All about Progesterone

Jul 20, 2023 | Let's Hear From The Experts

Sophia is a Registered Dietitian Nutritionist (RDN) who specializes in women’s fertility. Her greatest area of expertise is helping women tailor their nutrition to their lifestyle and support healthy progesterone production, strengthen their luteal phase, and increase their chance of a healthy implantation and pregnancy.‌

In this Episode:

  • What low Progesterone can look like
  • Best way to test Progesterone
  • Signs you may be pushing yourself too hard in the gym
  • Biggest mistakes about tracking ovulation
  • How to boost cervical mucus quality‌

Connect with Sophia:

Instagram: @ttc.nutritionist

Course: Ovulation Unlocked: An online course on ovulation and hormones: The effects on fertility — TTC Nutritionist

Proov PdG testing: Confirm PdG Tests Use code “foodfreedomfertility” for 20% off

Podcast Transcript

Lindsey Lusson  00:00

Welcome to the period recovery and fertility podcast. Here we discuss the challenging, rewarding and life changing process of recovering your period and finding freedom with food and exercise. Whether you’re hoping to regain your cycle to get your health back on track where you’re ready to become a mama, this podcast is for you. While the recovery process isn’t always rainbows and butterflies, it’s my hope to bring you both information and inspiration during your own recovery journey. I’m your host, registered dietitian and fellow ha woman Lindsey lesson. All right, everyone. Thank you for tuning in again to the period recovery infertility podcast I have a super fun guest that some of you guys are probably already familiar with. Sophia Sophia is a registered dietician nutritionist who specializes in women’s fertility. Her greatest area of expertise is helping women tailor their nutrition to their lifestyle and support healthy progesterone production, strengthen their luteal phase and increase their chance of being healthy and plant implantation and pregnancy. Sophia studied nutrition at St. Pierre University, a naturopathic medical school and has been helping women to build their families since 2015. With online resources courses and a co host of the food freedom and fertility podcast. She is also a proud military wife and mother of two daughters. Sophia loves food loves to laugh and can rattle off more quotes from the office than you ever want to hear. I love it. One of the things that I thought was funny too, in your online bio that I was like picking up was. You said that you’re also a plant Mom, is that right?

Sophia Pavia  02:08

Yes, I am a plant mom. I love my plants very much. It’s kind of a joke between my husband and I because he is such a Spartan. He has no room in his life for anything superfluous. So anything that’s there just because it’s beautiful. He is like what the hell this is get this out of here. Like we can’t even have a Christmas tree. He is like so anti decorations. But I love plants. And we have no yard at all. So I have house plants. And he’s always like, ah, these damn things because I’m like, No, this one needs this. Don’t don’t move it. It doesn’t like to be moved. It needs indirect filtered sunlight, but only 78 hours a day. And he’s like who the hell cares? So I do I love house plants and outdoor plants. I love plants. Well, I’m

Lindsey Lusson  02:54

impressed because I can’t keep anything alive. And my husband is I guess my I guess he’s my plant daddy. Because all the plants alive and buys all the plants and and that’s the only reason we have plants because I can’t

Sophia Pavia  03:06

We got an opposite situation over here, he would never buy a plant ever.

Lindsey Lusson  03:11

Well, let’s talk about you. And let’s talk about the wonderful news. So I’m curious because one of the things that you announced recently on your Instagram is that you are moving from you are the TTC nutritionist and the TTC digest. But you announced that you’re kind of like niching down a little bit further to focus mainly on progesterone production during pregnancy, which is so needed and I’m really excited about  progesterone production while you’re trying to conceive and into pregnancy.

Sophia Pavia  03:40


Lindsey Lusson  03:40

So like what led to the switch?

Sophia Pavia  03:42

Well, the foundation of it really was low progesterone was a part of my pregnancy journey. It was a part of my trying to conceive journey personally. And with my first pregnancy, I needed to supplement progesterone during my luteal phase and through my first trimester. And the more I have been practicing, the more I’m like, gosh, this is just so necessary. No one is doing this. No one is specializing in this. No one is talking about this. And everyone needs this. Everyone needs this. It does not matter. If you get pregnant at the drop of a hat, your progesterone production needs to be on point. It doesn’t matter if you are using medication to get pregnant doesn’t matter if you need surgery to get pregnant. It doesn’t matter if you have PCOS. If you have hypothalamic amenorrhea. It doesn’t matter. If you have D dimer. It doesn’t matter if you have antiphospholipid syndrome like no matter what your barrier to motherhood. Progesterone is important for you. And it has implications throughout your entire pregnancy. So thinking that you’re just going to skirt by this you don’t need this. It’s all good because I can get pregnant. We’re now seeing data that shows that many of the pregnancy related complications cause pregnancies to end pregnancies to have difficulty pregnancies to end in things like preterm birth, preeclampsia, and cervical insufficiency like all of this kind of stuff, it is influenced by your progesterone production. So that was a big reason why I was like, I want to step into this and, you know, be brave, and learn and do something new. And also, I just found that fertility is just sort of broad, like, even ulinzi, you specialize in women who are recovering their cycles so that they can become pregnant. It’s just so hard, I find that like, people were coming to me that had questions I couldn’t answer, you know, they’re like, Okay, I’m going into my 10th, round of IVF. And my doctor said that I should be using this medication. But I tried that before, but I was combining it with this other medication. But I also think that I need to be having this procedure, and I have these tests. And I’m like, ma’am, this is a Windows. No, I’m like, I I’m a dietitian. I am so sorry that this has been so hard for you. And what you just described to me is exceptional. And I, uh, wow, have you been through it? I wish that you could get the help that you need. And I hope that you find it, but it’s not me. I’m a dietitian, and I am not an expert in these things. And for me to be speaking into all of that is going to be really stepping outside my scope of practice. And it’s just not what I do. So I wanted to do what I do. And progesterone production is greatly impacted by your nutrition and lifestyle. In fact, that is the single biggest factor in progesterone production. It’s not the only factor. But it is the biggest factor in progesterone production. So that is why I made the switch.

