Do I Need Progesterone Testing?

I always look forward to reading articles by Naturopathic doctor Lara Briden because she explains hormonal issues in a clear way.

Many women wonder if they should get hormone tests before using bioidentical hormones. The simple answer is yes, if you want to check your levels. However, most women rely on their symptoms and how severe they are to guide their decisions.

It is important to remember that most standard blood tests are just that—blood tests. Progesterone however is best measured in saliva, but this test is not usually offered on the NHS or generally.

In this article, she explains that testing is not the only option and provides helpful suggestions on how to monitor your progesterone levels

Why you may have low progesterone levels

There are two ways to have low progesterone if not post menopause and understanding that difference is key to understanding your cycle.

The first is an anovulatory cycle, when you don’t ovulate and therefore make no progesterone at all.

The second is a short luteal phase, when you do ovulate, but your progesterone window is too brief, and the hormone never reaches its full potential.

If post Menopause, you are no longer producing progesterone from the ovaries and the levels drop significantly, but small amounts are still made in the adrenal glands.

The temperature story

Progesterone is not just a test result. It is a story told by your cycle, and one of the clearest ways to understand that story is to track your basal (resting) body temperature or BBT.

After the release of an egg, progesterone pushes BBT higher. You can track that change with a thermometer used under the tongue or a wearable device.

When you see a steady shift of at least three higher temperatures, you know that the release of an egg has occurred. From there, a healthy phase after ovulation should last for at least ten days.

If your temperature never rises, it is proof you did not release an egg (even if you have a period). If it rises but falls again before ten days, you had a too-short phase after ovulation.

It can help to think in terms of ‘progesterone days’, which are the high-temperature days when you actually make progesterone. More progesterone days means having more of its benefits for your womb lining, breasts, brain, and immune system.

And too few progesterone days means too little progesterone, even if your measurable progesterone level on any given day is within the normal range.

Testing progesterone

While charting is the best way to track progesterone, you can also measure it with an at-home urine test or a test from your doctor.

Timing is important because peak progesterone is in the middle of your luteal phase: roughly seven days after ovulation and seven days before your next period.

That could fall anywhere between day 14 and 28, depending on the length of your cycle.

So rather than relying on the standard “day 21 progesterone test,” a better approach is either to chart temperatures to find ovulation and then test five to seven days later, or to test when you believe you’re about a week from your period.

In that case, wait until your period actually arrives before reading the result. Then ask yourself: “Was the test done within the 14 days before my period?” If not, the result has no value.

Timed properly, a blood progesterone level of 3 ng/mL (9.5 nmol/L) is enough to confirm ovulation, but higher is better, and a best level is above 10 ng/mL (30 nmol/L).

Don’t worry about a low-normal number, though, because progesterone naturally rises and falls every 90 minutes. Your test may have simply caught progesterone at a low moment.

Also, it’s not really possible to have too much natural progesterone.

Using hormonal birth control?

There’s no point testing progesterone if on the Pill or Coil because you have none as most contain synthetic progestins – not progesterone.

Perimenopause is when luteal phases start to wobble

One of the first signs of perimenopause is that the luteal phase, which occurs after ovulation, starts to get shorter. You might still ovulate, but the level of progesterone decreases, and this change marks the beginning of perimenopause.

Tracking these changes can help you see what is happening and better understand the transition.

Signs and symptoms of low progesterone

Besides charts and lab results, your body gives its own signs when progesterone is low.

For example, you might notice fertile-type mucus appearing in the phase before your period, spotting before your period, or heavier, longer bleeding.

Those are all possible signs of having too low progesterone levels.

The big picture

Your progesterone health cannot be explained by just one number. It is reflected in your menstrual cycle, symptoms, and by observing the strength of your luteal phase. These factors provide more insight into your hormone health than any single lab test.

This story changes over time. In your twenties and thirties, the focus is on strengthening your luteal phase.

In your forties, you should pay attention to any changes in your luteal phase as progesterone levels begin to decrease naturally.

Helpful information 

It is important for women to keep good progesterone levels throughout their lives. This is necessary not just in their early years for help with PMS and fertility, but also to protect against hormonal cancers, heart disease, and osteoporosis later on.

Do not think that PMS only affects younger women as it can also happen during perimenopause.

https://blog.wellsprings-health.com/why-pms-can-strike-at-any-age/