How to Increase Progesterone Based on Clinical Research

Ovulation Is the Only Natural Way to Raise Progesterone

Progesterone production occurs primarily in the corpus luteum after ovulation, making regular ovulatory cycles the only natural mechanism to raise luteal levels. The corpus luteum forms directly from the empty follicle following the release of an egg. Without ovulation, this temporary endocrine structure never develops.

In non-pregnant cycles, serum progesterone reaches its peak six to eight days after ovulation. The hormone is secreted in distinct pulses. Circulating concentrations may fluctuate up to eight-fold within ninety minutes.

According to the American Society for Reproductive Medicine committee opinion (2026), a luteal value above 3 ng/mL provides presumptive evidence of recent ovulation. The committee stated that no minimum serum threshold defines normal or fertile luteal function.

As explained by the Cleveland Clinic progesterone overview, circulating levels decline in the years leading to menopause as follicular ovulation ceases. Cleveland Clinic adds that the adrenal glands and placenta also make progesterone. If conception does not occur, the corpus luteum breaks down and blood concentrations fall.

The corpus luteum only exists after ovulation, so no food or pill can stand in for a cycle that never ovulated. The natural route is treating what stopped ovulation. ASRM lists eating disorders, significant weight loss, excessive exercise, stress, PCOS, thyroid dysfunction and hyperprolactinemia among the conditions associated with luteal phase deficiency. The ASRM committee found no evidence that adding progesterone improves fertility in natural cycles. Prescription progesterone is labelled or guideline-recommended for specific uses: fertility-treatment cycles, protecting the uterus during estrogen therapy, absent periods, and early-pregnancy bleeding after a previous miscarriage.

Treating the Conditions That Deplete Progesterone

Conditions that interrupt regular ovulation reduce progesterone by preventing the formation of a functioning corpus luteum. According to MedlinePlus progesterone testing guidance, low levels outside pregnancy correlate with anovulation, amenorrhea, polycystic ovary syndrome, elevated stress, perimenopause, and low cholesterol. Excess cortisol can impair the physiological mechanisms required to synthesize progesterone.

In its 2026 committee opinion, ASRM connected luteal phase deficiency to eating disorders, excessive exercise, significant weight loss, obesity, thyroid dysfunction, and hyperprolactinemia. Women with elevated prolactin exhibited shortened luteal phases with lower plasma progesterone. Hypothyroidism may also result in secondary hyperprolactinemia.

An Endocrine Society clinical guideline published by Gordon and colleagues (J Clin Endocrinol Metab, 2017) defines functional hypothalamic amenorrhea as chronic anovulation linked to stress, weight loss, or excessive physical exertion. The authors stated that effective treatment requires multidisciplinary medical, dietary, and mental health support.

Guidance from the Cleveland Clinic luteal phase defect resource says a provider may recommend lifestyle changes like reducing stress or reaching a healthy weight, and that treating an underlying condition can often correct a luteal phase deficiency. It also cites one study that found people who smoke cigarettes have shorter luteal phases than those who don't. Physical indicators of hormonal disruption are detailed in our review of low progesterone symptoms.

What Studies Found for Foods, Vitamin B6 and Vitamin C

None of the food or vitamin studies cited here tested whether a food or vitamin raises a confirmed low progesterone level. Cleveland Clinic says, "Although research is limited, eating foods that contain certain vitamins may help support healthy progesterone levels," and lists zinc (beef, shellfish, cashews, chickpeas, lentils, eggs), vitamin C (citrus fruits, peppers, strawberries, broccoli), vitamin B (carrots, spinach, walnuts, poultry) and magnesium (green vegetables, nuts, seeds, beans). No source cited here measured progesterone after eating any of these foods.

The BioCycle Study followed 259 regularly menstruating women. In what the authors called an exploratory analysis, Mumford and colleagues (Am J Clin Nutr, 2016) found that one fatty acid, docosapentaenoic acid (DPA), was associated with increased progesterone and a lower risk of anovulation (highest vs lowest third of intake, RR 0.42 for anovulation, 95% CI 0.18 to 0.95). This observational association does not show that fatty acid intake directly increases hormone output.

In the same BioCycle cohort, Kim and colleagues (J Acad Nutr Diet, 2020) evaluated dietary B vitamins across 259 women aged 18 to 44. The authors found no associations between B vitamin intake and the risk of sporadic anovulation. They concluded that riboflavin, vitamin B6 and vitamin B12 "do not appear to influence the ovarian cycle" in premenopausal women.

High-dose vitamin C supplementation was evaluated during a randomized, placebo-controlled trial by Griesinger and colleagues (J Assist Reprod Genet, 2002). Investigators administered 1, 5, or 10 grams daily of ascorbic acid to 620 women undergoing their first IVF cycle. The trial found no differences in implantation or clinical pregnancy rates. The trial did not report progesterone levels.

No study cited here tested bananas or any single food on progesterone concentrations. A large randomized trial showing that a specific dietary compound or vitamin raises luteal serum progesterone would alter this assessment.

Vitex (Chasteberry): One Small Trial and an NCCIH Caution

Vitex agnus-castus has documented evidence for raising progesterone in only one small trial involving women with elevated prolactin. In that randomized trial, Milewicz and colleagues (Arzneimittel-Forschung, 1993) administered 20 mg daily of vitex extract for three months to 52 women with latent hyperprolactinemia. Among the 37 completed cases, prolactin release decreased, shortened luteal phases normalised, and deficits in luteal progesterone synthesis were eliminated.

