13 Signs You May Have Low Progesterone, According to a Women's Health Expert

Medically Reviewed by Felicia Newell, M.S., RDN

October 24, 2023

Progesterone levels rise and fall in a cyclical manner all throughout a female’s life. This is normal! But when progesterone levels get too low, it can lead to irregular menstrual cycles, mood changes, brain fog, and a whole slew of symptoms.

As a registered dietitian who has focused on women’s health for the past twenty years, I list out 13 symptoms of low progesterone that I commonly see in clients of all ages. If you’re experiencing any of these, it may be time to speak with your doctor on how to best rebalance your hormones (and to rule out any other underlying health conditions). 

How Can I Tell If My Progesterone Is Too Low?

While it’s important to remember that progesterone levels can fluctuate—especially if you’re still menstruating—having consistently low progesterone can be associated with the following side effects…

1. Irregular Menstrual Cycles

Irregular menstrual cycles can often be a sign of insufficient progesterone levels in the body. This hormone plays a crucial role in regulating the menstrual cycle and preparing the uterus for pregnancy. 

If a woman's progesterone levels are low, the frequency and regularity of her menstrual cycle may be affected (1). This irregularity can take the form of periods that are too frequent, too far apart, or even absent altogether.

2. Painful Periods (Dysmenorrhea)

Low levels of progesterone can also lead to painful periods, a condition medically referred to as dysmenorrhea. This is because progesterone plays a crucial role in regulating the menstrual cycle, and an imbalance can lead to irregular uterine contractions, causing pain and discomfort. Dysmenorrhea may be accompanied by other symptoms such as nausea, fatigue, and, in severe cases, fainting (2).

3. Infertility or Difficulty Conceiving

Progesterone's role in the reproductive process extends beyond menstrual cycles. An optimal level of progesterone is crucial for the successful implantation and growth of a fertilized egg (3). 

If progesterone levels are too low, the lining of the womb may not become thick enough for the egg to implant, leading to difficulties in conceiving—this is often a common cause of infertility in women. Moreover, even if implantation occurs, insufficient progesterone can result in early pregnancy loss or miscarriage.

4. Breast Tenderness or Swelling

Low progesterone levels in the body can also lead to breast tenderness or pain, a condition known as mastalgia (4). This is because progesterone, along with estrogen, plays a critical role in breast development and cyclic breast changes during the menstrual cycle (5). 

When the balance between these hormones is disrupted—such as when progesterone levels are too low—it can lead to an overgrowth of breast tissue, causing discomfort and pain. Breast tenderness can range from mild to severe and may be accompanied by a sensation of heaviness or fullness in the breasts.

5. Bloating & Water Retention

Progesterone also plays a vital role in regulating fluid balance in the body. When progesterone levels are low, the body may retain more water and sodium than usual, leading to bloating and a feeling of puffiness, especially around the abdomen (6). This can also result in weight gain and increased blood pressure. 

Women may experience these symptoms more acutely in the week leading up to their menstrual period, a time when progesterone levels naturally dip. If such symptoms persist or cause significant discomfort, it’s advisable to seek medical advice for potential treatment options.

6. Acne or Oily Skin

Another symptom that can be attributed to low progesterone levels is oily skin and acne. Progesterone helps regulate the production of sebum, the skin's natural oil (7). 

The body may produce excess sebum when progesterone levels drop, leading to oily skin and clogged pores. This can result in acne breakouts, particularly during the premenstrual phase of the cycle when progesterone levels typically decrease. 

7. Increased Facial Hair (Hirsutism)

An unexpected symptom linked with low progesterone is the growth of facial hair in women, also known as hirsutism. Progesterone, along with helping regulate menstrual cycles and maintaining pregnancy, also counters the effects of estrogen. 

When progesterone levels are low, there’s an increase in the relative concentration of estrogen and testosterone in the body. This higher level of testosterone can cause an increase in the rate of hair growth, particularly in areas such as the face, where hair growth in women is usually minimal (8). While some hair growth is normal, excessive or sudden changes in hair distribution should be discussed with a healthcare professional. 

