Should Low Progesterone Be Treated?
Question
I’m 35, have been diagnosed with low progesterone from an NFP P.A. She also told me that my FSH and LH ratios are inverted. She said that my symptoms indicate a mild form of Polycystic Overian Syndrom because of this ratio inversion…yet when I read up on this I really don’t have any outward symptoms that describe it.
My husband and I have been open to having a 3rd child but so far, we haven’t gotten pregnant. I’m okay with this and even relieved at times with my apparent “infertility”.
My questions:
1. What are the negative affects of low progesterone other than infertility? If I don’t have my heart set on pregnancy, should I be worried about treating it? I don’t really have PMS, excessive tiredness or any other bothersome symptoms either. I’m mostly concerned about bone loss (osteoporosis runs in my family) and other problems that would affect my overall health. For three cycles I took Prometrium 300mg post peak for ten days but it really hasn’t helped my pre-menstrual spotting or tail end brown bleeding either. Same thing with the 400 mg of B6, not much change. I’ve since stopped taking both and have not gone back for follow up at the NFP Medical clinic since it’s two hours from where I live and very hard to coordinate the trips.
2. What do you think of the PCOS diagnosis? I’m really skeptical. She said my symptoms lean toward being pre-diabetic. (I’m not obese. 5’5″ and 130lbs) Do you have any resources I could read up on that give symptoms for mild cases? Is there something else you think it could be? Can exercise help significantly to regulate hormones? Diet?
3. What could be causing the low progesterone? I’ve read that it’s become very common and one of the new “epidemics” of our day. Is it due largely to the estrogen dominance in our water supply etc., chemicals??? Do you think I gave up too soon on the Prometium treatment? Could I benefit from a cream instead? Is it even worth treating since it’s not really affecting me greatly right now? Should I see a reproductive endocrinologist? None in my area…grrrr. I’m sure you’ve guessed by now that I’m a person who likes to get to the bottom of things. I just want to know what’s going on with my body.
Sorry so many questions. I think of everything to ask. 🙂
Christine
Answer
Last Updated: August 15, 2023
Very good questions. To begin with,the symptoms usually considered part of PMS include irritability, anxiety, crying easily, bloating, breast tenderness, carbohydrate cravings, often chocolate cravings, depression, decreased concentration, fatigue, headaches, mood swings, and sleep disturbances.
If you are not having trouble with these symptoms, there may still be a reason for progesterone supplementation, but it would require further evaluation. Was the low progesterone from just one lab value, or from a series of every other day blood draws? Although we often take short cuts with just one lab because of the convenience, there are times when it can mislead us. However, when the clinical scenario doesn’t fit the labs it’s better to do more investigation. Other things we would look at is whether or not your post peak phase was widely variable, and the length of the perimenstrual spotting to see how aggressive the evaluation should be.
If you are overall feeling well, it would be wise to be sure you have the usual health habits in place – balanced diet without too much concentrated sweets if you have risks for diabetes, and regular, weight bearing exercise, with calcium and vitamin D either in your diet, or supplemented, to help decrease your risk of osteoporosis. A peak + 7 estradiol level can also help assess the risk for osteoporosis.
If your chart continues to be abnormal, I would recommend you have your charts, and possibly blood work reevaluated. One of the great beauties of charting is the potential to detect disorders early, and they can also reflect the improvement of health when beneficial lifestyle changes are made.
It’s great to have an inquisitive mind to explore the mysteries revealed in us. Keep up the good work!
Lynn Keenan, MD
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