- High progesterone symptoms include weight gain, water retention, anxiety, and mood changes, and these can result from over-supplementation, stress, or menstrual cycle changes.
- Check both progesterone and estradiol levels at the same time during days 19-21 of your cycle to get an accurate picture of your hormone balance, as the ratio between these hormones matters more than individual values.
- If you're taking synthetic progesterone supplements or birth control, be aware that these can trigger high progesterone symptoms even when serum levels appear normal due to how synthetic hormones activate your receptors.
- Stress management, proper sleep, balanced diet, and optimizing nutrient levels are fundamental lifestyle changes that can naturally normalize your progesterone levels without medication.
- Your thyroid, cortisol, and other hormones directly influence progesterone, so get a complete hormone panel to identify which imbalance is driving your symptoms.
Dizziness, weight gain, water retention, what do these symptoms have in common?
They can all be caused by high progesterone.
Elevated progesterone may not be as common as low progesterone, but it’s still a problem for many women.
And you can use this checklist to determine if it’s a problem for you:
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).
Progesterone, on the other hand, causes the exact opposite (2).
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 causes 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)
- Pregnancy
- 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.
Why?
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)
- Drowsiness
- Depressed feelings but not overt depression
- Slight dizziness
- Waking up groggy or “on edge”
- Bloating
- 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)
- Insomnia
- Increased appetite
- Overt anxiety or panic attacks
- Depression
- 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. Simply check 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 levels 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 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 it will help you put individual results into context.
Treating High Progesterone
Treating high progesterone largely depends on the cause.ย
By far the most common cause of high progesterone and therefore high progesterone symptoms is 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 overstimulation of adrenal function which results in the 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.
You can learn more about testing for adrenal issues here and how to treat adrenal fatigue here.
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, a 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 that improve your natural stress response
- Make 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.
For instance:
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?
If you have high progesterone make sure to also check your thyroid status as well as other hormones like leptin, insulin, and testosterone.
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 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.
First:
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.
Second:
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.
Remember…
Fat can act as a vehicle to store fat-soluble substances including hormones, endocrine disruptors, and fat-soluble vitamins.
Conclusion
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!
Scientific References
#1. https://www.ncbi.nlm.nih.gov/books/NBK279054/
#2. https://www.ncbi.nlm.nih.gov/pubmed/3297211
#3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852629/
#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987489/
#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2783957/
#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1600943/
#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146195/
#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520819/
#9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146195/
#10. https://www.ncbi.nlm.nih.gov/pubmed/2346674
I am a 38 year old female. My husband and I have been trying to conceive for a year. (I have a 15 month old) My FSH was normal so my doctor put me on Clomid bc my ovulation tests always look negative. My Day 21 progesterone results came back and they were 80. My HCG blood draw was 0. Does Clomid cause this? I’m terrified I might have cancer or something seriously wrong. I also went to my general practitioner 2 days ago due to pain in my left side. She said it could be pelvic or colon and ordered an ultrasound and colonoscopy. With this new progesterone information, what do I do next?
Hi, I suffer from terrible regular migraines with Aura. They first started at 16 when I went on the combined contraceptive pill. I immediately saw a link and came off the pill and my migraines vanished. However, when pregnant with my first child at 23 (and second at 25) the migraines returned and have never stopped. I’m now nearly 35 and really struggling with them. I think they must be hormone related and the only thing I can think of are that my levels haven’t settled since pregnancy. I just donโt know what to do to change them.
You could look into trying magnesium supplements, bisglyncanate form preferably as it it easily absorbed, alongside chelated calcium. For me it took 90% of my migraines away, including the hormonal ones.
I took a high dose for several months but now only need a regular maintenance dose of mag/calcium and to watch my diet for migraine trigger foods as I approach my period.
My doctor didnโt seem to have any info, but online and book research led me to this helpful solution after years of migraines.
Hope it helps
Can excess progesterone cause hair loss, i.e. Thinning eyebrows, eyelashes and receding hairline?
Hi Jeanette,
High progesterone can contribute to hair loss, but a receding hairline is usually related to testosterone levels.
Thank you for your response! I plan to have all my hormone levels checked in a couple of months and am hoping to get to the right combination of hormones.
