Progesterone: Should You Take Progesterone if You Are Trying to Conceive?

Summary

Dr. Natalie Crawford, a board-certified OB/GYN and REI, discusses the misuse of progesterone by those trying to conceive. She clarifies that progesterone levels naturally fluctuate and should not be constant, cautioning against daily supplementation without understanding one's cycle phase. Dr. Crawford emphasizes the importance of timing progesterone supplementation correctly, ideally post-ovulation, to avoid disrupting the implantation window and potentially hindering pregnancy. She also advises against daily hormone intake, which can alter the uterine lining and affect embryo implantation.

Takeaways

• 😀 Progesterone is not supposed to be present every day in the body's natural cycle.
• 🔬 During the menstrual cycle, the first half is estrogen dominant with low progesterone, and the second half sees the rise of progesterone post-ovulation.
• 🤰 In a normal pregnancy, progesterone levels should rise due to the hormone HCG, which stimulates the corpus luteum to produce progesterone.
• ⚠️ Misinterpretation of blood panels for progesterone levels can lead to incorrect supplementation, potentially harming fertility efforts.
• 🚫 Taking progesterone daily or starting too early in the cycle can close the implantation window, preventing embryo implantation.
• 💊 The script advises against the daily use of progesterone if prescribed without proper timing to the menstrual cycle.
• 📊 Normal progesterone levels can vary widely (3 to 40 nanograms) in the luteal phase and do not indicate the adequacy of the phase.
• 👩‍⚕️ For those with a history of miscarriage or concerns about progesterone levels, supplementation should ideally start 3 days post-ovulation and use vaginal suppositories over oral pills.
• 🌱 The script warns against the use of certain supplements and compounds with estrogen-like effects that can disrupt hormonal balance.
• 🚫 High levels of biotin can interfere with hormone assays, potentially skewing blood test results and affecting diagnosis.
• ❗️ When considering hormone supplementation, it's crucial to ensure the prescriber is a hormone expert and to consult a fertility doctor if in doubt.

Q & A

What is the main topic of the video by Dr. Natalie Crawford?

The main topic of the video is the role and proper use of progesterone in relation to fertility and pregnancy.

Why is it important to understand the hormonal cycle when trying to conceive?

Understanding the hormonal cycle is crucial because it helps to know when to supplement with hormones like progesterone and when not to, which can affect the chances of conception and the health of a potential pregnancy.

What does Dr. Crawford suggest is a common misconception about progesterone levels?

A common misconception is that having low progesterone levels always indicates a problem and requires supplementation, which is not necessarily true as low progesterone can be normal in certain phases of the menstrual cycle.

What hormone is primarily responsible for the growth of the egg follicle?

Follicle Stimulating Hormone (FSH) is primarily responsible for the growth of the egg follicle.

How does estrogen play a role in the menstrual cycle?

Estrogen is important for the growth of the uterine lining and preparing it for pregnancy. It also has positive effects on mood and energy levels during the follicular phase.

What is the significance of the LH surge in the menstrual cycle?

The LH surge triggers ovulation, allowing the mature egg to be released from the follicle, and stimulates the formation of the Corpus luteum, which then produces progesterone.

Why is it not recommended to take progesterone every day if you're trying to get pregnant?

Taking progesterone every day can disrupt the natural hormonal balance and the implantation window, potentially preventing the embryo from implanting properly.

What is the role of HCG in early pregnancy?

Human Chorionic Gonadotropin (HCG) is produced by the embryo after it implants in the uterine wall. It binds to the same receptors as LH, stimulating the Corpus luteum to produce progesterone, which is essential for maintaining pregnancy.

According to Dr. Crawford, when should progesterone supplementation ideally start if it's deemed necessary?

Progesterone supplementation should ideally start 3 days after ovulation if it's deemed necessary, to avoid closing the implantation window too early.

What is the preferred method of progesterone supplementation according to the studies mentioned by Dr. Crawford?

The preferred method of progesterone supplementation is through vaginal suppositories, not oral pills.

Why should one be cautious about taking certain supplements or chemicals with estrogen-like properties?

Taking certain supplements or chemicals with estrogen-like properties can alter the hormonal balance and potentially interfere with the body's natural signaling and hormone production, which is critical for fertility.

What warning does Dr. Crawford give about the use of biotin in relation to fertility testing?

