Low progesterone symptoms affect women of all ages. This hormonal imbalance may cause menstrual irregularities, depression, low libido, and fertility issues. Learn how to identify symptoms, treatment options, and common risks. Understand the different types of hormones and their role in a woman’s body.

What Is Progesterone?

Progesterone is one of several key female sex hormones produced in the ovaries and is necessary for optimal reproductive health. Hormones are chemical substances in the human body that help regulate and support a wide variety of functions, including the reproductive cycle, metabolism, and muscle growth. Together with estrogen, another vital hormone, progesterone affects menstruation, pregnancy, libido, and menopause.


Progesterone Supports the Menstrual Cycle

During a normal menstrual cycle, the hormones estrogen and progesterone work together to prepare the uterus for a fertilized egg. Estrogen rises sharply through the first half of the cycle, thickening the endometrium and then stimulating the release of an egg from the ovary.

Progesterone kicks in during the second half of the cycle, tempering the effects of estrogen on the lining and stimulating the release of a protein that would nourish and support a fertilized egg. If there is no fertilized egg, progesterone drops and stimulates the uterine lining to shed. This marks the beginning of the menstrual period.

Progesterone Is Vital to a Successful Pregnancy

pregnant

Progesterone plays an important part in continuing a successful pregnancy. Once a fertilized egg implants in the uterus during the second half of the reproductive cycle, the levels of both estrogen and progesterone remain high. This signals the body to halt the ovulation cycle so no new eggs will be released.

Progesterone is also responsible for those early pregnancy symptoms of nausea and increased breast tenderness. The newly growing placenta then takes over producing high levels of progesterone. If these levels decrease for any reason, the pregnancy will likely not continue to term.

Progesterone also affects other parts of a woman’s body during pregnancy. It helps to stimulate the growth of milk-producing glands in breast tissue. During pregnancy, progesterone inhibits actual milk production but allows a protein called prolactin to rise. After birth, the sudden drop in progesterone signals the body to use the prolactin and begin making breast milk.


Progesterone and Testosterone in Men

While many people think of progesterone as predominantly a female hormone, men also produce it.

Progesterone converts to testosterone, the male sex hormone, and aids in the production of sperm. If levels of progesterone are low, testosterone levels become low as well, and estrogen levels rise. This can cause a host of symptoms and risks of developing health conditions, such as hair loss, fatigue, and erectile dysfunction.

Causes of Low Progesterone in Women

Childbearing Years

During a woman’s childbearing years, progesterone levels naturally fluctuate throughout a monthly menstrual cycle, but sustained low levels could have several underlying causes. Some studies indicate that high levels of stress (and increased cortisol levels) inhibit progesterone production.

Women suffering from endometriosis or polycystic ovary syndrome often have both estrogen and progesterone hormonal imbalances. Thyroid conditions or high prolactin levels can also affect progesterone production. Progesterone levels would also be low in an ectopic pregnancy, or if a woman has just suffered a miscarriage or fetal death.

Low Progesterone Symptoms: Menopausal Years

senior woman sitting on a bench

Progesterone (and estrogen) levels naturally decrease as women age. After the age of 40, women may begin to see their hormone levels decrease and menopause symptoms begin.

The definition of menopause is 12 consecutive months without a menstrual period that has no other obvious causes. During the years leading up to menopause, hormone production declines and no longer supports the development and release of eggs from the ovaries.

It is the decline in progesterone that is most significant during menopause because the body then can become estrogen dominant. This can cause menopausal women to experience symptoms such as hot flashes, irregular bleeding, painful sex, and headaches or migraines.

Common Symptoms of Low Progesterone

Symptoms of low progesterone in younger, nonpregnant women include:

  • Irregular menstrual cycles
  • Hot flashes
  • Headaches or migraines
  • Depression
  • Anxiety
  • Low libido
  • Weight gain

If progesterone remains low, a woman trying to conceive may have trouble doing so, or may not be able to carry the baby to term. Symptoms of low progesterone in a pregnant woman include spotting or breakthrough bleeding and miscarriage.

