10 Signs & Symptoms of Low Progesterone Levels

Signs of Low Progesterone Levels

Hello I’m Sarah and this is my story of trying to conceive whilst having low progesterone…

I was so thankful that the two week wait was nearly up!

All I wanted to know if I was pregnant or not. I hadn’t had such a good feeling about our chances since we first started trying nearly 8 months ago. The suspense was killing me!

I had been optimistic before but this time was different. I used to be optimistic every cycle but as the months passed without that elusive positive pregnancy test, I made the decision (for my own sanity) not to let myself get my hopes up. I didn’t want to have to deal with the disappointment. However, this month was different…

10 Signs & Symptoms of Low Progesterone Levels

  1. You are between the ages of 35 and 50.
  2. You are having difficulty getting or staying pregnant.
  3. You are experiencing spotting or abdominal pain during pregnancy.
  4. You have short menstrual cycles or a short luteal phase.
  5. Your basal body temperatures rise slowly after ovulation.
  6. Hypothyroidism: You have low core body temperatures.
  7. You experience spotting in between periods.
  8. You experience bad PMS symptoms before menstruation.
  9. You have a low sex drive/libido.
  10. You have abnormally low cholesterol levels & are underweight.

 

Two months ago, after officially trying to conceive for about 6 months my doctor informed me that I was displaying some of the signs of low progesterone. He decided to run a test and sure enough, after a quick saliva test that I found out I had low progesterone levels – 4.8 ng/mL to be exact. At first I was in a state of panic.

In that moment the only thoughts running through my mine were. Am I infertile? Will I ever be able to have kids? All I could think of was the worst possible scenario. Would I die alone with my cats! 🙁

After that moment of madness, I composed myself and my doctor told me that low progesterone could have a big impact on my chances of getting pregnant but it was manageable if you took the right steps.

Before I knew it though, my doctor had decided that my time was up. He scribbled the name of a progesterone cream that I should use on a piece of paper, gave me a leaflet on low progesterone and sent me on my way.  I had so many more questions!

When I got home I immediately started Googling. But the more I found out about the symptoms of low progesterone the more my life started making sense. I read stories by women who had posted their stories online and the more I read the more it felt like they were talking about me.

I had always suffered from bad cramps and irritability in the lead up to my period but the symptoms were getting worse as I got older. It was later that I found out that this had a name – Premenstrual Syndrome or PMS. For a couple days every month I was a different me – both emotionally and physically. I felt like I had no control over my body. My husband (then boyfriend) and friends even had a running joke where we had name for my alter ego…we used to call her EJ for Evil Jen, because I was so unlike my “normal” self. After reading the stories of other women like me online who had low progesterone those days leading up to my period made sense now. One of the major causes of PMS is a progesterone deficiency just before your periods. But here’s the kicker…

My progesterone levels had been getting lower and lower over the past few years, which were causing my PMS symptoms to get worse. And it had never even occurred to me that my hormones could be causing my PMS symptoms.

I just thought it was stress! Which was playing a role (more on that later) but there was so much more going on that I wasn’t aware of.

So after making some changes to that would naturally increase my progesterone levels, including applying a progesterone cream twice per day. I quickly noticed my PMS symptoms disappear.

I hadn’t felt this good before my period for years!

The symptoms weren’t completely gone but they were nothing like they were before. For the first time I felt that I had control over my body. I no longer had wild mood swings, crippling bouts of fatigue and cramps in the lead up to my period. My friends and husband no longer had to  tip toe around me on those days.

It was almost like I could feel my progesterone levels increasing. I don’t know was it because was my good mood or could feel the progesterone cream working, but this month I got the feeling that we were going to get lucky.

Two days before my normal period I could swear I noticed some pink discharge in my panties. Was this implantation bleeding? Could this mean I’m pregnant?

