On the days leading up to your period are you...
a) Curled up in a blanket on the sofa, feeling exhausted, craving chocolate and crying at the drop of a hat?
b) Breaking out like a teenage boy and not wanting to wear a seatbelt or exercise because your boobs are SO SORE?
c) Feeling so irritable and moody, you want to lock yourself in a room so that no-one can annoy you?
d) All of the above
This may seem amusing to some of you, but let me tell you, PMS is common, but that doesn't mean it's normal!
The most common cause of PMS symptoms in women is low progesterone levels during the second half of their cycle.
We only create this magical hormone once we ovulate (release an egg). Ovulation occurs approximately half way through your menstrual cycle, (e.g day 14 of a 28 day cycle), however this can vary widely in each individual due to stress, conditions such as PCOS and our varying cycle lengths.
When an ovarian follicle releases an egg, the sac that is left behind becomes the corpus luteum. This structure is responsible for producing progesterone until either the placenta takes over (if we fall pregnant) or conception doesn't occur and this temporary gland breaks down, resulting in menstruation.
Women with PCOS often ovulate later than most women (even up to cycle day 25), if at all! This process can be disrupted by high insulin levels, androgens and inflammation.
What's so great about progesterone?
I like to think of progesterone as our calming, anti-PMS, 'everything's going to be ok' hormone.
You can also think of it as the YIN to oestrogens' YANG. They help to balance each other out.
An imbalance of these two hormones often results in symptoms such as heavy bleeding, insomnia, water retention, menstrual migraines and fertility challenges.
Progesterone is our pro-gestation (pro-pregnancy) hormone after all!
Don't want a baby any time soon? Don't worry, you still want all the amazing benefits progesterone provides!...
Here is a recap of a 'normal' menstrual cycle. As you can see, during the first half of the cycle oestrogen levels (red line) increase, whilst progesterone levels are low (blue line). Whereas during the second half progesterone peaks and is much higher than oestrogen.
Oestrogen should be dominant during the first half of our menstrual cycle (follicular phase) as it's job is to build up the uterine lining, ready for implantation.
After we ovulate mid cycle (hopefully), progesterone should then become the dominant hormone and it's job is to maintain and prevent excessive growth of the lining.
I like to think of it as a field of grass. Oestrogen sews the seeds, fertilises and waters the grass for growth. Progesterone acts as a lawnmower, keeping it trimmed, fresh and preventing excessive growth.
These days, many people focus on excess oestrogen (aka 'oestrogen dominance') as their main issue, however in the majority of these cases, it's actually low progesterone that's the problem.
It is possible to have high oestrogen levels, especially due to obesity, high alcohol intake, hormonal birth control use and environmental toxins, however more often than not, the issue is relative oestrogen dominance.
In layman's terms, this means that oestrogen isn't actually high, it just looks high in comparison to progesterone.
What are some common symptoms & related conditions?
Common symptoms of low progesterone levels include heavy bleeding, brown spotting or menstrual blood, clotted period blood, pelvic cramps, insomnia, headaches, anxiety that worsens premenstrually, low moods, aggression, irritability, weepiness, breast tenderness, water retention, sugar cravings, hot flushes and low libido. (I could go on!....)
Some of the associated conditions include Premenstrual Syndrome (PMS), Polycystic Ovarian Syndrome (PCOS), Endometriosis, Infertility, Premenstrual Dysphoric Disorder (PMDD), Fibroids, Hypothyroidism, Post-Birth Control Syndrome and Amenorrhea.
Causes of Low Progesterone...
Progesterone can be impacted by many modern day influences, including nutrient deficiencies from a poor diet or soil quality, environmental toxins (especially endocrine disrupting chemicals), a weak corpus luteum, being over the age of 35 and/or chronic inflammation.
Possibly the biggest factor when it comes to low progesterone levels is STRESS.
When I talk about stress, I don't just mean the mental, "oh my god, I cannot cope with my work load right now", kinda stress. Stress can also be emotional, physical, environmental and spiritual.
Here are some examples...
Psychological - Negative self talk, anxiety, relationship issues, financial worries, perfectionism, mentally draining job
Emotional - Not expressing emotions, loss of a loved one, social isolation, not feeling supported by friends and family
Physical - Over/under exercising, food intolerances, dehydration, over/under eating, nutrient deficiencies, excess alcohol intake, chronic infections, imbalanced blood sugar levels
Environmental - Exposure to heavy metals, air pollution, endocrine disrupting chemicals from skincare products, second hand smoke
Spiritual - Not having a purpose in life, misalignment with spiritual beliefs, unfulfilling work, lack of joy and happiness
The Negative Impacts of Stress
When our body is stressed, for whatever reason, this signals to the brain that the environment is dangerous and we are under attack.
10,000 years ago, the stressors we faced were a little different. They included famine, wars, life-threatening infections or being attacked by sabertooth tigers.
Our body adapted to these threats by shutting down reproduction. (Because who want's to have a baby when there's no food and we are about to be eaten by a grizzly beast?!)
The problem is, the body doesn't know the difference between the stress of 6pm traffic or a credit card bill and the actual life threatening stressors we faced back in the day.
This sense of constant danger and threat that our bodies consciously or unconsciously feel, can therefore impact not only our fertility and hormones, but also our immune system and digestive health.
Progesterone is the sex hormone that gets impacted most, when we are stressed. The brain is believed to down-regulate the communication signals to the ovaries and prevent ovulation, as a safety mechanism.
Another theory is that the body diverts the building blocks and cofactors away from making progesterone and instead sends them to create stress hormones like cortisol. However this mechanism known as the 'pregnenolone steal' may not be entirely accurate.