Hi Dr. Childs,
I was taking a 200 mg capsule of progesterone nightly. My blood test came back as having a low level, so my new DNP put me on a bioidentical cream at 200 mg. per night. I feel I have several of the high progesterone symptoms, waking early morning with a HOT flash, and especially a markedly increased appetite. This bothers me as I am already quite overweight. Maybe I should decrease it to 100 mg?
Btw, I have had hypothyroidism for years and am now taking 1 1/2 grains of WP Thyroid.
Thank you!
Hello!
I did serum testing and my progesterone is higher. Please, can you check these values and give me your opinion.
E2 – 210,pmol/L
FSH – 7.6 IU/L
LH – 3.3 IU/L
Prolactin(PRL) – 297 mIU/L
Testosteron – 0.96 nmol/I
Progesterone – 56 nmol/L
As I can see only progesterone is higher.
Progesterone was checked on the 21st day of the cycle and all the rest hormones on the 3rd day.
I think I might have done something stupid. I went to a medical spa to get my hormones checked. Wasn’t expecting the results… practically no Vit D, B12, DHEA, testosterone and progesterone, thyroid looking hypo (even though I’ve always been super thin) and my cortisol levels were 14.5… but I’m a shift worker and just went through an extremely stressful time losing my dad a few months before getting blood work. They are currently treating me for everything that was low, but I’m also currently on the NuvaRing for birth control. Since reading your article, I’m thinking I may not have been low at all in these areas since my birth control releases a synthetic form of the hormone, which I’m sure they don’t test for… would I be correct; and should stop taking the 75mg of Progesterone every night? I’ve been on everything for about a month, and since started my period 1.5 weeks early (always been regular) and have gained about 10lbs. First starting this, my night sweats went away, but now their back? Hopefully, I followed your rules so you’ll respond.
I have been using Bioidentical progesterone and estrogen creams for some time now. I am 60. The dosage was prescribed worked beautifully for quite some time until I started getting my periods back. They are now coming a week after my last day. I have no current doctor due to a move so I am stymied. I donโt want to stop them all together unless needed. Stress is high and I am taking a lot of supplements to help support. Any ideas as to what to do to regulate?
Thank you.
I am a 62-year-old woman who underwent a hysterectomy during Jan. of 2018 due to chronic vaginal spotting. I underwent D&C’s and uterine biopsies and no diagnosis was ever found as to the reason for this problem. There were two extremely small uterine fibroids that were not felt to be the cause but I went ahead with the surgery as I did not want to undergo a uterine biopsy to check for cancer every six months as suggested by my GYN. My uterus, cervix and fallopian tubes were removed. I asked that my ovaries were left. I have continued to experience frequent brownish vaginal spotting and still have no diagnosis for this. Shortly before the time of the hysterectomy, I had my hormones tested and as expected my estrogen level was extremely low as I had never undergone any hormone replacement therapy. My progesterone level at that time was above normal limits but my GYN seemed to have no concern about this. I have not had my hormone levels tested since that time but am wondering if a hormone imbalance could have something to do with the spotting issue- assuming I undergo the test again and my progesterone level is still above normal for a postmenopausal woman. I also am significantly overweight and do not seem to be capable of losing much weight regardless of how few calories I consume per day.
Can high progesterone levels in a postmenopausal woman be related to spotting and/or weight issues?
Hi there,
I was on the pill from the age of 17 until the age of 24. I really didn’t know anything about what it was actually doing to my hormones. All I knew is I’ve always suffered from hormonal acne due to an imbalance and/or sensitivity to my diet. Birth control worked for me beautifully. My acne disappeared and I felt extremely balanced. I lived a very active lifestyle constantly able to sleep well, exercise often, and maintain a healthy diet. I’m not sure if this means I was getting a higher level of progesterone or not, but my only negative side effect was headaches when I’d take that week off to “have a period.”
I’ve had two kids since then and am still breastfeeding my 19-month-old about 3 times in a 24 hour period. I know my hormones are off balance although I’m not sure how. I’ve gone through breakouts, depression, mood swings, anxiety, having a short temper and extreme fatigue. I don’t even recognize myself, to be honest. I’m debating getting back on the pill or using more holistic supplements to regulate my hormones. As I said, I liked the balance I got with the pill before kids. I’m not sure how it would effect me now after kids. I also am discouraged by the fact that it blocks such a natural process in my body using synthetics. I’m inclined to do this testing you talk about, but figure while I’m breastfeeding it might not be so accurate. Any advice would be appreciated. I’m quite new to understanding these things called female hormones.
