An intricate balance of hormones within the body plays a dynamic role in maintaining overall health and wellness for women. Among the sex hormones, progesterone has a vital role in reproductive health processes. When it comes to regulating the menstrual cycle, pregnancy, postpartum health, and menopause, progesterone levels are relevant.

Knowing the signs and symptoms of a progesterone imbalance and how to test effectively will assist you in correcting the underlying disturbances. There are natural avenues that can fix issues like progesterone deficiency, a few of which we will explore here. 

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Understanding Progesterone

Progesterone is predominately a female sex hormone. It’s also considered a steroid hormone due to its role in chemical messaging for physiological processes. Its primary role is in the menstrual cycle and a key player in fertility, pregnancy, postpartum health, and menopause. During the menstrual cycle, progesterone's role is to prepare the uterus for fertilization and, subsequently, implantation. If a fertilized egg is not the case, progesterone will drop and trigger endometrial shedding, which results in your period. 

Progesterone also has systemic functions that keep your body in homeostasis. This includes urine output regulation, modulating metabolic rate, and relaxing smooth muscle. It’s cardioprotective, raises basal body temperature, provides pain relief benefits, supports skeletal muscle, keeps your memory sharp, and has an immunosuppressive effect. 

Balanced progesterone plays a dynamic role in both these reproductive processes and bodily functions. When there is an imbalance in this hormone, you may experience a variety of symptoms. Low progesterone can lead to amenorrhea (absent menses), abnormal uterine bleeding such as spotting, fertility issues, PCOS, mood fluctuation, PMS, and preterm labor. 

Elevated progesterone can result in decreased libido and emotional cravings with increased eating. Systemic signs and symptoms of imbalanced progesterone could be a variety of things relating to the roles that systemic progesterone does. One example is the role of progesterone in counteracting the estrogen propensity in the development of autoimmune diseases like systemic lupus erythematosus (SLE). 

Testing Progesterone Levels

Hormone dysfunction can be due to various hormone imbalances. Evaluating which specific hormone(s) is out of range will provide not only confirmation of that hormone independently, but it can be looked at in conjunction with other hormone levels. 

For example, progesterone deficiency or excess can often indicate estrogen dominance. Testing sex hormones as a comprehensive panel is thorough and will allow for precise intervention. Progesterone can be tested through three different means- blood serum, salivary testing, or a urine test. 

Progesterone Blood Test

A serum Progesterone Test will look at a snapshot of progesterone levels in the blood.

Salivary Progesterone Testing 

Measuring progesterone through salivary testing is a non-invasive and simple means of collecting data. Evidence suggests that salivary testing is a promising means of testing both estradiol and progesterone. You can obtain a comprehensive Salivary Profile hormones test, which includes progesterone. 

Progesterone Urine Test

Evaluating progesterone and concomitant sex hormones and their metabolites is possible through urine spot testing. The DUTCH Complete test is a dried urine test where samples are collected over two days. This test can monitor hormones like progesterone through different stages of reproductive health. If you are a menstruating female, collection days should start 6 to 9 days before your cycle is complete. 

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Interpreting Progesterone Test Results 

Working with an integrative practitioner who looks at lab values in a functional range is highly beneficial to individualized care. Many times, patients will have results from their primary care physician, and they’ll state that their hormones are within range. Once labs are assessed based on functional lab values, which are much more specific, it can reveal a different picture. 

Lab values for progesterone also depend on the reproductive health stage. Here are the common female reference ranges for progesterone.

• Pre-ovulation: less than 1ng/mL
• Mid-cycle: 5 to 20 ng/mL
• Postmenopausal: less than 1 ng/mL
• 1st-trimester pregnancy: 11.2 to 90.0 ng/mL
• 2nd-trimester pregnancy: 25.6 to 89.4 ng/mL
• 3rd-trimester pregnancy: 48 to 300 (or more) ng/mL

*Note: It’s best to work with a functional medicine practitioner for assessment in a functional range. 

When high or low progesterone is present, it results in the signs and symptoms mentioned above. This can impact your menstrual cycle, which will play a role in ovulation and, potentially, fertility. Women also experience things such as mood swings when their hormones are dysregulated. This occurs with PMS and is common in perimenopause, where women may experience rage. 

Natural Ways to Increase Progesterone

There are various ways to support the body’s natural production of progesterone. Addressing the determinants of health, which includes assessing and optimizing your diet, hydration, sleep, exercise, stress, and environmental exposures, is a foundational starting point.

