The signs of low progesterone, why levels drop, how a blood test finds it, and what you and your doctor can do.
Low progesterone symptoms show up in your periods, your sleep and your mood. Your periods come when they feel like it. You lie awake at night. You feel on edge for no clear reason. But these signs are not proof. PMS, the years before menopause and other health problems cause them too. A blood test, timed to your cycle, is the way to check your level. And once your doctor finds the cause, there are ways to treat it.
What Progesterone Does
Progesterone is a hormone. Hormones are messengers. They tell your body what to do, like notes passed in class. Your ovaries make most of this one. Small glands on top of your kidneys make a little too. So does the placenta when you are pregnant. It works as a team with estrogen, the other hormone from your ovaries.
Its Job Each Month
Each month, an ovary lets go of an egg. The empty sac left behind turns into a small gland. Doctors call it the corpus luteum. This gland makes the hormone. The hormone thickens the lining of your womb, like a soft bed, so a fertilized egg could attach and grow.
If you do not get pregnant, the gland breaks down. Your level falls. The lining breaks down too, and your period begins. So a drop each month is normal. In fact, it is what starts your period.
Its Job in Pregnancy
If you do get pregnant, your level keeps rising. The hormone supports the pregnancy. It also helps keep your womb from squeezing too early, which could bring on early labor. Later on, the placenta makes most of what you need.
Other Jobs
The hormone has a few more jobs. It helps control the bleeding in your period. It supports your thyroid. It helps with breastfeeding. And it helps your mood.
Why Timing Matters
Your level is not the same all month. It is low in the first half of your cycle. It rises after you let go of an egg. Then it falls before your period. So a number that is fine on one day can be low for another day. That is why your doctor looks at the day of your cycle when they read your test.
Low Progesterone Symptoms
The signs are different when you are pregnant and when you are not.
If You Are Not Pregnant
The most common signs are:
- Periods that are not regular
- Trouble getting pregnant
- Mood changes, worry or low mood
- Trouble sleeping
- Hot flashes
A low level may also leave you more tired than usual.
When Estrogen Takes the Lead
The two hormones work as a team. They keep your cycle in balance. When this one is low, estrogen can take the lead. Picture a seesaw with one side stuck down. Then you may notice:
- Periods that are not regular
- Tender breasts
- Low mood or mood swings
- Gallbladder problems
- A low sex drive
If You Are Pregnant
In early pregnancy, a low level can make it hard to stay pregnant. It raises the risk of a miscarriage, of a pregnancy that grows outside the womb, and of early labor. Are you pregnant, with spotting or cramps? Call your doctor.
These Signs Can Have Other Causes
No single sign proves your level is low. PMS brings mood swings, worry, sore breasts, tiredness and poor sleep in the second half of your cycle. The years before menopause bring hot flashes, mood changes, poor sleep and periods that skip. Other health problems cause these signs too.
So a list of signs is only a starting point. A test from your doctor tells you your level.
Write It Down
Do these signs come back each month? Write them down. Note the day of your cycle, how you slept and how you felt. A few months of notes can show a pattern. Your doctor can use them to see what bothers you most.
Why Progesterone Gets Low
Most causes come back to one thing. Your body makes most of this hormone after it lets go of an egg. So when no egg comes out, your level stays low.
The Main Causes
The known causes are:
- Not letting go of eggs the normal way
- No periods at all
- PCOS, a hormone problem that causes missed periods
- High stress
- The years before menopause
- Low cholesterol
Stress
Under a lot of stress, your body makes more cortisol. That is the stress hormone. Too much of it can get in the way of making progesterone.
PCOS
PCOS causes missed periods. It also makes it hard to know when an egg will come out. And when eggs do not come out, your body makes less of this hormone.
The Years Before Menopause
Doctors call this time perimenopause. It often starts in your mid-40s, but it can start in your mid-30s. It begins about 8 to 10 years before menopause. It lasts about 4 years on average. For some women it lasts up to 8 years.
In these years, your ovaries make less of their hormones. Estrogen falls, and the balance between the two shifts. Levels go up and down like a rollercoaster. Your periods are often the first thing to change. You reach menopause after 12 months in a row with no period. Some women say their PMS gets worse in these years. And yes, you can still get pregnant.
In Pregnancy
In pregnancy, a low level can be a sign of trouble. It may point to a pregnancy outside the womb, a miscarriage, or a problem called pre-eclampsia. These need a doctor right away.
How to Tell If Your Progesterone Is Low
Signs can point to a low level. A blood test is the only way to know.
The Blood Test
A health worker takes a small sample of blood from a vein in your arm. It takes less than five minutes, most of the time. You may feel a small sting. Doctors use this test to see whether you are letting go of eggs the normal way. It can also show whether fertility treatment is working. There is very little risk, apart from slight pain or a bruise.
You may need the test if:
- You have trouble getting pregnant
- You bleed when you should not, and you are not pregnant
- You have signs of a low level, like periods that are not regular, hot flashes or poor sleep
- You are pregnant and have a higher risk of a miscarriage
Timing Matters
The result depends on where you are in your cycle when your blood is taken. So your doctor may ask for the first day of your last period. Levels change so much that you may need the test more than once.
Tests in the Years Before Menopause
At this stage, your hormones swing so much that tests are not reliable. You do not need hormone tests to name it. Doctors go by your signs, your age and your health history instead.
