Guide to Using Progesterone for Women’s Health

How to use natural progesterone.

Body-identical or bioidentical progesterone is a viable treatment for women’s health conditions such as PCOS, PMDD, migraines, endometriosis, adenomyosis, and perimenopause.

Progesterone is called oral micronized progesterone and requires a doctor’s prescription. Brand names include Prometrium, Utrogestan, Teva, and Famenita, depending on your country. Alternatively, progesterone cream is available over-the-counter in some countries and can help with mild symptoms but is generally not as effective as capsules.

Here’s what you need to know.

First, progesterone is different from progestins such as norethisterone, levonorgestrel, and drospirenone. Progestins are sometimes referred to as progesterone, but they shouldn’t be because progestins are not progesterone and have their own set of drug side effects. For example, levonorgestrel is quite testosterone-like and so can cause androgen side effects such as weight gain. If you’re not sure if you’ve been prescribed progesterone or a progestin, read the ingredient label and consult this chart.

Second, progesterone might be worth trying, even if you have “progesterone sensitivity.” It’s all about the dose. Because of the bimodal association between serum allopregnanolone and adverse mood, you might feel better on a 200 mg capsule compared to a cream. In other words, anxiety can be relieved by moderate dose progesterone but worsened by low or high dose.

👉🏽 Tip: If you consistently experience anxiety from progesterone capsules at any dose, consider switching to a vaginal progesterone pessary.

Third, understand that your doctor may, unfortunately, be reluctant to prescribe real progesterone because it is currently approved only for menopausal hormone therapy and not for conditions such as heavy bleeding, endometriosis, or adenomyosis. Yet, the consensus from gynecologists to whom I’ve spoken is that progesterone can be used for those conditions, with a few caveats:

  • real progesterone is gentler than a progestin so needs to be used at a higher dose to have the same period-lightening effect
  • real progesterone may not be strong enough for certain conditions, such as endometrial hyperplasia
  • real progesterone is more expensive than a progestin. (Depending on the pharmacist, it costs 30-50 cents per day.)

👉🏽 Tip: Oral micronized progesterone does not carry a clotting risk like oral estrogen and some progestins.

Bioidentical progesterone for women's health conditions.

Conditions that benefit from progesterone

Menopause (either progesterone-alone or with estrogen as part of menopause therapy). Progesterone can be helpful even if you’re sensitive to progesterone and even if you don’t have a uterus. Your doctor may think that progesterone’s only job is to protect the uterus, but it has many other benefits, including promoting sleep, strengthening bones, and protecting the breasts. Progesterone-alone has a few advantages over estrogen: 1) it’s better for sleep and migraines, 2) it’s safer for breasts, and 3) it’s easier to stop because it’s not addictive like estrogen.

If you would like to try progesterone-alone for menopause, try saying:

“According to Canadian endocrinology professor Jerilynn Prior, micronized progesterone alone can relieve menopausal symptoms.” Print out the following study and take it to your appointment: Oral micronized progesterone for vasomotor symptoms—a placebo-controlled randomized trial in healthy postmenopausal women. Or simply accept the script for both estradiol and progesterone but start by taking only the progesterone.

Perimenopause as described in my book Hormone Repair Manual and my blog post Rescue prescription for perimenopause. If you need help obtaining a prescription, try saying:

“According to Canadian endocrinology professor Jerilynn Prior, micronized progesterone can be helpful for perimenopausal symptoms.” Print out the following study and take it to your appointment: Oral micronized progesterone beneficial for perimenopausal hot flushes/flashes and night sweats.

Heavy periods as described in my books and blog post How to treat heavy periods with diet and natural progesterone. If you need help obtaining the script, try saying:

“Could I try a few months of Prometrium or Utrogestan for heavy bleeding (or pain)? I understand it can work as well as a progestin to lighten flow (or help pain) but without the side effects. See this protocol by Canadian endocrinology professor Jerilynn Prior.” Print out the following document and take it to your appointment: For Healthcare providers: managing menorrhagia without surgery. Draw your doctor’s attention to the paragraph that states: “For heavy flow in a woman who already has anemia or who is in Very Early Perimenopause with regular cycles or in the Early Menopause Transition Phase with irregular cycles plus typical perimenopause experiences such as night sweats, new sleep problems, and increased premenstrual concerns, full-dose oral micronized progesterone (OMP, 300 mg at bedtime) must be given daily for a full three months.”

Endometriosis and adenomyosis as described in my books, particularly Hannah’s endometriosis patient story in Period Repair Manual and Francine’s adenomyosis patient story in Hormone Repair Manual. Progesterone helps to suppress the growth of endometrial tissue and regulate the immune system—therefore, potentially also addressing the immune dysfunction that lies at the heart of both conditions. See also my blog post Immune treatment for endometriosis. Progesterone can be used in addition to a hormonal IUD.

Migraines as described in my new book and blog post Natural treatment of menstrual or hormonal migraines. It works by reducing histamine and glutamate and calming the brain. Progesterone capsules are usually the best treatment, but progesterone cream is also an option.

Perimenopausal and premenstrual mood symptoms (PMDD) as described in my blog post Top 6 natural treatments for premenstrual mood symptoms.

PCOS as described in my new peer-reviewed paper, Professor Prior’s protocol for cyclic progesterone therapy, and my blog post Cyclic progesterone therapy for PCOS. Progesterone works for PCOS because it lowers androgens and helps to restore ovulation.

Of course, progesterone is only one aspect of treatment for all these conditions. It combines well with other treatments such as magnesium for migraines, inositol for PCOS, and immune treatment for endometriosis.

170 thoughts on “Guide to Using Progesterone for Women’s Health”

  1. Hi Lara,

    I’m 27 and my progesterone levels during my luteal phase is 16 ng/ml.

    I was planning to start utrogestan but I’m wondering if my own progesterone levels are enough or 16 is low ?

    Thanks in advance for answering.

  2. I read somewhere that taking progesterone lowers magnesium levels, is this true?
    Something to do with genetic SNPs where some people cant absorb mag from the gut.

  3. Hi Lara, this post was SOOOO helpful for me to understand more about progesterone. I have low E, low P, normal T. I have been prescribed estrogen cream and 200 mg natural progesterone by my OBGYN, however my functional medicine doc recommends 20 mg progesterone only and DHEA instead, along with some herbs for cortisol. I do not have a cycle and have experienced acne and weight gain after stopping the pill and increasing my food intake to 2500kcal. Do you have any advice for the correct dosage of progesterone in this case?? Any thoughts appreciated 🙂

  4. Hi Dr Briden
    I read your book and was able to get my GYN to prescribe me prometrium. I first took 200 mg and it caused me to have significant low back pain and my skin itched. I tried to lower the dose to 100 mg however I still was having the back pain. I have since started topically applying the 100 mg prometrium contents to my inner arm on day 15-25. I don’t seem to be having any of the side effects and it feels as if my night sweats have diminished. Is this a placebo effect or do you think I am actually absorbing some of the medication this way?

  5. Hi Lara, thanks for your emails!
    When I started using bioidentical progesterone, it made me so much worse. Why would this happen? I’ve also noticed my symptoms/rage specifically get worse AFTER my period now — why?? It used to be more strictly PMDD/PMS but now it’s been hitting worse after my period. How can this be? Seems like I’m always suffering.