Much appreciated,
Tamra Williams
I have just completed a saliva test that indicated my estradiol levels to be 100 and my progesterone at 54,000. My Bioidentical compounding pharmacist has advised me to stop my hormone replacement and see my doctor for further testing. I have all the symptoms list in this last section. I have been on Bioidentical Hormone repayment therapy for the past 5 years after having a complete hysterectomy overdoes removed at the age of 46. I am now 51. Any advice?
Hi Kimberley,
I’m not a fan of hormone testing through the saliva because I don’t believe that it is the most accurate way to test for these hormones. I wouldn’t give any advice based on the results of that particular test.
This is the first blog I’ve come across where so many women are having so many problems with progesterone. At 46 (now 49) when I first researched peri-menopause everything online indicated progesterone ‘good’ and estrogen ‘bad’ during this time (i.e. estrogen dominance). Therefore my peri-menopause journey initiated with OTC progesterone cream supplementation. Even went up to unmeasured high doses, chasing symptoms that I was led to believe were due to estrogen dominance. Ended up with severe anxiety, palpitations, lack of focus, was miserable. Following this I went into a state that I can best describe as hyperthyroid (heavy underarm sweating and weight loss without trying). Went to an MD, saliva tested, and based on results (high progesterone, mid range estrogen, low cortisol, low testosterone, low DHEA) was started on 1.25 Bi-Est w lowest does of testosterone, 100mg progesterone capsule, DHEA, ashwaganda, and maca, along with adrenal complex (MD works with a compunding pharmacist). Felt good for a while only now I believe I’m hypothyroid (cold hands and stubborn weight gain, acne, extreme difficulty waking). My basic thyroid panel shows ‘normal’. Question: Can massive swings in hormones over the course of 2 years mess up thyroid signaling (not sure if this is correct term)? Put another way, can excess progesterone CAUSE hyperthyroid, and can a ‘new’ introduction of estrogen trigger hypothyroid? I’ve read where estrogen supplementation can cause hyperthyroid. Still chasing symptoms and frustrated. Recall when I was a teenager entering menses I had difficulty waking. Just can’t seem to determine if that was from increasing progesterone or estrogen. Sharing that because I seem to be experiencing the same ‘exit’ as my ‘entry’ into female hormonal existence. Thank you for this site! Honestly need to shut down or include greater warnings on the dangerous (personal opinion) progesterone advocate sites out there. I’ve lost a year of balance to them. MD’s lack training, and even with GREAT (PPO) insurance hormonal panels aren’t covered for as frequently as I believe they should be (monthly!!!) so this is truly a challenging time.
Hi Elizabeth,
Progesterone, in high doses, can cross-react with estrogen receptors which is probably causing the symptoms you are experiencing. Both estrogen and progesterone can also impact your thyroid but this would be evident with a full thyroid panel.
Thanks for this very informative article. I have been on estradiol and progesterone for almost 20 years, post complete hysterectomy. I took orally at first, then went to creams, and now transdermal drops. I have been on the same doses for many, many years. I am also hypothyroid, controlled by Synthroid and Cytomel. Recently I have begun to suffer from many of the symptoms I find here indicating excessive progesterone. I have bloating, fibrocystic and sore breasts, insomnia, pounding heart, weight gain, etc. I plan to simply stop the progesterone for a bit to give my body a chance to flush out the excessive progesterone. I also have a sluggish, fatty liver. I am wondering if it will actually take a full six months to remove all the progesterone from my system. Do you have any thoughts on this given the lengthy time I’ve been on these hormones. I am 67 years old.
Hi Lee,
Progesterone can build up in your fat stores which may release for months after you stop taking it. Because you’ve been on it for so long, I would expect it to take a while to completely eliminate from your system.