Lindsey Lusson  06:49

And I think that like there’s so many like, because I listen to a lot of like fertility podcast and like, fertility podcasts. And I feel like kind of like Western medical way of thinking about progesterone is Oh, progesterone is low. Let’s just supplement progesterone.

Sophia Pavia  07:03

And that can be a piece of the puzzle.

Lindsey Lusson  07:07

Yeah, sure. But like, much more you can do, and like, you know, kind of probably kind of maybe where we’re going with this is like talking about why progesterone is low in the first place. And we can address that. Like what would you like, what would you say like where do you go? So I come to you and I am trying to get pregnant. But I’ve got luteal phase, which means my progesterone is low, correct?

Sophia Pavia  07:32

I mean, that’s not the only reason someone can have a short luteal phase. And progesterone can be part of the reason that this isn’t so recognized by mainstream medicine is your progesterone fluctuates, and it fluctuates quite a bit at times. And so doctors sometimes won’t even want to draw, they won’t even want to check because they’re like your progesterone could be 40 today, and it could be 22 Later today, so I don’t really you know, drawing this and then trying to reach some sort of conclusion about it is not really that science based as far as what doctors think at times because it fluctuates, but there’s information inside of that fluctuation. And yeah, you’re right, doing a one time blood draw. And just looking at this one lab in a vacuum is not going to tell us that much. So if we want to get a more accurate picture, we need to do something other than just a singular blood draw one time, and we also can’t only look at a symptom profile. Now a symptom profile is going to get us most of the way there. Okay, if you are having short luteal phases, if you are having recurrent pregnancy loss, if you are trying to conceive, and you’re just not getting pregnant, but your tubes are open, your partner sperm looks good, you know you’re ovulating. This could be a piece of it. If you are seeing spotting before and after your period like dark brown spotting, spotting leading up to your cycle and then afterwards like you’re not just like having your period and then it’s over. There’s like some lingering spotting. That can be a sign of low progesterone and low progesterone. Like we’re not just talking about it being low all the way through your cycle. That is something that can happen. We can see ovulation occur progesterone rise and sort of like a wimpy way and sort of limp along for a few days and then peter out and your period comes. But we can also see a robust ovulation where you know we get plenty of progesterone to start with, but then things drop off too early. That is also a luteal phase insufficiency. That’s also a luteal phase defect, but it would be harder to diagnose if we’re just doing this like one time draw, because we’ll just see what what your progesterone is 30 Like you’re looking great girlfriend, but three days later, you’re bleeding and you’re like what the hell you know, on my luteal phase was eight days just now and because on day three It was so high. Now here we are on day eight, and I’m bleeding already. That’s not long enough. And it’s also sort of an interesting thing, because it’s not a problem unless it’s a problem, right? Similar to a lot of people that you work with some women can endurance train, some women don’t eat a lot of carbs, and they get pregnant easily have healthy babies. Some women can naturally weigh 110 pounds and have six pack abs and not lose their periods and everything is fine. Some women are at 160 pounds. And they do one day of too hard of training, and they miss their cycle for three months. And it’s like there isn’t sort of a cookie cutter image that we’re looking at just like with Ha, it doesn’t have a size. It doesn’t have you know, there’s the typical female athlete triad. But if that’s all we’re using to diagnose, we’re gonna miss a lot. Right? And progesterone can be similar to that where, you know, have women gotten pregnant with an eight day luteal phase. Yeah, yeah, they have. They’ve gone on and had healthy pregnancies. So an eight day luteal phase in and of itself, maybe not a pathology. But if you’re struggling to become pregnant or stay pregnant, you have an eight day luteal phase. Now that’s now we’re looking at something. Yeah. Have women gotten pregnant, stayed pregnant had healthy pregnancies with a post ovulation progesterone of six? Yes, they have it that’s sort of exceptional, it has happened, it does happen. That doesn’t mean that that’s optimal. And if here you are struggling to get pregnant, struggling to stay pregnant, and your progesterone is six, at that point is where I start saying there’s something wrong here. Your body’s not doing well with this,

Lindsey Lusson  11:48

I think that that’s such an important point to bring up is that, yeah, exactly. Like it’s not a problem at all. It’s a problem. And if you are having trouble getting pregnant, and you’re noticing some of the symptoms that Sophie has already mentioned, like this is something that should kind of clue you in. And so to recap, symptoms of low progesterone, and we talked about spotting before your period. What are the other things that we talked about?

