How & When to Use Natural Progesterone Cream: The Complete Guide

Nov 10, 2017

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Progesterone is an essential and critical hormone involved in many important processes in the female body.

Normal progesterone levels are required for fertility, mood, weight maintenance (1), to balance estrogen levels, and much more.

One of the benefits of progesterone is, unlike other hormones, how available it is.

Progesterone USP (bio-identical progesterone) is available for purchase over the counter in the United States.

Does that mean you should start taking it?

Well, not necessarily, but in this article, we will help you determine if it’s helpful for you.

Should you use Progesterone Cream?

Why is progesterone so important?

One of the most important reasons is that Progesterone helps to regulate and balance estradiol (2) in the female body.

Without a balance of both hormones, women may experience symptoms ranging from weight gain to depression and even infertility.

You can think of estradiol (and other estrogens) as growth hormones in the body.

They primarily act to increase the size of specific target tissues.

For example:

High estrogen activity on breast tissue will cause an enlargement (3) of the glandular tissue and increase the size of the breasts (and make your breasts tender which tends to occur around the menstrual cycle).

Estrogen also causes the endometrial tissue to grow (another important part of the menstrual cycle) and unopposed estrogen is a risk factor for the development of both breast and endometrial cancer (4).

In addition, estrogen also increases the growth rate of fat cells in the body.

Under the influence of estrogen, fat cells enlarge in specific areas of the female body – mostly the hips, thighs, and the gluteal (butt) region.

The characteristic physiologic “shape” of women who have high estrogen tends to be the “pear” shape.

So where does progesterone fit in?

Progesterone helps to perfectly balance the effects of estradiol on the tissues.

So while estrogen helps fat cells grow, progesterone helps regulate these fat cells and may help with weight loss.

Progesterone also counteracts the effects of endometrial and breast tissue growth (5).

This may sound interesting – especially if you suffer from some of the symptoms I’ve outlined above, but it doesn’t mean you should just jump into supplementation.

It’s the ratio of estrogen to progesterone that is actually important.

One of the reasons that supplementation with progesterone has become so popular is that many women in recent days have a tendency to have more estrogen relative to progesterone.

The name for this syndrome is known as estrogen dominance and it is meant to imply an improper ratio of estrogen to progesterone in the body.

There are many reasons that women suffer from low progesterone (and high estrogen) including the following:

Exposure to endocrine disruptors that latch onto and trigger estrogen receptors (6) (EDCs are ubiquitous and they are found in plastic food ware, cosmetic products, foods, and in water bottles – you come into contact with these on a daily basis)
Excessive fat or obesity (7) (extra fat cells increase the conversion of androgens to estrogens in a process known as aromatization)
The use of birth control medications and other synthetic hormones
Age (starting at around age 35 progesterone levels tend to fall more rapidly than estrogen levels)
Other hormone disorders such as hypothyroidism which leads to low progesterone
Menopause (8)
Excessive stress (social, physical, or emotional stress)
Cellular progesterone resistance syndromes (9) (commonly seen in conditions such as PCOS and endometriosis)

These conditions are actually quite common which is why many women suffer from low progesterone.

Symptoms of Low Progesterone

What kind of symptoms may be associated with low progesterone?

Luckily low progesterone is easy to identify through symptoms and can be confirmed through basic serum lab testing (discussed below).

Symptoms of low progesterone include:

Inability to fall asleep at night
Water retention and bloating
Roller coaster emotions (especially unexplained irritability, depression, or anxiety)
Changes to your menstrual cycle (missed cycles, heavy bleeding, etc.)
A personal history of conditions such as PCOS, endometriosis, uterine fibroids, or fibrocystic breast disease
Decreased libido (low sex drive)
Breast tenderness (especially during your menstrual cycle)
A known diagnosis of PMS or PMDD
History of multiple miscarriages or issues with infertility

If you are experiencing 3+ of the symptoms listed above then your next step should be to consider assessing your serum levels of both progesterone and estradiol (I recommend doing this before supplementation).

Some of these symptoms are also associated with other hormone imbalances and other medical conditions which is why it’s important to confirm the diagnosis through testing.

How & When to Use Progesterone Cream

If you do decide to use progesterone cream, then there are several things you need to know in order to get the best results!

First and foremost, it’s important to find a cream that contains the active ingredient of progesterone USP.

Progesterone USP is the bio-identical version (10) of progesterone and the exact same hormone that your body produces naturally.

Note: Just because your body produces it naturally doesn’t necessarily mean that it will work for you though!

Next, you need to make sure that you use it correctly.

In general, it’s best to use progesterone cream over oral pills because of the way that your body absorbs the hormone.

Under normal conditions, progesterone is secreted directly into your blood cells and then makes it to your tissues before it is metabolized by the liver.

When you consume progesterone orally you bypass this system and send it directly to the liver first.

This produces high levels of the progesterone metabolite pregnanediol and it’s not known if this metabolite is harmful long term.

Because of this, it’s best to use the transdermal (or application through the skin) first.

While there are advantages to using the transdermal route, there are also potential disadvantages.

Among those is the concept of dermal fatigue.

Dermal fatigue basically refers to a situation in which all of the adipose tissues in a specific application site have become saturated to a point that reduces further absorption.

Basically, this means that if you use the same spot to apply progesterone on your body for an extended period of time it may no longer work.

You can bypass this by simply alternating the spot where you apply progesterone on your body.

Potential application spots include the neck, the forearms of both arms, the lower abdominal area, and the inner thighs.

It’s best to alternate either daily or every other day for the best results.

In my experience, the forearms tend to be the best place for transdermal absorption due to the network of veins that are very close to the surface (and the small amount of fat tissue in the area).

The next step is to make sure you are using it at the right TIME of the month.

When to apply progesterone if you are menstruating:

If you are menstruating (meaning you are NOT menopausal) then the time that you apply progesterone is important.

Whenever possible, and whenever we are using powerful hormones, it’s always best to try and mimic what the body does naturally.

By following this advice we see that progesterone tends to peak in the last 2 weeks or so of the traditional 28-day menstrual cycle.

Because of this, it’s best to use progesterone on days 14-28 of your cycle or during the luteal phase.

It’s not advisable to take progesterone throughout the entirety of your cycle (days 1-28) because you may interfere with the traditional hormone fluctuations associated with the menstrual cycle.

This obviously becomes more difficult if you do not have a standard menstrual cycle or if your cycle is unpredictable.

In these cases, you can try to find a midpoint of your menstrual cycle and then use the progesterone until your cycle starts.

When to apply progesterone if you are postmenopausal:

Women who are menopausal should use progesterone differently than those who are menstruating.

Menopausal women no longer experience the cyclical changes to progesterone and estradiol that menstruating women do.

Instead, their hormones tend to reach a “steady state” with very little fluctuation in hormone levels over time.

For this reason, menopausal women can get away with near-daily dosing of progesterone (usually in lower dosages).

You can do this in 2 separate ways:

#1. Use daily on days 1-28 of the month and take a 3-day break before restarting on the 1st of the next month.
#2. Use 6 days and take a 1-day break every 7 days (so 4 days of “rest” each month).

There is no preference on which method you use, instead, try to find what works best for your schedule and stick to it.

Progesterone Dosage:

The dose of progesterone that you use each day will vary (sometimes significantly) from person to person.

I’ve found the average dose to be somewhere between 20 to 40mg per day.

Having said that some women need much more and some women need much less.

It’s worth spending some time playing around with your dose to figure out what works best for you.

You can use this list of low progesterone symptoms and high progesterone symptoms to help adjust your dose.

If you use 40mg and still experience low progesterone symptoms then you may consider increasing it.

Conversely, if you use 20mg and start to experience symptoms of high progesterone that may mean you need even less!

Just remember:

Finding your dose may take some trial and error.

Where to apply progesterone cream:

We went over the application sites previously, but I wanted to include a list here as well.

If possible you will find the best results by alternating the application site each day that you use progesterone.

You can alternate between the following sites:

Left inner thigh
Right inner thigh
Neck area
Left forearm
Right forearm
Lower abdomen
Vaginal/Labial area

Another important point is to avoid using the same site for different hormones!

For instance:

If you are using testosterone vaginally, then you don’t want to also use progesterone vaginally.

It’s often better to break up your compounded hormones and use individual hormones rather than double or triple hormone “stacks”.

The Best Progesterone Cream

When purchasing progesterone cream over the counter I recommend using a product that is paraben and fragrance-free like this one.

Alternatively, you can also use compounded progesterone cream from your pharmacy if your physician is willing to prescribe it.

In my experience, I haven’t seen a huge difference in pharmaceutically compounded progesterone vs. over-the-counter progesterone cream.

Side Effects of Progesterone Cream

Will using progesterone cream have side effects?

The short answer is maybe, but not if you use it correctly.

