Can Progesterone Cause Constipation?

October 9, 2025 •

4 min read

Between 11% and 38% of pregnant women experience constipation, a common digestive issue strongly linked to the body's elevated progesterone levels. This powerful hormone, while essential for uterine health, also acts as a smooth muscle relaxant that can significantly slow down the digestive tract and lead to uncomfortable constipation.

Quick Summary

Progesterone's relaxing effect on intestinal muscles reduces gut motility, leading to slower transit time and harder stools. This is common during the luteal phase, pregnancy, and with progesterone medications. Strategies involving diet, lifestyle, and supplements can help manage symptoms.

Key Points

Smooth Muscle Relaxation: Progesterone directly relaxes the smooth muscles of the gastrointestinal (GI) tract, which slows down the movement of food and waste.
Slower Transit Time: This relaxation leads to a longer intestinal transit time, allowing the colon to absorb more water from the stool, making it hard and difficult to pass.
Hormonal Fluctuations: Constipation is commonly triggered by high progesterone levels during the luteal phase of the menstrual cycle and throughout pregnancy.
Medication Side Effect: Prescription progesterone, used for fertility treatments or HRT, frequently lists constipation as a potential side effect.
Effective Management: Simple lifestyle changes, including increased fiber and fluid intake, regular exercise, and probiotics, can effectively manage symptoms.
Medical Consultation: If symptoms are severe or persistent, a healthcare provider can recommend safe and effective treatment options, including mild laxatives.

The Physiological Mechanism Behind Progesterone Constipation

Progesterone's primary function in the reproductive system is to relax the uterine muscles to maintain a pregnancy. However, this effect is not confined to the uterus; it extends to other smooth muscles throughout the body, including those lining the gastrointestinal (GI) tract. Research indicates that progesterone exerts its inhibitory role on gut smooth muscle cells by increasing nitric oxide (NO) synthesis, which induces relaxation. This relaxation significantly slows down the natural, wave-like muscle contractions known as peristalsis, which normally move waste through the intestines.

When intestinal transit time is prolonged, the colon has more time to absorb water from the waste material. This process results in hard, dry stools that are difficult to pass, a defining symptom of constipation. This mechanism explains why digestive discomforts like constipation and bloating are commonly experienced when progesterone levels are elevated.

Hormonal Contexts for Progesterone Constipation

The impact of progesterone on bowel movements is most noticeable during specific periods of hormonal fluctuation or when progesterone is administered medicinally.

The Menstrual Cycle

During the luteal phase—the two weeks following ovulation—progesterone levels naturally rise to prepare the uterine lining for a potential pregnancy. This is a common time for many women to experience symptoms like premenstrual constipation, bloating, and gas. The discomfort typically subsides as progesterone levels fall just before menstruation begins.

Pregnancy

Throughout pregnancy, progesterone levels remain consistently high to support the gestation. This prolonged elevation of the hormone's muscle-relaxing effects makes constipation a very common complaint for expectant mothers. Other contributing factors during pregnancy include pressure from the growing uterus and iron supplementation.

Progesterone Medication

For those undergoing fertility treatments, hormone replacement therapy (HRT), or other medical interventions, progesterone medication is often prescribed. Side effects lists for these treatments frequently include constipation. The dosage and form of the medication (e.g., oral capsules like Prometrium, injections, vaginal suppositories) can influence the severity of digestive side effects.

Strategies to Manage Progesterone-Related Constipation

Lifestyle and Dietary Adjustments

Implementing simple lifestyle and dietary changes can help counteract progesterone's effects on gut motility.

Increase Fiber Intake: Aim for 25-30 grams of fiber per day by incorporating more fruits, vegetables, whole grains, nuts, and legumes. Both soluble and insoluble fiber are beneficial for adding bulk and softness to stool.
Stay Hydrated: Drinking plenty of water is crucial for helping fiber do its job and softening stools. Herbal teas and other non-caffeinated fluids also contribute to hydration.
Get Regular Exercise: Physical activity stimulates the muscles of the digestive tract and promotes regular bowel movements. Even a 20-30 minute daily walk can make a significant difference.
Respond to Urges: Ignoring the urge to have a bowel movement can worsen constipation.