Sophia Pavia  12:11

So low progesterone, we’re not only looking at this, like like I said before, like drawing lab looking at it in a vacuum low progesterone, we’re looking at progesterone to estrogen ratios as well. We’re looking at how progesterone opposes estrogen in your cycle, because when we’re having and we can kind of see this in Ha some some overlap with what you do is sometimes we see women that have estrogen go in nutso in very little progesterone, and that’s where we’re seeing heavy painful cycles. That’s what we’re seeing more frequent cycles. And that’s what I was experiencing before I started trying to conceive for the first time over exercising, not resting enough not eating nearly enough. A constant state of stress. I had infections I had endometriosis infection in my uterus I had a tinea Versicolor and potters form folliculitis infections on my skin. I was just a mess right looked great if you didn’t look too close at my skin that is you know, got my abs rockin was super lean, strongest girl in the gym. But that body on me was diseased that’s a disease state for me and for for most women, being sure you’re strong, you’re fast, you’re lean, and it might look good. But that’s that’s not actually a healthy body. So for me, my progesterone, my ovulation is were so weak, I would have all of this estrogen and instead of losing my period, as happens to a lot of women in the situation, mine was coming more frequently and heavier. Because I was making barely any progesterone after each ovulation so my body would make estrogen and get ready for ovulation. I would you know, squeak out the saddest little egg and then have a 10 day luteal phase, a nine day luteal phase and a day luteal phase until I was bleeding more than half of every cycle. And you know, enough was enough. And I had to make some changes to my body and my lifestyle. But that is something that can also happen where it’s not just that progesterone is low is that estrogen is coming up too high as a part of it as well.

Lindsey Lusson  14:21

So that’s so interesting. I personally haven’t seen that any of my clients. I have a colleague who works with gymnasts. And we were actually talking this week about how she asked me that question is like what would cause someone to have like, closer together heavier periods? And it’s like, I don’t know. And so now to refer her over to Oh, interesting.

Sophia Pavia  14:43

It’s it’s very atypical and I mean, I It doesn’t surprise me that that that you haven’t seen that. First of all, it’s a typical Secondly, the way that you I just think the way watching you online and stuff like I wouldn’t have looked at my symptoms in thought, Oh, this is the lady to help me. Yeah, I would have been like, Oh, I’ve got something different going on. This is worth Sure. Yeah, this isn’t what she’s talking about. But for me, the cause was the same. Interesting.

Lindsey Lusson  15:11

I’m learning a lot. And I already have so many questions for you. So oh, let’s let her rip. Yeah, so low progesterone, like it’s it’s a thing. And really, we need to be aware of it. And we talked about periods being closer together, estrogen certain ratio being off, we talked about spotting, what were your period, any other things that would show up for somebody that might have them blue? And like, why this might be why progesterone might be why I’m struggling to get pregnant.

Sophia Pavia  15:39

So those are sort of like the classic symptoms. Those are like, you know, the core four like those symptoms are, that’s the that’s the hoof beats, right? Like if you hear hoofbeats think horses, not zebras. So some of the things that maybe make you a little more like a zebra like me a little more rare is breast tenderness before your period. PMS. I wouldn’t say PMS is rare. But sometimes PMS is caused by progesterone being too low in that estrogen was too high at that time as well. And so that’s where we’re getting like mood swings, we’re getting cravings we’re getting tearfulness We’re getting anxiety can also be a part of it. Progesterone, think of that as like the chill out hormone. And when you’re not making it, you can have higher anxiety. So if you have anxiety that seems to really heighten right before your cycle, and then once you get your period, you’re like, ah, relief, I’m starting to feel so much better. That can be a sign that your progesterone is not where it needs to be. It can also what else would be a sign that I talked about breast tenderness and night sweats. Night sweats can be a piece of it as well.

Lindsey Lusson  16:49

Whether that be night sweats in your luteal phase Sofia or night sweats at random times?

Sophia Pavia  16:54

That’d be night sweats in your luteal phase. And before your period comes, you’re having night sweats.

Lindsey Lusson  17:00

And we already kind of talked about how like, you know, it can be difficult to test if you just go to like your OB, and you’re like, let’s just progesterone, they’re like your progesterone is 25 You’re doing great. But you’ve got all these symptoms. And so you’re like, something’s off. What is the best way to test progesterone?

