what causes low progesterone

9 Ways to Improve Low Progesterone & Boost Fertility

Dr. Jolene BrightenPublished: Last Reviewed: Sex Hormones Leave a Comment

You’re probably familiar with the potential symptoms of low progesterone: mood swings, anxiety, fatigue, low sex drive, and sleep disturbances. For some women, PMS hits the week before their period. For others, the symptoms are more erratic, seemingly lasting throughout the month. If this sounds like a normal month for you, we need to talk. There are natural ways to improve your progesterone and if you're interested in having a baby, boost fertility too.

First of all, feeling bad should never be considered normal.

Secondly, these symptoms could be a sign of low progesterone, which can dramatically affect fertility. If you’re working on boosting fertility or want to resolve symptoms associated with PMS, you’ll first want to address low progesterone.

What is Progesterone?

Progesterone is a female sex hormone that prepares the uterus for pregnancy. Progesterone is the main hormone of the luteal phase which begins following ovulation (around day 14 of your cycle, but can vary for each person). The drop in progesterone (and estrogen) at the end of your luteal phase triggers the beginning of your menstrual cycle.

But what does progesterone do? Progesterone's job is to maintain the lining of the uterus which makes it possible for a fertilized egg to implant if you're trying to get pregnant. It also helps maintain healthy cervical mucus which provides nourishment and safe travels for sperm as it moves towards the egg.

Progesterone stays high throughout a pregnancy as well, which helps to ensure survival and overall health of the baby.

Why is Progesterone Important?

Without sufficient progesterone, your estrogen levels go unchecked & you can end up with estrogen dominance.

Then the PMS drops.⁠⠀
The sleep goes bye bye!⁠⠀
And the brain goes ACK!⁠⠀
⁠⠀
Plus, without progesterone we can have issues using our thyroid hormone. Yeah, it's more than just those sex hormones impacted.⁠⠀

Progesterone is also important for brain health, bones, mood, metabolism, and a whole lot of processes that make you thrive.

Why is Progesterone so Important for Fertility?

Well, first off … libido! Arguably the best and most important part of fertility. 😉 Progesterone is a hormone that low progesterone can make it very difficult to get into the mood.

If babies aren’t on the brain, I hope you’ll consider correcting low progesterone anyway. Because the symptoms can be brutal and affect overall hormone regulation. Low progesterone also be due to estrogen dominance, which has its own set of health issues.

Progesterone and Pregnancy

Progesterone is the hormone that helps prepare the uterus for implantation and helps you maintain a healthy pregnancy.

When progesterone is insufficient, maintaining a pregnancy may not be possible and a miscarriage may occur. In these cases, progesterone hormone therapy is generally used.

Reasons You Might Have Low Progesterone

1. Stress

Your body will always choose survival over procreation. This means you will preferentially make cortisol over progesterone when exposed to chronic stress. In times of stress, the brain signals to the glands to prioritize cortisol production over progesterone.

This is what was once known as the “pregnenolone steal.” As you’ll read in the article linked above, this isn’t quite what happens.

It is also important to note that cortisol blocks progesterone receptors, which means that you can not efficiently use the progesterone you are making.

Allostatic Load and Hormones

Allostatic Load (AL) is the breakdown or deterioration of the body that occurs with chronic stress exposure.⠀⠀
⁠⠀⠀
AL can lead to hormone changes that cause irregular periods, infertility, diabetes, and increased inflammation.⠀

High stress and AL can make you more sensitive to cortisol and less likely to make progesterone when stress goes high. Your cortisol can even look normal on labs and still mess your cycle up!⠀⠀
⁠⠀⠀
What factors contribute to increased allostatic load:⁠⠀

  • High ACE (adverse childhood event) scores⠀
  • Being a woman, especially a WOC is associated with a higher allostatic load⁠⠀⠀
  • Lower socioeconomic status⁠⠀⠀
  • Being a Black woman ⁠⠀⠀
  • Identifying as LGBTQ⁠⠀

We all need community support to manage stress, but if you check any of those boxes then this is a MUST.⠀
⁠⠀⠀
⁠These are factors that cannot be controlled by the individual. This is why focusing on what can be controlled is so important.⁠ Quality sleep⁠, food, and exercise are some of the foundational health promoting behaviors we'll talk about. But we have to recognize that even these are difficult for some people.⁠⠀⠀⠀

2. Hypothyroidism

Pregnenolone is what I call the “mama hormone” because it gives birth to your sex hormones. Without pregnenolone, we can't make progesterone.

Pregnenolone synthesis requires thyroid hormone. To even make the molecule you need to create progesterone you must first have adequate thyroid hormone.

In addition, the brain signaling when we are hypothyroid (too little thyroid hormone) can be problematic for healthy menstrual cycles. You can read about this in the Hypothyroid and Menstrual Cycle article.

