Growth and sex hormones play various roles for the body's overall function and maintenance. These hormones secreted by glands in the endocrine system carry messages between the organs and cells.1
One particular sex hormone that has been linked to different benefits, especially for women, is progesterone. This page will discuss what progesterone is, how to determine if you are deficient, what to eat to naturally increase your body's stores and whether or not you need to resort to progesterone supplements.
What is Progesterone?
Progesterone is a pro-gestational steroid hormone secreted by the female reproductive system. It plays a vital role in a woman's menstrual cycle and pregnancy, and in embryo development. Progesterone production begins during ovulation, when the ovaries release a single egg cell every month that moves down to the fallopian tube, where it can be fertilized by a sperm cell. 2
After ovulation, the corpus luteum develops. This is a temporary hormone-producing gland that forms from the empty ovarian follicle. The corpus luteum now becomes the main source of progesterone, which the body needs to maintain a pregnancy after fertilization and implantation.
If fertilization does not occur, the corpus luteum breaks down, resulting in a decrease in progesterone production. This breakdown eventually causes the progesterone levels to become too low to promote the growth of the uterine wall. Eventually, because the womb's lining is no longer maintained by sufficient amounts of progesterone for the corpus luteum, the lining breaks away and results in menstrual bleeding.
Although progesterone is a female hormone, men also need this to produce testosterone. Just like in females, the adrenal glands, along with the testes, produce progesterone. Levels of progesterone in males are said to be similar to those of females during the follicular phase of the menstrual cycle.
Progesterone naturally occurs in the body, but laboratories can produce synthetic progesterone called progestins, which are natural or man-made substances with properties similar to that of natural progesterone.3 This artificial form of progesterone is available as supplements: capsules, vaginal gels, creams,4 implants, intrauterine devices (IUD) and injections.5
What Does Progesterone Do?
Progesterone is first produced by the ovaries, placenta and adrenal glands. It then travels in the blood to tissues where progesterone receptors are present. Progesterone attaches to the receptors to produce these significant effects in the body:6
- Regulating the condition of the endometrium, or the inner lining of the uterus
- Preparing the uterus' tissue lining to enable the implantation of the fertilized egg
- Maintaining the endometrium throughout a pregnancy
- Preventing further egg cell release until a pregnancy is finished
- Inhibiting fertilization of more than one egg at a time, although more than one egg is occasionally released
- Stopping muscular contractions in the fallopian tubes once the egg has been transported
- Playing an important role in fetal development during pregnancy
- Stimulating breast tissue to promote lactation and prompt the glands to get ready for milk production
- Strengthening the pelvic wall muscles to prepare for labor
Meanwhile, the duo of estrogen and progesterone is responsible for releasing an egg from the ovaries during ovulation.
Symptoms of Low Progesterone Levels
A woman typically has low amounts of progesterone before ovulation, but her progesterone levels will continue to increase during this period and remain steady for a week after ovulation.7 Progesterone levels continuously increase if a pregnancy occurs or if the hormone fails to initiate menstruation. Women experiencing a multiple pregnancy (a pregnancy with twins, triplets and so on), have higher progesterone levels compared to women expecting one baby.8
If progesterone levels don't increase or decrease monthly, this may indicate a problem with ovulation, menstruation or both. There are other reasons why a person can have high or low progesterone levels:
- Ovarian cysts, non-viable pregnancies, a rare form of ovarian cancer, progesterone overproduction by the adrenal glands, adrenal cancer and/or congenital adrenal hyperplasia (CAH) can prompt increased progesterone production.
- Toxemia or preeclampsia late in the pregnancy, decreased ovarian function, amenorrhea (absence of a woman's menstrual period during the reproductive years that may not be caused by a pregnancy9), ectopic pregnancy and/or miscarriage are all possible causes of low progesterone levels.
