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Low on Progesterone? Why Stress Reduction Might Be the Only Way to Hack It

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One of the biggest hormone problems that plagues women is having low progesterone levels.   On some level this is natural: it happens during menopause, perimenopause and in periods of hormonal flux.  These natural fluctuations can be mitigated with diet and lifestyle to an extent, but they may on some small level just have to be tolerated for a while.  Some women supplement with progesterone cream throughout menopause and find that this eases their symptoms.  On the other hand, many women on natural paleo-type diets find they can stop supplementing progesterone and remain symptom-free.

Nonetheless: a diagnosis of low progesterone is fairly common even among women of reproductive age.    This occurs to two classes of women: first, the estrogen dominant, and secondly, the stressed.

If you are estrogen dominant, you may have other symptoms: these include being overweight, experiencing PMS, experiencing menstrual cramps, decreased libido, bloating, breast swelling and tenderness, fibrocystic breasts, PMS-related headaches, mood swings, and thyroid malfunction.

A couple decades ago, most researchers thought that these symptoms were a result of high estrogen levels alone.  Today, researchers typically acknowledge that it is more a problem of imbalance with progesterone rather than high estrogen in and of itself that causes most of these problems, such that the diagnosis “high estrogen” may also mean “low progesterone.”  It is hard to tell: the variables are too closely linked.

For this reason, if your true diagnosis is estrogen dominance, you may want to experiment with the guidelines I outline in The Estrogen Dominance Post.

If, on the other hand, your problem is not high estrogen per se but actually low progesterone levels, you have few avenues available to you.

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Progesterone is synthesized fairly early in the hormonal cascade, and it’s activity is highly influenced by the level of stress–either physical or emotional–a woman is experiencing.   I wrote about this in a post about a year ago, titled “The HPA axis: what is pregnenolone steal?”

Another way to describe pregnenolone steal is as progesterone steal.

Pregnenolone is the primary “precursor” hormone.  It sits at the top of the food chain and is directed to be used by the body however it sees fit.

If a woman is stressed, her body “steals” the  pregnenolone for stress hormone production instead of progesterone production.  This means that other female hormones also take a hit — accounting for why some women have low hormone levels across the board — but progesterone is one of the hardest hit.  If a woman has low progesterone in her labs, it’s a pretty good bet that her body is using her resources to produce cortisol rather than the good stuff.

For this reason, reducing stress is actually the only clinically well-known way to increase progesterone production.

This isn’t an easy answer.  Stress reduction takes real work.  We cannot just promise to sleep more or to spend more time with ourselves or our families, and then let these promises drift away as life marches on.  Instead, we have to make concrete changes to our schedules, to our jobs, to our relationships, to our feelings about our existence.   Often, psychologists can be uniquely helpful, as can group involvement, friendship, spiritual communities, and yoga and meditation.

Stress levels can also be reduced by making sure to eat a nourishing diet that doesn’t have any kind of a starvation component.  Eat when you are hungry, and do your absolute best to assure your hypothalamus that it has nothing to stress about.

Symptoms of low progesterone (without estrogen dominance) include classic hypothalamic amenorrheic symptoms: irregular cycles, infertility, anxiety, low libido.   If you reduce your stress levels, you may see these problems slowly tick away.  Perhaps most delightfully, progesterone is well-known as carrying with it significant libido-enhancing power.   Reduce your stress, and your sex life make thank you, too.

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Managing director of Paleo for Women and author of Sexy by Nature.

46 Comments

  1. How long does it usually take to see an increase in progesterone once you reduce stress? Is there an improvement in a matter of days? Is it a cumulative effect over a few cycles?

  2. This post is brilliant! And, unfortunately, it’s a topic that is little discussed, especially in terms of overtraining. I experienced the symptoms of low progesterone when strength training three times a week vigorously. My diet was in order, life wasn’t too stressful, but the workouts were generating a huge metabolic/hormonal response. Because I was limiting exercise to three hours a week and supporting my training well calorically and nutritionally, I thought I was in the clear, but unfortunately, even that was too much. I got so frustrated I stopped altogether (and actually loosened up on my nutrition) and my system got back to normal almost immediately.

    However, I absolutely love strength training (maybe I’m addicted to the adrenaline rush!), and I really want to resume training, but in such a way that supports rather than destabilizes my hormones. Any advice would be much appreciated!

