The Role of Progesterone in Menstrual Cycle and during Pregnancy


Progesterone is a hormone that is produced mainly in the ovaries of a woman’s body and is very important in regulating menstruation and supporting pregnancy. Progesterone is also produced in the adrenal glands of men and its function is related to sperm development. Similarly, in a woman’s body, progesterone is also produced in different locations apart from ovaries, which include the corpus luteum, placenta, and adrenal glands. It is one of two female sex hormones and can affect menstrual periods and menopausal symptoms.

Progesterone Levels

Progesterone levels in women fluctuate throughout the menstrual cycle and can vary all through the month. Progesterone levels are measured in nanograms per millilitre (ng/mL) and can be measured through a blood test.

The following table depicts the normal levels of progesterone for an adult female during diverse points of the menstrual cycle (Pre-ovulation, Ovulation and Post-ovulation)

Stage

Normal level (ng/mL)

Pre-ovulation

0.89

Ovulation

≤ 12

Post-ovulation

1.8–24

This second table shows the normal levels of progesterone during pregnancy

Stage

Normal level (ng/mL)

First Trimester

11–44

Second Trimester

25–83

Third Trimester

58–214

Low Progesterone Level

Low levels of progesterone can affect both menstruation and fertility. Low levels can result in absence of menstruation, miscarriage, menopause and poor ovarian function. Symptoms of low progesterone levels are relatively different for pregnant and non-pregnant women. If a woman is not pregnant, some symptoms of low progesterone may include low libido, hot flashes, migraines or headaches, depression, anxiety, mood swings and irregularity or absence of a menstrual cycle.

On the contrary, during pregnancy, women need to maintain their progesterone level until they give birth to their babies. If the levels are too low, women may have difficulty carrying the baby until delivery. Pregnant women may witness some symptoms of low progesterone levels like spotting, abdominal pain, frequent low blood sugar, frequently tender breasts, constant fatigue and vaginal dryness.

High Progesterone Level

High levels of progesterone typically won't cause any negative effects on women’s health. However, these levels are believed to be moderately responsible for symptoms of premenstrual syndrome (PMS), like breast tenderness, creating a bloated kind of feeling and mood swings.

Progesterone in Women and Men

Progesterone is also produced in the adrenal glands of males and its assists in sperm development. In a male body, progesterone may not have an essential role to play and hence, men may not periodically keep a check on their progesterone levels. However, in women, progesterone has a major role to play in menstruation and pregnancy.

In women’s bodies, one of the most significant functions of progesterone is to cause the endometrium to secrete particular proteins during the second half of the menstrual cycle. These proteins prepare the body to receive and nurture an implanted fertilized egg. Progesterone helps to promote a good environment for a fertilized egg in a woman’s body. But, when progesterone levels are low, it’s difficult for a fertilized egg to develop and grow.

If implantation of a fertilized egg does not occur, the corpus luteum breaks down and a drop in the levels of estrogen and progesterone is witnessed. This results in menstruation as due to a drop in levels of progesterone and estrogen, the endometrium breaks down. Women may skip their period when the egg fails to ovulate and the body witnesses consequent low progesterone levels.

Progesterone is an important contributor to regulating the menstrual cycle as well as maintaining a healthy pregnancy in women.

Progesterone in Pregnancy

Progesterone helps to prepare the woman’s body for pregnancy by stimulating the development of the glands and new blood vessels. This provides an excellent environment for implantation by a fertilized egg.

Once an egg is fertilized, the corpus luteum does not break and this enables the body to continue producing progesterone. This progesterone arouses blood vessels to supply the endometrium and aids the endometrium to provide nutrients to the growing embryo. Once the placenta has formed, it becomes the primary progesterone producer and helps in the growth of the baby.

Levels of progesterone remain high throughout pregnancy and these elevated levels prevent the body from producing additional eggs. Progesterone also supports the growth of milkproducing glands in the breast during pregnancy and thus helps to trigger lactation.

A simple blood test or serum progesterone test (PGSN) can help the healthcare provider to assess if the progesterone levels are too low and suggest treatment accordingly to normalize the progesterone levels.

Progesterone Treatments

Natural treatments to boost low progesterone levels include eating foods like shellfish which have zinc, increasing intake of vitamins B and C, and regulating stress levels as an increase in stress leads to the release of cortisol and thereby reducing the progesterone levels. However, sometimes it becomes difficult to elevate the low progesterone levels and people have to take the help of medicines and supplements to boost their progesterone levels.

Hormone Therapy

Hormone therapy can help boost progesterone if someone is trying to conceive, as it thickens the uterine lining which may improve the chances of conception. Hormone therapy will probably be a combination of progesterone and estrogen if someone is using it for treating enopause symptoms. Progestogens are included along with estrogen in combination with oral contraceptives and menopausal hormone therapy.

Progestogens

Progesterone substances which are used for medical uses are called Progestogens and they are available in two forms. One is the synthetic version called progestin and another version, which is nearly identical to the body's hormone and derived from plant sources, is called ‘natural progesterone’.

Some women may choose to take a mini-pill which is a progestin-only pill. This pill permits women to avoid some of the worst side effects of estrogen and improves regular menstrual cycles. Mini-pills are greatly effective for preventing pregnancy, but missing a pill or taking it at a different time of day may make someone vulnerable to pregnancy.

People use progesterone supplements and other non-prescription medications for infertility, menopausal symptoms, and many other conditions. Prescription progesterone products are probably safe when applied into the vagina directly as part of infertility treatment or to prevent preterm labour in pregnancy. But progesterone may be unsafe to consume through supplements during pregnancy for any other purpose without consulting the doctor.

Also, one should not use non-prescription forms of progesterone if one has the arterial disease, breast cancer, depression, liver disease, porphyria and undiagnosed vaginal bleeding. Progesterone and estrogen are indeed both hormones which may be taken together. Progesterone can reduce some of the side effects of estrogen, but it might also decrease the advantageous effects of estrogen. In some cases, taking progesterone medicines along with estrogen might cause breast tenderness.

Conclusion

Progesterone is an essential hormone in our body and it is extremely important to maintain its optimum levels. Nevertheless, several factors may result in low progesterone levels and affect normal menstruation and pregnancy in women, while sperm development in men. Serum Progesterone test (PGSN) can help in determining the progesterone levels and one must immediately consult a health care provider before taking any supplements or medicines to normalize the progesterone levels.

Updated on: 02-Jan-2023

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