The Role of Probiotics and Supplements

Probiotics: Some individuals find that taking a probiotic supplement or consuming probiotic-rich foods like yogurt, kefir, and kimchi can help regulate digestive function. A balanced gut microbiome is vital for overall digestive health.
Magnesium: Magnesium citrate is a gentle osmotic laxative that can help relieve constipation by drawing water into the colon. It also offers the added benefit of relaxing muscles. Consult a healthcare provider before using new supplements, especially during pregnancy.

Pharmacological Interventions

If lifestyle changes are not enough, certain over-the-counter options may offer relief. It is always important to consult a healthcare provider before starting any new medication.

Bulk-forming laxatives (e.g., psyllium husk)
Stool softeners (e.g., docusate sodium)
Osmotic laxatives (e.g., polyethylene glycol)
Stimulant laxatives should generally be used only as a last resort and under a doctor's guidance.

Comparison of Progesterone's Digestive Effects by Life Stage


Feature	Luteal Phase	Pregnancy	Menopause	Progesterone Medication
Progesterone Levels	Rise and peak before menstruation.	Remain consistently high throughout.	Decline significantly.	Dependent on dose and route of administration.
Impact on Gut Motility	Slows intestinal contractions.	Significantly slows digestion, often leading to chronic constipation.	Can contribute to slow motility, alongside lower estrogen.	Varies, with oral forms potentially having more intense GI side effects.
Typical Digestive Pattern	Constipation and bloating leading up to menstruation, sometimes followed by diarrhea.	Persistent constipation is very common.	Increased frequency of constipation can occur.	Can cause constipation, bloating, and nausea.
Primary Cause	Cyclical hormonal shift.	Sustained high hormone levels and uterine pressure.	Overall decline in hormones and muscle tone.	Direct pharmacological action.

Conclusion

Can progesterone cause constipation? Yes, both naturally elevated levels and progesterone medications can cause constipation by relaxing the smooth muscles of the digestive tract. The mechanism involves the hormone delaying transit time, which results in harder stools. This effect is most notable during the luteal phase of the menstrual cycle and throughout pregnancy but can be experienced whenever progesterone levels are high. Fortunately, in most cases, this is a manageable condition. By adopting simple, effective strategies such as increasing fluid and fiber intake, maintaining regular physical activity, and, if necessary, using over-the-counter remedies, you can find relief. Always consult with a healthcare provider if constipation is severe, persistent, or accompanied by other concerning symptoms to rule out other underlying health issues. For more information, refer to reputable health resources like the Mayo Clinic's drug information on progesterone.

Frequently Asked Questions

Progesterone causes constipation by relaxing the smooth muscles in your digestive tract, a process that slows down the movement of waste through your intestines and results in harder, drier stools.

Yes, taking progesterone pills (like Prometrium) can cause constipation. It is a known side effect listed by medical authorities and occurs because the hormone slows intestinal motility.

Constipation can be a symptom of high progesterone levels, such as those experienced during the luteal phase of the menstrual cycle or early pregnancy. However, other factors can also cause constipation, so it is not a definitive indicator on its own.

To relieve progesterone-induced constipation, increase your intake of fiber and fluids, engage in regular exercise, and consider adding probiotic-rich foods or a magnesium supplement. Consult a doctor before using any laxatives.

Yes, it is very normal to experience constipation during the luteal phase (the week or two before your period) as progesterone levels are at their peak and slowing down your digestion.

Both soluble and insoluble fiber can help with constipation. Soluble fiber (oats, apples, nuts) absorbs water to form a gel, while insoluble fiber (whole grains, vegetables) adds bulk to stool, helping it move more quickly.

Yes, regular physical activity, including light to moderate aerobic exercise like walking, cycling, or swimming, can stimulate the digestive muscles and help promote more regular bowel movements.