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Patients can experience low progesterone for a number of reasons, including natural physical changes, medications, and stress. An endocrinologist can order some tests to determine levels of estrogen and other hormones in the body. These tests can provide information about the causes for abnormalities and are also beneficial for monitoring response for treatment. Patients are usually concerned about low progesterone levels in connection with infertility.
Men typically have low levels of this hormone, and in women they are highest among those of reproductive age. The levels naturally fluctuate through the menstrual cycle, and when women get pregnant, they will start to rise to support the developing fetus. A doctor concerned about the causes of low progesterone levels can look for several possible culprits.
Abnormal estrogen levels are one of the causes of low progesterone levels. This hormone suppresses progesterone production and will keep levels down. It may be abnormally high because of medications, weight gain, or an underlying endocrine imbalance and could push progesterone down. Another potential cause is insulin resistance. Diabetes, associated with weight gain and insulin resistance, is another factor.
Stress, diet, and inactivity can also be causes of low progesterone levels. Patients who are in a state of high stress, do not eat well, and exercise irregularly may experience abnormal hormone levels. In addition to progesterone, other hormones may get out of balance. Another potential cause is polycystic ovarian syndrome (PCOS), a condition that brings about abnormal fluctuations in estrogen and other sex hormones. When other causes of low progesterone levels are ruled out and a patient is categorically not pregnant, aging is the most likely factor, as levels of this hormone can drop as women start to enter menopause. Usually other symptoms develop as well and can provide diagnostic clues for a doctor trying to get to the root of a patient's hormone imbalance.
In pregnancy, the causes of low progesterone levels can usually be traced back to the pregnancy itself. If levels of this hormone are lower than they should be, it may be a sign that the developing fetus is not viable. The body does not generate enough progesterone to support the fetus because it may be preparing for a spontaneous abortion of a fetus that is not developing properly. Pregnant women should not panic if screening shows low progesterone levels, but they are a cause for concern, and the doctor may need to perform some additional tests to find out more about the pregnancy.
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