Meanwhile, common indicators of low progesterone levels in women who aren't pregnant are:10
- Headaches or migraines
- Mood changes, including anxiety or depression
- Low sex drive
- Hot flashes
- Irregularity in your menstrual cycle, or absence of periods
Maintaining progesterone levels is important for women in their childbearing years. A progesterone deficiency can result in trouble conceiving or remaining pregnant.
As mentioned earlier, progesterone helps thicken the uterus in anticipation of a fertilized egg. If the uterus isn't thick enough, implantation will not occur. Plus, low progesterone levels may trigger abnormal uterine bleeding. If you or someone you know develops these symptoms of progesterone deficiency, consult a physician, doctor or OB-GYN immediately.
Importance of Progesterone in a Pregnancy
If you're pregnant, it's normal for your body's progesterone levels to increase after the egg fertilizes and implants in the embryo to help with the baby's early development. Maintaining progesterone levels within the healthy range during a pregnancy is important until birth.11
Low progesterone levels in the early stages of a pregnancy can increase the risk for a poor pregnancy outcome in the first trimester,12 or result in the uterus not carrying the baby to term. Pregnant women with low progesterone levels often experience symptoms like:13
- Constant breast tenderness
- Unrelenting fatigue
- Frequent low blood sugar levels
- Vaginal dryness
Low progesterone can be a precursor to toxemia, an ectopic pregnancy or a nonviable pregnancy, and these conditions may lead to a miscarriage or a fetal death. Insufficient amounts of progesterone in the body can also cause estrogen to become the dominant hormone, resulting in:
- Weight gain
- Decreased sex drive
- Mood swings
- Gallbladder problems
- Thyroid dysfunction
Your OB-GYN can recommend progesterone treatments to help prevent a premature birth:14
• Vaginal progesterone — If you have a short cervix and are pregnant with one baby, vaginal progesterone, which comes as a gel, a suppository or a capsule, can be used. The applicator for vaginal progesterone resembles a tampon. Treatment can begin before or up to 24 weeks of pregnancy, and is often taken until just before 37 weeks.
• Progesterone shots — These refer to a kind of progesterone called 17 alpha-hydroxyprogesterone caproate (17P). Progesterone shots during a pregnancy are typically recommended for women who had a spontaneous premature birth (wherein labor began on its own without the help of drugs or other methods, or once the sac around the baby broke early).
Progesterone shots are given between 16 and 24 weeks of a pregnancy, and a shot is received weekly until the 37th week of pregnancy. I urge you to think twice about getting progesterone shots, however, since they won't always work in preventing a premature birth. These shots do not lessen the possibility of a premature birth either, if you're pregnant with multiple children, and do not reduce your chances of a premature birth if your previous premature birth was not spontaneous.
What Are the Benefits of Progesterone Treatments?
Aside from women in their childbearing years, those who are in their menopausal years may turn to progesterone treatments to counteract the effects of reductions in estrogen and progesterone levels, and help with maintaining ideal levels of the latter in the body.15 Progesterone treatment during and after menopause was found to help in delivering these benefits:16
- Helping preserve bone density by stimulating bone-building cells or osteoclasts, and increasing the rate of new bone formation17
- Assisting with preventing development of normal and cancerous breast cells, according to certain studies
- Assisting in reducing breast cancer risk (women with higher progesterone levels tend to exhibit this low risk)
- Enhancing energy production in brain cells
- Shielding against nerve cell damage and brain damaging
- Helping relieve depression in women
Meanwhile, women who underwent hysterectomies may benefit from bioidentical hormone therapy with progesterone. Compared to usual hormone therapies, bioidentical hormone therapy is better since hormones that are received during this procedure are biologically identical to natural hormones.
Women on this type of therapy often have no increased risk for disease; on the other hand, women who have had hysterectomies but are not on progesterone therapy are more likely to die from heart disease and have a higher risk for brain and bone diseases.18
Hormone therapy involving progesterone can also help address hot flashes, night sweats and vaginal dryness, improve mood and state of mind and reduce the risk of osteoporosis and diabetes. Oral progesterone may also deliver a calming effect and make sleeping easier.
