Progesterone is a hormone that your ovaries make from puberty until menopause. It is essential for normal menstruation, for becoming pregnant and for carrying a baby to term. Low levels of progesterone cause problems like irregular periods, infertility and miscarriage. Your doctor can run tests to determine if your progesterone is low and decide on the proper treatment for your symptoms.
Symptoms
The most serious symptom of low progesterone for many women is infertility. You may be unable to become pregnant due to low progesterone, because progesterone plays a crucial role in preparing the lining of your uterus for pregnancy. If the uterine lining is not ready, a fertilized egg cannot attach to the uterus and grow into a pregnancy. Progesterone is also essential for maintaining pregnancy, so low progesterone puts you at greater risk for miscarriage if you do become pregnant. Other symptoms of low progesterone include irregular periods, lack of periods or amenorrhea, clotting during menstruation, spotting between cycles, weight gain, vaginal dryness, breast sensitivity and night sweats.
Causes
A menstrual disorder called luteal phase defect (LPD) can lead to low progesterone levels. The luteal phase is the part of the menstrual cycle just after ovulation. After your ovary has released an egg into the fallopian tube where it can be fertilized, a structure called the corpus luteum forms in the ovary and produces progesterone for about 12 days. If you become pregnant, the corpus luteum will stay active during the pregnancy; otherwise, it will degrade. If your body doesn't produce enough follicle stimulating hormone (FSH), the corpus luteum cannot form properly, so you will not have enough progesterone. Or, for unknown reasons, you might have a corpus luteum that works normally but degrades too soon. Other problems like too much estrogen, poor diet, chronic stress, insulin resistance or polycystic ovary disease can also lead to low progesterone.
Diagnosis
Your doctor can diagnose low progesterone with a blood test or by testing a sample of your saliva. Common reasons for ordering this test are if you are not menopausal but are not having normal periods, if you're having abnormal uterine bleeding or if you are having problems getting pregnant or maintaining a pregnancy. If your progesterone level is low, your doctor will probably order other tests to find out why and determine the proper treatment.
Treatment
The right treatment for low progesterone depends on what is causing the problem. If your doctor thinks you suffer from LPD, he will need to order tests such as an ultrasound or uterine biopsy to find out which type of LPD you have. If the corpus luteum does not form properly, an injectable medication such as Clomid is a good option. If the corpus luteum forms properly but does not last long enough, progesterone supplements during the luteal phase are a good treatment to improve fertility; some progesterone supplements are injected, and others are vaginal suppositories.
Considerations
It is important to talk to your doctor about which treatment is right for you. The right treatment depends not only on what is causing your progesterone to be low, but also on what problems it is causing for you. If you are trying to get pregnant, Clomid or progesterone supplements are helpful. If you are not trying to get pregnant but are having other symptoms, a birth control pill is probably a better option. Communicate with your doctor, and write down any questions you have for him before your visit.
References
- Association of Women for the Advancement of Research and Education: About Progesterone
- TestCountry.org: Signs and Symptoms of Low Progesterone Hormone During Pregnancy
- International Council on Infertility Information Dissemination: Luteal Phase Defect
- California Association of Natural Family Planning: Low Progesterone Levels
- Lab Tests Online: Progesterone
