Lack of Progesterone: What You Should Know
Low progesterone is a common hormonal issue that can mess with your cycle, mood, sleep, and chances of getting pregnant. If your periods are irregular, spotting before your period, or you feel unusually anxious or tired around the luteal phase, low progesterone could be part of the problem. This page gives clear, practical steps for spotting it, testing it, and what to do next.
Causes & Common Signs
Why does progesterone fall? Often because ovulation didn’t happen or the corpus luteum (the structure that makes progesterone after ovulation) is short-lived. Causes include stress, extreme dieting or weight change, polycystic ovary syndrome (PCOS), thyroid problems, and perimenopause. Certain fertility treatments or medications can also affect levels.
Watch for these specific signs: irregular or short cycles, spotting before your period, trouble getting pregnant, more PMS and breast tenderness, low libido, and sleep problems. Some people notice mood swings, anxiety, or bloating in the second half of the cycle. If symptoms come every cycle and match your luteal phase (after ovulation), that pattern is a clue.
Testing and Treatment Options
Want to check for low progesterone? The common approach is a blood test during the mid-luteal phase—about seven days before your expected period or roughly day 21 in a 28-day cycle. Ovulation tracking (basal body temperature, ovulation kits) helps time the test right. Doctors may also use saliva or multiple tests across the cycle for a clearer picture.
Treatment depends on the cause. If you’re not ovulating, the first step is fixing ovulation with lifestyle changes or fertility meds. If you ovulate but progesterone is low, doctors often prescribe progesterone therapy—oral micronized progesterone, vaginal suppositories, or sometimes injections. Each method has pros and cons: vaginal forms act locally and can help the uterus lining, oral forms can cause drowsiness for some people.
Simple lifestyle steps help too: reduce chronic stress, avoid extreme dieting, maintain a healthy weight, and get regular sleep. Supporting nutrients include vitamin B6, magnesium, and zinc, but talk with your provider before adding supplements. Tracking your cycle and symptoms before starting treatment gives you and your clinician useful data.
Know the side effects and risks: progesterone can cause sleepiness, breast tenderness, spotting, or mood shifts in some people. It’s important to discuss medical history—especially blood clots, liver disease, or hormone-sensitive cancers—before using hormone therapy.
If you’re trying to conceive or have persistent symptoms, see a gynecologist or reproductive endocrinologist. They’ll run targeted tests, look for underlying issues like thyroid dysfunction or PCOS, and design a treatment plan that fits your goals—whether that’s regular cycles, symptom relief, or pregnancy.
Want a next step? Start tracking ovulation, note when symptoms appear, and bring that info to your provider. That small data habit speeds diagnosis and leads to simpler, safer solutions.
