Progesterone Insufficiency

In menstruating women, progesterone is one of two primary sex hormones (the other being estrogen) produced each month by the ovaries. During the first 14 days of the menstrual cycle (called the follicular phase), the ovaries secrete increasing amounts of estrogens, halfway through a woman’s cycle, typically around day 14, a follicle on one of her ovaries will ovulate and release an egg. After ovulation, the follicular tissue from which the egg was released then transforms into the corpus luteum and begins producing progesterone. Therefore, this second half of the cycle, called the luteal phase, will have increased progesterone. Progesterone's role is to maintain the lining of the uterus which makes it possible for a fertilized egg to implant if you're trying to get pregnant. Normally, the luteal phase should last ~14 days. If the egg fails to be fertilized and no pregnancy occurs in that time, the production of both progesterone and estrogen will rapidly decline, resulting in a period.

Luteal Phase Defect

Women who have too little progesterone during the second half of the cycle often have a shortened luteal phase (called a luteal phase defect). Can contribute to infertility and early pregnancy loss. If a woman has a cycle shorter than 26 days, and ovulation is around cycle day 14, the shortened luteal phase may not allow sufficient time for implantation. The chemical signals that trigger the period to start begin 3-4 days prior to the onset of menses. A fertilized embryo takes approximately 5-7 days to get to the endometrium, where it can implant. A shorter cycle can cause those time frames to overlap so that the menstruation process begins prior to implantation.

How to increase progesterone

There are plenty of natural ways to increase progesterone:

  1. The most important is to decrease stress. Chronic stress increases the secretion of cortisol (stress hormones) at the expense of sex hormones (namely, progesterone). So whether is it cutting toxic people out of your life, a meditation practice, increasing time outdoors, or taking more hot baths, find a stress management practice that works for you.

  2. Eat more healthy fats. All steroid sex hormones come from cholesterol, so you need cholesterol to produce progesterone. Focus on healthy fats, like those from cold-water fish (salmon), grass-finished meat, olive oil, nuts, seeds, and avocado.

  3. Vitex (chaste tree). This is one of my favorite herbs for luteal phase defect. It increases LH secretion from the brain to stimulate progesterone production.

  4. Vitamin B6. Vitamin B6 possesses “progesterone-like effects” and has been shown to reduce estrogen while increasing progesterone levels. And definitely eat some of the following B6-rich foods: liver and other organ meats, fish, poultry, egg yolk, dried beans, peanuts, walnuts, banana, prunes, cauliflower, cabbage, and avocado. 

  5. Talk to your doctor about bioidentical progesterone supplementation.