  6. Hi Dr Briden
    Can i take progesterone continuously until menopause..? or just 2 weeks on and 2 weeks off? Or a week before period? I am 48, have couple of perimenopause symptoms, but no hot flushes. This month (july) period didn’t arrive ( it’s been late for 8 days now) I took micronized progesterone a week of my assumed period. And stoped! I want to start again, not sure what would be best in my case?
    I felt better while on it. Of course i would like my period to come back again. Working on it 😌🤔
    Thank you

  7. I am desperately trying to find a solution for my 20 year old daughter. Gyno wants to fit Mirena and do a laparoscopy to see if the pain on Day 1 of period is endo.
    In the past she has reacted extremely badly to the progestin in the mini pill and had to stop it within two weeks.
    I’m nervous that the progestin in the Mirena will potentially be the same and it’s being fitted under GA, but not at same time as Lap. so a big deal.
    Her anxiety would make me suspect hormones are off, but bloods say they are fine.
    Just don’t know where to turn, as I feel a trial of Utrogestan might have been appropriate before surgery, but I appreciate that if blood levels say it’s okay then maybe it’s not needed. However, sometimes her cycles are 45 days long, so I’m left wondering if she ovulates enough to make sufficient progesterone…or indeed does it get converted to cortisol?
    As I’m now post meno and on HRT, I am reminded of how I was before and see some of the same characteristics, so am concerned there is an underlying hormone imbalance that is not being recognised.

  8. Thanks for sharing a great info and keep sharing with us. Progesterone is a crucial part of the menstrual cycle and maintenance of pregnancy. Progesterone helps to regulate your cycle.

  9. Thanks for sharing a great info and keep sharing with us. Progesterone is a crucial part of the menstrual cycle and maintenance of pregnancy. Progesterone helps to regulate your cycle.

  10. Hello,
    I was on Prometrium 200 mg and I loved it but my body didn’t. I got enormously bloated, so my doc suspected the peanut oil in it. Now I use compounded progesterone 150 mg and feel good. Except I have developed all around bloating like an inner tube. 🙁 Should I stop progesterone? I am 50 and it was prescribed to stop heavy bleeding, endometriosis pain and perimenopause symptoms.

    I am starting to get hot flushes at night. More than my face, I feel it in my legs like they are on fire.

    Thank you!

  11. Hi Lara,
    How long does one take bio-identical progesterone before the cycle returns to normal in case of irregular periods. My gynaec says progesterone cannot be a long-term option and that my cycle will return to being irregular once I stop taking the progesterone. She’s put me on tranaxemic acid to deal with prolonged heavy bleeding, with hopes that the irregular cycle will resolve itself slowly. She suggest an IUD like Mirena if the tranaxemic acid doesn’t work. I know the Mirena can last 5 years, so I wanted to check what is the duration of progesterone therapy. I am 44 with irregular periods, heavy prolonged painful periods for the last 1.5 years. My prolactin levels are normal.

    • Hi… I’m just wondering how you feel taking the tranaxemic acid? I noticed that my periods were a little lighter (though not as light as they use to be), but that it lasted twice as long. And than I also spotted for several days between that period and the next.

      We seem to have a similar situation going. When I was 39, my periods went from being very very light and very regular, to suddenly the complete opposite. October 2019, perfectly normal period. November 2019… the dam broke and never repaired itself. I bleed through a tampon in an hour. They still only last 3 days or so, but they come every 15-24 days instead of the 28 they used to come on. I also developed dry skin around this time. I feel like I might be early peri, but the doctor says no because of my hormone levels. However, you can’t really accurately measure levels because they change constantly. And because my period is irregular, I can’t time the testing with with proper phase. Have you considered that you may be peri as well? I don’t know that I am, but it seems possible.

  12. Hi Lara, I’m 33 years old, no children yet. I have had low progesterone serum and irregular periods for awhile now. My periods have shifted into very heavy and painful with heavy blood clots (as they were as a kid). I experience extreme anxiety, insomnia, terrible moods before my period. I was put on 100mg of oral progesterone daily in September 2021 by a functional medicine doctor. This hasn’t helped. I’m thinking of going off of the progesterone but I am worried about unopposed estrogen and my estrogen at times can be on the higher side. Any thoughts? Desperate. Don’t know what to do.

  13. Hello! I’m wondering what your thoughts on bioidentical progesterone for amenhorrea are? It’s been 3 years since BCP that I haven’t had a period, could this work if low estrogen and progesterone in blood work?

    • what is your diagnosis? Because if it’s hypothalamic amenorrhea, the main treatment is to eat 2500+ calories per day. Plus a possible interim treatment with body-identical estrogen and progesterone (not progesterone alone).

      • No one seems to know the diagnosis, I have low estrogen and progesterone but everything else seems fine. No PCOS. I’ve had issues with my gut for years so I’ll be testing for SIBO-C as it’s thought that those problems could potentially be why I never got my period again after stopping BCP 3 years ago.

      • Yes prolactin is good, it’s 65. My FSH: 6 U/L and LH: 1 U/L, (0.17 ratio) progesterone is <1 . It’s been years of just being told that my period will come when I stop thinking about it which I find really upsetting.

          • Hi Lara,

            Thank you! I have Checked both out. I am slowly increasing my calorie intake but a big part of me thinks that the issues could also be from undiagnosed SIBO / leaky gut so I wonder if healing those two issues could help bring back my cycle due to the link between gut and hormones ? Have you experienced this with any patients ?

          • What can often happen is that underlying gut problems lead to undereating. (ie. restricting carbohydrates etc to try to improve the gut) My approach with patients is to treat SIBO with herbal antimicrobials and HCL etc. To eliminate digestive bloating and therefore be able to eat full high-calorie meals and get their periods back. It can take 6 months at 2500+ calories to restart ovulation.

  14. What is your opinion on compounded progesterone troches? I was on 200mg Prometrium, but my doctor switched me to 200mg oral troches. I am no longer experiencing the wonderful calm sleepy feeling I felt with Prometrium. My doctor felt I would benefit more from the troches, but I am noticing more side effects and missing the extra help with sleep. I am very tempted to switch back.

    • Because oral progesterone has greater conversion to the sedating neurosteroid allopregnanolone, oral progesterone is more sedating or tranquillizing than troches. So, yes. You may want to switch back.

      • Switching back to Prometrium did not bring back the evening sleepiness. What would cause that to cease after 4 months of feeling it? I’ve actually had to stop Progesterone altogether because of side effects… mostly horrible nausea.

  15. Hi, Thank you for your great work! I am hoping so much you can advise us. Our 22 yr old daughter is currently taking the oral micronized progesterone capsules for the very intense and severe mood swings she was experiencing. They would veer between rage, panic attacks, high anxiety and general manic-like behaviour to sadness and feeling hopeless. She got pregnant (unintentionally) and miscarried, but we noticed that while pregnant, all her mood issues went away, literally like magic! We realized hormones must be playing a role and found a naturopath who tested and prescribed the bio-identical progesterone. The problem now is, she is only in it days 7-28 (sometimes less, as her moon doesn’t always arrive the same day), and the days off it are really really bad, scary.
    My questions:
    1. Is it possible to take daily, and in that case would it act as birth control?
    2. If yes, are there any side effects or long term effects to consider, physically or mood-wise?
    3. If no, do you have any suggestions for the days she is not on the progesterone to help with her extreme moods? (she already takes Vit D, SAMe, Vit B, magnesium, Omegas, Vit C, Stabilium, and a natural cortisol manager, not sure the ingredients, but they don’t seem to work when she is off the progesterone).
    4. Is there anything else you suggest we look into? When her moods go off it is as if she is not herself, and can’t communicate properly and resorts to self-harm at times. Her boyfriend helps as much as he can, but it is really terrifying for all of us.
    So looking forward to your response. I understand if you are not able to offer advice for this complex situation, in which case could you please refer us to someone who is taking new patients?
    Many, many thanks,

    • That is a complex situation. So, of course, I cannot make any specific recommendations.

