- 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!
Do you know what this means? My basal body temp appears to rise after ovulation then dip in the middle and rise again today on day 25? I also have brown spotting when it dips. Any feedback would be greatly appreciated
Hi Lisa, you may want to get your progesterone levels tested for confirmation. It’s hard to know what could be happening in your cycle without actually seeing your charts.
I’ve always suspected my progesterone levels are low bc around two weeks prior to my cycle starting my sleep goes haywire. I have always struggled with sleep issues, but it consistently gets really bad right before I start and then improves (relatively). I’ve been meaning to get it tested, but I have yet to consistently track bbt. This is a very helpful post! Thank you!
So, I have had two early miscarriages. My progesterone was checked when I was pregnant the 2nd time. It was at 9.2., which they said was low. I took progesterone, but I miscarried 2 weeks later. I have a pretty “normal” cycle give or take 2 days. I ovulate 2-3 days later than expected sometimes but my period always stays on track by also coming 2-3 days later than expected, which makes me believe I do not have a luteal phase defect. My luteal phase is usually 14 days. I have a 7 day period that is a medium flow. I had an ultrasound during my first miscarriage and they said my lining was nice and thick, which they also said at my second when I was about 5.5 weeks along but there was no sack present (this was before I even started bleeding). What is going on!!!!! I don’t know whether to think I have low progesterone or not….
I also got pregnant FAST both times. First pregnancy took one cycle, 2nd 3 cycles.
Hi There!
I’ve just had what felt like a million blood tests to check all sorts of things. I have just come of the pill after 12 years in June, and had a withdrawal bleed but no period since. I’m on cycle day 85 (but can you count it as a cycle even?). My bbt has remained low and it doesn’t look like I have ovulated even once in all that time! The only thing the blood tests revealed was low progesterone so my GP had me have a pelvic ultrasound and one more blood test to check another hormone.
I’m desperately hoping that being on the pill for so so long and skipping so many periods is the only reason why. Over the 12 years I probably averaged at about 4 ‘periods’ a year because I was told I could skip continuously without problem. I have been having acupuncture twice a week for about 12 weeks + been taking herbal medicines for about 6 weeks but still nothing.
I will be off to a gynaecologist next but as above, am hoping I’ll just need a few progesterone injections to reset my body back.
Is this likely?
Thanks,
Hi
If period is late (today is the 50 day from the First day at last period). last period was on 19 july
I did a progestrone test on 3 september it was 0.2 ng/ml lab normal range(follicular phase<0.1-3ng/ml. Luteal phase 1.2-15.9ng/ml)
I am 34years old . unmarried. Not pregnant. Have always been regular with my periods and i do track them with an app (clue)
Any ideas please???
This is very helpful thank you!
My OPK suggested I was due to ovulate on day 21/22 this month but GP insisted on testing my hormones on day 21. Progesterone showed as very low – 2nmol/l and whilst this is probably abnormally low regardless of the date, I still think they took it too early to give me accurate results. I will ask for another test on day 28!
Hi,
I would be beyond grateful if you could reply to my comment.
I’m in my early 20s and I’ve been observing my body for a longer period of time, that is about 2 years. I’ve done a lot of hormonal tests. It seems like I have tooo low progesterone (that means 0,1ng/ml, yes – ng/ml) and a bit too low estrogen and it looks like estrogen dominance. I went to several doctors and basically they told me I’m overreacting and this is the way my body is lol I got cysts and fibroids and they say it’s normal?! I have depression, dark body hair, acne, water retention etc…
It’s probably unusual question but I have small breasts. My mother and grandma have E/F sizes and they used to be barely A before pregnancies in their 20s/30s. I talked to them and they had similar issues as me (obviously they didn’t test their hormones when they were my age). Do you think their breast growth may be associated with their hormones balancing during pregnancies? And if so, is it possible that if I would balance my hormones my breasts would grow?
Hi Cat, if you’re looking for specialized support, take a look at my program offerings. Also have a listen to this podcast episode about finding a practitioner who will support you.
Have you had your prolactin levels checked?
My doc said I have very low progesterone (.02) but she tested on day 6 of my cycle?
Hi Cg, a progesterone test is only useful post ovulation. By day 6 you hadn’t ovulated yet. Have a listen to this podcast episode (here).
This was extremely helpful. I had a miscarriage in May of this year, and it has taken a couple cycles for my cycles to become “normal” again. I have been charting for over a year, and my luteal phase is generally 12-13 days, but recently, I had noticed that post O, my CM wasnt drying up, and I was also missing pms that I had before (sore breasts, cramping, etc). I saw my dr, she did an ultrasound to make sure everything was healthy post MC, and luckily I had ovulated 4 days before the ovulation (according to my BBT. I started using clearblue fertility monitor this month, but it gave me “high” results for about 10 days, before showing “low” which showed the day after my temp rise). But, the ultrasound showed the ovulation had occured, and I had my levels tested at 9DPO.
