One of the features of PCOS is a hormonal imbalance, particularly low levels of progesterone, which can lead to irregular periods, infertility, and other health complications. Knowing how to increase progesterone in PCOS is essential for hormonal balance, improving fertility, and supporting overall health. 

This article explores natural and medical strategies for how to increase progesterone in PCOS effectively.

What is progesterone?                 

Progesterone is a steroid hormone primarily associated with female reproductive health, influencing ovulation, pregnancy maintenance, and hormone replacement therapy.

Progesterone is mainly produced by the corpus luteum in the ovaries after ovulation in luteal phase and plays a key role in embryo implantation and maintaining early pregnancy. It also prevents preterm delivery (1).

What’s a Normal Progesterone Level?

Progesterone levels vary significantly depending on sex, age, menstrual cycle phase, pregnancy status, and specific medical conditions.

­­Stage	Progesterone Levels (ng/mL)
Follicular phase (pre-ovulation)	< 0.89
Ovulation	< 10
Luteal phase (post-ovulation)	2-24 (less than 10 is considered low)
First trimester	11-44
Second trimester	25-83
Third trimester	58-214
Post-menopause	< 0.5

What does progesterone do to your body?

Progesterone has many functions in body which are as follows:

• It is produced mainly by the corpus luteum after ovulation and prepares the uterus for implantation of embryo by thickening the endometrial lining
• Role in role in immune modulation, preventing the maternal immune system from attacking the developing fetus
• Regulates the menstrual cycle
• Contributes to breast development in preparation for lactation
• Precursor for other hormones, such as testosterone, cortisol, and estradiol
• Improve your mood

Progesterone role in pregnancy

Progesterone is often referred to as the hormone of pregnancy due to its essential role in establishing and maintaining pregnancy. It prepares the uterus for implantation by thickening the endometrial lining and suppressing uterine contractions to prevent early pregnancy loss (2).

If an egg is fertilized by sperm at ovulation, human chorionic gonadotropin (HCG) tells the corpus luteum to make more progesterone to support the developing embryo.

During the first trimester, progesterone is produced by the corpus luteum, but as pregnancy progresses, the placenta takes over hormone production. It continues to suppress uterine contractions, support fetal development, and prepare the breasts for lactation.

It also regulates maternal immune responses, preventing the mother’s immune system from rejecting the developing embryo (3).  In assisted reproductive technologies (ART), luteal phase support with progesterone improves pregnancy success rates and reduces miscarriage risk.

Progesterone role in pcos

In PCOS, chronic anovulation leads to lower progesterone levels, which contributes to menstrual irregularities, infertility, and increased risk of endometrial hyperplasia and cancer (4).

Ovulation is important for progesterone production because the corpus luteum, formed after the egg is released, secretes this hormone. Without ovulation, progesterone levels remain low.

Moreover, High insulin levels in PCOS also cause low progesterone.

Low progesterone symptoms

Low progesterone means high estrogen levels. Symptoms of low progesterone are

• Irregular or missed periods
• Difficulty conceiving
• Premenstrual spotting
• Mood swings and anxiety
• Fatigue
• Breast tenderness
• Weight gain
• Headaches and migraine
• Mid cycle spotting

Causes of low progesterone in PCOS

High stress levels, Hypothyroidism, elevated prolactin levels, estrogen dominance, and birth control pills are some of main reasons of low progesterone in PCOS. Let’s dive into their details:

Stress

Your body in stress prioritize to produce cortisol over progesterone production. Elevated cortisol levels also suppress gonadotropin-releasing hormone (GnRH), disrupting luteinizing hormone (LH) pulsatility, leading to anovulation and insufficient corpus luteum formation, which are major causes of low progesterone in PCOS.

Hypothyroidism

Progesterone is produced from pregnenolone. Pregnenolone production requires thyroid hormone. In hypothyroidism there is low production of thyroid to support production of pregnenolone.

Studies also suggest that subclinical hypothyroidism (SCH), which is common in PCOS, is correlated with higher BMI and insulin resistance, both of which contribute to poor ovarian function and lower progesterone synthesis (5).

