Reader Question: I have been trying to get some information on bioidentical progesterone cream use for short luteal phase issues and can not find information anywhere. I have been tracking my cycles for almost 10 years using the sympto-thermal method and after the birth of my second son, the length of my luteal phase has been VERY short…too short to sustain a pregnancy. I know this is most likely caused by low progesterone infertility and was told that going the bioidentical progestone route can help me. I am hesitant to do so.
Would you simply recommend Vitex and vitamin B6 to increase luteal phase length?
First, a primer on progesterone
An important part of conception, progesterone is also needed to carry a pregnancy to term. A woman’s body has to produce enough progesterone to support the pregnancy until the placenta is developed enough to take over (this happens at the end of the first trimester).
One of the reasons progesterone may be too low, is that there may be too much estrogen in the body and the first thing to look at is the weight of a woman {groan}. Our fat cells help to produce and carry estrogen in the body and when we are overweight, we’re more apt to have higher estrogen levels. Losing weight is neither fun nor easy, but even losing 10% of your body weight (should you need to lose any) can help balance out hormone production.
Another reason hormone levels can become unbalanced is if a woman is still nursing, as it’s a natural way our bodies “protect” themselves. Breastfeeding keeps our prolactin levels higher, thereby keeping the progesterone levels low. Weaning usually solves this problem within a few months, though the age of the baby should be taken into strong consideration as nursing until two years old is recommended. I have my own feelings on trying to conceive while breastfeeding, but vitex has been shown (in some women) to help lower the prolactin levels enough to boost progesterone.
Weak or no ovulation also causes low progesterone, so if you aren’t ovulating during your cycle there is no corpus luteum to signal progesterone production. (and no, you don’t always ovulate even if you have periods!)
Stress can also throw hormones out of whack. Lack of sleep and healthy foods (both hard to get when taking care of a baby) can cause stress to these organs. When these organs are not running at optimal levels, hormones become unbalanced. When our bodies are stressed the adrenals use the precursor hormone for progesterone (pregnenolone) to produce the “fight or flight” hormones instead.
A diet high in sugar and refined carbs also does a number on the balance between estrogen and progesterone! One main reason why is that our bodies are dependent on vitamin B6 to help process carbohydrates. So even if we think we’re getting enough vitamin B6 in our diets, our bodies may be using more than we’re consuming, essentially leaving us mal-nourished.
photo credit, Alliance Images, via Canva.com
My Answer:
I think that there are a lot of things you can do with whole foods to help a body heal, but it does take time. Make sure the diet is void of refined sugars and carbs, and full of healthy fats (butter, evoo, coconut oil), a variety of veggies and fruits, and good wholesome dairy.
Vitamin B6 is often linked to luteal phase problems and it’s a great place to start! But I also think nutrients are best utilized and absorbed when we find them in foods. So dietary changes are essential and should be looked at prior to, or along with, any supplementation. It’s also important to think about the B vitamins as a whole, whether you are supplementing or trying to boost intake through only foods. They all work together and should be consumed together.
When supplementing: Be sure to use a B-complex vitamin made from food sources and search out supplements that contain folate instead of folic acid
Vitex may be helpful for some women, but it definitely isn’t a one size fits all herb! From talking with other women, many of them have had good luck with vitex getting their cycles back on track, especially after a baby and while nursing. Not only does it seem to help lower prolactin levels, it may also assist balancing out the estrogen:progesterone ratio as well.
On the other hand, some women find that vitex makes their symptoms worse, so it’s important to match a herb to all of your symptoms, not just the most annoying one at the time. I interviewed an acupunturist and fertility expert about vitex a while back, so please listen to her advice on the herb, or at least read through our summary – Vitex for fertility.
Many Vitex supplements contain other herbs as well, so before taking check to make sure that all of the herbs will be helpful for your situation.
Progesterone Creams – I think that if a woman who is having trouble lengthening the luteal phase or producing enough progesterone, that a progesterone cream is definitely an option. Especially if it’s been 3-6 months of adhering to a whole foods diet, lifestyle changes, and supplementation. I would personally seek the guidance of a health practitioner well versed in both natural alternatives to balancing hormones and the use of bio-identical progesterone creams. If a couple is actively trying to conceive (and not taking steps to avoid pregnancy while trying to balance the woman’s hormones) and the woman has a short luteal phase or known low progesterone levels, I’d almost be hesitant to not use a progesterone cream.
