Progesterone is an essential hormone that is key for the menstrual cycle, fertility, and pregnancy. You may have learned about it in biology class. But, chances are, you haven’t thought about the importance of progesterone since then.

Most women are not aware of how much their hormones affect them. They come into my office feeling exhausted without realizing that they are dealing with progesterone deficiency and adrenal dysfunction.

I remember meeting Lisa, a 38-year-old graphic designer, for the first time. She didn’t even have to tell me; I knew she was exhausted.

Like many women, at her age, Lisa was working herself into the ground by putting in 14 to 16 hours days during deadline weeks. She was traveling for work often. Despite trying her best, she was not available for ‘mother-daughter time’ with her teenage daughter.

Lisa was not only tired and stressed beyond belief, but also had a bucket full of health complaints. She was experiencing intense PMS symptoms, vaginal dryness, thinning hair, and weight gain. She was irritable, forgetful, and had trouble concentrating. She regularly woke up at 2 am and felt like she needed a nap as soon as her alarm went off in the morning. 

Do you recognize yourself in Lisa’s story? Many women that walk into my office tell me that they don’t feel like themselves anymore. Their life just feels out of control with a long list of health issues.

What Lisa didn’t know was that she was experiencing adrenal dysfunction and low progesterone. It wasn’t her, it was a hormonal imbalance that was causing her issues. 

Addressing her low progesterone and adrenal dysfunction, Lisa overcame her symptoms. And you can too. Let’s talk about low progesterone and adrenal fatigue and what you can do about it, and how it happens to begin with. 

What is progesterone deficiency

Progesterone is one of your major female sex hormones. The corpus luteum in your ovary releases progesterone during your cycle to prepare your endometrium for a potential pregnancy after ovulation. It helps to thicken the lining of the womb to accept fertilized eggs, reduces muscle contractions that can lead to rejecting fertilized eggs, and stimulates glands that nourish the embryo.

Progesterone is a very calming hormone. Unfortunately, like Lisa, many women don’t realize that progesterone deficiency is the culprit behind their anxiety, moodiness, PMS, heavy periods, and other symptoms. Low Progesterone may also cause symptoms in menopausal and post-menopausal women.

What may surprise you even more is that progesterone deficiency may also contribute to symptoms of adrenal fatigue. How is that possible? 

Nothing in your body happens in isolation. All your hormones need to be properly balanced for your body to function at its best. If one hormone is out of whack, chances are, there will be other imbalances as well. Since progesterone is also produced in your adrenals, not just your ovaries, it is not surprising that progesterone deficiency shares similar symptoms to adrenal dysfunction and the two issues are often connected.

Symptoms of progesterone deficiency

Some of the typical symptoms of progesterone deficiency include:

  • Migraines or headaches
  • Mood disturbances, including mood swings, irritability, anxiety, and depression
  • Bloating and water retention
  • PMS and/or irregular periods
  • Vaginal dryness
  • Low or no sex drive
  • Brain fog
  • Sugar cravings
  • Weight gain
  • Fatigue or exhaustion
  • Acne
  • Facial hair growth
  • Hair loss
  • Dry skin and brittle nails

What is adrenal dysfunction

Adrenal dysfunction may feel like walking through a perpetual fog all day. You may feel groggy, irritable, or anxious. You may have trouble concentrating, sleeping, or losing weight. You may have digestive issues, PMS, or severe menopausal symptoms. Life just feels like a chore.

While many doctors use the term adrenal fatigue, I much prefer the term adrenal dysfunction. Why? Because that’s what’s happening: your adrenals are not functioning well, they are dysfunctioning.

Your adrenal glands are located at the top of your kidneys. They are responsible for producing and releasing a list of hormones that your body can’t function without. If your adrenals are not working as they should, these hormones get out of balance leading to a list of unwanted symptoms.

The primary responsibility of your adrenals is to help your body respond to stress. They release adrenaline and cortisol to allow your body to survive. 

Cortisol is also known as the stress hormone. It converts nutrients from food into energy, reduces inflammation, supports the immune response, and regulates your blood pressure and cardiovascular function. It also activates the “fight, flight, or freeze” response under stress.

This comes in quite handy under acute stress if you are facing a real threat. Our ancestors were often chased by animals or had to run away from fire or other danger. Cortisol was there to help and allow them to escape or fight and survive. This mechanism can also help you react appropriately and survive if you get mugged or get into a car accident.