Hi Dr. Childs, Thank you so much for taking time to respond. Want to share recent experience and an interesting NCBI article in case it helps. I re-ignited a hyperthyroid state after stopping Bi-Est and using low dose progesterone only. Ultimately was concerned over impact of Bi-Est on thyroid. Interestingly, using progesterone cream only, even a tiny amount, triggered hyperT, so I added a tiny amount of Bi-Est and voila, it countered the hyperT anxiety. I did read somewhere that topical Bi-Est doesn’t effect the thyroid although oral does so curious as to why I am having this experience. In any event, here is an article that touches on autoimmune disease triggered by progesterone and includes a section on thyroid: Progesterone and Autoimmune Disease
Grant C. Hughes, M.D. (NCBI). Great read and findings seem to make sense for those of us that over supplemented and have hyperT symptoms when using any amount of progesterone now. Is there any correlation (to your knowledge) of normal-low end of range free T3, normal-low end of range free T4, and an almost perfect TSH (1.6-1.7) and graves or more likely with these numbers is hashi more likely? Those are the only data points I have to offer. Will be getting a full thyroid panel soon. Clearly my thyroid is functioning (TSH) but I’m totally messing up T4 and T3 with BHRT creams. Like others, I wish I could flush my system of progesterone immediately. Dangerous stuff given the fact we cannot test levels frequently enough to catch a build-up before it happens, even at a lower dose. Dang peri-menopause.
I have a question as to how quickly someone can come to have progesterone excess with supplementation. I am 45. I began bcp over the winter for mood swings and very excessive, but regular, periods. I was also treated for anemia and low ferritin. Within a month my periods were lighter, moods improved, and the anxiety I had been suffering with for ten years was gone! I didnโt know how hormones could affect anxiety. Three months later I had gradually gained 15 lbs, was lethargic and began having suicidal ideation the week before my period.
I quit the pill and was referred to a gynecologist who found my estrogen was normal, FSH normal, low vitamin d, B12, thyroid, and testosterone. I am being treated for all of that. He was going to prescribe progesterone cream, but I asked for the capsule because my insomnia. I get great for a month, just a little tired, lost a couple pounds even. I still have exhaustion in the afternoons but fall asleep easily at night. But I keep waking at 3 or 4 in the morning unable to go back to sleep. This month, though I am careful with diet and exercise, I have gained four pounds. Worst of all is the horrible abdominal cramps I get that last all day.
Does using the cream still help with mood and sleep? Are these symptoms because of having too much progesterone? How long does it take to get out of your system?
Also, I was diagnosed with adenomyosis with an englarged uterus. Only options are an IUD, which my doctor doesnโt recommend or hysterectomy. I was hoping a daily dose of prometrium would help in the long run.
I’ve been on BHRT for several years. I’m post-menopausal and am on thyroid replacement (NP Thyroid and cytomel) after a thyroidectomy. Last labs showed T3 and T4 are optimal. I recently had hormone labs run and progesterone level tested at 46.1 pg/ml which is well beyond the normal level. I’ve been taking 200 mg of progesterone daily for 3-4 years. I haven’t had any significant weight gain, but have other symptoms like depression, anxiety, fatigue, constipation, dry skin, water retention, not sleeping well, low libido and allergies. My problem is finding a doctor who understands and knows how to deal with this issue. My current doc does not even monitor my progesterone levels (despite being on supplementation) and I ran the labs on my own.
Years ago throughout my 20s at different times I tried the progesterone only mini pill (BCP). The doctors insisted it was generally safer without the estrogen.
I always ended up with the same symptoms for months and months. Which were …constant spotting, pelvic and groin type pains, fatigue, and muscle weakness and a feeling joint instability. I felt like a rag doll. The doctors kept insisting my body would eventually adjust but things never improved.
Now my doctor insists I take a BCP with both estrogen and progesterone but a lot more progesterone than most pills. My body and cycles are changing and some small irregularities and symptoms of peri-menopause and I have not been on any hormones or BCPs in about a year or so. The high progesterone scares me. Also, I am thin and therefore my doctor decided that my estrogen is low. I just don’t understand that conclusion alone. I have a friend who has always been very thin and is well past menopause and has breast cancer and has estrogen dominance.
Hi there – Took the 21-day serum test (UK) and my
oestrodial 299 pmol/L
Progesterone 55.8 nmol
Is this ok? I can’t work out ratios! Please help.
