Is your cycle very irregular?
Do you suffer from spotting?
Have you been trying to get pregnant for a while, but it just doesn't work out?
Have you had an early miscarriage or even several?
Or do you suspect you are menopausal and want clarity?
In all these scenarios, a hormone test is often suggested. This can be through a saliva sample (self-test) or with a blood test at your GP's office. However, these tests are also often criticised. This is because a test alone is not enough to indicate the true state of your health and fertility [1]. In this blog, we will tell you how a progesterone deficiency occurs and what you can do about it.
Why is tracking your progesterone production important?
One thing is certain: if you want to get and stay pregnant, your progesterone levels must be good. In short, without sufficient progesterone, you cannot get pregnant. Fortunately, most of us (yes, men too) produce it without any problems. You can tell whether your progesterone production is going well by looking at the graph of your readings after ovulation (see second example below).
Progesterone is produced to a large extent in the ovaries and to a lesser extent in the testes and the adrenal gland [2]. Progesterone keeps oestrogen production in humans from becoming unbalanced. It also promotes mental stability, a strong immune system and metabolism and, in men, healthy sperm formation [2]. For women, the main role of progesterone is to promote conception and implantation and then maintain pregnancy [3]. Also, studies show that progesterone makes sperm more motile, which facilitates fertilisation [3].
Progesterone during the menstrual cycle
In the first phase (the follicular phase), the egg matures in the follicle and oestrogen causes the endometrium to grow. Then ovulation takes place and the egg membrane of the follicle (corpus luteum) produces a lot of progesterone.
After fertilisation, the corpus luteum continues to produce progesterone for more than two months, after which the placenta takes over around the twelfth week of pregnancy.
In cycles in which no fertilisation occurs (lower temperature line in the image above), the corpus luteum decreases and progesterone levels drop about a week after ovulation. Menstruation then starts a week later and with it a new menstrual cycle begins.
Recognising progesterone deficiency
Progesterone deficiency or corpus luteum insufficiency (CLI) can only be detected with data. A shortened cycle or short luteal phase (phase after ovulation until the first menstrual day), can be a clue (see image below).
Daysy users can keep an eye on their temperature curve throughout the cycle, as a peak (high temperature) should be visible after ovulation that is stable in height. If it is shorter than 10 days, the basal body temperature will rise only gradually or remain at a low level and this may be an indication of progesterone deficiency.
Intermittent bleeding, ovulation bleeding
You may have bleeding after ovulation as a result of progesterone production not starting or progesterone deficiency. The colour of this bleeding is usually not red but brown watery like spotting and less than during periods.
The reason is usually a hormonal imbalance because the switch from the phase before ovulation in which you make estrogen to the phase after ovulation (progesterone) is not adequate. Indeed, your temperatures may be lower or drop after initially rising. Not an ideal situation, it creates confusion because you think your period is already coming through. One thing is clear, this may happen once but if you have this more often then it is definitely wise to schedule a 1-to-1 zoom call appointment. Our professionals will advise you in improving progesterone production thus your hormonal balance.
Restoring progesterone, but how?
Because progesterone levels fluctuate during the cycle and throughout your life and also vary from person to person, one-off or sporadic tests are difficult. Using progesterone cream, based on bioidentical hormones can be a valuable supplement. No side effects of this version are known to us, stick to the dosage as indicated, 1 cream-hub or 1 grain, right after ovulation until your first menstrual day, and you'll be fine.
Taking prescription progesterone medication available (possibly not the bioidentical form) can cause headaches and drowsiness, menstrual irregularities and interactions with numerous medications are possible when overdosing [4].
Progesterone saliva test
A progesterone test should be performed when progesterone levels are highest, i.e. around day seven after ovulation or seven days before the expected start of the next period. Saliva samples should then be sent to a laboratory. This progesterone test lets you collect saliva at 5 times between 7 and 9 in the morning.
Women using the Daysy have the advantage of being able to set their own optimal test date: seven days before the expected first day of their period. So if you have a short cycle averaging 25 days, day 18 would be ideal. Or if you have a long cycle of around 35 days, day 28 would be ideal. This is when progesterone levels may be highest.
Just stopped contraception and want to test your progesterone levels?
