle begins to secrete it in large amounts. 

High progesterone levels prepare the uterine lining for implantation. There are a couple important ways that this happens:

  • It makes the lining thicker and more able to nourish the fertilized egg
  • It reduces muscle contractions in the uterus that can prevent implantation

 If pregnancy happens, the placenta will eventually take over making progesterone.

 If pregnancy doesn’t happen, the corpus luteum (empty egg follicle after ovulation) will break down. This causes the progesterone levels to also decrease and triggers the start of a period.

Premenstrual Syndrome

Ever get PMS? You know that bloaty, tired, sore breasts feeling? You can thank a decreasing progesterone level for that. Mood swings? Yup, that’s thanks to changing progesterone levels as well.


 Progesterone is also important for maintaining a pregnancy, especially in the beginning. It actually prevents ovulation to keep a woman from becoming pregnant again.

 Progesterone also helps to stimulate the development of breast tissue. This prepares the breasts for milk production and breastfeeding. 

 Early pregnancy symptoms, such as breast tenderness, feeling tired, bloated and moody? Those are also due to progesterone, just like with PMS right before your period

Get Pregnant with PCOS

What happens if you have low progesterone?

Progesterone is most important during child-bearing years. This is especially true if you may be trying to get pregnant, or think you want to get pregnant soon.

In women who aren’t pregnant, low progesterone can cause abnormal uterine bleeding or irregular periods. 

Having a low progesterone level can also cause estrogen levels to increase. Estrogen is another female sex hormone that plays a role in menstruation and pregnancy. High estrogen levels can cause symptoms such as:

  • Weight gain
  • Heavy or irregular menstrual bleeding
  • Mood swings or depression
  • Uterine fibroids
  • Breast tenderness
  • Gallbladder problemsIn women who are pregnant, serious complications can result. These can include miscarriage or pregnancy loss.

Low progesterone levels during pregnancy can also indicate an ectopic pregnancy.

An ectopic pregnancy means that the fertilized egg has implanted outside of the uterus. A woman with an ectopic pregnancy should see her healthcare provider immediately. Without proper medical care, an ectopic pregnancy can be life-threatening.

What causes low progesterone?

There are several conditions that can cause a low progesterone level.

  • Luteal Phase Defect:
    The luteal phase of the menstrual cycle is the second half of the cycle, after ovulation but before a period. It is during this phase that progesterone levels are usually elevated (remember from the corpus luteum, or empty egg follicle, after ovulation?).
    A luteal phase defect is when there are low progesterone levels. This causes the uterine lining to not develop enough for implantation to occur.
    Doctors aren’t sure what causes a luteal phase defect. They think it could be caused by poor progesterone secretion by the ovary, or an issue with the development of the uterine lining.
  • Menopause:
    Menopause is the period of time in a woman’s life when her periods stop. The time leading up to menopause is also known as perimenopause.
    During this time, the reproductive hormones like estrogen and progesterone can be a little out of whack. This can cause progesterone levels to be low.
  • Stress:
    Have you ever been crazy stressed out and skipped a period or two? Well, chronic stress can cause a woman to skip ovulation and her period. This can cause low progesterone. 
  • Polycystic Ovary Syndrome (PCOS):
    Women with PCOS may not ovulate regularly, which can lead to low progesterone levels. As a result, it can be difficult to figure out the best time to have sex for conception.
    Read More : PCOS And Pregnancy: All You Need To Know
  • Weight:
    2017 study at the the University of Illinois at Chicago found that women who are overweight or obese have lower progesterone levels. The same study found that women who are underweight may also have low progesterone levels. Getting to a healthy weight is an important step in preparing for a pregnancy.

What are symptoms of low progesterone?

Symptoms of low progesterone may be subtle. If you aren’t pregnant, these symptoms could include:

Low Progesterone Symptoms
  • Low libido – Progesterone helps to boost the sex drive. A woman who has low progesterone levels is more likely to have a decreased sex drive.
  • Mood changes – Low progesterone can lead to irritability, depression, anxiety, and mood swings. This is similar to how you feel right before you get your period. 
  • Irregular menstrual cycle – Low progesterone usually means that you are not ovulating regularly. Irregular ovulation also causes a woman’s menstrual cycle to be irregular. 
  • Infertility – Low progesterone level can make it difficult to get or stay pregnant. An irregular menstrual cycle can make it tricky to time conception. In addition, not ovulating means that there isn’t an egg available for conception. 
  • Miscarriage – Low progesterone levels makes the body unable to maintain a pregnancy. This means that a woman with low progesterone is more likely to have a miscarriage, or pregnancy loss.
  • Hot flashes – When progesterone is low, it can cause estrogen levels to rise. This imbalance between the two hormones can cause hot flashes, especially at night.
  • Headaches – Do you get a migraine or headache right before your menstrual cycle? Low progesterone may be to blame for that. The rise in estrogen levels can cause water retention and changes to blood vessels in the body that can trigger a headache. 

How can I test my progesterone levels?

