Progesterone Levels:

Does low progesterone cause any major symptoms?

What side effects come from high progesterone levels?

How about optimal progesterone levels? How do they affect women?

Child-Bearing Years

In women of child-bearing age, progesterone levels go up every month after ovulation, then subside. So progesterone is pretty high during the second half of a woman's monthly cycle (called the luteal phase) and pretty low during the first half (called the follicular phase).


Over a woman's lifetime, progesterone gradually declines over the 4 to 6, even 10 years leading up to menopause. It still has these little month-to-month bursts that happen after ovulation. But ovulation starts sputtering as you get closer to menopause. You may not ovulate every single month, which often means your progesterone's going to be low that month.

Estradiol fluctuates wildly during perimenopause. Some days it's really high and some days non-existent. That means there could be stretches where you experience estrogen dominance. That's where there's too much estradiol IN RELATION to the progesterone. It's not that the absolute estradiol level's too high. It's that the relative level of estradiol is overpowering the progesterone.


By the time you stop having periods, your progesterone level is really close to zero. In some ways, it's good that estradiol also drops to almost zero. There's no longer estrogen dominance. Now you have a different set of problems that are caused by too little estrogen or estradiol. I posted another video about that scenario.

Low Progesterone Causes

These are the 4 main low progesterone scenarios and the impacts of each one

Low progesterone could be caused by :

  • No ovulation - often related to PCOS (polycystic ovarian syndrome)

Ovulation is the release of an egg from the ovary. After that egg gets released, there's tissue leftover inside the ovary called the corpus luteum. That corpus luteum is where progesterone comes from, for the most part.

In PCOS (polycystic ovarian syndrome) ovulation doesn't happen every month. So that means there's no leftover tissue or corpus luteum where the egg came from. The fact that there's no corpus luteum means the main source of progesterone is missing. Because ovulation doesn't happen, at least not every month, there's a shortage of progesterone.

Low progesterone isn't exactly a cause of PCOS but it's a major feature of it.

  • Postpartum - having a baby causes a huge drop in progesterone in just a few hours
  • Perimenopause - ovulation happens less and less. Progesterone declines gradually over 4-6 years
  • Menopause - ovulation doesn't happen at all. No progesterone coming from corpus luteum or ovaries

Low Progesterone Effects

Sub-optimal progesterone levels can lead to depression. Common examples include postpartum depression and menopausal depression. Both are caused by a drop in progesterone levels. Postpertum depression happens rapidly and post-menopausal depression comes on gradually.

Low progesterone can cause or worsen anxiety. Some women have talked about post-menopausal or perimenopausal anxiety so severe, they can barely leave their house. Some women have anxiety so severe, they can't even walk out to check the mail.

Insomnia is extremely common in women, beginning around the time of perimenopause. Progesterone levels that are too low mean sleep is never all that deep or restful. The sleep deprivation from low progesterone is a major cause of brain fog and forgetfulness in menopause or perimenopause.

High Progesterone Effects

Nausea: very high levels of progesterone during pregnancy may be related to the nausea of morning sickness. In addition, other hormones like estradiol and HCG can make nausea worse.

Drowsiness: progesterone helps with sleep and high levels can make you drowsy during the day. Side note - progesterone applied to the skin in a transdermal cream has little to no effect on insomnia. Only oral progesterone is metabolized into a derivative that helps with sleep issues.

Depression and anxiety: some women experience paradoxical anxiety and depression with increased progesterone although most have the opposite effect.

Headaches: migraines or other types of headaches may be related to high progesterone levels. Some women experience headaches as a result of estrogen dominance.

Optimal Progesterone

Optimal levels are not too high, not too low, but just right. This chart shows 10ng/ml as about the average progesterone during the luteal phase of a woman's monthly cycle.

Optimal Progesterone Graph

Just right levels of progesterone enhance sleep, decrease insomnia, decrease the fog of menopause that's related to sleep deprivation.

Just right progesterone levels reduce anxiety and depression in postpartum and menopausal women.

Progesterone reduces symptoms of estrogen dominance in women experiencing PCOS or perimenopause. It can help reduce hot flashes and night sweats in menopause, although not as effectively as estradiol. Optimal progesterone levels can also help reduce these long-term risks in menopause:

  • osteoporosis
  • endometrial overgrowth
  • endometrial cancer
  • Alzheimer's Disease

If you're a patient, looking for help with your progesterone, estradiol, or you're not really sure . . . there's a link at the bottom of this page to request a referral.

If you're a hormone provider, I'd love to help you find new patients. Click here to join my provider database and I'll see if I can match you up with some.

The Menopause Solution!

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