PCOS & the Progesterone hormone: Symptoms of low progesterone, Why it’s important, and How to improve levels with Dr. Samina Mitha!

PCOS & the Progesterone hormone with Dr. Samina Mitha

Many PCOS women deal with low progesterone which can lead to symptoms like long cycles, heavy periods, trouble sleeping, miscarriages, and more.

On today’s episode, Dr. Samina Mitha joins us to talk all about Progesterone. We talk about what Progesterone is, how it is produced, and how low levels of progesterone can affect PCOS symptoms.

You’ll learn:

– Natural ways to support Progesterone

– Why Progesterone is important for overall health and TTC

– Synthetic Progesterone vs Natural Progesterone

– When & how to test Progesterone levels

To find more PCOS resources from Dr. Samina Mitha, check out her website and Instagram! You can also join her PCOS facebook group!

Join us in The Cysterhood, a community of women learning how to manage PCOS & lose weight, Gluten and Dairy Free!




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Full Episode transcript:

Welcome everyone to another episode of a sister and her mister. Today we have Dr. Samina Meha. She is a licensed and board certified naturopathic doctor and she was diagnosed with P C O S around 12 years ago. Following her diagnosis, all her symptoms made sense, the irregular periods, her cism, anxiety, stress, and cravings. And at that time she felt as if her options were limited and she received help from a naturopathic doctor and that changed everything for her.

From that point on, she began to understand her body and health and she developed a special interest in all things hormone and fertility related. She is now focused on helping other women restore their clarity, confidence, and control so that they can live a life of good health. Dr. Go. So I became a sisters. Sam, we’re so happy to have you here.

Yes, welcome back. Thank you so much for having me. You’re one of the guests that we’ve had on like, I think you, you probably like top first or second in terms of like number of guest appearances. I don’t know who number one is, but it’s either you or I think maybe Dr. Nadia Patua. I’m not sure. Maybe.

Yeah, maybe. Nice. We love that you’re a naturopathic doctor. It’s like right up our alley with P C O S and everything that we talk about on this podcast. So it’s gonna be a really fun episode covering progesterone. Yeah, it’s one of my favorite topics, honestly. So I’m really excited to be here. Is it really, why is it your favorite topic?

I think it’s because it’s such a big part of my practice now and I find that it helps so many women in so many different ways. Sometimes even when I’m just talking about work to my husband, I’m like, progesterone this, progesterone that. He’s like, It sounds like all you do is just progesterone. Yeah, Yeah. And honestly, yeah,

it, it’s helped so many of my patients so I just wanna spread the word about it. Yeah. And try to help other p c s women out there, see if progesterone can help them as well. Yeah, and I, I personally feel like it’s not a topic that’s talked about enough in terms of how much of a effect it can have on P C O S symptoms.

Could we talk about like what are the symptoms of low progesterone as well as hide progesterone? If, if that can also be possible progesterone’s a hormone? Correct. Yeah, so if we back it up, actually maybe we start from when we produce progesterone. So we are producing progesterone throughout the cycle. At the very beginning it’s extremely low. So when I,

I say very beginning, it’s when we get our period, what happens is, you know, follicles will come to the plate in terms of which follicles are going to end up maturing and which follicle the one and only follicle will end up actually ovulating out. Now the way the follicle actually matures is through estrogen. So more estrogen we build, the follicle grows and grows and grows and then when estrogen gets to its peak,

that’s when LH is gonna surge. This is lutin hormone. It allows for ovulation to happen and then that follicle that houses the egg becomes something called a corpus ludia. And that corpus ludia actually produces progesterone and sets our body up for a possible pregnancy if that egg gets fertilized. So in the second half of the cycle, that’s where we’re producing majority of our progesterone.

So we often talk about, you know, what’s going on in the second half of that cycle to show us like is there any signs of low progesterone? One of the biggest signs I would say is spotting before a period. That one is like, okay, yes for sure there’s something going on here with progesterone and we need to take a look at what’s going on.

The other signs are very interesting because it can be related to an imbalance between estrogen and progesterone. So sometimes it doesn’t necessarily mean that your actual progesterone number is low, but it could be low in comparison to the amount of estrogen you’re making. So what progesterone does is it helps to oppose estrogen and if we have too much estrogen there, we need a little bit more progesterone to oppose that,

to kind of bring these PMs symptoms down. So oftentimes in the second up the cycle patients will complain of, you know, feeling down, depressed, maybe getting some P M D D, that’s another sign. Progesterone is low. The spotting, like I mentioned, maybe the second half of the cycle is shorter. Typically we have a 14 day lal phase,

so if it’s shorter than that, that can also mean progesterone could be a little bit low. So many signs there in the second half of the cycle. In P C O S specifically though, when we’re looking at is progesterone low, the number one thing I would say is the patient cycles are irregular because they’re not ovulating. So we’re not building that progesterone.