It is not exactly practical when you are experiencing constant everyday stress, such as being stuck in traffic, dealing with job frustration, or reading the news all day long. When you are under chronic stress from family, relationship, job, and other life issues, your body is under a constant stress response. 

Your body never gets the memo that everything is alright, and it can relax and chill a little bit. Instead, your adrenal gland will produce cortisol constantly, causing imbalances in your other hormone levels. At one point, your adrenals may also get tired of the continuous cortisol demand and start producing too little cortisol instead. Too little cortisol can also lead to problems, including exhaustion and hormonal imbalance. 

Before I get into the connection between progesterone deficiency and adrenal dysfunction, I want to go over the symptoms of adrenal dysfunction. You may notice that some symptoms overlap with progesterone deficiency.

Symptoms of Adrenal Dysfunction

Adrenal dysfunction is a widespread problem. Like Lisa, most women are familiar with the list of symptoms that are affecting their entire body. If these symptoms seem familiar to you, you may also be experiencing adrenal dysfunction:

  • Feeling tired in the morning even after a good night’s sleep
  • Inability to stay awake in the evenings, yet having trouble falling asleep at night
  • Feeling both wired and exhausted
  • Dozing off when you sit down for a quiet activity, such as reading or meditation
  • Feeling dizzy or lightheaded when standing up
  • Feeling dizzy in general
  • Low blood pressure or blood pressure varying between high and low
  • Indigestion, diarrhea, and other digestive issues
  • Heart palpitations
  • Weakness
  • Weight gain, especially around your waist
  • Losing muscle and gaining fat
  • Low exercise tolerance
  • Feeling unwell
  • Feeling cold a lot
  • Frequent headaches
  • Swollen ankles
  • Water retention
  • Dark circles under your eyes
  • Dry mouth
  • Sweaty hands and feet when you are nervous
  • Low blood sugar when missing a meal
  • Salt, sweet, or high-protein food cravings
  • Needing a frequent coffee or sugar fix
  • Intense symptoms of PMS, perimenopause, or menopause
  • Irritability
  • Prone to anger or rage
  • Feeling constantly on the edge
  • Feeling depressed or numb
  • Low sex drive
  • Frequent nightmares
  • Feeling an overpowering urge to cry
  • Trouble concentrating and brain fog
  • Anxiety
  • Feeling stressed all the time
  • Everything feeling like a chore

The Connection Between Progesterone Deficiency and Adrenal Dysfunction

As I mentioned before, having a stress response is not bad. It’s natural and necessary for survival under acute stress. An ongoing stress response due to chronic stress is what’s causing trouble instead. Your body shouldn’t be under a ‘fight, flight, or freeze’ response because of small daily stressors, like a traffic jam.

Chronic stress taxes your adrenals and eventually leads to adrenal dysfunction and overproduction of cortisol. Progesterone is essential for cortisol production. However, when your adrenals are working overtime to make an excessive amount of cortisol, they have to cut back on progesterone production, causing estrogen-progesterone imbalance.

At first, you may only experience some fatigue, trouble sleeping or feeling more ‘wired yet tired’ than usual. But if your adrenal dysfunction goes unaddressed, you will start experiencing more extreme fatigue and symptoms. Due to prolonged stress, your body then reaches that stage called ‘pregnenolone steal’.

Pregnenolone is the compound that makes cortisol, progesterone, and Dehydroepiandrosterone (DHEA). DHEA helps produce two other critical sex hormones, estrogen and testosterone.

When you are experiencing ongoing, chronic stress and your adrenals are pumping out cortisol around the clock, then pregnenolone reduces progesterone and DHEA production to create more space for the creation of more and more cortisol instead. Cortisol ultimately steals the space from progesterone. 

Beyond producing too much cortisol, another consequent problem that happens during stress is that the production of enzyme 17 alpha(α)-hydroxylase lyase or 17/20 enzyme lyase gets blocked. 17/20 enzyme lyase acts upon pregnenolone and progesterone and is essential for hormone production, sexual development, and reproduction. 

Since enzyme 17/20 lyase is critical for hormone production, this can become a serious problem. It blocks the conversion of cholesterol to hormone production, which is why your progesterone levels get low.

This leads to an imbalance in both your sex hormones, such as progesterone and the hormones that are normally produced. This serious hormone imbalance is the culprit behind progesterone deficiency. This is why so many women have progesterone issues.

