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How Does Low Progesterone affect Pregnancy?

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Progesterone is a crucial hormone responsible for maintaining a healthy pregnancy. The ovaries generally produce it after successful ovulation. It maintains the optimal hormonal levels in the body, responsible for regulating a healthy pregnancy.

However, more than its role in maintaining a healthy menstrual cycle, the hormone has a lot of benefits in the maintenance of a healthy pregnancy. But, the topic here, sparks a lot of controversies, especially due to the lack of clear knowledge.

We will discuss the hormone progesterone, low progesterone levels during pregnancy, and its implications in this article.

What is Progesterone?

Progesterone is a female sex hormone produced by the ovarian corpus luteum, transiently maturing the uterine lining to prepare it for a potential pregnancy in the given cycle.

Following the fertilization and implantation of the embryo into the uterus, the human chorionic gonadotropic (hCG) hormone triggers the corpus luteum to keep a steady progesterone secretion until the second month of pregnancy. By this time, the placenta matures itself enough and takes over progesterone production.

The primary objective of progesterone for pregnancy is to keep the uterine lining thick and healthy throughout the pregnancy to reduce the risks of miscarriage and other displacement complications.

What are the Normal Progesterone Levels during Pregnancy?

Like most markers throughout pregnancy, even the progesterone levels vary through the different trimesters. It starts with a nominal amount in the first trimester and is at its peak during the third trimester, when the baby needs maximum protection to grow and develop well.

Following are the normal progesterone levels throughout pregnancy:

First trimester – 11.2 to 90 ng/ml

Second trimester – 25.6 to 89.4 ng/ml

Third trimester – 48 to 300+ ng/ml

If your progesterone levels are significantly lower than the normal levels, it is a sign of concern. Your OBGYN, in that case, will diagnose you with low progesterone levels or so called, luteal deficiency. The diagnosis is very rare and only predominant in very high-risk pregnancies.

Low progesterone is termed luteal deficiency during pregnancy. The primary reason behind this is because the hormone is generally produced during the luteal phase of the menstrual cycle.

There are a lot of controversies surrounding low progesterone levels during pregnancy. While some medical experts believe it doesn’t have any substantial impacts during pregnancy, some experts suggest that it might lead to many complications (especially with risks of displacement of the implanted fetus).

What are the Causes of Low Progesterone Levels?

Since there is very little scientific evidence that explores the interaction between progesterone levels and pregnancy, identifying the exact causes behind the low levels is quite a complicated task.

However, some of the most acceptable causes are:

  • Miscarriage
  • Threatened miscarriage
  • Ectopic pregnancy
  • Lack of regulated menstrual cycle (not during pregnancy)

Most women who have experienced a miscarriage during their pregnancy were later found to have low progesterone levels; hence it is considered a possible cause.

What are the Symptoms of Low Progesterone Levels?

A woman’s body undergoes a lot of changes throughout pregnancy. So, when it comes to low progesterone levels, distinguishing its distinct symptoms from the “standard pregnancy symptoms” can be difficult.

Some of the most notable low progesterone symptoms include:

  • Headaches
  • Migraine
  • Sudden changes in the mood
  • Experiencing miscarriages frequently
  • Spotting
  • Vaginal bleeding
  • Abdominal pain
  • Fatigue

Remember that these symptoms might not be a sign of low progesterone levels and might be general pregnancy symptoms as well. So, ensure that you seek medical guidance as needed.

What is the Treatment for Low Progesterone Levels?

As we mentioned, low progesterone levels might not alarm every healthcare provider. However, if your OBGYN wants to ensure optimal safety for the baby and the mother, they will get you on additional treatment to bring the levels back to normal.

Supplemental progesterone is the easiest and safest treatment option. It is administered via:

Progesterone injections – reduce the risks of preterm labor. It is also administered to women undergoing IVF treatments.

Vaginal progesterone suppositories – ideally administered in IVF treatments. It is also given to women with a “shorter cervix” near their delivery date.

Progesterone oral tablets – prescribed during earlier stages of pregnancy in women with a history of frequent miscarriages.

These external supplements are often commonly prescribed to patients experiencing frequent miscarriages after their conception. Your OBGYN, in such cases, will prescribe these progesterone supplements at an earlier stage of pregnancy to prevent future risks of miscarriages so the baby can be carried to full-term and then delivered safely.

Discuss any complications with an experienced medical professional instead of self-treating the condition since hormonal imbalances can turn fatal if treated inadequately.

What is the relation between Progesterone Supplements, Miscarriage, and Preterm Birth?

Women who have experienced miscarriages or preterm birth have recorded low progesterone levels. This is one of the reasons why researchers are working to establish whether the supplements have positive impacts in alleviating the risks.

Preventing Miscarriage

Although there is a lack of research to back up the relation between progesterone levels and miscarriages, however, a recent study found promising ties.

A study with 800 pregnant women with a history of recurrent miscarriages found that progesterone therapy resulted in higher live births than women who didn’t get hormonal therapy.

However, another study with 2000 women spanning 14 trials found little to no significant changes to the miscarriage risks in a pregnant woman with low progesterone levels.

Preventing Preterm Birth

Preterm birth often leads to multiple developmental complications in the delivered newborn. Administering vaginal progesterone suppositories was found to be quite effective in reducing the risks of preterm birth, especially in women with a short cervix.

However, the treatment effects were only effective in pregnant women with a singleton pregnancy. It wasn’t effective for women giving birth to multiples (twins and more).

FAQs

Does low progesterone cause infertility?

Low progesterone levels aren’t a direct trigger for fertility issues. However, the condition is often paired with additional hormonal complications, hampering regular menstrual cycles and leading to complications.

Can low progesterone affect the results of IVF?

Women undergoing an IVF cycle have a medically low progesterone level to enhance their chances of conception. So, they need external progesterone supplementation to combat the imbalance.

Conclusion

Progesterone plays a very crucial role throughout pregnancy. If you are diagnosed with low levels, it is ideal to discuss the situation with your doctor. Often, the situation isn’t fatal until there are additional complications involved. Your OBGYN will run thorough testing to rule out all possible complications before getting you on a treatment regimen.

Somapika Dutta (B.Sc Physiology, Honours)
Somapikar holds Bachelors Degree in Physiology from University of Culcutta. She has 6+ years of experience writing in different niches, including health, tech and lifestyle. An animal enthusiast and a raging foodie, experiencing life - one day at a time.

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