      I will just say that in general, in some situations, it is okay to take progesterone every day. Knowing that doing so might suppress ovulation and lead to irregular bleeding (which is sometimes worth it for symptom-relief).
      And even though daily doses above 200 mg can suppress ovulation, they cannot be relied about as a way to avoid pregnancy.

      Finally, speak to her practitioner about N-Acetylcysteine (NAC), which is one of my favourite supplements for mood.

      • Ah thank you so much for your response! I appreciate it greatly and will definitely ask about the NAC.
        Also, I think she is on just 100mg per day of progesterone, so perhaps will ask if that should be increased. Does size/weight matter with that, as my daughter is only 5’3″ and very slim?
        Thanks again!

      • Just to mention, in case this makes anything clearer, I just found her hormone/neurotransmitter test results (saliva/urine) from early February 2022 which showed:
        High levels of Dopamine, Serotonin, GABA, Hystamine, Creatinine, and Norepinephrine/Epinephrine ratio, and low Epinephrine and PEA.
        Also her evening Cortisol was high, and her Testosterone was on low end (just inside low end of the reference interval).
        PG/E2 ratio low.
        She has lost weight these past couple of months as well.
        I understand you cannot give any specific recommendations, but if there is anything else you suggest we ask her practitioner about, based on the above, please let me know.
        Many many thanks

      • Thank you Jessica, I will look at that study. Will be interesting if there is any correlation with iron and progesterone. As mentioned above, when she is on the progesterone she acts and feels ‘normal’. Then when off it everything crashes.

  16. Hi Lara
    I just finished reading your book on hormones and I learned so much. WOW!!!! I spoke to my OB/Gyn and she prescribed Progesterone (bio-identical form). My question for you is can I continue to take DIM/Calcium D-Glucarate while on the progesterone? Thank you for all of you knowledge! It has changed my life! Also I asked my dr to check the fasting insulin and she said that was no longer used but instead wanted to check A1C? Will that also show insulin resistance?

  17. Hi Lara, I’m 33 years old, no children yet. I have had low progesterone serum and irregular periods for awhile now. My periods have shifted into very heavy and painful (as they were as a kid). I experience extreme anxiety, insomnia, terrible moods before my period. I was put on 100mg of oral progesterone in September 2021 by a functional medicine doctor. This hasn’t helped. I’m thinking of going off of the progesterone but I am worried about unopposed estrogen and my estrogen at times can be on the higher side. Any thoughts? Desperate.

  18. Hi Lara, I’m 54 and have had a hysterectomy and one ovary removed. I’ve been taking 100mg of progesterone 5 nights a week to help sleep, calm my stress, and improve body pain. I’ve found I am sleeping well mostly but have worsening body pain and am becoming increasingly depressed and stressed. I know there may be many contributing factors but wondered if progesterone is not right for me. I’ve an oestrogen cream which I use on occasion but not a lot. I know my androgens are in the higher range and I have middle weight gain.

    • If you’re 54 you’re past the statistical age for menopause and ovaries can fail anyway after hysterectomy. It’s likely oestrogen you need?

    • Yes. At 54, you’re likely to have progressed to menopause may need a more substantial dose of estrogen (along with progesterone).

      • My understanding is that oestrogen can be hard to tailor off of, wouldn’t it be better to work at reducing possible insulin resistance, improving gut health, checking thyroid function etc and use oestrogen therapy as a last resort? (I have been working on these areas but maybe not as thoroughly as I could). And if using oestrogen would it be better to use patches only? I know I had unopposed oestrogen prior to hysterectomy and so had fibroids and a cell was found by pathology from a fibroid that was of unknown malignant potential therefore I have thought it may be best to steer clear of using oestrogen therapy.

        • Definitely yes to identifying and reversing insulin resistance. Which actually, can be helped by an estrogen patch. Have you had a chance to read Hormone Repair Manual? In the book, I discuss the “testosterone dominance” associated with the insulin resistance of menopause and explain how both estrogen and progesterone can be helpful. And yes, if estrogen, then a patch is the gentlest and safest and (as I explain in the book) it’s important to always take estrogen with progesterone — even if you don’t have a uterus.

  19. Hi Lara, after reading Hormone Repair Manual( best book I ever purchased) I started on 100 mg of progesterone and the headaches went away and sleep improved. I was getting sore breasts so my integrative doctor (Tim Ewer) put me on DIM which helped. I’m 47 and wondering how long is it ok to take progesterone for? Months or years? Until menopause or if symptoms change? Thanks 🙏

    • Hi Lara, Thanks for sharing your story. Professor Prior recommends taking progesterone for about 7 years, through the perimenopause transition and then a few years after the final period. But of course, talk to your doctor.

  20. I have been on 200mg progesterone continually for nearly 8 weeks in an attempt to help perimenopausal mood dips. I had 2.5 weeks of anxiety and low grade depression which then resolved but it didn’t help with my mood dip last month. This month I all have been experiencing a very flat mood, which I didn’t have before.

    Do you think this will settle or should I give up the progesterone? Many thanks

  21. I love progesterone & it had really helped my migranes just before my period started. Then I started getting awful migranes from day 4 to day 12. Progesterone didn´t help. I started a low dose estrogen patch (25ug/24hrs) from day 2 to day 14 and the migranes are much reduced & I feel so much better. I am reluctant to take estrogen whilst I am still cycling but my life is severely distrupted with these migranes.

    Problem is my periods are now coming from 32-38 days to 17 to 21 days! Not as heavy as I am used to though.

    Do you have any thoughts on this? I recently had bloodwork done on Day 9 of my cycle without taking any estrogen.

    Iron 42ng/ml
    Serrum Iron 131 ug/dl
    FSH 63 mui/ml
    LH 36.5 mui/ml
    Estrogen 45 pg/ml
    Progesteone 0.51 ng/ml

    Does anything jump out?

    Many thanks

    • Sam, I am the exact same. I had a question, why estrogen from day 2 to 14? I had read a continuous patch is best. Is it because you only really need it during those two weeks, before estrogen increases naturally? Do you find it okay when you stop on day 14? I’ve heard that can induce a migraine, but maybe you have enough estrogen to compensate then? I started the patch at one point, but I’m wondering if the rollercoaster levels of estrogen (which can spike super high in perimenopause) were a factor. Going to try the patch again, so it’s good to hear your experience. 🙂

  22. Hi Lara, I am just wondering about breastfeeding while taking 200mg of Prometrium in the luteal phase. My doctor agreed to let me try it, but she is unfamiliar with prescribing it for anything other than HRT. I am 44 with endometriosis, suspected adenomyosis, fibroids, painful and heavy periods with flooding, and pms consisting of migraines, bloating, nausea, fatigue and mood swings. I am implementing your recommendations on reducing inflammation and increasing magnesium, zinc and b6. I still breastfeed my toddler and am unsure of the effects of taking Progesterone while breastfeeding as I am finding conflicting info online. Could you point me in the direction of some credible information or offer me some advice on this? I understand breastfeeding affects your hormones and we are in the process of weaning but won’t be fully weaned for some time. Thank you.

