Progesterone and estrogen are the hormones which play key role in reproductive functioning of women. Imbalance of these hormones can have implications as serious as female infertility. For this reason, women who have problems with conception are examined for hormonal levels as well as physical abnormalities while finding the exact cause of infertility.
Progesterone is particularly significant in women of childbearing age as it is crucial for menstrual cycle as well as maintenance of a healthy pregnancy. This hormone is synthesized by the ovaries during ovulation each month and its production decrease as the woman reaches the menopausal age. Let us know more about the role that progesterone plays for female fertility.
Progesterone and Female Fertility
Though progesterone is vital for regulating a woman’s menstrual cycle, it is primarily concerned with preparing the uterus for the embryo to get implanted therein. As a woman ovulates during her menstrual cycle, progesterone works to thicken the uterine lining so that it gets ready for the implantation of the fertilized egg. If the fertilized egg gets implanted, the hormone will act to maintain the lining of the uterus so that pregnancy is supported. On the other hand, if pregnancy does not take place, the levels of progesterone drop again and the woman starts menstruating.
Besides ensuring the implantation of fertilized egg and sustenance of pregnancy, there are also other ways in which progesterone supports fertility:
- Regulates the consistence of cervical mucus so that it can carry the sperm to meet the egg for fertilization
- Ensures that the developing baby is not rejected by the uterus, thus minimizing the risk of miscarriage
- Aids the development of the fetus during gestation
- Carries out the conversion of body fat into energy during pregnancy
- Improves the libido during ovulation
Since progesterone supports sexual functioning as well as reproduction in more than one ways, it is imperative that imbalance of this hormone can be a cause of concern for women battling with female infertility. Specifically speaking, women with insufficient levels of the hormone may face problems in getting pregnant and staying pregnant. Implantation is practically impossible when the uterine lining is not thick enough to accept the embryo, which happens in the absence of adequate progesterone supply. Also, pregnant women who lack the hormone may not be able to carry the pregnancy to full term.
Low progesterone levels are indicated by recurrent headaches, poor sex drive, mood swings, hot flashes and irregular menstrual cycle. It may cause abnormal uterine bleeding or even absence of periods in some women. On the other hand, pregnant women with depleted progesterone levels can come across symptoms such as abdominal pain, spotting, vaginal dryness, fatigue and low blood sugar. It may be an indication of serious complications such as ectopic pregnancy or toxemia and sometimes may even cause miscarriage or stillbirth.
Low Progesterone Levels: Diagnosis and Treatment
Progesterone levels vary with the age of a woman and the time of the menstrual cycle; they usually peak around the ovulation in a childbearing woman and remain high if she becomes pregnant, otherwise it falls once menstruation begins. When low levels of progesterone are suspected, the doctor recommends a simple blood test to establish the same. The test is useful for the cases of undiagnosed female infertility treatment as well as monitoring of high risk pregnancies. It can also confirm the timing of ovulation for women attempting conception, natural or assisted.
Low progesterone levels may or may not be symptomatic and a woman might even not need treatment unless she is trying to conceive. The fertility specialist may recommend hormone therapy for raising the progesterone levels to aid thickening of the uterine lining for implantation. Additionally, it boosts the chances of healthy, full term pregnancy besides reducing the risk of miscarriage.
Progesterone supplementation may be recommended for women up to 16th week of pregnancy in case she has become pregnant with the hormone therapy. The placenta takes over the role of producing adequate levels of the hormone in the later pregnancy. The ones who are not pregnant or attempting for it but suffer from complications like abnormal bleeding and menstrual irregularity may also need the therapy.
The treatment options for progesterone insufficiency include oral hormonal medication, topical gels and creams (to be applied vaginally), vaginal rings and suppositories. While the therapy has its own benefits, it also enhances the risk of blood clots, stroke and gall bladder problems. Also, it is not advisable for women at high risk of breast or endometrial cancer. Natural remedies like intake of vitamin B, vitamin C and zinc through food sources, is an effective measure to maintain progesterone levels. It is best to consult an expert fertility specialist to get the best treatment option that would work according to individual needs.
Gaudium IVF is the top IVF Centre in Delhi where patients can avail advanced fertility techniques and high-tech treatments for an array of gynecological issues. Contact for free second opinion from Dr Manika Khanna, the award-winning IVF specialist in Delhi.