In detail

Progesterone and its influence on fertility

Progesterone and its influence on fertility

Hormonal balance is an extremely important factor when it comes to fertility and the ability to become pregnant. During a menstrual cycle, several types of hormones ensure ovulation and menstruation. Progesterone is one of these key hormones. An insufficient amount of progesterone can lead to miscarriages, infertility and affective disorders.

How progesterone is produced

Progesterone production is triggered by the luteinizing hormone (LH), secreted by the pituitary gland in the brain. After ovulation, it stimulates the luteal body - or follicle from which the egg broke off, to produce progesterone, in order to support a possible pregnancy. Under the action of progesterone, the wall of the uterus thickens, thus allowing the fertilized egg to be fixed.

If the egg is fertilized by the sperm, the luteal body continues to secrete progesterone for 7 weeks, after which the synthesis of this hormone is taken up by the placenta throughout pregnancy. Otherwise, the luteal body disintegrates, which results in decreased progesterone levels. The endometrial tissue formed on the wall of the uterus also begins to decompose, eventually to be eliminated by menstruation.

The role of progesterone

Progesterone causes thickening of the uterine mucosa (or endometrial tissue), which makes it possible to fix the fertilized egg in the uterine wall and survive it. He briefly fulfills the following functions:

• It helps the sperm to pass through the cervical mucosa;
• Allows the embryo to survive;
• Prevents the rejection of the fertilized egg by the mother's immune system;
• Allows full development of the fetus during pregnancy;
• Helps the body convert fat into energy;
• Prevents secondary sexual development (secondary sexual development);
• Increases the libido around ovulation;
• Activates osteoblasts (young bone cells, involved in the formation of the baby's skeletal bone);
• Protects against endometrial, breast, ovarian and prostate cancer;
• Normalizes blood clotting.

Progesterone deficiency

Too low a level of progesterone is always harmful to pregnancy, leading to spontaneous abortion or premature birth. At the same time, it can lead to infertility and other hormonal imbalances, such as excess estrogen, another female sex hormone involved in ovulation.

Symptoms associated with progesterone deficiency are:

• repeated miscarriages;
• lack of menstruation (amenorrhea);
• lack of ovulation;
• cramps during menstruation;
• swollen breasts and pain or fibrocysts;
• decreased libido or even disappearance of sexual appetite;
• fluid retention;
• hirsutism (excessive facial hair);
• blisters or night sweats;
• vaginal dryness;
• blurred thinking;
• memory problems;
• sleeping disorders;
• palpitations;
• urinary incontinence.

At the same time, the progesterone deficiency is correlated with the installation of the following conditions:

• endometriosis;
• premenstrual syndrome;
• polycystic ovary syndrome;
• problems of blood coagulation;
• obesity;
• depression;
• functioning disorders of the thyroid gland;
• osteoporosis.

Methods for determining progesterone level

If you suspect that you are suffering from a progesterone deficiency, it is recommended that you consult your gynecologist or endocrinologist for further investigation and confirmation of the diagnosis. The tests include both hormonal dosages, established by blood tests, and other methods such as menstrual cycle representation, saliva testing, or basal body temperature determination.

1. Basal body temperature

The period after ovulation is also known as the luteal phase of the menstrual cycle. It lasts about two weeks and is marked by certain changes, such as slight increases in body temperature. About 2 days after ovulation, it increases by about 0.3 - 0.4 degrees Celsius. If you have taken your temperature every day of your menstrual cycle and you have not noticed any increase in your menstrual cycle, you may suffer from a progesterone deficiency.

2. Length of the luteal phase

For women who have a regular cycle of 28 days, ovulation usually occurs on the 14th day of the menstrual cycle. To determine the exact date of ovulation, you can use ovulation tests or basal temperature measurement. If the menstrual cycle occurs less than 11 days after ovulation, you may suffer from a luteal phase defect.

3. Saliva testing

Recent research has shown that hormonal analyzes in saliva can accurately determine the level of sex hormones. Similar to the pregnancy test, saliva analysis can indicate whether or not a woman suffers from a progesterone deficiency.

4. Blood tests

Measurement of progesterone by blood tests should be done about 7 days before the presumed date of the next menstruation. For a complete picture, your doctor may recommend a complete set of hormonal tests, which include tests to determine the level of FSH (follicle stimulating hormone), LH (luteinizing hormone), TSH (thyroid hormone), estrogen and proalactin.

When you need to measure your progesterone level

If you want to become pregnant and you know you are suffering from irregular or amenorrhea cycles (lack of menstrual cycle), it is very important to know how you are doing with your blood progesterone level.

The optimal period for the measurement of serum progesterone is represented by the median luteal phase: either 7 days after ovulation or 7 days before the expected menstruation. Specialists believe that the maximum level of progesterone is reached only during these periods.

In the case of a 28-day cycle, it is recommended to test the progesterone level on day 21 of the menstrual cycle. If your cycle lasts for 35 days, it is advisable to carry out the tests on the 28th day after the onset of menstruation.

Tags Progesterone Progesterone level Fertility problems