My levels came back at 3ng, which she said are low. I have an appointment with her in a couple weeks (holiday season is packed apparently!), but I have been looking up more things, and have been told that low progesterone is not a diagnoses, but more a sign that something else is wrong. Is this correct? Everything I have read indicates that low progesterone is a hormonal imbalance, and not directly showing that something else is wrong and I need more tests (the person whom said this recommended other diagnostic test such as CD3 blood work).
I want to be well equipped with knowledge and questions on where to go from here when I have my appointment. Any advice would be beyond appreciated!
Hi Britt, for support charting your cycles, and interpreting what’s happening in your cycles, consider joining one of my programs. Also, seek the support of a functional medicine practitioner to help you identify the underlying issue that is causing your symptoms.
I had my Progesterone tested on cycle day 21 and it came back at 11.7 (Ovulation phase). I had my first Peak result on OPK on cycle day 15 of this month. Would that suggest I do ovulate on cycle day 15 or 21? ? ?
Consider listening to this interview: http://fertilityfriday.com/106 and also charting your cycles to help you identify ovulation. You’ll also find this episode helpful: http://fertilityfriday.com/20
Hi, I have been trying to conceive for a year now after coming off the pill. I have been experiencing dark brown spotting anything from 4-7 days before my period starts. Had my progesterone tested in the summer, first test was borderline & 2nd was positive for ovulation but spotting still continues each month… Had a pelvic scan which was all normal. Any ideas as to why the spotting?
c
Hi.im trying to conceive this month..and i need help so bad.1 wk after ovulation,i felt a high bbt,but went back down after it.and i still have to wait 1 week for my nxt period to come.what is this?ur comment wud be highly appreciated.tnx
I realize that I am kind of jumping the gun here, but my husband and I have been doing Natural Family Planning/Fertility Awareness method for almost 17 years and my luteal phase is always 13 days. My 7th child (all 7 babies were planned btw) is 19 months and I finally had my first ovulation a week and a half ago! (He’s a passionate breastfeeder). Prior to his pregnancy, we miscarried twice due to low progesterone, which was discovered by my midwife very early on in his pregnancy. I have made some diet and exercise changes since then hoping to get my body back on track, but my luteal phase after ovulating for the first time since baby #7 was very short – about 8-9 days, so I’m already 3 days into my first period. Kind of bummed and want to be on top of this issue.
My natural cycle is generally around 28-30 days and my uterus lining is always thick (around 12mm) when I do a round of IVF. This contradicts what I know about low progesterone. How is this possible? A doctor did say that the progesterone levels in my blood are different to the progesterone levels in my uterus- is this correct?
I’m currently in a round of IVF and after transferring two healthy embryos and being on a high dosage of vaginal and injection progesterone for 1 week prior to the transfer my progesterone level was only 6.94. How can I help my body absorb the progesterone medication or naturally produce it myself?
HI I have low progestron and estradiol levels and I am 38 I am trying to get pregnant dose it have treatment to make it high?
I have regular 26 days cycle and slim I am taking levothyroxine and lamotrgine medication for long time. I am also worried may be I am going to monoposal I never missed my period and regular cycle. Please answer my question
Hi Rebecca, you will benefit from working with a functional medicine practitioner who can provide individualized support. Grab a copy of The Fifth Vital Sign for more on timing sex accurately, charting your menstrual cycles, and navigating fertility challenges. Also have a look at my Get Pregnant Naturally Program.
My fertility doctor asked me to take an ovulation test. Once the test was positive I was instructed to have my pergesterone level 7-9 days after the positive test. I was tested in day 9 and my result was 4.4 ng/ml.
I was also told if I didn’t get a positive ovulation test that I could go on day 21.
I use the Creighton Method for charting. My red flags were brown spotting a day or two before my period and after. My luteal phase has been 10-11 days. I had my progesterone tested 7 days post peak. My estrogen was at 94 (they told me 110 was what they like to see but they weren’t worried). My progesterone was 11 (14 was what they want to see). I wasn’t ready to start injections at that time so I researched and I started taking more vitamin c and b6. I seed cycled. I tried cutting back on exercise. Nothing made a difference. So I tried Vitex. My second month on Vitex I got a positive pregnancy test. My hCG and progesterone were low (hCG 12 / progesterone 11). So I started injections. Second hCG draw was 8, so I stopped progesterone and that pregnancy ended quickly. The following month I decided to go ahead and do the injections after ovulation. We got another positive pregnancy test. It was surreal but everything seemed to be progressing fine. At what should have been our 8 week appointment there was just a gestational sac and yolk sac; no baby. So I have again stopped progesterone injections, but after a week and a half nothing has happened. I’ll get my second hCG draw levels on Monday and we’ll fo from there. I want to take a few months off and try to work more on my nutrition and see if I can help my body work better on it’s own.
