Lab result explainedHormonesLast updated November 8, 2026

Progesterone blood test: what high and low progesterone levels mean

Progesterone · Reproductive hormone panel (often with LH, FSH, estradiol, hCG) · reported in ng/mL (1 ng/mL = 3.18 nmol/L)

Progesterone is the hormone made by the ovary after ovulation, by the corpus luteum (the shell of the follicle that released the egg), and later by the placenta. Its job is to thicken and stabilise the uterine lining so a fertilised egg can implant, and then to maintain a pregnancy. A progesterone blood test is ordered for three main reasons: to confirm that you ovulated in a given cycle, to assess an early pregnancy that is bleeding or painful, and to monitor progesterone treatment during fertility care. A mid-luteal value above 3 ng/mL confirms ovulation; most ovulatory cycles produce 10 to 20 ng/mL at the peak.

Timing is everything with progesterone. Before ovulation it is almost absent (under 1 ng/mL). It rises within a day of ovulation, peaks about 7 days later, and if there is no pregnancy it collapses over the next few days, which is what brings on the period. A test taken on the wrong day, which is extremely common, produces a low result that means nothing. The traditional day 21 progesterone assumes a 28-day cycle; the correct day is 7 days before your next period is expected, whatever your cycle length.

In pregnancy, progesterone climbs steadily: typically 11 to 44 ng/mL in the first trimester, 25 to 83 in the second and 58 to 214 in the third. In a woman with bleeding or pain in early pregnancy, a progesterone below 5 ng/mL makes a viable pregnancy very unlikely, and a value above 20 to 25 makes it probable, though hCG trends and ultrasound, not progesterone, make the final call. After menopause, and in men, progesterone is normally very low (under 0.2 to 0.5 ng/mL) and a low result is not a problem.

Progesterone at a glance

  • What it is: the hormone of the second half of the cycle and of pregnancy, made by the corpus luteum after ovulation and by the placenta from about week 8 to 10.
  • Normal: follicular phase under 0.9 ng/mL; mid-luteal 1.8–24 ng/mL (above 3 confirms ovulation, 10 or more is typical of a healthy luteal phase); after menopause under 0.2–0.5; men under 0.2–0.5. Labs differ; 1 ng/mL = 3.18 nmol/L.
  • Pregnancy: first trimester 11–44 ng/mL, second 25–83, third 58–214. Below 5 in early pregnancy with bleeding strongly suggests a non-viable pregnancy; above 20–25 is reassuring.
  • Low in the luteal phase usually means you did not ovulate that cycle or the test was taken on the wrong day; persistent anovulation is most often PCOS, hypothalamic suppression, high prolactin or thyroid disease.
  • High: pregnancy, a corpus luteum cyst, progesterone or progestin treatment, and rarely congenital adrenal hyperplasia or an ovarian or adrenal tumour.
  • Next step: repeat 7 days before the expected period, track cycles or use ovulation kits to time it, and add LH, FSH, prolactin and TSH if cycles are irregular.

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What Progesterone measures

Progesterone is a steroid hormone made from cholesterol. In the first half of the cycle the ovary makes almost none. After the LH surge triggers ovulation, the ruptured follicle becomes the corpus luteum and secretes progesterone in pulses, reaching a plateau 6 to 8 days after ovulation. Progesterone converts the estrogen-primed uterine lining into a secretory tissue ready for implantation, raises basal body temperature by about 0.3 to 0.5 °C (the basis of temperature charting), thickens cervical mucus and quiets uterine muscle. If an embryo implants, its hCG rescues the corpus luteum, which keeps making progesterone until the placenta takes over at about 8 to 10 weeks (the luteal-placental shift). If not, the corpus luteum dies after about 14 days, progesterone falls and menstruation follows.

The lab measures total progesterone in serum by immunoassay or, increasingly, by liquid chromatography mass spectrometry, which is more accurate at the low concentrations seen before ovulation, in men and after menopause. US labs report ng/mL; much of the world uses nmol/L (multiply ng/mL by 3.18). Because the corpus luteum secretes in pulses, luteal values can swing from 5 to 40 ng/mL within hours in the same woman, so a single low-normal result does not prove a weak luteal phase, and the American Society for Reproductive Medicine no longer regards a luteal phase defect diagnosed by progesterone level as a clinically useful entity.