Sophia Pavia  17:15

The best way to test progesterone, okay, you’re not going to like this. But we’re going to talk about the gold standard here. This is the best way to test it. I’ll give you some other options that can also work because this is gonna sound like girl, are you crazy. So the best way to test is to do serial blood draws. So that’s where you go in ovulation every other day from ovulation till the start of your period in get your serum progesterone taken at this roughly the same time every day. That is the gold standard, that is the best way to know what’s going on. And so that is what I have people go and do a lot of times. And that’s what that’s what doctors will do that are more like root cause focused, I sigh there because I’m like a lot of reproductive endocrinologist and fertility providers, they could give two shits what your progesterone is because there, it’s like just do IVF doesn’t matter what your progesterone is, we’re just going to do IVF. And you’re going to use progesterone oil injections, we’re just going to shoot your butt cheek full of progesterone oil every day. And it doesn’t matter. So it doesn’t matter what it is. So we’ll just we’ll just bypass the whole system. Yes. But that is really nuts. I mean, if we’re talking about like, we could just do two weeks worth of bloodwork, which is a commitment, right? But it’s pales in comparison to IVF. Let me tell you. So if you could just do some blood draws, and then get appropriate treatment via lifestyle, supplementation, medication, whatever it is that you need appropriate treatment, we see not only natural pregnancy rates skyrocket, but we see the health outcomes of those pregnancies be so much healthier, than if we just tried to bypass the whole system and went right to IVF. Not to mention, you’re gonna save yourself a cool 30 grand, and all the risk associated with the surgery and medications. So it’s a little bit of an older technology. And since IVF was invented, this sort of has fallen by the wayside, because it seems like why would we do that when we could just do IVF? And I’m like, oh, yeah, you’re gonna just do IVF just just in there, like, you’re just gonna go buy a Happy Meal. Like it’s not that’s not how it works, bro. So that’s the gold standard. Okay. I realized that can be challenging, because you would need to be working with a provider that knows how to interpret your numbers. And that can suggest appropriate treatment because what good is the test if there’s no treatment? Right? Yeah, so that’s can be challenging to find somebody who’s willing to put in the man hours and put in the work with you. Because it’s definitely not as lucrative is the more mainstream fertility treatments, though it is far more successful and more in line with your own body’s rhythms. Yeah. So if you’re looking for like a less invasive as far as your time and not having to get your vein poked every other day, prove p r o v, it’s their at home urine test strip that looks for the progesterone metabolite. Now, this is going to depend that the result of these strips, it’s going to depend on your hydration level, it’s going to depend on the way that your body processes progesterone and makes metabolite. So it’s not going to be as accurate as a blood draw. But if you want it to start somewhere in C at home yourself using just your Pap, what’s going on, this is a totally viable option. you’re peeing anyway. All right. So you could definitely get the strip’s test at home. And that is a much less invasive, much less time consuming way to do it. It’s not going to give you like a diagnosis that you can necessarily, like start looking at treatments for. But it’s definitely going to tell you okay, there’s smoke. Let’s look for the fire.

Lindsey Lusson  21:20

Yeah, I love that. And I’ll link i’ll link proof because I’m, I’m a fan, I think, I think, I think it’s great information. And, you know, you gotta have you got to know what’s going on with your body before you can, you know, know, like, what are the next steps and working with a practitioner and making those changes. And so somebody has, let’s say, somebody takes it really seriously. And they’re like, alright, I found my provider, I’m doing my 14 day, you know, serial blood draw, we’re really gonna look at progesterone, or maybe it’s only a 10 day law job because we’re maybe progesterone slow. What are the next steps? Like how can one naturally boost progesterone,

Sophia Pavia  21:57

So we’re going to need to really look at your lifestyle and see what your needs are. I can tell you what the most common reasons I see that someone is having low progesterone, and you can start working on that right away. And you could start working on this sister, even if you haven’t done all these blood drops and stuff. Because generally speaking, by the time you get to that point, you are looking to have more medical intervention, and that’s fine. So starting with nutrition and lifestyle, the biggest killer of progesterone is stress. And we’re not just talking about stress, like oh my gosh, my emails are overflowing. My boss is being an a hole. It’s accumulation of all the stress that your body perceives. So this is something like, Are you somebody that’s chronically running late? And you’re like, blood pressure’s up every time you hit a red light, because you’re like, oh, no, no, no, no, I’m late again, like you are causing yourself stress in that time. So something like these little bitty things because you can’t change your boss, you can’t necessarily change your job. You can’t change your in laws or where you live or like there’s a lot of things that can stress your body and brain out that maybe aren’t as changeable. But like is every time you walk into your messy closet, just stress you out and you hate going in there, SR set aside a day to go through it all get rid of what you don’t need and make that space peaceful. So that there’s one more chunk of stress that’s not weighing you down. So it’s your stress. It’s like your overall body stress. So it’s not just what you perceive emotionally, like that red light thing I was talking about or your boss or your mother in law, but things like illness infection, are there things that you know are going on in your body that you just kind of haven’t taken the time to deal with? Are you getting chronic sinus infections? What’s your oral health like have you needed to get a tooth pulled but it’s expensive and so you’ve been putting it off or you hate going to the dentist and you know your gums aren’t healthy but you need to go if you’ve been putting off going and getting treatment that is a stress on your body and that is limiting your ability to make healthy eggs and healthy progesterone. Okay, so stress from illness from untreated infection and please I know because I am you like I said my overtraining my under eating my poor rest. This was tanking my progesterone, I looked great. I was the strongest girl in the gym. Good for me. Hurray. I was like doing powerlifting meets and Beast and out. And it felt really good to my ego to be doing that. It was not good for my fertility systems. And I needed to take a step back from that. So that’s pretty easy to pinpoint. Like, are you a competitive lifter? are you competing in a sport? And you know you’re the sport will be there later on. If you’re trying to get pregnant, take a step back. Right that’s a stress on your body. I O As I mentioned, I’ve saved myself, I had chronic endometritis infection, I had pittosporum, folliculitis and tinea versicolor on my skin. And although these are not like life threatening issues whatsoever, it’s just something my immune system is having to deal with every day. And it’s a stress on my my body maybe not my brain like I’m not stressed about this like flaky patchy rash on my back, I could care less doesn’t hurt, doesn’t it, who cares. But my my immune system cared in my body trying to survive and keep it homeostasis cared. So little health issues that you might be sort of, you know, need to get addressed. But you haven’t really wanted to make the changes to deal with it. The next piece is eating enough. That is so key. And when I say eating enough, we’re not just talking about total calories, okay? I’m not just talking about total calories, as you know, okay, we’re not talking about like, you wake up, you have your coffee, you maybe have like a toasted English muffin with a singular egg on it. You go to work, work, work, work, work, work, eat like a baby Bell cheese. And you’re like sipping a Lacroix keeping your appetite low. And there’s no time to think about food, a couple bites of this a couple bites of that maybe you drive home and you’re starving. So you’re snacking while you eat dinner, then you eat dinner. And then you’re snacking all the way into the evening. And so you’re eating enough calories. If you’re hearing me say this, you’re like, I’m 40 pounds overweight, you can’t tell me I’m not eating enough calories. Well, Sister, you’re actually starving for like 10 hours out of the day, right? And your body is in a starvation stress state for those 10 hours. And that’s I’m glad that you are getting your calories in in the evening. I mean, at some point, but that eating pattern is not helping anyone.