Keep Notes Before Your Visit
Keep a daily log for at least 3 months. Write down:
- The days of your period
- How heavy the bleeding is
- How you slept
- How you felt
Bring a list of every pill you take, too. And do not stop any medicine before a test unless your doctor tells you to.
Progesterone, Calm and Mood
Many women ask if this hormone calms you. The answer has two sides.
How It Can Calm You
Your body turns it into other substances. One of them has a long name: allopregnanolone. It acts on a system in your brain called GABA-A. That is your brain’s main brake pedal. Some worry medicines work on the same system. So does alcohol.
At high levels, this substance calms you. In brain scans, high levels made the amygdala quieter. That is the part of your brain that fires up when you feel on edge. Low and high levels moved mood less than the levels in between.
Why It Can Also Upset Your Mood
Here is the surprise. At lower levels, like the ones in the second half of a normal cycle, the same substance can do the opposite in some women. It can bring worry and low mood.
Researchers think this may help explain PMDD. PMDD is a severe form of PMS. It hits about 3 to 8% of women who can have children. Up to 25% have PMS signs in the middle range. About 3 to 8% of people who take medicines for this brain system feel low instead of calm. In women with PMDD, mood gets worse as this substance rises after an egg comes out.
What This Means for You
So the hormone does not simply calm you or upset you. The effect depends on your level. It also depends on how your own brain answers it. Two women can take the same step and feel two different things. Does your mood drop hard before every period? Talk to your doctor about PMDD. Treatment can help. Does your mind feel slow before your period too? Read about period brain fog.
How to Treat Low Progesterone
Treatment depends on the cause. So the first step is to find out why your level is low.
What Your Doctor May Suggest
Your doctor may give you progesterone if you:
- Have signs in the years before menopause
- Need to make your periods more regular
- Want to prevent pregnancy, with the minipill
In those years, birth control pills can steady your hormones and ease your signs. Hormone treatment is another choice. That means estrogen, or estrogen with progesterone. Your doctor will walk you through the risks and the upside of each one. Worried a hormone pill will change your weight? Read whether progesterone causes weight gain.
When the Cause Is Something Else
Is PCOS, stress or some other health problem behind it? Then your doctor will treat that too. Is your body not letting go of eggs? Your doctor will want to know why.
What Is Still Unclear
You may read about luteal phase deficiency online. It means the second half of your cycle lasts 10 days or less. A leading group of US fertility doctors looked at it in 2021. On its own, they say, it has not been shown to cause trouble getting pregnant. Nor repeated miscarriage. They add that doctors do not agree on how to test for it. Or on whether treating it helps.
Food and Daily Habits
Some foods may help support healthy levels. But the research is thin. Look for foods with:
- Zinc, like beef, shellfish, cashews, chickpeas, lentils and eggs
- Vitamin C, like citrus fruit, peppers, strawberries and broccoli
- B vitamins, like carrots, spinach, walnuts and chicken
- Magnesium, like green vegetables, nuts, seeds and beans
These daily habits help in those years too:
- Exercise you do often, like a walk or weights
- Good sleep habits, like no screens before bed
- Less alcohol and caffeine
- Ways to calm stress, like quiet time to breathe
Good sleep habits matter here. So does a calm wind-down. Our Sleep formula was made for that hour of your day. It has chamomile, passion flower and lemon balm, calming plants that help you unwind. It also has ashwagandha and GABA to help foster a sense of relaxation before bed. No sugar gummies. No knock-out pills. Just two capsules before bed, and 60 days to feel it, or it’s free.
Not sure how well you sleep? Take our free Sleep Check. Answer 6 quick questions and see your sleep efficiency in about 30 seconds.
When to See a Doctor
See your doctor if:
- Your periods are not regular, or they have stopped.
- You have tried to get pregnant for a year with no luck.
- You are pregnant and have spotting or cramps.
- You bleed between periods or after sex.
- Hot flashes, poor sleep or mood changes make daily life hard.
- Your mood drops hard before every period.
Bring your notes to the visit. Tell your doctor about any pill or supplement you take. Ask whether a progesterone test makes sense for you, and which day of your cycle it should be done on. Your doctor can also check for other causes, like PCOS.
Common Questions
How to fix low progesterone?
It depends on the cause. A doctor may give you progesterone to make your periods regular, or to ease signs before menopause. Birth control pills or hormone treatment may help at that stage. If PCOS or stress is behind it, your doctor will treat that too.
How do I tell if my progesterone is too low?
Only a blood test can tell. Signs like periods that are not regular, hot flashes and poor sleep can point to it. But PMS and the years before menopause cause them too. The result depends on the day of your cycle. So your doctor will time the test.
What are the signs that progesterone levels are dropping before my period?
A drop before your period is normal. It makes the lining of your womb break down, so your period can start. In the days before, you may get PMS signs. Think bloating, sore breasts, mood swings or poor sleep. They ease 1 to 2 days after your period begins.
What is the calming effect of progesterone?
Your body turns it into a substance that acts on your brain’s main calming system. Some worry medicines use the same system. At high levels, it calms you. But at the lower levels of the second half of your cycle, it can bring worry or low mood in some women, as in PMDD.
Sources
- Progesterone, Cleveland Clinic
- Progesterone Test, MedlinePlus, National Library of Medicine
- Premenstrual Syndrome, MedlinePlus, National Library of Medicine
- Perimenopause, Cleveland Clinic
- Diagnosis and treatment of luteal phase deficiency: a committee opinion, Fertility and Sterility, 2021
- Allopregnanolone and mood disorders, Progress in Neurobiology, 2014