The adrenal glands make a small amount of progesterone as an intermediate on the way to cortisol and aldosterone, which is why men and postmenopausal women have measurable but very low levels, and why certain adrenal enzyme defects (congenital adrenal hyperplasia) raise it. Oral micronised progesterone and vaginal progesterone are measured by the test, but synthetic progestins (norethindrone, levonorgestrel, medroxyprogesterone, the progestin in most pills) are different molecules and do not register, so a progesterone test on the pill reads low.

Normal range for Progesterone

Reference ranges vary between labs and by age, sex and pregnancy. Use the range printed on your own report.

GroupTypical range (ng/mL (1 ng/mL = 3.18 nmol/L))Notes
Women, follicular phase (before ovulation)Below 0.9 ng/mLEssentially absent; a value under 1 before ovulation is normal and not a sign of deficiency. Labs differ; use the printed range.
Women, mid-luteal phase (7 days after ovulation)1.8–24 ng/mLAbove 3 ng/mL confirms ovulation occurred. Most healthy cycles produce 10 to 20 at the peak; a single value under 10 does not by itself mean a luteal problem.
Women, first trimester of pregnancy11–44 ng/mLBelow 5 with bleeding or pain strongly predicts a failing or ectopic pregnancy; above 20 to 25 is reassuring. Ultrasound and serial hCG decide.
Women, second trimester25–83 ng/mLPlacental production, rising steadily.
Women, third trimester58–214 ng/mLHighest just before delivery; twins and other multiples run higher.
Women, after menopauseBelow 0.2–0.5 ng/mLAdrenal production only. A low result is expected and needs no action unless on progesterone therapy.
Women on combined or progestin-only hormonal contraceptionBelow 1 ng/mLOvulation is suppressed and synthetic progestins are not detected by the test.
MenBelow 0.2–0.5 ng/mLAdrenal and testicular trace production. Rarely tested; raised values suggest an adrenal or testicular tumour or congenital adrenal hyperplasia.
On micronised progesterone (oral 200 mg or vaginal) in IVF or HRTOften 10–40 ng/mL or moreOral doses give brief peaks 2 to 4 hours after the dose; vaginal doses give steadier serum values that under-represent the uterine level.

High progesterone

A high progesterone in a woman of reproductive age almost always means one of two normal things: you have ovulated and are in the luteal phase, or you are pregnant. A luteal value of 15 to 30 ng/mL is a healthy result, not a problem, and a value of 25 to 40 in early pregnancy is reassuring. Values above the usual luteal range are common in women on progesterone treatment (oral or vaginal micronised progesterone for IVF, threatened miscarriage or HRT) and in twin pregnancies, and they are an expected effect rather than a cause for concern.

Genuinely abnormal highs are rare. A persistently raised progesterone with no pregnancy and no ovulation can come from a corpus luteum cyst that keeps secreting, a molar pregnancy (where hCG is extremely high), non-classic congenital adrenal hyperplasia (where 17-hydroxyprogesterone, a close relative, is the more diagnostic marker), or very rarely a progesterone-secreting ovarian or adrenal tumour. In men and postmenopausal women any clearly measurable progesterone above about 1 ng/mL should be repeated and, if confirmed, prompts adrenal and gonadal imaging.

Progesterone can also read falsely high on some immunoassays in people taking high-dose biotin supplements or with antibodies that interfere with the assay, and in the first days after an hCG trigger injection in fertility treatment. There is no established upper threshold at which progesterone itself is harmful; the question is always what is producing it.

Common causes

  1. Normal luteal phase

    A progesterone of 5 to 25 ng/mL in the week after ovulation is the expected result and the reason the test is done. Pulsatile secretion means values can exceed 30 for a few hours.

  2. Pregnancy

    The corpus luteum, then the placenta, raise progesterone from around 10 to 20 ng/mL at implantation to over 100 by term. A missed period and a progesterone above 10 should prompt a pregnancy test if one has not been done.