  3. I had no idea that cortisol production was involved here. I suffered from low progesterone (without estrogen dominance)about one year ago (at 27 yo). I have since recovered. I have psoriasis, which flares up with increased cortisol production. My psoriasis was at its worst when I had the low p problem. I wonder whether my flare up was a cause or part of a symptom of my problem? If my body was producing more cortisol to sustain the psoriasis, then I would have been loosing out on production of other hormones. My diet was unsuitably low in calories at the time.

    • Cee – Just wanted to comment, as psoriasis is often linked to diet. I have has psoriasis since I was a kid, and found out in my 20’s I am gluten-intolerant (gluten = wheat/rye/barley). When I changed my diet, my skin cleared up tremendously and I rarely have bad psoriasis breakouts. Just something to think about! – Kitt

  4. I have a question — I’ve been struggling with what I’ve been told is Hypothalamic Amenorrhea for a few years now. I’ve lost and regained my period several times due to fluctuations in weight, calorie intake, and exercise, but have always managed to get it back by changing my lifestyle. I had my period in January 2012, then didn’t get it again for an entire year. My gyno did bloodwork which was normal, except for low hormone levels (also had an ultrasound to check for cysts on my ovaries, result was negative.) In November of last year I took provera and had a withdrawal bleed, but no period in December. I then got my period this January (same time that I did last year, while I was on winter break from school) after further reducing my exercise, mainly cutting back on running. However, I haven’t gotten another period since.

    My question is about the provera test: since I responded, that means that I have adequate estrogen, right? So why am I not ovulating? Could I have a problem with progesterone production? I’m currently 5’4, about 110 lbs, exercising lightly about five times a week (playing squash, walking, yoga, and very short runs about once or twice a week) and eating 2000+ calories per day. I don’t have any of the classic symptoms of PCOS or estrogen dominance. I do have a fair amount of stress at school, but I do my best to manage it.

    Sorry for the lengthy post, but any feedback would be greatly appreciated! Your blog has been extremely helpful to me in my struggles with this problem.

    • Yes, that’s possible. Both estrogen and progesterone are likely low for you, and progesterone the lowest. Low progesterone is caused by stress to the hypothalamus — both metabolic and psychological. This takes real healing and real efforts, but it looks as though you are on the right track. :)

    • Adi, I am right there with you! I am the same height as you and was diagnosed with HA at 114 pounds. I reduced exercise to walking and yoga only and gained up to a BMI of 22.3 before my cycle returned, though irregular. You can do this! You know what has to be done and are working towards changing your lifestyle so you can be healthy on the inside, good for you!

      Stefani, thank you for your post! Since my cycle returned (and even on my Clomid cycles) my progesterone seems to drop a little too quickly but has gotten better. I completely agree that stress has something to do with it, the hardest part is trying to find ways to manage that stress! Thank you for all you do!

  5. Thank you for this! I just started using my progesterone cream on week two of the Whole 30 and have noticed that everything has come to a stand still and gotten worse (acne, tighter pant & a desire to nap) since I introduced the cream into my nightly ritual. I am going to shelf the cream, continue with clean eating and exercise and work on lower stress :)

    • Yes!!

  6. I’ve got a question… I had a miscarriage in ’05. Then had a very healthy pregnancy in ’08. Since then this past Feb we tried again and I suffered a horrible miscarriage. Last month I had yet another, luckily this one was quick and my body actually took care of it all. If I have low progesterone, could this cause the miscarriages? And if so, should I be tested for this before we try to conceive again?

    • Yes – low progesterone is highly correlated with miscarriage. However, the reason why is unclear. Does low progesterone itself cause the miscarriage? Or is it just a sign of another factor causing the miscarriage? Doctors are unsure. Nonetheless, it is worth talking over these issues with your doctor and doing everything you can to boost progesterone and reproductive health to safeguard your pregnancy as much as possible. All my best to you and your husband, Jorgan.

      • Check for the mthfr gene regarding miscarriages.

        • YES!

  7. I have low progesterone( 1.9ng/ml) , Can this unable me to get pregnant , what drugs can i use to increase it please ?

  8. I think my 20 year old daughter has this problem. We are having trouble getting a diagnosis and treatment. She has trouble with mood swings, sleeping too much, anxiety, and jitteriness. Medical doctors have been of little help and are referring her to a psychiatrist. She has had a blood test showing she is low on progesterone. Birth control pills were prescribed, which only made her symptoms worse. What kind of doctor can help her?
    Thanks for any information you can give me.
    Cindy, a frustrated mom

    • Hi Cindy, I am experiencing the same symptoms as your daughter and a naturopathic doctor can help her. I have finally found someone who understands what I am going through and wants to treat me naturally. They treat the problem not the symptoms, so important. I hope your daughter gets relief. I am looking forward to finally getting some myself.

