Complete Testing & Optimization Guide
Optimal ranges, provider comparison, and strategies to improve your Progesterone levels
Included in 8 of 10 major testing providers
Sex Hormones (Female)
Follicular:<1.0 ng/mL, Luteal:2.0-25.0 ng/mL, Postmenopausal:<1.0 ng/mL
Abnormal Progesterone levels can indicate underlying health issues that may go undetected without proper testing. Regular monitoring helps catch problems early when they're most treatable.
Understanding your Progesterone levels enables targeted interventions, tracks treatment effectiveness, and helps optimize your overall health and performance.
Progesterone is a steroid hormone produced primarily by the corpus luteum in the ovaries after ovulation in women, and in smaller amounts by the adrenal glands in both sexes and the testes in men. In women, progesterone is THE dominant hormone of the luteal phase (second half of menstrual cycle, days 15-28) and is essential for preparing the uterus for pregnancy, regulating the menstrual cycle, supporting pregnancy, and balancing the effects of estrogen. Progesterone has calming, anti-anxiety effects on the brain and is critical for sleep quality.
Here's what most people misunderstand:progesterone is not just a "pregnancy hormone."It's protective against estrogen dominance, supports mood and sleep, has neuroprotective effects, and is critical for bone health and breast tissue protection. Low progesterone in premenopausal women is common and often causes PMS, irregular cycles, anxiety, insomnia, and increased risk of estrogen-dependent cancers. In menopause, both estrogen AND progesterone decline, but replacing estrogen without progesterone (if uterus is intact) increases endometrial cancer risk.
Progesterone levels vary dramatically across the menstrual cycle. It's very low in the follicular phase (<1 ng/mL), then spikes after ovulation to 5-25 ng/mL in the luteal phase. Testing progesterone on day 21 of a 28-day cycle (or 7 days after ovulation) confirms ovulation occurred. Low progesterone despite normal estrogen=anovulation or luteal phase deficiency, common causes of infertility and menstrual irregularity.
Bottom line: TSH and Free T4 alone miss people with conversion problems. Free T3 is the only way to know if you have enough active thyroid hormone at the tissue level.
| Range Type | Level | Clinical Significance |
|---|---|---|
| Optimal (Luteal Phase) | 10-25 ng/mL | Mid-luteal phase (day 21 of 28-day cycle). Confirms ovulation occurred and adequate progesterone production. |
| Optimal (Follicular Phase) | <1 ng/mL | Progesterone should be very low before ovulation. Elevated progesterone in follicular phase may indicate luteinized unruptured follicle or adrenal issue. |
| Optimal (Pregnancy - First Trimester) | 10-90 ng/mL | Progesterone rises dramatically in pregnancy, produced by corpus luteum then placenta. |
| Optimal (Postmenopausal on HRT) | 1-5 ng/mL | Bioidentical progesterone HRT (oral or topical) maintains levels to protect endometrium if taking estrogen. |
Standard lab range:Follicular:<1.0 ng/mL, Luteal:2.0-25.0 ng/mL, Postmenopausal:<1.0 ng/mL
<5 ng/mL
Very Low (Postmenopausal without HRT)
Expected after menopause. Adrenal glands produce small amounts. If on estrogen HRT, must add progesterone to protect uterus.
Oral micronized progesterone (Prometrium):100-200 mg at bedtime. Bioidentical, identical to human progesterone. Has calming, sleep-promoting effects. Used for luteal phase support, HRT, or PMS.
Progesterone cream:Topical application (20-40 mg/day) absorbed through skin. Useful for perimenopause or mild progesterone deficiency. Variable absorption.
Progesterone suppositories:Vaginal or rectal. Used for luteal phase support in fertility treatment or early pregnancy.
Avoid synthetic progestins:Medroxyprogesterone acetate (Provera) and other synthetic progestins have different effects than bioidentical progesterone and may increase breast cancer risk and harm lipid profile.
Most common cause of low progesterone is anovulation (no ovulation=no corpus luteum=no progesterone).
Address underlying causes:PCOS (insulin resistance drives anovulation), hypothalamic amenorrhea (low body weight, excessive exercise, chronic stress), thyroid dysfunction, hyperprolactinemia.
Lifestyle:Maintain healthy body weight (BMI 18-25), reduce stress, adequate calorie intake (not chronic dieting), resistance training.
Vitex (chasteberry):20-40 mg/day may support ovulation and luteal phase progesterone in some women. Modest evidence.
Ovulation induction:Clomiphene or letrozole if trying to conceive and anovulatory despite lifestyle changes.
Note: If taking estrogen HRT and uterus is intact, you MUST take progesterone to prevent endometrial hyperplasia and cancer. | Oral micronized progesterone:100-200 mg at bedtime for 12-14 days/month (cyclic) or daily (continuous). Preferred over synthetic progestins. | Bioidentical progesterone safer:Unlike synthetic progestins (MPA), bioidentical progesterone does not increase breast cancer risk and may be protective. | If uterus removed (hysterectomy):Progesterone not required, but many women report better sleep, mood, and bone health with progesterone added to estrogen HRT.