  3. Progesterone treatment

    Oral micronised progesterone (100 to 400 mg), vaginal gel or pessaries and intramuscular progesterone in oil, used in IVF, for luteal support, recurrent miscarriage and HRT, produce values anywhere from 10 to over 100 ng/mL depending on dose, route and timing.

  4. Multiple pregnancy

    Twin and triplet pregnancies have proportionately more placental tissue and run higher progesterone throughout.

  5. Corpus luteum cyst

    If the corpus luteum fills with fluid and persists instead of regressing, progesterone stays raised, the period is delayed and there may be one-sided pelvic pain; most resolve within one to three cycles.

  6. Molar pregnancy (gestational trophoblastic disease)

    Abnormal placental tissue produces very high hCG and raised progesterone with a uterus larger than dates, bleeding and severe nausea; diagnosed by ultrasound and hCG.

  7. Congenital adrenal hyperplasia

    21-hydroxylase deficiency blocks cortisol production and shunts precursors into 17-hydroxyprogesterone and progesterone. Non-classic forms present in adolescence or adulthood with irregular periods, acne and excess hair, mimicking PCOS.

  8. Ovarian or adrenal tumours (rare)

    Granulosa-theca cell tumours, luteomas of pregnancy and some adrenal carcinomas secrete progesterone, usually with other hormone excess and a mass on imaging.

Symptoms that can go with it

  • Breast tenderness and fullness
  • Bloating, constipation and fluid retention
  • Fatigue, drowsiness and feeling warm (progesterone raises body temperature by about 0.3 to 0.5 °C)
  • Low mood, irritability or anxiety in the premenstrual week in women sensitive to progesterone metabolites
  • Nausea, particularly on oral progesterone and in pregnancy
  • A delayed period with one-sided pelvic pain (corpus luteum cyst)
  • Irregular periods with acne and excess hair when the cause is congenital adrenal hyperplasia

Low progesterone

The first question with a low progesterone is when it was drawn. Progesterone is naturally under 1 ng/mL for the whole first half of the cycle and in the last day or two before a period, so a low result on the wrong day is simply uninformative. A result below 3 ng/mL on a sample correctly timed 7 days before the period started means ovulation did not happen that cycle. One anovulatory cycle a year is normal, more so in the teens and in the years before menopause; recurrent anovulation needs a cause, and the usual ones are PCOS, functional hypothalamic suppression from low body weight, stress or over-training, high prolactin, thyroid disease and perimenopause.

A mid-luteal progesterone between 3 and 10 ng/mL is a grey zone. It confirms ovulation but is sometimes labelled a luteal phase defect or luteal insufficiency. Because progesterone is secreted in pulses and a single draw can miss a peak, and because trials of progesterone supplementation in women with low luteal values and otherwise unexplained infertility have not shown improved live births, the American Society for Reproductive Medicine considers this diagnosis unreliable and treatment unproven outside IVF. A repeat test, or two draws on consecutive days, is more useful than acting on one value.

In early pregnancy a low progesterone is a warning sign but not a cause. A value under 5 ng/mL with bleeding or pain predicts a failing intrauterine or ectopic pregnancy with over 95 percent certainty; between 5 and 20 is indeterminate; serial hCG and ultrasound decide. Progesterone falls because the pregnancy is failing, not the other way round, and giving progesterone does not rescue a pregnancy that is chromosomally abnormal, which is the case in over half of first-trimester losses. The one group in whom supplementation has shown benefit is women with early bleeding and a history of previous miscarriage.

Common causes

  1. Test taken on the wrong day

    The most common cause by far. A day 21 draw in a woman with a 35-day cycle lands in the follicular phase, when progesterone is normally below 1 ng/mL. The correct day is 7 days before the next expected period, or 7 days after a positive ovulation kit.

  2. Anovulation from PCOS

    Infrequent or absent ovulation means no corpus luteum and no luteal progesterone; cycles are typically longer than 35 days or absent. PCOS is the commonest cause of persistent anovulation in women of reproductive age.

  3. Functional hypothalamic anovulation

    Low energy intake, rapid weight loss, heavy exercise or sustained stress suppress GnRH and LH pulses, so follicles do not mature or ovulate; periods become light, irregular or stop.

  4. High prolactin and thyroid disease

    Prolactin above about 25 ng/mL and both under- and over-active thyroid interfere with ovulation and shorten or abolish the luteal phase; both are routinely tested when progesterone is low.