The reason I’ve spent so much time discussing the proper way to use progesterone cream is that it matters quite a bit.

Some women may seriously benefit from using progesterone cream but due to one bad experience (from overdosing or wrongful application) may never try it again.

Most of the side effects that women experience from progesterone have to do with using too much for their bodies (which is a fairly easy fix).

Occasionally (but more rarely) women simply don’t tolerate progesterone at all.

Some of the symptoms you may experience when using progesterone cream include:

Weight gain (stop using progesterone if you experience this side effect or dramatically lower your dose) – this weight is usually due to fluid changes and NOT fat mass but it is still concerning to women when it occurs
Fluid retention
Drowsiness
Dizziness
Groggy sensation or fatigue
Increased irritability or feeling “tense”
Not feeling like yourself
Headaches

If you experience negative symptoms associated with progesterone cream use you will most likely experience them rather quickly (within 1-2 weeks).

Also, one potential pitfall of progesterone use is that some women may not tolerate progesterone cream but may still benefit from the use of progesterone pills.

If you are confused about what is causing your symptoms then you should consult with a physician to help guide you through this process.

Will Progesterone Help with Weight Loss?

One reason that many women want to use progesterone cream is that they believe it will help with weight loss.

While some women do experience weight loss while taking progesterone I don’t think you should expect it or use it for this purpose.

I’ve written extensively about how progesterone can help with weight loss in this post.

The short story is that progesterone can be used to augment weight loss if it’s also combined with existing weight-loss strategies and therapies.

But by itself, it’s not a very effective weight loss hormone or medication.

In addition, some women actually experience weight gain (if they don’t use it correctly) while taking progesterone cream.

Progesterone Cream vs. Progesterone (Prometrium) Tablets

Bio-identical progesterone cream is available over the counter from places like Amazon, but this should be differentiated from prescription progesterone tablets.

Bio-identical progesterone tablets are also available under the name Prometrium.

These should NOT be confused with synthetic progestins or progestogens (11) which are synthetic pharmaceutical versions of the progesterone compound.

Prometrium IS a bio-identical oral progesterone medication and the only difference between progesterone cream and Prometrium is that Prometrium is taken orally (as a tablet).

Some women actually tolerate progesterone tablets better than progesterone cream.

The reason likely has to do with absorption issues and the difference in each person’s ability to absorb hormones transdermally.

If you find that progesterone cream just isn’t working for you, despite changing your dose, then it may be worth considering a trial of Prometrium.

In order to get Prometrium you will need to get a prescription from a physician, however, so keep that in mind.

The average dose of Prometrium is around 50 to 100mg per day.

Progesterone Cream vs. Birth Control Medications

Progesterone cream should also be differentiated from birth control formulations.

Birth control formulations usually consist of progesterone-like compounds known as progestins or progestagens.

These compounds are NOT bio-identical which means they are not metabolized exactly the same way that progesterone is in your body.

Pharmaceutical companies can not patent biological hormones and compounds so they generally opt to produce synthetic versions of various hormones.

The idea is that these synthetic versions look similar to the naturally occurring progesterone compound and they, therefore, are metabolized in a similar way.

This isn’t entirely true and is one of the reasons that birth control medications may cause various symptoms that bio-identical progesterone does not.

The metabolism of birth control pills results in compounds that the body is not used to producing and they may have some activity on both progesterone and estrogen receptors in various tissues.

For the sake of this article, it’s important to realize that progesterone cream and birth control medications are completely different compounds and should not be considered the “same”.

Some studies suggest (12) that the use of bio-identical hormones should be the “standard” due to their safety profiles, especially when compared to synthetic hormones.

Supplements to Boost Progesterone

In many cases, women will benefit from the concurrent use of progesterone cream and certain supplements.

While low progesterone is a problem for many, this issue is often accompanied by high estrogen.

The use of progesterone cream can help “balance” out the ratio of progesterone to estrogen in the body, but it may not be the ultimate treatment for the high estrogen.

In cases such as these, you may benefit from the use of supplements designed to help clear out estrogen which can also make more effective your dose of progesterone.

Supplements that help reduce estrogen include:

DIM or Indole 3 Carbinol – DIM is a special compound that helps increase the metabolism of estrogen in the body. This compound is found in brassica vegetables and can help alleviate the symptoms of excess estrogen. Take 100 to 300mg per day for best results.
Calcium D glucarate – Calcium D glucarate also helps directly increase estrogen metabolism by increasing glucuronidation in the liver. It can be combined with DIM. Use up to 3,000mg per day (at least 1,000mg per day).
Maca root – Maca root is a plant-based powder that has long been used for menstrual and sexual-related issues. Many people find great benefits while using maca even though studies show that it doesn’t alter serum levels of sex hormones. Use 1-2 tablespoons per day.
Ashwagandha – Ashwagandha is an adrenal adaptogen that has been shown to help balance estrogen levels by down-regulating estrogen receptors. Use up to 500mg per day.

Final Thoughts

Progesterone cream is a safe and effective hormone that is available over the counter for use in women who suffer from low progesterone.

Progesterone cream can be used to help balance the actions of estrogen in your body and may dramatically reduce the symptoms of excess estrogen.

While many women suffer from excess estrogen and low progesterone not everyone should use progesterone cream.

In addition, the use of progesterone cream may take some trial and error as you figure out how to apply it and what dose to use.

Now I want to hear from you:

Are you using progesterone cream?

Is it working for you?

Why or why not?

Leave your comments below!

Scientific References

#1. https://www.ncbi.nlm.nih.gov/pubmed/7039319

#2. https://www.ncbi.nlm.nih.gov/pubmed/14667967

#3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652894/

#4. https://www.ncbi.nlm.nih.gov/pubmed/17113977

#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038907/

#6. https://www.ncbi.nlm.nih.gov/pubmed/19496976

#7. https://www.ncbi.nlm.nih.gov/pubmed/11511861

#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987489/

#9. https://www.ncbi.nlm.nih.gov/pubmed/28423456

#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116364/

#11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960754/

#12. https://www.ncbi.nlm.nih.gov/pubmed/19179815

Comments

124 responses to “How & When to Use Natural Progesterone Cream: The Complete Guide”

Robin White

November 11, 2017

Thank you SO much for this article! I have been overdosing on progesterone for 10 years. I was taking the pills from 100-200mg for years and also compounded form at 175mg. I knew my serum progesterone was way too high at 39! But it never seemed to matter to the MDs(?!) I stopped taking it altogether to get it all out of my system and assess it again, and found my natural progesterone production is <0.5(!!!) so I will try the 20mg cream to see if that gets me to a more normal level.

Reply
1. Westin Childs
  
  December 12, 2017
  
  Hi Robin,
  
  No problem and glad you found it helpful! I think MD’s want to know more they just don’t have training in hormone management so they must figure it out on their own.
  
  Reply
  1. Jamie Cowan
    
    November 12, 2018
    
    Thank you for writing this article. I also was mis-dosed. I was given compounded cream at 180mg per dose, TWICE per day! Days 1-28! I did this for three months and found my symptoms getting worse. I abruptly stopped taking the cream, as I read that it can take a long time to leave the fat stores. Now, I am having another period at day 14. I’m assuming this is because of the drastic change in hormone levels. How long until I normalize again, and can anything be done to speed the process? Thank you!
    
    Reply
2. Catherine
  
  June 26, 2018
  
  Hey there are you having any better luck? I was taking BNPC about 2 years ago and right off the bat was over dosing and decided it was so great why make dietary and lifestyle changes? So I got hot flashes during the night and had to stop. I started again a few days ago I hear 40-80 a Day is he charm I’m excited to make the other changes too so as not just relying on it. I’m 46 with 3 small children it’ll it’s really turned my hormones into a mess.
  
  Reply
  1. Catherine
    
    June 26, 2018
    
    So much for my above comment. I’ve been awake for almost 48 hours and didn’t even take that much. It’s not worth it to me. Will try to lose 40 lbs and reverse insulin resistance and balance hormones the real natural way. Good luck everyone!
    
    Reply
    1. Anne
      
      November 11, 2019
      
      Hi Catherine. I hope this reaches you. Did you have any luck solving the issues the natural way? I’m struggling to figure this out myself and would love any input you could give.
      Thank you for any help!
      -Anne
      
      Reply
Maria

November 11, 2017

Thank you. This article was a great refresher. I suffered from adrenal fatigue and estrogen dominance back in 2010, but had to determine and solve that on my own. My doctor performed every test imaginable as to why I was experiencing some rather frightening symptoms (panic attacks, severe heart palpitations, fainting spells, migraine headaches, etc.) and, after having been referred to several doctors, having numerous tests and procedures performed (MRIs, echocardiogram, sonograms, etc.), all my primary could tell me in the end was that I was stressed and handed me a prescription for an anti-anxiety med.

