- The first thing to know about progesterone is that you only make it when you ovulate. When you’re on the pill your body isn’t making natural progesterone in any significant quantities. If you aren’t menstruating (and you’re not pregnant), then you’re not making any.
- The second thing to know about progesterone is that it is absolutely required not only for you to conceive, but for your body to sustain your pregnancy full term. If your body isn’t making enough progesterone you’re much more likely not to conceive in the first place, and have a miscarriage early on.
- The third thing you need to know about progesterone is that progesterone plays an important role in developing the uterine lining so that it is ready and able to sustain the life of a fertilized egg.
When you’re not making enough progesterone your uterine lining isn’t able to finish maturing, and that means that it’s not a nice place for your tiny fertilized egg to nestle into.
You can think of your uterus like your bed, and progesterone as the fluffy warm comforter. Without the comforter the egg won’t be able to nestle in and implant in the uterine wall.
That’s where fertility awareness charting comes in. If you’re new to Fertility Awareness, make sure to check out this post for an overview of the basics.
Fertility Awareness cycle charting allows you to record the important events that happen during your menstrual cycle, and gain invaluable information about whether your cycle is normal or not.
One is the length of your luteal phase. The luteal phase, or post-ovulatory phase, is the number of days between your confirmed date of ovulation and the first day of your next period.
If your cycles are healthy you can expect your luteal phase to be between 12-14 days. If you’ve recently come off hormonal contraceptives however, please keep in mind that it can take anywhere from 3-9 months (and in some cases 12 months to 2 years) for your cycle parameters to fall within normal ranges — especially if you aren’t getting the support you need to improve your menstrual cycle health naturally.
If you notice that your luteal phase is less than 10 days on a regular basis then that is a huge flag that your progesterone levels are probably low.
Another indication is premenstrual spotting. If you’ve noticed that you have some degree of light spotting for several days before your next period starts that is another huge flag.
This next section is the most important in this post. You can only accurately test your progesterone levels after ovulation. If you haven’t confirmed that you have ovulated the test is 100% useless.
The problem lies when your doctor sends you for a 21 day progesterone test. The whole concept of a 21 day test is based on the assumption that every woman alive ovulates on day 14. Since most women don’t ovulate on day 14 every single cycle (or ever), choosing an arbitrary day to test every woman’s progesterone makes absolutely no sense.
Again, this is where fertility awareness charting comes in. The day 21 progesterone test is trying to test a woman’s level of progesterone in the middle of her luteal phase, or 7 days after ovulation.
In order to assure that this test is done at the correct time in your cycle you need to first confirm ovulation. Taking your basal body temperature each morning before you get out of bed is the most accurate measure of ovulation (second to having a daily ultrasound of your ovaries). Once you see a sustained increase in your waking temperatures you have confirmed ovulation. You can then arrange to have your progesterone test done on the 7th day after your temperature went up.
A little heads up though. Most doctors are so set in their understanding of the 28 day model of a woman’s menstrual cycle that explaining this to them will be like banging your head on a wall over and over again. No matter how many times you try to explain it, or even if you bring in your charts and show your doctor, you’ll be told to come in on day 21 of your cycle.
You might have to massage the truth a little (i.e. say it’s day 21 even if it isn’t), but make sure you get that test done on the correct day of your cycle.
If you track your cycles and find that you ovulate on day 19 for instance, then taking your progesterone levels on day 21 will show that you have low progesterone, but your progesterone might not even be low. 7 days after ovulation in this case brings us to day 26. A blood draw on day 26 would give you an accurate measure of your progesterone levels in this example. After confirming that you ovulated on day 19, you’d have to be tested on day 26 in order to get an accurate reading of your progesterone levels.
The short answer is yes! There are a number of things you can do to improve your hormone levels naturally, but if this is the part where you expect me to give you a magic list of supplements that will fix your cycles quickly and easily, I’m about to disappoint you.
Your cycles are a reflection of your overall health and fertility. Healing your cycles starts with your diet, your lifestyle, your sleep habits, your gut health, and much more. It starts with making sure your body is getting enough nutrition to rebuild and repair. Only then can we crack out the supplements.
In the mean time make sure to take the first steps to improving your hormone profile by reading 7 ways to boost your fertility naturally.
And make sure to listen to the podcast that I did with Dr. Nora Pope for the full rundown!