Hello,
I have elevated progesterone levels. My period has diminished to none. My breasts are very tender. I feel like Iโm pregnant, but Iโm not. I recently started taking hemp oil around the time of the change in my body. Can this be the cause of the imbalance?
Thanks, Angie
Hi Angela,
Possibly, it would be hard to say for sure without a lot more information.
Hi Dr. Childs
Your article above is very intersting!
My progesterone level is through the roof. I tested it in the saliva and they said it was three times of what’s the “normal high”. I then went to my gyn and had it tested in the blood with the restult that the level was normal (tested on the 21st day of my cycle).
I also tested all the other sexual hormones and my gyn said that I got absolut perfect results. And that they do not see any imbalance.
Thyroid (T3, T4 etc was tested 2 years ago and all ok).
About two years ago I started to feel changes in my body and face before my period, after never having experienced PMS, acne, anything. I started to have greasy scalp and excess sebum production in my face, plus more facial hair, resulting in big pores. I got eczema and very sensitive breasts.
I must add that I’ve been suffering from depressio the last 2.5 years, due to a trauma, finally feeling good again. But it was a very time and my body has been going through a lot. Symptoms with no real diseases, lots of stress, hemogram was off, very low iron, zinc, B12, all together. I did lots of tests, a CT, MRIs, ultrasounds, scans.. You name it.
I got diagnosed with cysts in my kidney, endometriosis (had surgery a year ago) and kryptopyrroluria. Due to the last one, I had to take supplements with lots of zinc, B6 and mangan.
I just read now that if you have too low progesterone, you should increase your intake of zink and B6. Could this be a reason?
Or maybe the endometriosis, even though I still have my ovaries and they both work perfectly well.
My cycle is most of the time very regular (28 days) and I do not have any other symptoms..
How can I find out what imbalance I have and what causes it? Are there any other tests I can take? Any insight from you would be greatly appreciated.
Many thanks!
I forgot to mention that I recently turned 38
Hi Dr. Childs,
I have been experiencing many of the high progesterone symptoms you mentioned (Iโm in peri menopause at age 51). Iโm trying to adjust my dose of bio identical progesterone to alleviate these symptoms. My question is, could high progesterone be causing stiffness in my joints or muscles throughout my body?
Thanks for the article. Iโm trying to work out whether I have low or high progesterone at the moment!
Iโm 34, breastfeeding, and suffer with hay fever terribly (greatly exacerbated during pregnancy). I have had anxiety and depression in the past but fine now (although Iโm rarely โhappyโ). Due to breastfeeding cycles are very irregular so testing might be hard.
Any ideas? Iโm in the UK.
Hello. I am 38 years old women who was diagnosed with Premature Ovarian Failure and l am on body identical hormones. 50mcg estradiol patches and 200mgs natural progesterone for 12 days of the cycle then l get an artificial bleed. My question is that lately l ve heard one menopause specialist doctor saying that l could reduce my progesterone dose 1 capsule a day as l am using it internally and this way it gets more absorbed. On one hand l would love to do that as it gives me fatigue and dizziness during the progesterone part of the cycle however l am also hesitant to do so regarding the protection of uterine. Thank you.
Ive been diagnosed with hypothyroidism almost a year and a half ago but was untreated for many years.. on on 75mg of eltroxin and have had my hormones tested a few months ago but have been on progesterone for a while as Iโve been test and going through peri menopause.. Iโm taking 200mg of bioidentical progesterone. While it has helped my mood and depression and anxiety a bit, my breasts become super sore and achy for weeks until I get my period but when I get my period they are ok for a week.. also I get blurry vision some days worse than others, hair loss, scalp get sores and itchy, and foggy head. Iโm been to a natural path and my dr. and still trying to find answers.. should I get my adrenals and cortisol checked again along with thyroid which was tested a few months ago and it was getting high, and estrogen & progesterone tested as well? Iโve had to become my own advocate and looking for answers.. hope u can help
Yes I have all the symptoms of high progesterone, the most problematic of which is low libido. I’m post-menopausal and have been on bioidentical hormone replacement for years. I started on testosterone and estradiol pellets (plus oral progesterone) which initially gave me fantastic libido. Over time, however, libido became very random. A little over a year ago I switched to E & T injections hoping for a better result, but things have not improved. I’m convinced that the static dose of progesterone is largely to blame for my low libido (BC pills also killed my libido). But, how do you rectify this? Doctors tell you that you MUST take the daily 200mg of progesterone to avoid certain cancers. However, I know my pre-menopausal body did not secrete a daily dose of progesterone like this and, therefore, this seems unnatural. I also know that a great many women on a hormone therapy protocol that includes progesterone have the same issue with low libido (I was in a FB group and this issue came up frequently). Doctors I’ve asked about this are clueless and largely apathetic. One just shrugged and said, “well, women are complicated.” I’m to the point (although I swore I would never do this) where I feel that I need to cycle my hormones just to feel normal, even if it mean I will have to once again have a cycle. Hoping that some doctor somewhere will come up with an answer.