After months of pouring over numerous articles, I addressed the estrogen dominance by replacing as many commercial products as I could (soaps, detergents, shampoos, etc.) with natural/organic ones, drinking only filtered water, eating more organically, eliminating stressful and toxic relationships and applying bio-identical progesterone cream on a regular basis. Symptoms improved. Breast cysts reduced and life no longer felt like a perpetual crisis. I was on a ketogenic diet which eliminated my frequent migraines and removed about 12 pounds. I found a healthy relationship, was married two years ago, and I eventually weaned myself off the progesterone cream and did quite well…for a time.

Back then I was in my mid-40s, 5’5″ at 135 lbs. Now that I am 52 years old, my periods show up once every 4-6 months and I am having difficulty losing the 20 lbs I gained over the past two years…much of which is in my waist, hips and buttocks. The weight distribution was a complete surprise to me as I have always been an “apple” shape…more weight in my arms, breasts and back while my hips and legs seemed immune to any kind of weight gain. It’s difficult to determine if the occasional migraine headache is a result of hormonal imbalance. Ketogenic diet and exercise in the form of HIIT and/or weight lifting have proven fruitless this past year, as have other means to try and lose weight. I have also noticed in the past 6-12 months that I am sometimes tearful or angry at any given time and, only on rare occasion, a brief bout of anxiety. There comes a time when one’s brows furrow when finally putting things together…and that’s what set me on the path to learn, once again, if perhaps progesterone supplementation would be of benefit.

So, thank you for the information. I look forward to using it and take hope that there is some re-balancing to be achieved!

Best,
Maria

Reply
1. Westin Childs
  
  December 12, 2017
  
  Hi Maria,
  
  Sounds like you are definitely on the right track. Good luck and glad you found it helpful!
  
  Reply
2. Nicki
  
  January 24, 2018
  
  Hi Maria,
  You sound just like me. I just turned 50. I’ve been eating very healthy, getting lots of natural incidental exercise and doing HIIT workouts to no avail. I have about 20 pounds cursing me too, and it is driving me nuts. I’m trying some progesterone oil. Let’s hope we conquer this beast called perimenopause.
  
  Reply
  1. Maria
    
    January 24, 2018
    
    Hi Nicki,
    It’s been a few months since I wrote my last comment and I am finally seeing some progress, but it took more than simply applying progesterone cream. I do believe the cream is helping with the stress/emotional component of my symptoms, but for the weight loss, it has taken serious restructuring of my diet and exercise regimen. After a nine-month hiatus from working out, I have adopted HIIT three days per week, as well as dropped my caloric intake (I can’t believe I’m counting calories) to 1200-1400 per day. I’ve eliminated all dairy, coffee and sugar, and mostly grains (save an organic sprouted grain tortilla with my breakfast each morning). I still eat a LOT of food in the way of stir fry vegetables, eggs and lean cuts of meat. I’ve lost seven pounds in three weeks – no doubt a lot of water since I’m naturally not eating many carbs, but definitely some fat loss, too. I’ve been adhering to Marc Perry’s Builtlean program…rigorous, but very manageable. You can do this! You just have to find the right combination of what works for you. 🙂
    
    Reply
    1. Jenny
      
      February 22, 2018
      
      Maria,
      How much Progesterone do you take, what brand, and what is your dosing schedule? I am post-menopausal, have adrenal fatigue. I have already eliminated commercial soaps, laundry soaps, shampoos. I am eating Auto-immune paleo (grain, dairy, soy-free, etc). The high protein/fat has definitely helped, but I know I have been estrogen dominant for decades (still have lumpy, and somewhat tender breasts even 7 years after menopause officially started). So I’m wondering if a very small dose of progesterone would help.
      
      Reply
Joanna

November 14, 2017

I have Hashimotos and have been taking Ashwaghanda for a year now. Both my progesteron and estrogen levels are very low, does it make sense to continue with ashwaghanda? I have some issues related to low estrogen.

Reply
1. Westin Childs
  
  December 12, 2017
  
  Hi Joanna,
  
  I generally recommend against taking supplements if they aren’t ‘working’ but each case is slightly different and there may be other reasons to continue taking ashwagandha that you haven’t listed.
  
  Reply
2. Jeannine
  
  December 27, 2019
  
  I also have Hashi’s and am an editor in the medical and pharmaceutical arena. Ashwagandha is contraindicated for autoimmune diseases, and Hashimoto’s is an autoimmune disease. Ashwagandha makes Hashi’s worse. Search on Google for “ashwagandha + Hashimoto” to learn more. An excellent alternative is rhodiola rosea.
  
  Reply
  1. Dr. Westin Childs
    
    December 27, 2019
    
    Hi Jeannine,
    
    Ashwagandha is not contraindicated in autoimmune disease. In fact, there are several studies showing that it is beneficial.
    
    Reply
Bobbi Hedrick

December 19, 2017

Will taking a natural progesterone usp help reduce the horrible amount of sweating that i have daily? I dont do anything to make myself get hot to cause this flooding of sweat but I will slowly go out for iced tea but will still sweat like crazy. Got rid of caffeine, alcohol and hot spices. I am praying this progesterone works. Do you have Anything else that will reduce my over excited sweat glands. Its never at night. Just during the day and as long as I sit with a fan on me I can keep it down some. I truly need better help with this prolblem. Thanks!!

Reply
1. Westin Childs
  
  December 19, 2017
  
  Hi Bobbi,
  
  The progesterone may help depending on the cause of your sweating. If they are secondary to hot flashes from menopause then you may find some relief, if they are from some other cause then the answer is less clear. Typically the combination of progesterone + biest is sufficient to completely resolve hot flashes during menopause transition in most women.
  
  Reply
  1. Pamela
    
    February 12, 2019
    
    Thank you for this much needed forum. I’ve had terrible hot flashes for 11 years. I’m 61. Hrt,a combo of estradiol and prometrium didn’t help. Gave up hrt, and suffered for 5 years. Was recently referred to a nurse practitioner who apparently specializes in hormones. She put me on 1 mg bioest and 100 mg progesterone for 3 months which didn’t help. Did a saliva test which came back estradiol was now in range but estrogen dominant and low progesterone. She put me on 200 mg progesterone oral capsules and 2 mg bioest. I can’t understand why she doubled bio est. After 11 days experienced bad anxiety attack and next day same thing. I stopped the bio est for 2 days no more anxiety attacks. I think the bioest was way too much in my system. I have since been dosing myself with 200 mg progesterone a day and 1 mg Bioest every second day. Terrified of having more anxiety attacks. Thoughts please? Also she said the oral progesterone is better than the cream because it is slow release and breaks the blood/brain barrier but I’ve read the cream is better because the gut can kill the majority of the progesterone. I value your feedback. Thank you
    
    Reply
francine gilbert

January 8, 2018

I am menopausal, how long should I continue to use progesterone cream? My hot flashes have gone away. Thank you

Reply
1. Westin Childs
  
  January 8, 2018
  
  Hi Francine,
  
  It largely depends on the individual but may range from a short period of time to help you get through the symptoms associated with menopause to indefinitely if it helps other aspects such as bone strength.
  
  Reply
Jackie

January 10, 2018

Can I use progesterone cream if I have migraines with aura?

Reply
Mary

February 7, 2018

Does taking progesterone cream over long periods of time reduce your body’s ability to make its own progesterone? I am 46 and perimenopausal and want to take it as it helps my moods and night sweats but don’t want to harm my body in the long term. Any advice?

Reply
1. Theresa
  
  June 19, 2019
  
  I was wondering if you had a complete hysterectomy do you still benefit from taking progesterone? I am taking bio identical estrogen and testosterone. However, my Dr told me there wasn’t a need to replace progesterone if I didn’t have a uterus. However, I have some of the symptoms of low progesterone.
  