3. Polycystic Ovarian Syndrome (PCOS)

A hallmark sign of PCOS is anovulatory cycles or lack of ovulation. It may also be that you do ovulate, but it is irregular. Ovulation is when the ovary releases an egg, which is generally only once in the menstrual cycle. It's pretty rare to do it more than once.⁠⠀

⁠Following ovulation there is a structure that form in the ovary called the corpus luteum. It produces progesterone.⁠ You cannot produce sufficient progesterone without ovulation.⁠⠀

Rises in testosterone mean lower levels of progesterone. Making sure you’re producing adequate progesterone is essential in order to ovulate. Without ovulation, not only is it difficult for your body to adequately clear the uterine lining during menses, but it’s impossible to get pregnant. And it’s important to understand that even if you’re having a period, it doesn’t mean you’re ovulating! Read more about PCOS

4. Age

After age 35, there is an inevitable decline in progesterone. Luckily, I’m going to give you some ways to support hormone balance, so keep reading!

As we approach menopause, we ovulate less frequently. Remember, without ovulation, we can't produce sufficient progesterone. This is a time when progesterone cream or bioidentical progesterone therapy is often considered on an individualized basis.

5. Elevated Prolactin

Prolactin is the hormone that triggers lactation but can rise in non-lactating women as well. This is a problem because high levels of prolactin can interfere with progesterone production and inhibit ovulation.

High prolactin can be the result of a poor diet choices, stressful lifestyle or something more serious so you definitely want to get this checked out. In some cases, a benign brain tumor called a prolactinoma can be the issue.

6. Estrogen Dominance

Estrogen dominance occurs whenever a woman produces too much estrogen relative to her progesterone levels. Estrogen dominance can occur during perimenopause or menopause due to lack of ovulation. This is a relative estrogen dominance.

In a frank estrogen dominance, you may have normal progesterone, but because of the high amount of estrogen, it still feels like you don't have enough.

Excess body fat, chronic stress, and a diet high in sugar and processed starchy carbs can contribute to blood sugar imbalance and hormone dysregulation. When low progesterone symptoms present due to estrogen dominance, you’ll likely experience other symptoms like fluid retention, breast tenderness, and irritability.

Low progesterone symptoms

  • Insomnia or sleep disturbance
  • Low libido
  • Mood changes, anxiety and irritability
  • Breast tenderness
  • Headaches and migraines
  • Weight gain
  • Irregular menstrual cycle
  • Short cycles
  • Mid-cycle spotting
progesterone foods

How to Increase Progesterone

There are plenty of natural ways and foods to increase natural progesterone! For some women, using natural therapies alone will help them eliminate unwanted symptoms and increase progesterone. For other women, they may need additional support and may choose to use a progesterone cream or other forms of bioidentical progesterone.

These are natural ways to support your body in doing its job properly. Often, they can be used alongside other therapies, but be sure to check in with your provider before initiating diet, lifestyle, and supplement practices. Remember, supplements are not designed to prevent, cure, or treat disease. They are designed to support your system, as part of a healthy diet and lifestyle.

1. Manage Stress

As mentioned above, chronic stress increases the secretion of cortisol and adrenaline at the expense of sex hormones like progesterone. Find a stress management practice that works for you, whether it’s deep breathing, mindfulness, or just walking the dog or talking with a friend. Your health and your fertility depends on it!

2. Include Healthy Dietary Fats

Cholesterol is necessary for the synthesis of pregnenolone (the “mama” hormone), which in turn makes progesterone. Cholesterol is also necessary for the production of thyroid hormone!

Fat will also help to balance blood sugar. Insulin sensitivity or blood sugar imbalance has deleterious effects on your hormones. Studies suggest that improving insulin sensitivity can dramatically increase progesterone levels in those with luteal phase defects.(1) 

Fat from trusted sources of grass fed meat, fatty fish, and plant-derived fats like coconut oil, olive oil, olives, nuts, seeds, and avocado are all good progesterone food choices . Women wanting to improve their hormones should aim to eat at 1-2 tablespoons of fat at every meal to support natural hormone balance.

Give your body the nutrients it needs to create amazing hormones. Download your FREE Hormone Starter Kit with 7 Day Meal Plan & Recipe Guide Book.

3. Vitex agnus-castus (Chaste tree berry)

Vitex has also been shown to reduce prolactin secretion while raising progesterone levels. Vitex has also been shown to support healthy progesterone levels and may even be beneficial for PMS.

Read our Essential Guide to Vitex and the Chaste Tree

Balance by Dr. Brighten is formulated with Vitex to support healthy levels of progesterone. Supplements can be an excellent to support your hormone system overall and are not designed treat or prevent disease. So, if you suspect something like primary ovarian insufficiency, it is best to talk to your doctor about your specific needs.

Sometimes we just have to have a little fun when learning about hormone imbalances and how to support low progesterone.

4. Green tea

Green tea helps with estrogen metabolism, which is critical when dealing with estrogen dominance and lowered estrogen levels are associated with fewer incidences of cancer, especially breast cancer.  In one study, Japanese women who drank green tea daily had up to 40% urinary estrogen levels as compared to women who drank green tea only once per week.(4)

Often, more green tea is needed to initially correct estrogen dominance, making a supplement a nice addition to your tea ritual. I've formulated Balance by Dr. Brighten with this in mind. You'll find 100 mg of green tea extract in your serving of Balance.