If you suspect that you might have low progesterone, or you have been trying to get pregnant, you may want to test your progesterone levels. 

 The first way is to go to your doctor and get a prescription to have your blood drawn and tested. However, this route can be inconvenient. You may need to have your blood drawn a few times to capture your peak post-ovulation progesterone level.

A fertility monitor, like Inito, is another option. This home testing system can check your progesterone metabolite-PdG levels, along with FSH, estrogen and luteinizing hormone (LH). Checking the combination of all four hormones and gives you a clearer picture about your fertile window and when you actually ovulate.

 It provides you with several different possible results:

  • High fertility – This result means that your estrogen level is rising and you are approaching ovulation. Now is a great time to try to conceive. 
  • Peak fertility – A peak fertility result indicates that both estrogen and LH levels are rising. This means that you are going to ovulate within the next 24 to 36 hours. This is the best time to try to conceive.
  • Ovulation confirmed – This result indicates that your progesterone level has risen. It confirms that ovulation has occurred.

What should I do if I have low progesterone?

It depends. Are you trying to conceive and having difficulty? Are you pregnant? Are you bothered by symptoms of low progesterone? 

 If the answer to any of these questions is “yes” and you should see your doctor.

Also document your menstrual cycle dates and any symptoms that you may have. Important symptoms to include are migraines, mood swings, irregular bleeding, hot flashes, and anything else that you think may be related.

Make sure to bring a list of questions to your appointment, and some paper to take notes. 

 Some good questions to ask may include:

  • What is causing my low progesterone?
  • Do I need to take progesterone supplements?
  • What are the risks and benefits of taking progesterone?
  • Is a natural progesterone appropriate for me?
  • What are the risks and benefits of taking a natural progesterone?

Your doctor may order additional testing, such as blood testing of progesterone or other hormone levels. The doctor may also order an ultrasound of the reproductive organs.

What is the treatment for low progesterone?

If you and the doctor decide that treating low progesterone is necessary, there are several options, which include: 

Creams and gels: There are creams and lotions that can be applied to the skin or inserted into the vagina. 

Suppositories: Vaginal suppositories are often used because they are very well absorbed in the vagina. When administered vaginally, progesterone is also very close to the site of action (the uterus). Make sure to wear a panty liner or pad, though, because they do leak out of the vagina when they melt. 

Oral pills: There are some oral medications, either as progesterone alone or in combination with estrogen that can be used in some circumstances. 

Intramuscular injections: Intramuscular injections are often used as a last resort. Women who need this type of therapy are often taught how to do these injections themselves. This allows them to take their medicine regularly at home. 

Whichever option you decide on, make sure to take the medication exactly as instructed. 

Notify your doctor if you experience any unexpected side effects.

You can also speak to the doctor about natural options for raising your progesterone levels:

  • Increase your intake of foods that are rich in Vitamins B and C because they are needed for maintaining progesterone levels. Foods high in Vitamin B include whole grain, meat, eggs and dairy, legumes, and dark leafy vegetables. Citrus fruits are high in Vitamin C.
  • Increase your dietary intake of foods rich in zinc. They include seafood, beans, nuts, meat, poultry, fortified breakfast cereals, and dairy products.
  • Manage your stress. High stress levels cause the release of cortisol, which can suppress progesterone. Take up yoga, exercise, write in a journal, or find another way to deal with stress.
Natural options may not be right for some women to take instead of traditional progesterone supplements. However, it may be possible to use them in addition to prescribed supplements.

Having low progesterone when pregnant or trying to conceive can have serious complications. Please check in with your doctor about your specific situation. 


  • Progesterone is a special type of steroid hormone that is important in the female menstrual cycle and in pregnancy.
  • Progesterone is primarily produced by the empty egg follicle (also known as the corpus luteum) after ovulation.
  • Progesterone is most important during child-bearing years, especially if you may be trying to get pregnant, or think you want to get pregnant soon.
  • A luteal phase defect is when there are low progesterone levels, and the uterine lining is not developed enough for implantation to occur.
  • Symptoms of low progesterone include low libido, irregular periods, mood swings, headaches, and hot flashes.
  • If you suspect that you might have low progesterone, or you have been trying to get pregnant, it can be helpful to test your progesterone levels.
  • If you and the doctor decide that treating low progesterone is necessary, there are several different types of progesterone supplements that are available.

Causes and symptoms of progesterone deficiency. Retrieved from https://oklahomapaindoc.com/articles/causes-and-symptoms-of-progesterone-deficiency

Luteal phase defect. Retrieved from https://resolve.org/infertility-101/medical-conditions/luteal-phase-defect/

Both obese and anorexic women have low levels of ‘feel good’ neurosteroids. Retrieved from https://www.sciencedaily.com/releases/2017/11/171110164029.htm

Low progesterone: Symptoms, causes, and treatments. Retrieved from https://www.medicalnewstoday.com/articles/low-progesterone-symptoms

Understanding hormones: The roles of estrogen and progesterone. Retrieved from https://macarthurmc.com/understanding-hormones-the-roles-of-estrogen-and-progesterone/

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