Progesterone plays a vital role in preparing and maintaining the body during pregnancy. In fact, it’s often referred to as the “pregnancy hormone”.
But like many things in life, you don’t want to have too much of a good thing.
Too much progesterone can cause a variety of symptoms and may be of concern to you if you are trying to get pregnant.
We’re going to take a look at how to know if you have high levels of progesterone levels and what you can do about it.
First, let’s review the role of progesterone in your body and how it affects your menstrual cycle and your ability to become pregnant.
The importance of progesterone
Progesterone must be an adrenaline junkie because it goes on a rollercoaster throughout a woman’s life.
This fluctuation in progesterone is not arbitrary, though. It’s all by design.
To better illustrate this, let’s look at a breakdown of how progesterone levels vary throughout the month:
- During menstruation and the follicular phase, progesterone levels remain at a low level at around 0.1 to 0.7 ng/mL.
- After ovulation, the ruptured follicle that released the egg leaves behind a structure called the corpus luteum which secretes progesterone.
- Progesterone levels rise to around 2 to 25 ng/mL. This rise during the luteal phase increases the uterine blood flow and thickens the uterine lining, so an embryo can attach and grow.
- If pregnancy has not occurred, progesterone levels fall. This causes the uterine lining to shed during the next period.
- If pregnancy occurs, then progesterone levels stay elevated.
It’s an understatement to say progesterone is important for maintaining a healthy pregnancy. In fact, low progesterone during pregnancy is associated with a higher risk of miscarriage. This is because the uterine lining will not remain healthy enough for the fetus if there is not enough progesterone.
Progesterone also has these other functions during pregnancy:
- Maintains and prepares the breast for lactation, but inhibits lactation until delivery of the baby.
- Prevents uterine contractions which could result in premature delivery.
- Prevents the mother’s immune system from rejecting the fetus.
Normal progesterone levels in blood and urine
Progesterone levels are measured in the blood or urine.
A blood test measures the amount of unmetabolized progesterone. A urine test measures the amount of metabolized progesterone which is referred to as progesterone metabolite PdG.
The following are the normal levels of progesterone throughout the menstrual cycle and pregnancy.
- Follicular phase of menstrual cycle: 0.1 to 0.7 ng/mL
- Luteal phase of menstrual cycle: 2 to 25 ng/mL
- First trimester of pregnancy: 10 to 44 ng/mL
- Second trimester of pregnancy: 19.5 to 82.5 ng/mL
- Third trimester of pregnancy: 65 to 290 ng/mL
Urine levels (progesterone metabolite PdG):
- Follicular phase: 0-3 ug/ml
- Luteal phase: Rises to 6-40 ug/ml from the baseline values
A blood test is the best way to confirm high progesterone levels. To measure blood progesterone levels, you’ll need a blood draw at your doctor’s office or a laboratory. For this test, a phlebotomist will insert a venous catheter into a vein and obtain a blood sample.
A urine test to measure progesterone metabolite PdG won’t be used alone to diagnose high progesterone levels. But this test can be helpful if you have high progesterone and are struggling with your fertility as it can help determine if you are ovulating or not. This test can be done at a lab or in the comfort of your home.
Signs and symptoms of high progesterone
Symptoms vary depending on how high your levels are and may be similar to other hormonal imbalances or health conditions. Here are some common symptoms you may experience:
- Irregular menstrual cycles
- Fertility issues
- Decreased libido
- Increased appetite
- Breast tenderness
- Mood changes, anxiety, or depression
Causes of high progesterone
Progesterone levels are constantly fluctuating so you may have higher levels occasionally. However, certain cases cause prolonged high progesterone.
If you are pregnant and find out you have higher levels of progesterone than expected, you might be pregnant with more than one baby (multiple gestation). Progesterone levels may be up to 60% higher in twin pregnancies!
Don’t count your chicks before they hatch, though. A high progesterone level does not confirm you are expecting more than one baby. The best way to confirm if you are pregnant with multiples is by ultrasound. Your bloodwork may show you also have higher levels of hCG and alpha-fetoprotein.
A high level of progesterone is important in maintaining a healthy pregnancy and does not need to be lowered. Progesterone levels will decrease after the birth of the babies.
In rare cases, high progesterone may be seen in a molar pregnancy, also referred to as a hydatidiform mole.
In a molar pregnancy, an error occurs during the fertilization process. This causes abnormal tissue to rapidly develop which forms a noncancerous tumor. This results in an unviable pregnancy.
Molar pregnancy is a rare condition that affects 1 in 1,000 pregnancies.
It can be of two types: complete and partial.
Complete vs. partial molar pregnancy
A complete molar pregnancy does not contain a developing fetus. During fertilization, a sperm fertilizes an empty egg, but a placenta still forms and secretes hCG.