Lindsey Lusson  26:54

Right. And I think so many women get that wrong. Because to your point, like you know, if you look at just the numbers, maybe they are air quotes eating enough, but you talked about 10 hours a day everybody basically being in a fasted state, that’s almost half your day. Your body basically being starved. And I think that we don’t think about that. When we think about airboats eating enough.

Sophia Pavia  27:17

Yeah, you have maybe like 400-600 calories for the first 10 hours of the day. And then you have like a solid 2000 In the last two hours of the day. And that’s that’s stressful on your body on your woman’s body. Right I also see this Believe it or not intermittent fasting not appropriate for women of fertility time of women so trendy right now. Like it’s so trendy, and it can be so helpful other times in there are certain disease states that can be greatly helped by this. And it sort of defends are we talking about true fasting? Are we talking about timed eating? Are we talking about, you know, what is it that we’re doing, but the fact that you’re gonna, like, not eat breakfast, drink Diet Cokes in black coffee, all morning long. And then you’re just gonna be this like Python hungry monster that slams down food for the last six hours of your day. This is not intermittent fasting. And this is not help helpful for your fertility.

Lindsey Lusson  28:16

Yeah, well, and for progesterone production, you know, it sounds like the take home is, you know, stress is huge stress, like both perceived stress like and I love what you talked about, like cumulative stress, right? Like, because that’s it that’s think about right like the like, stress of traffic or like, you know, mom of three kids every year, like stress. And you know, like, just all of the things and while we can’t change all the things like what aren’t can we? Can we declutter the closet? Can we leave five minutes earlier? So we’re not hitting every single light red, like things like that. But like, those are, those are awesome, like, kind of, yeah,

Sophia Pavia  28:48

Can you can you spend one hour making a lunch plan for the week? So that every day you’re not like, Chuck, what am I gonna eat for lunch? I hate this, I hate this. I hate this. I hate this. I only have 10 minutes, what am I going to do? And your hands are sweating at the thought of trying to feed yourself. Whereas if you would have spent an hour at the beginning of the week, Browning some ground beef, getting some canned salmon, and just having like a couple of lunches that you can grab and eat. What do you know, at lunchtime when you walk into your kitchen? Peace, not stress. Look at that you just cut a chunk of stress off of your shoulders, you just made your progesterone that much healthier, because the substrate that your body makes progesterone from called pregnenolone. It’s also the substrate for your stress hormones. So when you’re in a stress state, your body is making stress hormones because it wants you to survive. It wants you to live reproduction is lower on the totem pole then survival. And so your body is funneling your pregnenolone down the stress pathway. And it’s not until we reduce that stress that we’re going to start funneling more are a bit towards the progesterone. And I know what you’re thinking, can’t I just take a pregnenolone substitute supplement so that there’s enough for everyone, you know, there’s enough for both, it won’t work that way, it’ll only keep going more down the stress pathway. Okay, it’s that think of like a train coming down the tracks, once the tracks are shifted, the train is going to go the other direction, putting more cars on the back of the train isn’t going to make them go down the other way, it’s going to make more cars go down the way that the track is shifted. It’s a very crude illustration, because your body is going to make progesterone, okay? It’s not there, there will be more trains going down both tracks if you have more pregnenolone. But it’s not going to work the way you think it will. And it’s also going to make a lot more stress hormone. So it’s just it’s not a good idea.

Lindsey Lusson  31:03

Talk to us about how exercise fits into this because I think so many times people think like oh exercises, my stress relief. I can’t not go run you know, my five miles at 5am Every single day. Talk to us about how like does, like you talk about stress is a progesterone killer. Do we count exercise in there too?