Dr. Crawford warns that high levels of biotin can interfere with steroid hormone assays, leading to inaccurate blood test results that may not reflect the true hormonal state.

Outlines

00:00

🤰 Progesterone and Pregnancy: Misconceptions and Advice

Dr. Natalie Crawford, a board-certified OB/GYN and REI, addresses the common misconceptions about progesterone supplementation during the process of trying to conceive. She explains that the body is not designed to have progesterone every day and warns against the misuse of progesterone, which can be detrimental to those trying to get pregnant. Dr. Crawford emphasizes the importance of understanding the normal hormonal cycle, where the first half is estrogen-dominant and the second half involves both estrogen and progesterone. She discusses the role of FSH, estrogen, LH, and the corpus luteum in the menstrual cycle and ovulation process, and clarifies that progesterone levels vary and are not an indicator of the luteal phase's adequacy. The video aims to educate viewers on the complexities of hormones and fertility, urging them to be cautious of oversimplified advice and to consult with fertility experts for accurate information.

05:01

📊 Understanding Progesterone Levels in Pregnancy and Miscarriages

This paragraph delves into the specifics of progesterone's role during pregnancy and the potential issues with its supplementation. Dr. Crawford clarifies that HCG, the hormone associated with pregnancy tests, mimics LH and stimulates the corpus luteum to produce progesterone, which is essential for maintaining pregnancy. She explains the exponential rise of HCG and its correlation with increasing progesterone levels. The doctor also addresses the misuse of pregnancy progesterone data during the luteal phase, cautioning against the application of pregnancy progesterone levels to non-pregnant individuals. Furthermore, she discusses the confusion surrounding progesterone levels in cases of miscarriages and ectopic pregnancies, where low levels may be observed due to insufficient HCG production. Dr. Crawford advocates for proper progesterone supplementation, if necessary, starting three days post-ovulation and using vaginal suppositories rather than oral pills, to support those with a history of pregnancy loss or potential luteal phase deficiency.

10:02

🚫 The Dangers of Improper Hormone Supplementation

In the final paragraph, Dr. Crawford warns against the daily use of hormones like progesterone, estrogen, and testosterone, which can disrupt the body's natural hormonal balance and potentially harm fertility. She explains that the hormonal flux is dynamic and should not be constant, as it is in a normal menstrual cycle. The first half of the cycle is estrogen-dominant, while the second half sees the presence of both estrogen and progesterone. The doctor also cautions against the use of substances with estrogen-like properties, such as certain supplements, which can interfere with the hormonal signaling system. She advises viewers to be wary of any recommendations for daily hormone supplementation without proper cycle timing and to consult with a fertility doctor for accurate and safe guidance. Dr. Crawford concludes by inviting viewers to ask questions for further clarification and to seek reliable information from fertility experts.

Keywords

💡Progesterone

Progesterone is a hormone that plays a crucial role in the menstrual cycle and pregnancy. It is produced in the ovaries and helps to thicken the uterine lining in preparation for a fertilized egg to implant. In the video, Dr. Natalie Crawford discusses the misconceptions about progesterone supplementation among those trying to conceive, emphasizing that progesterone levels naturally fluctuate throughout the menstrual cycle and should not be constant.

💡Estrogen Dominance

Estrogen dominance refers to a condition where estrogen levels are relatively higher than progesterone levels, potentially leading to various health issues. In the script, Dr. Crawford warns against the misinterpretation of blood panels that may indicate estrogen dominance without proper context, as this can lead to unnecessary progesterone supplementation.

💡Follicle Stimulating Hormone (FSH)

FSH is a hormone produced by the brain that stimulates the growth of ovarian follicles during the menstrual cycle. In the video, Dr. Crawford explains that FSH is the predominant hormone from the brain during the follicular phase, working in conjunction with estrogen to prepare the uterine lining for potential pregnancy.

💡Estrogen

Estrogen is a hormone that is primarily responsible for the development of female reproductive tissues and secondary sexual characteristics. In the context of the video, estrogen is mentioned as the predominant hormone from the ovary during the follicular phase, working to prepare the uterine lining for pregnancy.

💡Ovulation

Ovulation is the process where a mature egg is released from the ovary, ready to be fertilized. Dr. Crawford discusses the importance of understanding ovulation in relation to progesterone levels, as progesterone supplementation should ideally begin after ovulation to support a potential pregnancy.