  23. Hi Lara, I’m 39 and have just started perimenopause. My mum went through menopause at 45 so I’m sure that’s what it is! I’m getting terrible insomnia which started out just before my period and maybe over ovulation but now it seems to be most of the month. My doctor has given me progesterone 200mg to take the last half of my cycle which works amazingly but the rest of my cycle I still struggle with insomnia and being very hot at night. When I mentioned continuous progesterone she said that would be detrimental. I’m not sure what to do next but am suffering! I’m taking glycine and magnesium. I have your book and refer back to it all the time! Thank you

  24. I have read the Hormone Repair Manual and found it so very helpful. Thank you. I have recently been diagnosed with Adeno at 42. In my review with the Gyno I raised Projesterone as an option and she said ‘No, it is used mostly for Menopause’ and dismissed the idea. She prescribed me SLINDA (a progesterone: Drospirenone). Where do I go from here? I am supplementing with zinc, Magnesium, Vit D, and take a period pain mix. I am gluten and dairy free. I can’t take anti inflammatories as they gave me ulcerative gastritis. Thank you for all that you do.

  25. Dear Lara,

    Does the research on progesterone confirm no link with an increased risk of blood clot for migraine sufferers ? ( nor other health risks ?)

    I had a stroke at 26 a year ago while on Nuvaring (headaches got worse while on it). Neurologists confirmed the stroke slightly affected my hypothalamus.

    I now suffer from mid cycle/ PMS migraines with aura (they improve the week that follows ovulation ) fatigue and insomnia.

    Interestingly, I noticed a significant improvement of the migraines in correlation with drinking infusion with “progesterone like” plants.

    After reading your post, I started wondering if progesterone could be the key to feeling better.

    So far, I have implemented the below:
    – Quit gluten/ dairy 2 months ago
    – Eating more (BMI 17,5)
    – magnesium, b6, taurine,melatonin and b2

    Thank you for your time.

    Best from Switzerland,


    • Maya, I am a migraine sufferer and progesterone has made a world of difference for me. I had to get it up to 200 mg a day. I hope you feel better!!

      • Hi Jennifer,

        Interesting, did your doctor validate it as a long term treatment ? Can I ask how old you are ? I will hopefully get a prescription soon.

        Thank you for sharing your experience,


        • Yes. I am 52. My progesterone levels have fallen so we are topping them up. Good luck trying this. Hope you feel much better.

  26. I can’t seem to find my comment anymore. I’m wondering what happened to it. I posted it on September 29 and now I don’t see it.

  27. Hi there.

    Thanks so much for this post. I had PMDD, endometriosis and adenomyosis. After many years of trying so many medical and complementary treatments, I finally had a THBSO for the PMDD and adenomyosis, which showed no endo at that time, so previous surgeries for that must have been helpful.

    I am curious about progesterone for me now that I am menopausal.

    I am on a low dose of oestrogen for menopause HRT, but I have avoided progesterone because I don’t have a uterus, and because I presumed that a lot of my horrible PMDD was exacerbated by the treatment attempts with the Pill and the Mirena.

    From reading this it sounds like they included progestin, rather than progesterone.

    I guess I am just a little hesitant to try progesterone in case PMDD symptoms return.

    If you have any thoughts on this (I know you can’t give official medical advice), I would be most interested.

    I have also been considering adding testosterone for libido and energy, but am now hesitant about that after reading your article on testosterone and weight gain.

    Thoughts welcome, thanks so much for your work – stigma-busting stuff that should help many.


    • hi Annalise,

      If you were my patient and feeling well on just the estrogen and testosterone, I might be tempted to just continue as you are. That said, progesterone can have a beneficial breast-protective effect. But your history of PMDD could make it tricky to get started on progesterone. As I explain in my progesterone-mood post, progesterone is usually calming and beneficial for mood (even in women with a history of PMDD) and can be really good for sleep. But progesterone can sometimes cause anxiety or other mood symptoms — my observation is that about 1 in 10 women experience a paradoxical anxiety reaction to real progesterone.

      As for testosterone, the situation of no-ovaries is one time when androgen supplementation can be really helpful. Because normally the menopausal ovaries are a source of androgens. I wish it were easier to access DHEA because I think that’s a better type of androgen, but testosterone can be helpful as well. As long as the dose is not too high or causing insulin resistance.

  28. Hello, Lara!!

    I showed this article to my doctor, and she let me try bioidentical progesterone!

    I am 27 years old and I my doctor prescribed 200mg eache day after ovulation until my period starts.

    Thank you so much!

    I have a crazy PMS and about 10 days of spotting and crampie and more 7 days of heavy menstrual flow.

    I went to so many doctors and always heard that was nothing wrong with me, they just didnt know what to do for me to have a better quality of life… They all prescribed hormonal methods wich I had so many bad side effects that I gave up of them!!

    So thank you again!!

    I tried progesterone on this cycle and it really help me with my heavy flow and PMS!! I was so happy all my lutheal phase! My period was about 4 days and only 2 days were a moderate flow!

    My only doubt is about the spotting, it remained about 10 days with crampies (i dont have crampies when my period stars) Could it be solve changing the dosage of progesterone? Or must it be another reason?

    Do you have any suggestion of what to do (some test like magnetic resonance?) that i could talk to my doctor ?

    • Hello, I wondered If you ever solved your issue with spotting? I’m currently experiencing spotting myself and have been for almost 3 years. I spot exactly 7 days before my period, bleed for 7 and then spot after for almost a week too. It’s taken over my life and the Dr’s have no idea why! Thank you!

      • I experience the same as you have described and have done for twenty years. Drives me nuts. There is a lot of focus on heavy periods, but I can never find much info and Drs have not been helpful.

  29. Hi Lara,
    I had a hysterectomy (5 years ago now, ovaries retained) and think I may be Peri-menopausal (I’m 39, experience constant headaches/migraines) and was thinking Prometrium might help – I’ve read your book Hormone Repair Manual (amazing!) but not sure when I should take it as I don’t know where I’m at with my cycle or for how long I should take it.
    Do you think it is worth taking to treat headaches? And for how long/when in month?
    I have been tested for PCOS (negative), and my thyroid is fine, I also got a test for progesterone it was low – but again, didn’t know where I was at with my cycle.
    Thank you for all the work you do!

  30. Hi Lara,

    I was put on prometrium vaginally 300 mg at HS after 3Dpo for 10 days . This was prescribed because I was having luteal phase spotting 3 days or more before a period cycle is about 26 days long. We have been ttc with no luck for 2+ years. I have endometriosis & celiac disease which was diagnosed when I was 29, I’m now 34. The progesterone has made my PMS symptoms much more tolerable . But I have light spotting from ovulation to my period now even while on the 300mg of prometrium. Not sure what the next steps could be, if it is a dosing issue or possible the endo, wanted to pick your brain and see what you think.

    Thanks so much for any advice .

  31. Hi Laura! I’m 27 years old and I have no children. I use Silverflex IUD for 2 years. My luteal phase is hell for me! 🙁 I have 10 days of menstrual spotting. My estrogen is 8 x bigger than my progesterone in the luteal phase. My doctor prescribed GynPro (same as Ultragestan) for 10 days after the 16th day of my cycle. I took 4 days and I still have a lot of spotting. What to do?