What tests can I run?
Although symptoms can indicate certain hormone imbalances, it is always better to test, not guess, when it comes to your health. This is especially true if you are trying to conceive or want to add some of the progesterone boosting supplements I share below.
Your Doctor should be able to check your serum progesterone levels, however the blood draw is commonly taken on the wrong day of your cycle.
Aim for days 19-21 if you have a typical 28 day cycle, shifting up or down if your cycle is longer or shorter. To be more accurate, try and identify your day of ovulation through fertility tracking, temperature or LH (ovulation) tests then go for the test 5-7 days after. Getting the correct timing is crucial when it comes to progesterone.
My favourite way to test hormones is through the DUTCH Test. This functional medicine urine test is done in the comfort of your own home, and analyses not just progesterone, but also oestrogen metabolites, androgens, stress hormones, oxidative stress and markers of nutrient deficiencies.
The amount of information and data you get from this is amazing. It is a must for anyone dealing with PCOS, endometriosis, abnormal cycles, PMS and infertility. Or those of you just wanting to maintain optimal health and prevent some of this conditions.
If you would like to run a DUTCH test to identify and address your hormone imbalances, you can click here to work with me.
Ways to Increase Progesterone Levels Naturally...
You didn't think I would end this post without giving you some tips, did you? 😉
If you are reading this, I'm going to assume you are already eating healthily, avoiding junk food, staying hydrated and minimising alcohol, so I will focus on some more specific points.
I want all women of menstrual age to be ovulating each month and experiencing the wonderful benefits of progesterone.
Hormones take at least 3 months to show real changes, so you can't expect your period next week to be symptom free, after trying these recommendations.
Include a serving of high quality protein (wild fish, eggs, poultry, red meat, organ meats, sprouted beans/legumes) and healthy fat (avocado, olive oil, grass-fed butter/ghee, coconut products, nuts and seeds) at each meal.
This helps to stabilise blood sugar (reducing stress) and provides the building blocks for progesterone production.
Increase Magnesium rich foods.
Cashews, leafy greens such as kale, spinach and swiss chard, pumpkin seeds, black beans, lentils and other legumes (ideally sprouted), cacao and oily fish.
Increase Vitamin C rich foods.
Camu camu powder, acerola cherry, sweet potato, kiwi, strawberries, oranges, papaya, pumpkin, broccoli, bell peppers, tomatoes, brussels sprouts and lemons.
Increase Vitamin B6 rich foods.
Russet potatoes, salmon, high quality tuna (no more than 1x week), bananas, plantains, spinach, walnuts, beef, chicken, sweet potato, beans and prunes.
Increase Zinc rich foods.
Oysters, prawns (shrimp), beef, lamb, liver, shellfish, red meat, pumpkin and cashew nuts.
Sleep 7-9 hours each night.
This helps to reduce cortisol, allows our hormones to function better and promotes cellular repair.
Add more stress reducing activities.
This includes walking in nature, yoga, meditation, reading, taking an epsom salt bath, spending time with loved ones, dancing. Helps to reduce cortisol and supports hormonal balance.
Reduce caffeine intake.
Caffeine spikes our stress hormone levels (and we all know what that does to our progesterone levels!), so limit to no more than 2 cups per day before 2pm. I recommend you avoid coffee and other caffeine sources entirely if you are dealing with hormone conditions such as PCOS, endometriosis and PMS, or you are currently trying to conceive.
Avoid endocrine disruptors.
Certain chemicals such as phthalates, and plastics in our environment can enter our body and mess with our hormones. Use natural, organic skincare and cleaning products, rather than chemical laden products. Stainless steel, cast iron or glass cookware and tuppaware. Avoid plastic utensils and Teflon/non-stick pans. Filter your drinking water. Buy organic as much as possible!
Zinc (20-50mg per day) *be wary of copper depletion
Helps the pituitary gland produce Follicle Stimulating Hormone (FSH) and therefore supports egg development, ovulation and progesterone production.
Magnesium Glycinate (250-500mg per day)
Helps to reduce cortisol (stress) levels and also acts as a cofactor in the production and detoxification of hormones. I prefer the glycinate form as glycine is an amino acid that helps calm the nervous system and aids liver detoxification.
Vitamin B6 (25-50mg per day)
(Look for a supplement containing at least 25mg of the active P5P form or you can buy a methylated B-complex supplement)
Essential for the synthesis of progesterone. Magnesium and B6 are often found together in supplements as they really help to support progesterone production.
Vitamin C (500-1,000mg per day)
Depleted from the adrenals during stress. Supplementation can support a healthy stress response and directly improves the production of progesterone. (One study found that women supplementing 750mg per day boosted progesterone levels by up to 77%!) I like food state (acerola cherry and camu camu powder) and liposomal vitamin C supplements.
Vitex (Chasteberry/Agnus Castus)
This herb stimulates the ovaries to make more progesterone and also lowers prolactin. It works by increasing Luteinizing hormone (LH) which is responsible for ovulation. If you have PCOS and/or high LH levels in blood work, Vitex may not be suitable for you as it can worsen symptoms such as acne. I recommend you work with a practitioner or do your research before supplementing with Vitex as it needs to be at the right dose and taken cyclically.
I thought I'd leave you with a lovely quote that sums up the importance of healthy ovulation and progesterone...
“Ovulatory cycles are both an indicator and a creator of health” - Jerilynn Prior
Want to test your hormones, get access to practitioner grade supplements and address the root causes of your hormone imbalances once and for all? I'd love to work with you.
If you want more information, book in for your free 30 minute Hormone Troubleshooting call today. We will discuss your needs in more detail and come up with an effective plan to get your health back on track!