  Reply
Lizzie

February 11, 2018

Thanks for this article, Dr. Childs… it has given me just the information I needed. I have been on compounded transdermal progesterone for a very long time. I began traditional oral HRT right after menopause in August of 1998. After some intensive research & also attending an enlightening seminar from the, at that time, one and only Compounding Pharmacy, I was able to convince my (then, but not now) reluctant GP to prescribe transdermal progesterone. I have been taking it 26 days on/4 or 5 off since then… so 19 years. I have felt just fine for all of that time. It has been suggested by a Cardiologist that I come off for the sake of my heart… however, my wonderful Compounding Pharmacist has forwarded recent research to her & this seems to have allayed her fears. I do have a couple of questions: Is menopause simply delayed by taking HRT, or is the process going on ‘behind’ the hormone replacement, so to speak? And, can the progesterone eventually stop working? I ask this because I have been experiencing pretty intense sweating for the past year… several ‘gushers’ a day & often at night. They are much more intense than any I experienced before HRT & I have had really none until this recent onset of them. My Doctor has tested for other causes and we’ve found nothing. Any thoughts on this when you have time??? Thank you & cheers, Lizzie

Reply
Lisa Smith

February 12, 2018

I began with fibrocystic breasts issues in my late 20’s, diagnosed by a obgyn. At 40 yrs, I had a huge mass in the left breast. It was diagnosed as fibrosystic in both breasts. Since then, I took evening primrose oil, 2xs a day. Symotoms improved & the mass softened & went away. I still had some fibrosystic symotoms but not the mass. By age 45, I began taking lugols iodine 2% two times a week, eating more fish & salmon, & using filtered water. My fibroid symptoms improved further. I am now 48 yrs. Two months ago, I found a large cyst in my left breast (the 1st one since I was 40). It’s movable & round, fluctuates in size with my cycle. My right breast is still fairly good. For 1 year, my water filter has been broken & I’m going to replace it with a different kind of filter. I have never been over weight. I am 5’4″ at 110 lbs. My dermatologist a few years ago (who removed a couple of sebaeous hyperplaysia) told me that he felt my hormones were wacked out & that my skin was plumped up with estrogen. The gynocologists don’t do anything except mamograms & I avoid the trap of constant radiation. Hope this gives some helpful background. I am wondering if a natural progesterone cream usp may help in further controling the fibrocystic breast issue, at least the more recent large cyst. If you recommend, how should I begin using it? Is there any other advice you could give me?

Reply
amanda

February 19, 2018

Hi I stopped having my cycles when I was 14 and when I get ready to have children I could’t conceive because I did not have a period so I was not ovulating. I went to the obgyn and talked to my dr and I have takin several different things to start my cycle and I would start and have a normal 7 day cycle but would never ovulate. Then my dr would check my progesterone level and it would almost be zero. So I have been researching and found out about the progesterone cream and I hope that it gets my cyles and ovulation on track just started it today so we will see and I purchased mine from the health food store.

Reply
Laura

February 20, 2018

Hello Dr. Childs,

I’m looking in to using progesterone cream but my levels are 11.9. Is this too high to benefit? I’m 40 and TTC with endometriosis. I also have PMDD and very heavy periods so if it might be helpful I’ll try but if this level seems too high to utilize the cream I will try other options. Thank you!

Reply
Marzena

February 22, 2018

Hi Dr. Childs,
Recently I went to my gynecologist because I suffer from terrible mood swings and anxiety/depression week before my period. The Doctor suggested birth control pills and/or anti-depressants witch I refuse to take. I asked them to check my hormones and they refused because I’m young (31yo)and have regular cycle. They diagnosed me with PMDD. Can I take progesterone cream even though I don’t know my hormone balance? I’m trying everything just to make me feel a little bit better. I also take Vitex and prime rose oil.

Reply
1. Shawna
  
  June 8, 2020
  
  Get your hormones tested on your own. My doctor wouldn’t get mine tested either. It’s at lifeextension, the basic female hormone panel.
  
  Reply
Adeline

February 25, 2018

Hi I am 50 and been using progesterone cream daily for 10 months. Everything was great then suddenly this month I go sore swollen breasts before my period and my period came and went but my very swollen sore breasts are still the same as before my period. I’m suddenly having loads of fluid retention as well. Am I estrogen dominant again or are my progesterone levels too high now? I’m not sure if my swollen breasts and fluid retention are from excess estrogen or progesterone now? How can I have excess estrogen still after 10 months of progesterone?
Regards
Adeline

Reply
Shannon

March 4, 2018

Hi Dr Childs,

I had a miscarriage in January and then a regular cycle since and now am in the second cycle post m/c. I’m trying to conceive so I track my temps and I have noticed this cycle that my post ovulation temps are a lot lower then they normally are (only 36.25 up from 36.0 in follicular phase when they normally sit around 36.6 in my luteal phase). Any thoughts or suggestions? Is this okay to conceive or should I supplement with progesterone cream? I guess I should also mention I am 36 yrs old, and prior to the m/c my cycles were very regular, LP of 12-13 days, and temp charts looked pretty textbook. Thanks!

Reply
Jenn

March 14, 2018

Hi, my Progrsterone is low. I wanted to try a very natural transdermal cream. My partner is concerned he will be exposed to the hormone therapy. Thoughts?

Reply
Muffy

March 24, 2018

Hi, I’ve been taking 200 mg micronized progesterone for two years. It started at 50mg and has gone up each time I do a saliva hormone panel. I have hashimotos disease and have ahead a total tyoriodectomy, have a child with multiple chronic auto immune diseases which contributes to some sleep deprivation and am trying to better regulate hormones. The progesterone addition to my body has changed my life for good but i am still struggling with feeling like it isn’t a high enough dose. However the micronized capsules are expensive. I’ve heard you can take much less with a cream and am considering how do I convert from the 200 mg or possibly 300 mg of micronized progesterone down to the right dose for a cream? Do I need to take additional supplements (and at what dose) to increase effectiveness? I’m still lacking in focus and concentration and am hoping that upping my dose or switching over to a cream will be helpful. Any advice is appreciated!

Reply
Amanda H

March 24, 2018

Hello!
Thank you for your article!

I have been using 20mg progesterone USP twice daily. I started it on the 12th day of my cycle. I had stopped bleeding 2 days prior. I started bleeding again and have been having extreme up and down emotions. Is it ok to just stop taking it? I started using it 6 days ago. I was just diagnosed with simple endometrial hyperplasia and the doctor is trying to scare me into taking Provera or using Mirena. She didn’t want to test my progesterone and estrogen levels. She prescribed me instead 200mg of Prometrium but I am feeling nervous about the side effects.I have made major changes to my diet…no sugar…no gluten…no dairy. Exercising regularly to lose weight. Thank you for your time!

Reply
Sherry Weers

April 9, 2018

Hi, for my whole life I had signs of low progesterone starting at a very young age having a life-threatening miscarriage. Having spotting during my other pregnancies. I had two successful births but very bad times with depression and periods after. I took progesterone for years until the researchers decided that synthetic progesterone could cause blood clots. They would not prescribe anymore because I was diagnosed with Lupus anticoagulant factor. I’m told by a health advisor that only the synthetic progesterone was used in those studies. I would still like to take the progesterone but can’t get it where I live I don’t think. You mention buying it over the counter in the USA, where may I ask is that where I can purchase progesterone?
Thank you

Reply
Sherry

April 9, 2018

HI Dr Child’s,
I am wondering where I can purchase progesterone over the counter as you suggest in your article.
I have taken both cream and pills in the past but studies done in recent years show that progesterone can cause blood clots. I cannot take compounded progesterone now because of this study. I have been to,d that the study was done in synthetic progesterone not natural. I would still like to take the progesterone because it made me feel well and I certainly don’t feel well now.
Please let me know if indeed this can be purchased over the counter somewhere in USA
Thank you

Reply
1. Westin Childs
  
  April 10, 2018
  
  Hi Sherry,
  
  The link to purchase the cream should be in the article itself (big orange button).
  
  Reply
Ta Connery

April 11, 2018

Hello! Glad to come across this article! I’m 53 and menopause seems to be nowhere in my near future. I have endometriosis and part of it has gone into my bladder. I also have fibroids. I’ve had severe bleeding and pain for years until I was put on a number of meds which included agestyn (norethindrone). It all worked to stop all my issues. Now, for the past 6 months, the agestyn is working alone. I take 10mgs a day. I want to replace this with a bioidentical hormone and my dr suggested the progesterone cream. My question is…if she can make sure that the dosage equals the exact strength of the agestyn, do u think I’ll have a smooth, painless and blood-free transition? They say “if it ain’t broke don’t fix it”, but I’m really concerned about using synthetic hormones much longer. I’ve been using them for 2 years. I still get breakthrough bleeding occasionally (heavy) which my dr. says is an indicator that menopause has not crept up yet. Oh, I forgot to mention the progesterone comes in a clicker dispenser and my dr will give it to me at her office without a prescription. Thanks for your response.

Sincerely,

Ta

Reply
Faith

April 12, 2018

Hello,
I am 38 and had a hysterectomy a year and a half ago. About two months ago, I started having terrible hot flashes, low libido, and other unwanted symptoms. After doing blood work, my gyn said my estrogen was low, my body had hit menopause and wanted to put me on estrogen therapy. I do not wish to take this due to the risks. Can I use progesterone cream or is this only for high estrogen levels? Thanks

Reply
1. Westin Childs
  
  April 12, 2018
  
  Hi Faith,
  
  Progesterone can be used in cases of low progesterone (which tends to accompany menopause), but it’s not likely to completely turn around your symptoms, especially if your symptoms are caused by low estrogen.
  
  Reply
Belinda

April 19, 2018

Hello, I am 34 and I have very progesterone and very high cortisol. Can I benefit from taking progesterone cream? I’m just a bit afraid because my anxiety is through the roof!

