Progesterone and PCOS: How To Increase It Naturally
Polycystic Ovarian Syndrome (PCOS) is one of the leading causes of infertility in women.
For some women, that line right there can be difficult to digest.
PCOS and low progesterone levels can interfere with reproductive functions. As a result, making it difficult to conceive.
But PCOS can be reversed and progesterone levels can be increased.
In this post, we will look at why PCOS women have low progesterone levels. Also, we will look at why progesterone is important for women with PCOS and how to increase progesterone levels.
So, if you are looking to increase your progesterone levels continue reading the post.
Why Do Women With PCOS Have Low Progesterone?
PCOS is a condition where female sex hormones are out of balance. Women with PCOS are producing too many male hormones and this can occur for various reasons including, high insulin levels, chronic stress and inflammation. It is the high male hormones that interrupt the natural ovulation cycle and the production of female hormones, like progesterone.
Before we get into how to increase progesterone, let’s look at what progesterone is an why women with PCOS need it.
What is Progesterone?
Progesterone is a steroid hormone found in females. Steroid hormones are formed from pregnenolone but are derived from cholesterol.
Progesterone is predominantly produced by the corpus luteum. But it also in smaller quantities by the adrenal glands. The adrenals are small organs found above the kidneys and are known as stress glands. This is because they respond to stress by releasing hormones like cortisol.
Adequate amounts of progesterone are needed in the female body for the menstrual cycle and maintain a pregnancy.
Progesterone and the Menstrual Cycle
As you can see in figure 1, during week two of the menstrual cycle, there is a surge in luteinizing hormone. This increase triggers the release of an egg from the ovary, this is known as ovulation.
The egg that is released creates a temporary structure called the corpus luteum. The corpus luteum leads to an increase in the enzyme P450scc that converts cholesterol to pregnenolone. Pregnenolone is then converted to progesterone and is secreted out from the corpus luteum into the blood.
Progesterone helps prepare the body for pregnancy. It does this by thickening the uterine lining to create a supportive environment in the uterus for a fertilized egg.
Now, if fertilization (union of an egg and sperm) does not happen, the corpus luteum shrinks away and progesterone levels decrease. This then causes the uterine lining to shed leading to your period.
Why Do Women with PCOS Need Progesterone
Women with PCOS need progesterone for a healthy menstrual and for reproduction as discussed. But it is also needed for the overall functioning of the body.
Progesterone is Needed to Prevent Estrogen Dominance
The body cleverly produces estrogen and progesterone in quantities that ensure hormone balance.
For example, if progesterone levels fall, estrogen levels rise abnormally high. This is known as estrogen dominance. Symptoms include heavy bleeding, low libido, breast tenderness, hot flashes and mood swings.
Progesterone Prevents water retention
During a healthy menstrual cycle, estrogen and progesterone levels rise and fall. Before ovulation, estrogen is high and progesterone levels are low. During this time women tend to retain more water.
But after ovulation, progesterone is dominant and estrogen levels drop. Now here's the thing, because progesterone is a natural diuretic, it helps flush out the retained water.
Progesterone is Needed for Optimal Thyroid Function
The body needs a balance of progesterone and estrogen for thyroid hormones production.
Dr Izabella Went, a clinical pharmacist, says low progesterone and high estrogen levels can cause hypothyroidism. This is a condition where the thyroid is underactive. Meaning the thyroid is not producing enough of the thyroid hormones the body needs. So, excess estrogen can stop the production of thyroid hormones. Adequate progesterone is, therefore, needed to help stimulate the release of the hormone.
Progesterone Has Anti-Androgenic Effects
Researchers have found progesterone is anti-androgen. This means it can block the effects of male hormones like testosterone.
Because of its anti-androgenic effects, increasing it may help lower high testosterone levels in PCOS women.
Progesterone has Anti- Inflammatory Properties
Researchers have found that PCOS women suffer from chronic inflammation.
Inflammation is a response the immune system takes in an attempt to defend itself from outside invaders, such as viruses and bacteria.
Research shows progesterone has anti-inflammatory properties. Meaning it can help lower the level of inflammation in the body. So to protect the body against inflammation, progesterone levels must increase.
Further benefits of progesterone include
- Prevents bone loss
- Helps with sleep
- Help with anxiety
We have now looked at what progesterone is and why women with PCOS need it. You might be wondering.
How Do I Increase Progesterone Levels for PCOS?
As discussed, progesterone is only produced when we ovulate. So to increase it, you must first regulate your menstrual cycle. This can be achieved by addressing the root cause of your PCOS and the hormone imbalance.
Insulin resistance is the most common cause of high testosterone in PCOS women. So, high blood sugar and insulin levels must be managed. This can help balance hormones and increase progesterone. Here’s what you can do.
Choose Low Glycemic Index Carbs
Essentially, the Glycemic Index (GI) ranks a carbohydrate by how it will affect blood sugar levels after consumption. A carb with a low GI value will be digested and absorbed into the body more slowly. Causing a slower rise in blood sugar levels, that will be lower overall. The opposite would be true for a carb with a high GI value.