Sophia Pavia  31:48

So exercise, it is a stress but it’s a stress to relieve stress. So exercise basically the data says exercise, okay. So exercise is better than not exercise. But when we are looking at and you know who you are listener, okay, don’t bullshit me here. You know who you are. If you’re the girl that doesn’t freaking exercise, getting going is going to help your progesterone. But I have a feeling because you are listening to this podcast. That ain’t you. You’re the girl who’s looking in the mirror. You’re the one who’s looking at your mile time. You’re the one who’s looking at how much you can lift how fast you can go. You’re trying to get your name on the leaderboard, I see you I am you. And so that mentality, you need to take a step back. Working out is awesome. But we’re going to need you to incorporate low cortisol workouts. And because that stress hormone made from pregnenolone is cortisol, right? So we need you to be doing lower cortisol workout. So we’re taking longer rests in between sets, we’re not pushing the way in the volume to such a way that it’s causing you to have that CNS reaction that that central nervous system stress reaction, we are doing incline walking, instead of Hill sprints, we’re bringing down the intensity, we’re bringing down the volume, or bringing down the load. And honestly, endurance training. I’m looking at you endurance training not only because I personally hate it and have a problem in my own heart with wanting to run. No, I’m kidding. I’m not kidding about hating it. But if that’s what you love to do, that’s a beautiful thing. But we are going to need you to incorporate some other ways to move. And for a time for this delicate precious time, limiting your miles per week, slowing down your mile time, maybe doing some intervals where you walk around walk, where we are resting longer between runs, instead of going every day we’re going every other day with without keeping the miles the same. So we’re not going to do 10 miles every other day instead of five every day and prioritizing your rest. And so your 5am workout. I mean, if you’re going to bed at 830, fine. But if you’re going to bed at 11 and waking up at five to run, you will be better off sleeping and you are working out.

Lindsey Lusson  34:22

And I think that’s a message that a lot of people need to hear because let’s be honest, who is really going to bed at eight?

Sophia Pavia  34:29

I know some people that do it. I know some people don’t do it. They go to bed at like 830 and good for them. But for those of us that aren’t that disciplined and who just loved how good it feels to lay there scrolling our phones and eating snacks after the kids go to bed. It’s really hard to cut that off at 830. If you’re going to wake up at five to run and we don’t need to like slash everything out of your life. Can we just maybe do only like two 5am workouts this week, right? And maybe like other times do things that are a little less than two And can we just taper it back a little bit in some of the intensity department for this very worthy cause, which is your fertility your the your future of your family, because those miles will be there when you’re 40. Because you can do you can do the Masters competition, all right? When you’re 45, go, go be in the Masters division, weightlifting, go run the Boston when you’re 40, it’s, it’ll be fine. Do this after your family is complete. But for now, during this very delicate time, your body is smart, and it is telling you something. So pushing it harder and saying, No, you need to be running these miles, I don’t care. And we’ll just, you know, take fertility drugs and do all this other stuff to try to get pregnant while I maintain my high stress, high power, high speed lifestyle. You have to pay the man at some point, it’s not going to work out the way that you think it will. Yeah. And you know, it’s not gonna magically be easier to start solving these health problems once you have a newborn either.

Lindsey Lusson  36:02

That is so true. So true. Well, we’ve been talking about progesterone, which happens in the face, look back up a little bit and talk a little bit more about ovulation. Because I know that you talk a lot about ovulation. You have a whole course on ovulation. What are what are the three kind of biggest mistakes you see where people get it wrong in terms of like how they approach ovulation, Miss ovulation really? What are some mistakes?

Sophia Pavia  36:28

The biggest mistake is thinking that your period is the central event of your cycle. That’s the big mistake is that people are like, in fact, when you even say my cycle, I’m on my cycle. What do you think I’m saying when I say that you think I’m saying I’m bleeding. I’m on my period. I’m menstruating right now. versus looking at it as a cycle, which is something that’s continuing and has many phases, menstrual phase being one of them. So shifting your focus from period focus to ovulation focused, that’s a big piece of it. And making sure that you know what your body is up to by checking your fertile signs and understanding your body because sister you are not going to know how long your luteal phase is, unless you’re knowing when you ovulate. Right. A lot of people they have no idea to have a short luteal phase at all. Because people are like, Well, I have my period every 23 days. Doesn’t that mean I have a short luteal phase? And I’m like, not if you’re ovulating on day 10.

Lindsey Lusson  37:29

Right. Right.

Sophia Pavia  37:30

Yeah. Which is, which is some people, right? So I don’t know It’s all relative.  If you’re ovulating on day 15, we’ve got some issues. That is a short luteal phase. That’s not so good. But if you’re ovulating on day 10, you’re fine. That’s fine. So you need to know what your body is doing. You need to understand the signs leading up to ovulation, you need to understand when you’re ovulating. And I mean, who doesn’t understand when their period comes. It’s really hard to miss blood in your underwear. So everybody knows what’s going on with that. Even my friend Megan, who was born without eyes, she knows when she’s on her period.

Lindsey Lusson  38:10

And we knon when we’re missing our period to when we when there’s no blood, there’s no blood.

Sophia Pavia  38:15

Yeah, well, that sometimes sometimes people don’t notice that for quite some time, because they’ve been neglecting their bodies and not paying attention to their cycle for way too long.

Lindsey Lusson  38:25

Yeah, that happens too. Um, okay, so if number one is people just assuming Hey, you know, like my periods coming? Of course, I’m ovulating. That’s that’s probably mistake number one. What are the what would be some other mistakes you see when people get it wrong when it comes to ovulation and in understanding ovulation?