So we know progesterone is low in comparison to somebody who’s ovulating every cycle day 14 and getting a 28 day cycle right. In a year, their amount of progesterone that they’re gonna build is gonna be significant versus somebody who’s getting a 60 day, 120 day, 40 day cycle, like very variable, they’re not gonna produce as much progesterone as somebody who’s getting regular cycles.

Yeah. So usually let’s say a P C OS woman who is having irregular periods, and I’m gonna say usually cuz of course it may not be everyone. Yeah. Usually can be due to Lowes. Yeah. And the reason why is because when we first get our period ever so in puberty our LH is high and what happens is the, there’s hormones in your brain that start to be created and that’s when FSH follicle stimulating hormone also starts to become created.

And that allows you to ovulate cuz it stimulates the ovaries to produce estrogen. So what happens in P C O S is instead of FSH coming alive and making you know enough estrogen for us to ovulate, LH kind of builds this wall of it just stays high. And so testosterone is always high and it prevents the patient from ovulating. They may ovulate here or there,

but their LA just stays high and so they’re not able to ovulate because of that. The reason why like patients who have regular cycles actually end up ovulating cycle after cycles cuz they’re making this fsh, their body’s getting exposed to progesterone and the brain is getting that signal so their next cycles are gonna be able to become more regular. Because of that. In P C O S,

if LH is continually high, it’s harder for us to actually get that signal to the brain to allow for ovulation to happen cycle after cycle after that. So some patients will come in and they’ll say, you know, ever since I got my period, my cycles have been irregular. And so that’s like a warning sign that oh their LA is probably high,

their testosterone is high and what we need to do is expose the brain to more progesterone and allow that connection to kind of come alive between the brain and the ovaries. Did you hear about that sister who took OVASITOL and finally got her period after a year of not having one? Incredible, I see those kinds of messages on Instagram a lot. How does that even happen?

Well Ovasitol helps with healing insulin resistance, a common root issue that most P C O S sisters have. And by targeting insulin resistance, we’re seeing sisters kick those crazy cravings finally regulate their periods, ovulate and improve their egg quality. Each packet of ovasitol has a 40 to one ratio of myo acetol and D chiro acetol. This ratio is similar to the ratio that should be found in the body,

but with women like me who have P C O S, this ratio is often imbalanced. So taking AVAs can be super effective in treating insulin resistance starting from the root of the issue. So awesome. It tastes like nothing. So just warm me when you put it in a cup so I don’t drink it. You got it boo. Check out the link in the description to get 15% off your order.

What is happening that makes the LA child, like what can they do to counter that? Yeah, you know, honestly I don’t know what their research says in terms of that, but I honestly think it’s genetics. Mm. Is it one of those issues where when you’re insulin resistant it triggers high testosterone and then that can trigger high LH and like Yes,

that can be a problem. That can be one of the issues too. Yeah, you’re right. Like a combination of genetics and environment. I think so too. Yeah, for sure. Because oftentimes patients will come and say this is like a trend. I’ve seen that around the time of puberty they’re going into high schools or stressful, you know, the stress obviously caused inflammation,

maybe they weren’t eating well and just even that environment, if you’re predisposed of something like insulin resistance and diabetes from family history can kind of like trigger some of these symptoms that come alive and the genes to be expressed to allow this P C O S to kind of come into their picture. Yeah, I feel like in modern day we kind of create that horrible environment for like girls at that age when they start their period because they’re surrounded by candy and junk food,

they’re surrounded by toxins, toxins, bed, bath, I mean bath and body works toxins. Exactly. Yeah. Good makeup and candles and all those things. And then and stress of school, the stress of like not being outside and being in front of computers and getting more sleep and social and then, you know, we just like create that environment aside from the genetic factors we like bring it to life,

We do bring it to life I think. Yeah. So why is it important to care about progesterone levels if you’re not going to get pregnant anytime soon? I know it’s really important, but I want you to like lay it out, split it out because people who are listening might be like, well you know, who really cares? I’m not trying to get pregnant or ovulate or whatever.

