Our hormones influence our mood more than we realise. The premenstrual period isn’t the only time when our hormones can make us feel anxious, sad or angry – various imbalances and fluctuations affect how we think and feel throughout the month.

Progesterone is one of the prime culprits. Associated with its role in pregnancy and the menstrual cycle, it’s known for being a natural antidepressant and anti-anxiety hormone that can influence our sleep quality and our resilience to stress.

That’s all well and good when our progesterone levels are fluctuating as they should, but it means that any major imbalances can wreak havoc on our mental wellbeing. In fact, two of the main symptoms of low progesterone are spikes in anxiety and depression. So, how can you tell the difference between poor mental health and a potential hormonal issue?  

To find out more about low progesterone – including the symptoms to look out for and when to seek help from a professional – we spoke to Dr Fiona MacRae, a doctor, psychologist and hormonal health expert at the Marion Gluck Clinic. Here’s what she had to say. 

Alongside mental health conditions like anxiety and depression and mood-related symptoms such as mood swings, low progesterone can have a knock-on effect all over the body. According to Dr MacRae, some of the signs and symptoms of low progesterone include:

1. Infertility or difficulty conceiving

Progesterone plays a crucial role in preparing the uterine lining for implantation during the second half of the menstrual cycle, so low levels can lead to fertility challenges.

It’s for this reason that the National Institute for Health and Care Excellence (NICE) says women who experience bleeding in early pregnancy (before 12 weeks) and have had one or more miscarriages are offered progesterone after an ultrasound scan to confirm the pregnancy.

2. Severe PMS symptoms

While severe mood or symptom changes in the week leading up to your period can be the result of PMDD or PME, having bad PMS symptoms – such as bloating, irritability or breast tenderness – can be the result of low progesterone levels. Again, this is because the oestrogen in your system remains unopposed, leading to symptoms of high oestrogen.

3. An irregular menstrual cycle

In the female reproductive system, progesterone opposes oestrogen, which means low levels of progesterone can exacerbate the impact of oestrogen on the body.

“Unopposed oestrogen activity, as occurs when progesterone is low, leads to excessive thickening of the endometrium resulting in heavy and irregular bleeds,” Dr MacRae says. “Because of this, short or unusually heavy menstrual cycles can indicate low progesterone.”

4. Hot flashes and night sweats

While these symptoms are more common in women nearing menopause, hot flashes and night sweats can also be a sign of low progesterone, as the hormone can affect body temperature.

5. Spotting or bleeding

If you’re experiencing spotting or bleeding during the middle of your menstrual cycle, low progesterone could be the cause. This happens because progesterone helps the body to maintain the uterine lining, so when progesterone levels are low, the uterine lining can start to break down and produce light, period-like bleeding or spotting.  

Low progesterone doesn’t come out of nowhere – there are several factors that can lead to your progesterone levels being constantly low or dropping month to month.

1. Ovulation issues

Progesterone is primarily made in the ovaries by the corpus luteum – a temporary gland that develops after ovulation to produce progesterone for the first few weeks of pregnancy. If you don’t fall pregnant, this gland breaks down, progesterone levels fall, and your period starts.

However, if ovulation doesn’t occur, the corpus luteum doesn’t exist in the first place, so progesterone levels don’t increase – leaving you with the symptoms of low progesterone.

“Sometimes even when ovulation has occurred, the corpus luteal function is impaired, resulting in lower levels of progesterone,” Dr MacRae adds.

2. Polycystic ovarian syndrome (PCOS)

PCOS can lead to delays in ovulation, which therefore stops the corpus luteum from being formed and producing progesterone.

3. Thyroid disorders

Our thyroids release hormones that play an important role in hormonal regulation, which means a disruption to their function can wreak havoc on our hormone levels. 

“An underactive or overactive thyroid can disrupt hormonal balance, impacting progesterone production as a result,” explains Dr MacRae.

4. Stress

Progesterone is a calming hormone, so you might not be surprised to learn that having high stress levels for an extended period – also known as chronic stress – can cause problems.

“Chronic stress can lead to hormonal imbalances, including reduced progesterone levels, due to increased cortisol production,” Dr MacRae explains. Basically, as cortisol levels rise, progesterone production is impacted – leaving you vulnerable to the symptoms of low progesterone as a result.

5. Menopause or perimenopause

As ovulation becomes irregular and eventually stops after menopause, so too does the production of progesterone – leading to low levels.

6. Poor diet or lifestyle

“A lack of essential nutrients and a sedentary lifestyle can affect hormone production, including progesterone,” Dr MacRae explains. 

Key nutrients known to influence the production of progesterone include zinc, vitamin B6, magnesium, vitamin C and l-arginine. Foods high in one or more of these include lentils, nuts, spinach and broccoli.  

Low progesterone levels can have a big impact on your health and overall quality of life, so it’s important to speak to a doctor if you’re worried your levels might be low.

A simple blood, saliva or urine test is all that’s needed to test for progesterone concentrations in the body – you can speak to your doctor about the best approach for you.

Your treatment options will depend on the root cause of your condition, but some common treatments include diet and lifestyle changes (including stress management), progesterone creams or capsules and taking key supplements.

But, Dr MacRae stresses, “It is essential to work with a medical specialist to properly diagnose and treat low progesterone, as individual needs and responses to treatment can vary.” 

Images: Getty