💡Luteinizing Hormone (LH)

LH is a hormone that triggers ovulation and stimulates the formation of the corpus luteum, which in turn produces progesterone. In the video, LH is described as a critical hormone that allows the follicle to rupture and release the egg, and later stimulates progesterone production in the luteal phase.

💡Corpus Luteum

The corpus luteum is a temporary endocrine structure in the ovary that forms after ovulation and secretes progesterone. In the script, Dr. Crawford explains that the corpus luteum is responsible for progesterone production during the luteal phase of the menstrual cycle.

💡Luteal Phase

The luteal phase is the second half of the menstrual cycle, following ovulation, during which the corpus luteum produces progesterone. In the video, Dr. Crawford clarifies that progesterone levels naturally rise and fall during this phase and should not be used as a sole indicator of a healthy cycle.

💡Implantation Window

The implantation window refers to the period when the uterus is receptive to the implantation of a fertilized egg. Dr. Crawford explains that progesterone plays a critical role in opening and closing this window, and that starting progesterone supplementation too early can close the window prematurely, preventing implantation.

💡Pregnancy

Pregnancy is the state of carrying an embryo or fetus within the female uterus. In the context of the video, Dr. Crawford discusses how progesterone levels should be monitored during pregnancy and that supplementation should be timed correctly to support a healthy pregnancy.

💡Hormone Imbalance

Hormone imbalance refers to a state where the levels of one or more hormones are not in harmony with the body's needs. The video emphasizes the importance of understanding the natural hormonal fluctuations of the menstrual cycle and warns against the potential harm of daily hormone supplementation, which can disrupt the body's delicate hormonal balance.

Highlights

Dr. Natalie Crawford discusses the misuse of progesterone by those trying to conceive, which can actually be harmful.

The body is not designed to have progesterone every day, contrary to common misconceptions.

Some individuals are misdiagnosed with estrogen dominance or low progesterone due to improper blood panel interpretations.

A normal menstrual cycle involves a shift from estrogen dominance in the first half to both estrogen and progesterone in the second half.

Progesterone levels during the luteal phase can vary significantly and are not indicative of the phase's adequacy.

Pregnancy progesterone levels are different from those in the luteal phase, with HCG playing a key role in maintaining progesterone levels.

Misapplication of pregnancy progesterone data to the luteal phase can lead to unnecessary supplementation.

Progesterone supplementation should ideally start after ovulation, not before, to avoid prematurely closing the implantation window.

Vaginal suppositories are preferred over oral pills for progesterone supplementation when necessary.

The timing of progesterone supplementation is crucial and should be based on reliable ovulation tracking.

Taking progesterone too early in the cycle can interfere with the implantation process and embryo development.

Dr. Crawford emphasizes the importance of understanding the hormonal balance in a normal cycle and the risks of daily hormone supplementation.

The use of certain chemicals and compounds with estrogen-like properties can disrupt hormonal balance and fertility.

High levels of biotin can interfere with hormone assays, leading to inaccurate blood test results.

Dr. Crawford advises caution with hormone supplementation and to consult a fertility doctor for proper guidance.

The video aims to educate viewers on progesterone's role in fertility and the pitfalls of improper supplementation.

