Low Progesterone: Signs, Symptoms, and Management

Our bodies are truly amazing in how they cycle and prepare for pregnancy each month. The female reproductive cycle is controlled by strict parameters set by your hormones. Estrogen and progesterone are the two main female sex hormones that regulate the menstrual cycle. When one or both of these hormones are even slightly imbalanced, we can experience several unpleasant symptoms.

Progesterone plays a critical role in pregnancy

Progesterone works with estrogen to control the female reproductive cycle. Produced in the ovaries by the corpus luteum, progesterone levels are highest after ovulation and drop right before your period. If you become pregnant, progesterone remains elevated until you give birth. Maintaining a thick uterine lining for pregnancy is one of the most critical roles of progesterone. It also helps with breast development and milk production.

Like estrogen, progesterone levels wane in menopause. This decrease in progesterone occurs naturally when your ovarian function begins to decline in perimenopause. Some women can have low progesterone levels during their childbearing years as well before they hit perimenopause. Low progesterone is often the result of poorly functioning ovaries or a problem with ovulation. Women with low progesterone during their childbearing years usually suffer from irregular periods and have difficulty conceiving.

What are the symptoms of low progesterone?

One of the first signs of low progesterone is an irregular period. (Incidentally, changes in your period are also one of the early signs that you are entering the menopause transition.) Women with low progesterone often experience periods that are longer in duration, spotting in between periods, and a short time between ovulation and menstruation.

Other low progesterone symptoms include:

  • Infertility - Often, women who have difficulty conceiving have lower than normal levels of progesterone. This can be caused by several factors, including polycystic ovarian syndrome, pituitary gland dysfunction, and other causes that interrupt ovulation and the luteal phase.

  • Irritability, depression, anxiety, and brain fog - An increase in moodiness is often one of the first clues (along with an irregular period) that your progesterone levels may be low. Progesterone is considered a neurosteroid, so low levels can have adverse effects on your cognitive function. Most often, moodiness and cognitive impairment are attributed to estrogen levels in women. However, because estrogen and progesterone work in unison, estrogen levels may be perceived as higher by your brain when progesterone levels are low. This can cause you to experience symptoms of estrogen dominance, which includes feeling depressed and anxious.

  • Acne and dry skin - Women can suffer from hormonal acne, dry and cracking skin, and brittle nails when they have low progesterone. Treating low progesterone acne tends to require a combination of good skincare practices and treating the underlying hormonal imbalance.

  • Low libido - Your sex drive is often, well, driven by your sex hormones: estrogen, progesterone, and testosterone. When one of these hormones is low, it can certainly put a damper on your interest in sex.

  • Fatigue - Like most health conditions, when something is off-balance like your hormones, it takes a toll on your physical and mental energy sources.

  • Weight gain - Low progesterone can impact the efficiency and speed of your metabolism, which slows our ability to burn fat (especially around our midsection).

  • Migraines and headaches - Women are more likely to suffer from migraines and headaches than men, and our hormones are to blame. Fluctuating estrogen and progesterone levels in menstruation, pregnancy, perimenopause, and menopause can increase a woman’s risk for debilitating headaches.

Solutions for low progesterone

First things first: when seeking treatment for symptoms of hormonal imbalance like low progesterone, it is crucial to identify the root cause. While low progesterone can undoubtedly be a natural change for your body (like in perimenopause), it certainly can interfere with your quality of life.

There are always lifestyle changes that we can implement to help us combat low progesterone symptoms like fatigue, weight gain, and moodiness. Indeed, there are tremendous health benefits for making lifestyle changes such as eating healthy foods, getting more physical exercise, decreasing stress, and improving your sleep quality. But sometimes these changes alone are not enough to combat low progesterone.

If you are suffering from low progesterone symptoms, meet with your doctor to discuss your concerns. Your doctor may do a blood test to check your progesterone levels. If they are low, your doctor may recommend using lifestyle changes and hormonal therapy to improve your symptoms. There are a few different options for treating low progesterone with medication:

  • Progesterone cream - This therapy is made using plant-based progesterone from wild yams or soybeans and is available over-the-counter. It is important to note that many health products that are labeled as natural, like some progesterone creams, are not always regulated by the FDA for safety and efficacy.

  • Progesterone only birth control - Your doctor may prescribe a progesterone-only hormone replacement medication in the form of a contraceptive pill. If you are struggling with other menopausal symptoms like hot flashes, your doctor may consider prescribing a combination of estrogen and progesterone.

  • Progesterone vaginal suppositories - These are used primarily to treat infertility and prevent miscarriage.

Are your symptoms of low progesterone related to perimenopause? If so, join us in the Perry Community to connect with peri experts and other women in perimenopause!

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

Meet the Author

Perry Babe Julia ( RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations.

Much of her education and clinical experience are related to educating women on women’s health topics ranging from lifestyle improvements, disease management, and general health education.

Find Julia's Perry community profile right here.

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