Treatments to Consider If You Have Low Progesterone
Men, children and postmenopausal women have lower progesterone levels than women in their childbearing years. There is no set amount considered a "normal" progesterone level, but a person's age and gender can determine what the ideal level is. Additional factors come into play in determining this amount, particularly for women, such as a pregnancy or if she is in her menstrual cycle.19
To ensure you have normal progesterone levels, it may be suggested that you undergo hormone therapy. This can be important if you're trying to get pregnant, as progesterone can thicken the uterine lining and increase the chances of a healthy pregnancy and help carry the baby to term. There are various treatment options available, usually in these forms:20,21
• Progesterone oil, or an intramuscular injection
• Suppositories that are often used in addressing low progesterone levels that are a major cause of fertility problems
• Creams and gels that can be used topically or vaginally (for women)
• Vaginal rings that offer slower releases of hormones compared to oral medications
• Intrauterine devices and implants22
Studies on Progesterone
Studies conducted about progesterone focused on its effects on women's health, such as its potential in preventing miscarriages. However, the results were mixed: some studies claimed that progesterone does have a positive effect in lessening miscarriages, while other research refuted this statement.
A 2012 study from the Journal of Human Reproductive Sciences revealed that progesterone supplementation can have beneficial effects on women with unexplained recurrent miscarriages, or the loss of three or more consecutive intrauterine pregnancies before 20 weeks of gestation with the same partner.23
However, results from the PROMISE trial, published in The New England Journal of Medicine in 2016, showed that progesterone supplements did not have any effect at all in lowering the rate of miscarriage in women. This study involved 1568 women from hospitals across the U.K. and in the Netherlands who were 18 to 39 years old and were trying to conceive naturally after unexplained recurrent miscarriage.24,25
These two mentioned studies, because they contradict each other, should be taken with a grain of salt if you or someone you know is thinking about using progesterone to prevent a miscarriage. Meanwhile, other studies about progesterone highlighted its potential in:
• Reducing risk for breast and endometrial cancers26 — Researchers observed existing studies about the difference of using natural and synthetic progesterone in lowering breast cancer risk. Eventually, they concluded that a combination of natural estrogen and progesterone can be linked to reduced breast cancer risk, compared to synthetic progestin.
Meanwhile, 80 percent of endometrial cancer cases are attributed to either an excess of estrogen or lack of progesterone — an imbalance between these two hormones.27 Too much estrogen and too little progesterone can result in the former promoting endometrial cancer cell growth through direct and indirect regulation of gene transcription.
By counteracting the estrogen with progesterone by activating the latter's receptor, progesterone can promote differentiation, cell cycle arrest and apoptosis, reduce inflammation and combat invasion linked to metabolic disease.
• Improving brain function28 — According to results from a 2017 study from Microbial Cell, progesterone doesn't just function as a crucial sex hormone, but as a neurosteroid that can play vital brain function. Researchers highlighted epidemiological data suggesting that progesterone can aid with patient recovery after a traumatic brain injury.
Tests to Determine Your Progesterone Levels
A progesterone test (PSGN) can help your physician, doctor or OB-GYN determine your progesterone levels. A PSGN is a simple blood test that can offer clues regarding pregnancy-related dilemmas such as trouble conceiving. Other purposes of a PSGN include confirming whether you have ovulated or not and monitoring hormone replacement therapy or the status of a high-risk pregnancy.
Before undergoing a PSGN, you might have to disclose medications you might be taking, procedures you underwent or conditions you have been previously diagnosed with.29 If you're taking medicines (including birth control pills) containing estrogen, progesterone or both, you may be asked to stop taking these four weeks prior to a PSGN.
