You're probably well aware that your placenta has a big job during pregnancy—supplying oxygen and nutrients to your growing baby. But what you might not realize is the placenta doesn't develop until weeks 12 to 14.
So, what's responsible for supporting and nourishing your embryo until then? Enter: progesterone.
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After implantation, this ovarian hormone stimulates the growth of blood vessels in the lining of the uterus and glands that provide nutrients to your fetus, paving the way for a healthy placenta. Even after the placenta takes over, progesterone is still hard at work maintaining a healthy uterus and helping to prevent preterm birth. That's why it's so essential that your progesterone levels stay high throughout your pregnancy, says Nanette Santoro, M.D., professor and chair of the Department of Obstetrics and Gynecology at the University of Colorado.
So, how much progesterone do you need and how do you know if you're producing enough? Unfortunately, these questions do not have simple answers.
Doctors believe some women are at risk for luteal phase insufficiency (meaning they produce an insufficient amount of progesterone), in particular, women with marginally low body weight (BMI of 19 or less) or very low body fat; women who exercise more than four hours a week (or run 20 or more miles per week); women who have lost their menstrual periods in the past due to stress; and women who have a short luteal phase (their period comes 10 days or less after they ovulate).
Because these women often have difficulties getting pregnant, they are typically treated prior to pregnancy with medication that manages their whole cycle and stimulates the ovaries to make more hormones—progesterone is just one of them. (If you suspect you have luteal insufficiency, Dr. Santoro recommends speaking to your doctor about treatment immediately.)
But, generally, most women can't tell whether their progesterone is insufficient once they are pregnant. Moreover, Dr. Santoro says that although medical professionals believe that a threshold amount of progesterone is needed for a healthy pregnancy, this threshold is not well understood. It's frustrating for women to know that progesterone is essential for a healthy pregnancy but not be able to track and manage their levels without the help of a doctor.
The good news, according to Wendy Warner, M.D., ABHIM, an obstetrician-gynecologist in Langhorne, Pa., who also practices holistic medicine, is that most women's levels are fine.
"But if you've had a history of irregular periods, very severe PMS, or early pregnancy losses in the past, you may have a problem with unbalanced progesterone/estrogen," she explains. In which case, you'd be wise to ask your medical provider about the following five ways to maximize your progesterone levels naturally.
And even if you don't have any of the above symptoms, Dr. Warner and Dr. Santoro say these methods can't hurt (as long as you get your doctor's approval)—especially if they are part of a clean and healthy pregnancy lifestyle.
First, a bit of background: Estrogen and progesterone balance each other in the body. Increased body fat can lead to the production of excess estrogen in the fat cells (by converting other hormones to estrogen); unfortunately, the ovaries don't know this is happening, so they don't make enough progesterone to compensate. Maintaining normal weight doesn't directly increase progesterone.
"But it does help keep estrogen levels normal, which in terms keeps the balance of progesterone reasonable," Dr. Warner says.
Normal, moderate exercise won't hurt either progesterone or estrogen levels; rather, it's a good for you and your baby. "But excessive exercise—think 'competitive CrossFit'—may lead to unbalanced cortisol levels that will decrease progesterone overall," Dr. Warner explains.
Here's how this can happen: The stress of so much physical exertion leads to the elevated and prolonged production of cortisol (the main stress hormone). Because our bodies aren't designed to produce cortisol at such a high intensity, at some point the body looks for "help," which it finds by swiping the progesterone from the ovaries and converting it to cortisol. This compensation ensures survival, but it leaves the ovarian hormones out of balance.
This is easier said than done, right? But knowing what we do about the stress hormone cortisol (from No. 2 above), it makes a lot of sense. According to Dr. Warner, there's ample research showing that the practice of regularly shifting to positive emotions sends the message to the adrenal glands that they can resume normal function (and stop converting progesterone to cortisol).
Additionally, quieting the cognitive part of the mind can slow the overproduction of stress hormones (which as we saw above also helps to balance progesterone).
"Yoga, swimming laps, adult coloring books, knitting, tai chi, whatever works...just get quiet!" Dr. Warner says.
"Chasteberry is an herb know to improve progesterone production," Dr. Warner says. "It's also used for PMS, irregular menses, and support of early pregnancy when there is a history of potential progesterone imbalance." Specifically, it works by stimulating the pituitary gland to produce more luteinizing hormone, which, in turn, signals the ovaries to produce more progesterone.
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"Progesterone and estrogen levels aren't specifically mentioned in Chinese medicine," Dr. Warner says, "but many studies have show there is improved implantation after IVF, as well as decreased pregnancy loss if acupuncture is done early and regularly in pregnancy."
Just be sure to get the okay for your doctor before attempting this method.