Note: Vitamin B6 (50-100 mg/day):Supports progesterone production and may reduce PMS symptoms. | Vitamin C (500-1000 mg/day):May support corpus luteum function and progesterone synthesis. | Magnesium (400 mg/day):Improves sleep, reduces anxiety, supports HPA axis (stress impairs progesterone production). | Zinc (15-30 mg/day):Required for ovulation and progesterone synthesis. | Manage stress:Chronic stress elevates cortisol, which suppresses progesterone production and disrupts ovulation. | Adequate sleep:7-9 hours. Sleep deprivation disrupts reproductive hormones.
Sedation, drowsiness (if very high dose)|Dizziness|Bloating|Breast tenderness|Mood changes (rare with bioidentical;more common with synthetic progestins)
Source:Progesterone rarely causes problems even at high doses. High progesterone (>30 ng/mL in non-pregnant women) may indicate ovarian cyst or adrenal tumor (very rare).
Ovarian cyst (corpus luteum cyst):Persistent corpus luteum continues producing progesterone after cycle.|Adrenal tumor (very rare):Adrenal glands produce small amounts of progesterone;tumors can overproduce.|Pregnancy:Progesterone rises dramatically to support pregnancy.|Congenital adrenal hyperplasia:Rare enzyme deficiency causes overproduction of progesterone precursors.
Source:If trying to conceive:Test progesterone on day 21 of 28-day cycle (or 7 days post-ovulation if tracking ovulation). Should be >10 ng/mL to confirm ovulation and adequate luteal phase.|If starting progesterone supplementation:Retest mid-luteal phase after 2-3 months to ensure adequate replacement.|If on HRT:Monitor progesterone levels if using cream (variable absorption). Oral progesterone dosing doesn't require monitoring if symptoms controlled and withdrawal bleed occurs (if cyclic HRT).|If treating infertility:Serial progesterone testing in luteal phase to confirm ovulation and adequate support.|If perimenopausal with irregular cycles:Test progesterone day 21 (if still cycling) to assess ovulatory status and guide treatment.
Progesterone opposes estrogen's proliferative effects on breast and uterine tissue. "Estrogen dominance"(high estrogen relative to progesterone) increases risk of breast cancer, endometrial hyperplasia, fibroids, and endometriosis. This is common in perimenopause (progesterone declines before estrogen) and anovulatory women.
Source:Prior JC. Progesterone for symptomatic perimenopause treatment. Menopause. 2018;25(12):1453-1455.
Progesterone metabolite allopregnanolone acts on GABA-A receptors (like benzodiazepines), promoting sleep and reducing anxiety. Women with low progesterone often report insomnia, especially premenstrually. Oral micronized progesterone 100-200 mg at bedtime improves sleep quality.
Source:Caufriez A, et al. Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion. J Clin Endocrinol Metab. 2011;96(4):E614-623.
Bioidentical progesterone (Prometrium, compounded) is chemically identical to human progesterone. Synthetic progestins (medroxyprogesterone acetate/Provera, norethindrone) have different structure and effects:they may increase breast cancer risk, negatively affect lipid profile, and have more side effects. Bioidentical progesterone preferred for HRT.
Source:Asi N, et al. Progesterone vs. synthetic progestins and the risk of breast cancer. Syst Rev. 2016.
| Provider | Includes Test | Annual Cost | Total Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ |
 WHOOP Advanced Labs | — | $349 | 65 |
 Labcorp OnDemand | — | $398 | 30+ |
| ✓ | $486 | 40+ | |
| ✓ | $468 | 83 | |
| ✓ | $798 | 100+ | |
 InsideTracker | ✓ | $680 | 48 |
 Function Health | ✓ | $499 | 100+ |
| ✓ | $900 | 70+ | |
| ✓ | $1150 | 110 | |
| — | $Varies | 75+ |
Choose from 8 providers that include this biomarker in their panels
Progesterone is a sex hormones (female) biomarker that Hormone important for menstrual cycle and pregnancy The normal reference range is Follicular:<1.0 ng/mL, Luteal:2.0-25.0 ng/mL, Postmenopausal:<1.0 ng/mL. Regular testing helps track changes and identify potential health issues early.
8 out of 10 major blood testing providers include Progesterone in their standard panels. These include Superpower, Blueprint, Mito Health and others.
For most people, testing Progesterone 2-4 times per year is recommended to establish baseline levels and track trends. If you have abnormal results or are actively working to optimize this biomarker, more frequent testing (quarterly) may be beneficial. Always consult with your healthcare provider for personalized testing frequency recommendations.
The standard laboratory reference range for Progesterone is Follicular:<1.0 ng/mL, Luteal:2.0-25.0 ng/mL, Postmenopausal:<1.0 ng/mL. However, many functional medicine practitioners recommend tighter "optimal" ranges for peak health and performance. Your ideal range may vary based on your age, sex, health goals, and other individual factors. Work with a healthcare provider familiar with optimal ranges to determine your target levels.
Most direct-to-consumer blood testing services that include Progesterone provide the physician order as part of their service. However, some states have restrictions on direct-to-consumer testing. Check with your chosen provider about availability in your state and whether they provide the necessary physician authorization.
Prepares uterus for pregnancy and maintains early pregnancy. Low levels cause irregular cycles and infertility. Balances estrogen effects.
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs and before making decisions about blood testing.
