Do irregular menstrual cycles, mood swings, and skin issues have you down? Are you experiencing infertility, a decreased sex drive, or just plain old fatigue? These are all signs you may be suffering from low progesterone levels. Read on to learn what progesterone actually is and whether low levels are something you should worry about. Plus, discover seven symptoms of low progesterone and what you can do about them.

What Is Progesterone?

Progesterone is one of the two primary sex hormones for women — the other being estrogen. The hormone is necessary for women to maintain healthy fertility and a regular menstrual cycle. While progesterone is commonly considered a female hormone, men also produce it in smaller amounts (along with estrogen). However, testosterone is the primary sex hormone in males. To make things even more confusing, women also produce testosterone, albeit in smaller quantities than men. Now that you know all the sex hormones, let’s get back to progesterone. In women, progesterone production occurs in the ovaries following ovulation. Its primary role is to prepare the uterus for pregnancy by readying it to “receive, implant, and support” a fertilized egg (1). Right after ovulation (also known as the luteal phase of the menstrual cycle), your progesterone levels increase. Progesterone levels remain high for about five days before they decrease again. This increase in progesterone tells the lining of the uterus to thicken and get ready to receive a fertilized egg. If the egg implants, progesterone levels begin to rise from week nine to week 32 of pregnancy, supporting the uterine lining. After week 12, the placenta also begins to produce progesterone to help maintain a healthy pregnancy. If there is no pregnancy, progesterone levels fall and menstruation occurs (1).

Is Low Progesterone Something to Worry About?

First, it’s important to point out that progesterone levels naturally fluctuate with your menstrual cycle and with pregnancy. Progesterone levels are lowest during the follicular stage of your menstrual cycle then increase during the luteal stage. Progesterone levels also increase as pregnancy progresses — they are lowest in the first trimester, higher in the second, and highest during the third (1). These higher progesterone levels are actually to blame for some pregnancy symptoms, including breast tenderness. Progesterone levels are lower in girls who haven’t reached puberty yet as well as in postmenopausal women (1). The decline in both estrogen and progesterone during menopause is believed to be the cause of hot flashes, among other menopausal symptoms (2). If you plan on having children, low progesterone levels could cause problems when it comes to pregnancy — both getting and staying pregnant. If your progesterone levels are low during pregnancy, this could indicate that you’re at a higher risk of miscarriage (1). If you aren’t pregnant and your progesterone levels are lower than expected, you may be suffering from a condition known as hypogonadism — whereby your body doesn’t produce enough sex hormones (1). If you're concerned about your progesterone levels, you can ask your doctor for a progesterone blood test, which will measure the amount of progesterone in your blood.

7 Low Progesterone Symptoms

Hormonal imbalance can occur when the balance of estrogen and progesterone is disrupted. When hormone levels are out of whack, either from low progesterone levels or high estrogen levels, a state of estrogen dominance can occur. When progesterone and estrogen are balanced, progesterone stops excessive tissue growth, which could eventually lead to cancer, including uterine cancer, endometrial cancer, and breast cancer. But when estrogen is unopposed — due to inadequate progesterone — excessive tissue growth can result. The symptoms of estrogen dominance and low progesterone are very similar to one another. Here are seven symptoms of low progesterone to watch out for. Any one of these symptoms could also indicate estrogen dominance, so it’s best to work with your healthcare provider if you’re concerned about a hormone imbalance.

1. Irregular Menstrual Cycles and PMS Symptoms

In a 2019 study, researchers determined that a variety of symptoms associated with the menstrual cycle can be traced back to low levels of progesterone, including “irritability, depression, anxiety, bloating, fatigue, and breast tenderness” (3). Low progesterone is also believed to play a role in abnormal periods, including late or missed periods. In a 2012 study in the Journal of Clinical Endocrinology and Metabolism, researchers found that women with both longer and shorter cycles had lower levels of progesterone than those with normal-length menstrual cycles (4).