I took a pregnancy test but the result came back negative. I’m not going to lie that was disappointing, but I had to look on the bright side…

I still hadn’t gotten my period! Sure enough day 27 (my normal period date) came and went without any bleeding. So did day 28, 29, 30, 31. I was getting pretty excited at this point, but still no positive pregnancy test. Then…

The moment I had been waiting for nearly a year had arrived. I got the news!

Signs of Low Progesterone - Positive Pregnancy Test

I was 32 at the time I conceived Jamie but all I wish is that I had known the signs of low progesterone sooner. Because out of all the things that could be preventing you from getting pregnant, low progesterone levels is one of the most impactful but one of the easiest to correct if caught early.

What is Progesterone and Why is it so Important?

Every person with a menstrual cycle will tell you that there are a few days every month that are varying degrees of hell.  Mood swings come out of nowhere.  Migraines rule the day.  Breast tenderness makes wearing a bra excruciating.  These feelings are actually caused by the interaction of two complementary hormones – estrogen and progesterone.

progesterone - hormone graph

The relationship between progesterone and estrogen.

During the first 10 days of your menstrual cycle, your body produces almost no progesterone but increasing amounts of estrogen until it spikes during ovulation.  Estrogen then drops dramatically once ovulation is complete.  Once you ovulate, your body starts rapidly producing progesterone which ensures that you don’t shed your endometrial lining until a fertilized egg can be implanted in it.  If implantation occurs, your ovaries will keep producing progesterone until the placenta takes over progesterone production, usually around the 15th week of pregnancy.

If implantation does not occur, progesterone levels falls around day 27 of your cycle, triggering menstruation.  That drop off in progesterone levels is what makes you feel bloated, tired, anxious, depressed, and moody.  Likewise, in women with progesterone deficiency, the body’s inability to counterbalance levels of estrogen trigger the same symptoms as PMS, but for longer periods of time.

What is a Progesterone Deficiency and What Causes it?

Progesterone deficiency

A progesterone deficiency is when you don’t produce enough progesterone during your luteal phase.

When your body has a weak ovulation or fails to ovulate completely, progesterone levels do not increase the way they should, resulting in a condition known as estrogen dominance.  When too much estrogen is present, several symptoms start to pop up.  Mood changes, anxiety, irritability, headaches, hot flashes, low sex drive, irregular periods, PMS, breast tenderness, and weight gain are all indications that there is too much estrogen in the body in relation to progesterone levels. 1

But a lack of ovulation is not the only culprit for estrogen dominance.  Dairy, meats, and eggs treated with hormones can all contain large amounts of estrogen.  Pollution and stress cause the body to metabolize progesterone in order to create the stress hormone cortisol that drives the fight or flight response.  Eating large amounts of soy products can cause hormonal imbalances as does Polycystic Ovarian Syndrome (PCOS) and endometriosis.  Likewise, poor nutrition, a lack of exercise, and certain medications can contribute to low progesterone levels. All of these culprits of estrogen dominance can be mitigated by making smart choices in what you eat, reducing the stress in your life, and exercising regularly.

What Effect Does Low Progesterone Have on Your Fertility?

Progesterone plays several important parts in your fertility and pregnancy.  Not only does it maintain the lining of the uterus, allowing a fertilized egg to attach and survive, it also helps your body change your cervical mucous to allow for fertilization.  Progesterone prevents your immune system from rejecting the embryo as a foreign object, allowing for the development of the fetus.  And ultimately, progesterone aids the body in metabolizing fat for energy for you and the baby.2

Now that you understand why progesterone is so vital to your overall health and for your chances of getting pregnant, it’s time for:

10 Signs of Low Progesterone

Signs of Low Progesterone - What Are They

 1. You Are Between the Ages of 35 and 50.

One of the best indicators of if you are at risk of low progesterone is your age. Between the ages of 35 and 40 women begin perimenopause, a condition where hormone levels begin to drop in the lead up to menopause.