Sophia Pavia  38:43

They’re using ovulation strips, that is a big way to get it wrong, it can be a piece of getting it right. Some people like them, and they like to use them in combination with other ways to know what their body is up to. And that’s fine. But it should not be your only way. Because it’s not going to be accurate for you, you’re going to need to pay attention to your cervical mucus, your cervical position and your basal body temperature. And if you’re going we’ll get a word. Don’t worry sister, I have a whole course where I teach you exactly how to do this. It’s very accessible. So it’s more than I could just teach you in two seconds here on this show. But there’s much more information to be had, you can absolutely do this. And it’s going to help you because the only way that you can get professional help for this is if you tell them what you need help with. If you just go into your doctor’s office and say, I want to get pregnant, they’ll be like sounds good. Stop taking birth control pills and start taking a prenatal vitamin. Come back in a year if you’re not pregnant, and I’ll give you some Clomid. Yeah, bye. Yeah, if you come in and you’re like I’m having spotting in between my cycles. I’m having irregular bleeding and having hot flashes and night sweats and pain. That’s where they’re like, Oh, well, that’s not good. Let’s take a gander. Let’s take a look, see and make sure that there’s not infections like your girl right here, make sure that your hormones aren’t going crazy because of your terrible lifestyle like me. And I didn’t even want to say terrible lifestyle, because everybody would think my lifestyle was so healthy. And I was working hard at being healthy. It’s just that I was overdoing it in some departments. And I actually wasn’t healthy because of the amount of stress and strain my body was under.

Lindsey Lusson  40:33

Yeah. And I think that that’s important to recognize, too, because I think when you’re in the thick of like living that lifestyle, you’re like, This is fine. Like, I’m fine. Like, I can keep doing this indefinitely. And sometimes, sometimes, like a silver lining of the fertility journey can be like, hey, like, it forced me to slow down and realize that maybe I didn’t have the healthiest habits.

Sophia Pavia  40:55

And people get really bent out of shape about this, especially, I’m talking to you collegiate level athletes, because you are often like, well, what the hell, like, you know, I was running, lifting doing this, I was in my sport for decade plus, in everything was fine. My cycle was regular, my weight was great. Like, everything was going good. Why can’t you know, why am I and now that I’m 30, like, it’s not happening anymore. And I’m not even you know, training as hard as I used to. And the analogy I like to use is like, you could use a spoon for a shovel, and it would work for a while. But after digging for a long time, either the spoons gonna break, or you’re gonna have so many blisters in your hands gonna be so painful, you’re not going to be able to keep going. Yeah. And so just because that spoon dug a hole for a while doesn’t mean that that’s not going to come at a cost. Yeah. So you were able to do that for a long time. But because it was an unhealthy habit that was wearing on your body that wear and tear was building up. And now here you are dealing with it.

Lindsey Lusson  41:55

It’s so true. It’s such a good analogy to the spoon in the shovel. So you mentioned we’ll kind of wrap up here in a second. But you mentioned about you know, we’ll link your ovulation course in the show notes because it’s going to be super helpful for people who want to learn all about ovulation. But you mentioned several open ups and paying attention to cervical mucus and about this in your course. But like people who don’t have their cycle at all, okay, like we’re probably not seeing much of any cervical mucus. But as people are working on recovering and getting their cycles back, are there things that we can be doing beyond you know, eating up and resting and keeping our stress in check, are there other things that we can do to boost cervical mucus quality?

Sophia Pavia  42:33

Hydration is number one to birth cervical mood to boost cervical mucus. So staying well hydrated minerals, electrolytes that is going to be very helpful for you. Secondly, things that kind of crush your progesterone NS projection. I know we’re talking about cervical mucus, but I just want to say that caffeine can be a problem. I mean, it depends on how much you’re consuming. So and it really depends on the person like Are you the kind of person that can drink coffee before bed in it like this doesn’t even impact you? Well, you’re probably not really going to if you’re having like, two cups twice a week, okay, that’s probably not the reason okay. But are you drinking it every day? And do you feel a rush from it and a crash later jittery anxiety, now we’re talking, this is not something that’s jiving with your fertility. So you might want to take a step back from caffeine and have it as more of like every now and then beverage than a the way I always start my day beverage. And a supplement that can help a lot of people is vytex. So chaste tree Berry, and now it’s not right for everyone. If you have suspected endometriosis, I would steer very clear. But it is something that can be really helpful. It’s also not safe if you’re using any ovulation assistive medications. So that’s if you’re using letters all Clomiphene you would need to not use the biotechs. And it’s not a magic medicine, it takes a little while for it to start working. But that can be really helpful and acid to cysteine NAC also great for ovarian health, progesterone production, great for that cervical mucus. So NAC can also be really helpful, but a lot of times it just you need time to heal. And I know it can just be like, ah time is the one thing I don’t have. Because my fertile years are limited. I’m not going to continue being this fertile until I’m 50 I need to get on this train. And a lot of us type a women we’re over here being like okay, but I need to be pregnant now because my my sister’s wedding is at the end of the fall. And if I’m in this and I want to fit into my dress, and then I know that I know that the above it is above it, and I’m going to be in my master’s program. And so when I graduate, and we have this all of these plans and things that we’re trying to schedule it down to the Day, it doesn’t work like that. And that way of thinking is why you’re struggling with your progesterone. Okay, I say it because I am you. So taking a break from that way of thinking and saying, okay, my body is smart. It is telling me something, forcing it to be pregnant right now when I can’t even get a healthy ovulation and enough cervical mucus is not going to give me the pregnancy that I’m hoping for, it’s not going to give me the baby I’m dreaming about. So why don’t I take a break, give my body permission to heal, create the environment around it, where it can heal. And let this unfold. And I’ll start using supplements and professional help and maybe even medications as necessary. But this isn’t something that you can just press the gas on and expect your body to snap into line.

