Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Written on 6/25/21
Testing and properly treating your progesterone levels is critical! Keep reading to learn more about how to increase progesterone levels.
Between estrogen and progesterone, we’ve found that progesterone doesn’t get the most love. But progesterone is equally (if not more!) important than estrogen!
Low progesterone can cause unwanted symptoms, including mood swings, premenstrual syndrome, early miscarriage, and even infertility. This is why testing and properly treating your progesterone levels is so critical! Keep reading to learn more about how to increase progesterone.
What is progesterone and why is it important?
Progesterone is one of the two main female sex hormones. It’s responsible for regulating your cycle and is essential in conception and pregnancy.
Progesterone levels are low during the follicular phase. After ovulation occurs, the empty follicle from which the egg was released produces progesterone during the luteal phase.
During this time, progesterone is responsible for stabilizing and nourishing the uterine lining, making it “sticky” enough to allow a fertilizing embryo to attach during the implantation window. In order for the best possible chance at implantation and conception, progesterone needs to remain adequately elevated for several days during the luteal phase, specifically days 7-10 past ovulation.
If you don’t conceive, progesterone levels drop at the end of the luteal phase. This causes your uterine lining to shed and you’ll get your period.
If you successfully conceive, progesterone levels should stay high throughout pregnancy. During the first trimester, the empty follicle (also called the corpus luteum) continues progesterone production.
By weeks 8-12, the placenta typically takes over progesterone production. Progesterone continues to play an important part in the development of the fetus, the growth of maternal breast tissue, and in preventing premature uterine contractions.
Low progesterone production after ovulation may impact the receptivity of your endometrial lining, making implantation and pregnancy more difficult. Even if the embryo implants, low progesterone levels may end up causing early miscarriage.
Although progesterone is called the “pregnancy hormone,” its roles go beyond conception and pregnancy. Science shows us that progesterone has an important effect on cognitive function in women, as well as easing anxiety, protecting against uterine cancer, impacting neuroregeneration, and repairing brain damage. Needless to say progesterone is essential!
How do I test my progesterone levels?
Until recently, the only way of testing progesterone was to measure serum levels in blood, via a blood test typically taken on cycle day 21. While serum progesterone tests can confirm whether or not you ovulated, they fall short of giving the full view of your levels over time, which we know is so important when TTC and hormone balance in general!
First, progesterone blood tests are, as we mentioned, usually taken on cycle day 21. This is believed to be about 7 days after ovulation, when progesterone levels should be at an optimal level.
However, a cycle day 21 blood test assumes a woman ovulates exactly on cycle day 14. In reality, every woman and cycle length is different, and it’s totally normal to have cycle lengths anywhere between 21 and 35 days. This means you could ovulate before or after cycle day 14 and a cycle day 21 blood test could give an inaccurate assumption about your progesterone levels.
Additionally, studies show that serum progesterone levels fluctuate drastically — up to 8-fold in a singly 90-minute period! Because of this, a serum progesterone test only offers your levels at that exact moment in time meaning if you were to draw blood at 8 am versus 2 pm, you could get very different results.
While a serum progesterone test can confirm ovulation, scientists from the same previously mentioned study have agreed that it is not reliable enough to diagnose a luteal phase defect or low progesterone. To properly tell if your levels are good throughout the luteal phase, you’d need to have multiple blood draws during that 7-10 day window in order to get an average — ouch!
Yet, scientists also know that once it circulates through your blood, progesterone gets metabolized by your liver and excreted in urine as its main urinary metabolite, Pregnanediol Glucuronide (PdG). Studies show that PdG levels in first morning urine show an average of progesterone levels from the day before.
Like a progesterone blood test, PdG tests can also confirm ovulation. However PdG tests are non-invasive, meaning you can measure levels in urine over several days to ensure you’re producing enough PdG for long enough after ovulation.
Proov PdG tests are the first and only FDA cleared PdG tests to confirm successful ovulation at home. Testing with Proov PdG tests using Proov’s patented testing method, which includes testing on days 7-10 past peak fertility (i.e. a positive LH test) can help confirm both that ovulation occurred and whether or not it was successful. Successful ovulation refers to an ovulatory event in which an egg is released and PdG levels remain elevated for long enough after ovulation to allow for the best possible chance at conception.
We like to see 3-4 positive PdG tests on days 7-10 past peak fertility (with a positive on day 10) to confirm that ovulation was successful. If you get anything less than 3 positive results or do not get a positive on day 10, this could be a sign of “weak” ovulation (a.k.a. low PdG levels) which can make it more difficult to conceive.
We like to see 3-4 positive Proov PdG tests on days 7-10 past peak fertility (with a positive on day 10) to confirm that ovulation was successful.
How can I increase my progesterone levels if they’re low?
You’re probably here because you found out your levels are suboptimal and you want to do something about it. Luckily, we’re here to help! Here are a few of our favorite ways to increase progesterone levels.
Diet: Diet has an important effect on our hormonal balance. A healthy diet, with less sugar and simple carbs, more healthy fats, lean proteins and vegetables not only promotes weight loss but also balances hormones by improving insulin sensitivity. Also, even though food doesn’t contain progesterone directly, there are certain foods that promote progesterone production, such as: nuts, broccoli, Brussel sprouts, beans, cabbage, cauliflower, kale, pumpkin, and spinach.
Seed cycling: Seed cycling is another delicious way to restore your hormonal health and the delicate estrogen/progesterone balance. This method involves eating certain seeds during certain phases of your cycle to promote estrogen production during the follicular phase (flax and raw pumpkin seeds) and progesterone production during the luteal phase (sunflower and sesame seeds).
Herbal supplements: Herbal supplements are another option for improving progesterone levels. Vitex, ashwagandha, and maca are common herbals to look into.
- Vitex is one of the most common herbal supplements used by women who want to regulate their cycle. It stimulates LH production, which in turn stimulates progesterone production. It has been proven effective in lengthening shortened luteal phase, improving premenstrual syndrome, increasing mid-luteal progesterone levels, and lowering Prolactin levels.
- Ashwagandha is a plant traditionally used in Indian Ayurvedic medicine to relieve stress and enhance wellbeing. It is known to promote male fertility, but it is also useful for women since it helps regulate thyroid and adrenal glands.
Maca is one of the supplements that has proven effects on both female and male fertility. It promotes optimal function of the hypothalamus and the pituitary gland, and improves the functioning of endocrine glands. This Peruvian plant balances FSH, estradiol and progesterone levels.
Progesterone creams or oils: Progesterone creams and oils are a form of hormone replacement therapy initially meant to relieve menopausal symptoms. They usually contain bio-identical progesterone and are applied to the skin. Lack of access to prescription progesterone suppositories have transformed transdermal therapies to one of the “go-to” solutions for women trying to conceive. Some women may find oils tend to be a better option than creams as oils are better absorbed into the skin (creams can be too thick to pass through).
Some women may find progesterone oils tend to be a better option than creams as oils are better absorbed into the skin.
Prescription-strength progesterone supplements: Prescription-strength progesterone supplements are by far the most effective way of improving low progesterone levels. In fact, studies show that Progesterone supplementation may prevent miscarriage, especially in patients who experience early pregnancy bleeding or recurrent losses. Note that they do require a prescription from your doctor and are not available over-the-counter.
While low progesterone can be frustrating, there are plenty of ways to treat it. Often, the fix is simple but we always recommend consulting your doctor before trying any over the counter solutions.