How to manage low progesterone and thin endometrium

Nov 15, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

In general, low progesterone levels and thin endometrium may be caused by excessive dieting for weight loss, high levels of mental stress, polycystic ovary syndrome (PCOS), hyperprolactinemia, intrauterine adhesions, or other factors. It is recommended to seek timely medical attention, identify the underlying cause, and then improve the condition through lifestyle adjustments, medication, or other treatments under a doctor's guidance. In daily life, it is important to keep the abdomen warm and avoid raw or cold foods.

In general, low progesterone levels and thin endometrium may be caused by excessive dieting for weight loss, high mental stress, polycystic ovary syndrome (PCOS), hyperprolactinemia, intrauterine adhesions, and other factors. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through lifestyle adjustments, medication, and other methods. Specific analysis is as follows:

1. Excessive dieting for weight loss: Inadequate nutrient intake affects hormone synthesis and endometrial repair, leading to reduced progesterone secretion and thinning of the endometrium. Stop restrictive dieting, ensure adequate intake of protein and healthy fats, eat more lean meat, soy products, and nuts, consume sufficient daily calories, and gradually restore body weight and hormonal balance.

2. High mental stress: Prolonged anxiety can disrupt hypothalamic-pituitary function, suppress progesterone secretion, and impair endometrial growth. Practice 20 minutes of meditation or yoga daily, avoid staying up late, maintain regular sleep patterns, communicate frequently with family and friends, and seek psychological counseling when necessary to relieve stress.

3. Polycystic ovary syndrome (PCOS): Endocrine disorders lead to abnormal ovulation and insufficient progesterone production, resulting in a thin endometrium due to lack of hormonal support. Follow medical advice to use medications such as dydrogesterone tablets, ethinylestradiol cyproterone acetate tablets, and spironolactone tablets to regulate hormones. At the same time, manage body weight and reduce intake of high-sugar and high-fat foods.

4. Hyperprolactinemia: Elevated prolactin levels suppress ovulation and progesterone synthesis, indirectly causing poor endometrial development. Take medications such as bromocriptine mesylate tablets, vitamin B6 tablets, or cabergoline tablets as prescribed to lower prolactin levels. Avoid prolonged breast compression and maintain regular作息 (daily routines).

5. Intrauterine adhesions: Damage to the basal layer of the endometrium from uterine procedures can lead to adhesions, resulting in a thin endometrium and associated progesterone abnormalities. Hysteroscopic adhesiolysis is required, followed by placement of an intrauterine device (IUD) to prevent re-adhesion. Concurrent sequential estrogen-progestogen therapy should be used to promote endometrial repair.

In daily life, keep the abdomen warm and avoid raw or cold foods. Women who are planning pregnancy can take folic acid under medical guidance and regularly monitor progesterone levels and endometrial thickness. Engage in moderate exercise such as brisk walking or jogging to improve blood circulation and support recovery of bodily functions.

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What symptoms can occur with low progesterone levels?

In general, low progesterone levels may lead to symptoms such as menstrual irregularities, mood swings, dysmenorrhea, vaginal bleeding, and infertility. It is recommended to seek timely medical attention and, under the guidance of a qualified physician, use medications such as dydrogesterone tablets, progesterone capsules, or medroxyprogesterone acetate tablets. Additionally, maintaining adequate rest during treatment can aid in recovery.

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What to do if progesterone levels are low in early pregnancy

In general, low progesterone levels during early pregnancy may be caused by differences in examination timing, individual variation, insufficient luteal function, hyperactive adrenal cortical function, abnormal embryonic development, and other factors. Improvement can be achieved through general treatment, medication, and other approaches. During early pregnancy, it is important to get plenty of rest, ensure adequate sleep, and avoid excessive fatigue and strenuous exercise.

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Can the baby still be saved if there is vaginal bleeding in early pregnancy?

If the vaginal bleeding is light in amount, with a pinkish or brownish color, and there is no significant abdominal pain, and examinations show an intact gestational sac, normal fetal heartbeat and embryo development, but slightly low progesterone or human chorionic gonadotropin (hCG) levels, the condition is mostly due to threatened miscarriage caused by luteal phase deficiency. In such cases, with bed rest and progesterone supplementation, hormone levels gradually return to normal, bleeding stops, and the embryo can continue to develop normally, allowing the pregnancy to be successfully maintained in most cases.

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Can I take dydrogesterone tablets if I have uterine fibroids?

If uterine fibroids are less than 5 cm in diameter, grow slowly, and the patient has no obvious symptoms such as heavy menstrual bleeding or abdominal pain, and if the patient also has conditions like menstrual irregularity or low progesterone levels in early pregnancy requiring fetal preservation, oral dydrogesterone tablets may be prescribed for short-term use after physician evaluation. In such cases, the medication primarily serves to regulate hormones and maintain pregnancy, with minimal impact on the fibroids.