I like to find a theme or a play on words when I am writing, it helps me hone down which book to reference, or what article to dive into. As noted in last months post, this month I plan to write about Progesterone, the complementary hormone to Estrogen, and in looking for my motivation and direction, I found that the word hormone comes from the Greek “to arouse” or “to set in motion” which felt perfect as we step into April, the month that brings in spring in my neck of the woods.  (Aviva Romm, 2021)

Like Estrogen, Progesterone is produced in the ovarian tissue, but unlike estrogen which rises in the first half of your cycle, activating the ovaries job to initiate ovulation, the surge and fall of progesterone happens after ovulation has occurred and controls the work of the uterus and its lining. The “job” of progesterone in regard to fertility is to create the welcoming bed for the fertilized egg to nuzzle into, where it gets its first nutrients to grow in the early days of pregnancy. But remember, in the United States each woman only has an average of 1.66 babies(Michelle J.K. Osterman, 2023), yet the life time number of menstrual cycles is around 450 (7 Amazing Facts About Periods That Everyone Needs To Know, 2019), so progesterone spends much more time doing non-pregnancy activities, despite its best efforts to be welcoming to any potential baby that comes its way. When the uterine lining is not activated with pregnancy hormones (hcg), progesterone loses its hold, resulting in the menstrual bleeding. And no, the bleeding is not from the unfertilized egg leaving the body (a question I get often in regard to why women still bleed when they stop ovulating), it is from the lining that built up on the uterine lining.

So, what else is progesterone up to in the 448 cycles where it does not host a pregnancy? The answer is all sorts of magical calming things: Progesterone supports deeper sleep, a sense of calm, decreases inflammation and injury to brain tissue, enhances skin health, improves immunity and plays a role in balancing blood sugar. These are all nice things, and supportive to ones moods. Unfortunately for the women’s body, all things cycle, and you can imagine the devastation that the body and mood goes through at the end of the month when it plummets down from around 20 nanograms per milliliter (ng/mL) of blood to just 2 nanograms. (Low Progesterone, 2023) This drop is no joke for many, but, like with Estrogen, when we have dramatic symptoms, it usually means something is out of balance, and the symptoms are giving us clues on what those imbalances are.

The most common symptoms I hear about in the office is spotting or bleeding leading up to the menstrual period. A healthy hormone drop at the end of the menstrual cycle does not trickle out, it starts, makes itself known and then tapers off…so any spotting in the days before the period it is a sign worth looking into to. Other signs of low Progesterone are infertility, insomnia, anxiety, irritability, low libido, short menstrual cycles and water retention. These can be caused by Estrogen imbalances which prevent the trigger for the Progesterone surge, or medical diagnoses such s PCOS, and yes, while these may just be inconveniences, low Progesterone can lead to an increased risk of breast and uterine cancer and reduced bone density.

Every irregular menstrual symptoms as a message worth listening to. Your body is wise. And now you understand why I have these charts for you all to use, cause the more information you have to give to your provider to review, the better we can help. Next month I will share more about how to think about our hormones as seasons, so you can move through each one, harnessing the good and finding softness around the rough.

Click here for the April Tracker

Bibliography

7 Amazing Facts About Periods That Everyone Needs To Know. (2019, April 9). Retrieved from Helping Women Period: https://www.helpingwomenperiod.org/7-amazing-facts-about-periods-that-everyone-needs-to-know/#:~:text=From%20the%20time%20of%20her,that%20will%20be%20spent%20menstruating.

Aviva Romm, M. (2021). Hormone Intelligence: The Complete Guide to Calming Hormone Chaos and Restoring Your bodys Natural Blueprint for Well-being. NY: HarperCollins.

Low Progesterone. (2023, January 16). Retrieved from Cleveland clinic : https://my.clevelandclinic.org/health/diseases/24613-low-progesterone

Michelle J.K. Osterman, M. B. (2023, January 31). CDC – National Vital Statistics Report. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-01.pdf