How to Naturally Optimize Progesterone in Women of Menstruating Age

What is progesterone and why does this matter for women’s health?

Progesterone is a sex hormone, and one of its main functions for a menstruating female is to increase after ovulation occurs to prepare the body for pregnancy. Without underlying medical problems or nutrition problems, this is run of the mill in the luteal phase (second half) of the a menstrual cycle.

Also under normal health circumstances, when conception does not occur in any given month, the progesterone will then decrease after its surge and a menstrual period will result. This is generally speaking the a main role of this hormone from month to month, specifically in a non-pregnant women in their reproductive years.

If conception does occur in any given month, then progesterone naturally increases to help support the early stages of a pregnancy, and will (or should) remain elevated throughout the duration of pregnancy. Progesterone is often called “the pregnancy hormone.”

A women does not have to conceive a child, but physiologically speaking this is part of the design of a women’s body. And regardless of a women’s intent to have a child or not, optimal progesterone levels are correlated with good health. The ability to have a baby/the body’s ability to ovulate and overall female health are correlated.

What is an ideal level of progesterone to indicate that ovulation occurred?

If measured around day 20 or 21 of the menstrual cycle (day 1 is the day the period or bleeding starts), “normal” progesterone levels are >6ng/mL (note “normal” is debated) but an optimal progesterone is around 12 to 24ng/mL (note this is also debated like just about everything in healthcare).

Why are low progesterone levels a concern?

It is important to note that progesterone levels will naturally fluctuate during a menstrual cycle. However, consistently low progesterone levels can be a problem in menstruating females, especially in the luteal phase of the menstrual cycle.

Low progesterone levels (specifically in the luteal phase) in menstruating females are often seen in the context of:

• Overexercising
• Vitamin & mineral deficiencies (zinc, b6 to name a few)
• Diet low in antioxidants
• Emotional and physical stressors
• Undereating/too restrictive of a diet in terms of energy/calories
• Too little body fat
• Blood sugar imbalances
• Intestinal dysbiosis
• Adaptive cortisol dysfunction
• Toxic indoor mold exposure
  • mold can suppress progesterone production and this is well documented and part of the CIRS biotoxin pathway; start with checking your home for clinically significant levels of mold via ordering an at home ERMI dust kit #1 an if elevated around a 5 or higher, call a certified mold inspector
• Hormonal birth control usage (ovulation is stopped so there is no mid luteal progesterone surge)

Additional root causes of low progesterone to consider that are arguably non-modifiable, include thyroid disease presence, ovarian failure, pituitary disease, and high prolactin (*note this list is non-exhaustive). Also, low progesterone levels are often seen in a women with PCOS (polycystic ovarian syndrome) usually due to an irregular or absent menstrual cycle.

It is important to state that progesterone has several other functions and effects beyond reproductive health. For example, progesterone also:

• Calms the nervous system & helps the body combat stress
• Helps the body use fat for energy
• Protects against estrogen related cancers
• Supports metabolism & basal body temperature
• Acts as a natural diuretic (help decrease fluid retention or “puffiness”)

How do you know if your progesterone is low?

Symptoms of low progesterone levels can include:

• Chronic fatigue
• Irritability, mood swings, anxiety, depression, PMS
• Menstrual headaches or migraines
• Irregular periods or no periods at all
• Difficulty conceiving
• You are using hormonal birth control
• Mid-cycle spotting
• Insomnia
• Trouble losing excess weight
• Excess fluid retention or “feeling puffy”
• Excess hair shedding

Some of the symptoms of low progesterone can overlap with high or low estrogen, so testing is important.

Myself (and many other healthcare providers) will often order both serum (blood) or urine (DUTCH test) as part of an individualized nutrition evaluation. You can self order progesterone here and get drawn at any Quest labs. Low levels of progesterone often co-occur with Estrogen dominance which is characterized by a higher ratio of estrogen relative to progesterone.

Side note: For women in reproductive years, remember that progesterone levels will naturally increase once pregnancy occurs. While uncommon, there are some medical conditions associated with high progesterone levels, such as congenital adrenal hyperplasia or excess exogenous progesterone or precursors. Generally speaking, too high of progesterone is not common unless excess exogenous (external) sources are being used, like in medicines or progesterone containing creams. (Note progestin found in birth control is not the same as progesterone).

What nutrients can improve progesterone levels if they are low from a deficiency?

The good news is that there are foods, lifestyle factors, and strategies to try that can help increase luteal phase progesterone levels naturally.

That said, it is also important to understand WHY progesterone levels are low in order to identify and correct any root causes. As a dietitian that incorporates functional nutrition in my practice, I utilize an in-depth nutrition assessment combined with patient input to create an individualized nutrition action plan.

What foods can help raise progesterone levels?

Sound nutrition that is adequate in the following is associated with healthy progesterone levels:

• Magnesium
• B vitamins, especially vitamin B6
• Zinc
• Adequate calories
• Plenty of antioxidants

Some additional strategies to naturally increase progesterone levels include:

• Minimize alcohol consumption.
• Stop drinking tap water and drink RO water only so aren’t drinking known health deterrents in tap water. Fridge filtered water is not much better. You need RO or distilled water and general minerals from food.
• Drink herbal tea instead of sweetened coffee (to avoid too much caffeine)
• Use less plastic water bottles or contains, as plastics can be a big source of endocrine disruptors (which do what they say: disrupt hormones)
• Reduce the amount of stress in your life, and specifically addressing cortisol dysfunction or cortisol adaptation when present.
• Doing the “right amount” of exercise, which could be to increase or decrease physical activity depending if under or over exercising.
• If questioning mold in your home whatsoever, consider getting a urine mycotoxin panelto see if it is negatively impacting your body as mold can alter sex hormones

*Please note that lots of nuance exists when it comes to helping a woman achieve appropriate progesterone levels. This is a high level overview. Nutrition evaluation and individualized care is important. Also, Medical management may be required, like in the context of hypothyroidism for one example.

Looking for individualized nutrition guidance?

I heavily support (and utilize) functional nutrition in my practice. Sometimes, medical management is needed too and I refer out when needed. I recommend establishing care with an Integrative OB/GYN.

If you are interested in an individualized nutrition consultation, I offer telehealth nutrition packages.

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