People with bleeding or clotting disorders or taking blood-thinning medicines must inform their physician, doctor or OB-GYN before the test too, since continuous and/or increased bleeding can be a problem.30
Meanwhile, if you underwent a test that utilized a radioactive substance (tracer) within the last seven days, it can interfere with progesterone test results. Other factors that can affect test results include the intake of medicines like ampicillin and clomiphene, as well as the time of day when the test was taken, as progesterone levels may often fluctuate during the day.
You should also tell your doctor when the first day of your last period was. If you tend to have a light bleeding pattern or notice that the menstrual period begins with spotting, the "first day" can refer to the day with the heaviest bleeding. On the other hand, women having problems related to the menstrual cycle or cannot become pregnant may require more than one blood sample during progesterone testing to help identify the problem. A sample may be taken daily for several days in a row.
Ideal Dosage of Progesterone
Before determining your ideal progesterone dose, ask if you can take natural progesterone instead of synthetic progestins. The latter is associated with many side effects linked to hormone therapy.
Natural progesterone is better because it's often made from a substance called diosgenin, which is extracted from wild yams or soybeans. You might raise your eyebrows at the fact that natural progesterone comes from soybeans, but don't worry because it's a highly purified hormone without traces of problematic soy substances.
Oftentimes, progesterone capsules can be recommend, with dosage varying depending on a woman's age, body chemistry and symptoms.31 However, I wouldn't advise taking oral supplements of any bioidentical hormones — this is actually the worst option. When you take an oral supplement, the liver tends to process everything in the digestive tract first before entering the bloodstream, where most of the swallowed hormones will be metabolized into inactive and potentially harmful derivatives.
Only 10 to 15 percent of the swallowed hormones will eventually reach the targeted tissues. As a result, you may need to take an oral dose that is 500 percent higher than your required amount to fully get the desired effect. Methods that will involve bypassing through the liver tend to be more effective, but I advise consulting your physician before trying.
• Trans mucosal administration — I would usually recommend, since applying the cream to the mucous epithelial membranes lining the vagina can allow for more complete absorption.
• Sublingual drops — These enter the bloodstream directly and won't lead to build-up in the tissues. Plus, it's easier to determine the dose that you're taking, since a drop is about a milligram.
• Hormone creams administered transdermally or to your skin — This is a common alternative to bioidentical hormone application. However, hormones tend to be fat-soluble, and creams can build up in your fatty tissues and lead to hormone disruption. Plus, there is a tendency to inaccurately determine the dose while using creams.
If you miss a progesterone dosage, try to take it as soon as you can, but if it's almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Avoid doubling up on doses to make up for a missed dose.
Progesterone's Potential Side Effects
Prior to supplementation, consult with your physician, doctor or OB-GYN first because there are known side effects of progesterone:32
• Common — Headaches, painful or tender breasts, stomach pain, dizziness, gallbladder problems,33 depression and increased risk for viral infections
• Serious — Vomiting, swelling (feet, ankles and lower legs), missed periods or breakthrough bleeding, heart attack, stroke or blood clots in the lungs and even breast cancer (common in women between 50 and 79 years old)
• Rare — Mood swings and/or feelings of tiredness or nausea while taking progesterone
Another known side effect of taking too much progesterone is an increased risk for dementia among women older than 65 years old. If you're pregnant, take note of these potential side effects linked to vaginal progesterone and progesterone shots:34,35
| Vaginal Progesterone |
Progesterone Shots |
| Hives |
Itching |
| Difficulty breathing |
Nausea |
| Swelling of the face, lips, tongue or throat |
Diarrhea |
| Confusion, drowsiness and tiredness |
Reactions at the injection site such as pain, bruising, itching, swelling or formation of a hard lump |
| Mood swings |
Hives |
| Feelings of nervousness or irritability |
Blood clots |
| Stomach pain, diarrhea or constipation |
Allergic reactions |
| Nausea |
Fluid retention |
| Bloating |
High blood pressure |
| Swelling in the hands or feet |
Migraine |
| Breast pain, swelling or tenderness |
Jaundice |
| Cramps |
|
| Pelvic pain |
|
| Vaginal itching, burning or discharge |
|
You should also avoid progesterone if you have:36
- Allergies to progesterone or any of its inactive ingredients
- A history of blood clots, including acute thrombophlebitis or thromeboemobilic disease
- Been diagnosed with breast or genital cancer, or liver disease
- Experienced an abortion or an ectopic pregnancy
- Bleeding problems
- Lost consciousness or ability to function normally after a stroke
- Kidney problems
- Systematic lupus erythematosus (SLE)
- Bone metabolic disease
- High blood pressure levels
Meanwhile, if you have a family history of endometrial or breast cancer or a history of depression, endometriosis, liver disease or stroke, talk to your physician, doctor or OB-GYN before taking progesterone.37,38
Consulting any of these health professionals is highly advisable as well if a patient is bedridden, paralyzed or does not move around very much, because of the increased risk for developing blood clots. Furthermore, if you're about to undergo a major surgery and are currently taking progesterone, inform your doctor because you may need to stop taking progesterone four weeks before the procedure.