  32. Thank you! 3 years ago I was desperate when I had heavy periods and prolonged bleeding as well as fibroids. I came across your Period Repair Manual book which I bought and it helped me so much. I got my Gynaecologist to prescribe me Prometrium which she did reluctantly. She wanted me to take Progestin which has side effects as long as my arm. And she said that Prometrium doesn’t work as well.
    But due to my persistence she prescribed the Prometrium. After 2 months of taking 300 mgs daily my period had started to improved. I took it for almost 1 year. Now my periods are sooo much better I am no longer in fear of having my period or leaving home when I have it. Thank you!!

  33. Hi, is is safe to use Progesterone in the first half of the cycle. That’s when I benefit from additional progesterone and I don’t seem to need it after ovulation. Would be great to the know safety. Many thanks

    • it depends on your age, situation, and the dose. During perimenopause (when many cycles are anovulatory) it’s fine to take progesterone every day. For younger women, high dose progesterone in the follicular phase can have the unwanted effect of suppressing ovulation.

  34. Hi Lara, I have read in your blog that is ok to use utrogestan/progesterone cream whilst having the mirena to mitigate the side effects, did you mean for mood as well as sleep, potentially? I am not sure about taking with the pill at the same time for those side effects that it would work the same? You will not be surprised to hear my Endometriosis Specialist said Utrogestan would not help me and would not prescribe it (I possibly look into privately for this )and suggested a Prostap injection. Would appreciate any thoughts if you see my message. Thanks.

    • yes, Utrogestan can be taken along with Mirena. For sleep, Utrogestan capsules are more sedating than progesterone cream.

  35. Hi, just to add – I feel great from ovulation through to my period but suffer with insomnia, mast cell problems etc etc during the follicular phase. This is the time when progesterone seems to benefit me but I don’t know if it’s safe or recommended to use progesterone during the follicular phase. Would be grateful for any advice.

  36. Hello Dr. Briden: I just finished reading your book “Hormone Repair Manual” which I loved.
    Today it’s exactly 12 months since I have last gotten my period. I am officially in menopause and couldn’t be happier (I will be 55 next month).
    I take Venlafaxine ER 37.5mg for hot flashes and it gets rid of 80% of them.
    I just started taking 100mg oral micronized progesterone at night and that got rid of them completely.
    However, it doesn’t help me sleep. I tried 200mg and still nothing. I tried 300mg and that did the trick.
    Is that dose safe to take every night?
    I also have Vagifem which I haven’t used yet because I wanted to try progesterone on its own.
    Would Vagifem with 100mg or 200mg of progesterone help with sleep?

    Thank you so much for all you do!!!

  37. Hi Lara, thank you so much for the great information, I love your articles.
    I’m 48 and my bloodwork shows I’m menopause, had my last period in January and on ultrasound I show no more follicles. I have a very symptomatic menopause and most days I’m too tired to do anything.
    I recently tried the emerita progesterone cream 20mg/1/4 teaspoon twice a day, made of wild yam. It was great the first week and by day nine my blood pressure started to spike and pulse was rapid, I got so scared. At first I didn’t think it was the cream and continued to use it for two more days, I felt seriously at a verge of a heart attack, I stopped the cream and got back to normal a day later.
    I’m so frustrated and confused, I don’t know how is it possible, my progesterone showed so low on bloodwork, I don’t have any pre-existing conditions, I don’t drink, no smoke, no drugs, no meds, eat super healthy.
    Could I have an adrenal issue?
    Do you do telegraph appt ? I’d love to do a formal consultation
    Thank you!

  38. Hi Lara, I just read your book “Hormone Repair Manual”. You indicate that hot flushes in perimenopause while you are still having periods usually respond to progesterone than estrogen. However, then in the case study of Rita you prescribe progesterone (with magnesium) and say that that should suffice for her until she gets closer to menopause and starts symptoms from lower eostrogen such as hot flashes. So this has infused me as how are you suppose to know which of the two hormones you should be taking if you are in perimenopause? Does it depend on which other other symptoms you also have which are indicative of low eostrogen eg joint pain?

    • It’s all about estrogen levels. Estrogen is high in phases 1-3 of perimenopause, which is when progesterone-alone can be the better treatment. Estrogen is low in phase 4, which is when some estrogen can be helpful. Until the common occurrence of another cycle (and therefore a surge in estrogen) as described in Deborah’s patient story.

      Does that make sense?

      • Thank you for your reply Lara. I have been in perimenopause for at least 7 years but only just started on Estradot and Prometrium in March. The GP started me on a patch 50mcg with 200mg Prometrium and straight away my muscle/joint aches and pains went into overdrive. She then put me on 100mg and after about a week I woke in the middle of the night with heart palpitations and feeling wired (something that I hadn’t had for about 2 years). I stopped the patch altogether and stayed on Prometrium but my period was still on the heavy side with clots (mainly flooding) for 2 days only and spotting either end. I also had a very bad night sweat which I’ve never had. So then I went onto a 25mcg patch for about a month. I developed sciatica. I am now on Prometrium alone and the sciatica is subsiding along with physical therapy/stretches. I think it’s safe to say I am not at the stage of perimenopause where I need estradiol yet, even though the doctor won’t accept that. I told her I would try Prometrium on its own for a while longer even though she doesn’t get your concept of Progesterone only if you still have regular periods which I do have. To make my day even more she said I am 1000 times at more risk of a blood clot with HRT than I am getting the COVID vaccine! But I thought bioidentical or body identical and particularly transdermal did not pose the same risk as synthetic?

        • But were you having regular periods when you started the hormones? Period regularity can help you determine where you are in the phases. Neither transdermal estrogen nor progesterone carry a clotting risk.

        • My periods are still regular, I have never skipped a period yet during peri. They just come in anytime between day 24-35 days but only a couple of times in tge 30s, more often between day 24-29.

          • Hi Petta, How are you doing now? Are you still doing only progesterone, do you know what your hormone levels are? Thanks!

          • Hi Jessica I have since gone back on 25mg eostrogen patch because I was getting hot flashes again. My joint aches and pains persisted too so the doc said that was the queue to go back on the patch. I also tried 37.5 for a month but that made my muscle and joint aches worse. I don’t think the GP has a clue. I think that they believe in progesterone only. Also, my period was still heavy which is not what I expected from taking progesterone so instead of taking 200 for 12 days a cycle the doc changed my regime to 100 for 25 days a cycle. I haven’t had my first period on that regime yet so I can’t comment, also don’t know if changing Estradiol patch dose will affect. To also complicate matters, after having the Covid Pfizer vax my period came early while still on progesterone pills after both doses. Doc said such menstrual disturbances have been reported with the Covid vax. So really I don’t know what is going on with me at present.

          • Thanks for the reply Petta. Did the GP base your dose on your blood labs? This is all too confusing, trying to figure it out myself. I also have low ferritin that seems to be contributing to my hormone mess. Do you have low ferritin as well? Thanks!

          • Jessica in perimenopause hormone levels are all over the place all of the time GPs don’t test unless you have stopped your periods for a year and then your elevated FSH may indicate you are menopausal. My GP has tested my hormones a couple of times to appease me, but she just said they are “normal.” Yes my ferritin was low too and I’ve been on supplements ever since which have worked to bring levels up to a good level.

          • I thought so, thanks. How did you get your GP to prescribe hormones, I can’t get that far with mine. Can you recommend what iron you take? My ferritin only 15 points after 6 months supplementing. Thank you!

          • She was just one of those docs that are up to date with the latest research and hasn’t been stumped by the bad wrap that HRT got in the past. I take Ferrograd C 1 tablet daily.