There are different creams, some more natural than others. Natural Progesterone creams all contain the same type of bio-identical progesterone. It’s produced in a lab by making changes to the chemical structure of a compound found in wild yams. The other ingredients though as varied and many contain parabens, synthetic fragrances, and preservatives I choose to stay away from. There are many good options for progesterone cream and many are even oil based (which means they don’t need a preservative like water based products do). One oil based product I’ve used before is from Beeyoutiful, though there are others.
From our Facebook community:
- My understanding is that it can take up to 6 months for the luteal phase to get back to normal after the first post partum period. I would try to heal the body via whole foods and correcting imbalances first, because it is more than just progesterone that is probably out of whack, there is a whole series of hormones.
- My reproductive endocrinologist & immunology specialist told me that treating a Luteal Phase Defect is treating a symptom, and the root cause of low progesterone in the luteal phase is insufficient estrogen in the ovulatory phase. Thus balancing hormones across your cycle would be best.
- I have been fighting with this since my first miscarriage almost 4 years ago, and it’s not easy. It’s a slow process, depending upon how low your progesterone levels are to begin with, but there IS hope! In the last 6 months of working on it, I have had the best results with –
- changing my diet (off of sugars and grains, unless they are soaked, adding lacto-fermented veggies and drinks [beet kvass is very high in B vitamins–good for progesterone!])
- getting proper exercise (t-tapp has a workout designed specifically for balancing hormones and it works!)
- supplements (Vit. B complex, C, D, E, Zinc, Selenium, Evening Primrose Oil, Vitex).
- I have my youngest because I used progesterone. I have PCOS so my estrogen is very high and I needed to balance it with the progesterone. Once I conceived, I used everyday till 10wks (because I had miscarried the pregnancy before) when I allowed the midwife to try the heartbeat on a doptone. Then I weaned off it as the baby had implanted so my progesterone production was sufficient.
Have you ever dealt with a short luteal phase? What did you do to treat it?
*All information is given to inspire and encourage you to do your own research, learn from others experience, and learn to ask your doctor more questions. No answer given is from a medical professional and should not be taken as medical advice.
Donielle Baker
Coconut Milk Steamer
Great post…lots of good suggestions for low progesterone. I had difficulty conceiving my second child until I began charting and realized I had low temps. I started using pro. cream and three months later we were pregnant. I used Beeyoutiful’s pro. cream…it worked great for me and is a great price. You can search online for their site. 🙂 They have great customer service as well.
After I had my first child I noticed that my hormones were off. After I had a miscarriage I knew I had to do something to figure out why my body was imbalanced. I saw lots of doctors/naturopaths etc but decided that there is no one more passisonate than myself to help myself so that is exactly what I did. For years I did lots of research while working with a naturopath. I have always been fit, eat completely organic and with absolutely no sugary foods, processed foods or refined carbs in my diet. It was so difficult because I had felt that there was little left for me to change. I found this amazing website that speaks of low progesterone, short luteal phase, menopause, infertility etc. And honestly it has helped me in soo many ways. Along with a very healthy diet, exercise, supplements, and what I think is the best progesterone cream there is (cause I tried many), I was able to conceive and have a healthy pregnancy. But it isnt just about me being able to have another child it was the journey of figuring out how to get myself back to health and i did because I can totally feel the difference and I just feel back in tune with myself.
The website that I found is called http://www.progesteronetherapy.com. The cream they sell on there is called Natpro if anyone is interested. They also share very helpful and useful information.
I really appreciate this post as I am struggling with the same issue. I’m glad to know that there are natural progesterone cream options and better yet foods like beet kvass that might help. I think I’ll be making some soon even though when I made it before I just couldn’t get used to the taste!
@Michelle, I dont like beets, but I made the beet kvass for health reasons. What I find that works best for me to get it down is to put some beet kvass in a glass and add some tomato juice or V8 type juice with it and it tastes fine that way.
@Michelle, Thanks, I will definitely try this! 🙂
My question is whether I need to get a blood test to start using the natural progesterone cream. I had 2 long cycles.. 38 and 40 days (never been that long in my life) and two faint positive pregnancy tests. I am really confident that low progesterone or high estrogen is what my issue is. I have been told by my chiropractor that fiber can strip away your excess hormones to help regulate them, but I also read about all the gluten free stuff and it confuses me. I am trying to incorporate Quinoa into my diet because I have heard that is a gentle grain. I know that raw veggies would give me great fiber as well so we are trying to eat a lot more salads and spring rolls and raw veggie snacks. Thanks!