After the age of 35, it is common that some cycles you won’t ovulate or your body is unable to produce the proper amount of progesterone after ovulation even if you have a regular cycle and menstruation. In one research study done with a group of 18 regularly cycling women (average age of 29) seven of them (39%) were found to have low progesterone levels as they weren’t ovulating. That is scary isn’t it?

By the time you reach the age of 50, your estrogen levels will have dropped 35%.  However, the important bit is that your progesterone levels will drop 75% at the same time! 3 If left unbalanced, you will begin to experience several low progesterone symptoms: premenstrual headaches, fluid retention, heavy, painful periods, endometriosis and functional hypothyroidism. 4

Low Progesterone & Estrogen Dominance

As you age your progesterone levels decrease faster than your estrogen levels. Leading to estrogen dominance.

Perimenopausal and menopausal women can become overloaded with estrogen and since their bodies are producing less progesterone, there is no way for your body to naturally counterbalance it by itself.  So you are over 35 and are experiencing differences in your mood, period, weight, or energy level, ask your doctor to test for progesterone deficiency.

2. You Are Having Difficulty Getting or Staying Pregnant

Progesterone prepares the lining of the uterus for implantation of an embryo.  When implantation does not occur, progesterone levels drop signalling the body to begin menstruating.  If a progesterone deficiency exists in the body, the uterine lining will be shed to soon, thus preventing a healthy implantation from occurring. This can make it more difficult for you to get pregnant.

Not only are low progesterone levels a key factor in getting pregnant, they are a crucial to your chances of having a healthy pregnancy. The high levels of progesterone during pregnancy prevent the premature shedding of the endometrial lining. However, if progesterone levels drop too low then you could suffer a premature delivery or bring about a miscarriage in the early trimesters.

Other studies have shown that this risk can be reduced by giving you progesterone. One such study was published in the New England Journal of Medicine and it showed that you could reduce your miscarriage risk by up to one third if a pregnant woman was given supplemental progesterone to counter act any progesterone deficiency she might have. 5

Having trouble conceiving or staying pregnant is often the sign of low progesterone that you and your doctor first detect. If you have struggled to get pregnant for 4-6 months or have suffered a miscarriage in the past, talk to your doctor about a blood or saliva test for low progesterone levels. Even if you find out your progesterone levels are normal at least you will have narrowed out one possible cause that might be preventing you from getting pregnant.

3. You Are Pregnant and Are Experiencing Spotting/Abdominal Pain

Signs of Low Progesterone - Pregnancy

Progesterone not only plays an important role in getting pregnant, it plays a vital part in maintaining a healthy pregnancy.  During pregnancy, low progesterone can lead to spotting, abdominal pain, and miscarriage may be caused by toxemia or ectopic pregnancy 6.  If progesterone levels drop at any time during pregnancy, your body interprets it as a signal to begin shredding your uterine lining with the fetus attached.

If you notice any abnormal spotting, discharge or abdominal pain during pregnancy you should contact your doctor immediately as it could be a symptom of low progesterone levels.

4. You Have Short Menstrual Cycles (Short Luteal Phase)

Sign of Low Progesterone - Short Luteal Phase

A luteal phase of less than 10 days is an indication that you have low progesterone.

One of the most well known symptoms of low progesterone is when you have shorter than normal menstrual cycles or if you have a luteal phase that lasts less than 10 days. The luteal phase in menstruation is the time between when you ovulate and when you begin your period.  In normal women, this lasts 11 to 14 days, which is the lifespan of the ovary’s temporary progesterone-secreting glad, the corpus luteum.

A luteal phase defect is when a woman is producing less progesterone during the luteal phase of her cycle than normal. A symptom of this is if your luteal phase of less than 10 days which is most often caused by low progesterone levels. Having a short luteal phase may make it difficult to get pregnant.  If the corpus luteum stops producing progesterone after 9 days, the uterine lining will break down and exit the body before the fertilized egg ever gets a chance to leave the fallopian tube.

