Can You Have a Successful Pregnancy with Low Progesterone?

Known as the pregnancy hormone, progesterone is vital in helping you get and stay pregnant, but what if you have low progesterone? This all-star female hormone is responsible for everything from maintaining your sex drive to fully functioning fallopian tubes and even provides the building blocks for all other female fertility hormones but nowhere does it shine more than during pregnancy.

The name itself literally means pro gestation so it’s no wonder that the effects of low progesterone levels in early pregnancy is a hotly debated topic. The dynamic nature of this hormone can make it difficult to understand what “normal” levels are like during your fertility journey, so you may be wondering if you can have a successful pregnancy with low progesterone. 

Read on to learn more about levels, the role of this hormone during pregnancy, and what you can do if you suspect you might have low progesterone.  

What is the role of progesterone during pregnancy?

The core functions of progesterone during pregnancy are to maintain the uterine lining, prevent ovulation, and aid in the development of the cervical mucus plug. Progesterone also supports the fetus, prepares the breast tissue for breast feeding, and helps strengthen muscles in the pelvic wall ahead of labor. It works on the smooth muscles and prevents uterine contractions so the uterus doesn’t reject the fetus.  

Progesterone is the reproductive hormone that is necessary to promote a healthy pregnancy, and once you become pregnant, your body will naturally increase production and levels will rise throughout your pregnancy. The rise in progesterone levels is responsible for some of the early symptoms of pregnancy like breast tenderness and nausea.       

Can you have a successful pregnancy with low progesterone?

Sufficient progesterone levels are essential to a successful pregnancy. In fact, experts believe that low progesterone levels may contribute to recurrent miscarriages in some women. During pregnancy, low progesterone levels may be a sign of miscarriage or ectopic pregnancy.  

If progesterone levels are too low, you are at a greater risk of miscarriage or pre-term delivery.  Your body needs a certain amount of progesterone to maintain your uterus until the baby is born, and without proper supplementation, low progesterone can result in miscarriage or even fetal death.  It is possible to have a successful pregnancy with low progesterone if you are taking supplementation or being treated for low progesterone.    

Progesterone levels and pregnancy

When it comes to progesterone levels and pregnancy, there can be some variation in levels and how they are interpreted. There is a wide range of normal, and levels can fluctuate based on when the reading was taken.  

What are normal progesterone levels during pregnancy? 

Progesterone levels vary from person to person and what is considered “normal” can depend on a number of factors. As women age, progesterone decreases naturally along with other hormones.  The following ranges are based on figures from the Mayo Clinic Laboratories and are measured in ng/mL, which is the measurement of progesterone levels in the blood.   

Before conception 

In the first half of your cycle, the follicular phase, progesterone does not play an active role in the menstrual cycle, and levels tend to remain low. In the follicular phase, progesterone levels are usually less than or equal to 0.89 ng/mL.  

During ovulation levels start to rise and can get up to 12 ng/mL. It is primarily produced by the corpus luteum, a temporary gland formed in the ovaries after ovulation, during this part of your cycle, known as the luteal phase.  If pregnancy does not occur, progesterone production will drop and cause the uterine wall to break down, triggering menstruation. If pregnancy does occur, progesterone will continue to be produced by the corpus luteum until around week ten, where production will transition to the placenta for the remainder of the pregnancy.    

Early pregnancy 

In early pregnancy, as production transitions to the placenta, progesterone levels continue to rise. Typical levels can range from 11-44 ng/mL during the first trimester rising to 25-83 ng/mL during the second trimester and beyond.   

Late pregnancy 

Progesterone continues to be produced throughout the pregnancy and rises as the pregnancy continues. During the third trimester, levels can range from 58-214 ng/mL as it helps to support the development of the fetus and maintain the pregnancy. Progesterone peaks around 32 weeks and drops dramatically after birth.  

What does it mean if you have low progesterone levels?

Low progesterone can mean different things to different people based on your risk factors and health history. There is a wide range of what is considered normal, and you may not even know you have low progesterone if it is not manifesting in symptoms such as irregular periods or spotting.    

A number of complications can occur when progesterone levels are too low including irregular menstrual cycles, difficulties conceiving, and high-risk pregnancies. Not to mention that when progesterone is low, estrogen becomes comparatively high allowing it to have a dominant effect on the body resulting in estrogen dominance. 

If progesterone levels are too low during pregnancy, you are at a greater risk of miscarriage or pre-term delivery. Low progesterone is actually quite uncommon during pregnancy, and unless your doctor is concerned, it’s unlikely you’ll even be tested for progesterone levels past the first trimester. First trimester values lower than 6-10 ng/mL around the sixth week of pregnancy are considered low and your doctor may suggest various methods of treatment.            