Transcripts

should you take progesterone if you're

trying to get

pregnant hi friends I'm Dr Natalie

Crawford and I'm a board certified OB

Joan and REI I'm a fertility doctor and

I talk about fertility and hormones

every single day and today I want to

talk to you about progesterone this is

not my first time talking about

progesterone however I am seeing more

and more people come see me and they're

taking Progesterone

and these are educated people who are

trying to do everything they can to get

pregnant yet they're actually doing

something that's hurting them and that's

what I want to break down with you about

progesterone if you are new to the

channel welcome this channel exists so

that we can spread information about

your bodies your health your

reproductive system so you can learn

more about your own body and hormones so

please subscribe and share and spread

this information with more people so if

we're going to talk about progesterone

what we are going to talk about is who

needs supplementation and when

I have talked more about progesterone

this week probably than ever and

clinically when I'm seeing patients and

we're talking so much about it it's just

making me wonder what is going on out

there so number one let's remember the

body is not supposed to have

progesterone every single day and so if

you are going and getting diagnosed with

estrogen dominance or being told your

progesterone is

low caution with what comes after it

doesn't mean that may not be true but

what I am finding is that some people

are having big blood panels drawn by

people who don't know how to interpret

them or where they are in their cycle

and then they're getting prescribed

something so here's what I mean by that

let's talk about the normal cycle inside

your ovary are all your eggs every month

you have a group of eggs come out of the

Vault inside your ovary and from this

group one egg is going to be selected to

ovulate eggs are microscopic so each egg

actually grows inside a follicle the

brain sends out follicle stimulating

hormone or FSH FSH is well named and

it's going to get get a follicle to grow

as that follicle starts growing it makes

estrogen now estrogen is so important it

gets the lining to start growing

preparing for a pregnancy it feeds back

to the brain so the brain drops the

amount of FSH it needs to send because

we only need one egg and estrogen works

on the brain to make you feel good and

happy and energetic and this is why in

that follicular phase the first part of

a cycle when an egg is growing or a

follicle is growing FSH is the

predominant hormone from the brain

estrogen is the predominant hormone from

the ovary and you really you don't have

any progesterone in this phase and

that's very very normal so the entire

folicular phase is estrogen dominant

progesterone

low after you ovulate when that egg

makes enough estrogen so it's about 200

pams for about 50 hours that's going to

signal to the brain that you have a

mature egg and the brain is then going

to send out a surge of a different

hormone called LH or lutenizing hormone

LH is a very important hormone and what

it does is it allows that follicle to

rupture and it allows the egg to come

out so job one that's ovulation if you

have pain with this because you can feel

that sometimes that's called middle

schms which means pain in the middle

it's a German word for ovulatory pain

now that follicle forms back together

and it becomes the Corpus ludum and so

lutenizing hormone stimulates the corpus

ludum and the Corpus ludum is making

progesterone this is what makes

progesterone in the ludal phase ludal

phase is the time from after you ovulate

until when you get that Next Period and

then we say if you get pregnant you

really don't end the ludal phase of

keeps going but in that ludal phase what

is happening is this Corpus ludum is

making progesterone and progesterone is

being stimulated in Pulses from the LH

Pulses from the brain so you have LH p

pulsing stimulating that Corpus ludum to

have pulses of progesterone so

progesterone can be anywhere from 3 to

40 nanograms at any moment in the ludal

phase depending when you're drawing

blood in relation to an LH surge from

the brain and you don't know that so

normal no progesterone you ovulate and

now you have ups and downs of

progesterone ranging in this 3 to 40

range or the ludal phase so if you come

in and you get a blood draw for

progesterone if it's over three all it

can tell me is that you ovulated the end

there's no progesterone level that's

telling us the ludal phase is adequate

in the ludal phase now when you're

pregnant progesterone should be a

certain level so when you're doing

pregnancy checking of progesterones or

fertility treatment and we're trying to

get there that's a different situation

because in pregnancy as soon as you get

pregnant that embryo is in the uterus

about one week after ovulation and it

starts to grow into the uterine wall and

it makes HCG and HCG is the hormone that

we all know because you pee on the stick

and it turns positive but HCG is now

what binds to the same receptors as LH

so HCG binds to the same receptors and

so now it is constantly stimulating that

Corpus ludum to make progesterone and

because a good normal pregnancy makes

HCG approximately doubling every two

days you know have an exponential rise

in HC G therefore you have a constant

yet increasing stimulus of progesterone

production from that corium so you went

from this pulsatile production very

normal and now you get pregnant and now

you have a constant stimulus and your

progesterone is going to rise and that

is pregnancy different than what we see

before we're pregnant yet in the ludal

phase yet people are applying this

pregnancy data saying oh we need a level

of 15 or 20 or higher to represent a

good pregnancy

into the ludal phase and then they're

putting people on progesterone yet

they're not giving them instructions on

how to use it so we're going to go over

that because what's happening is the

pregnancy data is to try to help us