Hello Dr. Childs! What a great site, thank you! I am struggling to figure out how to help my progesterone dominance. I am 40 yo and have had extreme breast tenderness in the week before my cycle starts. Stress has been high over the past several years. I tested via DUTCH test first and a blood test 2 months later, both around day 21 of my cycle. I was very progesterone dominant on both labs. On the DUTCH test, estrogen was frankly low and progesterone was high normal. Oddly, cortisol levels were very low too but epinephrine was high. 2 moths later, my estrogen had improved (I had been taking herbal adrenal support and herbal phytoestrogens), but my progesterone is still high and the breast tenderness is unrelenting. My thyroid levels are: TSH 2.23, free T4 and are T3 in middle of reference range but high reverse T3 at 24. I am working on managing my stress, but I still have a busy lifestyle. Any other suggestions for the breast tenderness? I’m at a loss. Thank you!!!
Hello Dr. Childs,
I was very estrogen dominant with endometrial hyperplasia, and morbidly obese, and my doctor put me on a daily micro progesterone pill. Over the last year Iโve lost over 100 lbs, and am feeling great in most ways. However, for almost the entire time between ovulation and my period, I have swollen and extremely tender breasts. Could my weight loss have changed the estrogen dominance so that now Iโve got too much progesterone from the micro pill?
Hi Ash,
It’s certainly a possibility. I always say that if someone has lost 100 pounds or more that they are a completely different person than they were previously so all hormones/medications/etc. should be checked and adjusted as necessary.
Hi, Iโm 48 five months ago Iโve been getting really bad hives like urticaria on my face and neck. Iโve noticed a pattern it happens about 1 week before my period. Iโve seen over 12 doctors. One doctor has diagnosed me with autoimmune progesterone dermatitis catamenial anaphylaxis. No one has even done any hormone tests. Iโve only had blood work and my thyroid was high in December 6.92 itโs now 1.19 now. Please give me some feedback.
Thank you,
Rachel
I’ve had the same issue for almost a year now, and I am 48!
I believe my own body is rejecting it’s progesterone leaving me with autoimmune progesterone dermatitis.
Hi Melissa,
It’s rare but it can happen.
Hi Dr. Childs,
I am at perimenopause stage near 50. My periods had still arrived every month although not as full as previous years but still came. Last month i had an intensive workout trying to deal with work stress and felt fatigued after (still recovering from anemia). This month my period didn’t come and i had straight days of insomnia starting from the day i should have had my period. Do you have an explanation on this? It feels like I’m wired and adrenaline-filled at night. My bp is higher than usual. My heart is palpitating especially lying down. Even after my workout, i can fall asleep for the next 2 to 3 weeks leading up to my period. I do not know whether my workout has impacted my hormones in a negative way. Just on the day of my period, i started having insomnia. Any insight please? And what should i be getting tested?
