PMS When You’re Pregnant? Say Hello To Progesterone Intolerance

I hear this nearly every day. Mothers-to-be are speaking up in their support groups hoping it’s not just them:

“Is anyone else losing their shit on their partner every other minute?”

Is it normal? No. But is it common? Oh yes.

Is it “just the pregnancy hormones?” Sort of. But it appears there is a reason it happens to some and not others.


Hormone Hell


Hormones are a vital component in our daily lives. They maintain our youth. They influence what we think, how we feel, and how we behave, as well as carrying out important physiological duties.


Just as the menstrual cycle ebbs and flows with hormones like estrogen and progesterone, pregnancy ebbs and flows, too. We know when we are in the luteal phase of our menstrual cycle we must slow down, take note of our surroundings and what is influencing us, and use that feedback to shape the way we walk through our lives.


Pregnancy is much the same. We must use the signs that our body and mind are giving us — albeit through underlying hormones — to stay in tune with that spiritual side of ourselves that needs us to stay calm for our babies.

What is Progesterone?


Progesterone is an important sex hormone that is critical for pregnancy to sustain. You make boatloads of it when you’re expecting. In the beginning, the corpus luteum makes all of this progesterone for you. By around week 12, the placenta begins to produce all the progesterone the pregnancy will need.


While some women only struggle with synthetic progesterone — such as is found in birth control or progesterone supplements given to women with low progesterone during the first trimester — others are also intolerant to their very own progesterone.


We don’t know for sure what causes PI. What we do know is a lot of women appear to develop it after the use of synthetic progesterone products.

Signs You’re Dealing With PI


Think you’re dealing with progesterone intolerance? Let’s peruse the signs of it we see most often. Do keep in mind having only one or two of these symptoms is not likely indicative of the presence of PI, also known as progesterone hypersensitivity. Rather, most women who have PI have more of these symptoms than not.


Understand that I am not a doctor. Also, understand that progesterone intolerance has no strict medical classification. My opinions are based on my experience over the years working with women on their menstrual cycles, pregnancies, and births.


Free-Photos / Pixabay

1. I Think I’ll Sleep It Off


Are any of us here strangers to the fatigue that knocks us on our rears by week six? I think not. Pregnancy requires much more rest from us because our body is doing so much more than it normally does.


Luckily, that fatigue tends to melt away by the time we exit the first trimester. However, some of us will continue to feel completely depleted and exhausted for the duration of our pregnancy. Often, these women have progesterone to blame. But it’s more than that…

2. Here Come The Waterworks


Antenatal depression is a term many women are not familiar with. While we’ve all heard a great deal about postpartum depression and other post-baby mood disorders, focus on mood disorders during pregnancy is limited. I say “mood disorders” because that is what most would refer to them as. To truly understand the extent to which our hormones impact the body and mind, we must be open to the idea that a mood disorder is not necessarily an impairment of the brain. In simple terms: kick the stigma from your mind.


What does depression look like? Do we have to feel suicidal to be depressed? No. Depression can manifest itself as a loss of interest, as feeling detached from yourself or others, and even as a mild weepiness beyond that which makes the pregnant woman cry during diaper commercials. Depression can also manifest as severely intense mood instability that comes with such low “lows” that the individual sees no clear way out and feels hopeless.


You know yourself best. If pregnancy has taken you from being a productive, happy and engaged human being to being someone who would rather not get out of bed every day because they feel the world has nothing to offer them, mention it to your provider. Whether it is PI or something else doesn’t matter. Get help.

3. Worry, Worry


Anxiety. Suddenly you’re pregnant, and you know you should feel nothing but elation and joy, but all you feel is intense worry. You can’t help it. No amount of deep breathing or your other half telling you it’s going to be okay is getting through.


Anxiety during pregnancy — often referred to as prenatal or antenatal anxiety — can truly cripple the expectant mother. During a time when she should arguably feel her best, she’s hyper-focused on whether the pregnancy will work out, on whether the baby will be okay, and whether her partner is still attracted to her, among other things. While these aren’t unusual concerns at all for pregnant women, the level of anxiety that they can cause with PI sure is.


This kind of worry knows no bounds for the pregnant woman with PI. She can’t escape it and it interferes with daily life. Mental health symptoms should always be reported to a therapist or medical provider. Sometimes, nearly knowing what’s going on with you is enough to soothe the anxiety itch. But some women need more than that, and that’s okay.

4. Do Not Touch Me


Typically, a headline of this nature would convey that this isn’t the time and place for your provider to do a cervical check. Not this time, ladies.


While some of us are going wild with those sex hormones during the nine-month gestation period, others are doing all they can to keep their distance from their partners.


All of that estrogen that was flowing during ovulation, and the excitement of making a baby, seem to flow right out the window when you got pregnant. Instead, you want nothing to do with your partner in the bedroom.


While hormones are certainly responsible for sex drive, having an abundance of progesterone can really dry things up, so to speak. No, this isn’t a matter of lubrication, although some mamas will need a water-based lube to have sex comfortably throughout pregnancy. There are some women who will not have a sex drive at all while they’re pregnant. This can be totally normal for many women. However, if you have no sex drive coupled with a lot of the other symptoms listed here, it may be PI.

5. Pregnancy Brain Gone Insane


What’s that? Do you find yourself forgetting why you walked into a room on the daily? Can you remember what you had for breakfast? While many of us can fall victim to “pregnancy brain,” PI brings with it a whole new realm of neurocognitive issues.


