The main symptoms of low progesterone in women who are not pregnant are irregular periods, headaches, mood changes, trouble sleeping, hot flashes, bloating and difficulty conceiving. These overlap with many other conditions, so a blood test timed to the menstrual cycle is needed to confirm it. This guide also covers the signs and causes of high progesterone.
What progesterone does
Progesterone is a hormone made mainly by the ovaries after ovulation. Cleveland Clinic describes its main job as preparing the lining of the uterus for a fertilized egg. If no pregnancy occurs, the level falls and a period follows. If pregnancy occurs, the level keeps rising to support it.
Symptoms of low progesterone
Cleveland Clinic lists these symptoms in women who are not pregnant:
- irregular menstrual periods;
- headaches;
- difficulty conceiving;
- mood changes, anxiety or depression;
- trouble sleeping;
- hot flashes;
- bloating or weight gain.
Progesterone is balanced by estrogen. When progesterone is low, estrogen can be relatively high, which Cleveland Clinic links to heavy menstrual bleeding, a lower sex drive and weight gain. See our guide to the symptoms of low estrogen levels for the other side of that balance.
During pregnancy
Low progesterone in pregnancy can show as spotting, breast tenderness, tiredness and low blood sugar. It is linked to a higher risk of miscarriage, ectopic pregnancy and preterm labor. Bleeding or cramping in pregnancy needs prompt medical attention.
In men
Men need much less progesterone. Cleveland Clinic lists low mood, low sex drive, erectile dysfunction, loss of muscle and fatigue as possible signs. These overlap with the symptoms of low testosterone. Our guide to the symptoms of low testosterone covers that.
What causes low progesterone?
MedlinePlus and Cleveland Clinic list these causes in women who are not pregnant:
- not ovulating normally;
- polycystic ovary syndrome (PCOS);
- perimenopause, the years just before menopause;
- high stress, because the stress hormone cortisol can affect progesterone production;
- an underactive thyroid;
- high prolactin levels;
- over-exercising or extreme dieting.
Symptoms of high progesterone
High progesterone is expected in pregnancy and in the second half of each menstrual cycle. MedlinePlus names vaginal dryness and bloating as signs that may prompt a test.
Outside pregnancy, MedlinePlus says a high level may be linked to:
- a cyst on the ovaries;
- adrenal gland problems, including an inherited condition called congenital adrenal hyperplasia;
- ovarian cancer or adrenal gland cancer.
In pregnancy, a higher than expected level may mean twins or more. It can also be a sign of a molar pregnancy, an abnormal growth of tissue in the uterus.
If you take progesterone as medication, for example as part of hormone therapy, and notice new symptoms, tell the provider who prescribed it.
How progesterone is tested
Progesterone is measured with a blood test. The result only makes sense alongside the timing. Cleveland Clinic gives these typical figures:
- first half of the cycle: less than 2 ng/mL;
- about a week after ovulation: around 20 ng/mL;
- after menopause: may fall below 0.5 ng/mL.
Because levels change through the cycle and through pregnancy, MedlinePlus notes that you may need to be tested several times. Cleveland Clinic says progesterone cannot be checked at home.
Treatment options
Treatment depends on your symptoms and goals. Cleveland Clinic explains that progesterone may be given to support the uterine lining when trying to conceive, or alongside estrogen to ease menopause symptoms. It comes as vaginal creams or gels, pills and injections.
Each form has side effects and risks, so the benefits and risks should be discussed with your provider. In menopause hormone therapy, the American College of Obstetricians and Gynecologists explains that a progestin is added to estrogen to reduce the risk of cancer of the uterus.
Cleveland Clinic also lists sleep, stress reduction, exercise and a balanced diet as measures that may help.
When to see a provider
Cleveland Clinic advises contacting a provider if you have irregular cycles, bleeding between periods, headaches or migraines, or depression, anxiety or other mood changes. It notes that the symptoms of low progesterone are similar to other conditions, so an accurate diagnosis matters.
Frequently asked questions
What are the symptoms of low progesterone after 40?
They are the same symptoms, and perimenopause is a common cause at this age. Irregular periods, hot flashes and trouble sleeping are typical.
Can low progesterone cause weight gain?
Cleveland Clinic lists bloating or weight gain among the symptoms. Weight gain has many causes, so it is not a reliable sign on its own.
Can I test progesterone at home?
No. According to Cleveland Clinic, only a blood test ordered by a healthcare provider can check it.
Next step
You can read about hormonal imbalances and hormone therapy at Beauté Medical Aesthetics, or book a consultation to discuss your symptoms.
Sources
- Cleveland Clinic. Low Progesterone.
- Cleveland Clinic. Progesterone.
- MedlinePlus, U.S. National Library of Medicine. Progesterone Test.
- American College of Obstetricians and Gynecologists. The Menopause Years. Patient FAQ.
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