How Progesterone Influences Fertility, Pregnancy, and Menopause

Progesterone (黃體酮) is a key hormone in women's reproductive health. It influences fertility, the course of pregnancy, and the onset of menopause. Understanding how to manage progesterone levels can help optimise health and well-being during these critical phases of a woman's life. 

Where is Progesterone Produced?   

Progesterone (黃體酮) is primarily produced in the ovaries and the adrenal glands. During pregnancy, the placenta also takes over progesterone production to maintain a healthy pregnancy until the delivery of the baby. In males, small amounts are produced in the adrenal glands and testes. Progesterone production is crucial for regulating the menstrual cycle, supporting pregnancy, and influencing sexual health in both genders. 

Progesterone Effect in Women 

The following are some of the main effects of progesterone in women: 

• Maintain normal menstrual cycle, together with oestrogen 

• Maintain a normal pregnancy until delivery (the “hormone of pregnancy”)

• Promote breast milk gland growth in normal (non-pregnant) breast development and during pregnancy 

• Promotes bone formation, protective against osteoporosis, together with oestrogen 

• Plays a major role in the hypothalamic-pituitary-adrenocortical hormone axis of the body 

• May have neuroprotective function against degenerative diseases of the brain and nervous system 

Progesterone plays a critical role in women’s reproductive health, but imbalances can lead to a variety of side effects. Having either too much or too little progesterone can affect a woman's overall well-being.

Symptoms of Low Progesterone in Women:

• Irregular or missed periods: A decrease in progesterone may disrupt the menstrual cycle, making it unpredictable.

• Difficulty in conceiving: Low progesterone levels can make it difficult for the body to prepare the uterus for pregnancy.

• Mood swings and depression: As progesterone has a calming effect, low levels can cause irritability, anxiety, or depression.

• Spotting or bleeding between periods: Low progesterone may lead to abnormal uterine bleeding and possible development of endometrial hyperplasia (due to unopposed oestrogen) and risk of endometrial cancer.

• Low libido: Progesterone imbalance often affects sexual drive and satisfaction.

Symptoms of High Progesterone in Women:

• Bloating and weight gain: High progesterone levels can lead to water retention and bloating, particularly during the luteal phase of the menstrual cycle.

• Mood changes: Excess progesterone may cause mood swings, similar to symptoms of premenstrual syndrome (PMS).

• Fatigue and sluggishness: High progesterone levels can lead to a sense of constant fatigue or lethargy.

• Breast tenderness: Swelling and tenderness of the breasts are common when progesterone levels are high, especially before menstruation.

• Headaches or migraines: Hormonal fluctuations, including high progesterone, can trigger headaches or migraines in some women.

Symptoms of High Progesterone in Women:

While progesterone supplements can be beneficial for managing hormonal imbalances, fertility issues, or menopausal symptoms, here are side effects that you should report to your care team as soon as possible:

• Breast Tenderness: Increased progesterone levels from supplements may cause swelling and tenderness in the breasts, which can be uncomfortable.

• Bloating and Water Retention: Progesterone can lead to fluid retention, causing bloating and weight gain. This is more common in higher doses.

• Mood Swings: Some women experience mood fluctuations, irritability, or anxiety when taking progesterone supplements, particularly if the dosage is not well-balanced.

• Fatigue and Drowsiness: Progesterone has a calming, sedative effect on the brain, which can lead to excessive tiredness or a sense of sluggishness, especially when taken in the evening or at bedtime.

• Headaches or Migraines: Hormonal changes can trigger headaches in some individuals, and progesterone supplements may increase the likelihood of migraines, especially in those who are already prone to them.

• Nausea: Some women may experience nausea or gastrointestinal discomfort when using oral progesterone or other forms of supplementation.

• Irregular Bleeding: Progesterone supplements can sometimes cause breakthrough bleeding or changes in menstrual patterns, particularly during the adjustment phase.

• Depression: In some cases, progesterone supplementation can exacerbate symptoms of depression, especially in individuals with a history of mood disorders.

• Acne and Oily Skin: As progesterone can influence the skin’s oil production, some users may notice an increase in acne or changes in skin texture.

• Dizziness: Some women may experience dizziness or lightheadedness as a side effect of progesterone supplements, particularly when starting or adjusting the dosage.

Important Note: It is crucial to consult with a healthcare professional before starting any progesterone supplementation. The correct dosage and form should be carefully monitored to avoid adverse effects, and regular check-ups should be done to ensure hormone levels remain balanced.

How to Normalise Progesterone Levels in the Body? 

