7 Symptoms of Low Progesterone You Don’t Know

By Kim Crawford, M.D. Last updated: March 5, 2021
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Updated version of this blog on the 18 Signs/Symptoms of progesterone deficiency is found here.

If you’re “tuning in” to read this article, chances are that you are somewhat versed in the common signs of progesterone deficiency which, yes-I’ll definitely mention. However, you will likely be quite surprised when I discuss not only the unusual symptoms of low progesterone, but the root causes of exactly why those symptoms occur.

Know that you don’t have to be pre-menopausal to experience symptoms of low progesterone. In fact, you can be in your teens and have a week or two during your cycle in which your progesterone levels are too low. During this time, you can experience the typically discussed or not-typically discussed symptoms I’ll be explaining. Of course, at the end-I’ll give you some direction regarding what to do if you spot yourself in this article. First let’s get the more commonly known issues out of the way.

Well-known Progesterone Deficiency symptoms

Most women know to  ask their Gyn’s about menstrual irregularities and to their credit- most Gyn’s are aware of what I’ll talk about concerning menstruation, fertility, PMDD, and so on despite the fact that they usually offer synthetic hormones (birth control pills) as the answer.

Menstrual Irregularities

The luteal phase of your cycle is the phase where your uterine lining (endometrium) is building up to receive a fertilized egg. This phase is shortened when you are progesterone deficient and you are more likely to have mucous. Your periods might be irregular due to progesterone deficiency. You might have spotting pre-period and clots during your period.

Gynecological Issues

You might be having fertility issues. You might develop ovarian cysts. Everyone thinks that fibroids and endometriosis are estrogen-dependent but it is the ratio of estrogen to progesterone that is important, so low progesterone can cause these issues too. Similarly, fibrocystic breast disorder can be caused by low progesterone. Your libido is (mostly) controlled by your free testosterone level but progesterone also plays a role. Estrogen deficiency isn’t the only hormone that can cause hot flushes. Progesterone deficiency or cortisol excess (early adrenal fatigue) can also cause these annoying symptoms.


Most women are aware of the typical symptoms of pre-menstrual dysphoric disorder. You can have fluid retention (bloating), breast tenderness, and mood swings. However PMDD can last all month or almost all month-and the symptoms are much more than this well-known list. Let me first go into some metabolic issues that will interest you a lot if you feel that you have hit a “weight loss wall” or if you have suddenly developed high blood sugar, pre-diabetes or diabetes. It all just might be your progesterone!

Less Well-Known Symptoms of Low Progesterone

Metabolic Issues

Now that I have piqued your interested about weight loss, let me discuss that topic first by saying the low-progesterone lowers the production of serotonin. This is a very important neurotransmitter which you’ll be hearing about a lot in the subsequent discussion.

symptoms of low progesterone

First of all, low serotonin can trigger sugar cravings. Eating more sugar is obviously going to cause weight gain at some point.

But that’s not where “low pro” gets you, generally speaking.

Low progesterone is the first stage of the rise in the hunger hormones leptin and ghrelin. And leptin is the hormone that makes you “hold onto fat”, starting with belly fat.

So low progesterone can begin the march to menopausal weight gain.

Low progesterone can also trigger inflammation which does many thing including cause a rise in your blood sugar levels. Meaning yes- low progesterone can actually trigger the start of diabetes. Since progesterone helps to normalize thyroid hormones, it can lower those, causing your metabolic rate to drop-and you can see this reflected in a lowering of your morning basal temperature as well as possible fatigue. However. fatigue can occur due to another problem which I’ll discuss next.

Sleep issues

You need two brain chemicals (neurotransmitters) to help you fall asleep and then stay asleep. The fall-asleep brain chemical you need is called GABA and the stay asleep chemical is our friend, serotonin. You know where this is leading, don’t you? Yes, when progesterone falls, so do levels of both GABA and serotonin, making falling and staying asleep more difficult. When this happens, women often get a poor night’s sleep which leads to daytime fatigue and eventually, all sorts of other problems.

Mood issues

Yes, I know we talked about mood swings. But we didn’t discuss “anxiety disorders” and panic attacks due to the (sometimes) massive drop in GABA some women experience. Often, women are prescribed addictive benzodiazepines such as xanax, rather than root-cause solutions such as (duh!) bio-identical progesterone replacement. If this is you, please get a luteal phase (day 21) progesterone checked.

We also didn’t talk about depression-not just PMDD but depression, requiring treatment. This is related to those low serotonin levels. I personally treat low-serotonin with 5-HTP but non-functional-medicine doctors use anti-depressants. However, logic will tell you that bioidentical hormone replacement is the answer in this particular case.

The Signs of Progesterone Deficiency not Well-known

Issues with other hormones

As I alluded to in the beginning of this article, low progesterone can contribute to adrenal dysfunction and even frank adrenal fatigue. This then leads to another reason for low-progesterone induced fatigue which is best treated with adrenal support.

Since progesterone boosts thyroid hormone levels as previously discussed, thyroid hormone levels can be decreased simply due to low progesterone. I know we covered “metabolic issues” but you might not have realized how important the hormone leptin, really is. Known as the principal hunger hormone, it’s main role is that of a fat storage hormone. When you have high leptin levels and your leptin receptors become less sensitive (leptin resistance) you have a really hard time losing weight. Adding progesterone to your regimen might be the missing piece.


signs of progesterone deficiencyLow levels of brain serotonin have been linked to migraines, accounting for the statistical increase in migraines reported by women with documented low progesterone levels.

Indeed, BI progesterone is a natural treatment for a select group of migraine sufferers.

Recent studies have shown that, compared to a regular diet, a nutritional ketosis diet appears to be great for keeping migraines at bay.

The mechanism of action is currently being investigated.

Memory issues

It astounds me that so many women who I speak with about hormones think that it is “normal” to start becoming forgetful at age 40! In fact, in case no one has told you; we now know that if we live a healthy lifestyle including eating an anti-inflammatory diet, keeping our weight normal, our stress levels down and our exercise routine regular, along with some other anti-aging “tweaks” that there is no reason we should ever have memory issues.

However, being foggy-brained and having memory lapses can indeed by directly caused by progesterone deficiency. We don’t think of progesterone as a sleep supplement or a brain supplement but in fact, BI progesterone is just that.


Now this is one I’ll bet you didn’t know about. Did you realize that most of your serotonin is made in your GI tract-not in your brain? And did you ever wonder if the reason you got a little constipated prior to your menstrual period was due to the drop in progesterone that normally occurs to allow for endothelial shedding? That’s right- progesterone and serotonin play an important role in GI tract motility. If you’re constipated, adding more of both is often the cure!

Final Notes

If you think that you might be suffering from low progesterone symptoms, ask your Gyn to order hormone levels. Yes, the gold standard as of the last 5+ years has been serum, not salivary testing so your doctor can just order: estradiol, estriol, estrone, testosterone, free testosterone, SHBG, progesterone and pregnenolone to be drawn on about day 21 of your cycle. If your doctor can’t analyze your results, just do an email consult with me and I’ll be happy to do so. The interim solution is to take some pregnenolone, 5HTP and pure chewable PharmaGABA. But you’ll want a good long-term solution with a real-life doctor like me who knows how to prescribe bioidentical progesterone correctly.

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