Hi Avis,
You may be slipping into menopause and experiencing the symptoms associated with that. I would recommend comparing your symptoms to those found here to see if they match: https://www.restartmed.com/menopause-symptoms/
Hi Dr. Weston Childs,
Thank you for the great article. I am a 42 year old female, prescribed 100 mg of bioidentical progesterone troches. The DUTCH test showed post menopausal levels of progerone. It worked well for about 6 months, no more pms symptoms, lighter flow, slept better, and lost ten pounds. Recently I have been experiencing some unwanted symptoms such as brain fog, bloating, gained 4 lbs in four months, heavy flow and cramping all through the luteal phase. It seems like each month in the luteal phase I gain 1 lb and it never goes away. Does this sound like I now need to decrease the progesterone? Or is it possible I need to increase? Any advise would be great. Feeling very defeated. Thank you
Hi, Iโm a 52-year-old female, taking 200 mg daily of progesterone 60 mg daily of armor thyroidโฆ Also taking one DiM capsule and have testosterone pellets. Itโs been four months since I started this regimen. Still feeling pretty terrible. A lot of Hair loss, very fatigue, feeling down and a little anxious, suddenly having a lot of low back and left hip pain. From what Iโm reading Iโm wondering if my
Progesterone dose might be too high? Feeling a little frustrated with the doctor Iโm seeingโฆshe doesnโt seem on top of what Iโm taking, my side effects and my lack of improvement. Thoughts?
Hi Tracy,
There are many other hormones that can contribute to your well-being and they must all be looked at it concert with one another. You’ll want to look at more than just your progesterone including hormones like estrogen, testosterone, thyroid hormone, and cortisol.
Hi, found this good reference searching for high progesterone symptoms. I’m going to guess my case is unusual in that I’m a 52yr old male who supplemented with 3-5mg a day for 6-8 weeks to try to increase libido. I read that very small amounts in men can be helpful.
I’ve monitored with saliva testing from the start but after 8 weeks my P4 level went through the roof. As in twice the high end of the range. No overt symptoms but that was a bit of a shock. I’ve stopped straight away and to be honest it didn’t do much other than see me gain 5 pounds & have a bit of day time fatigue.
Lesson learnt I guess! DHEA would have likely been a better option.
Hi Jay,
Men tend to do better using pregnenolone or DHEA (as you mentioned) as opposed to progesterone. But you are correct in that using progesterone can sometimes improve libido in men. The only problem is that, from my experience, the risk of problems is too high when using progesterone because the dosing tends to be more directed toward women. For this reason, it’s easy to take too much and cause more harm than good. But that’s just my experience.
Dr. Childs,
Your article really educated me on progesterone issues. I am struggling with break outs along my hair line and on my scalp every month. This has been going on for many years. It is very uncomfortable and painful. I have taken birth control pills consistently for the majority of my life, 17 -30 years old, stopped to have my babies, then back on it from age 33 to 43 present day. I went to a functional doctor here in Tulsa. He mentioned it was my progesterone levels causing lesions on my head. I do drink 1 cup of coffee each day and took note on what you mentioned about caffeine and cortisol levels being connected. I was wondering what your thoughts were about these reoccurring bumps, I am so over them. Do you think this may be a progesterone thing as well ? Thanks for your time. Katie
Thank you for your article, hoping you can help answer my question? I had premature ovarian failure in my late 20’s so have been post-menopausal for about 10 years now. I use an estrogen patch but have never taken progesterone. I also had a hysterectomy 8.5 years ago.
I went to see an endocrinologist because I am having a lot of hormonal imbalance symptoms: fatigue, serious weight gain despite dieting/fasting/weight loss programs, complete lack of libido, hair loss, breast pain/swelling, joint and leg pain, depression, anxiety, hot flashes, heat intolerance, increased appetite, decreased strength and endurance. I thought it could be due to low testosterone (my labwork shows it is low) but my doctor won’t let me try a supplement.
My most recent labwork showed a progesterone level more than 10x the normal expected level. I’m wondering if the progesterone is causing some of these symptoms and what I need to do? My doctor won’t answer and can’t see me until February but I’m worried because I can’t see any reason for my progesterone to be this high!
dear dr Childs, I would be very grateful if you could answer, I am desperate.
I am 46 years old women with androgenic alopecia. My dermatologist prescribed me Diane 35 birth control pills(in addition to spironolactone and minoxidil). When I quit birth control massive shedding started, now lasting for 7 months. Meanwhile, I did my blood serum hormones (third day of cycle) and it appeared my estadiol is too low (since I am in perimenopause) but progesteron high. However, doctor said that progesteron in folicular phase is not important, but I read that high progesteron can cause shedding. All other sex hormones are normal. Please, help me with advice! Gynecologist sugests HRT, but which one? I am so scared not to worsen the situation with shedding even more by introducing HRT, because I am prone to hormonal imbalance since younger age(as a young 25 YO I have had amenorhea for several years).