Reply
Trinette

April 22, 2018

Thank you for this article. It was understandable and detailed. My instincts tell me this is the right information for me. I’ve read a lot of different things about hormone replacement. Thanks again.

Reply
1. Westin Childs
  
  April 24, 2018
  
  Hi Trinette,
  
  Glad you found it helpful! Keep us updated on your progress 🙂
  
  Reply
Cindy Cyrus

April 22, 2018

Hello! Thank you for your article!

I am 50 and I have taken the Birth Control Pill (2 mg Estradiol plus 2 mg DIENOGEST) through for over 10 years without a break. I like to add the positive effects of progesterone cream. Do you have experience if I can just add a low amount of progesterone cream to my pill?

I cannot switch to HRT yet as I like to further suppress my bleeding. But I would like to benefit from the positive effects of progesterone as this is suppressed anyway.

What is your opinion?

Reply
1. Westin Childs
  
  April 24, 2018
  
  Hi Cindy,
  
  Progesterone should never be used in conjunction with the birth control pill. Make sure you discuss your options with your current hormone doctor to prevent any negative and unwanted side effects.
  
  Reply
Alice

April 23, 2018

Almost 2 years ago I started using progesterone cream (twice a day on my wrists) and a sugar-free diet. The result was dramatic! In about 6-8 weeks I lost 12 pounds and about 12 inches all over-but mostly in my torso. About 6 months ago I noticed that my waist was thickening again and I gained 3 pounds. Now I’ve gained another2 pounds and I’m getting a roll around my middle. After researching, it seems I have Dermal Fatigue. So I have started rotating the placement of the cream daily-left side of the neck, right side, left elbow, right, inside left thigh, right, behind left knee and right. I’m back to being very strict with my eating. I also exercise 4-6 days a week. Some weights but mostly cardio dance classes-Zumba and others.
Any suggestions would be appreciated. Guess I should also mention that I am 65 and was 39 when I started menopause.

Reply
Kimberly

April 24, 2018

Hi! I just purchased progesterone cream from the NOW co. It pumps out exactly 20mg per pump. I am 47 yo and in perimenopausal phase. I’ve only applied it twice so far so still waiting to see if it helps w my night sweats, decreased libido and sore breasts during my period. Wish me luck!!!

Reply
Lucy Williams

May 16, 2018

Hi

I’m trying to find out how long does the progesterone cream keep your levels up after you stop using it. I’m due to have day 3 and 21 blood tests done but I may only have 3 days without the cream before the day 3 tests.

Should I wait until I’ve had another complete cycle without the cream before I have the tests or is 3 days of no cream enough?

Reply
Mary

May 23, 2018

Hello,
I had a TAH/BSO 11 months ago. I’m 39 years old. I’m now in Surgical Menopause. Initially, my surgery was for an ovarian cyst. I ended up having 2 very large ovarian cysts, a Uterine fibroid, and stage 4 Endometriosis. My question is, although my Dr. did prescribe HRT -Bio-Identical Oral Estradiol and
Oral Methyltestosterone Testosterone, he did not give an RX for Progesterone. I was told that since I have no Uterus I no longer need Progesterone. Then I have read contradictory information regarding this, stating that progesterone can even be beneficial to women with no Uterus or ovaries. I would love to know what your thoughts on this are.

Reply
Chris

June 10, 2018

Hi Dr. Childs,

I would like to know if maca powder 1-2 tablespoons can be used along with the 20-40mg of progesterone creme? I have used maca 1tablespoon for years and it helped me but after I turned 51 I have been having trouble losing weight. I stopped using the maca powder because I did not know if it would be too much. I started using the progesterone creme and lost 2 pounds but now I get hot flashes which I never got using maca powder. Just wanted to know if If adding in the maca powder would help? Also, does your program help with Hashimotos? Thank you for your very helpful articles!

Reply
1. Westin Childs
  
  June 11, 2018
  
  Hi Chris,
  
  Maca is generally well tolerated and should be safe to use with progesterone. My program is designed to improve overall health but some aspects may help reduce inflammation and treat Hashimoto’s as well.
  
  Reply
Lenore DeFranco

June 11, 2018

Hi Dr Child’s
I am a 67 yr young female had TAH at 55 due to breast ca in 2003.
My doctor started me on progesterone because of weight gain, insomnia, irritability and hot flashes. Some of these symptoms have gone away only I have had an increase in hot flashes. So I am wondering if this is from the progesterone do I need to increase it, decrease it or stop it all together? Should I try something different.
I live in Florida so these hot flashes are very annoying!
I look forward to any suggestions you may have.
Thank you.

Reply
1. Westin Childs
  
  June 26, 2018
  
  Hi Lenore,
  
  Hot flashes are typically a sign of insufficient estrogen (not progesterone), but you wouldn’t want to use hormone unless you know that your breast cancer was ER/PR negative.
  
  Reply
Laura Alice

June 12, 2018

Dr. Childs,
I was wondering if you have any ideas on what I should try?!? Here is my original post:
Almost 2 years ago I started using progesterone cream (twice a day on my wrists) and a sugar-free diet. The result was dramatic! In about 6-8 weeks I lost 12 pounds and about 12 inches all over-but mostly in my torso. About 6 months ago I noticed that my waist was thickening again and I gained 3 pounds. Now I’ve gained another2 pounds and I’m getting a roll around my middle. After researching, it seems I have Dermal Fatigue. So I have started rotating the placement of the cream daily-left side of the neck, right side, left elbow, right, inside left thigh, right, behind left knee and right. I’m back to being very strict with my eating. I also exercise 4-6 days a week. Some weights but mostly cardio dance classes-Zumba and others.
Any suggestions would be appreciated. Guess I should also mention that I am 65 and was 39 when I started menopause.
Thank you

Reply
1. Westin Childs
  
  June 12, 2018
  
  Hi Laura,
  
  It might also be worth exploring other hormone imbalances such as insulin resistance, leptin resistance or thyroid disease which all may be contributing.
  
  Reply
  1. Laura Alice
    
    June 13, 2018
    
    Thanks for your reply. I’ll check it out.
    
    Reply
Mina

June 25, 2018

I had a miscarriage 4 months ago due to low progesterone levels. I’ve started using progesterone cream for the past 2 months after ovulation and stopping the day before my period starts. For some reason I don’t think it’s helping me get pregnant. I found on another forum that if you don’t have issues producing progesterone after LP then you should not use progesterone until after you have a positive pregnancy test. Is that correct?

Reply
Carolyn

June 25, 2018

Dr. Childs, I use estriol cream, vaginally, .25 gram, 2 times weekly. Uterus removed. Should I use progesterone every day, or just the 2 days I use estriol? I use for hot flashes and anxiety and mood. Thank you.

Reply
1. Westin Childs
  
  June 25, 2018
  
  Hi Carolyn,
  
  You don’t have to take progesterone just because you are using estriol but you may still need it if your progesterone is low or you have the symptoms of low progesterone.
  
  Reply
Carolyn

June 26, 2018

Dr. Childs, thank you for answering so quickly! I still need to know: if I take estriol 2 days a week, do I take pergesterone JUST those 2 days or more days? I have been tested by applied kinesiology , and was told I was estrogen dominant. Thanks again!

Reply
Sylvi

July 7, 2018

[email protected]
Thank you for a great explanation of how progesterone cream works. My Gyn. placed me on Estradoil cream for dryness, but I’ve had spotting- which she says not to worry about. I have asked about balancing the estrogen with progesterone, but she says I’m on such a low dose, it’s not necessary. I’d like to ask if I can use both, to protect from possibilities of thickening lining & to balance my hormones and dryness? I’m supposedly post menopausal, but I’ve had spotting to a full heavy 7 day period, in the last year. So we m not sure if I’ve ovulated, as I’ve read some women can still ovulate after being declared post menopausal. I’m 53, and have conidered IVF, will using progesterone & estradiol effect my future chances of possibly caring a child to term? Any comments/advice & dosing advice is much appreciated.

Reply
1. Westin Childs
  
  July 7, 2018
  
  Hi Sylvi,
  
  Spotting while taking estrogen is a sign that you are potentially taking too much estrogen. You absolutely want to avoid those type of symptoms when using hormones, especially if you are using unopposed estrogen (no progesterone to balance it).
  
  Reply
Jean

July 10, 2018

How long can a postmenopausal woman stay on progesterone cream? I have been using it for approx 15 years; I stopped using it because I thought I read that it is not good to use it long term. I really miss it. Is it ok to continue using?
Thank you!

Reply
1. Westin Childs
  
  July 10, 2018
  
  Hi Jean,
  
  The general idea is that you can stay on it indefinitely as long as you don’t experience any issues that would warrant stopping it.
  
  Reply
Sabrina

July 16, 2018

I have low progesterone and estrogen I wanted to start creams for progesterone but I’m on Seasonique birth control which my period comes every 3 months. How do I use progesterone cream with this birth control?

