Anxiety, insomnia, and heavy periods are well-known signs of low progesterone. Learn the other symptoms and 18 root causes of low progesterone!
Low progesterone is extremely common in women and has a variety of root causes. For many, the symptoms can look like estrogen dominance ,while in others it may look very different – even opposite of that. To fix your low progesterone, you need to find your root cause(s). This article will help you with that.
Symptoms of Low Progesterone
- Bad PMS
- A few days of brown spotting before period
- Heavy Periods
- Luteal phase defect (< 10 days between ovulation and your next period bleed)
- Anovulatory cycles (you bled, but you didn’t ovulate)
- Skipping periods or losing your period altogether
- Endometriosis or Adenomyosis
What Causes Low Progesterone?
Progesterone can be low for a number of reasons – some of them are completely natural (hello puberty, perimenopause, and menopause), but others are a result of imbalances that can and should be addressed.
Production of progesterone and other hormones can lag behind during the year after the first period. (1)
2. Over 35 years old
Progesterone levels begin to naturally decline in late 30s and continue to fall throughout the perimenopausal period.
When the ovaries shut down after menopause, progesterone levels become undetectable.
4. Chronic stress
This is the most common cause of low progesterone in cycling women I see in my practice. The body was designed to prioritize responding to stress over fertility when it senses the environment isn’t safe to bring a baby into. But today we’re never not stressed – from constant phone notifications to overfilled schedules to unprecedented world events. This steady flow of stress shunts energy away from making hormones like progesterone.
5. HPA Axis Dysfunction/Adrenal Fatigue
When chronic stress isn’t addressed, it can disrupt the signals between our brain and our hormones, leading to dysfunctional cortisol patterns as well as hormone imbalances like low progesterone. If you have extreme daytime fatigue, but struggle falling asleep or staying asleep, HPA Axis Dysfunction could be the cause of your low progesterone.
6. Not ovulating
Ovulation triggers a rise in progesterone during the luteal phase (2nd half) of our menstrual cycle. If you’re not ovulating consistently (raw eggwhite type mucus mid-month, a mid-month rise in basal body temperature, and a positive Ovulation Predictor Kit test are all good indicators of ovulation), it’s probably contributing to your low progesterone. About 85% of the time, a lack of ovulation is due to HPA Axis dysfunction. (1)
Remember, if you’re on any type of hormonal birth control, you’re likely not ovulating.
7. Low estrogen
Remember, the spike of estrogen in the follicular phase (1st half) of our menstrual cycle is the first domino in a cascade that triggers ovulation and a progesterone spike. If estrogen is low for whatever reason, you’re very likely to have low progesterone too. Signs of low estrogen include brain fog, low mood, dry/thin/saggy skin, vaginal dryness, frequent UTI’s, urinary leakage, and light or missing periods.
Not eating enough is viewed by the body as starvation, which it views as a threat. In response, it will slow down the metabolism and hormone production to conserve resources to fuel the stress response. If your low progesterone symptoms followed a significant diet change or period of weight loss, this dynamic could be at play.
9. Exercising too much
Exercise is a type of “hormetic” stress on the body, which simply means, if it’s not too much, it benefits us…but if it’s more than our body can handle at that time, it has a negative effect. If other stressors in your life are peaking right now, higher intensity workouts or distance running may be adding to your stress and taking away from hormones like progesterone.
10. Low body fat
Like overexercising and undereating, the body perceives low body fat as a threat to survival, so it scales back production of hormones like estrogen and progesterone to prevent fertility. Some research suggests 22-28% body fat is ideal for hormone balance and regular periods.(2) Many leaner women and female athletes fall well below this range.
11. Low cholesterol
Progesterone is made from cholesterol, so low cholesterol levels can potentially limit the amount of progesterone the body makes. (3)
Anovulatory cycles and low progesterone are very common in women with PCOS, which explains why getting pregnant and holding a pregnancy can be difficult for these women as well. (3)
The body produces lots of prolactin (pro-lactation) when breastfeeding, which suppresses GnRH, FSH, LH, ovulation, and progesterone. This is why it’s harder (but not impossible!) to get pregnant while breastfeeding.
14. Prolactin secreting Pituitary Tumors
Tumors on the pituitary gland are usually non cancerous, but secrete prolactin, which will suppress GnRH, FSH, LH, ovulation, and progesterone.
- Hormonal birth control (pills, patches, rings, hormonal IUDs, injections)
- Risperidone (Brand names: Risperdol, Consta, etc.)
- Amitriptylines (Brand names: Elavil, Endep, etc.)
- SSRIs like fluoxetine, citalopram, etc. (Brand names: Cipramil, Prozac, etc.)
- Bupropion (Brand names: Wellbutrin, Zyban, etc.)
- NSAIDs like ibuprofin, naproxin, and aspirin (Brand names: Advil, Motrin, Naproxen, Bayer, etc.)
- Opioid pain medications like oxycodone, hydrocodone, and morphine (Brand names: Percocet, Vicodin, MS Contin, etc.)
16. Low Thyroid
17. Hypothalamic failure
Failure of the Hypothalamus (in the brain) to signal production of hormones including progesterone is rare and is usually a result of genetics, certain autoimmune conditions, or head trauma. (1)
18. Celiac Disease or Non-Celiac Gluten Sensitivity (NCGS)?
More research is needed to understand the gluten-progesterone link, but some researchers suspect a connection since Celiac and NCGS have been linked to multiple factors related to low progesterone (inflammation, infertility, lower estrogen, higher prolactin, etc.). (9, 10, 11)
The Bottom Line
Many factors can deplete progesterone, but I’m sure you noticed the theme of stress in the list above. Just about every woman struggling with low progesterone will benefit from focusing on stress reduction and management. Stay tune for more tips to help raise progesterone naturally!
Check out these related posts!
How to Lower Estrogen Naturally
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