8. Thinning Hair or Hair Loss (Alopecia)

Another symptom of low progesterone can be hair loss or hair thinning. Progesterone is vital for regulating the hair growth cycle, promoting the growth phase of the cycle. When levels of this hormone decrease, the hair growth cycle could be disrupted, leading to a prolonged telogen or shedding phase (9). 

This imbalance can result in noticeable hair thinning or even hair loss. It's important to note that other factors, such as stress, diet, or certain medical conditions, can also contribute to hair loss.

9. Mood Swings

A less visible but equally disturbing side effect of low progesterone is mood swings. Fluctuating hormone levels can have a significant impact on the brain's neurotransmitter balance, including serotonin, which is often referred to as the ”feel-good hormone”. 

When progesterone levels decline, serotonin levels may also decrease, resulting in mood instability (1). This hormonal imbalance can lead to feelings of anxiety, irritability, or depression. 

10. Difficulty Concentrating or Brain Fog

One of the cognitive symptoms associated with low progesterone is the experience of “brain fog.” Brain fog refers to feelings of confusion, forgetfulness, and a lack of mental clarity. 

Decreased progesterone levels can affect the function of GABA, a neurotransmitter that promotes calmness and helps in reducing mental stress. When progesterone levels are low, GABA function may be compromised, potentially leading to brain fog. 

11. Joint Pain or Stiffness

Progesterone has anti-inflammatory properties, meaning it can help to reduce inflammation in the body (10). When progesterone levels are low, this leads to an increase in inflammation, which can manifest in joint pain and stiffness. 

In some cases, individuals may experience a noticeable increase in joint discomfort during certain times in their menstrual cycle when progesterone levels are typically lower. It's worth noting that joint pain and stiffness can have many causes, so if these symptoms persist or worsen, it's crucial to consult a healthcare provider. 

12. Dry Skin

Progesterone plays a role in skin health, and low levels of this hormone can result in dryness and other skin issues. Progesterone helps stimulate the production of sebum, the skin's natural oils, which keeps the skin moisturized and maintains a healthy skin barrier (7). 

When progesterone levels drop, there can be a corresponding decrease in sebum production, leading to dry, flaky skin. Additionally, progesterone's role in promoting collagen production means that low levels can contribute to the appearance of wrinkles and fine lines.

13. Increased Risk of Heart Palpitations

Hormonal fluctuations, including low progesterone levels, can also have an impact on heart health and potentially lead to heart palpitations. Progesterone aids in regulating blood pressure and reducing inflammation, both critical factors for maintaining heart health. 

When progesterone levels fall, it can disrupt these processes and may result in increased heart rate or palpitations (11). These are sensations where the heart feels like it's pounding, racing, or has skipped a beat. 

Takeaways

Low progesterone levels can result in various surprising symptoms that extend beyond the commonly known reproductive and menstrual cycle impacts. These symptoms can range from mood fluctuations and sleep disturbances to skin changes and even heart palpitations. Awareness of these lesser-known symptoms is key to identifying low progesterone and seeking the appropriate treatment. 

As with any health concern, it's essential to consult with a healthcare provider to discuss symptoms, understand potential underlying causes, and develop a personalized treatment plan. Comprehensive care involving lifestyle changes, dietary modifications, stress management, and possibly hormone therapy, can effectively manage these symptoms and support overall well-being.

Lauren Manaker
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Lauren Manaker

Lauren Manaker is an award-winning registered dietitian (RDN), certified lactation educator (CLE), author, and speaker with over 20 years of experience. She earned her BS in Food Science and Human Nutrition from the University of Florida (go Gators!) and an MS in Clinical Nutrition from Rush University in Chicago.

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    Medical Disclaimer

    This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Chad Walding nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement, or lifestyle program.

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