Can Low Progesterone Cause Low Blood Sugar? Hormones, Hunger and Hypoglycemia

Medically reviewed by Mark Strehlow, MD, Medical Director — September 2026

There’s no good evidence that it does. Research in women points the other way: when progesterone is higher, as it is in the second half of the menstrual cycle, the body tends to respond a little less to insulin, which nudges blood sugar up rather than down. True low blood sugar (hypoglycemia) is uncommon in people who don’t take medicine for diabetes. When it does happen, the usual causes are medicines, alcohol, serious illness, a shortage of cortisol, or rarely a tumor, not a shift in estrogen or progesterone. Feeling shaky or irritable when a meal is late is common, and most of the time it isn’t hypoglycemia.

How progesterone affects blood sugar

Progesterone rises after ovulation, in the second half of the menstrual cycle, and falls before your period. In a US study that followed 257 healthy women through their cycles, insulin resistance was higher early in that second half, mainly because insulin levels rose. Higher progesterone and higher estrogen were both linked to it. Women with type 1 diabetes, who see these swings on their glucose readings, tend to run higher blood sugar and respond less to insulin in the second half of the cycle.

Studies in this area are few and don’t all agree. But we found none showing that low progesterone causes low blood sugar.

Can high progesterone cause low blood sugar?

That isn’t a recognized effect. Low blood sugar isn’t listed as a side effect in the FDA prescribing information for oral progesterone or on MedlinePlus. The label lists increased blood sugar among the effects reported after approval.

After menopause, progesterone is usually taken with estrogen. A systematic review of micronized progesterone found that, taken with estrogen, it left fasting blood sugar and insulin unchanged or improved them, an effect the authors credited mostly to the estrogen.

Can HRT cause hypoglycemia?

Low blood sugar isn’t a listed side effect of menopausal hormone therapy. In large trials, estrogen tended to help the body handle insulin a little better:

• In the PEPI trial, estrogen slightly lowered fasting insulin and fasting blood sugar, although blood sugar two hours after a glucose drink was a little higher.
• In the Women’s Health Initiative, 3.5% of women taking estrogen plus a progestin developed diabetes needing treatment, compared with 4.2% on placebo.
• In the HERS trial, new diabetes was 35% less common with hormone therapy.

The Menopause Society notes that hormone therapy reduces new cases of type 2 diabetes but isn’t approved for that purpose. Estrogen labels still warn that it can reduce glucose tolerance and worsen diabetes in some people, so effects vary.

If you have diabetes, hormone changes can move your numbers. The CDC notes that falling estrogen after menopause can cause unpredictable ups and downs in blood sugar, and that the estrogen and progestin in birth control tend to raise it. When you start, stop or change hormone therapy, tell the clinician who manages your diabetes and check your blood sugar more often for a while.

Which hormones actually control blood sugar?

Insulin lowers blood sugar. Glucagon raises it and keeps it from dropping too low. Cortisol, a stress hormone, releases glucose from the liver and prompts the pancreas to make less insulin and more glucagon. These are the hormones that pull blood sugar back up when it falls.

So the hormone deficiency that can cause true hypoglycemia is a shortage of cortisol, not of progesterone. In adrenal insufficiency, the adrenal glands don’t make enough cortisol. Low blood sugar is one of its possible symptoms, along with fatigue, weight loss and craving salty foods. It’s uncommon and needs specific tests to diagnose.

Low progesterone symptoms

Progesterone thickens the lining of the uterus after ovulation and supports early pregnancy. In women who aren’t pregnant, low progesterone can show up as irregular periods, trouble getting pregnant, mood changes, trouble sleeping or hot flashes. Low blood sugar isn’t on the list.

Progesterone declines in the years leading up to menopause, as ovulation becomes less regular, and stays low afterward. A blood test for progesterone is mainly used to check whether you’ve ovulated. If you’re pregnant, questions about progesterone belong with your obstetrician.

Why you get “hangry”

The irritability that comes with hunger is real, and it isn’t a hormone disorder. In an Ohio State University study, 107 married couples measured their blood sugar for 21 days and, each evening, stuck pins in a voodoo doll that stood for their spouse. On evenings when their blood sugar was lower, they used more pins. In a 2022 study, 64 adults recorded their hunger and mood five times a day for three weeks. When they were hungrier, they felt more anger and irritability and less pleasure. That study didn’t measure blood sugar, so hunger itself may be what matters.

Hunger hormones play a part. Ghrelin, made mainly in the stomach, rises when your stomach is empty and falls after you eat. Leptin, released by body fat, helps regulate hunger and fullness and balances food intake with energy use over the long term. In one study, two short nights of sleep lowered leptin, raised ghrelin and increased appetite for sweets, salty snacks and starchy foods. For why sweets in particular call to you, see what causes sugar cravings.

Does progesterone make you hungry? It may. Research suggests estrogen tends to reduce food intake, while progesterone may stimulate appetite. In the second half of the cycle, when progesterone is higher, women tend to eat more and have more cravings, which is one reason appetite changes before a period and during PMS. MedlinePlus doesn’t list increased appetite as a side effect of progesterone medicine, though.

Is it really low blood sugar?

Low blood sugar can make you feel shaky or jittery, sweaty, hungry, tired, dizzy, irritable or anxious, with a fast heartbeat or a headache. These feelings are common, and most of the time they aren’t caused by low blood sugar.

Doctors confirm hypoglycemia with three findings together, called Whipple’s triad:

1. symptoms of low blood sugar
2. a low blood sugar level measured at the time of the symptoms
3. symptoms that go away when blood sugar is brought back up

The Endocrine Society recommends looking for a cause only when all three have been documented. In people who don’t take diabetes medicine, the causes it lists include medicines (alcohol among them), serious illness, cortisol deficiency, some tumors, including rare insulin-making tumors, and low blood sugar after gastric bypass surgery. MedlinePlus adds liver and kidney disease.

When to see a doctor

• Call 911 if someone with possible low blood sugar is too confused to eat or drink, has a seizure or passes out.
• See your doctor if a blood sugar test has shown a low reading, if shaky spells keep happening, or if they started after weight-loss surgery.
• If you have diabetes and take insulin or another medicine that can lower blood sugar, follow your treatment plan. The usual advice is the 15-15 rule: eat or drink 15 to 20 grams of glucose or fast-acting carbohydrate, then recheck your blood sugar after 15 minutes.

Common questions

This article is general education, not medical advice.