It is not helpful to test your progesterone levels in the first few months after discontinuing contraception. Your body is changing and busy producing its own progesterone which was suppressed before. Many women do not have clear ovulation and progesterone production in the first cycles after discontinuing contraception. After all, as much as you want to know, you can menstruate without having ovulated. This is another reason why it is important to measure your BBT (basal body temperature) because progesterone production after ovulation means rise in temperature.
With the help of Daysy, you will know - even with an irregular cycle - the time of your ovulation.
What values are normal?
Obviously, you should not take a progesterone test if you use hormones (e.g. the pill or other hormonal contraception) or if you have recently been pregnant or breastfeeding.
Different laboratories use different reference values for what is considered a normal progesterone concentration in blood serum. After menopause, the end of menstruation, only progesterone levels of up to 1.00 µg/l are detectable [3][8].
Hormone test blood tests at the doctor's office
Suppose you also grab other hormone levels to get tested. FSH, LH, oestradiol, testosterone and progesterone. FSH, LH, oestradiol are active before ovulation. Testosterone during ovulation and progesterone after ovulation. You understand that the results won't give you a good idea of whether all these hormones are working properly at the time you need them! Because you have the blood taken at 1 moment. It's logical that most of the hormones will be low then.
Progesterone deficiency! And now what?
With low progesterone levels, we need to find out what the underlying reason is. If you used hormones up to a few months ago, it may take some time for your progesterone levels to return to normal. Other common causes of low progesterone levels include:
Ovarian insufficiency: the pituitary gland does not secrete enough of the hormones FSH and LH
Polycystic ovarian syndrome (PCOS), a common hormonal disorder
Adrenal, thyroid or pancreatic dysfunction, such as hypothyroidism or diabetes
Vitamin and nutrient deficiencies, for example due to poor diet or chronic inflammatory bowel disease
Menopause
Hot flushes
Tense breasts
Migraine
Irregular cycle
Unfulfilled desire for children
Sleep disorders
Reduced libido
Weight problems
Headaches and/or migraines
Depending on the diagnosis, further investigations should take place to see if treatment is needed. In many women, tips such as an orthomolecular diet and lifestyle adjustments appear to help control hormones better and restore balance.
Increase progesterone naturally
Stress reduction, sufficient relaxation
Support with vitamins, minerals & adaptogenic herbs > 'Cyclus+ Package'
Support your liver with the right food: cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, cauliflower and kale
Avoid xenoestrogens: no foods from plastic and use only natural cosmetics & cleaning products.
Conclusion: Think you might have a progesterone deficiency? Check your BBT!
As you can see, progesterone deficiency has many consequences. Check your BBT (basal body temperature. Discuss your doubts during a 1-on-1 Zoom appointment with our experts who not only know how the Daysy works but also have professional hormone, cycle and orthomolecular knowledge. So you can work on improving your cycle, more regularity and in the prospect of pregnancy when the time comes and you are ready for it. In case of medical problems, consult your GP.
Sources:
1) Merlot J: SPIEGEL online, 2. November 2013 spiegel.de/gesundheit/diagnose/speicheltests-auf-hormone-aerzte-warnen-vor-unnuetzen-analysen-a-930835.html
2) Oettel M, Mukhopadhyay AK. Progesterone: the forgotten hormone in men? Aging Male. 2004 Sep;7(3):236-57. doi: 10.1080/13685530400004199
3) Voos D, Apotheken-Umschau 2017: apotheken-umschau.de/diagnose/laborwerte/progesteron-zyklus-und-schwangerschaftshormon-740809.html
4) Maucher IV, Gelbe Liste 2019: gelbe-liste.de/wirkstoffe/Progesteron_21326
5) Norman RJ: Aust Prescr 2002;25:38-40; nps.org.au/australian-prescriber/articles/fertility-testing
6) Endokrinologikum-Aesculabor: endokrinologikum-aesculabor.de/leistungsverzeichnis/hormone/parameter/progesteron.html
7) Med4You: med4you.at/laborbefunde/lbef3/lbef_progesteron.htm
8) Hermes S: Eltern.de; eltern.de/kinderwunsch/gelbkoerperschwaeche
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