Updated: Mar 11
We sometimes underestimate the influence of little things... (Charles W. Chesnutt)
When I think about female fertility, I see a big chain reaction machine consisting of many tiny devices linked together, whose final goal is that of making a baby.
Kind of like a Rube Goldberg machine, the making of a baby is nothing but a series of events, all equally important, like an intricate puzzle that is not complete until the last piece has found its unique place.
When, for various reasons, the machine doesn’t work, and the baby doesn’t come, we usually tend to focus on the big and obvious things, forgetting that even the tiniest of the components may throw our machine off.
One component that can literally make or break the female fertility machine is Progesterone.
We hate it, because it mimics pregnancy symptoms and gives us false hopes.
We hate it because it is the main culprit of our PMS syndrome.
Yet we know we can’t do without it.
World, meet Progesterone!
One of the most important hormones in our bodies, Progesterone is a sex hormone that plays a major role in regulating the female reproduction.
We call it the “hormone of pregnancy” because its levels increase post ovulation, in order to prepare the endometrium for implantation in case fertilization occurs.
The levels peak around 7 days post ovulation and stay elevated throughout the luteal phase (i.e the second half of the menstrual cycle).
If pregnancy does not occur, they typically drop by 13-14 dpo so that our period may start.
If you are pregnant, progesterone stays up throughout pregnancy.
Sometimes, even if you do menstruate quite regularly, you may not ovulate. We call this an anovulatory cycle with dysfunctional uterine bleeding.
Other times you may ovulate, a Corpus Luteum is formed, but it fails to produce enough progesterone, and your levels do not rise properly. Your egg may even get fertilized, but without an adequately developed uterine lining, the embryo has a hard time implanting. The luteal phase shortens and your period arrives earlier than expected.
Sometimes, this happens before you even get the chance of knowing you were pregnant. It used to be a common occurrence back in the days when home pregnancy tests didn’t exist yet.
Sometimes it happens right after a positive sensitive pregnancy test. We call them chemicals, or missed miscarriages. We usually blame them on egg quality and chromosomal abnormalities.
But sometimes, the cause is simple, and very easy to address: low progesterone.
A Progesterone level of 5ng/ml confirms ovulation, but it is not enough to sustain a pregnancy, in which case supplementation is necessary. To support proper implantation, most doctors want progesterone levels over 10 ng/ml in natural cycles, whereas for a medicated cycle they expect values over 15ng/ml.
What is the Luteal Phase Deficiency and how can we detect it?
The period of time comprised between Ovulation and the first day of your next period is called the Luteal Phase. A healthy fertile woman would have a luteal phase of at least 11-12 days, ideally 14, for a cycle averaging 28-30 days.
If your Luteal Phase lasts less than 10 days, you may safely assume you are having a Luteal Phase Deficiency (LPD), caused by low progesterone levels.
What are the symptoms of LPD?
· period arrives earlier than expected
· brown spotting a few days before period arrives
· spotting or light bleeding in between periods
· no pregnancy, although all tests are normal and ovulation does occur
· recurrent early miscarriages without a known cause
The good news is low progesterone can be detected by having it measured in blood 7 days post ovulation, in a laboratory.
The better news is an American scientist, having suffered herself recurrent miscarriages that she later found out were due to low progesterone, decided to help women avoid what she herself had been through, and invented PROOV: the first test that allows you to track your progesterone levels in the comfort of your own home in just 5 minutes.
World, meet PROOV!
Aware that the #1 cause for infertility is low progesterone, but realizing blood testing in a lab on a monthly basis is very difficult for many of us, be it for geographical or financial reasons or simply because our schedules don’t always allow it, Amy Beckley thought about how a urine progesterone test would have changed her life, and would have made her dream of becoming a mother come true sooner than later.
If women use ovulation tests to track their LH surges and pregnancy home pregnancy tests to check their Beta HCG levels, why shouldn’t they be able to track their progesterone levels post ovulation? After all, Progesterone is at least equally important if not more important for a woman trying to conceive.
So, after 3 years of infertility and seven miscarriages, Amy took her PhD in Pharmacology and her passion for helping people, and developed PROOV, to empower women to measure their progesterone levels easily, at home.
PROOV employs urine strips and is used exactly like the ovulation and pregnancy home tests: you collect your urine, dip the test, wait 5 minutes and read the result.
Ideally, you should test once before ovulation, so that you can have a baseline and be able to make a comparison later on.
And then, you recheck 7 days post ovulation, to make sure you did ovulate.
And if you did, is your progesterone level high enough to support a pregnancy?
In order to make absolutely sure your levels are and stay good, it is best to retest 8, 9 and 10 days post ovulation.
With the LH test, we only need to see a surge. With progesterone, we need to see sustaining high levels, to make sure the lining is ready for implantation and levels do not drop too soon.
That’s what Dr Beckley considers to be the most important improvement in progesterone testing methods: the use of urine allows multiple days of testing, versus a single blood test drawn on 7 days post ovulation.
Unlike the ovulation and pregnancy tests, PROOV displays two lines in case of a negative test. If you only have one pink line, PROOV is positive. It means you have ovulated and your levels are elevated to at least the approximate 10ng/ml blood equivalent.