diagnose a uterine pregnancy from an

ectopic pregnancy or an inevitable

miscarriage because one of the ways that

a pregnancy that's not dividing normally

talks to the body is it's not making HCG

at that constant interval

and because the Corpus ludum can only

live from brain stimulation for about 14

days the brain's going to stop sending

out those LH pulses and if you don't

have high enough HCG you're not going to

make as much progesterone therefore that

low progesterone is often seen in

inevitable miscarriage or ectopic

pregnancy Cycles so this leads to

confusion because people who are having

recurrent miscarriages might get these

pregnancy progesterones drawn and

they're always low and we feel like

progest tone is the problem and I'm not

saying it's not but I'm not saying it is

and I'm not saying I haven't told you

how to fix it yet because what's

happening is people are fixing it wrong

so number one progesterone we wish

overcame all of these miscarriages I

went through a bunch of losses and I

wish progesterone could come in and save

them all if you're going to give

progesterone it might help I do think

there's a certain amount of people who

are having ludal phase deficiency or low

progesterone it's contributing to their

carriage or their loss rate and it's

probably an ovulatory issue if you're

not ovulating a good enough Corpus ludum

it can't make the progesterone it needs

to make so personally I like ovulation

induction chomal ovulate better it'll

make more progesterone but I also often

give progesterone and I don't think it's

wrong to give progesterone but if you're

going to give it what the study support

is that it needs to start after

ovulation because you're not having

progesterone before progesterone opens

and closes that implant anation window

so if you start progesterone before you

ovulate you have now closed your

implantation window and when you have an

embryo ready to implant those are not

synchronous meaning the uterus is so

interesting it gets all this estrogen to

prime it once it starts being exposed to

Progesterone it's going to have this

perfect level of receptivity and once

you're past that an embryo can't implant

and this is the entire premise with many

forms of birth control espec

progesterone only birth control because

daily progesterone is giving this

constant progesterone exposure to the

uterus and making it so that you can't

implant progesterone birth control does

not typically prevent ovulation so

things like a progesterone IUD or a

daily mini pill those often are not

really preventing ovulation they're

really working their mechanism of action

much more at the uterus so if you go

somewhere and get diagnosed with low

progesterone and somebody gives you a

prescription for progesterone and says

your estrogen dominant or your

progesterone low and you should take

this every day you should not if you're

trying to get pregnant or they tell you

you should take it um just flat out days

14 to 28 of your cycle probably wrong

because you need to start it after

ovulation and what the studies are

looking at as the best time is that if

you have a current pregnancy loss or

we're worried that progesterone could be

an issue for you if you're going to

replace it number one we should use

vaginal suppositories not oral pills

number two we should start it 3 days

after ovulation which means you need to

be able to reliably and predictably

track your ovulation and I have some

videos on that for you but if your

periods are irregular and you can't

track your ovulation you should not be

just randomly taking it during those

cycle days is it going to harm you if

you're already pregnant to take

progesterone no is it going to harm you

if you started too early yes and that's

why we say three days after ovulation is

a safe window so what I want you to know

is that you should not have have all

these hormones every single day the

body's hormonal balance is a constant

Dynamic flux that in a normal cycle you

know your hormones are balanced because

you have regular cyclic periods and if

you don't you might have a problem but

even in a normal cycle you're not

supposed to have these set levels of

estrogen progesterone every single day

first half the cycle is estrogen

dominant the second half you have both

estrogen and progesterone you shouldn't

have progesterone every day so if

somebody's telling you to take

progesterone if they're telling you to

take estrogen if they're telling you to

take testosterone please know it's going

to blunt the brain's response for other

hormones and it does change the uterus

it can thin out the lining it can also

cause issues with the developing betas

so no thank you if you're trying to get

pregnant also be wary of chemicals and

compounds that have estrogen like

properties because that can change the

brain's ability to Signal or interpret

signals because this is a really

important system so things like Maca

Vitex Chase Berry I don't love those in

the average regular person but a lot of

people will be on these warning sign for

biotin if you're having periods that are

irregular or you're going to the

fertility doctor because bioten can

actually bind to our steroid hormone

assays and in high levels it can

actually make our blood test not make

sense with what's really going on so

just want you to be aware of the world

around you and if somebody's trying to

put you on a daily hormone or they're

just giving you these random dates and

they're not timing it to your cycle big

red flags please think are they really a

hormone expert who are they what are

their credentials and if there's any any

doubt please see a fertility doctor I

hope this helped you understand

progesterone a little bit I have some

extra videos about it will'll link down

below and would love if you would ask

questions that's how we get topic ideas

for more of these videos as always you

can find out more information on the as

awom podcast and thank you

friends

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