Normalising progesterone levels can benefit women experiencing low progesterone symptoms, which can primarily affect disrupt menstrual cycles and cause fertility problems. Methods to boost low progesterone include: 

• Dietary Adjustments: Consuming foods like beans, broccoli, spinach, and nuts, which are rich in magnesium, vitamins B and C, can help enhance progesterone production. 

• Lifestyle Changes: Reducing stress through yoga and meditation can help, as stress is known to decrease hormone production. 

• Supplements and Progesterone Cream: Using over-the-counter progesterone creams and taking supplements like vitamin B6, zinc, and L-arginine can aid in increasing progesterone levels. (Please consult with your doctor prior to using topical hormone preparations to be aware of precautions and possible side-effects). 
  
  

What Time of Day is Progesterone Highest?

Progesterone levels fluctuate throughout the day, typically peaking in the morning. This diurnal variation is why it's often recommended to test hormone levels in the morning to obtain a more accurate reading of the body’s progesterone status. 

Progesterone Effect in Men   

Although progesterone is commonly referred to as a female hormone, it does have effects in men such as: 

• Influences spermiogenesis, the development of sperm cells 

• Affects testosterone production in the testes 

• Central nervous system affects such as sleep improvement and effects on certain tumors 

How to Normalise Progesterone Levels in Men?   

High levels of progesterone in men can lead to side effects such as fatigue, decreased libido, and depression. To lower high progesterone levels, men can: 

• Adjust Diet: Limit foods that increase progesterone production, such as nuts and dairy products. 

• Exercise: Regular physical activity can help regulate hormones and reduce progesterone levels. 
• Consult a Healthcare Provider: Men experiencing high progesterone symptoms should seek professional medical advice. A healthcare provider might recommend medications that inhibit progesterone production.
   

How to Increase Progesterone in Perimenopause and Menopause

As women transition into menopause, balancing progesterone levels becomes crucial to manage symptoms like hot flashes, mood changes, and irregular periods. Here are some strategies to specifically boost progesterone during this time:

• Herbal Supplements: Herbs like chasteberry (Vitex) can help naturally support progesterone production and balance hormones. Unlike phytoestrogens, which mimic oestrogen, chasteberry helps stimulate the body's production of progesterone.

• Bioidentical Hormone Replacement Therapy (BHRT): In cases of significant hormone imbalances, some women may consider using bioidentical progesterone under medical supervision. This treatment involves using hormone preparations that are chemically identical to those the body produces, helping to restore progesterone levels during perimenopause or menopause.

• Healthy Fats: Including more healthy fats in your diet, such as those found in avocados, coconut oil, and flaxseeds, can support hormone production. Omega-3 fatty acids, in particular, are beneficial for regulating hormone levels.

• Manage Stress: Elevated stress levels increase cortisol production, which can lower progesterone. Incorporating stress-relieving activities such as proper sleep, yoga, meditation, and mindfulness can help maintain a healthier hormone balance.

• Balanced Diet: Focus on foods rich in magnesium, vitamin B6, and zinc, such as leafy greens, nuts, and seeds. These nutrients play a key role in progesterone production.

By focusing on naturally supporting progesterone levels during perimenopause and menopause, women can alleviate symptoms and promote hormonal balance.

Progesterone is a vital hormone with significant implications for women's health, affecting everything from fertility to the transition into menopause. Whether you're looking to increase or decrease your progesterone levels, it is important to approach changes holistically and under the guidance of a healthcare professional. Understanding how to manage and optimise progesterone levels can significantly enhance their overall health and well-being during various stages of life. 

References

1. Cleveland Clinic. Progesterone. 25 June 2024 Retrieved from https://my.clevelandclinic.org/health/body/24562-progesterone   
2. WedMD. Progesterone - Uses, Side Effects, and More. 25 June 2024 Retrieved from https://www.webmd.com/vitamins/ai/ingredientmono-760/progesterone  
3. Healthline. Everything You Need to Know About Progesterone. 25 June 2024 Retrieved from https://www.healthline.com/health/progesterone-function  
4. Kolatorova, L, et. al., Progesterone: A Steroid with Wide Range of Effects in Physiology as Well as Human Medicine, 20 July 2022, International Journal of Molecular Sciences, Retrieved on 04 July 2024 from https://www.mdpi.com/1422-0067/23/14/7989 
5. Franco, O.H., et. al., Use of Plant-Based Therapies and Menopausal Symptoms, A Systematic Review and Met-analysis, 21 June 2016, Journal of the American Medical Association, Retrieved on 04 July 2024 from  https://jamanetwork.com/journals/jama/fullarticle/2529629