High prolactin levels

Prolactin is the hormone that triggers milk production in women but can also rise in non-lactating women. This is a problem because high levels of prolactin can interfere with progesterone production and inhibit ovulation.

Estrogen dominance

Estrogen dominance occurs when estrogen levels are disproportionately high relative to progesterone, which is commonly observed in women with polycystic ovary syndrome (PCOS).

This imbalance primarily arises due to anovulation, where the lack of ovulation leads to insufficient progesterone production from the corpus luteum (6).

Birth control pills

Birth control is not the same as natural progesterone. While birth control pills may help “regulate” menstrual cycles, they don’t provide the same benefits as natural progesterone that your body produces, especially in terms of mood and bone health.

Birth control pills are capable of “masking” hormonal issues they did not solve the underlying issues.

How to increase progesterone in PCOS naturally?

Magnesium, vitamin B6, zinc and healthy fats like omega 3 are important to increase progesterone naturally in PCOS.

Magnesium

Magnesium regulate HPA axis. Chronic stress and high cortisol levels deplete pregnenolone, the precursor for progesterone. Magnesium acts as a natural cortisol regulator, helping to preserve pregnenolone for progesterone synthesis.

Estrogen dominance suppresses progesterone levels, and magnesium helps by modulating estrogen receptors and balancing estrogen clearance.

Foods with magnesium include Almonds, Spinach, Black beans, Avocados, Dark chocolate, yogurt, and edamame.

Vitamin B6

Birth control pills and estrogen dominance deplete B6 levels which results in low progesterone levels. So eat vitamin B6 rich foods like Salmon, chicken breast, potatoes, bananas, spinach, pistachios, and avocado.

Zinc

Zinc has a role in releasing FSH hormone, promote ovulation and involves progesterone production. Zinc-rich foods include:

• Oysters and shellfish
• Beef and lamb
• Chickpeas
• Pumpkin seeds
• Yogurt
• Oatmeal
• Mushrooms

Omega 3 fatty acids

Cholesterol is important for production of pregnenolone. Pregnenolone is than converts to progesterone. So you should add healthy fats to your diet to balance progesterone levels. So incude foods rich in omega 3 to your diet also.

Include healthy fats in your meals from sources like:

• avocado or avocado oil
• whole nuts and seeds
• olive oil
• fatty fish like salmon or sardines
• eggs
• coconut oil
• grass fed butter

How to Increase Progesterone Levels with Herbal Supplements?

Herbal supplements best way to boost progesterone in pcos patients. Vitex, rhodiola rosea, ashwagandha, maca root, red clover, holy basil, green tea and resveratrol are herbs that has shown effects in boosting progesterone levels.

Vitex (Chasteberry)

Chasteberry induces ovulation and increases the production of progesterone by stimulating the pituitary gland to release more luteinizing hormone (LH). According to studies, taking chasteberry on a regular basis can help regulate reproductive hormones and reduce symptoms like premenstrual syndrome (PMS) and irregular periods.

Rhodiola Rosea

This adaptogenic herb indirectly supports progesterone production and hormonal health by balancing cortisol output and enhancing mood and cognitive abilities. 

It is beneficial for preventing anxiety, restlessness, and restless nights as well as for assisting your body in managing stress.

Ashwagandha

Another adaptogenic herb that has become well-known for its capacity to assist the body in coping with stress is ashwagandha. 

Prolonged stress raises cortisol levels, which might worsen PCOS’s hormonal imbalances by suppressing progesterone production.  Ashwagandha indirectly supports the production of progesterone by lowering cortisol and encouraging calm. 

Because of its adaptogenic qualities, it is particularly helpful for women who are coping with the emotional and physical stressors that are typical of PCOS.

Maca root

By controlling the hypothalamic-pituitary-adrenal (HPA) axis, which is essential for hormone synthesis, maca may help lessen the symptoms of hormonal imbalances.  Furthermore, maca root is abundant in nutrients including magnesium, zinc, and iodine all of which are critical for progesterone synthesis and reproductive health.

Traditionally used to support hormonal balance, but clinical studies specific to progesterone in PCOS are lacking.

Red clover and black cohosh

Black cohosh, which has long been used to enhance ovulation and control menstrual cycles, and red clover, which contains phytoestrogens that may help balance progesterone and estrogen levels.