Diet and Nutrition to Increase Progesterone

Implementing a healthy diet with whole foods can assist you in increasing progesterone through functional nutrition. There is a consensus that a low-inflammatory diet is the most beneficial approach to hormone balancing. When it comes to conditions where low progesterone is prevalent, a low-inflammatory Mediterranean Diet has shown fruitful results. In a small-scale study, women with PCOS were put on a Keto Mediterranean Diet for 12 weeks. Improvements in numerous biomarkers were displayed, along with an increase in progesterone. 

While some women may benefit from a ketogenic diet, it does have the potential to negatively impact the stress hormone cortisol, which is a common preexisting issue in women with hormone imbalances. In this case, it’s best to obtain functional labs and discuss with your practitioner what the best-individualized plan is for you. 

Within your nutrition plan, it would be beneficial to include foods high in vitamins and minerals that support the production of progesterone. Foods rich in zinc, vitamin B6, and magnesium are all important as these nutrients play an essential role in progesterone levels.  

Zinc-Rich Foods

This trace mineral is essential for many physiological functions, including hormone receptor functionality. Obtaining enough zinc through your diet can help support progesterone production. Here are the top zinc-containing foods:

• Oysters
• Beef
• Blue Crab
• Oats
• Pumpkin seeds
• Lentils

Vitamin B6-Rich Foods

This vitamin supports both hormone metabolism from the liver and anterior pituitary, which can impact the production of progesterone. Here are some of the foods that have a high vitamin B6 value:

• Chickpeas
• Beef liver
• Fish (tuna, yellowfin, and salmon)
• Chicken
• Potato
• Banana

Magnesium-Rich Foods

Deficiency in magnesium can result in reproductive health issues such as painful periods, PMS, and postmenopausal symptoms. These are also symptoms present with progesterone deficiency. Consuming adequate magnesium in your diet can theoretically support balancing your progesterone levels. Here are the top magnesium-containing foods:

• Almonds
• Flaxseed
• Black beans
• Quinoa
• Yogurt
• Spinach
• Avocados
• Dark chocolate

Herbal Support for Increasing Progesterone

Adding herbal medicine to your hormone-balancing protocol is an effective way to support your body’s natural production of progesterone. Research has shown that these three botanicals have great potential in supporting progesterone levels. 

Chaste Tree (Vitex Agnus-Castus)

This plant medicine is known for its progesterone-promoting capabilities and is widely used in naturopathic medicine and integrative healthcare to help women support their hormones. One study found Vitex to be effective in women with luteal phase defects. After three months of treatment on 20mg of Vitex, the treated women had a decrease in prolactin, luteal phases were normalized, and progesterone levels increased. Depending on the symptoms and your health goals, Vitex dosage varies. Starting with 20mg is an average starting dose, but it is best to consult your holistic practitioner on the appropriate dosage for you. 

Maca Root

This traditional Andes mountain native plant is commonly used in women’s endocrine and reproductive health conditions. In a study of perimenopausal women took 2g/day of the product Maca-GO, which is pre-gelatinized organic maca. In addition to an improved symptom picture, labs were measured, which revealed an increase in progesterone and other sex hormones. This plant is typically used as part of a comprehensive treatment plan and should be monitored by your doctor. 

Stress Management for Hormone Regulation

There are numerous reasons as to why women experience stress, one of them being progesterone deficiency and its linked to mood imbalances. Low progesterone can lead to mood and mental health issues such as anxiety, depression, or anger. This can trigger a stress response, which propagates a vicious cycle due to the stress hormone cortisol negatively impacting sex hormones. 

It’s important to assist your body in adapting to stress as you work through the underlying root cause of your hormone dysfunction. Incorporating stress reduction practices into your activities of daily living can help you mentally, emotionally, and physically. This is also a catalyst for getting hormones into balance, as it is very much a two-way interaction between stress response and hormone regulation. Some helpful mind-body practices include meditation, yoga, and exercise. 

Sleep is also essential to healing. Creating a healthy sleep hygiene routine, getting enough hours of sleep, and restorative quality of sleep will help regulate your circadian rhythm. This is essential in supporting appropriate stress hormone responses. 

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Summary

Progesterone has numerous roles and benefits to health and well-being. Women who experience a deficiency in this hormone often are left feeling the mental, emotional, and physical implications. With the help of laboratory diagnostics and an integrative treatment plan, a holistic-minded doctor can assist you in optimizing your progesterone levels and regaining your vitality.