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Monitoring Progesterone Levels

What is progesterone?

Progesterone plays an important role in the menstrual cycle and in maintaining the early stages of pregnancy. During the second half of the menstrual cycle, called the Luteal Phase, progesterone is secreted by the corpus luteum, an outer layer that forms around the egg. The detection of progesterone after ovulation is the clearest indicator of an egg being released. Progesterone is released to help prepare the body for pregnancy in the event that the released egg is fertilized. Specifically, progesterone causes the uterine lining to thicken so the fertilized egg, or embryo, can implant. If the egg is not fertilized, the corpus luteum will break down, the levels of progesterone begin to drop and the uterine lining begins to shed resulting in a period.

What does a good progesterone chart look like?

Progesterone levels fluctuate throughout the menstrual cycle so it is important to follow the overall trend of the hormone behavior versus specific numbers each day. 

To confirm ovulation, the progesterone should begin to elevate 24-72 hours after the LH peaks. With Oova, we have seen the levels begin to elevate anywhere within that range.

In order to confirm ovulation, the progesterone levels should rise at least 5 ng/mL above the baseline progesterone values captured during the earlier part of the monitoring window.

Here is are two examples of good progesterone behavior confirming ovulation:

Example 1


Example 2

Oftentimes, we see patients display dramatic progesterone behavior representing a zig zag pattern. In this pattern, the progesterone levels elevate, then drop, and then elevate again. If this pattern continues throughout the luteal phase, it can indicate that the corpus luteum is not releasing a steady stream of progesterone. Here is an example:

What are the levels we are looking for?

During the follicular phase, progesterone levels should be close to their baseline levels or very low. Post ovulation, the progesterone should begin to rise. In order to confirm ovulation, an increase of 5 ng/mL over baseline is expected. In term of Oova percentages, women should expect to see a percentage at or above 22.2%.

How many days post-ovulation does the progesterone begin to rise?

This differs for every woman, however, typically progesterone will rise anywhere from 24-72 hours after ovulation.

What happens if progesterone is very low?

If progesterone levels are on the lower side, irregular and heavy menstrual bleeding can occur. It can also lead to a miscarriage or early labor if the progesterone drops substantially during the pregnancy. If there is no progesterone rise that happens after ovulation, it can mean that the ovary failed to release an egg during the LH peak and that particular cycle was anovulatory.

What are some things you can do if your progesterone is low or behaving irregularly?

If the progesterone levels are low or you often see a zig zag pattern in the luteal phase, you may benefit from a progesterone supplement. It is important you speak with your healthcare provider prior to taking any supplements but it is worth a conversation to see if this is the right option for you. Supplements can be topical (applied as a cream) or ingested via oral pll. You can also incorporate certain foods that can stimulate your body to produce more progesterone naturally such as:

  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Kale
  • Nuts
  • Pumpkin
  • Spinach
  • Whole grains

Some additional ways to increase the body’s natural progesterone is to maintain a healthy body weight, reduce stress, and avoid over-exercising.