Like what should I care? It’s so important. Yeah, well yeah, super, super important to be shedding the lining for example, especially if you are building the lining, if you are making nitrogen, maybe not enough to like get ovulation going, but enough to build that lining, you wanna protect the lining by shedding it because it can, you know,

after a long period of time may predisposing some to something like endometrial cancer. Right? And so that’s why a lot of women are also put on birth control pills because they’re told that their lining needs to get shed in order to protect their uterus, which makes sense, right? So it, it does, it is important to be shedding that lining and the way that we can be doing that is by using progesterone because progesterone will help shed the lining as well because once we put the progesterone in,

we take it out. Not only will it help with ovulating, it’ll also help to shed the lining when we take the, So I would say that’s like number one, but also as a PS woman myself and like I feel like listeners out there would definitely, you know, feel the same is like when you don’t have your period, you feel like absolute yes.

You know what I mean? Like you just feel so bad, like you just feel moody and cranky and like all the PMs symptoms are coming but you’re not getting this period and all you want is a period and every time you go to the washroom you’re like, oh my god, is it gonna come because if it’s not here I’m gonna like lose my shit.

Yeah, Yeah, yeah. So honestly I feel like just getting a period makes you feel so much better and it makes sense because our body does need to reset and it does need to, you know, feel, get the hormones going and it needs the hormones to change day in day out. And so I do really feel that it’s important to even come Through it.

Yeah, there was like a a, I mean we get these messages once in a while but I’ll never forget like a certain message where I saw and it just for me was unfortunate that this person didn’t have like enough, you know, awareness about or being educated on her menstrual cycle. But she was basically saying how, oh like if I don’t have my period,

isn’t that a good thing? You know, like I, I, I prefer it if I don’t get my period. And of course like she was unfortunately she just didn’t get the, you know, proper awareness about her cycle and things like that. But you know, I think it’s also important to to have your menstrual cycle because that’s part of, you know,

like having a proper like balance hormones in your body and such. Yeah, I’m, I totally understand that too. I mean it’s not necessarily the funnest thing to go through when you get it. Yeah, it’s like a cat 22 when you get it, you’re like ah, but it’s like you need it, you want it because you wanna feel better.

And also I think a lot of women struggle with their period, they’re, you know, their cycles are heavy, they get pain, they have all these PMs symptoms so a lot of them don’t experience the best periods when they get it and if they haven’t had it for a while, you know, that period that’s coming can cause a little bit of anxiety of like what is this period gonna bring for me?

You know what I mean? Yeah. So I can understand that point of view as well. But definitely important to, you know, again, protect the uterus and also make sure that your hormones are balanced because that’s gonna impact your daily like activities of daily living too, you know? Yeah. How much energy you have, what’s your mood like, how irritable are you,

like those types of things too. And and speaking of that, when you have low progesterone or the ratio is off, that can also cause like painful periods. It can cause painful periods. Yeah, because we have if there’s more estrogen there. Okay. Yeah. What about bone health and brain health? Cause I know that progesterone’s really connected to that as well and especially in like developmental ages,

your teens, early twenties and everything. You wanna like maximize the benefits towards your brain and bones because you’re like setting the foundation for your older age in the future. Yeah, progesterone is actually important for bone health as well. And I’m honestly forgetting this one thing here, so I’m just looking it up. No worries. Just gimme one second. Cause we know estrogen is really good for our vascular system and also progesterone helps with our vascular system as well and it actually,

progesterone helps support like bone formation too. So it’s like you’re saying, it’s extremely important for bones and also for the cardiovascular system to prevent long term chronic disease. So important for us to actually be building progesterone as much as we can. And the way that we do that in P C O S is by stimulating those progesterone receptors with bioidentical micronized progesterone. And so when we do that,

then we kind of open up these progesterone receptors and tell our body that hey there we can actually make progesterone ourselves so let’s do it. And that’s how I, I found using progesterone actually works Using like a natural progesterone cream or like a medication? Yeah, so it’s called micronized identical progesterone And it comes in different forms. So we can use a topical cream,

we can use an oral form of progesterone or we use a vaginal suppository. And so there’s different, you know, indications for whichever one we’re using. But technically speaking, you know, topical won’t be as effective as something like oral or vaginal suppository just because, you know, it just has lower levels in the bloodstream and it’s harder to absorb through the skin.

But if we use something like oral micronized progesterone, it actually gets higher in the bloodstream and it can really impact the brain more so than even vaginal suppository. The issue with oral form progesterone is it can cause fatigue and grogginess, but it is helpful for those who have insomnia, especially before their period. So that’s helpful in the oral form. And then the vaginal suppository,

the nice thing about vaginal is it gets so close to the uterus, so very beneficial for things like dysmenorrhea, so painful periods, men heavy periods, and really protecting that uterine environment and You take it temporarily and then that kind of stimulates your body into producing its own progesterone. Yeah, so what it’s basically doing is we cycle it as if we’re having a regular cycle.