  5. Perimenopause

    In the 5 to 10 years before menopause, ovulation becomes intermittent and luteal progesterone falls while estrogen still fluctuates, producing irregular, sometimes heavy cycles.

  6. Failing or ectopic pregnancy

    A progesterone under 5 ng/mL in a woman with a positive pregnancy test and bleeding or pain predicts a non-viable pregnancy; between 5 and 20 needs serial hCG and scans.

  7. Hormonal contraception

    The pill, patch, ring, implant, injection and hormonal IUD suppress ovulation in most users, and the synthetic progestin they contain is not measured by the test, so progesterone reads below 1 ng/mL.

  8. Menopause and surgical removal of the ovaries

    Without ovulation there is no corpus luteum; progesterone is permanently under 0.5 ng/mL and this is expected, not a deficiency to be corrected unless estrogen therapy requires it for uterine protection.

  9. Short luteal phase after stopping breastfeeding or in the first cycles after the pill

    The first ovulatory cycles when fertility returns often have a short luteal phase with lower progesterone; this normalises over a few cycles.

Symptoms that can go with it

  • Irregular, infrequent or absent periods, or cycles shorter than 21 days with early spotting before the period
  • Difficulty conceiving
  • Very light or very heavy periods with no clear pattern
  • Spotting in early pregnancy, or cramping and bleeding with a positive test
  • Absence of the usual premenstrual breast tenderness or temperature rise, which some women notice in anovulatory cycles
  • Hot flushes, night sweats and sleep disturbance if the cause is perimenopause or ovarian insufficiency
  • Acne, excess hair growth or weight gain if the cause is PCOS

Read it alongside

  • hCG — in early pregnancy, the hCG level and its 48-hour rise, with ultrasound, determine viability; progesterone adds supporting information only.
  • LH — a positive urine LH surge 7 days before the progesterone draw confirms the timing was right; a high blood LH:FSH ratio points to PCOS as the cause of anovulation.
  • FSH and estradiol — drawn on day 2 to 5, they show whether anovulation is from ovarian insufficiency (high FSH, low estradiol) or from hypothalamic suppression (both low).
  • Prolactin — a common and treatable cause of anovulation and short luteal phases.
  • TSH — thyroid disease disrupts ovulation and raises prolactin; checked in every cycle work-up.
  • 17-hydroxyprogesterone — the specific marker for non-classic congenital adrenal hyperplasia when progesterone or androgens are unexpectedly high.
  • Testosterone, SHBG and DHEA-S — define androgen excess in suspected PCOS.
  • AMH — a steadier measure of remaining ovarian follicles when anovulation may be perimenopausal.

What usually happens next

  1. If the result was low and the timing uncertain, repeat 7 days before your next expected period, ideally 7 days after a positive home ovulation test, or draw on two consecutive days to smooth out the pulses.
  2. If a correctly timed value is below 3 ng/mL in two cycles, expect a baseline panel on day 2 to 5 (FSH, LH, estradiol, prolactin, TSH) and often testosterone and a pelvic ultrasound to find the cause of anovulation.
  3. In early pregnancy with bleeding or pain, progesterone is read with the hCG level and its trend over 48 hours and a transvaginal ultrasound; a low value speeds up, but does not replace, that pathway.
  4. If you have had a previous miscarriage and are bleeding in a new pregnancy, ask about vaginal progesterone, which in the PRISM trial increased live births in this specific group.
  5. Track cycle length, home ovulation tests and basal body temperature for two to three months before an infertility appointment; that record is often more informative than a single hormone level.
  6. Ask what is making progesterone low rather than how to raise it; replacing progesterone does not restore ovulation, and treating PCOS, thyroid disease, high prolactin or low energy availability does.

Diet, lifestyle and natural levers with evidence

What can move Progesterone once the cause is known. Nothing here replaces finding the cause.

Restoring ovulation through weight change and energy balance

Strong evidence

Progesterone cannot be raised naturally without ovulating, so the levers that restore ovulation are the ones that raise it. In women with PCOS and excess weight, losing 5 to 10 percent of body weight restores regular ovulation in around half within 6 months in lifestyle trials. In functional hypothalamic amenorrhea the reverse applies: increasing intake and reducing training restores ovulatory cycles in 70 to 80 percent of women within 6 to 12 months, typically after regaining 2 to 5 kg.