@Katy, I don’t think that you NEED to get a blood test done in order to start using the natural progesterone cream, but it helps to figure out how low your levels actually are. I had a feeling that my levels were pretty low for quite a while, but never knew how low they were until I tested. Boy, were they LOW!! 🙂 But after discovering that and taking 6 serious months of work, my levels increased to low-normal. The test didn’t tell me anything I didn’t already know (through charting), other than quite how low I had gone, and that helped me in figuring out how much progesterone cream/what supplements/etc. to use.
I used the blood-spot test from ZRT Laboratories, http://www.zrtlab.com/. Some say that the saliva test is more accurate, but I think that that is more for thyroid testing than hormone testing. All that you have to do is find someone in your area that sells the tests (our local pharmacy sells them and the results are sent to my doctor) to purchase the test. You can test for just progesterone, I think, but I decided to go for the full female hormone panel, since I really didn’t want to prick my finger multiple times and pay for multiple tests. 🙂 The test can be expensive, but it’s definitely cheaper than being tested at a doctor’s office. You can generally find a naturopath or maybe even a chiropractor that you can get the tests sent to, so that saves on physicians’ fees. Hope that this helps a little! 🙂
Katy, I use flaxseeds for that very reason, to try to decrease my estrogen. They, not just being fiber, but being flax, are supposed to be good for that. Don’t take too many tho as they are goitrogenic in larger amounts. Keep at or under 3T a day, ground. If you use the oil (very pricey), get the high lignans oil as they are the key, I’ve read.
Also I went online and found a very, very cheap place for progesterone cream after paying the horrendous prices in the store. It was like $6 a jar (month’s supply). Yes, really! I can’t remember the name of the website now, but I could not afford to buy the other prog creams so I thot, nothing to lose, it’s this or nothing. It worked just fine. I think it’s becuz as long as you use a USP cream, it’s gotta have the prog, in the amount it says, in it.
This topic is one I’ve been immersed in for the past two years. Hypothyroidism, adrenal fatigue, and low testosterone and low progesterone resulted in persistent depression, no energy, and we don’t know how many miscarriages. My goal is to feel good, be free of depression, and to have children.
We’ve been on the Real Food journey for several years, and eating much more healthfully has definitely helped. But I was not improving enough. Thank God we have a wonderful physician’s assistant not too far from us whose life work is women’s hormones. Her website is http://www.returnofpassion.com, if you want some good info about BHRT, as well as some quizzes and charts for tracking symptoms.
For two months, my treatment consisted of tracking symptoms, (trying to) eat 6 small meals a day; exercising 30 minutes 5 days a week; taking multivitamins, calcium, magnesium, vit. D, and evening primrose oil; eating low carbs; and NO SUGAR. It took about a month, but things definitely improved. We tested my progesterone level and it was between .8 and 10% of the normal level! Also, based on symptoms, we could tell my testosterone was also waaaaay too low.
For the next three months, my job is to continue the above protocol, adding first 30 mg per day, then 60 mg per day of progesterone cream. We’re seeing more improvement, even after less than a week on 60 mg.
I’m so excited to see the changes–being much happier, being able to take care of my house so easily, and Liking my husband much more. ; ) And if things keep improving, we can start trying for a baby in just a few months . . .
Best wishes to all of you trying to find answers!
Maria
I supplement with Red Raspberry leaf and B6 for LPD. I too have PCOS. The two have helped me have a longer Luteal phase.
I am new to luteal phase issues as I had my first child out of the shoot, no problems. We have been trying for 6 months with no luck and I have picked charting back up to see what’s going on. My last chart showed a 9 day LP, which I realize is not terribly low, but enough to make for issues. I saw an OB who was very unhelpful, disagreed with me, told me they are now rethinking progesterone issues on the whole and I just need to chill out/keep trying. Not knowing a ton about LP stuff or natural options I am hesitant to start self treating with vitex, b6, brewers yeast, creams, and the like; so my question is, is it ok to just try some of the herbal options even if your Dr. has not confirmed a short LP or progesterone problem? Are there consequences to taking some of the supplements if you are not low on progesterone? Of course all of the (herbal) bottles themselves read, “do not take if you are pregnant, want to become pregnant, or are nursing” this has lead to more confusion. In short, if I suspect through charting and other symptoms that my LP is insufficient should I just go for it with the herbal treatments/creams or wait for a Dr. to confirm and recommend treatment?
