Progesterone Deficiency: Infertility, Irregular Cycles and More

Low progesterone production is a significant and frequent finding in the realm of women’s healthcare. It is no wonder that the term estrogen dominance can be found throughout magazines, health blogs and other sources of medical media. While estrogen dominance does exist, the label is often over-used and does not differentiate between the unique forms of hormone imbalance facing women of all ages.

Names and labels aside, low progesterone is at the root cause of various symptoms, including infertility, irregular cycles, painful & heavy periods, breast pain, premenstrual syndrome, poor sleep, and more. In addition to its direct roles in menstruation and pregnancy, progesterone is involved in multiple physiological processes such as water balance, and nervous system function. At healthy levels, it prevents excess water retention, and helps to calm the nervous system through its effect on neurotransmitters in the brain. For these reasons, low progesterone can cause pre-menstrual symptoms like bloating and weight gain, mood changes and poor sleep.

Lets discuss a few of the common health complaints linked to progesterone deficiency:

Infertility
Progesterone has the unique job of sustaining a healthy uterine lining for the two weeks following ovulation. This short window is necessary for conception. Furthermore, the ovaries must produce enough progesterone to support pregnancy for the first 10 weeks, until the placenta takes over.
The term luteal phase defect refers to a period of less than 10 days between ovulation and the 1st day of bleeding. Many women suffer from this symptom of progesterone deficiency without knowing it, even if they have a seemingly normal, 28 day cycle. Every women struggling with infertility should consider progesterone deficiency as a potential causes; your healthcare practitioner can help your to properly track your cycle, and order blood tests when needed.

Irregular Cycles
Progesterone deficiency often plays a role in menstrual cycles that are irregular. If your cycle does not occur on a monthly basis, or the time between your menstruation changes, you likely have an imbalance between progesterone and estrogen. This imbalance may be relative (meaning your progesterone is within normal range, but your estrogen levels are high), or purely due to low production of the hormone.

Uterine Fibroids & Endometriosis
Estrogen plays the role of stimulating tissue growth in the uterus to prepare for ovulation and pregnancy. Progesterone is responsible for balancing this and other effects of estrogen so that the tissue does not grow in excess.
When this balance fails, patients may develop signs of excess estrogen stimulation, including endometrial hyperplasia (overgrowth of uterine lining) and fibroids (benign tumors of the uterus). Insufficient progesterone is also suspected to play a role in endometriosis, a painful condition in which uterine tissue grows outside of the uterus. Though fibroids and endometrial hyperplasia are more common in middle-aged women heading toward menopause, all three may occur in young women and play a role in infertility.

Thankfully, low progesterone and associated hormone imbalances can often be corrected via botanical therapies, physiological hormone replacement, or both. When properly dosed, studies show that Vitex agnus-castus can significantly increase progesterone production. Likewise, there are hormone precursors that can be safely supplemented by your healthcare practitioner to support your body’s hormone production. When indicated, physiological doses of bio-identical progesterone can also reverse the symptoms of progesterone deficiency.

Dr. Kaley Bourgeois

References:
Natural Medicines Comprehensive Database. Updated Jan 4, 2013.
http://naturaldatabase.therapeuticresearch.com/