      • Hi Kathryn, can I get your contact info. I am having symptoms of low progesterone and it causes me insomia. I never seek medical help cause im working in middle east now and most of the doctors here arw not even verse with hormonal problems. I suspect im having low progesterone. I really need help, there are months that I will have 10days without proper sleep

    • Cindy, What you described is exactly what I have been dealing with. I am 35 yrs old & have had a child…However, I have never been able to take b/c, it does exactly as you described your daughter. I recently had my hormone levels tested, with low progesterone but estrogen is good. I also have very high cortisol levels… I’m trying to find some answers as this, along with some other health issues…is ruining my life! If I could get the irritability & lack of energy to level out, I might have a fighting chance. I read your post & felt as though it could be my own mother writing! I’m curious if you’ve gotten any answers for your daughter…
      I would love to chat with someone that can relate.

      Best Wishes~ Heather

      • Heather what is ur contact info I am going through the exact same thing n can give u some info.

      • Heather, I have same problems as you. High cortisol, insomnia, low progesterone. Have you found some things to help?

  9. Hi! I’ve been searching hi and low for an answer to my continuous light period. 11 days now and counting. This is my first period like this. I am 48, one child, normal periods until the past 3 months when they started coming very close together, now non-stop. Recent blood and saliva work shows a low Pg/E2 ratio and higher than normal testosterone. Everything else on blood/saliva = normal. I have wicked breast pain now, too; plus constant fatigue and a hard time losing weight although I eat right and exercise. I’m not overweight, just more than I’d like to be for my pants! In desperation, I used a little Progest creme last night. Slept great, but still period. Thoughts? And, many thanks!

    • Sounds like you’re doing the right things, especially paying attention to your progesterone and estrogen levels. I’d personally give it a little more time to see if it works itself out on its own — menopause can do some interesting things when it starts cropping up (and 48 is a perfectly normal age for that to happen). On the other hand, you may want to explore whether or not you have any kinds of cysts or fibroids, which can cause long-term bleeding, with your doctor if these symptoms persist.

      Sprint exercises, though not too many, keeping your carbohydrates within a reasonable limit, weight-training exercises, plenty of sleep, and sleep reduction are all other great steps to take to keep hormones as balanced as possible in this time of transition.

  10. I have extremely low progesterone and have had it since puberty. I have been fired from jobs (dealing in customer service) because I would become irate and become a total b*tch on my period, I have severe insomnia (I sometimes go 5 days with 3 hrs a night of sleep), constipation (1 bowel movement a week if I am lucky), I know the minute my period starts and even the minute I start ovulating because the pain becomes unbearable, I can’t be on birth control because IUDs were worse then childbirth for me, I now have seizures every time I ovulate and menstruate (in the last 3 months I have had 6 seizures), my heartbeat is horrifically irregular and my chest always hurts, I have a constant headache and I do mean constant for like months at a time, I have breathing problems, sometimes all I do is pass blood clots on my period, I have horrid neck pain and all over pains, if I pick at my nails the whole nail comes off, I have lost the hair on the sides of my head, I become dizzy up to 20 times a day, night sweats, I get cysts almost constantly, I am tired all the time even when I just woke up, spotting, I get taser like shocks all over my body, and I can go on and on but those are the truly scary things that can happen with low progesterone.

    My point is, if you have severely low progesterone go to a doctor if you can and if you can’t eat healthy as possible and get some progesterone natural cream. You can and more then likely will have a stroke if you let it go too long. I just thought I wasn’t woman enough to handle the changes when I was menstruating and never told anyone, don’t ever just think it’s normal and not ask. I am trying to fix it myself (I have no insurance) but who knows if it will work or not. My period starts tomorrow so we will see.

  11. I did a saliva test this past summer, and found out I have very low progesterone. According to my Results/Chart, The Normal Range ranges from 75 to 270. My morning rate was at 30, where as my night Rate was 21. Can this be what’s been causing some brain fog/foggy thinking? Thanks!
    ~ Kayla.

    • quite possibly!

  12. Hi, thank you for this Info!! I found out my husband and I are pregnant after having a miscarriage 2 months ago. I had blood work done and I have extremely low progesterone levels and may quite possibly lose this baby. We think that may be the cause of my other 2 miscarriages, although we do have 1 daughter. Can low progesterone lead to uncontrollable irritability? I know it can lead to mood swings. I was on progesterone birth control for a long time, and the high levels of progesterone made me extremely difficult and moody. I’m wondering if I just need a more balanced progesterone level. Your article helped me understand jus how much my extreme stress is hurting my body!! Thank you!

