In the intricate dance of hormones within the human body, progesterone plays an important role, especially in the female reproductive system. When levels of this hormone dip below optimal levels, it can lead to a cascade of symptoms affecting both physical and emotional well-being. Recognizing the signs of low progesterone is the first step towards addressing potential imbalances. In this comprehensive review, we’ll delve into the common indicators of low progesterone, explore the underlying causes behind suboptimal progesterone and discuss natural strategies to support and restore healthy progesterone levels.

Signs of low progesterone:

• Poor sleep: Low progesterone levels can disrupt sleep patterns, leading to difficulty falling asleep or staying asleep throughout the night.
• Increased anxiety and or depression: Progesterone plays a role in mood regulation, so decreased levels can contribute to feelings of anxiety or depression.
• Weight gain: Hormonal imbalances, including low progesterone, may contribute to weight gain, particularly around the abdomen.
• Heavy periods: Insufficient progesterone can result in irregular or heavy menstrual bleeding.
• Hot flashes: fluctuations in hormone levels, including low progesterone, can trigger hot flashes, particularly during perimenopause and menopause.
• Difficulty conceiving: Progesterone is essential for maintaining a healthy pregnancy, so low levels may hinder conception or lead to recurrent miscarriages.
• Headaches/Migraines: Hormonal fluctuations, including low progesterone, can be associated with headaches or migraines in some individuals.
• Short luteal phase: Low progesterone can shorten the luteal phase of the menstrual cycle, which may affect fertility.
• Persistent spotting before your period: Insufficient progesterone levels can cause spotting or light bleeding before the onset of menstruation.

Low levels of progesterone can stem from various underlying factors. Here are some of the ones I see most commonly in my practice:

• Hypothyroidism (underactive thyroid): The thyroid gland regulates metabolism and plays a vital role in hormone production. In cases of hypothyroidism, where the thyroid gland is underactive, hormone levels, including progesterone, can be affected. This imbalance disrupts the menstrual cycle and can lead to low progesterone levels.
• Ovulation issues (e.g., anovulatory cycles, polycystic ovarian syndrome – PCOS): Proper ovulation is essential for the production of progesterone. Anovulatory cycles, where ovulation does not occur, or conditions like polycystic ovarian syndrome (PCOS), characterized by hormonal imbalance and ovarian cysts, can result in insufficient progesterone levels.
• Low cholesterol: While we often worry about cholesterol being too high, it can also be problematic if it is too low. Cholesterol serves as a precursor for the synthesis of steroid hormones, including progesterone. Insufficient levels of cholesterol in the body can disrupt the production of progesterone, impacting reproductive health and hormone balance.
• Elevated cortisol: Chronic stress triggers the release of cortisol, a hormone produced by the adrenal glands. Elevated cortisol levels can adversely affect ovulation by suppressing the surge of luteinizing hormone (LH), essential for ovulation, consequently leading to anovulatory cycles where ovulation fails to occur. Additionally, during times of stress, the body may prioritize cortisol production over progesterone, diverting precursors such as pregnenolone, a phenomenon termed “pregnenolone steal.”
• Menopause/Perimenopause: As women approach menopause, ovarian function declines, leading to fluctuations in hormone levels, including progesterone. Perimenopause, the transition phase preceding menopause, is characterized by irregular menstrual cycles and declining progesterone production.
• Elevated prolactin: Prolactin, primarily known for its role in lactation, can also affect reproductive hormones, including progesterone. Elevated prolactin levels, a condition known as hyperprolactinemia, can disrupt ovulation and progesterone production, leading to hormonal imbalances.

Now that we know the symptoms of low progesterone and potential causes, let’s dive into ways to improve them.

Natural ways to support healthy progesterone levels:

• Make time for you/Stress Reduction: Chronic stress can disrupt hormone balance, including progesterone levels. Practices like meditation, yoga, deep breathing exercises, and regular physical activity can help reduce stress and support hormonal health.

• Healthy fats: Healthy fats and a nutrient rich diet help support good cholesterol levels. Cholesterol serves as a precursor for the production of steroid hormones, including progesterone. Insufficient levels of cholesterol in the body can disrupt the production of progesterone, impacting reproductive health and hormone balance.

• Vitamin B6: Vitamin B6 plays a crucial role in hormone regulation, including progesterone production. Consuming foods rich in B6 or taking supplements can support hormonal balance.

• Magnesium:  Magnesium deficiency can affect hormone levels, including progesterone. Consuming magnesium-rich foods like leafy greens, nuts, and seeds, or taking supplements may help support progesterone levels.

• Vitamin C: Vitamin C is an antioxidant that may help reduce oxidative stress and support hormone balance. Consuming foods high in vitamin C or taking supplements can be beneficial.

• Vitex (Chaste Tree Berry): Vitex works to support progesterone through a couple different mechanisms. Not only can help lower prolactin levels, but it also stimulates the pituitary gland to produce luteinizing hormone (LH), which is the hormone that triggers ovulation and the development of the corpus luteum.

• Bioidentical Hormone Replacement Therapy: involving progesterone creams or oral supplementation can help supplement low progesterone levels. This can be especially helpful for women in perimenopause, menopause and in some cases for women who are trying to conceive.

Low progesterone is an issue I encounter frequently in my practice. Consulting with a Naturopathic or Functional Medicine doctor can help identify the underlying causes and develop appropriate treatment strategies, which may include lifestyle modifications, targeted nutritional support, hormone therapy, or medication. It’s essential to consult with your own healthcare professional before starting any new supplement regimen, especially if you’re already on medication or undergoing hormonal treatments. Additionally, individual responses to these natural remedies may vary, so it is important to monitor progesterone levels and figure out what therapies work best for your body.