The hormone progesterone is vital to a healthy ovulation cycle, making it possible for a woman to conceive and maintain a pregnancy. Progesterone levels increase just before ovulation and continue to rise until the beginning of your menstrual period. A low progesterone level between ovulation and your period may indicate that ovulation did not occur, says the website Project Aware. This anovulation might be the result of a hormonal imbalance or even impending menopause. Whatever the reason, your doctor can diagnose it and advise you regarding ways to alleviate the shakiness, as well as other symptoms you are likely experiencing.
Significance
Detection of a low progesterone level between the time you normally ovulate and when you begin your period is significant, as it indicates a disruption in the normal hormonal cycle. If you are at the age where the onset of menopause -- or perimenopause -- is a possibility, intermittent anovulation is an expected phenomenon. However, if you are a woman of childbearing age, and you are experiencing low progesterone and corresponding symptoms, it is important that your doctor rule out other potential causes of the hormonal imbalance.
Potential Causes
A disruption in the normal menstrual cycle resulting in low progesterone and anovulation may be an indication of one of several underlying endocrine disorders. Because these disorders carry health risks besides menstrual disruptions, it is important that your doctor perform the necessary testing to rule them out.
There are three key players in the complicated process of a normal menstrual cycle: the hypothalamus, the pituitary gland and the ovaries. The relationship between the three is known in the medical community as the hypothalamic-pituitary-ovarian axis. A hormonal disruption in the process is an important risk factor, as it indicates a possible malfunction of one or more of the three components. Your doctor will likely rule out tumors of the hypothalamus and pituitary glands. She may also recommend tests to uncover genetic and environmental causes of hypothalamus or pituitary dysfunction. Premature ovarian failure is another potential cause of hormonal disruption, and treatment of its causes, including metabolic and autoimmune disorders, may correct the imbalance. Other causes of anovulation resulting from low progesterone are polycystic ovarian syndrome, hyper- or hypothyroidism and adrenal gland malfunction, such as Cushing's syndrome, according to teh Merck Online Medical Manuals.
Identification
After the initial blood test to determine your progesterone level, as well as a physical examination and patient interview to discuss other symptoms, your doctor will determine what type of further testing is needed. He may order further studies of hormonal evaluation, results of which are obtained through blood tests during critical times of your menstrual cycle. If he suspects dysfunction of either the hypothalamus or pituitary gland, he may recommend a special scan to look closely at those two structures. He may also perform an ultrasound of your abdomen to look at the structure of your ovaries.
Effects
There are many side effects of low progesterone. Those specific to feeling shaky include low blood sugar, or hypoglycemia, and anxiety associated with irritability and frequent mood swings. Blood loss from heavy blood flow during your period may also cause you to feel shaky. Other common side effects of suboptimal progesterone include water retention, tender breasts, insomnia, weight gain, hot flashes and night sweats.
Treatment
Your doctor may prescribe treatment as noninvasive as dietary changes and exercise, as excess weight can affect hormone levels. If pertinent, he may ask you to consider discontinuing the use of alcohol and cigarettes. He may talk to you about initiating hormone replacement therapy or low-dose oral contraceptives to help regulate your menstrual cycle and lessen some of your symptoms. If testing reveals a disorder, such as polycystic ovarian syndrome of Cushing's syndrome, your doctor will prescribe an appropriate regimen of medication and lifestyle changes. There are as many treatments as there are underlying causes of the hormonal imbalance. Your doctor will choose the one that is right for you.
