Why do I Have Low Progesterone Levels with PCOS?



Are PCOS and Low Progesterone Levels Linked?

If you are reading this article then you likely  have PCOS. We will keep the explanation for PCOS brief then. PCOS is a multi-faceted endocrine, metabolic and hormonal condition that has an impact on wide-spread areas of health including your menstrual cycle and fertility. Recent estimates show that PCOS affects somewhere around 1 in 6 or 1 in 8 women. 

In the context of figuring out ‘why you may have low progesterone levels in PCOS,’ a basic understanding of what Polycystic Ovarian Syndrome is will be helpful. We don’t know exactly what causes PCOS, but it is likely a combination of genetics, environmental exposures and lifestyle factors. 

PCOS has impacts on the ovary. In a woman experiencing PCOS their ovary produces more testosterone than it should. The ovary produces lower levels of progesterone and also has some altered metabolic functions in the fluid surrounding developing eggs. This altered follicular fluid impacts the metabolism and health within the developing follicles themselves.

All of these things impact how and when progesterone is made. Progesterone is a hormone that has widespread effects in the body. You’d be hard pressed to find a body system it doesn’t impact: reproductive tissues, mammary glands, brain, bones, cardiovascular system, skin, immune health and more. 

Having little or no progesterone production is so common in PCOS it is one of the main things I treat in my nutrition and fertility practice as a dietitian.


What does Progesterone do and why do I Need to Care if I have PCOS?

When you ask someone what are female hormones, they may respond: progesterone and estrogen. Answering that would be correct. These are two of many “female” hormones that impact a woman throughout her menstrual cycle. They come on the scene with puberty and start leaving the party in perimenopause. 

In between during your fertile years as a woman, they play notes in a delicate symphony that dictate your hormonal health and fertility. You need to care about this outside of fertility to avoid an. increased risk of heart attacks or breaking your hip at 70, but typically that’s not something top of mind for the day to day 20-40 year old.