  39. Hi Lara,
    Would you be able to suggest some possible mechanism for why taking bio-identical progesterone (Progestelle) would cause bleeds in a menopausal woman? It causes what looks like a heavy period but there is almost certainly no ovulation occurring. Specifically this happened – no periods for 6 months, then upon taking a dropper of progestelle a day for 5 or 6 days transdermally a very heavy bleed began. The product was stopped as the bleed was excessive and brought on a uti. Several months later it was resumed and the same thing happened. it was again stopped, and when it was resumed 4 months later this time using only a very small dose of a few drops on the skin – within 3 days minor spotting was observed.

    Thus it seems consistent that progesterone is causing the bleed, and the dose correlates with the extent of the bleed. Could you speculate as to why this might be happening?
    The woman is normal weight, and otherwise healthy except for not being able to achieve deep refreshing sleep – which is why she was trying the progestelle. She uses no cosmetics that might introduce estrogen like compounds and eats very well. Thank you.

    • if she’s only six months since her last period, she’s still in phase 4 of perimenopause — see my new book Hormone Repair Manual for a description of the phases.

      Stop and start periods is quite common during phase 4, and she likely still has quite a lot of estrogen contributing to a build-up of her uterine lining. And then the progesterone triggers a breakthrough bleed.

  40. I’m so glad I found your information! I’m 50 and entering perimenopause. I got your book and I have two questions:
    1. A lot of months, my period comes at six or seven weeks. What I just use progesterone cream/capsules from the third week on until my period comes?
    2. My most painful migraine comes on the 3-5th Day of my period. So I wouldn’t be taking progesterone. Do you know what is happening in the middle of my period caused this migraine? I already take magnesium iron, eat low histamine, I feel like I am covering all my bases and yet this is the most painful migraine I get. Thank you for any help

  41. Thank you for all your insightful info! I have read about Professor Prior’s protocol for PCOS. My daughter (14) is suffering from rapid weight gain, acne on forehead, upper lip hair, fluid retention (face, legs, hands), depression/anxiety. Despite being very active and eating well, there has been significant changes over the past year and even further the past 8 weeks. DHEAS is on the higher side of normal range. She has just done the DUTCH test so waiting for results. I have done extensive reading and she has been taking zinc, mg, vit d for a few months now. Naturopath had her on vitex which has made no improvement and she has put on further weight over this time. Suffers from cellulite on her legs which even extends to her lower legs and knees. She has also had chronic psychological stress over the past 18 months. Being a dancer it’s got to the point where she feels she can no longer continue. My question has to do with lack of ovulation. She has period cycles of 22 days so am unsure if she has PCOS or not but she fits the picture. There doesn’t seem to be much info about the significance of anovulation and therefore lack of progesterone and weight gain in PCOS. Can this be a significant factor in body changes or would insulin resistance be the main issue? She has been menstruating for nearly 2 years so if she has never ovulated could this unopposed estrogen state be a cause of weight gain with her? Would this worsen with each cycle due to the lack of progesterone each cycle? If she can be assisted to ovulate with each cycle could this help with her weight issues and could we find someone to assist us to use Professor Prior’s protocol? I did read on her site that she helped a 12 year old girl with PCOS using cyclical Prometrium. I am also aware that upper lip hair may not be enough to diagnose high androgens in PCOS. Is this correct? Could this just be a transient state due to being an adolescent? Same situation with the acne being on the forehead. I have read that it’s mainly on the chin with PCOS. I am concerned that if the DUTCH test comes back as normal and is not PCOS what could be causing all her body and mental changes and how to help her.

  42. I finally got a Dr to test my hormones, I’m 42 – have crazy heavy painful periods, crazy angioedema that started 2 years ago. My E2 was normal ranges but my progesterone came in at 7 mol/L and is supposed to be 11-81 during luteal phase. He said my level wasn’t low and it wasn’t anything to follow through with and refused to talk further about it even when I said the line about “Canadian Endocrinology Prof…”. How do I navigate this. I’m exhausted. I’ve started myself on USP cream, and have been doing the 400mg of magnesium since I read your book 6 months ago – cut out sugar entirely.

    • Unfortunately it’s going to take a new doctor. Also 400 mg of magnesium isn’t very much. You should take to bowel tolerance.

    • I developed angiodema too around this time. I seem to be better now that my estrogen levels have dropped a bit. I’m sure it was connected. I’m on progesterone (my last level was 15) which is lower than the normal range and it’s really helping me! If you can, I’d find another doctor, a menopause specialist if you can. Many doctors just don’t have the knowledge when it comes to this to treat. I was fortunate enough to go private.

  43. I’m 43 started compounded Testosterone and my levels got too high so I stopped. I began having horrible high estrogen symptoms. I started 100mg of prometrium vaginally at night for 12 days. I felt better the first 2 months, then on the 3rd month after the first dose I had cramping, soreness in my pelvic area, severe fatigue, bloating… so I stopped. Felt bad the the next several days with uncomfortableness in pelvic area. Then started bleeding on day 17 of cycle. I had been feeling great the 2 weeks prior. Could my progesterone be too high? Should I have continued taking it? Or is this normal?

  44. Hello Lara! Can you please share your perspective:
    I’m a 33 years old woman, who is 8 months postpartum (3 kids total). I got the Mirena in October 2020 and I’ve been spotting irregularly ever since. My 1st post-IUD period was a light bleeding for 5 days in October. Next, I spotted for 26 days of the 30 days in November. Then I spotted for 25 days from December into January. Next, I spotted for 16 days in February.
    My OB/gyn took an ultrasound and said the Mirena IUD is lying low in my cervix. She said she could take it out and put me on the pill.
    Before I got Mirena, my body expelled the Paragard after my 2nd child. So I put in another Paragard but it got embedded and had to be taken out by a specialist.

    I also get hormonal migraines in the middle of a period or at the end of my cycle.

    I feel like I’m suffering so much. Can you please help me? Should I take out this IUD and get on the pill? Or does the mirena ever “settle down” on its own?

  45. Hi:-)
    I have always had irregular periods and no ovulation, low progesterone but no high male hormone, acne or hairtism which rules out pcos and low Lh to FSH ratio which rules out HA. All other hormones are also normal. Would progesterone be the answer to help me ovulate?
    I really appreciate all your help!

  46. Hello!
    I have HA and had no period for 4 years now after i stopped taking the pill (took the pill fir 8 years).
    My gyn now told me to take estrogen in the morning and utrogestan every night for 3 weeks and then stopf for 1 week.
    I would really appreciate your opinion on that comboination…i‘m just not sure if i just should let my body heal without external hormones and try to stick to your nutrition and supplement recommendations or if i should continue to parallel take the estrogel+utrogestan…

    Thank you so much for your response!

  47. After I started having migraines the only things that really helped manage them was your go to prescription of Vitamin B’s, Magnesium and Taurine however for the past couple of years I have been trying to obtain progesterone from my Doctor especially now I have insomnia, nausea and fatigue. Dr gave me Estradiol 100mg
    patch which stopped the severe migraine at the start of my period but instead gave me symptoms of withdrawal, she explained to me today. When asked again for progesterone I was told that since my periods were still regular she was not comfortable prescribing it especially as the creams are not consistent and she had referred to colleagues who had the same train of thought. She will send a referral letter to the gynecologist to get further advice on next steps and whether progesterone is right for me and starting me on MRT. I love that you have helped me get my migraines under control but it is incredibly frustrating when I feel, I know, what I need will help me, I can not get with out some forward thinking of my doctor. Thank you for your new book.

