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Progesterone Levels in Early Pregnancy: Twins

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Talking about progesterone levels can be intimidating but it is necessary. Especially if you’re concerned with the normal progesterone levels in early pregnancy twins are expected to have. In a nutshell, progesterone is known as “the pregnancy hormone.”

Without it, women will not be able to see a pregnancy through, nor will they be able to get pregnant at all. This is only a tip of the iceberg when we talk about progesterone.

What is progesterone’s role in a pregnancy?

Progesterone is a hormone produced by the ovaries that help the uterus prepare for pregnancy. It thickens the uterus lining to support a pregnancy. It also keeps the uterus free of bacteria by creating a mucous plug.

Progesterone increases the levels of glycogen and arterial blood in the uterus lining so the fetus gets the essential nutrient it needs to develop well. More importantly, it also prevents uterine contractions that may lead to a miscarriage.

What are the Normal Progesterone Levels in Pregnancy?

According to the American Pregnancy Organization, the guideline to progesterone levels during pregnancy are as follows:

  • 1-28 ng/ml during the Mid-Luteal Phase or the latter phase of the menstrual cycle where the corpus luteum begins to form. The average progesterone level is over 10 for un-medicated cycles and over 15 with medication.
  • 9-47 ng/ml during the First Trimester
  • 17-146 ng/ml in the Second Trimester
  • 49-300 ng/ml in the Third Trimester

Note, however, that there are different averages for progesterone levels and the values above are merely guidelines. It is best to talk to your doctor about this.

Are Progesterone Levels Higher with Twins?

Progesterone levels during the early stages of pregnancy are different from the levels in the final stages. When we talk about twins, if a woman is pregnant with multiples, having higher levels of progesterone is to be expected. To understand why this happens, we would need to understand how progesterone specifically works during the various stages of pregnancy.

Within the first two weeks of pregnancy, progesterone levels will be around 1-1.5 ng/ml. This is when the body starts preparing for a pregnancy resulting in progesterone. In the third and fourth week, which is the time after ovulation, the ovaries start producing more progesterone so it rises to 2 ng/ml.

This helps in the process of thickening the uterine lining in preparation for implantation. It is in week three that fertilization occurs so progesterone levels may reach 3 ng/ml everyday or every other day until it reaches the peak at 10-29 ng/ml.


In weeks five and six, progesterone levels are at an average of 10-29 ng/ml. This stage is when progesterone starts stimulating blood vessel growth in the uterus to make the placenta healthy. This is also what causes the “pregnancy glow” among women because the growth of blood vessels happen throughout the body.

Within the seventh to fourteenth week, the placenta now begins producing progesterone until the end of the pregnancy. After the tenth week, progesterone levels increase reaching a peak of 15-60 ng/ml before the third trimester.

Given these normal progesterone level projections for singleton pregnancies, expect that in twin pregnancies, progesterone levels are higher.

What Happens if I Have Low Progesterone Levels?

Having low levels of progesterone may cause some problems getting pregnant or staying pregnant. If, for example, an egg is released from the ovary, progesterone levels should rise to thicken the uterus to receive the fertilized egg. If it isn’t thick enough, the egg won’t get implanted.

The symptoms of progesterone deficiency who are not pregnant are migraines, headaches, depression, mood changes, ovarian cysts, and an irregular menstrual cycle. Low progesterone also causes abnormal bleeding in the uterus when a woman is not pregnant.

For women who are pregnant, the indication of low progesterone levels includes spotting and miscarriage. It can also indicate an ectopic pregnancy.

How is Low Progesterone Managed?

Low progesterone is treated with progesterone supplementation or hormone therapy. Supplementing progesterone can be done by using creams or gels which are used vaginally or topically; suppositories which are used to treat fertility problems; and oral medication.

For hormone therapy, this usually includes either estrogen only or a combination of estrogen and progesterone. Hormone therapy may help with various symptoms like night sweats, vaginal dryness, and hot flashes.

Hormone therapy will not be administered if a person has had breast cancer, endometrial cancer, blood clots, liver disease, or stroke.

how are twins made

How to increase progesterone levels naturally

Some natural remedies for increasing low progesterone levels can also be done. One is to increase the intake of B-complex vitamins (particularly vitamin B6) and magnesium. Be sure to get enough micronutrients, too.

Eat plenty of food rich in B-vitamins and magnesium like avocado, dark chocolate, dark green leafy vegetables, almonds, seeds, nuts, beans, and blackstrap molasses. Consume foods rich in zinc, like grass-fed beef, flax seeds, spinach, pumpkin seeds, oysters or shellfish.

Food rich in B6 includes wild salmon, bananas, organic chicken breast, sweet potatoes, and garlic. Also, consume a healthy amount of good quality saturated fats that produces cholesterol which in turn produces progesterone. Eat a serving of good quality organize protein three times a day. The serving size should be the size of your palm.

Avoid dairy and non-organically grown meat and eggs. Animal products are the highest source of hormones in our diet. A study found that a major source of estrogen in a human diet that came from animals is from milk and dairy products. This accounts for 60-70% of consumed estrogen.

Lastly, it is important to control stress levels. This is because if the body is stressed cortisol is released more, instead of progesterone.

What Causes Low Progesterone?

Although the cause of low progesterone is not fully known, doctors believe that it is caused either by poor nutrition, stress, or the lack of exercise. Sometimes, medications also interfere with the production of progesterone.

What are the normal progesterone levels in early pregnancy? With an understanding of progesterone levels in early pregnancy twins are expected to have as well as other related information, being more aware of our food intake and being more particular with taking care of our well-being is important for a healthy pregnancy.

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