Dizziness, weight gain, water retention...
These are just some high progesterone symptoms.
If you think you are experiencing issues with progesterone you need to make sure you understand what causes high progesterone, but also how to treat it.
Use this checklist to determine if you meet the criteria:
What Causes High Progesterone?
Believe it or not, women have more progesterone than they have estrogen (in absolute concentration).
This means that progesterone is incredibly important to the female body because it directly counteracts the effects of estrogen.
You probably think of estrogen as the "female" sex hormone, responsible for the majority of sexual characteristics that females have (breast development, etc.).
But, like many things in this world, too much of something isn't always better.
This principle is true of both estrogen AND progesterone.
These two hormones live in balance with one another.
You can think of estrogen as a growth hormone making things bigger, and you can think of progesterone as the exact opposite.
Estrogen causes breast tissue to grow, it causes endometrial tissue to grow and it causes fat cells to grow (1) (not exactly what most women want).
It helps regulate breast tissue growth, it helps regulate your menstrual cycle and it can help with weight loss.
But what you need to realize is that it is the balance of these hormones that really matter.
It's not as easy as simply increasing progesterone for weight loss, etc.
And it's the imbalance of these two hormones which cause significant symptoms in many women.
To be fair, the majority of women nowadays have excess estrogen and too little progesterone (3).
This combination leads to a condition known as estrogen dominance.
But some women still suffer from the symptoms of excess progesterone.
But if most women suffer from low progesterone, how do some women get high progesterone?
Many things can cause high progesterone levels, so let's dig into the most common causes of high progesterone in women:
- Changes in your menstrual cycle (elongation of the luteal phase)
- A reduction in estrogen levels in the body (
- Too much supplementation with progesterone (either oral or transdermal progesterone)
- Excess supplementation with pregnenolone or other progesterone precursors
- Adrenal related problems (overproduction of adrenal hormones or improper adrenal enzyme signaling)
As with other hormone imbalances, it's always important to correctly identify what is causing the problem in your body.
Because then you can properly target your treatment!
Before we talk about treatment let's discuss the many symptoms of progesterone:
The Complete List of High Progesterone Symptoms
Most common symptoms of high progesterone:
Remember that these symptoms stem from too much progesterone, but not extreme or excess progesterone levels.
Slightly high levels can come from taking just a little bit too much over the counter progesterone (4), pregnenolone or during the luteal phase of your menstrual cycle (last 2 weeks).
- Weight fluctuations (usually mild weight gain of 5-10 pounds)
- Depressed feeling but not overt depression
- Slight dizziness
- Waking up groggy or "on edge"
- Sense of physical instability
- Spinning sensation
- Discomfort or pain in the legs
- Water retention
- Anxiety or just feeling "tense"
- Changes to libido (usually decreased sex drive)
- Not feeling like yourself
Less common symptoms of high progesterone:
Remember that these symptoms are much less common and usually only occur if you have higher levels of progesterone circulating in your system.
These symptoms are worth pointing out because they can start to mimic the signs of excess estrogen in your body.
- Hot flashes (due to an overload of estrogen receptors)
- Increased appetite
- Overt anxiety or panic attacks
- Significant weight gain
As you might have noticed some of these symptoms are very subtle or very general.
This can make the diagnosis difficult.
For this reason, it's important to remember that each person will present with different symptoms in the setting of high progesterone.
But consider this:
You know what is normal for your body and what isn't normal.
If you notice that you have symptoms that are similar to the ones listed on the list but not very specific then you should still have your serum progesterone levels evaluated.
Testing your Serum Progesterone levels
There are several ways to evaluate progesterone levels.
The easiest way to check your progesterone is through your blood or serum by simply checking your serum progesterone.
But there are a few things you should realize before you get tested:
#1. You must evaluate progesterone AND estradiol at the same time.
Remember when we said that it's the relative BALANCE of estrogen and progesterone that matters more than the absolute value?
Well, this principle needs to be applied when you evaluate your serum levels.
That means you must check your estradiol levels in addition to your progesterone levels AT THE SAME TIME.
Most physicians know how to do this, but just in case you may want to remind them to check both.
Look for a ratio that is about 10:1 that is, if your estradiol level is 50, then your progesterone level should be at least 5.
*Note: This ratio is only true for serum testing.
#2. The time of the month matters (if you are still menstruating).
If you are menstruating then it's important to check your progesterone and estradiol levels during days 19-21 of your cycle.
At this point in your cycle your progesterone should be at its absolute highest (5) and the ratio I mentioned above only applies here.
Both estrogen and progesterone change on a near daily basis, so it's important to put your values into context.
You simply cannot get a good reading if you randomly check your progesterone level.
There is one exception:
That is after menopause.
Because you are not ovulating it's okay to check your progesterone and estradiol level at pretty much any time.
Another point worth considering is that a single test may not tell the whole story.
In some cases (for difficult to diagnose patients) you may need to check your estrogen and progesterone values at multiple times during the month.
#3. You must realize that serum levels may not be the most accurate way to test your progesterone levels or other sex hormones.
Much like other hormones in your body, serum levels may not be the absolute best way to assess what is really happening in your body.
I generally recommend you start with serum levels first because they are easy to order and insurance will almost always cover the test.
But, if you continue to have symptoms or your serum levels are not helpful, you may need more advanced testing.
In some cases, you can get a more accurate reading of progesterone by checking for urinary metabolites of pregnanediol (6).
Checking urinary levels of sex hormones also allows you to get a better idea of what is happening to your estrogen levels (as there are at least 3 primary estrogen metabolites that are not regularly checked in the serum).
This process is somewhat more advanced than serum testing, so make sure you find a Doctor who understands this process and can help you interpret your tests.
#4. Progesterone levels change as you age.
