Low Progesterone in Pregnancy: Why and What to Do

Amidst the joys of having a new baby on the way, there can be complications like, low progesterone. Progesterone is one of the key hormones that helps pregnancy progress normally. In some women, this may be a cause of pregnancy loss. The good news is that if an imbalance is caught early in pregnancy, it is treatable with hormone replacement. There are also other steps you can take to make sure you have adequate levels to support a pregnancy, before you even get pregnant. Read further to see what progesterone does for you during pregnancy, things you can do to make sure you have enough, and warning signs to watch for.

Effects of Low Progesterone During Pregnancy

Your body makes progesterone to help get your uterus ready for implantation of your baby when you become pregnant. For the first 10 weeks, your ovaries produce progesterone, and after that the newly formed placenta takes over production for the rest of your pregnancy to maintain the lining.

It is the first 10 weeks that adequate progesterone levels are crucial to the survival of your pregnancy. This hormone will help to prevent uterine contractions that could expel the fetus, and increases blood flow to where the pregnancy sac has implanted. If you do have low levels, the uterine lining may break down leading to pregnancy loss. Low progesterone levels are described as a level below 12 ng/ml that does not increase every 3 days during your first trimester. If you are at risk for miscarriage or are having a possible ectopic (tubal pregnancy) your doctor may check your progesterone levels every few days. A level that does not go up may indicate this complication.

After the pregnancy has progressed into the second trimester (12 weeks and later), the placenta takes over progesterone production and the risk of pregnancy loss diminishes. In a small number of women, progesterone levels may remain on the lower end throughout pregnancy.

Causes

If you are wondering why this may be happening, there may be a few different causes. These include:

  • Polycystic Ovarian Syndrome (Chronic Ovarian Cysts)
  • Thyroid Disease
  • Adrenal Gland Disorders (Addison’s Disease, Cushing’s Disease)
  • Advanced Maternal Age (Over 35)
  • Chronic Health Conditions (Diabetes, Hypertension, Autoimmune Disorders)
  • Infertility (Pregnancy Was Conceived via Artificial Means)

If you have any of these known conditions, your doctor may choose to watch you more closely even before you experience symptoms of low progesterone.

Symptoms of Low Progesterone in Early Pregnancy

Whether or not you are at risk for this condition, it is important to recognize the symptoms of low progesterone during pregnancy early on. This condition can be successfully treated in many women, enabling pregnancy to progress to full-term. The symptoms may be mild and go unrecognized until it is too late. Watch for things like:

  • Spotting or bleeding in early pregnancy
  • Period-like cramping
  • Tender sore breasts
  • Severe fatigue
  • Loss of vaginal moisture/discharge
  • Blood sugar issues
  • Severe mood swings
  • Anxiety
  • Headaches (although, increasing progesterone can also cause headaches)

A few number of women experience no symptoms at all, only to discover they have low progesterone after experiencing a miscarriage. In other cases, some women have low progesterone and don’t need treatment. It truly is very individualized, and a case-by-case basis. You and your doctor can decide the best way to proceed if you discover an issue with progesterone, or are at risk for low progesterone while you are pregnant.

Things You Can Do

Not all women are deficient in progesterone, and usually only find out after a failed pregnancy. Discuss any treatment options, including home remedies with your doctor. Some of the possible things that can help are:

1.         Progesterone Replacement

Hormone replacement is used if progesterone levels are found to be too low to maintain a pregnancy in the early stages, and rarely until the 38th week of pregnancy. Progesterone can be taken; orally, vaginally, topically on the skin, or injections. This is commonly prescribed if there is history of miscarriage due to low progesterone, in women treated for infertility, or women with advanced maternal age.

 2.      Close Watching

Your doctor may opt to watch your levels at first to see if things “kick in” naturally. You may have to go in for laboratory testing at the beginning of pregnancy, and every few days for the first few weeks. If levels continue to rise, you may not need any treatment at all. You will be asked to report any symptoms of low progesterone to your doctor right away. You may even be prescribed bed rest in early pregnancy until you are given the “all-clear” from your doctor, usually around 13 weeks.

3.       Dietary Changes

While it is not a treatment for low progesterone, eating a healthy diet with certain nutrients can help your body maintain the pregnancy better. Nutrients that assist your body with progesterone production include; B vitamins, Vitamin C, magnesium, zinc, and vitamin E.

4.       Stress Reduction

Increased stress can cause the adrenal glands to release too much cortisol. This can reduce the amount of progesterone your ovaries produce, and blocks the effects of any progesterone they do make. You may be advised to keep your stress levels down early in pregnancy to help maintain optimal levels. Your doctor may suggest; stopping work for a period of time in early pregnancy, avoiding large crowds, cutting a busy schedule down, meditation and relaxation exercises, or treatment for increased cortisol levels.

When To Worry

Having low progesterone during pregnancy? You should contact your doctor immediately if you experience signs of miscarriage in the first 12 weeks of pregnancy, including:

  • Severe cramping or low back pain
  • Period like bleeding or increased spotting
  • Dizziness, feeling faint, or loss of balance
  • Severe and sudden stabbing pain in either side of the pelvis (ectopic pregnancy)

Progesterone replacement therapy can have side-effects. Some can have complications like blood clots, stroke or problems with your gallbladder. Signs of these complications include: 

  • Leg or calf pain
  • Redness, heat, and tenderness to the touch in the leg
  • Sudden shortness of breath with chest pain
  • Severe and stabbing pain just under the right lower side of the ribs
  • Yellow skin (jaundice)
  • Loss of feeling on one side of the body
  • Slurred speech
 
 
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