5. Rhodiola rosea

Rhodiola is an adaptogenic herb that helps to balance cortisol output, which indirectly supports healthy progesterone production.

 Aim for a supplement that contains 100 mg of Rhodiola daily. Adrenal Support, which is part of my Period Problems Kit™ contains Rhodiola and other adaptogenic herbs to support adrenal health and hormone balance.

6. Zinc

Zinc increases follicle stimulating hormone (FSH), which supports healthy ovulation, which triggers the ovaries to produce progesterone.

Get plenty of zinc-rich foods like oysters, herring, beef, lamb, pork, liver, egg yolks, oats, pecans, Brazil nuts, pumpkin seeds, ginger root, mustard, chilli powder, peas, carrots, beets, and cabbage. You can also consider seed cycling, which provides you with dietary zinc.

Bonus points for getting your man to eat these zinc-rich eats as well. Zinc is amazing for sperm motility and health! (5) If you are supplementing with zinc, always be sure to balance with copper! 

7. Magnesium

Magnesium is involved in many of the body’s reactions and is essential to adrenal health, which is essential for healthy hormone production!

Aim to eat plenty dark green vegetables, almonds, pecans, cashews, brazil nuts, seeds, legumes, brown rice, avocado, and dried apricots as these are all sources of magnesium. If you're you're in need of more support, consider 150-300 mg magnesium nightly.

8. Vitamin B6

Vitamin B6 is involved in estrogen metabolism and can easily become depleted if estrogen dominance is a problem. Vitamin B6 possesses “progesterone-like effects” and has been shown to reduce estrogen while increasing progesterone levels.(6,7)

Take 30-50 mg once daily as a part of a B-complex or Balance by Dr. Brighten. And definitely eat some of the following B6-rich foods: liver and other organ meats, fish, poultry, egg yolk, dried beans, peanuts, walnuts, banana, prunes, potatoes, cauliflower, cabbage, and avocado. 

9. Vitamin C 

Antioxidants like vitamin C may increase and intensify the effects of progesterone. Vitamin C has also been shown to raise progesterone levels and resolve luteal phase defects, resulting in improved fertility.

I often recommend 1,000 mg daily of vitamin C to my patients because it raises progesterone. Or, you can try these high-vitamin C foods: Citrus fruits, strawberries, mango, papaya, watermelon, tomatoes, broccoli. Brussels sprouts, cauliflower, cabbage, and spinach.(7,8,9)

Progesterone is Important for Overall Health

As you can see progesterone is super important to your fertility and ability to become pregnant. I’ve shared 9 different ways for you to boost yours starting today.  

As I explained above, there underlying root causes that are behind progesterone issues.  Getting to the bottom of what causes low progesterone and fixing them is the best way for you to get amazing hormones and is what I recommend to my patients.  

 

 

This comprehensive hormone support protocol will help you say buh-bye to PMS, while supporting increased energy, mood, and libido. Balance your hormones naturally and ditch the bad moods, bad skin, and bad periods for good with our Period Problems Kit™.

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References

  1. Meenakumari KJ, Agarwal S, Krishna A, Pandey LK. Effects of metformin treatment on luteal phase progesterone concentration in polycystic ovary syndrome. Braz J Med Biol Res. 2004. 37(11). 1637-44.
  2. Mayo L. A Natural Approach to Menopause. APPLIED NUTRITIONAL SCIENCE REPORTS. 1999. Vol. 5, No. 7.
  3. Sliutz G1, Speiser P, Schultz AM, Spona J, Zeillinger R. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res. 1993. 25(5). 253-5.
  4. Fuhrman BJ1, Pfeiffer RM, Wu AH, Xu X, Keefer LK, Veenstra TD, Ziegler RG. Green tea intake is associated with urinary estrogen profiles in Japanese-American women. Nutr J. 2013. 12:25. 10.1186/1475-2891-12-25.
  5. Egwurugwu JN1, Ifedi CU, Uchefuna RC, Ezeokafor EN, Alagwu EA. Effects of zinc on male sex hormones and semen quality in rats. Niger J Physiol Sci. 2013. 28(1). 17-22.
  6. Elsevier Inc. Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. FERTILITY AND STERILITY. 2003. 80(2).
  7. Milewicz A1, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teucher T, Schmitz H. [Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study]. Arzneimittelforschung. 1993. 43(7). 752-6.
About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is one of the leading experts in women’s medicine and is a pioneer in her exploration of the far-reaching impact of hormonal birth control and the little known side effects that impact health in a large way. In her best selling book, Beyond the Pill, she shares her clinical protocols aimed at supporting women struggling with symptoms of hormone imbalance, including Post-Birth Control Pill Syndrome and birth control related side effects. A trained nutritional biochemist and Naturopathic Physician, Dr. Brighten is the founder and Clinic Director at Rubus Health, an integrative women’s medicine clinic. She is a member of the MindBodyGreen Collective and has been featured in prominent media outlets such as Forbes, Cosmopolitan, ABC news, and the New York Post. Read more about me here.