  13. Hi Stefani,
    I was diagnosed hypothyroid last year and have been on rx since then. I stopped birth control in march and never regained my cycle. I have reduced stress, reduced exercise to 4x a week, and eat paleo. With my gyno i have done progesterone withwrawl to force a period a few times. Each time I seem to lean out and loose a little weight. Additionally I get a little “Hyperthyroid” while on the progesterone. Can this indicate a deficiency? Thanks for all you do!

    • WHY DOES ELIZABETH GET HYPER THYROID ON PROGESTERONE
      WHAT KIND OF PROGESTERONE WERE U ON

  14. I HAD ALL THE SYMPTOMS OF HYPO THYROIDISM. MY DR RAN A BLOOD TEST AND TOLD ME ALL WAS FINE AND PUSHED ME OUT THE DOOR. GETTING NO JOY – I HAD SLOW SPEECH WHICH GOT WORSE\I AM POST MENOPAUSE AGE 57 SO I WENT ON JUST ANSWER.COM AND WAS RECOMMENDED TO DO SEX PANEL TEST :ESTROGEN PROGESTERONE AND TESTERONE AS WELL AS ALL B VITAMINS HEAVY METAL AND GLUTEN INTOLERANCE
    I BET I HAVE LOW PROGESTERONE I GET MY RESULTS IN 5 DAYS
    IS THE NATURAL PROGESTERONE CREAM FREE OF SIDE EFFECTS
    MY SLOW SPPECH GETS WORSE FROM AM TO PM

    • Hi Dee, I am on this page reading about progesterone, but when I read your post I wanted to make a comment. I hope you see it. Please check out Stop the Thyroid Madness and Thyroid Change for help!! The slurred speech might be caused by poor thyroid functioning! Did your doctor do a complete thyroid panel? For us thyroid patients, we know a COMPLETE panel is necessary. (TSH, T4, T3, and anti bodies.) I would get a second opinion on that thyroid test. Call it a hunch, but I bet you are a fellow low thyroid sufferer. Good luck!

  15. What is the difference between low on progesterone and estrogen dominance? Other articles explain them as being the same thing.

    • Well, I see it two ways. You can have a good amount of progesterone but an overabundance of estrogen, or a normal amount of estrogen and a low amount of progesterone, and you’d want to fight them in slightly different ways. Low P needs healing from stress, and estrogen detox needs all of the liver and gut support.

      • Thanks a lot for the explanation!

  16. I am 24. For the past two years I have been a medical guinea pig. My problems started out by having horrible painful cramps and sometimes breakthrough bleeding in my second week of ovulation and also during my actual period. After being on 8 different forms of BC, depo provera (which I got pregnant with my son on) I had other forms of BC includong Apri, two forms of Zovia and Zovia combined with a 5mg Provera pill. Everytime they switched my BC I would get better for a cycle and then come back even worse. My horrible cramps and breakthrough bleeding were then added onto with hot flashes, night sweats, weight gain, inability to self lubricate,and more pain. After three ultrasounds and a laparoscopy I decided to ask..”hey why havnt we done any bloodwork”? I had bloodwork done just before I got off zovia and six weeks later to compare. Being off birth control did wonders for me! All my added symptoms disappeared but I am still back to horrible period cramps and breakthrough cramps. I was told friday that my labs indicated my estrogen to progesterone ratio is 10.8 to 5.2 and they want to begin me on a 12 day/mo natural progesterone supplement. I am to start it next week. I eat very very healthy (portion, fresh produce, unlrocessed meats, etc) and do light jogging and yoga often. I am naturally high strung and suffer from OCD. I cant lose weight and Infact am overweight. Being a 3rd shift mom with a 3 & 6 year old doesnt help my disorder either. What is your opinion on my case?

  17. I am 48 y/o and I have had one pregnancy and birth. My medical history includes 20+ history of hypothyroidism, treated with Levo thryoxine 200mcg, severe insomnia and migraines. I had an endometrial ablation 10 years ago which stopped my periods until about 2 years ago. Since the ablation they were very light. They ended about 8 months ago.
    SEVERE FATIGUE is what took me in to the physician’s office. I finally requested a hormone panel and I have high estradiol and low progesterone. I am set up to do the saliva test. I have virtually no stress in my life at this time (although I am a recovering TYPE A personality). I have been at my ideal weight for about 3 years. To my knowledge I do not have irritability, mood swings, breast tenderness, etc. Just fatigue and headaches. I work in the medical field but nothing I read makes sense. Am I to assume that I’ll be given a progesterone cream/pill? BTW, my Thyroid panel was WNL.