Reply
1. Westin Childs
  
  July 16, 2018
  
  Hi Sabrina,
  
  You should not use both birth control and progesterone at the same time as that may cause many issues.
  
  Reply
Chris

July 16, 2018

Hi Dr. Westin,

A couple of months ago I began having severe joint pain. I had not had my cycle for two months. I am 52. I had been using progesterone cream for at least a week. All of a sudden my cycle came back. Is this normal? I thought my cycle had actually stopped. I had went to the doctor for the joint pain. She thought I might have lymes disease or lupus. I also felt cold. My temperature was actually 97. She said this was normal. Is this? I feel like it is not. Seeing it is blistering hot like almost 98 degrees outside. My test came back and my thyroid levels were 1.310. No lymes disease and no lupus. I think I have some sort of thyroid problem. If I do; I really do not know what to do about it if the doctor says everything is normal. I eat healthy but still can not lose weight either. Please help with this.

Reply
1. susan
  
  January 3, 2023
  
  Dear Chris, Did you ever get an answer for your problems? I have similar issues. Susan.
  
  Reply
Tina

July 16, 2018

Can you apply progesterone cream randomly just when you have period pain or not?

Reply
1. Westin Childs
  
  July 17, 2018
  
  Hi Tina,
  
  I would probably advise against that approach.
  
  Reply
Sheree

July 16, 2018

Great information, thank you, Dr. Childs! I just got my first container of progesterone cream (am a two years post-menopausal) and I am wondering if it is best to apply it daily for three weeks so it can build up in the system or is it okay right off the bat to apply it for five days and then take two days off, etc. Thank you in advance~~

Reply
1. Westin Childs
  
  July 17, 2018
  
  Hi Sheree,
  
  I usually determine that based on the individual. I wouldn’t say there is a “best” way because everyone is different.
  
  Reply
AnMre

July 20, 2018

I am in my mid twenties and have not had a period for six months. I am wondering if it could be partly because of using topical progesterone cream daily (every day of the month). Should I give my body four to five days off each month to try to mimic a normal cycle? I don’t know what day menstruation should start since my cycle is irregular, but maybe I could choose a week and not use the progesterone that week? Thanks for any tips.

Reply
1. Westin Childs
  
  July 20, 2018
  
  Hi AnMre,
  
  Yes, it could potentially be because you are using it daily and not allowing your body to cycle normally. I would recommend that you seek out professional guidance because the last thing you want to do is suppress your normal hormone cycling due to long-term exogenous hormone use.
  
  Reply
Andrea

July 22, 2018

Dr. Child’s, Can progesterone cream cause hair loss? I started with 20-40 mg then up to 100 mg. Hair is been falling out a lot! Then when I stopped for my cycle it’s falling out even more. I’m afraid to start back up.
Have you heard of this before?

Thanks!

Reply
1. Westin Childs
  
  July 23, 2018
  
  Hi Andrea,
  
  Yes, taking progesterone can potentially cause hair loss.
  
  Reply
Chelsea Bloom

August 6, 2018

Dr. Child’s,

I am 30 years old and have pcos. I am on Metformin, 4g daily inositol, and prenatal vitamin. I always have a period around 32 days apart, sometimes they are anovulatory though. Blood work from past two months shows high estrogen and low progesterone. So, I started progesterone cream this cycle on day 14. I bled that night and everyday since, it is now day 17. Is this unusual? Should I stop the cream or does this level out usually? My husband and I are trying to conceive.

Reply
1. Westin Childs
  
  August 6, 2018
  
  Hi Chelsea,
  
  I would say that is not normal. Ideally, you would want to check what your serum progesterone is before supplementing.
  
  Reply
Kerrie

August 9, 2018

Hello,

Thank you for this article, it was very helpful. I just purchased a bottle of natural progesterone cream. I have researched this topic on my own for that last few years as it seems my doctor thinks I’m too young to complete any hormone testing and the signs are leaning toward low progesterone. I recently ordered my own progesterone blood test through Lab Corp-6 days post-ovulation my progesterone level was 5.6ng/ml. This seems to be on the lower side given this should be the peak time for levels to be at their highest. Since I am waiting on my order, I am wondering if I can start the cream 10 days post ovulation when it arrives? And if I should stop on the first day of menses? Thank you!

Reply
1. Westin Childs
  
  August 27, 2018
  
  Hi Kerrie,
  
  I would consider looking at both your estradiol and progesterone prior to starting the progesterone cream. It may be that you don’t need it or that you can focus on lowering your estradiol levels first.
  
  Reply
Mandy

August 26, 2018

So, I take the progesterone cream and recently got some DIM. If I am taking the PC on days 14-28 when should I take DIM — every day and morning or night?
Thanks

Reply
1. Westin Childs
  
  August 27, 2018
  
  Hi Mandy,
  
  Usually, every day is fine for DIM.
  
  Reply
Yvonne

September 16, 2018

Hi,
How do you measure out 20/ 40mg?

Reply
1. Westin Childs
  
  September 17, 2018
  
  Hi Yvonne,
  
  Dosing is based on the concentration of the cream that you are using. Usually, something like 1 tsp of cream is equal to 20mg of progesterone but this can change based on how it is formulated.
  
  Reply
Jackie

September 21, 2018

I’m 43 years old and have been diagnosed with perimenopause. My periods have been very irregular lasting 28+ days with just a week or two break in between. I started applying natural progesterone cream twice a day to help regulate my cycle and help with the emotional side of all that was happening. I applied the cream twice a day for several months before realizing I was suppose to take a break every 21 days or so. During that time, 5-6 months, I did not have a period. A week ago I restarted the cream after the 5 day break, and today I got a period (first one in 6 months). My question is, donI stop the cream againand restart it in day 14? Or do I continue applying it through the period until the 21 days are past and take the break on days 22-26? I’ve been reading all kinds of articles and I’m still confused.

Reply
Maria

September 25, 2018

I’m 52yrs old. I was hit hard about 5 years ago with depression, anxiety, memory loss. I had some blood work done and found out I was low in estrogen and testosterone. I wanted to do a bio identical so I opted for the SottoPelle therapy. It has been a life saver for me. I also had a hysterectomy within the five years due to uterine fibroids. I wish I would have researched this a little more and not had the surgery. I do have one good ovary left too. Recently I was prescribed promethium, 100 mg by my doctor to help me sleep and some other issues. It made me feel bloated all the time and I hated it. I found out that it was made with soy and peanut, and soy was making me feel this way. The weird thing is that I also experience melasma on my face and when I started taking the prometrium, my skin started clearing up. It was the weirdest thing and my doctor couldn’t explain it either. I’m now on a compounded progesterone cream made with yam. I take one gram of cream from a small vial and rub it into my inner thigh. I’ve been on it for 7 days and I feel nothing, as in I don’t think it’s doing anything. I don’t like the idea of the cream and having to worry about the cream getting on other areas of my skin. I would like to know exactly the best time to apply the cream, morning or evening. And what other areas can I apply the cream besides always rubbing into my inner thigh.
I really liked the pill and the convenience of just popping into my mouth at night, and could feel the effects more than the cream.
I heard that the oral Progesterone is not as safe as the cream. What are your thoughts.
Thank you!!

Reply
Patty

September 29, 2018

Great article! Very informative. I do have a question though. I recently learned that I have estrogen dominance (high estradiol low progesterone) I know that I would benefit from a progesterone cream and supplementation with DIM. I just bought them. The problem is I’m not sure when to start using them. I got a uterine ablation over 15 years ago due to heavy bleeding and severe anemia and I do not know when my cycle begins/ends. How should I proceed to maximize the benefits of supplementation?

Reply
Kristie A. Blank

October 5, 2018

Hi Dr. Childs:
Thank you so very much for your invaluable website.
As a 62 year old post menopausal woman with history of Adrenal
Fatigue, Estrogen Dominance and Hypothyroid issues (Hashimoto’s) these waters of hormone balance have been very tough to navigate. I have been struggling with extreme fatigue, insomnia, muscle pain/wasting and severe bloating, severe water retention, unexplained weight gain and fat gain, all of which seem to be my hormones crying out for help.I have lost my motivation and joy of life and am trying to get my life back. I have been taking DIM daily and also tried progesterone cream 20-40 mg daily, which hasn’t made a significant difference. I was wondering if I have not been taking enough progesterone. My estradiol level was <5, total estrogens 56 and progesterone level was 0.29. I was not sure how to interpret my results and any wisdom you could offer would be so very much appreciated. Many thanks!