Kindly help with advice.
Hi,
I have been on RDT progesterone since 30 years old (75mg daily) to balance high estrogen. I am now 43 and experiencing what I feel is progesterone overdose: insomnia, dizziness, depression, pms. My doctor tried to change dose and titrate it last year but I ended up with terrible insomnia lasting 4 months and sever night sweats. I was put back on original tablet and dose and have now developed lichen planus Pigmentosa. I also have hashimotos. I have been on 120mg of dedicated pig thyroid RDT also for 10+ years. Can I wean off my progesterone slowly? Or at least reduce dose safely?
Hi,
I just started BHRT but looking back on results from a naturopath last year, she had put me on Calcium D-Glucarate – can people take this with BHRT or does that clear them out of the system too fast? If so, is there an alternative for lowering B-Glucuronidase levels?
Thanks!
Hi Anina,
It’s fine to take calcium d glucarate with HRT, you just need to be aware of your symptoms while doing so.
You mean just keep an eye on any different symptoms that crop up after starting the Calcium D-glucarate? I heard there’s potential for it to lower estrogen. If it did, would I just adjust the HRT to counteract the new symptoms?
Hi Anima,
Yes, you could make changes to your dosing as needed.
Hello,
You mentioned a ratio of 10:1 Estradiol to Progesterone. I noticed the labs seem to report estradiol in pg/mL and progesterone in ng/mL. Do you need to do a conversion to calculate the correct ratio?
Hi Dr. Childs, I’m 53 still menstruating and on HRT. I have a history of a luteal phase defect while TTC – my cycles were always long. I stopped using the combined BCP in my mid 40s due to blood pressure concerns which were gotten under control through diet and exercise. My weight is stable, my diet is good and I exercise regularly. But ever since stopping the pill I have suffered from excessive core sweating – no hot flashes, no night sweats – and it is just my core, not hands and feet. I do feel it’s worse when I am taking oral progesterone for 2 weeks of the month. I also have had Raynaud’s Disease since my teenage years and it comes in response to exposure to cold as well as after exercise when my body cools down, regardless of the outside temperature (e.g. even in the heat of the summer). My thyroid labs have been fine. No one has an answer for me. What would you suggest testing? Thank you.
Hey Nicole,
The core sweating that worsens on oral progesterone is a big clue. Progesterone raises your basal body temperature by acting on the hypothalamus, and in some women this triggers excessive sweating as the body tries to cool itself down. The fact that it started after stopping the pill and gets worse during your progesterone weeks strongly suggests a hormonal connection.
Combined with the long history of Raynaud’s and luteal phase defects, what I’d want to look into is your overall autonomic nervous system function. Raynaud’s is fundamentally an issue of vascular tone regulation by the autonomic nervous system, and temperature/sweating regulation runs through that same system. It’s possible you have an underlying autonomic sensitivity that’s being unmasked now that you’re no longer on the pill (which tends to flatten out a lot of hormonal fluctuation).
In terms of testing, here’s what I’d suggest:
First, get a full thyroid panel, not just TSH. I know you said your labs have been “fine,” but that often means only TSH was checked. You’d want free T3, free T4, reverse T3, and thyroid antibodies. Subclinical thyroid dysfunction can absolutely contribute to temperature dysregulation and is easy to miss with standard testing.
Second, check your estrogen and progesterone levels during both phases of your cycle to see exactly where you stand. At 53 and still menstruating, you could be in a transitional hormonal state where your levels are fluctuating more than your current HRT protocol accounts for.
Third, look at cortisol (preferably a 4-point salivary cortisol or DUTCH test) since cortisol interacts heavily with both thermoregulation and autonomic function.
Fourth, consider checking inflammatory markers (CRP, ESR, ANA) given the long-standing Raynaud’s. Sometimes Raynaud’s is the first sign of an underlying autoimmune process that can take years to fully develop.
You might also experiment with switching from oral progesterone to transdermal progesterone cream and see if the sweating improves. Oral progesterone gets metabolized into allopregnanolone in the liver at higher rates, and that metabolite has stronger effects on the central nervous system, including thermoregulation. A topical form may give you the progesterone you need with less of that sweating side effect.
Hope that gives you some direction!