Green tea and resveratrol

The ovaries benefit from the anti-inflammatory and antioxidant properties of resveratrol and green tea. As we age, resveratrol in particular has been shown to enhance ovarian hormone function.

In order to control estrogen dominance, green tea helps with fat oxidation and estrogen metabolism.

According to some research, women who regularly consume green tea may experience other favorable hormonal benefits, including higher levels of estrogen.

Lavender increase progesterone in PCOS

A randomized clinical trial on 68 PCOS patients found that both lavender (250 mg twice daily) and metformin (500 mg three times daily) significantly increased progesterone levels and reduced menstrual cycle length over 90 days (7).

Progesterone levels rose similarly in both groups, with 45.2% of patients reaching >3 ng/mL. Lavender also shortened menstrual cycles more than metformin, though not significantly. These findings suggest lavender as a potential natural alternative for PCOS treatment.

Increase progesterone in PCOS through lifestyle

Manage stress by yoga, meditation, mindfulness, moderate exercise, time in nature, socializing, reading, and anything else that relaxes you.

In adequate sleep disturbs ovulation and results in low progesterone. So sleep 7-8 hours for better progesterone production.

Frequent exercise can help control menstrual cycle hormones, lower inflammation, promote gut flora, enhance blood sugar, and lower cortisol levels.

Q/A

How do you give progesterone to PCOS?

You can use Cyclic Oral Micronized Progesterone (OMP), and metformin on advise of your Doctor to boost progesterone. Further, you can add progesterone boosting foods, and herbs to your diet.

What are symptoms of progesterone rising?

High progesterone symptoms are as follows:

• Breast swelling and tenderness
• Water retention and bloating
• Fatigue
• Anxiety or agitation
• Depression
• Reduce sex drive
• Weight gain

Does fasting increase progesterone?

Progesterone levels may temporarily drop after meals, but the long-term impact of fasting on progesterone production in reproductive-aged women, particularly those with PCOS, remains unclear.

Does lemon water increase progesterone?

There are no direct research studies examining the effects of lemon water on progesterone levels. However, citrus fruits, including lemons, contain vitamin C and flavonoids, which may support overall hormone health. Some studies suggest that vitamin C can play a role in progesterone production by supporting adrenal function and reducing oxidative stress, which can indirectly benefit hormonal balance.

References:

Kolatorova L, Vitku J, Suchopar J, Hill M, Parizek A. Progesterone: A Steroid with Wide Range of Effects in Physiology as Well as Human Medicine. Int J Mol Sci. 2022 Jul 20;23(14):7989. 

Rahman, N. A. A. (2022). The Role of Progesterone in Pregnancy (pp. 50–60). Cambridge University Press eBooks.

Szekeres-Bartho, J. (2023). Progesterone orchestrates foetal-maternal interactions in pregnancy. Journal of Reproductive Immunology.

Briden, L., Shirin, S., & Prior, J. C. (2020). The central role of ovulatory disturbances in the etiology of androgenic polycystic ovary syndrome (PCOS)—Evidence for treatment with cyclic progesterone. Drug Discovery Today: Disease Models, 32, 71–82.

Yasar HY, Topaloglu O, Demirpence M, Ceyhan BO, Guclu F. IS SUBCLINICAL HYPOTHYROIDISM IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME ASSOCIATED WITH BMI? Acta Endocrinol (Buchar). 2016 Oct-Dec;12(4):431-436. https://pubmed.ncbi.nlm.nih.gov/31149127/

Kareem, H. R., Jaafer, H. A., & Hashim, Z. H. (2017). The role of estrogen and progesterone on vaginal cytology during proliferative and secretary phases of menstrual cycle in women with polycystic ovarian syndrome. Iraqi Journal of Medical Sciences, 15(1), 78–87.

Simaei SR, Askari VR, Rostami M, Kamalinejad M, Farzaei MH, Morovati M, Heydarpour F, Jafari Z, Baradaran Rahimi V. Lavender and metformin effectively propagate progesterone levels in patients with polycystic ovary syndrome: A randomized, double-blind clinical trial. Fitoterapia. 2024 Jan;172:105720.