Remember that age (in addition to your menstrual cycle) will alter your progesterone levels and progesterone metabolism.
As women age progesterone levels tend to fall more rapidly than estrogen levels which can set the stage for estrogen dominance.
This trend tends to occur right around age 35.
But just because this tends to be the general "trend" for most women, does not mean that it will happen to you.
For this reason, it's best to at least keep tabs on what is happening with your progesterone level over time.
If you can keep track of your yearly progesterone levels which will help you put individual results into context.
Treating High Progesterone
Treating of high progesterone largely depends on what the cause is.
By far the most common cause of high progesterone and therefore high progesterone symptoms are due to over supplementation.
#1. Treating high progesterone due to taking too much progesterone:
Which makes things very easy to treat.
If you recently started taking progesterone and you are noticing the changes listed above then you should consider checking your serum progesterone levels (to compare them to your pre-supplementation level) and also consider dropping your dose.
#2. Another common cause of high progesterone is due to overstimulation of adrenal function which results in overproduction of progesterone in the adrenal glands:
Due to the high amount of stress that most women are put under, the adrenal glands are often put under intense pressure.
This pressure may lead to abnormal changes in hormone production or enzyme metabolism.
This cause of high progesterone is usually accompanied by excess levels of fatigue and other symptoms that may indicate you have adrenal fatigue or cortisol level abnormalities.
Studies have shown this to be the case (7).
Stress leads to both high progesterone AND high cortisol and both of these hormones may contribute to weight gain and other symptoms.
If you aren't sure where to start I've also included some basic recommendations below:
- Cut caffeine usage completely
- Take steps to actively manage and reduce your stress (if possible)
- Cut back your exercise routine if you are overexercising
- Take the right supplements designed to help balance cortisol levels
- Check your serum cortisol level and DHEA level
- Change your diet to completely exclude sugary carbohydrates and refined carbohydrates
This is really just a starting point for treatment if you have adrenal problems so I encourage you to check out the links above if you feel this may be contributing to your progesterone level.
#3. Treating high progesterone related to elongation of your cycle or the luteal phase.
You probably already know that various factors can alter the length of your menstrual cycle.
More common causes include stress, a change in your diet, change in exercise routine, social situations, etc.
The point here is that basic lifestyle factors play a role in determining the length of your menstrual cycle and therefore your progesterone level.
Whenever possible it's important to make basic lifestyle changes that can regulate or normalize your menstrual cycle.
These changes include things like:
- Eating a real whole food diet without excessive caloric restriction
- Managing stress levels by taking certain supplements or partaking in certain activities which improve your natural stress response
- Making sure you sleep at least 8 hours each night
- Regulating your exercise so you aren't exercising too much or too little
- Managing your weight (this means making sure you don't gain too much weight or lose too much)
Following these basic recommendations should dramatically help normalize your menstrual cycle and your luteal phase which should go a long way to improving your progesterone level.
#4. Get your thyroid evaluated (and other hormones!)
You should consider the hormones in your body as one intertwined system.
This means you can't disentangle them from one another.
It has been shown that changes in thyroid function alter both progesterone and cortisol levels (8).
We already know that stress alters cortisol and progesterone (9), and we know that obesity alters thyroid function.
It's easy to see how even slight changes to other hormones in your body can impact other hormones including progesterone.
The bottom line?
Treating High Progesterone from Birth Control Medications
Another important topic worth discussing is the impact that birth control has on normal hormone and progesterone levels.
Most birth controls act as synthetic or fake progesterone levels, and they actually tend to completely reduce or block your body's normal production of endogenous progesterone.
Having said that, these synthetic hormones still sit on and activate progesterone receptors and "feedback" to the brain making your body think progesterone is still in circulation.
This is how these synthetic medications can act as birth control - they block the normal hormonal pathways in the body.
This isn't a secret, but what's interesting is that by taking birth control medications you are introducing a synthetic type of progesterone (known as a progestin or progestogen) into your body which has many effects.
These progestins tend to act like progesterone and may trigger cellular messengers and make your body think that it actually has excess progesterone in circulation.
This may cause the symptoms of high progesterone even though your serum progesterone levels may be "low" or "normal".
And this is also why so many women who start birth control medications end up with symptoms such as weight gain, swelling or mood swings (all symptoms of excess progesterone).
But does that mean it's normal?
Not by a long shot.
So what do you do about it?
Obviously, if you are reacting negatively to birth control medications your next step should be to go off of them (assuming that is an option for you).
But just going off of the medication may not be sufficient to restore normal progesterone and estrogen levels.
You need to ensure proper elimination and metabolism of these hormones through the liver, and you can augment this in a couple of ways.
You can increase liver metabolism and phase I and phase II elimination pathways by taking the supplement calcium-d-glucarate.
This supplement has been shown to increase glucuronidation (10) (which is an elimination pathway in the liver).
You can also take other supplements designed to improve liver metabolism such as milk thistle or MSM.
You need to ensure that you normalize your body weight and remove any excess fat cells that you may have gained while taking birth control pills.
Fat can act as a vehicle to store fat-soluble substances and this includes hormones, endocrine disruptors, and fat-soluble vitamins.
If you think you may be suffering from high progesterone make sure you spend time trying to figure out what is causing the problem in your body.
By figuring out the root cause of your hormone imbalance you can then target treatment and REVERSE the issue.
Also, remember that general physicians are not very knowledgeable when it comes to hormones and hormone balance in your body.
You may ultimately need to seek out a physician who specializes in hormone replacement therapy to get the proper help (this doesn't necessarily mean an ob-gyn).
Now I want to hear from you:
Are you suffering from high progesterone? Do you have the symptoms listed above?
Have you been able to lower your progesterone level with treatment? Why or why not?
Leave your comment below!
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