2. Mood Changes, Anxiety, and Depression

Studies show an increase in anxiety, irritability, nervousness, and depression at different life stages when progesterone is low, particularly during the premenstrual phase (or luteal phase) of the menstrual cycle, or in women experiencing menopause (5, 6).

3. Headaches and Migraines

The same study that uncovered the association between progesterone and PMS (premenstrual syndrome) symptoms also found that sex hormones, particularly progesterone, play a role in headaches, too (3). Researchers don’t yet know exactly how progesterone and other sex hormones effect headaches, migraines, or other PMS symptoms.

4. Infertility

Progesterone is one of the key hormones that prepares the lining of the uterus — known as the endometrium — for pregnancy. Researchers say that inadequate levels of progesterone could therefore be to blame for “recurrent pregnancy loss and infertility” (3).

5. Skin Issues, Including Acne, Dry Skin, and Brittle Nails

If you have skin issues, your body may not be making enough progesterone. According to Naturopathic Doctor Alaina Overton, “having low progesterone in relation to estrogen can increase blood sugar levels. This leads to androgen excess, which amplifies testosterone production in the skin, producing unwanted acne. Dry, dull skin, brittle, cracked, or peeling nails, and hair loss can also be signs of a shift in hormones” (7).

6. Low Libido or Sex Drive

Scientists know that the sex hormones estrogen, testosterone, and progesterone all play a role in sex drive. Exactly how they impact your libido is not entirely understood yet. According to Krisha McCoy of Everyday Health, “researchers are still working to understand the role that progesterone plays in a woman's sexual function, but changing levels of progesterone are thought to be involved in a woman's sexual behavior” (8).

7. Weight Gain

When your hormones are imbalanced and progesterone is low while estrogen is high, estrogen dominance occurs. According to Dr. Christiane Northrup, a leading naturopathic doctor (ND) in the study and treatment of women’s health issues, this can cause you to gain weight, particularly around the midsection and hips (9).

Treatment Options for Low Progesterone

Low progesterone does not always negatively affect your health. In fact, you may not have any symptoms at all. Not everyone requires treatment for low progesterone. However, if you’re trying to get pregnant, hormone replacement therapy can be helpful. In this case, hormone therapy increases your progesterone levels, which helps support a healthy uterus throughout your pregnancy. Some individuals who wish for more regular periods choose to take birth control pills. These are often a combination of synthetic progesterone (one type is called progestin) and estrogen. Hormone therapy is not without its side effects. According to Ana Gotter of Healthline, “it may increase the risk of heart attack, stroke, blood clots, gallbladder troubles, and certain types of breast cancer” (10). If you have a history of certain types of cancer, including breast cancer and endometrial cancer, liver disease, blood clots, or stroke, hormone therapy is not recommended (10). If you would like to avoid the risks associated with synthetic hormones, consider natural treatment options for low progesterone. A good place to start is reducing stress, getting enough sleep, exercising, and taking hormone balancing herbs.

Low Progesterone Symptoms: The Key Takeaway

Progesterone is a primary sex hormone in women. Progesterone levels go up and down depending on where a woman is in her menstrual cycle, whether or not she is pregnant, and whether she is experiencing menopause. Symptoms of low progesterone include irregular menstrual cycles, PMS, mood swings, anxiety, depression, headaches, migraines, infertility, acne, dry skin, brittle nails, a low sex drive, and weight gain. If you’re concerned about your progesterone levels, your doctor can order a blood test. Many people with low progesterone don’t experience any symptoms or need treatment. For those looking to pursue treatment, hormone replacement therapy is a common option. Natural treatment options include reducing stress, getting adequate sleep, and taking hormone balancing herbs. As a friendly reminder: we’re not doctors and this information does not constitute medical advice. Always consult your healthcare provider if you’re concerned about hormone imbalance. If you’re ready to take control of your hormones, sign up for our email list and receive exclusive health tips straight to your inbox.