Hi Amanda, I’m sorry for your loss. Fertility challenges are complex, and are related to multiple factors (including possible male factor). Grab a copy of The Fifth Vital Sign. I devote an entire chapter to preparing for pregnancy, and outline what both you and your partner can do to improve sperm and egg quality. Everything is backed with multiple scientific references and I know you’ll appreciate it (especially since you use the Creighton Method). Wishing you the very best!
I think I tested my progesterone maybe at 6 dpo because I was unsure of exact ovulation. It is supposed to be CD 17 and I tested at CD 23. The result was 6.12 could it have been higher if I had waited till CD 24 and could I conceive? I feel pregnant and my luteal phase is 14 days. Please help!!
Hi Leila, have a listen to this episode: http://fertilityfriday.com/106 In order to time the test accurately, you’ll want to track your fertile signs and identify ovulation (your cervical mucus and basal body temp!).
My progestrone was 1.4 on day 21 and my doctor said this is positive for PCOS but i didn’t start my period until day 31. I told her I thought the test was done too early but she said nope the 31 day cycle was consistent with PCOS.
Hi! My luteal phase is usually 16 days. Now I read 12-14 is normal and less than that usually means low progesterone. What about a long luteal phase – does anything jump out at your there?
A healthy luteal phase ranges between 12 to 14 days in length. Have a listen to this episode for additional details: http://fertilityfriday.com/106
So helpful; thank you!
I believe I recall Dr. Pope mentioning the importance of knowing your Peak day. If my Peak day is a day or two prior to ovulation, should I have my progesterone tested seven days from my Peak day or seven days after my temperature rise? Thanks so much for clarifying!
7 days after peak (and it should coincide with your temp shift in a normal cycle).
Very informative information. Im 33 with no known medical conditions. I’ve been tracking my cycles since stopping birth control coming up 1 year ago. I use an app, and also use OPK to track ovulation. Im not consistant with temping. I’ve been pregnant twice, both times failing to make it past 8 weeks.
I was recently trying to investigate late ovulation and discovered short luteal phase is a problem.. my cycles range from 26 to 29 days with a luteal phase ranging from 7 to 10 days. I did get tests done 4 AND 7 days past ovulation. Day 4 was 20.6 nmol/L and day 7 is 9.8 nmol/L (CD30 TODAY).
I do have follow up with my general practitioner in 2 days time but I’m not hopeful she will be able to help with treatment (was banging my head with blood tests). I understand your stance on a natural approach, but do you have any information or advice on progesterone treatment otherwise?
Thanks so much (from New Zealand)
If you have questions about your progesterone levels and treatment I recommend working with a functional practitioner to support you! Also, have a listen to this podcast episode.
Hello I am charting my BBT and I saw the peak of my temperature on CD 15 which would be normal showing that I ovulated then it stayed high for only 4 days so on CD 19 it drops down again to the same levels that I had on the preovulatory days. I am very regular my periods always comes on day 28-29 so I don’t know what might caused my temperature to drop like that. Do you think I have low progesterone?
Hi Lisa,
Your podcast has been so helpful for me in re-regulating my cycle and levels post birth control pill. I went off of it mid October 2020 and had short luteal phases for the 3-4 months following, but I did get my period back the first month (yay!) and I am pretty positive that I have been ovulating as well (have been charting my cycles, BBT, CM, etc). Per listening to your episodes including some of the things mentioned in this article, I seemed to have low progesterone (pre-menstrual spotting, lower pre-ovulatory temps, 8-9 day luteal phase). However, per your and other doctors’ suggestions on your podcast, I added in more animal fats, specific foods and supplements, and grass fed butter and this past month, my BBTs have been mostly higher and last month, my luteal phase seemed to be about 13 days. I’m hopeful.
I did just have my progesterone and hormone levels checked on (cycle day 10) and my progesterone was 0.06. That seems very low from what I’ve been reading. But after reading this article, maybe that’s okay since I haven’t ovulated yet? What’s your take on this?
Thank you for all that you do! Your podcast has helped me so much!!
I’m confused how to know for sure that I’ve ovulated if I have low progesterone. My BBT rises so slowly that it’s hard to determine which day was ovulation. I’ve taken ovulation tests and they don’t match what my fertility tracking app indicates as my ovulation date. My CM also seems to be the fertile consistency for a few days, so pinpointing an actual date has been hard. What are your suggestions? Thanks!