@MK, most doctors will tell you that you need to “chill out” and everything will be fine. Well, if your problem is adrenal stress, that might be the case, but not with low progesterone! And with a 9 day LP, I would say that you definitely have some progesterone issues. Unfortunately, you’re going to have to do most of the legwork yourself since most doctors aren’t trained to think outside the box when it comes to hormonal problems.
All of the advice given on this post is good, sound, tried-and-true advice from those of us that are actually dealing with these issues on a daily basis. If you’re nervous about trying anything without a definitive answer, get a hormone-level test done from ZRT Labs. It will answer your questions about your levels and you can go from there. But you will definitely not get into any trouble using Vitex and the like on your own! The herbal supplements, particularly, are some that women have taken for years as cycle support and have no problems with them. Stick with the recommended dosage and you’ll be fine. The warning labels are on everything nowadays and are there for legal issues…if you get pregnant, you should stop taking Vitex, but that’s the only occasion that it’s an issue.
If you’d like to read up on this subject a little more, try finding “Fertility Cycles and Nutrition” by Marilyn M. Shannon. It’s an older book but quite insightful! I disagree with some of her nutritional conclusions, but I am more of a Nourishing Traditions gal myself. 🙂 But the advice that she gives on dealing with fertility problems are very helpful.
Good luck with this! It’s hard to realize that your doctor isn’t really the best person to turn to in this kind of situation, but there are so many resources (such as this blog!) available to us now that our chances of success are much higher.
@Rachel, Rachel, thank you so much for responding, your feedback is helpful. I checked out ZRT and found a pharmacy in my area, however I am able to have my progesterone levels tested at my Drs which would also be covered by my insurance. Is there a reason not to do that given it’s covered? Also, would taking vitex, B complex and brewers yeast be the better first thing to try or would an OTC progesterone cream be more effective. (I realize you’re not a natropath, but you’re certainly more knowledgeable than I so I’d love to hear more of your thoughts ). Also, I can see a midwife, have you had any more success with them listening to you? Thanks!
@Mk, MK, I would definitely use the doctor’s testing if it’s covered by your insurance! My husband is self-employed so our insurance doesn’t cover much. 😉 The test will show the same results no matter where you get it done…it’s just that getting it from ZRT Labs is easier (and cheaper!) for those of us who have pay for everything out of pocket anyway. 🙂
In my opinion, the first step would be to get tested and then proceed from there. If you are indeed suffering from low progesterone, your doctor might prescribe a supplement such as Prometrium, a natural-based progesterone (but not completely natural :P). I am on this right now, but it’s only to get my levels up a little higher than they are currently–I wouldn’t want to take it long-term. If your levels aren’t too low, you might want to try just going with a natural progesterone cream/lotion (my favorite is from Gentle Pharmacy, http://gentlepharmacy.com/).
If you have painful/difficult/unpredictable cycles, I would definitely say to get on Vitex right away, along with some Evening Primrose Oil and B complex–these will improve your over-all cycle and are something that you can take every day. The progesterone lotion/supplements should only be taken after your temperature shift until the drop before you start your next cycle. Also, you should consider the diet/exercise aspect that is spoken of in the article above…it was only after I instituted all three (diet, exercise and supplements) that I really saw change in my levels.
You might also want to think about getting your thyroid and adrenal levels tested while you’re there, since both of those can affect your fertility cycles as well. And if you have access to a good midwife, I would highly recommend using one! They are generally more open-minded, though infertility isn’t their main area of expertise.
God bless!
@MK, I definitely agree with Rachel. 🙂 She gave you some great advice on the progesterone issue!
Nine days is a rather short LP – most say less than 12 is to short to sustain a pregnancy.
If you’re worried about self treating with the creams, you can hold off on those and try other things for a few months first. Supplementing with vitamin B is actually rather safe – just use a good quality supplement! Vit., B is water soluble, so what your body doesn’t use, it flushes out. You can also just make sure you’re eating lots of foods high in vitamin B instead of supplement with pills. Instead of vitex, you might also try maca – an ‘herb’ that’s also a root vegetable. Since it’s more ‘food like’ some like to take it over vitex, and it also helps to balance out the hormones.
I’ve read that a low dose of vitex (175 mg/day) can actually raise prolactin levels. Higher doses are standard in most supplements though. 400mg or more should lower prolactin levels.