Progesterone can also interact with certain medications, so if you are taking any of the following, ask your physician or doctor about other possible options:
- Cancer drugs such as Gilotrif (afatinib), Zydelig (idelasalib) and Tafinlar (dabrafenib)
- HIV/AIDS medicine such as Stribild (eltivagravir/cobicistat/emtricitabine/tenofovir)
- Adempas (riociguat)
- Afrezza (inhaled insulin)
- Fanapt (iloperidone)
- Kalydeco (ivacaftor)
- Lysodren (mitotane)
On a final note, avoid taking progesterone alongside:
• Alcohol — This can trigger dehydration that can dry up the mucous membranes, including the vaginal lining. Vaginal dryness is common among many women after menopause, and increased instances of drinking alcohol while taking progesterone can make this condition more difficult to treat.
• Grapefruit juice — According to Amy Karch of the University of Rochester Medical Center School of Nursing and an expert on drug interactions, this juice is metabolized by the same enzyme in the liver responsible for breaking down many drugs, called P-450 3A4.39
If you drink too much grapefruit juice alongside progesterone, the juice can overload the system, keeping the liver occupied and preventing it from breaking down drugs and other substances. This can then lead to adverse side effects or interactions with progesterone.
Natural Sources of Progesterone
Aside from resorting to supplementation, you can increase your body's progesterone levels by consuming foods rich in certain nutrients. Although these foods do not contain this steroid hormone, the nutrients can help stimulate the progesterone production:40,41
• Vitamin C — Studies have shown that vitamin C has potential in boosting progesterone levels and correcting luteal phase issues. Notable vitamin C sources include sweet potatoes, kiwis, oranges, papayas, lemons, broccoli, tomatoes, mustard greens and Brussels sprouts.
• Vitamin E — Research has highlighted that vitamin E may assist with improving luteal blood flow and increasing progesterone levels in some women. Sunflower seeds, almonds and hazelnuts are major vitamin E sources, although avocados, red peppers, collard greens, asparagus and broccoli contain small amounts too.
• Vitamin B6 — This B vitamin can assist with fighting stress and helping the liver break down estrogen byproducts and decreasing estrogen production. You can find vitamin B6 in wild-caught Alaskan salmon, bananas, spinach and walnuts.
• Zinc — This assists in improving immunity and skin health, and aids the pituitary gland in releasing follicle-stimulating hormones that encourage ovulation and influence the ovaries to produce more progesterone. Zinc-rich foods include oysters, kefir, spinach, pumpkin seeds, cashews, pastured chicken, wild-caught Alaskan salmon, grass fed beef and mushrooms.42,43,44
• Magnesium — It can aid with preserving progesterone levels by promoting calmness and helping with the breakdown of antagonistic estrogen metabolites, potentially reducing estrogen dominance. Leafy green vegetables like kale and Swiss chard, cashews and pumpkin seeds are abundant in magnesium.