Is it possible to increase your progesterone levels?

Yes! It is possible to increase your progesterone levels either naturally or through treatment.  This can be done through diet, supplements, or other lifestyle changes to bring your hormones into balance.  Taking synthetic hormones may be supported with natural options to increase the effectiveness of your efforts and support your progesterone levels.

There are many ways to naturally boost your progesterone levels. This includes eating foods that are rich in protein, healthy fats, and magnesium and maintaining a healthy weight.  Reducing caffeine intake and keeping stress levels low can also help. And supplements like zinc, chasteberry, magnesium, and vitamin c may help balance progesterone levels.   

Symptoms, causes, and treatments

Low progesterone symptoms

If progesterone levels don’t rise and fall as they should, you may experience irregular periods as well as difficulty conceiving. Other symptoms of low progesterone include no menstrual period at all, headaches or migraines, mood changes, and frequent miscarriages. During pregnancy, spotting and abdominal pain may be symptoms of low progesterone. This can also indicate an ectopic pregnancy, a rare complication that only occurs in 2 % of all pregnancies but needs immediate medical treatment.    

Low progesterone causes

An exact cause of low progesterone isn’t always known, and the symptoms of low progesterone may also be caused by other factors. During pregnancy, low levels of progesterone have been linked to miscarriage or a threatened miscarriage as well as an ectopic pregnancy and a short cervix. In non-pregnant people, low progesterone levels may be a result of hypothyroidism, heightened levels of cortisol, and body weight that is either too high or too low.   

Outside of the reproductive system, progesterone levels can also be influenced by cholesterol levels, and thyroid, pituitary, and adrenal gland issues. The cause of your low progesterone will determine the appropriate treatment.  

Low progesterone treatments

Progesterone is routinely given when undergoing fertility treatments such as IVF or IUI. A doctor may also recommend progesterone treatment if your levels are lower than average, you have a short cervix, or you have experience recurrent miscarriages. The most common treatment options are vaginal suppositories, progesterone injections, or oral tablets.     

Low progesterone and the body

Progesterone levels change throughout the course of the menstrual cycle and levels naturally decline with age.  Its role in regulating the menstrual cycle and pregnancy is well known, but progesterone also plays a role in mood and supports thyroid function as well.  

Does low progesterone affect fertility?

Progesterone is key for fertility, and having low levels may affect your ability to conceive and carry a pregnancy to term.  Progesterone is required for a healthy pregnancy and insufficient amounts mean successful implantation and support of the fetus simply won’t take place.

There is some debate about the clinical significance of low progesterone and often the symptoms seen are a by-product of other underlying hormonal issues, rather than true infertility.  Once those hormonal issues are addressed, progesterone levels should be restored. Research conclusively shows that while progesterone supplementation doesn’t necessarily help with fertility, it can decrease the risk of preterm birth in women with a history of the complication.       

Does low progesterone guarantee miscarriage?

While low progesterone is associated with miscarriage, but it does not guarantee it. Some researchers have theorized that having low progesterone prior to having a miscarriage may have played a role in causing that miscarriage, but it is a controversial topic with much debate around the issue.    

The American Society for Reproductive Medicine currently suggests that progesterone supplementation is not useful for preventing sporadic miscarriage, but it might be helpful for those who have had recurrent miscarriages. A more recent study found however, that progesterone supplements did not result in improved pregnancy outcomes in women with recurrent miscarriages.  Clearly more research is needed in this area since miscarriage is such a devastating experience.  

Low progesterone pregnancy success stories

It is possible to have a successful pregnancy even with low progesterone. Low progesterone pregnancy success rates are hard to track down in an official format, but we did find several stories of success online.  

Although the main site is no longer being updated, the authors transferred an archive of success stories written by people with low progesterone levels in early pregnancy. What started out as two success stories grew to many more.  Read through the many stories to see how others had a successful pregnancy with low progesterone.

On the March of Dimes community forums, you’ll see many questions relating to low progesterone levels. Many of the questions lament at the possibility of a miscarriage based on low progesterone levels or symptoms of low progesterone during pregnancy. The responses are overwhelmingly supportive as people share their own stories of low progesterone levels during pregnancy and their ultimate success. 

Community forums can be a source of information and comfort, especially when you have questions. On this site, you’ll see loads of positive comments from people who have had successful pregnancies even with low progesterone. Hearing from others going through the same things as you can be a big stress relief, especially when there’s little you can do in the moment to affect your hormone levels.    
In this story, you’ll read about a woman who experienced multiple miscarriages before doctors suggested progesterone supplements to try to stop the miscarriages. She made many lifestyle changes as she went through her issues but held out hope for success with progesterone supplements – and it paid off.