The insufficient production of progesterone leads to progesterone deficiency, estrogen-progesterone imbalance, hormonal imbalances, worsened PMS, perimenopausal, or menopausal symptoms, infertility, low sex drive, irritability, moodiness, fatigue, brain fog, blood sugar imbalances, and other issues.

If your body continues to overproduce cortisol for a long time, eventually, it will reach ‘burnout’. It will stop producing cortisol while still only producing low levels of progesterone and DHEA. At this stage, your symptoms became even worse, making daily life very challenging. Your risk of digestive disorders, other hormonal imbalances, autoimmune conditions, infertility, and other health issues also increase.

Improve your progesterone levels for adrenal health

If you are experiencing symptoms of progesterone deficiency and adrenal dysfunction, chances are that you’ve been to countless conventional doctors without much success. You are not alone. Lisa and most of my patients have gone from doctor to doctor without results until they finally found improvement with the help of some natural solutions.

It seems so simple, but your body is incredibly wise. If you support it with natural strategies and allow it to rest, it will repair itself. Like Lisa, you may also find success with the following natural strategies. 

Reduce your stress levels

Let’s be honest, if you don’t give your body a break, your adrenals won’t be able to slow down either. Completely eliminating stress is impossible, of course. But you can reduce stress and learn how to respond to stress better.

Breathwork is one of the most powerful ways to relax your body. Start your day with a few conscious deep breaths and stop throughout the day to practice deep breathing for a moment. Practice meditation to release your feelings and identify negative patterns. Try meditation or yoga to calm your mind and body. Spend time in nature to slow down and connect with yourself.

Sleep plenty

Sleep deprivation is one of the main underlying causes of stress and adrenal dysfunction. Aim to get a restful night’s sleep every day. Try to go to bed and wake up around the same time every day to support your natural sleep-wake cycle and ensure 7 to 9 hours of sleep each night. Avoid stress, heavy foods, and electronics. Engage in relaxing activities instead that help your body and mind calm down. Reading fiction, journaling, coloring, crossword puzzles, and meditation are great evening ideas.

Follow a hormone-supporting diet

Food is medicine. It’s simple but true. Be conscious about what you put into your body. Avoid refined sugar, refined oil, and processed foods. Consume nutrient-dense whole foods, including lots of greens, vegetables, fruits, legumes, whole grains, wild-caught fish and seafood, and lean red meat. Choose organic whenever possible and available. 

Pay attention to the way you are eating as well. Don’t rush your meals. Sit down comfortably and focus on your meal instead of scrolling on your phone or watching TV. Slow down, chew your food, and stop between bites. Stop eating when you feel satisfied before you become uncomfortably full.

Support your body with supplements

Vitamin B and C helps to boost your progesterone levels. Vitamin B6 is not only great for optimal progesterone levels but also helps to break down estrogen and reduces estrogen dominance. Vitamin C also offers antioxidant benefits, lowers oxidative stress, and reduces free radical damage.

Magnesium helps to regulate your hormones and maintain optimal progesterone levels. Zinc promotes progesterone production in your ovaries and helps you to maintain healthy progesterone levels.

To meet your vitamin and mineral needs, I recommend taking a high-quality multivitamin. Always check with your healthcare provider to make sure that a particular supplement is appropriate for your unique needs. Testing for vitamin and magnesium deficiencies may help you to choose the right supplement.

Try herbal support

Adaptogenic herbs help to reduce stress and improve your adrenal health. Astragalus root helps your body’s stress response, immune function, and blood sugar levels. Ashwagandha helps to lower stress, reduce cortisol, improve brain function, and lower anxiety. 

Rhodiola Rosea helps to reduce stress-related fatigue, improve immune function, boost mental clarity, reduce anxiety and depression, improve immune function, and regulate blood sugar levels. Licorice root supports adrenal balance, energy, and endurance. Always check with your healthcare provider to make sure that these herbal supplements are right for you.

Bioidentical progesterone cream

Unlike synthetic hormones, bioidentical hormones offer the same cellular structure as the hormones in your body. They absorb easily, are quite effective, and are generally safe. You may benefit from using bioidentical progesterone cream. However, make sure to check with your functional medicine practitioner to ensure it’s right for you.

Regain your health naturally

Lisa was able to overcome her symptoms by reducing her stress and supporting her health through natural strategies. You improve your health too, as she did. Supporting your diet with stress-reducing techniques, better sleep, a hormone-supporting diet, vitamins, minerals, and adaptogenic herbs is a road worth taking. I can’t wait to see you on the other side.

Reviewed by Dr. Mark Menolascino, MD