Dr Libby: The Roles Progesterone Plays Outside Fertility

In this special series, guest writer Dr Libby Weaver shares her health insights.

Progesterone is a vital player in the realm of women’s health. Although its association with pregnancy is well-known (its name softly implying “pro-gestation”), its influence spans a broader spectrum, affecting the lives of women in profound ways.

Often overshadowed by its hormonal counterpart, estrogen, progesterone holds the power to balance the scales of our internal chemistry.

Its absence or insufficiency can wreak havoc on our wellbeing, leading to a host of uncomfortable symptoms. This is why it’s essential to recognise that progesterone is more than a mere player in the menstrual cycle — it is one of the regulators of equilibrium within the body.

How does the body produce progesterone?

Understanding how progesterone is synthesised is crucial to appreciating its role in our lives.

During the years of menstruation, the ovaries predominantly produce progesterone in a cyclical manner. Smaller quantities are generated by the adrenal glands throughout a woman’s life (which becomes important as a woman begins her transition into perimenopause — more on this later). The trigger for ovarian progesterone production is ovulation, the pivotal event in this intricate dance of hormones. Post-ovulation, the corpus luteum, a temporary gland formed in the ovary, takes the reins and produces progesterone until just before menstruation — an interval known as the luteal phase.

Though often referred to as the second half of the menstrual cycle, the luteal phase may not necessarily be a strict half, as its duration varies among individuals.

Ideally lasting about two weeks, progesterone levels reach their peak, about midway through this phase. To gauge progesterone levels accurately, a blood test is best conducted approximately seven days before menstruation begins, usually around day 21 of a 28-day cycle.

The road to ideal progesterone production is riddled with potential obstacles. Regular ovulation is paramount, and any hindrance to this process is important to address.

Chronic stress, a hectic lifestyle, inadequate rest, emotional turmoil, insufficient nutrition (nutrient insufficiencies and/or undereating), and excessive exercise all contribute to disrupted ovulation.

Stress, in particular, casts a long shadow on progesterone levels, as it sends signals of danger to the body, which can interrupt ovulation itself or simply downregulate progesterone production. Always prioritising survival, our body doesn’t want us to fall pregnant during stressful periods when it may be more “dangerous” to conceive and raise a child. The body cannot tell the difference between real stress — that caused by physical peril such as in war, famine or drought — and perceived stress — the stress we feel in response to day-to-day perceptions of pressure and urgency, for example.

What are progesterone’s other roles?

The problem, of course, is that less progesterone in the body affects much more than just fertility because biologically, progesterone has numerous other roles.

It is a powerful anti-anxiety agent, an anti-depressant, a diuretic (prevents fluid build-up) and it is important for healthy thyroid function, which in turn supports a robust metabolism. Without it, not only might metabolic rate be affected but you may also have a tendency towards an anxious or depressed mood; if you feel like you have a fortunate life and yet you still feel flat, add guilt to that emotional cocktail and a degree of confusion about what is really bothering you.

You can see how layer upon layer of physical and emotional stress can form a surefire way for women to make even more stress hormones that can also further interfere with sex hormone balance.

What are the signs of low progesterone?

The signs of low progesterone levels are clear indicators of its importance in our bodies. These symptoms can include headaches or migraines with a pattern to them, spotting prior to menstruation, bloating and fluid retention, tearfulness, anxiety and/or heart palpitations in the lead-up to your period, irregular cycles, and even missed periods, when pregnancy is not a factor.

How to navigate your progesterone levels as you age

As a woman enters perimenopause, one of the first changes is an increase in anovulatory cycles, hence irregular progesterone production.

A small amount of progesterone is made by the adrenal glands, however, this transition can be particularly challenging if a woman has been chronically churning out stress hormones, which may have been impacting adrenal sex hormone production for many years or even decades.

What about life after menopause? As ovulation ceases, progesterone levels naturally decline, shifting the responsibility to the adrenal glands and making adrenal health and their capacity for progesterone production even more important.

Compared to ovarian production, adrenal production is tiny, yet good adrenal health can help mitigate some of the suffering nonetheless.

Signs of lower-than-ideal progesterone during perimenopause and post-menopausally can include all of the above as well as sleeplessness, more generalised anxious feelings (i.e. not tied to your cycle), low libido, breast tenderness, mental fogginess, fatigue and possibly shifts in body fat levels (often linked to an underperforming thyroid).

Tips for supporting healthy progesterone levels

We want to nurture our progesterone production for as long as possible. How can we support this? The ovaries love all nutrients. They particularly love iodine, selenium, zinc, magnesium, vitamin D and the essential fatty acids.

Dietary sources include seaweed and iodised salt for iodine, Brazil nuts for selenium, oysters, red meat, eggs and seeds like sunflower seeds for zinc, and leafy greens, tahini, seeds, nuts, seaweed and cacao for magnesium. Sunshine is our best source of vitamin D and oily fish gives us important fats.

Supplementation of minerals can be of benefit for women who are experiencing the symptoms of inadequate progesterone, while others will do well eating more total food — the ovaries don’t respond well when we undereat.

The ovaries don’t love stress. Incorporating strategies to help reduce and manage stress or worry, such as daily breath-focused practices and getting to the heart of what stress really is for you so you are able to make fewer stress hormones in the first place, is also incredibly supportive. That’s a big topic all of its own — I wrote about it in The Invisible Load.

Herbs such as paeonia, Siberian ginseng, licorice, withania, schisandra, saffron and Black Cohosh (not all at once, which ones are best will depend on your life stage) can assist with adrenal and nervous system health while also supporting hormonal health.

Dr Libby Weaver PhD is a nutritional biochemist, 13 times best-selling author and international keynote speaker. For more on balancing your hormones, visit Drlibby.com

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