A low GI is 55 or below, medium 56-69 and high is anything over 70. By choosing low GI carbs, you are better able to balance your blood sugar levels.
Combine carbohydrates with protein and fat
Prepare balanced meals that contain all three macronutrients, protein, carbs and fat.
By combining carbs with a protein and fat blood sugar levels will not spike resulting in a surge in insulin.
Studies show fiber can lower blood sugar levels. It does this by slowing down digestion and the release of sugar.
High fiber foods include vegetables, fruits, oats, beans and legumes.
Stress is a huge cause of high testosterone and low progesterone in women. Dr. Sara Gottfried, Harvard-educated MD, says excess cortisol stops progesterone from doing its job.
To lower cortisol levels you must,
Stop high intensity and endurance workouts
High intensity and endurance workouts increase cortisol levels. Instead, opt for low-intensity exercises like walking, swimming and yoga. Low-intensity exercises do not significantly raise cortisol levels.
Caffeine is a stimulant because it activates the stress response and causes the adrenal glands to release cortisol. Avoid or cut back on your caffeine consumption to lower cortisol levels.
For more information on caffeine for PCOS. As well as the coffee I drink to manage the release of cortisol, check out my ‘Caffeine and PCOS: Should You Avoid It?’ post.
Research shows sleep deprivation can increase cortisol levels. So, aim to go to bed between 9-11 pm and strive for 7-8 hours of sleep. To help you do this, avoid all blue light, so no looking at your mobile phone or any screen at least 1 hour before bed. As well as eating foods that contain tryptophan (a sleep-inducing amino acid) like turkey, spinach and nuts, can help your body relax.
Support the Thyroid
An imbalance of progesterone and estrogen can affect thyroid function. But a damaged thyroid can be the trigger of the imbalance of both hormones.
The thyroid is often referred to as a ‘hormone powerhouse’. This is because it plays a role in various functions in the body including ovulation.
The thyroid hormone stimulates the release of progesterone from the luteal cells that make up the corpus luteum. So, low thyroid hormone production will shut down ovulation and result in low progesterone levels. In turn, causing an imbalance in progesterone and estrogen.
But supporting the thyroid and the production of T3 (the active thyroid hormone) can boost progesterone.
Here is what you can do to support your thyroid and increase the production of T3,
Dr. Datis Kharrazian, a functional medicine practitioner, says 20 percent of thyroid function depends on a healthy gut to convert T4 (the inactive thyroid hormone) to T3. So, probiotics may help support your thyroid and boost progesterone levels.
Include fermented foods like sauerkraut, kombucha or kimchi into your diet. Or take a probiotic supplement.
Avoid inflammatory foods
Foods like seed oils, sugar, gluten and junk foods can trigger inflammation in the body. So you must avoid these inflammatory foods.
Selenium Supports the Thyroid
Selenium is an antioxidant that supports thyroid function.
Healthy levels of selenium are necessary for the conversion of T4 to T3. Which as discussed, the body needs to function properly.
The Thyroid needs Iodine
Iodine is an essential mineral needed for the production of thyroid hormones. A deficiency in iodine can cause a decrease in the release of thyroid hormones.
Iodine rich foods include seaweed, fish, eggs and prunes. You can also add iodized table salt to your meals.
But before you increase your iodine intake consult a doctor. This is because taking too much can have the opposite effect and instead damage the thyroid.
Increase Progesterone Levels by Eating more Fat and Cholesterol
All steroid hormones, like progesterone, are formed by pregnenolone, a hormone made from cholesterol. So, to ensure a healthy production of progesterone, you must support the creation of pregnenolone. This is can be done by eating more fat and cholesterol rich foods.
Eating fat can also balance blood sugar levels and as a result, support hormonal balance.
Always choose high-quality sources of fat and cholesterol. For example egg yolks, 100% grass-fed meat and fats, avocado, coconut and olive oil.
Now, I understand you may be concerned about eating cholesterol because for years we were told it was bad. But researchers have found that diet isn't a driving force for high cholesterol, rather it is genetics. You see, the liver produces larger amounts (85%) of cholesterol. So eating cholesterol foods isn't going to affect blood cholesterol levels as much.
Eat Nutrient-Dense Foods to Boost Progesterone Levels
Foods do not contain progesterone, but they have nutrients that may help increase it. They include:
Vitamin B6 has “progesterone-like effects”. Meaning it can lower estrogen while boosting progesterone levels.
Foods rich in vitamin B6 include
- liver and other organ meats
- egg yolk
Vitamin C is an antioxidant that may help increase and help progesterone work better.
A study found women suffering from luteal defects that took 750mg of vitamin C increased their progesterone.
Now, this study was done on women with luteal phase defects. So, we cannot say for certain vitamin C will help women who do not suffer luteal phase defects.