  48. Hi Lara,
    I am 50, in perimenopause and taking a combo pill for birth control. I started taking 100mg prometrium to help with side effects of the pill. Is this safe? Will the progesterone make the bc ineffective? My compounding pharmacy nurse thinks it’s fine. My gynecologist doesn’t believe in bhrt and says I could get pregnant. What do you think. I’m feeling so much better with the progesterone.

  49. I am 53 years old and have few issues with perimenopause/menopause. I am diagnosed with PCOS, Type 2 diabetes and having high blood pressure and in recent times deficiencies of iron, b12 etc. In the past I have had diane ed35, mirena and various other synthetic progestin. Throughout I have issues with controlling sugar mostly related to periods.

    The question I have is does 2 tests of fsh levels above 30 determine that one has reached menopause? Whilst still having almost regular periods since stopping all the hormone pills. Does the periods mean they are abnormal bleeding after menopause?

  50. Thank you Dr. Briden for all of the great information you are empowering women with! I am truly grateful for the opportunity to ask you a question. I am 47 and and feel I started mild symptoms of peri-menopause in my early 40s. Symptoms became increasingly worse the past 2 years with very irregular periods and then ultimately bleeding that seemed to never stop along with brain fog and anxiety. Ultrasound and uterine biopsies confirmed no serious issues were present. However, the bleeding had no end in sight so my OBGYN prescribed me an oral progesterone back in October (I can’t recall the actual name of it now so not sure if it was synthetic or not). To my relief and surprise the progesterone helped me almost immediately. I felt a sense overall of feeling better and the bleeding ceased within 3 days. Based on that my Dr recommended I try a low dose IUD. In my case the Kyleena levonorgestrel 195mg which I ended up getting inserted on 12/1/20. Spotting and light bleeding persisted irregularly until just recently a few weeks ago where I no longer have had any bleeding. I overall feel good. I work-out nearly 7 days a week and eat healthy which I believe helps. However, I do feel bloated and I’ve noticed a fairly significant weight gain in my stomach area even though I exercise and do some pretty tough workout programs that incorporate cardio, core work and lifting so this is a super frustrating potential side-effect. After reading your blogs I am now concerned if I made the right choice and it bothers me knowing I’m using a synthetic form of progesterone based on what I learned from you. The IUD is supposed to remain for 5 years. Do you have any guidance or recommendations on what I should consider doing? This has been overwhelming to try to find the right solution for my body/mind/spirit. I do not take any prescription medications (with exception of the IUD) and don’t even take an ibuprofen unless absolutely needed which is rare. So I worried about taking any hormone replacement or oral medications. And, while the IUD is a medication….my mind played tricks on me thinking it was still a safer way to go in order to get some sort of normal life back. Any thoughts or advice would be amazing. Again, thank you so much!

  51. Hi! I am lean PCOS (Insulin resistance) and have managed most of my symptoms by changing my diet (no dairy/gluten) and exercise habits. I have regular periods (26.5 days cycle and 3-4 days long with normal flow) and my only noticeable symptom is acne. I’m 39 so its a little annoying to say that I’ve had acne for decades now.

    The acne isn’t just around the chin and jawline areas which is a hallmark of PCOS. It’s all over my face, all around my neck and into my hairline even and usually happens around ovulation. Very inflamed cystic acne. I suspect a progesterone/estrogen imbalance. I’ve taken DIM but it only make my acne worse. I take Zinc supplements for my skin and I take Vitamin D, Omega 3s.

    I don’t live anywhere near an English speaking Natural Medicine clinic as I live in Okinawa, Japan. What would you suggest is my next step for diagnosing this issue? I’ve read your Period Repair Manual and follow Clare Goodwin too. Thanks for all of your help.

  52. Hi I am 42 yrs had symptoms of perimenopause approx 1.5 years back and a doctor here asked me to take oral contraceptives till 50 yrs to have regular periods till i reach menopause.
    I did some research and have been taking Vitex 1500(Thompson brand) since the last 1.5 to 2 yrs and my periods/mood swings were regular and much better.
    Last month I stopped taking Vitex to give it a break and now my periods have stopped since last 2 months..
    Please guide if I can keep having Vitex till I am 50?Or please guide me on any vitamins I should take(I have hypo thyroid and bp too post delivery).Please help!

  53. Hi Lara, I asked my doctor if I can try prometrium for my hormonal migraines and she said she’s willing for me to try it but she doesn’t know enough about it or how much the dose should be. She wants me to find out and come back to her with your book. What dose do you recommend for hormonal migraine? I will take the Period Repair Manual to my doc but your bew one won’t be out before my appointment. Thanks so much!

    • Standard dosing of prometrium is 100 or 200 mg at bedtime during the luteal phase (premenstrually and sometimes into day 2 or 3– ie the migraine danger window)

  54. Hi Lara 🙂 I read your book and loved it, I’ve implemented all you said to do for insulin PCOS and now I’ve just found out I’m pregnant! I’m so excited but I just wanted to ask, should i stay gluten & dairy free while pregnant? I’ve been told pcos disappears when your pregnant but I want to make sure I do right by us both. Thankyou so much for your book 🙂

  55. Dr. Lara, I have just received my progesterone form the lab that my friend brought me. It says progesterone benfotiamina, do you know if it’s ok to take this formula?
    Thank you

  56. I forgot to mention that last december, my second period in the same month started and just after that i started using wild yam cream which contains natural progesterone. I wonder if this could be linked to my continuous bleeding as in January i have started to use it every day?

  57. Hello,
    I have been advised to ask my question here for some general guidance. I know it doesn’t replace a consultation of course.
    I have had my period for the past 2 months multiple times. For the past month up to this day, I have been bleeding. I have seen Gp several times and the only thing they recommend is to take hormones which doesn’t feel right for me. I think it might just be a release of stress but am unsure. I have no pain whatsoever but because of the constant bleeding I am a bit tired.
    I have asked my GP for an ultrasound which she didn’t want me to do.
    Any insights or thoughts on that?
    Thank you 😊

  58. Hello Lara!
    If a woman have heavy flows and PMS… If the dosage of progesterone to reduce the flow is high and the dosage of progesterone to aliviate PMS symtomps is Low… How you manage it?

  59. I am concerned oral progesterone building up in the liver. I stopped taking it. I am staying subscribed here to see if you cover this topic. I am also following a lifestyle and diet that detox “Vitamin” A so that my liver can clear and hopefully all systems in my body repair, heal and reset hormones. I hope that more people consider covering this topic and openly discussing it, as a possible true root cause for so many of our diseases.

  60. Hello Lara

    Thanks for the interesting information. I was recently recommended for HRT by a dermatologist due to hair loss and thinning. My GP said Estrogen Gel and Mirena Coil.(Progestin). After reading your article titled ‘The crucial difference between Progesterone and Progestins’ I decided against the Mirena Coil and asked for natural Progesterone. I have been taking Utrogestan 100mg daily capsules for 3 weeks now….Have I made the right choice?

    • According to most experts these days, the best and safest type of menopausal hormone therapy is the combination of transdermal estrogen and oral micronized progesterone (like you’re taking).

  61. Hello Lara, thanks for this very informative article. I am now in perimenopause, and I was wondering if taking an hormonal treatment (progesterone + oestrogenl) would delay the menopause? Thanks for your answer.