We aren’t just forgetting details; we have trouble thinking clearly. Our brain feels fuzzy, muddled and mixed up. We’ve entered into pregnancy and suddenly developed issues with attention span and focusing on a task at hand.


While rage and a complete repulsion for your partner are no cakewalk, many women with PI swear that their lack of ability to focus is the toughest symptom for them to manage.

6. Feelin’ A Little Woozy


Cue that fluid retention again. The very same fluid being packed on by progesterone that causes potential headaches and blurred vision can also cause dizziness and vertigo.


It is thought this is due to the increase in pressure in the inner ear from the buildup of fluid retention. Do you be sure to always report issues with dizziness to your provider as they can be indicative of far more serious issues than a little intolerance to your hormones.


kalhh / Pixabay

7. Headaches From Hell


So you’re dealing with pregnancy headaches pretty regularly. Maybe you mentioned them to your doctor and they told you to take some meds and essentially suck it up. But what if there’s more to the story? What if you’re the type of woman who doesn’t want to be dismissed with a random solution but rather one who demands a root cause that she can treat?


While some women may just have minor headaches, others will experience debilitating migraines. You might even experience aura — which is little fluttering lights in your peripheral vision.


If it’s actually progesterone causing these issues for you, you’ll likely experience these headaches throughout the duration of all symptoms. I’ve never suffered from PI myself. But among the women I’ve helped over the years, many find the painkillers just don’t do the trick. Some have found relief from headaches by upping their water intake and removing inflammatory foods such as dairy and other heavily processed foods. Magnesium is also a critical component for many mamas.

8. I Can’t See Clearly Now


Well, most pregnant women will be no stranger to swelling by the end of their pregnancy, some see swelling as early as the first pregnancy test.


If you’re in that lucky category, keep an eye out because you might experience other symptoms of PI. Do note: any kind of swelling during pregnancy should be reported to your provider because there are potential risk factors one needs to be aware of with regard to preeclampsia.


The hormone progesterone causes the body to retain fluid. This is the same hormonal mechanism behind fluid retention in the luteal phase of your menstrual cycle that leaves you feeling more fond of your sweats that those skinny jeans when Aunt Flo is due to come into town.


This fluid retention causes pressure on optic nerves and that leads to blurred vision for some women. It is thought that this visual disturbance may also contribute to the headaches associated with progesterone intolerance.

9. Raging Bitch


Does it seem like every last effing thing is on your nerves now? From your neighbors to your in-laws to your partner to your coworkers to even your damn self. Why is everybody so annoying?


The truth may be rooted in your own hormonal cocktail, mama. Women with progesterone intolerance commonly find themselves flying off the “deep end.” They struggle to cope with everyday annoyances, often which weren’t even remotely annoying to them prior to conceiving. It’s a miraculous reminder that we really are a sum of our hormones. These chemical compounds are fueling all of our thoughts and feelings. If you need help refraining from acting on them, there’s no shame in seeking help with that during pregnancy from a coach or therapist. Many women do!


RyanMcGuire / Pixabay


10. I Seriously Hate My Partner


Expanding upon that whole no sex drive issue, let’s examine the role that progesterone plays in making us literally loathe our other half.


So, when a woman comes to me and asks “how can I tell if I have progesterone intolerance?” My answer is simple. It’s a question: how are you feeling about your partner?


Suddenly, the little things he does, things he’s always done, irritate the shit out of you. He can’t do anything right. His breathing is too loud. Has he always dressed like that? Why doesn’t he just leave you alone while simultaneously comforting you and making you feel supported during this pregnancy? Talk about a tall order for Dad.


Oh honey, welcome to progesterone intolerance. This is one of the hallmarks of PI. As soon as I see a woman posting in my groups about the level of irritation she has for her partner going through the roof since she found out she was pregnant, I dig deep with her on this issue. When given the checklist of symptoms laid out here, her response is usually the same: OMG, this is me.

11. This Itch Is A Bitch


Last but not least, know that progesterone intolerance can come with serious itchiness. This is also best to mention to your provider because one would never want PUPPS or Obstetric Cholestatis to go unnoticed. While some women experience bouts of itching and hives, others find that the itching they experience is more relegated to the vagina — specifically, the vulva. Should this occur, women should keep a close eye on the nether regions postpartum to rule out Lichen Sclerosus and Lactational Vaginal Atrophy.


Pexels / Pixabay


How To Kick It To The Curb


Support. Understanding that it won’t last forever. As a past sufferer of PMDD (which has many similar symptoms), I understand how difficult that is to do. Coaching or therapy may be helpful for women or couples who need extra support and reinforcement getting through pregnancy.


If all else fails, know it’ll fade almost immediately after birth. If you’re breastfeeding, high prolactin levels will keep your estrogen and progesterone quite low. As though we needed one more reason to nurse our babies.


Be aware that there may be a correlation between PI and PMDD (premenstrual dysphoric disorder), which can develop postpartum just like PPD, PPA and more. Women with PI may be more likely to develop PMDD, and vice versa.

Be aware women with PI (which can develop anytime even if you had no issue on birth control or with pregnancy in th past) typically experience these same symptoms when using hormonal birth control, which makes it worse for many. Most find birth control intensifies the issue and it doesn’t necessarily go away with discontinued use.


In the meantime, use these symptoms to learn to understand your body better than ever before. If you’re struggling with irritability or even rage toward a partner, strengthen those meditation practices, work on deep breathing that can be used during labor, and talk to your partner. Keep communication flowing. This too shall pass.

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