Reply
Kim

October 15, 2018

Hi! I took a month of clomid and letrozole and landed up with a 5.1 ovarian cyst, high estrogen levels, and low progesterone levels. My doctor wants me to start a birth control pills to ” stop my brain from talking to my ovaries” to hopefully decrease the estrogen and shrink the cyst so I can regulate my cycle (my cycle had always been regular prior to this). After reading your blog, I am wondering if using the cream and something to help eliminate estrogen in my body would be beneficial instead of the OCP?
Thanks,

Reply
1. Westin Childs
  
  December 29, 2018
  
  Hi Kim,
  
  I personally believe that there are better ways to reduce estrogen, so yes I would say that there are better options available. OCP does reduce estradiol levels in the body but it only does that because it pumps your body full of synthetic estrogens instead.
  
  Reply
Amy

October 30, 2018

Hello Dr. Childs,
I am 40 years old and have been using a biogenetical progesterone cream for the last few years. It really helps lower the amount of headaches that I was getting and pms symptoms. I was using an over the counter 20mg lotion and then I didn’t feel it was working that well after a year so I went to a new GYN and she recommended 100mg. That was working ok, but I told her I still felt “off” so she put me on 150mg about 6 months ago. I don’t know if I am getting too much or if I need more, but I am now starting to experience PMDD (self diagnosed) about 3 days prior to my cycle and then about 3 days into it. It was so bad this last time I thought I would have to go to the psych ward at the hospital. I felt so depressed. Where are you located? Are you accepting new patients? Or where can I find someone who specializes in this sort of thing. I am happy my GYN can prescribe the bioidentical progesterone, but she really doesn’t seem to know how I should be taking it. She tells me to just put it on every night before bed. She said it makes it easier to track if I just do it every day, but now I see your caution about doing so above. Also, I always put it on my arms…maybe it’s not working there anymore? I don’t know. I feel so confused. If you have any advice I welcome it. Thank you. Ps. I have 5 children, I could stand to loose 5-10 lbs, I have a diagnosed anxiety disorder anyway and have had depression issues in the past, but I know this stuff is made worse around the start of my cycle. I also have very heavy periods and they range from every 23-30 days with the occasional skip or very early one and bleeding lasts a week. Thanks for any help you can offer.

Reply
Sunny

October 30, 2018

Hi there,

Can you quickly explain the ‘cycle’ – what day are we counting from? My period is long and mostly light, so can be 10-12 days total. (Yes I have had it checked with my doctor and all ok.) So it’s easier for me to think of stages of my period not the ‘cycle’.

I take progesterone cream occasionally at the start or end of my period but I’m not sure if that timing is correct.

Thank you.
Sunny

Reply
1. Westin Childs
  
  October 30, 2018
  
  Hi Sunny,
  
  The 28-day cycle is the standard run of the mill cycle that we use to talk about menstrual cycles. If you aren’t sure when you ovulate then you’ll need to use an ovulation kit to help you determine (this is helpful for people with longer or shorter cycles than the 28 days outline here). Once you figure out your ovulation date then you can determine when is the appropriate time to use progesterone. Some women don’t ovulate every month and have what is called anovulatory cycles which can make the picture a little bit confusing. This may or may not be contributing in your situation.
  
  Reply
Nancy

November 26, 2018

Good Evening Dr. Childs:

I was diagnosed with estrogen dominance and low progesterone. My functional doctor prescribed me custom dosed bio identical 7 keto DHEA progesterone cream, 1/2 ml. After reading your post, I obviously was applying incorrectly for a year. Although you indicate most tend to gain weight with progesterone, does the addition of 7 keto DHEA act as a weight loss or metabolism accelerator, in other words, could it be acting also as a weight loss drug/supplement? Wondering if it could contribute to pulmonary hypertension?

Also note: my thyroid levels are ‘normal’/ ‘optimal’ except for TPO’s. Along with the progesterone, I’ve been supplementing with 12.5 mg iodine every other day (was deficient). First time sent my thyroid levels to hyper thyroid TSH at .18 and then diagnosed with pulmonary hypertension and moderately enlarged right ventricles. The hyperthyroid Could be from the iodine. The PH could be from hyperthyroid + the 7 keto DHEA ?

Out of fear, I have cut the iodine to 2 times a week and quit the progesterone as my cardiologist suggested PH can be caused by weight loss supplements. She was skeptical of the progesterone cream, estrodim ( ortho molecular brand), phosphatylserine (integrative) and ashwagandha I take. I am getting thyroid labs, iodine labs done this week.

I am still not sure of the bio identical 7 keto DHEA progesterone cream and its side effects.

Thank you for any insight.

Nancy

Reply
Megan

December 19, 2018

When is the best time to dose progesterone cream? Morning? Mid-afternoon? Thanks!

Reply
Missy

March 13, 2019

Bioidentical progesterone cream got me through some very bad perimenopausal symptoms and I used it for a few years. Now I am 62 and this last 9 months, have had almost disabling anxiety, night sweats, unexplained purpura and more. Would it hurt to try the progesterone cream once again? It all seemed to start up when I was given a steroid injection for bronchitis last spring and it seemed to throw off my whole system. Other than prescribing benzos, my doctor has been at a loss on this.

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1. Westin Childs
  
  March 19, 2019
  
  Hi Missy,
  
  It sounds like you need to be evaluated by an HRT physician and to undergo a complete exam + lab/hormone testing before you make any treatment decisions.
  
  Reply
Sarah

March 25, 2019

What about progesterone for increased breast size? Has anyone seen a difference? I’ve been self-conscious for years about the size of my breasts, particularly the left one which is significantly smaller and kind of looks underdeveloped. Wondering if HRT will help even them out or help grow fuller breasts.

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1. Westin Childs
  
  March 25, 2019
  
  Hi Sarah,
  
  I’ve never seen progesterone fix that particular issue.
  
  Reply
2. Lisa
  
  May 27, 2023
  
  Hi Sarah, I am 1.5 cycles into using Progesterone cream, and i have increased in breast size significantly. I used to be one flat palm of breast volume, and now I am a curved palm and 2 finger joints in volume (when i use my hand for measure). I am not sure about evening out breast sizes.
  
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Laura

May 21, 2019

Will this help lengthen a short luteal phase? I’ve been having a 6 day luteal phase. I’m waiting for a referral to a specialist but my GP won’t prescribe progesterone.

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Mary

June 15, 2019

How long do you recommend using it for in regards to balancing hormones/regulating cycle? And can you stop using it “cold Turkey”?

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1. Dr. Westin Childs
  
  June 17, 2019
  
  Hi Mary,
  
  Each person is different. I wouldn’t say there is a standard in terms of how long you should be taking it. Further, you never really don’t want to stop any hormone cold turkey as that would be less than ideal, though it’s technically possible to do so.
  
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Lisa

June 27, 2019

Dr. Childs, I love this website! Lots of thorough information!

I have a question about starting hormones. I am 45, have had extreme anxiety since late 30’s and pmdd, insomnia, extreme irritability, very heavy and painful periods. First doc prescribed low dose BCP, which erased anxiety and insomnia, and lightened my periods. Unfortunately I developed serious depression in just a few months.

New doc did more lab work, estrogen and FSH levels are normal, but thyroid and testosterone are low. Also I have an enlarged uterus due to adenomysis. Got the testosterone pellet. I was prescribed natural progesterone pills (100mg) for mood and sleep and low dose armour thyroid. Started last night. I feel like I’ve taken Valium! It was nice to sleep more than five hours, and I don’t feel tired really, but kind of spacey. At least I don’t feel confrontational today!

Could it take a week or two for my body to adjust to these meds? Also, could the progesterone help with adenomyosis?

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1. Dr. Westin Childs
  
  July 2, 2019
  
  Hi Lisa,
  
  Yes, it can take several weeks to take root. And yes, progesterone may help with adenomyosis but it’s not a guarantee.
  
  Reply
Anna

July 10, 2019

Could Progesterone Cream (USP) help alleviate my joint and muscle soreness?

I have been experiencing extremely sore/tight joints and muscles after being still, and in bed in the middle of the night. This extreme version started about 4 months ago but was sort of there for a few years before that. This is including my hands and as a piano player this is distressing. I had an x-ray and there is no arthritis. I had basic blood work, that came back normal. When I move I still have full range of motion again after warming up. (I looked up other joint/muscle diseases and my symptoms don’t seem to fit anything in particular)

I am 56 and had regular periods until about 8 months ago. Missing some since then, and now the last period was three months ago. I was diagnosed with low progesterone about three years ago but did not treat it. I have recently started having a few hot flashes a day as well.

I just started applying progesterone cream. 40 grams twice a day. (this is the highest recommended dosage on the jar) Is this worth continuing in an attempt to alleviate my joint/muscle issues or is this not normally related?

Thank you!