Lindsey Lusson  45:46

Yeah, no. And I appreciate that too. Because I think so often people are looking for a quick fix like oh, well I’m not getting any cervical mucus. Like often I get a cervical mucus production

Sophia Pavia  45:54

Maybe not even like a quick fix. But like there’s, I’m thinking of like physique, configure athletes that are like, Okay, well, I know my body can change drastically in six weeks. So you just tell me what to do. And I’m gonna crank that soulja boy and I’m gonna get there in six weeks. And I’m like, I love that drive. But that’s not how this is gonna work. Yeah, let’s saying you can prove your health in six weeks. You absolutely can. But it’s not going to be like you’re going to get on this very specific dialed in plan and your ovaries are just gonna be like, Oh, yes, Master and like, hop right in. That’s not how this is gonna work.

Lindsey Lusson  46:29

Yeah, yeah. And thinking too about like, you know, for people like athletes, like people that have maybe been training at a certain level for years and years and years and years and years. It is like we do have to think about take that into account when we’re thinking about someone’s fertility journey, especially if they’re coming into their fertility journey. What some some barriers of like no cycle or low progesterone or various other fertility issues. It’s just kind of thinking about what has, you know, like, what has your lifestyle looks like? And recognizing that most things are not an overnight fix?

Sophia Pavia  46:59

Yeah, or even a six week fix. Sometimes we’re looking at I would say three months is realistic to start seeing improvement. Give yourself time to heal. And don’t come into my DM saying what do I eat in my luteal phase to make this pregnancy make myself pregnant? This cycle? What What can I eat to improve my luteal phase? I just confirmed ovulation. Okay. Now what do I eat to make this a strong luteal phase? Sr? That is not how it works, right? That’s probably my most like pet peeve question. Yeah, it’s a pharmaceutical culture being like, you know, you’re used to like, oh, I have a sinus infection. I’ll just I’ll take some augmentin for seven days. And then then that’s how that’s gonna work.

Lindsey Lusson  47:44

Yeah. And I think a lot of people are wired, but I think we’re also kind of wired to think that way, right? Like, whenever we Yeah, yeah. Give me Give me Give me the quick fix give me the give me the clip notes and all the things but but this has been super informative. I think we’ve learned so much about Progesterone.

Sophia Pavia  48:00

Happy to be here. Till we go through your your questions, listeners, the email that Lindsay sent me before this, she wrote out some question just so I wouldn’t be going into this blind her computer. I don’t know what it did. But the font was so tiny. It was like unreadable.

Lindsey Lusson  48:17

And I was like OMG. Becasue that’s the way I do it for every podcast. Now I’m like, Oh, my gosh, have I sent everyone a tiny word doc?

Sophia Pavia  48:27

And he’s like, yeah, what is this center for? And it needs to be at least three times as big. Like that was this font. It was like, What is this a font for ants? It is so small, but it gave me a good laugh. My husband, I had a laugh at this. And then I showed it to Lindsey right before this. And she was like, Oh, my God, am I doing this to everyone? Am I sending them the like, most itty bitty font like like point five size font, and they’re over there, like for printing it out and trying to like get a magnifying glass. It was a good laugh.

Lindsey Lusson  48:59

Maybe you’re just the first that brought it to my attention. I’ll have to go back and figure that out. So if you had any last thing that you would want to leave listeners with feeling maybe frustrated in their fertility journey?

Sophia Pavia  49:11

I would want to tell you that the opposite of stress is laughter and fun. So even if you’re having stressful things going on in your life that you maybe can’t change, bring in some more fun stuff. Do something that makes you laugh, be silly. Do something that just gets that dopamine, those endorphins, that stress busting chemical in your brain and body pumping, because we can’t always change everything about our stress levels. And some of us it’s like, you know, or we can change it but the cost is going to be so high that we don’t want to do that just yet. So I would say laugh. Have Lindsey send you a tiny font email, have a good laugh. Find ways to be joyful and silly and playful in your day. It is going to go a long way to help reduce stress and bring up your progesterone production. So what am I saying? I’m saying like, eat and laugh, go be a medieval Lord and eat food and laugh with your friends. It’s going to do a lot for you. Yeah, take a vacation. Yeah. Are you? Well, yeah, that’s maybe one piece of it, where people are like, Oh, go on vacation, you’ll get pregnant. My sister in law got pregnant once they went on vacation. And I’m like, kind of like, wow, she must have been eating a lot and being really peaceful because it probably brought up her progesterone production.

Lindsey Lusson  50:34

Yeah, there you go. Well, hey, thanks so much for your time. And you’re well, we’ll link your course in the notes so that people will be able to go check that out. And it’s you talking all about progesterone with us today. Thanks, Sophia!


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I’m a fertility nutritionist and registered dietitian who specializes in hypothalamic amenorrhea. My passion is helping women trying to conceive find freedom with food and exercise, so they can recover their period, and get pregnant naturally.

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Jan 19, 2022

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