Myo-inositol in PCOS

Moderate evidence

Myo-inositol, 2 g twice daily for 3 to 6 months, improved ovulation frequency and menstrual regularity compared with placebo in a meta-analysis of randomised trials in women with PCOS, with effects on ovulation similar to metformin. More ovulatory cycles means more cycles with a normal luteal progesterone; it does not raise progesterone directly.

Mild gut upset at higher doses; if you are trying to conceive and have not ovulated after 3 to 6 months, ovulation induction is more effective.

Chasteberry (Vitex agnus-castus)

Preliminary evidence

Vitex lowers mildly raised prolactin by acting on pituitary dopamine receptors, and small randomised trials (20 to 40 mg of extract a day for 3 months) in women with high prolactin and short luteal phases reported lengthened luteal phases and modest rises in mid-luteal progesterone. The trials are small, old and heterogeneous, and there is no evidence of benefit in women who already ovulate normally or in PCOS.

Avoid in pregnancy, alongside dopamine-acting drugs or hormonal contraception, and with hormone-sensitive cancers; stop once pregnancy is confirmed.

Vitamin C

Preliminary evidence

A single randomised trial in 150 women with a documented luteal phase defect found that 750 mg of vitamin C a day raised mid-luteal progesterone (from about 8 to 14 ng/mL) and pregnancy rates compared with no treatment over three cycles. It has not been replicated in a placebo-controlled trial and should be considered unproven.

Doses above 1,000 mg a day increase kidney-stone risk in susceptible people.

Stress reduction and sleep

Preliminary evidence

Psychological stress and short sleep suppress GnRH pulses and have been associated with more anovulatory cycles and lower luteal progesterone in prospective cohort studies of women trying to conceive. Small trials of cognitive behavioural therapy in functional hypothalamic amenorrhea restored ovulation in about 6 of 8 treated women versus 1 of 8 controls, but evidence in women with regular cycles is observational only.

When to see a clinician promptly

  • Bleeding or one-sided pelvic pain in early pregnancy, particularly with shoulder-tip pain, dizziness or fainting: a possible ectopic pregnancy is an emergency regardless of the progesterone value.
  • A progesterone under 5 ng/mL with a positive pregnancy test, which needs same-week ultrasound and serial hCG.
  • Periods absent for 3 months or more, or fewer than 8 cycles a year, which need a full hormonal work-up rather than a progesterone test alone.
  • Difficulty conceiving after 12 months (6 months if over 35), or sooner if cycles are irregular or you have had two or more miscarriages.
  • A clearly raised progesterone in a man or a postmenopausal woman, which should be repeated and investigated for an adrenal or ovarian source.
  • Severe pelvic pain with a delayed period and a known ovarian cyst, which can indicate rupture or torsion.

Frequently asked questions

What is a normal progesterone level?

Before ovulation, under 0.9 ng/mL. In the mid-luteal phase, about 7 days after ovulation, 1.8 to 24 ng/mL; a value above 3 confirms ovulation and most healthy cycles produce 10 to 20. In pregnancy, 11 to 44 ng/mL in the first trimester, 25 to 83 in the second and 58 to 214 in the third. After menopause and in men, under 0.2 to 0.5. If your lab reports nmol/L, divide by 3.18 to get ng/mL. Ranges vary between labs.

What should a day 21 progesterone be?

Above 3 ng/mL (about 10 nmol/L) confirms you ovulated; many clinics regard 10 ng/mL (30 nmol/L) or more as a comfortably normal luteal level. But day 21 is only the right day in a 28-day cycle. The test should be drawn 7 days before your period is due, so day 28 in a 35-day cycle. A low day 21 result in a longer cycle usually just means you were tested before ovulation.

What progesterone level indicates pregnancy?

None reliably; progesterone cannot diagnose pregnancy because a luteal value of 15 to 25 ng/mL occurs in every ovulatory cycle whether or not conception happened. In an established early pregnancy, values are usually 11 to 44 ng/mL. A level above 20 to 25 is reassuring for a viable pregnancy and below 5 strongly suggests a failing one, but hCG and ultrasound make the diagnosis.

