Progesterone & Periods: How Is It Connected?

by Dec 8, 2020

Progesterone plays an important role in regulating your monthly cycle and preparing your body for conception. If you are using progesterone treatments, you will be wondering about the effects of this hormone on your cycle and when changes can be expected. This post will explore the role progesterone plays, what it does for your body, where it comes from, and the different ways it can affect your period.

A woman looking concerned

What is progesterone?

Sometimes called the pregnancy hormone, progesterone is an all-star female hormone that works on many fronts. From preparing your body for pregnancy to maintaining your sex drive, progesterone primarily supports your body in getting pregnant and maintaining that pregnancy.

It is the major hormone in a class of hormones called progestogens and impacts sexual development and reproduction. Made by the ovaries, placenta (if pregnant) and adrenal glands, the rise and fall of this hormone helps signal your body to shed the uterine lining and trigger your period.  

Where does it come from? 

Secreted by the corpus luteum, progesterone is mainly produced in the ovaries. The corpus luteum, a temporary gland formed in the uterus after ovulation, is made from a follicle that housed a maturing egg and forms as soon as the egg pops out.  

A small amount of progesterone is produced by the adrenal glands that sit atop the kidneys, and once pregnant, production takes place in the placenta.

What does progesterone do?

Responsible for not only getting your body ready for pregnancy, but also maintaining that pregnancy, progesterone has a number of jobs to prepare your body:

  • Thickening the uterine lining to welcome a fertilized egg
  • Concentrating mucus in your cervix to keep out harmful bacteria
  • Maintaining the uterine lining throughout pregnancy
  • Preventing uterine contractions
  • Priming the glands involved in breastfeeding

Progesterone primarily supports your body in maintaining a pregnancy, and as a result, levels change during your menstrual cycle.

Why am I being prescribed progesterone?

Commonly used as a fertility treatment, progesterone is widely recognized to treat a variety of issues. It can be useful to bring on menstruation, help severe symptoms of PMS and treat abnormal uterine bleeding. 

When it comes to fertility treatments, your doctor may recommend progesterone hormone therapy to help support your goal of getting pregnant. Often prescribed to initiate menstruation or because your ovaries don’t produce enough naturally, there are other reasons your doctor may recommend you take progesterone. This hormone can be unintentionally removed from your ovaries by certain procedures, and other medications may be suppressing your ability to naturally produce progesterone. Because this hormone is the building block of pregnancy, supplementation is often necessary.  

Progesterone & Periods: How It Works

Your period is controlled by a delicate balancing act of hormones, including progesterone. During the three phases of your menstrual cycle, progesterone levels vary and the rise and fall of these levels is what signals your uterine lining to begin shedding at the right time. 

Progesterone levels are lower prior to ovulation but become the dominant hormone when the process is complete. If conception doesn’t occur, levels fall again and a period is triggered. If progesterone levels don’t rise and fall as they should, you may experience irregular periods as well as difficulty conceiving.  

Forms of progesterone treatments

Progesterone can come in different forms and therefore there are a number of treatment options available. Whether synthetic or natural, treatment delivery options include:

  • Vaginal gels
  • Vaginal suppositories
  • Vaginal inserts
  • Oral capsules
  • Injections

The various forms of delivery are used to achieve different goals and your healthcare provider will work with you to find the best option for you and your goals.   

How soon will I get my period on progesterone?

The standard protocol for progesterone treatments is to wait two weeks to see if a period is triggered. Since progesterone can delay your period, a pregnancy test must be performed. If conception hasn’t occurred, your period will usually begin 2-5 days after stopping treatment.  If no period occurs in 10-14 days, your health care provider will likely do further testing.  

What happens if I don’t get my period after using progesterone?

If you have confirmed there is no pregnancy, and you still don’t get your period after using progesterone, your health care provider will do further testing to determine what’s going on. Typically, if bleeding does not occur, it may be that your body is not producing enough estrogen. What happens next will depend on the outcomes of testing and exams performed by your doctor.  

Are there any progesterone side effects?

Since progesterone treatment can be prescribed for a number of medical uses, including diagnostic aids and birth control, you may experience side effects with this type of hormone therapy. Interestingly enough, many of the side effects mimic PMS, which typically occur when progesterone levels peak. Serious side effects include blood clots, changes in cycle flow, and depression.

Typical, but less severe, side effects may include:

  • Cramps
  • Breakthrough bleeding
  • Moodiness
  • Dizziness
  • Dry mouth
  • Nausea
  • Tiredness
  • Irritability
  • Bloating caused by water gain
  • Irregular period

In addition to these common side effects, researchers have reported that progesterone may impact sex drive and mood. Subjects reported a drop in sex drive when progesterone levels were higher, coinciding with the luteal phase (or after ovulation) in your reproductive cycle.  

Progesterone alternatives 

Although the science is still young, alternatives to traditional hormone therapy are gaining scientific momentum. Herbal supplements and foods claiming to increase progesterone levels have little research to support these claims and more studies are needed to confirm them. 

The most effective alternatives include lifestyle changes that will support healthy hormone production and use in the body. Natural remedies such as these include reducing stress, adopting an overall healthy lifestyle, getting regular sleep, and maintaining a healthy weight. Given the role it plays in your hormonal health, it’s no surprise that progesterone is known as the rockstar of female hormones. You cannot currently track progesterone levels without the help of a physician, but in the future, Mira plans to release a progesterone test wand for easier testing at home – stay tuned!

✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG

Banafsheh Kashani, MD, FACOGBanafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training. 

Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.

Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).

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