Risks of Low Progesterone

Even if a woman isn’t planning to conceive, normal progesterone levels are vital to good health. When progesterone is low, estrogen levels rise and can become a problem. Estrogen dominance is a type of hormonal unbalance that can cause many health problems. Symptoms include:

  • Bloating
  • Weight gain
  • Trouble sleeping
  • Mood swings
  • Irritability
  • Increased PMS
  • Hair thinning and hair loss

Diagnosing Low Progesterone

It is easy to determine progesterone levels with a simple blood draw called a serum progesterone test. If you are having trouble conceiving, or are having low progesterone symptoms, your doctor may order this test. The test results can help to determine the cause of multiple miscarriages or ectopic pregnancies, and may be able to determine whether ovulation still occurs or not.

There is no special preparation or fasting needed for this test. Be sure to tell your provider if you are on any hormone medication such as birth control pills or hormone replacement therapy as this can affect the results of the test. Your doctor may also ask you for the first day of your last period to determine where the test falls in your cycle. This will help to ensure an accurate assessment of the results.


Low Progesterone Symptoms: What Is a Normal Serum Progesterone Test Result?

There are degrees of “normal” in every serum progesterone test. A nonpregnant woman in the first week of her cycle will be similar to that of a postmenopausal woman. The amount of progesterone increases dramatically as a woman enters midcycle. If pregnant, a woman’s progesterone level increases during each trimester.

If your test falls outside of normal ranges, you may be asked to take the test again at a later time. It’s possible that one abnormal test result is merely a factor of where you were in your cycle when the test was administered. More than one serum progesterone test can help determine a pattern.

If your progesterone level is unexpectedly high, your doctor may order other tests to determine if there are some other underlying conditions causing this result.

Treating Low Progesterone In Women

Progestin: Synthetic Progesterone

progesterone pills

While the body produces progesterone naturally, the synthetic and manmade version is called progestin.

It has progesterone-like attributes and acts like natural progesterone in the body. Because progestin can be administered in precise dosages depending upon the goal, it can be used to treat a variety of conditions.

Progestin helps to regulate menstrual periods by working in conjunction with estrogen to control the thickening of the uterine lining, and then allowing the lining to shed when there is no implanted fertilized egg.

Progestin may also treat endometriosis, a painful condition where endometrial tissue grows outside of the uterus and affects other organs. It can also be used to treat heavy and irregular periods. High doses of progestin may be able to help a woman continue her pregnancy, while low doses may help prevent a pregnancy in the form of birth control pills.


Low Progesterone Symptoms: Hormone Therapy Overview

Hormone therapy is designed to help restore the balance of hormones in a woman’s body. Depending upon the severity of the hormone deficiency and of the symptoms being treated, your doctor may suggest a combination of progesterone and estrogen supplementation. There are several different options for treating low progesterone in women.

Hormone therapy can be administered through vaginal suppositories, creams, and gels, injections, oral medications, implants, or IUDs.

For nonpregnant women, progesterone-only hormone treatments are most commonly given through vaginal suppositories. Once-daily treatment often involves inserting the suppository at bedtime to allow proper time for absorption and lessen the amount of medication lost through discharge.


Bioidentical and “Natural” Hormones Are Not Safer

There has been some controversy over the use of hormones that are called “bioidentical” and “natural.” These are medications that are derived from plant and animal sources and not created in a lab.

The Food and Drug Administration (FDA) claims that while those products may indeed come from nature, they still need to undergo major commercial preparation to become bioidentical. Even some synthesized hormones found in traditional therapies come from natural sources.

Some women do find relief for their symptoms from these products marketed as natural. The FDA asserts, however, that there are no reliable studies available that prove that these natural hormones are any better than the standardized dosages of traditional hormone therapies.

Doctor with a female patient for Hormone Therapy


Risks of Hormone Therapy

Like most medications and medical treatments, hormone therapy does carry some health risks.

Women using hormone therapy are at greater risk for heart attack or stroke, blood clots, deep venous thrombosis, and certain cancers such as breast, endometrial, and colon. These particular cancers are considered estrogen-dependent, and when a patient with higher risk factors uses long-term hormone therapy, these cancer risks increase.

Overall risks vary greatly depending upon the age of the woman when treatment first begins, the length of treatment, and if treatment is just progesterone or a combination with estrogen. Other risk factors include previous medical history and a family history of heart disease or cancer.

Low progesterone symptoms can affect women at virtually any age and can cause menstrual irregularities, depression, low libido, and fertility issues. The benefits of hormone therapy may easily outweigh the risks for the right patient. Be sure to discuss all of your options with your doctor.

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