Reply
1. Dr. Westin Childs
  
  July 10, 2019
  
  Hi Anna,
  
  The short answer is yes, it *potentially can alleviate muscle pain, but there are so many other causes of muscle pain that upping your progesterone dose without addressing these issues is probably not advisable. If you overdose on progesterone you will have a whole new set of symptoms to deal with: https://restartmed.stagemarketingdemo.com/high-progesterone-symptoms/
  
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Leigh

September 29, 2019

I’m confused about what seems to be conflicting advice/info. If you suffer from hot flashes and night sweats, experts say that progesterone cream will help. But then I see where you say that hot flashes call for estrogen, not progesterone. So can progesterone cream help? Estrogen cream does nothing. I’m Postmenopausal, age 68, and still bothered with the night sweats and hot flashes.

Thanks!

Leigh

Reply
1. Dr. Westin Childs
  
  September 30, 2019
  
  Hi Leigh,
  
  I would say the problem is in the binary thinking associated with estrogen and progesterone. Progesterone has a small chance to reduce hot flashes due to how estrogen and progesterone interact at the same receptor (progesterone with much lower affinity, obviously) but this does NOT mean that progesterone is the ideal treatment for hot flashes.
  
  It is uncontroversial to say that estrogen is the predominant driver of hot flashes in women. The reason progesterone is used frequently is because it is considered to be both safer than estrogen and it’s also available over the counter whereas estradiol is not.
  
  There are, of course, also nuances and individuals who don’t fit the mold but these are the exceptions rather than the rule.
  
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April Shearer

February 25, 2020

Is there a certain time of day I should use Progesterone cream?

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SF

May 8, 2020

Curious if Doc or anyone here has experienced EXTREME hormonal cystic acne breakouts when taking compound pharmacy progesterone pills & creams?

My estrogen dominance is thru the roof and progesterone is nil (on dutch test and serum) despite healthy diet, lots of broc, DIM supplementation and a clean household and beauty routine.

I also have insulin resistance, and have gained 40 lbs and cannot lose a lb 5 years after thyroidectomy no matter diet or exercise.

I’m working with an integrative doc, but I am not exactly thrilled with her ability to get to the root cause of my hormonal issues. HELP!

(I really wish you were taking patients, hint hint 😉

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1. Dr. Westin Childs
  
  May 8, 2020
  
  Hi SF,
  
  Yes, it’s actually quite common for some people to develop cystic acne with the use of pregnenolone, progesterone, and DHEA.
  
  Reply
Victoria

September 16, 2020

Dr. Childs, what is the best way to test your hormones (estrogens, progesterone, testosterone, etc)? As far as I know, hormone levels fluctuate not only during the month but also during the day.

We did a DUTCH test for my 14-year old daughter and it showed off the charts high estrogen, extremely low progesterone and high testosterone. She was prescribed DIM, and Calcium D-glucarate plus 1 ml daily of Progest-Avail progesterone serum (I’m so happy you recommend some of these supplements yourself!!)

Given that the test was expensive and time consuming, and we’ll probably need to repeat it soon, is there a different alternative? Will blood test give us accurate information? Is there a reliable saliva test?
Thank you!!!

Reply
1. Dr. Westin Childs
  
  September 16, 2020
  
  Hi Victoria,
  
  No test is perfect but the serum blood tests are the cheapest and easiest to get so I prefer to use them. I will occasionally use DUTCH or 24 hour urine but not frequently.
  
  Reply
Melissa Native

December 9, 2020

A doctor said to me that prescribed doses of progesterone cream start close to 100mg per day. She said over the counter is too low. My blood test showed low progesterone and I was wondering if we need to use a lot more of the over the counter cream? Most of them provide only 20mg per 1/4 teaspoon.

Reply
1. Dr. Westin Childs
  
  December 9, 2020
  
  Hi Melissa,
  
  It’s the exact opposite, actually 🙂 The standard oral capsule doses are too high for what most people need. You really shouldn’t dose progesterone based on the serum progesterone level or you’ll almost always end up overdosing: https://restartmed.stagemarketingdemo.com/high-progesterone-symptoms/
  
  Reply
joann

December 24, 2020

Hi Dr. Childs,
I have been researching on how to fix my hair loss.
I am 32 and l feel like I am going bald!! Ive tried everything else – vitamins, supplements, going healthy keto, managing stress, but nothing is working!
I was trying to do my own “research” and read somewhere that taking progesterone could inhibit the 5 alpha-reductase and could potentially help my hair grow back.
What are your thoughts?
Thank you so much for taking the time to answer all those questions.

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Linda

March 8, 2021

I am 79 years old and have had a complete hysterectomy due to endrimetrios. I have been on and off taking a natural progesterone cream. Someone told me that if I have had a hysterectomy, I do not need to be taking progesterone. Is this true. I am not taking it now……

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1. Dr. Westin Childs
  
  March 8, 2021
  
  Hi Linda,
  
  Nope! That is not true at all. You can still benefit from progesterone even without a uterus 🙂
  
  Reply
M

March 18, 2022

Hi Doctor Childs!
For 3 months I was using Now progesterone cream (at that time I was also using Vitex 1200 mg) – 2 cycles I had during this time shortened to 26 days (and sometimes it lasted 150 days). In the third month, I increased the dose of the cream twice to 30 mg and no menstruation occurred. I took a 14-day break and introduced the 20 mg cream again (I stopped Vitex because it led to depression), during this time my body weight started to increase slightly (I did not change anything else, I am a dietitian, I take great care of my diet and physical activity) After a week, I stopped using the cream for fear of this water retention. Bleeding started after 2 weeks, but the water remained. After another 2 weeks, I reintroduced the cream, the weight tended to increase again, I stopped after 5 days, the bleeding started immediately – it lasted 3 days. The water has not come off. For these 2 months I have been holding 2 extra kg (I am very slim, it feels a lot). If it was too little cream that led to an estrogen advantage (before I started the cream, I was low in both estrogen and progesterone), will I see it in the test results? What can I do to get rid of this residual water? After this experience, I don’t want to go back to the cream. How long can I feel its effects? I really hope for some answer. I would be very grateful for any tip. Greetings!

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Claire

October 21, 2022

Progesterone cream saved me!!! I was suffering severely from my hormonal IUD, and after applying the cream, I realized for the first time that I didn’t have to suffer such severe chronic anxiety anymore. It literally made me euphoric the first month and a half I took it!! I slept like a baby, it gave me energy I never knew I had. I got the IUD out, and was diagnosed with Hashimoto’s. But I still take anywhere from 224-400 mg of progesterone every day, because my progesterone is still very very low and my body still hasn’t figured out how to ovulate (I’m 28). It does not seem to effect my estrogen rise and fall at all.

Eventually I may experiment more with taking it at certain times and not taking it at others. But I’ve been on birth control for nine years, and had my ovulation suppressed for a good chunk of that time. It’s going to take a while before my body figures out how to ovulate again. Fingers crossed it does tho!! I want to be fertile. I want to have a period and cycle normally. I want all of these things. Hopefully time and getting the Hashimoto’s under control and my antibodies down will help with that!

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Laura Stirton

December 8, 2022

Hi Dr Child’s. I live in the UK and my sister suggested I visit your site regarding Hashimoto’s which my brother has. I also struggle to lose weight but readings in UK always come back “normal” and I think UK doctors use different “numbers” and have a higher threshold before recommending medication. So it’s been great to read your articles on thyroid, diets and hormone imbalances.
I have also self-medicated with natural progesterone cream since my mid-40’s when travelling abroad a lot and couldn’t get to see a doctor. I am now 67 and have stopped and started over the years with the cream, which I order from the USA. I wonder if I have been under using my 2% serenity cream as they say to use it days 1-24 and a pea-size amount morning and evening, and you advise days 1-28. I have also used it on the underarms and face and buttocks which I read to use on a UK site but you have not mentioned and wonder if that is why I have “bat wings”. Although it could be other hormonal imbalances too. So a lot more for me to read on your site but I am more hopeful of sorting myself out. I used to do the Atkinson diet when I was younger and it worked but not so since being post-menopausal. Thanks.

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Jess

October 4, 2024

Hello! Does progesterone affect facial hair in women? a few years ago I was using the cream because I heard it could help prevent postpartum depression. around the same time I got a couple chin hairs. I was 31 at the time which seems early to get chin hairs. I hought that was for older ladies–60s and up. Coincidence or was it the progesterone?

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Karen Walter

December 21, 2024

I’m not sure if you, Dr Childs, are still answering? But here it goes: I always used BHRT progesterone transdermal cream. It seemed to be not enough for me. I was put on oral instead. 25mg to 50mg to 75mg. All was good until 75mg. I was also put on organic biest oils. One drop in the am and pm. My question is: what form or way of delivery does NOT mess with your digestive system. I have SIBO/Ibs-C and I’m a mess. It is slowing down my digestive tract really bad. Is it the biest or progesterone or both? Will transdermal creams do this? Or is there a less likely chance of this side effect with transdermal cream for progesterone and trans vaginal for estrogen?

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