Having a short menstrual cycle of less than 21 days is a good indication if you might not be producing enough progesterone during your luteal phase as it is unlikely that ovulation isn’t occuring. However, having a short cycle doesn’t automatically mean you have a short luteal phase. As it might the follicular phase (the period from when you start menstruating to the day of ovulation) could be short and the luteal phase could be healthy.

To determine if you have a short luteal phase you will need to find out what day you normally ovulate on. To do this you will need to start tracking your menstrual cycles using an ovulation testing kit or preferably a basal thermometer.  If after tracking your cycle you suspect your luteal phase is shorter than it should be, consult with your doctor as it could be a sign of low progesterone.

5. Slow Rising Basal Body Temperatures After Ovulation

Sign of Low Progesterone - Slow Rise in BBT

A BBT chart that shows a slow rise in temperatures after ovulation could be a sign that you have low progesterone levels.

This sign of low progesterone can only be seen if you are tracking your menstrual cycle using BBT tracking. After you ovulate the corpus luteum will start releasing progesterone for about 14 days. However, if not enough progesterone is being released by the corpus luteum then your basal body temperature will rise slowly instead of a rapid increase over the course of 1-2 days. This could be an indication that your hormones might be out of sync causing you to have low progesterone levels during the luteal phase.

If you notice your basal temperatures are increasing slowly after you ovulate it might be an indication that you have low progesterone. In this case you should either take a home progesterone test or talk to your doctor about it.

6. Hypothyroidism: You have Low Core Body Temperatures

Progesterone stimulates your thyroid which in turn heats up your body.  This is why your basal body temperature (BBT) increases when you ovulate and stays that way until you begin your period. If you have a low core body temperature or have been diagnosed with hypothyroidism then it could be a indication that you have low progesterone levels.

It is believed that about 10% of the general population is hypothyroid, but about 5 times more women than men are hypothyroid. However, the proportion of women to men with hypothyroidism increases with age. With 20% of women over age 65 being diagnosed as being hypothyroid.

To check if you might have hypothyroidism you can use what is called the Barnes Basal Body Temperature Test. Using a basal thermometer you should take your temperature as soon as you wake up in the morning before getting out of the bed. You should measure your basal body temperature for five days starting on day 2 of your cycle (the 2nd day of your period). A normal basal temperature is around 97.8-98.2 degrees Fahrenheit (or 36.6-36.77°C). If your average temperature over the three days is less than 97.8°F (36.6°C), then according to Barnes you may have hypothyroidism. This could be an sign that you also have low progesterone levels.

7. Premenstrual Spotting

Light spotting or bleeding in between periods is one of the easiest to spot signs of low progesterone. As progesterones job is to stabilise the uterine lining, a progesterone deficiency may cause a small amount of bleeding 3-4 days before your period starts.  How do you know if you are spotting or having a period?  Spotting generally stops in a few hours or up to a day.  A period will usually last 4-7 days.  Spotting also does not involve large amounts of blood, the blood often resembles pink discharge and is painless.

Light Pink Bleeding/Spotting Between Periods

Spotting should always be discussed with your doctor, whether you are trying to conceive or not.  He or she may order a blood test to determine hormone levels as well as other precautionary tests to find an underlying cause.

8. PMS – Joint Pain, Water Retention, Breast Swelling, Headaches, Mood Swings, And Poor Sleep Patterns.

Estrogen dominance causes PMS, which in turn is caused by low progesterone levels in comparison to estrogen in the body. Premenstrual syndrome (PMS) is the most common complaint among women.  In the 1930s, PMS was described as a “state of unbearable tension”, and was likely written by a man who had never experienced it first hand. 7  Some women have PMS from the beginning of their menstrual cycles, but most women do not develop it until their mid-thirties when hormone levels start to fluctuate. Many of the most common PMS symptoms coincide with symptoms of progesterone deficiency and can include joint pain, water retention, breast tenderness, headaches, mood swings, and poor sleep patterns.