That finding reflects a single trial in a highly specific diagnostic subgroup. A systematic review by van Die and colleagues (Planta Medica, 2013) evaluated twelve randomized trials of vitex and noted small sample sizes in some studies as a limitation. The authors identified the Milewicz trial as the hyperprolactinemia trial reporting higher mid-luteal progesterone concentrations.

The National Center for Complementary and Integrative Health (NCCIH) says several low-to-moderate-quality studies have looked at chasteberry for PMS symptoms, that "there isn't a lot of strong research" on it for other conditions, and that there isn't enough reliable evidence to know whether it helps with infertility. NCCIH says use during pregnancy or breastfeeding "may be unsafe" and that chasteberry may not be suitable for women with hormone-sensitive conditions such as breast, uterine or ovarian cancer. NCCIH notes that supplements are not approved before they are sold.

Do Over-the-Counter Progesterone Creams Work?

Over-the-counter progesterone creams deliver the hormone into saliva and capillary blood, but circulating serum concentrations remain low and erratic. Small pharmacokinetic studies found that topical absorption does not reliably create systemic blood levels comparable to oral or vaginal pharmaceutical preparations. No study cited here tested a cream for treating a confirmed low level.

• Carey and colleagues (BJOG, 2000) evaluated 19 postmenopausal women using 40 mg daily of progesterone cream for 42 days, finding a small, highly variable increase in serum levels with uncertain clinical benefit.
• O'Leary and colleagues (Clin Endocrinol, 2000) tested a single 64 mg topical dose in 12 women and observed that serum progesterone did not rise during the first three hours, and serum levels did not reach those seen after oral or vaginal progesterone.
• Burry and colleagues (Am J Obstet Gynecol, 1999) administered 30 mg and 60 mg daily to six postmenopausal women on estradiol patches, recording modest mean serum concentrations ranging from 1.6 to 3.3 ng/mL.
• Stanczyk and colleagues (Menopause, 2005) reviewed the topical data and called it "a major concern" that serum levels with creams are too low to have a secretory effect on the endometrium, adding that endometrial effects should be judged by histologic examination of the tissue.
• Du and colleagues (Menopause, 2013) applied 80 mg daily for 14 days in ten postmenopausal women, reporting saliva and capillary blood levels 10-fold and 100-fold higher than serum, warning that serum tests could lead clinicians to underestimate tissue accumulation.

Differences between compounded topicals and regulated options are detailed in our analysis of bioidentical hormones versus HRT. Hormonal interactions are discussed in the comparison of estrogen versus progesterone.

When Doctors Prescribe Progesterone

Physicians prescribe pharmaceutical progesterone for assisted reproduction, secondary amenorrhea, and uterine protection during menopausal hormone replacement.

A Cochrane systematic review by van der Linden and colleagues (2015) analyzed 94 randomized trials comprising 26,198 women undergoing assisted reproduction. Across five of those trials (642 women), progesterone compared with placebo or no treatment was associated with a higher rate of live birth or ongoing pregnancy (OR 1.77, 95% CI 1.09 to 2.86). The authors categorized the underlying evidence quality as very low.

The prescribing label for Crinone 8% vaginal gel (DailyMed) indicates the drug for progesterone supplementation or replacement in infertile women undergoing assisted reproductive technology. Crinone 4% is indicated for secondary amenorrhea. Oral micronized progesterone is also approved for secondary amenorrhea and endometrial protection.

The prescribing label for Prometrium capsules (DailyMed) specifies 200 mg daily at bedtime for 12 days per 28-day cycle alongside conjugated estrogens. In a three-year trial cited on the label, endometrial hyperplasia developed in 6 percent of women taking combination therapy compared to 64 percent taking estrogen alone. Prometrium is contraindicated in peanut allergy due to peanut oil content. The Prometrium label also lists undiagnosed genital bleeding, known or suspected breast cancer, active or past blood clots, stroke or heart attack, and liver disease as contraindications.

Cleveland Clinic notes that clinicians prescribe progesterone to regulate irregular cycles or manage perimenopause symptoms as part of combined hormone therapy. Clinical considerations for menopausal regimens appear in our overview of HRT for menopause.

In the PROMISE trial, Coomarasamy and colleagues (NEJM, 2015) randomized 836 women with unexplained recurrent miscarriage to vaginal micronized progesterone (400 mg twice daily) or placebo. Live birth rates were 65.8% with progesterone and 63.3% with placebo (relative rate 1.04, 95% CI 0.94 to 1.15). The authors reported that progesterone "did not result in a significantly higher rate of live births."

An updated Cochrane review by Haas and colleagues (2025) examining eight trials with 1,276 participants concluded that progestogen probably results in little to no effect on miscarriage risk in unexplained recurrent pregnancy loss (RR 0.91, 95% CI 0.76 to 1.07). ASRM guidance similarly affirms that progestogen supplementation has not been shown to benefit pregnancy outcomes in unexplained recurrent miscarriage.

For early pregnancy bleeding, the PRISM trial by Coomarasamy and colleagues (NEJM, 2019) evaluated 4,153 women receiving 400 mg twice daily of vaginal progesterone or placebo. Live birth rates at 34 weeks or later were 75% with progesterone versus 72% with placebo (relative rate 1.03, 95% CI 1.00 to 1.07, P=0.08). The overall trial found no statistically detectable difference between groups.

However, the National Institute for Health and Care Excellence (NICE guideline NG126) recommends vaginal micronised progesterone 400 mg twice daily for women with an intrauterine pregnancy documented by an ultrasound scan who have vaginal bleeding and a history of previous miscarriage. NICE concluded that evidence supported improved live births in this specific subgroup. NICE says there was no evidence of benefit for any other preparations or doses.

A clinician can order a mid-luteal progesterone test, and the low progesterone page covers when it is drawn and what one result can and cannot show.

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