So like I said, after the follicle releases the egg, it’s gonna make a corpus sodium and that’s when we’re gonna build progesterone. That stage is after we make the corpus sodium for 14 days, that’s the lal phase and that’s where we make majority of our progesterone. So we do it for 14 nights and we usually start around cycle day 14 to 18 depending on your specific case.

Sometimes we wait a little bit longer because we’re allowing the body to ovulate on its own. And what the progesterone is doing is it’s helping to bring the LH down, so the, the lutin hormone that increases testosterone in the ovaries and as it does that, it allows the body to ovulate. So I often find that when the patient starts the progesterone, maybe let’s say on cycle day 18,

that on cycle day 18, 19, 20, 21, that’s when they usually ovulate and then they keep on the progesterone for 14 nights when they first started it on cycle day 18. And then they stop and then they wait for their period to come. Or if they’re trying to conceive, they take a pregnancy test, they see if they’re pregnant and if they are, they continue or they discontinue if they aren’t.

So the benefit of this is what’s gonna happen is on the next cycle it’s gonna help because we’re inevitably showing the brain, hey, progesterone is here and we’re telling the body bring the testosterone down to allow for estrogen to rise. For us to ovulate. That’s super interesting. Yeah. And is this like a, like would this be considered as synthetic or like a natural progesterone supplementation?

So, good question. So basically this is micronized biodentical progesterone. So micronized means that it’s in a small enough form to be absorbed through the digestive tract if we’re using it in an oral form. And then biodentical means that the chemical structure of this progesterone looks just as similar as the progesterone that we naturally produce. And this progesterone comes from ydm. So ydm has a component in it.

So this is a, a botanical herb, it has a component called dias, and Dias looks just like the chemical structure of our natural progesterone. So it can actually sit on progesterone receptors in the body and that’s what helps to really stimulate those receptors and tell the body to bring the testosterone down. So yeah, it’s not synthetic, it’s actually compounded by like pharmacies compounded,

or actually there is some br names that are progesterone. Like for example here in Canada we have Creon and endometrium and Prometrium and so these are mostly used in fertility clinics from what I’ve seen. But yeah, they, all of it is biodentical, so comes from wild. Yeah. Oh, and they also get testosterone from Wild D if I’m mistaken or is No testosterone.

Testosterone mostly comes from, it’s very interesting for women with testosterone because herbs can act differently with women versus men. Oh, Okay. So yeah, Trius for example, will increase testosterone in men, but in women it will help to raise estrogen and help those fellows to grow together. Yeah. So it’s very interesting and it, and it can get very confusing cuz herbs do so many different things synergistically together when they’re put to other herbs.

Yeah, it’s very complicated and confusing. So if you’re ever ever taking herbal medicine, always ask somebody before you take it because it can get very complicated. Wow. Yeah. So I’m really curious why like when someone’s missing their period, they’re not given progesterone, bioidentical progesterone and instead they’re just put on birth control, which actually doesn’t allow them to even go through the menstrual phases and the ups and downs of estrogen and progesterone and all of this.

So like birth control, just like bypasses all of it. Whereas we could just be taking some progesterone for a few months and then be fine afterwards. Yeah. Someone explain this, I dunno, I dunno. Like I, I only learned about progesterone in the last few years, but I’ve used it in so many cases now and seen so many benefits and a lot of this research comes from Jerry Lynn prior,

she’s a reproductive endocrinologist at bc. She, her website is Samco, so Center for menstrual research and she has really pioneered this information on micronized pone and we need to put the word out there and yeah. Yeah. And that’s, that’s what I’m trying to do. That’s, That’s what this episode’s for. Yeah, Yeah, I know. But it,

it’s true. Like why are we given a, oftentimes patients are given hydroxy progesterone, which is a synthetic form of progesterone to get their period going. Right? And it doesn’t necessarily help the actual issue, it’s more so just allowing that patient to, to bleed, right? It’s just a withdrawal bleed. This is actually changing the environment and supporting what’s the root cause of why this patient isn’t ovulating getting their period.