The test comes with 7 strips. Being a low-progesterone veteran myself, Amy sent me the PROOV kit and asked me to try it and give her my thoughts.
I am very much in tune with my body and I do use ovulation tests so basically I wouldn’t have needed to test with PROOV for a baseline.
If you are like me, and you can tell your follicular phase from you luteal phase, you don’t need to test pre-ovulation, your test will come negative anyway.
I did test pre-ovulation though, because I was curious to see how it worked, and I got back the expected negative result. I kept on tracking my LH and retested with PROOV 7 days post Ovulation, i.e 8 days post positive ovulation test.
I got a positive. Retested 9 dpo, still positive. This month I’m good, apparently. Most months I’m not.
And I am thinking of all the months I wasn’t good and of my early miscarriages due to low progesterone.
And I am thinking of the many women out there who aren’t good either and who are required to have three early losses before having their progesterone tested and I can’t contain my excitement about PROOV and my admiration and gratitude for Amy, not only for having imagined such a life changing product but for having the courage and perseverance to turn it into reality.
Endorsed by doctors, FDA registered, PROOV is your ally in all things progesterone and provides as accurate a result as any blood test performed in a laboratory.
Bonus points: it is non-invasive and you get the results in 5 minutes!
This is a game changer in terms of progesterone monitoring, not only because getting poked with needles isn’t so fun, but because PROOV enables multiple days of testing.
And because progesterone needs to go up and stay up to support proper implantation, PROOV arguably provides better information than a single point in time blood test.
PROOV vs BBT (Basal Body Temperature Charting)
Some of us, wanting to track ovulation but not being able to have our blood tested every cycle, would use the BBT method.
I have to confess I tried it two months in a row and gave up altogether.
First of all, I passionately hate charts.
Second, I don’t wake up daily at the same hour. I like to sleep late on a Sunday morning and when temping, I had to set my alarm at 7.00 am, like I would, during the week. Horror!
Third, and you may consider it stupid…I would sometimes forget to temp! Like, the alarm goes off, you stop it, you sleep an extra 10 minutes and then you’re late…Who has time to temp when you barely have the time to have your coffee on your way out?
But just in case you are a temping fan, know that while BBT tracking can be used to measure the slight increase in body temperature caused when progesterone rises and can therefore be used to confirm ovulation, it falls short of telling you if you have sufficient progesterone to conceive.
Your basal body temperature typically rises by 0.5 to 1 degree Fahrenheit after ovulation, due to the presence of progesterone.
But the temperature spike does not correlate with the amount of progesterone present.
So, getting a spike of 0.5 degrees does not necessarily mean you have low progesterone and getting a spike of 1 degree also does not mean your progesterone is high enough to sustain a pregnancy.
PROOV measures the metabolite of progesterone in urine. If blood levels are subject to fluctuations, as progesterone is released in blood in waves (which may explain why your blood tests may have different results from one day to another) measuring urine metabolites gives us a more even measure of what levels were averaging the day before.
If you would like to see for yourself, you can buy PROOV here with a 5 USD discount graciously offered by the creators of PROOV for the readers of Getthegoldenegg.
Ensuring progesterone levels are where they need to be is important, especially when we are trying to have a baby.
But it is equally important to know that low progesterone can also be caused by health conditions. And in this case, further assessment is necessary, because you would want to address the cause and not only treat the effect.
What can cause low progesterone?
· Polycystic ovaries (PCOS)
· Thyroid disorders
I guess the conclusion of this article would be that low Progesterone is a venue worth exploring if you have trouble conceiving or if you encounter any of the symptoms mentioned above.
And even if you don’t have any of the aforementioned symptoms, adding PROOV to ovulation predictor kits helps give a view of both parts of the cycle – information that can be helpful as a couple starts out on their trying to conceive journey.
PROOV is that $40 “insurance policy” that can help couples know where they stand on progesterone from the start – even if there isn’t a suspected deficiency.
A simple PROOV test performed at home may save you time and heartache and although early miscarriage may have many other causes, from chromosomal abnormalities to clotting and auto-immune issues, low progesterone is nevertheless one of them.
And low progesterone is also the easiest one to detect and prevent.
Dr Amy Beckley accepted my invitation to attend our Free Webinar in March. We will discuss PROOV, low progesterone, luteal phase defect, ways to naturally improve progesterone levels when prescription progesterone is not available.
I will keep you updated both here and in our Facebook group about the date and time, so that your are able to send your questions ahead of time, in case you won’t be able to participate. The webinar will also be available for replay.
E, M. (2019). Endometriosis and luteal phase defect. - PubMed - NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8379865 [Accessed 5 Dec. 2019].
Brazilian Journal of Medical and Biological Research (2004) 37: 1637-1644 , Hyperinsulinemia and luteal phase progesterone deficiency
Schliep, K.C. et al., 2014. Luteal phase deficiency in regularly menstruating women: prevalence and overlap in identification based on clinical and biochemical diagnostic criteria.
The Journal of clinical endocrinology and metabolism. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037737/ [Accessed December 5, 2019].