What are the symptoms of low progesterone?

Low progesterone itself is really a sign of not ovulating, so the symptoms are those of anovulation: irregular, infrequent or absent periods, cycles shorter than 21 days or spotting before a period, and difficulty conceiving. Fatigue, mood changes, headaches and poor sleep are often attributed to low progesterone online, but they are non-specific and are not reliably linked to measured progesterone in studies.

Can low progesterone cause miscarriage?

Usually it is the other way round: a pregnancy that is failing, most often because of a chromosomal abnormality, stops producing hCG and the progesterone falls. Low progesterone is a marker, not the cause, in most cases. The exception where treatment helps is women with bleeding in early pregnancy who have had one or more previous miscarriages: in the PRISM trial of 4,153 women, vaginal progesterone raised the live birth rate in that group (from 57 to 68 percent in women with three or more previous losses), while women with no previous miscarriage did not benefit.

How can I increase my progesterone naturally?

The only way to produce more progesterone is to ovulate, so the effective levers are the ones that restore ovulation: weight loss if you have PCOS and excess weight, eating and resting more if you are under-fuelled or over-training, and treating thyroid disease or high prolactin. Myo-inositol has moderate evidence for restoring ovulation in PCOS. Foods, seed cycling and most supplements marketed to raise progesterone have no trial evidence that they change measured levels.

Does progesterone need to be tested fasting or at a certain time?

No fasting is required. The day of the cycle is what matters: 7 days after ovulation (confirmed by a positive ovulation kit or temperature rise) or 7 days before the expected period. Time of day is less important, but because progesterone is released in pulses, a value that seems borderline can be rechecked the next day. If you take oral progesterone, note the time of your last dose, because levels peak 2 to 4 hours after it.

Is a progesterone of 1, 5, 10 or 30 low or high?

It depends on the day. A progesterone of 1 ng/mL is normal before ovulation and means no ovulation if drawn mid-luteal. A value of 5 confirms ovulation but is at the lower end; 10 is a typical healthy luteal level; 30 is a strong luteal value or an early pregnancy level, and is normal in both settings. None of these numbers is abnormal in itself without knowing where you were in your cycle and whether you might be pregnant.

References

  1. Progesterone test. MedlinePlus, US National Library of Medicine (2023)View source
  2. Progesterone, serum: clinical and interpretive information. Mayo Clinic Laboratories (2024)
  3. Practice Committee of the American Society for Reproductive Medicine. Current clinical irrelevance of luteal phase deficiency: a committee opinion. Fertility and Sterility (2015)
  4. Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertility and Sterility (2015)
  5. Verhaegen J, Gallos ID, van Mello NM, et al.. Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies. BMJ (2012)
  6. Coomarasamy A, Devall AJ, Cheed V, et al.. A randomized trial of progesterone in women with bleeding in early pregnancy (PRISM). New England Journal of Medicine (2019)
  7. Wahabi HA, Fayed AA, Esmaeil SA, Bahkali KH. Progestogen for treating threatened miscarriage. Cochrane Database of Systematic Reviews (2018)
  8. Ectopic pregnancy and miscarriage: diagnosis and initial management (NG126). National Institute for Health and Care Excellence (2019)
  9. Stricker R, Eberhart R, Chevailler MC, Quinn FA, Bischof P, Stricker R. Establishment of detailed reference values for luteinizing hormone, follicle stimulating hormone, estradiol, and progesterone during different phases of the menstrual cycle on the Abbott ARCHITECT analyzer. Clinical Chemistry and Laboratory Medicine (2006)
  10. Henmi H, Endo T, Kitajima Y, Manase K, Hata H, Kudo R. Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. Fertility and Sterility (2003)
  11. van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Medica (2013)
  12. Gordon CM, Ackerman KE, Berga SL, et al.. Functional hypothalamic amenorrhea: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism (2017)

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This page is educational and is not medical advice or a diagnosis. Lab results have to be interpreted together with your history, symptoms and other results by a clinician who knows you. Do not start or stop a supplement to change a lab value before the cause is known.