I have been trying for years now to conceive after a miscarriage. My first two daughters were back to back, then the miscarriage – 3 pregnancies in 3 years. Then for the last 3 years, nothing. I have a 28/29 day cycle with only 10 days for my luteal phase. I ovulate on cd18 like clockwork. I am taking Dr. Lee’s Progesterall cream during my short luteal phase, but I can’t figure out how to move my ovulation date up by 4 days. I am going to try the lunaception method. But, as I read above, usually the reason for low progesterone in the lp, is low estrogen in the foll. phase. If that’s true, which I believe it is, how can I also work on raise estrogen levels during my follicular phase, as well as raise my progesterone during my luteal phase? I’d like to have both bases covered, to try and kick my body into normalcy. Do I eat a bunch of conventional meat and dairy and use a lot of plastic during the first half of my cycle (lol Kidding) – what do i do to up my estrogen levels during the first half, while not being estrogen-dominant? I don’t want to keep pushing progesterone high, only to be pushing the estrogen even lower during the foll. phase – which is the root problem?
I hope that makes sense – and please – help! 🙂
Thanks!
Angela
@Angela, Totally makes sense. 🙂 One thing you might want to try is a fertility tea with red clover in it. it’s phyto-estrogenic, which shouldn’t necessarily cause estrogen dominance, but may help in the follicular phase.
I would also try out lunaception as some women have found it to help move their day of ovulation. 🙂
Hi I have recently been told by my doctor that I have bouts of low progesterone. Some months it’s okay some not. But I have had two miscarriages because of this. I am currently trying to conceive and I am trying to figure how to boost my progesterone naturally right after ovulation so that if I do get pregnant I will not miscarry again. I am wondering if it is okay to use the progesterone cream right after ovulation to help boost my levels just in case i do get prego to help substain the pregnancy..
@Tiffiney, If I was in that situation, I would use the cream. It’s important to wait until after ovulation though and if you are pregnant, I would have your OB or midwife run a lab for progesterone to make sure the cream is enough. I would also have this done multiple times during the first trimester. This way you know if you need to switch to a bioidentical progesterone suppository which gets more into your system.
I’m not big on recommending hormones to women, but in some cases the benefit greatly outweighs the risk. And if it’s for the short term and not months and years, it shouldn’t have to much of a negative effect on the body. Especially when done in conjunction with a diet and lifestyle that also help to boost progesterone.
I miscarried in May 2011 and we have been trying to conceive off and on since then without success. We’ve had tests done and seem to be pretty healthy – there wasn’t any major concern with my hormones; things seemed normal (no serial progesterone test – just CD21). But my luteal phase has been shorter since I miscarried.
Before the miscarriage, I was 13-14 days consistently. Since then, I have had a few 13 day LPs, but generally it’s been 10-12 days (the past few months have been 10-11 days). I’m ovulating around day 18 (this is later than it was before the miscarriage).
I’m going to start taking a B Complex. But I’m wondering what else I should do to get things back to a more healthy place. This post is filled with great ideas, but I’m not sure which approach is best for my situation. I’m feeling impatient, so as I read through this I start to think, “Let’s try ALL THE THINGS IMMEDIATELY!” which may not actually be the best approach. 🙂 I’ve wondered about starting vitex in addition to the B Complex. Do I take vitex throughout the whole cycle or just after ovulation? I don’t want to delay ovulation any more … I’d like to get it a few days earlier. Should I try a progesterone cream or is that too much at this point? Are there other things I should be trying to re-balance my cycle?
@Rebekah, I’m a big fan of working through diet first and then adding herbs as needed. So a very low sugar diet with no processed foods and lots of good fats will be really helpful.
Herbs are one of those things where it isn’t just symptom specific, but person specific. So they can be helpful to one, but detrimental to another. If you start to use vitex and see it going the other direction, stop taking it. A lot of women start out using it just after ovulation to see how their body is reacting to it.
It might also be very helpful to get a full thyroid panel run as subclinical thyroid issues can be the cause of many different hormone imbalance issues.
Lunaception is also another thing that may be helpful for you and there are no side effects! http://www.naturallyknockedup.com/basics-of-charting-and-lunaception/
You could also think about doing a gentle cleanse to help boost your liver production. Since the liver is the organ that breaks down old hormones, if it’s ‘backed up’ it may have a hard time getting rid of old estrogen. http://www.naturallyknockedup.com/table-of-contents (look for the natural fertility 101 tab)