Increase in Progesterone Symptoms: Why it Happens and When it’s Not Normal

Progesterone levels normally increase during ovulation and pregnancy then subside as soon as each process is complete. When progesterone levels are high outside of ovulation or pregnancy, it can indicate hormone imbalances, ovarian cysts, congenital adrenal hyperplasia (CAH), a mole pregnancy, or if you’re of the age, menopause. Recognizing an increase in progesterone symptoms is important as it may help identify these underlying conditions early.

What is Progesterone?

Progesterone is a sex hormone that maintains a balance with estrogen and other hormones to support body function, the reproductive system, the menstrual cycle, and pregnancy. [1]

Synthetically-made progesterone, which is often included in birth control pills or hormone therapy is known as progestin.  

Progesterone During Ovulation

During ovulation when an egg is released, the follicle that it came from on the ovary shrinks to a mass of cells and becomes the corpus luteum. The corpus luteum then increases the production of progesterone to prepare and thicken the lining of the uterus (endometrium) to receive a fertilized egg (implantation).

If fertilization or implantation do not successfully occur, the corpus luteum disintegrates and progesterone levels decrease to normal levels.

Increased progesterone symptoms around ovulation typically include:

• Breast tenderness
• Sore nipples
• Food cravings
• Changes in cervical mucus
• Slight rise in body temperature
• Pain on one side of the lower abdomen

 Progesterone and Pregnancy

When a fertilized egg implants in the uterine lining, the corpus luteum continues to produce progesterone to support pregnancy and the embryo. Once the placenta forms at 8-10 weeks, it takes over the production of progesterone for the growing fetus and the corpus luteum breaks down. [2] 

Through the placenta, the production of progesterone continues to increase during pregnancy with the female body producing as much as 10 times more than usual to support the developing baby.

Increased progesterone also supports expecting mothers by slowing tissue growth within the uterus and stimulating bone growth to avoid osteoporosis.

Higher levels of progesterone also prepare the breasts for breastfeeding. It acts as a diuretic to maintain healthy salt and fluid levels in the body. It also reduces cravings for sweet foods while helping convert body fat into energy to maintain a healthy pregnancy weight. 

High Progesterone Symptoms in Early Pregnancy

The first hint of pregnancy is usually a missed period, and although the only way to confirm pregnancy is with a test, the following symptoms of high progesterone in early pregnancy [3] can provide additional indicators. These include:

• Bloating
• Nipple sensitivity
• Constipation or diarrhea
• Fatigue
• Headaches
• Spotting
• Frequent urination
• Morning sickness
• Muscle aches
• Feeling extra emotional

If you experience these symptoms, an early response pregnancy test can help confirm pregnancy sooner.

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When Is Progesterone Increase Not Normal?

Outside ovulation and pregnancy, high progesterone levels are not normal and typically indicate an underlying condition like hormone imbalance, ovarian cysts, congenital adrenal hyperplasia (CAH), a mole pregnancy, or menopause.

While some of these require medical attention, not all are cause for concern.

Hormone imbalances involving high levels of progesterone during the reproductive years can be caused by certain progestins (synthetically made progesterone) used in birth control pills. Research has found that particular types of progestins can build up in body tissue when taken for long periods of time. [4] 

Consult with your OB/GYN if you experience any symptoms of increased progesterone and try another type of birth control.

Ovarian cysts, particularly corpus luteum cysts, are known to cause increased progesterone and estrogen levels. With an increase in progesterone symptoms can include; breast tenderness, bloating, abdominal pain, or emotional upheavals. [5]

Most corpus luteum cysts dissipate without any treatment. But in rare cases, ovarian cysts can damage the ovaries or fallopian tubes and are surgically removed.  

Congenital Adrenal Hyperplasia (CAH) is rare and refers to a group of genetic disorders that impact the adrenal glands, which are located on the top of each kidney. These glands produce and regulate hormones like cortisol, testosterone, and aldosterone. [6]

In people with CAH, the body lacks particular enzymes required for the production of hormones produced by the andrena glands. This can cause the body to produce too little or too much of other hormones, such as progesterone. CAH is not life-threatening but it does require medication.  

Molar pregnancy is when a fertilized egg becomes a tumor (also known as a mole) instead of a fetus. The body initially responds as if it is a normal pregnancy, producing increased progesterone to sustain the endometrium and develop the placenta.

However, pelvic pain, nausea, vaginal bleeding, and an unusual vaginal discharge with lumpy masses eventually occur.

If left untreated, the risk of a molar pregnancy turning into a type of cancer called choriocarcinoma is high. If you experience any of the associated symptoms, contact your OB/GYN immediately, who will likely perform a dilation and curettage (D&C) and look for any signs of cancer.

Menopause, and the transitional phase before it known as perimenopause, can result in increased progesterone due to the drop in estrogen levels at this time of life. [7] Perimenopause normally begins in the late 40s to early 50s but it happens earlier for some women.

Due to decreasing estrogen levels, and by default increased progesterone, symptoms of menopause can include the following:

• Irregular menstruation
• Mood swings
• Interrupted sleep
• Lowered libido
• Vaginal dryness
• Dyspareunia (painful sex due to vaginal dryness)
• Urine leaks
• Increased UTIs
• Depression or anxiety
• Higher risk bone fractures and osteoporosis

Hormone therapy is often prescribed to rebalance estrogen and progesterone during perimenopause and menopause. However, estrogen supplementation at this time of life can also increase the risk of uterine and breast cancer.

For a more natural approach, a plant-based supplement called Chasteberry mimics the effects of estrogen in the body and helps regulate menopausal hormones. Additionally, fertility support supplements containing essential nutrients and herbal extracts may help regulate hormonal balance naturally.

When to Consult with Your Doctor

It’s a good idea to consult with your doctor if you experience any of the above-mentioned symptoms associated with increased progesterone outside ovulation or pregnancy. Particularly if symptoms persist and affect your quality of life.

Conclusion

Progesterone levels naturally increase around ovulation and during pregnancy. Besides these two body processes, high progesterone is not normal and can result in uncomfortable symptoms.

Although increased levels of progesterone are rarely life-threatening, a blood test can help diagnose the cause, and symptoms are usually relieved by normalizing hormone levels.  

References

1. You and Your Hormones - What is Progesterone - https://www.yourhormones.info/hormones/progesterone/
2. American  Pregnancy Association - Early Fetal Development - https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/early-fetal-development/
3. Very Well Health - Early Pregnancy Symptoms - https://www.verywellhealth.com/early-pregnancy-symptoms-before-missed-period-7500769
4. Science Direct - Effects of hormonal contraceptive phase and progestin generation on stress-induced cortisol and progesterone release - https://www.sciencedirect.com/science/article/pii/S2352289518300857?via%3Dihub
5. Springer Link - Radiological appearances of corpus luteum cysts and their imaging mimics - https://link.springer.com/article/10.1007/s00261-016-0780-1
6. Cleveland Clinic - Congenital Adrenal Hyperplasia - https://my.clevelandclinic.org/health/diseases/17817-congenital-adrenal-hyperplasia
7. Endocrine Society - Menopause - https://www.endocrine.org/patient-engagement/endocrine-library/menopause