In a partial molar pregnancy, an embryo is present but miscarries quickly due to the invasive nature of the rapidly developing tissue.
The tell-tale signs of molar pregnancy include:
- Extremely high hCG levels.
- Ultrasound shows an abnormal mass that looks like a cluster of grapes.
- No heartbeat found during an ultrasound.
A dilation and curettage (D&C) is usually performed to remove the tissue from the uterus. Once the molar pregnancy has ended, progesterone and hCG levels drop.
Congenital adrenal hyperplasia (CAH)
CAH is a rare disorder of the adrenal glands that is often diagnosed at birth. The adrenal glands are right above the kidneys and they produce important hormones. CAH is a genetic condition that results in a mutation of the enzyme 21-hydroxylase. This causes the body to make too much progesterone and not enough cortisol.
Symptoms of CAH:
- Early onset of puberty.
- Irregular periods.
- Excessive facial or body hair.
- Unwanted masculine characteristics such as hair growth and a deep voice in females.
- Infertility or subfertility.
Glucocorticoid therapy may help reduce progesterone if you have CAH. It may also increase your chances of getting pregnant.
Cancer of adrenal glands or ovaries
Certain cancers of the adrenals or ovaries can secrete high levels of progesterone.
As long as the tumor remains, progesterone levels will be high. The best way to decrease progesterone levels is to remove or shrink the tumor. This can be achieved by surgery, radiation, and/or chemotherapy.
Hormone replacement therapy (HRT)
Menopausal women may find relief for symptoms such as hot flashes and vaginal dryness by taking hormone replacement therapy. High levels of progesterone may occur since HRT includes progesterone.
You could experience the following side effects if you take too much progesterone:
- Tiredness and drowsiness
- Sleep disturbances
- Abdominal pain
- Altered bowel movements
- Breast tenderness or heaviness
You should notice symptoms resolve by decreasing your progesterone intake. Talk to your doctor about altering your progesterone dosage.
We’ve explored many of the causes of high progesterone Now, let’s discuss how high progesterone levels are diagnosed.
Diagnosis of high progesterone levels
A blood test is the most common way to diagnose high progesterone levels.
But since progesterone levels fluctuate across the menstrual cycle, it’s hard to diagnose high progesterone after one blood test. It may take multiple blood tests for a definitive diagnosis.
So, you’ve learned all there is to know about high progesterone. Yet, you’re still wondering “Is high progesterone that big of a deal?”
Will high progesterone affect my TTC journey?
You may be concerned about high progesterone if you are trying to get pregnant. But worry not. High progesterone without additional symptoms should not affect your fertility.
Some conditions may affect your ability to get pregnant. They are as follows:
- Congenital adrenal hyperplasia can make it difficult to become pregnant due to menstrual irregularities and infertility.
- Primary ovarian insufficiency (POI) can occur after treatment for ovarian and adrenal cancer. This can cause your ovaries to stop releasing eggs and estrogen.
Frequently Asked Questions (FAQs)
Is high progesterone really a problem? Should I be worried?
You likely shouldn’t worry about high progesterone levels if you aren’t experiencing other symptoms.
If you have high progesterone levels that are accompanied by other symptoms, consult your doctor. This could indicate a rare condition such as molar pregnancy, congenital adrenal hyperplasia, or ovarian/adrenal cancer.
Will high progesterone affect my TTC journey?
High progesterone probably won’t affect your trying-to-conceive journey. However, if you’ve had treatment for ovarian or adrenal cancer or have congenital adrenal hyperplasia, fertility issues may arise.
What happens if I take too much progesterone?
If you take too much progesterone, you could experience side effects such as headaches, sleep disturbances, abdominal cramps, breast tenderness, or mood swings. Consult your doctor to discuss decreasing your progesterone dosage.
Can men also have high progesterone?
Yes, men can have high progesterone too.
Progesterone plays an important role in the male body as it acts as a precursor to testosterone, helps counteract the effect of estrogen, and helps prepare sperm for fertilization.
But too much progesterone can cause symptoms such as decreased libido, weight gain, erectile dysfunction, gynecomastia (enlarged breast tissue), or mood changes.
Men may have too much progesterone for the following reasons:
Treatment for each man will depend on the underlying medical condition causing the high levels.
- Progesterone is a jill of all trades. It helps maintain the menstrual cycle, supports the health of the uterus during pregnancy, and stimulates the growth of breast tissue for milk production.
- High progesterone is not usually a cause for concern but needs to be addressed in some cases such as molar pregnancy, congenital adrenal hyperplasia, or adrenal and ovarian cancers.
- Symptoms of high progesterone may include irregular menstrual cycles, fertility issues, mood changes, decreased libido, fatigue, breast tenderness, and acne.
- Diagnosing high progesterone requires multiple blood tests.
- High progesterone levels without additional symptoms should not affect your ability to get pregnant.