A woman’s response to her own hormones is unique which is why it is essential to become familiar with your own body and your own symptoms.  If you feel as though something is wrong, do not take the convenient road an antidepressant offers.  Push for an explanation at the root of your PMS symptoms, it just might be a sign that you have low progesterone levels.

9. You Have A Low Sex Drive / Libido

Signs of Low Progesterone - Low Sex Drive/Libido

If feel that you have decreased sex drive/libido then it might be a sign of low progesterone.

Progesterone deficiency actually suppresses testosterone. Yes, women produce testosterone. It is actually the hormone responsible for the sex drive in both men and women. But estrogen dominance (due to a lack of progesterone) works against the arousing powers of testosterone in a woman’s body.  Once estrogen and progesterone levels are restored to normal, sex drive comes back.

Female sexuality is a complex thing, but isn’t one that you have to accept as a result of aging.  If you are concerned talk to your doctor and see if a progesterone imbalance is to blame.

10. Abnormally Low Cholesterol Levels & Being Underweight

Another sign of low progesterone is abnormally low cholesterol levels which results in low to no progesterone production. Cholesterol is one of the fundamental building blocks used to produce your hormones, this includes progesterone. So if you have abnormally low cholesterol or have very low body fat levels then you could have low progesterone levels.

What Should You Do if You Notice One of These Signs?

Signs of Low Progesterone - What Should You Do

If you think you have low progesterone levels, you should discuss the possibility with your doctor.  He or she will be able to order blood or saliva tests that will reveal if you have a progesterone deficiency.  In the meantime:

Track your BBT

Tracking your BBT over a month allows you to see how long your cycle is, how long your luteal phase is and how much of a temperature increase you experience during ovulation. All of these measurements can tell you if you have low progesterone levels.  For more information on tracking your BBT, check out Link to article on BBT tracking (not written yet).

Do a Saliva Hormonal Test

You can order an “at home” saliva test that you perform during certain times in your cycle then send away to a lab for analysis.  You will receive the results in the mail.  Saliva tests are often more accurate than blood tests since they provide a full picture of hormone levels at different times of the month, rather than at the one time you have a blood test.

Blood Test

If you suspect you have low progesterone, asking your doctor for a blood test is the first step.  For the most meaningful results, have the blood drawn 7 days before your period is due.  Your blood level of progesterone should be highest at that point of your cycle.

Summary

If you are trying to conceive and believe it is due to low progesterone levels, check out our guide, How to Naturally Increase Low Progesterone Levels.

Low progesterone is very common and can happen at all phases of a woman’s life.  Not only does it wreak havoc on our bodies, it can have a profound effect on our mental health and stress levels.  The important thing to remember is there is hope and help and the solution is likely easier than you think.

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References

All facts and information provided in this article has been researched using biomedical, scientifically reviewed literature from sources such as MEDLINE and the National Center for Biotechnological Information (NCBI). We have tried to incorporate a variety of scientific perspectives to provide you a comprehensive and unbiased overview of current knowledge in the field.

 

  1.  John R. Lee, 1999. What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Your Life From Thirty to Fifty. 1 Edition. Warner Books. p49
  2.  John R. Lee, 1999. What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Your Life From Thirty to Fifty. 1 Edition. Warner Books. p64-65
  3.  Progesterone – The Almost Forgotten Hormone. 2016. Progesterone – The Almost Forgotten Hormone
  4.  John R. Lee, 1999. What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Your Life From Thirty to Fifty. 1 Edition. Warner Books. p46-47
  5.  Meis, P. J., Klebanoff, M., Thom, E., Dombrowski, M. P., Sibai, B., Moawad, A. H., et al. (2003). Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. New England Journal of Medicine, 348, 2379–2385
  6. John R. Lee, 1999. What Your Doctor May Not Tell You About Premenopause: Balance Your Hormones and Your Life From Thirty to Fifty. 1 Edition. Warner Books. p46-47
  7. Facts About Symptoms of PMS (Premenstrual Syndrome). 2016. Facts About Symptoms of PMS (Premenstrual Syndrome).

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