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Progesterone Deficiency: Treatment, Procedure, Cost and Side Effects

Last Updated: Oct 28, 2021

What is the treatment?

Progesterone is one of the two hormones present in the reproductive system of women. It prepares the uterus for pregnancy and is known as the ‘pro-gestation hormone.’ Not only does progesterone prepare the body for pregnancy, but it also regulates the menstrual cycle in women. Progesterone levels drop off if pregnancy does not occur and a menstrual period takes place. Progesterone receptors are also found in the brain, breasts, bones and blood vessels.

Progesterone levels tend to fluctuate throughout the menstrual cycle. They usually peak a week before periods and even varies during the course of a day. It is natural for estrogen and progesterone levels to drop during menopause while, ordinarily, poor progesterone production is primarily the function of ill-performing ovaries. Low progesterone levels may result in toxemia or ectopic pregnancy which can further lead to miscarriage or death of the fetus.

Cream and gels, which can be used topically or vaginally in the case of women are said to enhance progesterone production. Suppositories are used to treat fertility problems resulting from low progesterone count. Another treatment option is the use of vaginal rings which cause hormones to be released slowly. Various oral medications can also be used to treat this condition. Moreover, there are 3 different ways by which progesterone deficiency can be addressed. They are making some changes in lifestyle, use of medicine (herbal and others) and hormone replacement therapy.

What are the signs of Low Progesterone?

Signs of Low Progesterone can be as simple as a headache or can be complicated as Fibroids some of the signs are:

  1. Headaches or Migraines: The imbalance between the level of estrogen and progesterone can create a headache. Especially pre and during menstruation migraines can occur. Also if the level of estrogen is higher than progesterone, it can lead to vasodilation and water retention which often cause headaches and migraines.
  2. Unpleasant and unstable mood swings: One of the main jobs of progesterone is connected to GABA neurotransmitters. Low Progesterone mainly causes an interruption in the neurotransmitter which can make you feel irritated, anxious, depressed and in some cases, it can lead to insomnia and anxiety disorder.
  3. Unexpected weight gain: Low level of progesterone, could lead to weight gain as it will unbalance the overall hormonal system.
  4. Irregular Menstrual Cycles: Since progesterone is one of the key hormones responsible for regulating the menstrual cycle, One of the common symptoms of Low Progesterone is irregular periods. Its main work is thickening the endometrial lining and making it ready for pregnancy. Imbalance in the levels of progesterone can cause unpredictability in the period cycle like it can make it longer or shorter.
  5. Infertility: Progesterone is the main hormone that is responsible for regulating the menstrual cycle, a low level of progesterone can also affect an individual's fertility. If your body has a low level of progesterone the egg implantation and thickening of the endometrial lining can also get affected. Even though infertility and miscarriages may have many other major reasons, low levels of progesterone can also be the one.
  6. Hot Flashes: One of the main reasons behind hot flashes is an imbalance in the hormonal system. Low levels of progesterone can increase the levels of estrogen, raising the temperature of the body.
  7. Fibroids, Endometriosis: The medical condition is not directly related to low levels of progesterone yet it is one of the main reasons why this happens. Low levels of progesterone create a sudden increase in the levels of estrogen which can also lead to heavier cycles, broids, endometriosis, cysts, and cystic breasts.

What happens when progesterone levels are low?

When your progesterone level is low, women often suffer from problems associated with hormonal imbalance. Some of them are:

  • Abnormal menstrual cycles.
  • Infertility and difficulty in conceiving.
  • Complicated pregnancy which includes miscarriage and preterm delivery.

Not only do the complications occur during menstruation years but also during the menopausal phase where it is common to have a hormonal imbalance. Even hormonal treatments sometimes have side effects that cause progesterone deficiency. Birth control pills also cause side effects which include fluctuation in blood sugar and pressure.

What causes a progesterone deficiency?

The root cause of imbalance in the levels of progesterone is underlying medical conditions associated with ovaries or uterus.

Does Low Progesterone cause hair loss?

Low levels of female hormones like progesterone and estrogen can cause hair thinning and even fall. An imbalance in hormones also causes your new hair to grow slowly and in severe cases, it also leads to baldness in some cases.

Can Low Progesterone cause insomnia?

Any type of hormonal imbalance can cause sleep interruption as it will cause a disturbance in the whole body. Progesterone deficiency is one of the main reasons in case of sleep interruption due to hormonal imbalance. Even an increase in estrogen level as compared to progesterone can cause insomnia and sleep interruption.

How is the treatment done?

The simplest but not the easiest treatment for progesterone deficiency is making some lifestyle changes. Progesterone levels drop when estrogen level is high. So it is important for a person suffering from progesterone deficiency to have foods that regulate stable estrogen level like apple, alfalfa, soy, potatoes, rice, wheat etc. Some of the foods that help to boost production of progesterone are olives, avocados, nuts, seeds and oils. It is also essential to regulate the level of stress in a person with progesterone deficiency. Thus, that person should adopt techniques like yoga or meditation and he/she should also exercise daily.

Lifestyle changes, although helpful in reducing the symptoms of progesterone deficiency, do not address the root of the problem. This is why alternate medicines are used, of which herbal medicine is the most prominent. The two types of herbs can be beneficial for treating progesterone deficiency are: phytoestrogenic herbs and hormone-regulating supplements. Phytoestrogenic herbs introduce plant-based estrogens in the body. Hormone-regulating supplements stimulate the production of hormones by causing the endocrine glands to produce natural hormones more efficiently.

The third approach to treat progesterone deficiency is the hormone replacement therapy. However, this method costs a lot and is often associated with a number of serious risks.

