8 Signs of Low Progesterone

Has your cycle been longer than usual lately? Or have you been dealing with headaches, and more feelings of anxiety? If yes, the underlying culprit may be progesterone. This hormone tends not to get as much attention as estrogen, but progesterone is a key hormone for the health and well-being of women, impacting everything from menstruation & your mood, to pregnancy and beyond.

We’ll explain what role progesterone plays in how you feel every day, and how you can evaluate your hormones to recognize and address this hormonal imbalance.

What Is Progesterone?

You may only know progesterone as being related to pregnancy, and while it’s a key player during that time, it’s actually of vital importance beginning in puberty and all the way through menopause.

Progesterone is produced primarily in the ovaries following ovulation, and in smaller amounts by the adrenal glands. Despite its association with pregnancy, progesterone is integral for a woman’s entire adult life, working in harmony with estrogen to regulate the menstrual cycle and ensure reproductive health.

Related: Adrenal Fatigue or Perimenopause?

Understanding the Role of Progesterone in the Body

From a holistic perspective, progesterone has far-reaching effects on your entire body. It is essential for maintaining the uterine lining, regulating the menstrual cycle, and even has a calming effect on the brain, being a precursor to the “feel-good” neurotransmitter GABA (1). In conjunction with estrogen, progesterone can impact:

  • Menstrual cycle patterns
  • Breast fibroids
  • Bone density and heart health
  • Mood, including worsening feelings of depression or anxiety

Read: Tone the Vagus Nerve to Reduce Stress & Balance Hormones

The Signs and Symptoms of Low Progesterone

When progesterone levels drop, the body’s delicate balance is thrown off-kilter, leading to a variety of signs and symptoms that can range from merely inconvenient to severely debilitating. 

These can include:

Irregular Menstrual Cycles

One of the most common signs of low progesterone is a short menstrual cycle, 24 days or less. Sometimes, your period may cease entirely, indicating a lack of ovulation.

Not ovulating is common with PCOS, and is a primary reason why those with PCOS may have trouble with fertility (2).

Premenstrual Syndrome (PMS)

Elevated estrogen levels (also called estrogen dominance) coupled with inadequate progesterone can exacerbate PMS symptoms, leading to severe mood swings, anxiety, and depression, and physical symptoms like breast tenderness and bloating (3).

Infertility and Miscarriage

Since progesterone is crucial for a successful pregnancy, significantly low levels can lead to difficulty conceiving or maintaining a pregnancy, often resulting in recurrent miscarriages.

Reduced Libido

Progesterone, in addition to estrogen, plays a role in sexual desire. A deficiency in this hormone can lead to a reduced sex drive, impacting sexual health and overall quality of life.

Insomnia and Sleep Disturbances

As a precursor to GABA, progesterone can have a calming effect on the brain. When levels are low, sleep disturbances, such as insomnia, can become prevalent.

Migraines and Headaches

Some women may experience an increase in the frequency and severity of migraines and headaches, potentially linked to fluctuations in progesterone levels.

Weight Gain

Changes in progesterone levels can also impact metabolism and lead to weight gain, especially around the midsection.

Mood Swings

Progesterone is thought to play a role in mood regulation. Low levels can lead to mood swings, irritability, and even depression (4).

Low Progesterone Sometimes Occurs Naturally

Low progesterone can occur at various stages in a woman’s life. These include:

During Menstrual Cycles

Throughout the month, progesterone levels fluctuate naturally. The first half of your cycle (beginning on day one of your period), known as the follicular phase, has the lowest levels of progesterone. 

The luteal phase of the menstrual cycle (the time between ovulation and the start of the next period) is when the body produces the most progesterone. If no ovulation occurs, or if the corpus luteum—the body responsible for progesterone production in the uterus—is not functioning properly, levels drop.


In the years leading up to menopause, the ovaries gradually produce less progesterone, leading to a hormone imbalance that can cause various physical and emotional symptoms. Perimenopause symptoms like insomnia and anxiety are common with decreasing progesterone.

Adrenal fatigue and/or cortisol dysfunction is common during this time also, which makes it harder for the body to cope with hormone shifts.

After Menopause

Once a woman has reached menopause, her ovaries stop producing progesterone. For some, bioidentical hormone replacement therapy can help you regain balance and reduce symptoms of estrogen dominance.

I talk more about the nuance, benefits, risks, and misunderstandings around bioidentical HRT in my latest book, The Hormone Shift.

PCOS or Endometriosis

Polycystic ovary syndrome (PCOS) and endometriosis, can also lead to fluctuations in progesterone levels.

Testing Progesterone Levels and Holistic Treatment Options

If you suspect you have low progesterone, you can measure levels using a blood test or saliva test.

If you’re not going through menopause (or perimenopause), progesterone levels should peak about 5 to 9 days after ovulation, so progesterone is usually checked 6 to 8 days after ovulation (or around day 21 if your cycle is 28 days long).

Once diagnosed, treatment options can range from conventional hormone therapy to more natural remedies, which may include:

Hormone Replacement Therapies

For many women hormone replacement therapy (HRT) can help rebalance estrogen and progesterone levels. This treatment is typically reserved for menopausal women or those experiencing significant disruptions due to perimenopause.

Don’t hesitate to be honest with your provider about how you’re feeling. Many women miss out on the benefits of bio-identical HRT trying to cope with symptoms.

Natural Progesterone Creams

Over-the-counter natural progesterone creams may relieve some symptoms of low progesterone when applied to certain parts of the body. It is important to use these under the guidance of a healthcare professional.

Lifestyle Changes

Making changes to your diet, reducing stress, and ensuring you get regular exercise can help support healthy hormone levels. Foods rich in certain nutrients, like zinc and magnesium, can aid in the production of progesterone.

Nutritional Supplements & Herbal Medicine

Vitamin and mineral supplements can also support the body’s hormone production. Some women may benefit from the use of chasteberry (vitex), a traditional remedy believed to stimulate the production of progesterone.

Traditionally used herbs like black cohosh, red clover, and maca root have been touted for their ability to promote healthy progesterone levels.

Read: Best Adaptogenic Herbs to Balance Hormones

Balance Progesterone Levels with Holistic or Integrative Medicine

Working with a holistic healthcare provider who practices personalized medicine can be beneficial. These practitioners take a comprehensive look at your health and develop unique treatment plans.

We help patients balance their hormones at my integrative medicine center in Atlanta and around the world with virtual visits. You can learn more about what we do here. 

The Takeaway

Low progesterone is not a condition to be taken lightly. It can significantly impact a woman’s health, fertility, and quality of life. However, with the right knowledge and approach, it is manageable. The first step is recognizing the signs and symptoms of low progesterone. From there, you can explore the wide array of treatment options, both at home and by working with a holistic provider. Remember, you are not alone in this experience, and there is always hope for managing hormonal imbalances effectively.