  18. well explained about progesterone learned many things about it thanks for sharing.

  19. I quit lactating and taking domperidone in July very abruptly and had insomnia, hot flashes and hyperventilating… The hyperventilating and hit flashes went away but the insomnia stayed… After 6 months I tried to relactating out if desperation took double domperidone but only made 10 Oz vs my old 30 Oz… Didn’t help me sleep so I quit.. A bit slower over a week.. Its been 6.5 weeks and no period yet… I’m dying to get biodentical testing done as my blood work appears normal. I’m crying and don’t feel like life is worth living… I’m just so exhausted.. Any advice?!!

  20. I have a question. I’m forty one and the Dr. Put me on Progestrone to shed the lining every month since I might twice a year. He put me on progestrone since those levels were low and try to force my body. He said if the lining is not shed every two or three months it could make a bed for cancer cells to grow. Still no lining shed. Is this common knowledge?

  21. I am 35yo with no kids. Was on the pill since age of 18. I went off the pill to conceive in Dec 2013 and got my period immediately after and then got nothing for 3 months. Went to the drs and got test which showed low progesterone. Everything else was fine. I was prescribed some progesterone tablets in March 2014 and got my period immediately afterwards. Now I am getting no period again but am not pregnant. Could this just be because I was on the pill for so long? Because I am 35, the dr wants me and hubby to have tests next week

  22. Hi !! So glad to read this. I have been irregular in my periods since I was 16. I am now 34 and have two children. My first pregnancy was very tough as I bled often and had low progesterone. My doctor put me on progesterone until I was in the clear at about 13 weeks. Same with my second pregnancy. A few months ago I started getting terrible panic attacks and anxiety. I always have brain fogs and I am extremely forgetful. My doctor referred me to a psychiatrist and therapist and that was that. They put me on Lexapro. I am doing very well on it but I still have little mood swings and still no normal period. I am so frustrated because for many years, my fight to figure out what is wrong, has failed. No doctor has ever looked into why I have never had a normal period. I feel like this article gave me some insight. Thank you !

  23. I’m 49 and my period is 5 weeks late. I had blood work done and I have NO progesterone or pregnenolone and low T3. Suggestions??? Stress? Yep! Lots and lots. Divorce, cheating husband, 14 year old son turning on me…influenced by father and bad friend. Not the best of times but lots of good stuff going on also. Worry of kids kind of trumps all though.

    • STRESS.

  24. Hello,

    I have been diagnosed with Hashimoto’s Hypothyroidism (2 months ago) and my TSH levels are now in the normal range. However, not all of my symptoms have been resolved. I still have digestive issues, so I went on a gluten-free and now a full-blown Paleo diet. I also experience depresion-like symptoms, sleep issues/insomnia, libido issues, headaches and PMS, irritability, and trouble losing weight.

    A few months ago I had a very short cycle (23-24 days) which got better with accupuncture. But this month I was very stressed out and I had a 23 day cycle. My progesterone levels have been low consistently 3, 5, 7 on the three mid-luteal phase readings I’ve had over the last few months. My Estradiol seems to be low normal.

    My husband and I want to have a baby and we’ve experienced an early loss. We want to start trying again in a couple months and I really want to be at optimal health prior to trying to conceive again. I feel pretty anxious that something else is also going on with my health and I’m not getting answers from my health issues.

    To relieve stress I’d like to start meditating. But I currently do pilates/regular exercise and try to keep a fairly stress-reduced life… I’m sure I could do better.

    While I’m sure this latest month is attributable to stress, I’m not sure if other issues are related – or if that is the root cause. Any advice and feedback is helpful. Recommendations for next steps?

    H.

  25. I took 100mg Microgest and slept for longer :)

  26. Hi– I am 24 and I have very low cortisol, low estrogen & low progesterone. I have been battling 20lb weight gain as I had gotten off of birth control after being on it for 8 years. I got off it 11months ago & have yet to get a period as well. What do you suggest for getting back to my normal weight & gaining my energy back.

  27. Hello, I am 46 years old. I have low progesterone and we thought I was hypo but after taking meds for it I quickly became hyper with scary symptoms so I am off them now. I currently have weight gain, joint pain, fatigue, hair loss. I realize there is the progesterone cream, but is it really possible to increase my progesterone through exercise, stress reduction and diet? Are there women who manage it this way for their entire lives without taking hrt? I would love this but it is not often heard of to manage it without taking hormones! I don’t want to take them, but want to be clear on whether there are solid, long term alternatives. Thank you!

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