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Who is eligible for the treatment? (When is the treatment done?)

Women who have not reached menopause have low progesterone levels. Again, women who do not experience regular periods or women who do not ovulate normally generally have low levels of progesterone. There are, however, some symptoms which help to understand whether a person has progesterone deficiency or not. These symptoms are premenstrual mood changes, insomnia, anxiety, infertility, recurrent miscarriage, painful or lumpy breasts and unexpected weight gain. A person suffering from one or more of these symptoms should take medical advice and undergo required treatment.

Who is not eligible for the treatment?

Progesterone deficiency normally has a number of symptoms. They include menstrual irregularities, infertility, brittle nails and dry skin, depression, anxiety, mood swings, low libido, fatigue, slow metabolism leading to weight gain and migraines, headaches and pain in the joints. Furthermore, a progesterone test helps a doctor to understand whether a person is indeed suffering from progesterone deficiency or not. Hence, without proper medical advice and without any of the symptoms associated with low progesterone levels, a person is not eligible for treatment.

Are there any side effects?

Hormone replacement therapy may increase the chances of developing heart disease, blood clots and even cause strokes. Women who have had strokes or blood clots should not do opt for this treatment. Hormone replacement therapy increases the risks of breast cancer. It can also cause swelling or tenderness of the breasts. This therapy can cause bloating, fluid retention and nausea. A person can even develop gallstones or other gallbladder problems.

What are the post-treatment guidelines?

Medicines or the hormone replacement therapy may help you to deal with progesterone deficiency and its symptoms for the time being. But a person will still need to maintain a healthy lifestyle and incorporate healthy foods in his/her diet. This will help him/her to find a long-lasting solution to the problem. The lesser side-effects of hormone replacement therapy usually subside with the passage of time. Therefore, it is necessary to remain under medical supervision for at least up to 3 months after the treatment.

How long does it take to recover?

A man undergoing hormone replacement therapy usually see improvement in 4-6 weeks. Women can experience resolution of their problems like hot flashes and night sweats within a few days. However, it can take several weeks before a woman can experience improvements in memory or neurological problems. A person can understand the benefits as soon as the hormone levels reach a balance. A person who had not had hormonal balance for a fairly long time is will surely take more time to experience the good effects.

What is the price of the treatment in India?

Hormone-regulating supplements can cost anything between Rs 500 and Rs 2000 in India. More expensive variations are also available. Hormone replacement therapy generally requires the consumption of a medicine in the form of a pellet about three times per day. The cost of these pellets comes to around Rs 280 per day. Thus the cost of medicines for hormone therapy for a whole year will be Rs 3360 approximately. This does not include the consultation fee of the doctor and the cost of post-treatment check-ups and other expenses.

Are the results of the treatment permanent?

A healthy lifestyle which incorporates nutritional food and a fair bit of exercises can go a long way to control the symptoms of progesterone deficiency. However, this does not address the root of the problem. Hormone regulating supplements stimulate the production of natural hormones in our body. They are considered the safest to treat the symptoms of progesterone deficiency. However, there is no proof that they provide permanent relief from the disorder. Hormone replacement therapy can produce favorable results but the person might have to continue with the therapy for a long period of time.Thus a permanent solution is rather difficult to get.

Which foods are high in progesterone?

Foods that are rich in vitamin B6 and zinc will help you boost your progesterone level.

Foods that are rich in vitamin B-6 include:

  • Chickpeas
  • Lean red meat
  • Tuna
  • Spinach
  • Potatoes
  • Bananas

Foods that are high in zinc are:

  • Shellfish
  • Chickpeas
  • Cashew nuts and almonds
  • Kidney beans

Apart from that, it is important to have a balanced diet to ensure the overall health of the body. A healthy diet will boost your immunity and strengthen your hormonal system.

How can I increase my progesterone levels naturally?

Here are some of the remedies that can increase your progesterone levels naturally:

  1. Reducing stress: Stress is one of the major reasons for hormonal imbalance, excess stress can cause unbalance in the levels of ovaries and sex hormones. Stress management techniques like exercising, meditation, and journaling can be a great way to cure the problem.
  2. Taking herbs and supplements: Herbal extracts like chaste berry and evening primrose oil are rich sources of progesterone which will help you maintain hormonal balance. Even though they are natural and don't have any side effects, it is advisable to consult your physician before consumption.
  3. Getting regular sleep: Like stress, interrupted sleep can cause hormonal imbalance. It is important to have 7 and 9 hours of REM sleep every day to keep hormonal in check.
  4. Maintaining a healthy weight: Women who weighed high or lower than the optimum Body Mass Index often have complaints about hormonal imbalance, especially women with obesity, who often have progesterone imbalance. Keep your weight in check and keep your hormonal levels intact for a healthy life.

What are the alternatives to the treatment?

You can treat progesterone levels by incorporating foods reach in magnesium like dark leafy greens, fish, whole grains, nuts and seeds. A woman suffering from progesterone deficiency should consume 250-500 mg of Vitamin C per day. Foods rich in zinc and Vitamin B6 are also beneficial to tide over the progesterone deficiency. Natural progesterone cream, which is bio-identical hormone cream, helps to boost progesterone levels. Diindolylmethane is also helpful in maintaining a healthy level of the hormone.

Summary: Progesterone deficiency is a medical condition in which the hormone progesterone is found low in the patient's body. In most cases it balances out on its own, but if not it can cause serious imbalance in other bodily functions.

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Written ByDr. Jayashri S MBBS,MS - Obstetrics and GynaecologyGynaecology
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