Vitamin C rich foods include citrus fruits like strawberries, kiwi, papaya and watermelon. But also vegetables like bell peppers and Brussels sprouts.
Magnesium is a vital mineral that can help balance hormones and boost progesterone.
Lowers Cortisol Levels
This mineral helps keep you calm, but chronic stress depletes the body of magnesium. This is because your body burns through magnesium to support your adrenal glands when making cortisol.
Lowers Excess Estrogen
Magnesium helps the liver remove excess estrogen from the body in urine or the stool. Low magnesium levels can cause a hormone imbalance by inhibiting estrogen removal. This can then cause high estrogen levels and low progesterone.
Increases Insulin Sensitivity
Adequate amounts of magnesium can increase insulin sensitivity. This can help treat insulin resistance and boost progesterone levels.
Foods high in magnesium include dark leafy greens, avocados, cacao, almonds, mackerel, lentils and kidney beans.
Zinc increases the release of follicle-stimulating hormone (FSH). This hormone encourages ovulation and in turn the production of progesterone.
Research also shows zinc may play a role in the conversion of T4 to T3. So, zinc is a mineral needed for the thyroid that can, in turn, boost progesterone levels.
Foods high in zinc include
- egg yolks
- Brazil nuts
- Pecan nuts
- ginger root
The Progestin-only pill for PCOS
The Birth Control Pill is a daily pill containing man-made hormones. These hormones are like a female’s real hormones, estrogen and progesterone.
There are two types of birth control pills. The combined contraceptive pill which is a combination of progestin and estrogen and the progestin-only pill. Progestin is made to act like the body's natural progesterone. As a result, it is able to do some of progesterone's tasks in the body. But it does not fully resemble progesterone, so in some situations, it may act differently to the real hormone.
What's the purpose of the progestin-only pill?
Doctors may prescribe the progestin-only pill to PCOS women to increase their progesterone. But keep their estrogen levels constant.
But here’s the thing.
The purpose of the birth control pill is to prevent pregnancies and suppress ovulation. It does this by shutting down all communication between the brain and the ovaries. Meaning the body’s natural process of producing hormones is replaced by these man-made hormones.
You might be wondering.
Will the Progestin-only pill help PCOS?
While on the pill you may get a monthly period and notice an improvement in some symptoms. But the progestin-only pill does not fix the hormone imbalance. This is because it does not address the root cause of PCOS. As explained in the 'how to increase progesterone' section.
The man-made hormones have stopped the body from producing its own hormones. So when you come off the pill, the hormone imbalance still exists. The body is still unable to ovulate and make its own hormones.
Also, researchers found that certain progestins are more androgenic and estrogenic than anti-androgenic. Meaning the progestin looks and acts more like testosterone and estrogen in the body. But women with PCOS don’t want more testosterone in the body because it is already high.
Should I take Bioidentical Progesterone for PCOS?
Bioidentical progesterone is chemically identical to the progesterone the body creates. It is made by extracting a chemical called diosgenin from foods like wild yams. Doctors can prescribe it or it can be bought in either cream or tincture form.
Bioidentical progesterone is best taken under the supervision of a medical professional. But if you do purchase it on your own accord, it is recommended you use it in the last half of your menstrual cycle. The time when you would be ovulating and producing progesterone naturally.
When it comes to dosage consulting a doctor is best. But always start off small and pay attention to your symptoms.
Keep in mind there is no guarantee bioidentical progesterone will work. Increasing progesterone may not be the first thing to address if your body is too imbalanced.
As discussed, low progesterone in women with PCOS is due to a lack of ovulation. This is caused by a hormone imbalance due to high testosterone.
Depending on what is causing your PCOS and low progesterone levels, making dietary and lifestyle changes may help.
If your PCOS and low progesterone is caused by insulin resistance, balancing blood sugar levels is key. You can achieve this by eating low GI carbs, combining protein and fat with carbohydrates, and eating fibre.
PCOS and low progesterone caused by high cortisol needs a decrease in stress levels. You may have to avoid high-intensity workouts, get better sleep and cut back on caffeine. Add long walks in nature, yoga or meditation into your daily routine.
An underactive thyroid can interfere with the production of progesterone. So, support the thyroid by adding probiotics and avoiding inflammatory foods. As well as supplementing with selenium and iodine.
Progesterone can be increased by eating more fat and cholesterol like egg yolks. Also including
foods that contain vitamin B6, vitamin C, magnesium and zinc.
Bioidentical progesterone and the progestin-only pill may help increase progesterone in some women. But getting to the root cause of your PCOS and addressing it may help boost progesterone levels. There is no quick or easy fix to hormones. Always consult a medical professional before changing anything in your diet or lifestyle.
Hey there! I am Despina Pavlou, founder of PCOS Oracle and online coach. I want to share with you the diet and lifestyle changes I made to naturally reverse my PCOS and achieve hormonal balance. I believe using my holistic approach you too can take back control from PCOS.