Yeah, that’s awesome. And also to, to kind of touch on supplementation as well as like, like natural treatment options besides the progesterone replacement, are there like other things that like listeners can do in terms of maybe diet changes or lifestyle changes that help with progesterone? So yeah, there’s so many options actually when we talk about how to increase progesterone in the body,

I have found that supplements can help. But to be very frank and honest with you, when I started using micronized biodentical progressional with patients, that’s what really pushed the needle in a lot of these P C O S women. But we can go over a few things that may help here. One of the ones that’s commonly talked about online is chase berry,

and this actually is a herb as well. It helps to regulate progesterone by regulating the pituitary gland. So very interesting here, but from what I have seen, it really only helps if prolactin is high in a, in a patient with P C O S or even in general to be honest. So it’s very specific in its use I find when it comes to treating progesterone levels,

That’s, That’s chase. Chase barrier? Chase, Yeah. Chase barrier. Oh, chase barrier, okay. Vix. Yeah, VIX is the other thing. Oh, Vix. I see, okay. Yeah, yeah, yeah. And then another big one is magnesium. And magnesium levels just really help to keep progesterone levels intact. It will help after you ovate cuz it’s helping your natural progesterone levels,

right. It’s not gonna help you to ovulate. So that’s where the biodentical micronized progesterone would come in. Yeah. And then also vitamin B6 is another one that helps to raise progesterone naturally and even zinc. So there are a few supplements that can help naturally raise your own progesterone, but if we’re talking about how to actually ovulate it might those things, we need to figure out why the patient isn’t ovulating in the first place.

Yeah. If their testosterone is high because of low progesterone, then using progesterone in it’s micronized BI form could help if it’s, they’re noting because they have, you know, quite a bit of insulin resistance and we’re using, you know, diet and lifestyle through that. Maybe it’s a combination of treating insulin resistance and treating the low levels of progesterone. Yeah,

right. That’s great. Yeah, and I think for anyone who’s like, who’s experiencing the symptoms that we talked about today, if you suspect that you may have low progesterone or, or the ratio is off, I think it’s a good, good idea to definitely get, get your labs checked, check your progesterone levels and see if you know the treatment options like these are good for you.

Yeah. Actually, to that point, which I think one more thing if you don’t mind. Yeah. When we talk about progesterone and when to test it, what’s really interesting is a lot of women when they get to the fertility clinic are told to test their progesterone on cycle day 21. And this is very interesting because when it comes to P C O S,

first of all we’re ovulating very irregularly some of us. And so what happens is we wanna test progesterone seven days after we ovulate. So oftentimes if a patient has, you know, let’s say a 40 day cycle, then they’re gonna be probably ovulating around cycle day 26. And we only make progesterone after we ovulate. So if you’re testing your progesterone on cycle day 21,

then you’re missing that progesterone level. And so what happens is the patient’s progesterone comes in and it looks extremely low because they haven’t ovd yet and they, they’re basically told that they’re not ovulating at all. And that’s very incorrect because if you just gave them, you know, a few more days they would’ve ovulated and then we could have tested at what, what would it be?

It would’ve been cycle day 33, which is when we should be testing them because that’s where the mid point of the second half of the cycle would be. And that’s when we would see that ratio between estrogen and progesterone. And our progesterone should be at a level that would tell us that she ovulated. Yeah. So if it’s, if it’s incorrectly tested,

basically it can show that you have low progesterone. It wouldn’t maybe, in fact, like okay, so is that what That’s exactly what I’m saying. Yeah. So it, I would just say if you’ve been told that you’re not ovulating, but you still get periods and they’re just irregular and I’m talking like a full flow, nice period, it means you’re still ovulating.

It just means that it might not be as regular as someone as that would have like a 28 day cycle. Yeah, Well that’s good to know. And like reassuring to a lot of women who have later cycles. Yeah, Yeah, exactly. Yeah. Amazing. Thank you so much Dr. Samina. And if for, for anyone who, who may wanna work with you or find out about your practice,

where can they, Where can they find you? Yeah, so my website is mha.com. You can also find me on Instagram, doctor dot samhat ND d. And I also have a PS Facebook group. So it’s called Natural PS Facebook Group. Oh, nice. Cool. Yeah. Amazing. We’ll put all that information in the episode description. So for anyone interested,

we highly recommend to check out Dr. Sam’s website and her Instagram and her Facebook group. She is one of our favorite naturopathic doctors in the P C OS world, so we highly recommend her. Thank so much for joining Us. Yes, thank you for being here. Of course. Thanks so much for having me. All right, Bye sisters. We’ll talk to you next week.

Until then, take care. Bye. If you enjoyed listening to this podcast, you have to come check out the sisterhood. It’s my monthly membership site where sisters, just like you are learning how to move through the stages of P C O S from stage one cold and alone at the doctor’s office to stage five, nailing the P C O S lifestyle,

pollutant and dairy free. Get ready to finally feel in control of your body again.


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