• Fiber — It's a nutrient that assists with proper bowel movement and elimination of metabolized hormones, such as harmful estrogens that prevent proper progesterone function. The best sources of fiber include organic psyllium husks, cauliflower, green beans, berries and flax, hemp and chia seeds.
• Sulfur — Foods rich in sulfur contain glucosinolates that activate phase 2 detoxification in the liver. Sulfur helps filter estrogen metabolites, and prevent increased circulation of estrogen Sulfur is found in broccoli, collard greens, kale, Brussels sprouts and Swiss chard.
• L-arginine — This amino acid is helps the body produce nitric acid that may relax blood vessels and promote healthy circulation. Improved circulation can guarantee that the corpus luteum and other organs like the ovaries experience improved blood flow to promote progesterone production.
Food sources of l-arginine include wild-caught Alaskan salmon, pasture-raised chicken, pumpkin seeds, walnuts and chickpeas.
• Good cholesterol/healthy dietary fats — Your body needs good cholesterol to create pregnenolone, or the mother hormone that assists with making progesterone. Increase the amount of good cholesterol by consuming adequate amounts of coconuts and coconut oil, avocados, organic pastured egg yolks, butter made from raw and grass fed milk and raw nuts like pecans and macadamias.
The thought of maintaining optimal progesterone levels, especially for some women, may not occur before it's too late. Progesterone is important in boosting reproductive health and brain function among women, and even in reducing risk for certain diseases, as studies have revealed.
A progesterone deficiency can lead to unwanted health risks. Fortunately, there are numerous natural sources of this steroid hormone, as well as different forms that can be recommended by your physician or doctor.
However, I suggest that you consult a physician, doctor or OB-GYN before resorting to progesterone treatments. Determine whether your body has adequate levels of this particular steroid hormone, and/or if you need to take progesterone in the first place. Just as having low levels of progesterone can be harmful, the same can be said if you have excess progesterone in your body.
Frequently Asked Questions About Progesterone
Q: What causes low progesterone levels?
A: Generally, progesterone levels are low before ovulation, but will gradually increase during ovulation and remain steady afterwards. However, if progesterone levels remain low, this can signal that there is a problem with ovulation, the menstrual cycle or both.
Q: How does progesterone work?
A: Progesterone, which is first produced by the ovaries, placenta and adrenal glands, travels throughout the blood and into tissues where progesterone receptors can be found. After attaching to the receptors, progesterone delivers significant effects on the body. These are mostly geared towards the reproductive system, such as providing a healthy environment for a baby to grow and promoting optimal function of organs.
Q: Does progesterone cause weight gain?
A: Weight gain isn't a usual side effect of taking progesterone. In fact, it's said that progesterone can help prevent weight gain. A progesterone deficiency can lead to a condition called estrogen dominance that slows down your metabolism and causes weight gain.
Supplementing with bioidentical progesterone can aid in balancing estrogen levels and averting estrogen dominance. Plus, progesterone is known to promote the assimilation of the thyroid hormone into the cells, raising your metabolism and helping relieve fluid retention.
Q: Does progesterone cause nausea?
A: Yes, although nausea is a rare side effect of progesterone. For pregnant women, there is a higher risk for nausea if the patient takes either vaginal progesterone or undergoes a progesterone shot.
Q: How do you increase progesterone levels naturally?
A: You can increase your body's progesterone levels by eating foods with vitamins B6, C and E, minerals like magnesium and zinc, nutrients like l-arginine, fiber and sulfur and good cholesterol or healthy dietary fats. These nutrients can stimulate the body's progesterone production.
Q: How do you take progesterone?
A: You can take progesterone via injections, suppositories, creams, gels or vaginal rings that are available and may be recommended by your physician, doctor or OB-GYN.