  62. I have used happy progesterone cream for several years and now I’m entering menopause at 50. Can I stay using it without a break or do I need to stop using it for 7 days every month? I’ve gotten off of it for 2 weeks every month when I was menstruating every month. I’m assuming this is a safe progesterone. What do you think? Thanks for your help

  63. Hello Dr Lara, thank you for your article. What would be a recommended reliable brand for magnesium taurine in the US?
    Thabks in advance

  64. Hi! Im from argentina and i am 36 years old, i am reading your book and i think i have hypothalamic ammenorrea, because the hormonal studies are ok (only hl is low). My doctor gave me progesterone and when my period comes he would give me the pill (i dont want to).
    What do you recommend me?
    Should i take progesterona and then try with sauzgatillo herbs?
    Thank you so much. I love your book!

  65. Would love some more detailed guidelines on how to know if you need or could benefit from progesterone supplementation if you have PCOS but you do ovulate. I am 36, I ovulate every cycle, usually day 17-25, have a milder PCOS phenotype (lean, acne, body hair, some hair loss), have luteal phases that are 11-13 days long with weak temperature rise and periods that begins and end in brown bleeding. So I do produce preogesterone, just not in ideal quantities. I am worried about things like breast and bone health (especially given a history of low Vitamin D), and wondering if progesterone supplementation would help with hair loss. Also curious about how to implement progesterone supplementation in people who do ovulate every cycle.

  66. Thanks Lara for this detailed article. When I came off the pill in 2016 and after 6 month of amenorrhea, my gynecologist prescribed me UtrogestanⓇ to be taken vaginally during 8 days every 3 months if my period wasn’t there. At that time, I was a bit worried about the treatment as I didn’t want to take any synthetic hormones. I am glad to learn that the drugs I took were like natural progesterone.

  67. Hi Dr. Lara. Loved your book, cant wait for the next one.
    I have a question. Im 45 and thinking about taking progesterone for migraines. In your book it says its better to start with oral progesterone in such cases. Do you recommend a dose of 50 or 100mg? Also, I ordered from a lab in Brazil, they said its bioidentical, can I trust this? I live in Spain and only recently found out that the sell it here. Thank you!

    • Hi Dr B. I love your books and this post in particular. I’ve got a script for estrogen patches and ustrogestan capsules. As I have both oestrogen dominance and histamine intolerance could I just take the natural progesterone capsules alone? I’m hoping it might help me sleep (my biggest peri problem) and lighten my periods as they’re very frequent painful and heavy and I don’t want a coil! I’ve got 100mg capsules and was told to take 200mg every day for half the month. Would I take 100mg every day instead? Thank you! Can’t wait for the new book. Liz.xx

    • She says that standard dosing is 100 or 200 mg taken at bedtime the two weeks before your period and sometimes into day two or three which is the migraine danger window.

    • I’ve actually been using 200 mg as it seems to be the dose that’s really helping my migraines. Progesterone cream didn’t help me, oral progesterone did. Dr Jerilynn Prior, who Dr Briden refers to in her book, talks about 300 mg being helpful for women with migraine. You can check out her research at CEMBOR UBC. Hope you feel better!

  68. Thanks for all the information Lara. I’m currently taking bioidentical Progesterone Cream 6% made by a compounding pharmacy. It’s been 8 months. With a long history of not having periods for long periods of time, after starting with the progesterone cream I’m having now periods every 17 days, which has derived in a severe anemia. As recommended by the doctor I’ve been playing with the amount of cream that I apply, reducing it as much as I can. Do you have any experience on this symptom? Would you recommend any practice to help my body find a healthier biorhythm? I’d also like to ask if you know for how long someone should use the cream until arriving to a point when the body generates progesterone by itself? Thank you very much. Maria.

    • If you’re younger than 45 and not in early menopause, you should be able to re-establish ovulation and therefore make progesterone. It all depends on why you weren’t ovulating. i.e. on the diagnosis. (eg. hypothalamic amenorrhea, PCOS etc)

  69. I took 100mg of prometrium for a while but i felt it caused yeast infections…. is that common? According to my labs my progesterone levels are low and I’d like to start using it again. Any suggestions?

  70. I’m 41 and I was taking ATP Science products for around 2 years- during which time my progesterone (blood test) levels increased and were consistently in the healthy normal range and I felt wonderful; after 6-8months having a break my progesterone level had halved. It’s now been 18 months and I have not felt the same since.

    At the suggestion of my naturopath, I tried to get a Prometrium script from my GP 6 months ago, and she refused claiming it wasn’t a natural progesterone 🙁
    I had a laparoscopy and hysteroscopy last week and was told yesterday that I have Adenomyosis (very early) and to consider starting IVF very soon.
    Can I still start taking Prometrium in the months before IVF now, or is it best to leave it until after that?

    Lara- your guidance and information for women is so appreciated xx

    • Just as a general guideline, never use the word “natural” when speaking about progesterone to a doctor. It’s far better to just ask for it by brand name. And short answer, yes, it should be ok to take prometrium in the months before an IVF cycle but check with your doctor.

  71. Hi Dr. Briden,

    Love this post and looking forward to your new book due in Feb.
    Am 43, in perimenopause, with major issues being insomnia and cyclic joint pain but otherwise in good health. My periods are closer together and vary between being light and heavy. I take B6 50mg, Mag glycinate 300mg and turmeric. My elbow hurts for half a month, every month, and I’m guessing its the estrogen-autoimmunity. Do you think progesterone will help with calming my immune system so as not to attack my own body. I’d love some input, as I’ve not read much about this.

    Thank you so much for all your work.

    • Progesterone seems to have helped with my autoimmune disorder. My specialist thought it might. I had high levels of estrogen. And the progesterone helps with insomnia and sleep. Hope you feel better!

  72. I have joint pain specifically elbow pain that seems to get worse in the follicular phase, I read that there is a connection between estrogen and mast cell autoimmunity. I am perimenopausal at 43, with low progesterone indicated by a dutch test. Estrogen is within range but is higher when compared to progesterone. Would oral progesterone be able to mitigate my cyclical joint pain issues?
    Thank you,

    • Maya are you saying the higher eostrogen is a actually causing your joint pain? I’m so confused because we have been told low eostrogen can cause join pain. I am not disputing you I’m just trying to make heads or tails of my own situation.

  73. What are your thoughts on oral progesterone used in combination with an estradiol patch for hypothalamic amenorrhea? I have osteoporosis (and many other symptoms) from years of HA and am struggling to get my estrogen and progesterone up. Bio identical hormones have been recommended.

  74. I’m very curious if you hear complaints from patients about weight gain from taking oral progesterone, and, if you have any thoughts about managing the weight gain?

    • I have not observed significant weight gain from progesterone. In fact, Professor Prior is adamant that progesterone can promote weight loss because of its anti-androgen and metabolic-stimulating properties. I talked to my colleague Fiona McCulloch about it and she says that it probably would only cause weight gain in the context of very low estradiol. Which is why in my new book I advise against taking progesterone-alone for early or surgical menopause. (ie. It’s important to also take estradiol in those situations.)

  75. I am excited to read your new book so can’t wait until February!

    I am 44yrs old and have just got off BCP last August and my period came back straight away (I implemented your advice from period repair manual), I ovulate each month (nice temp shift) but have a very light, short period (2 days). I have recently started waking every couple of hours in the night though magnesium and taurine are helping me get back to sleep I am still waking up and it effecting me the next day. My question is would micronized progesterone be helpful in my situation? Or do you think maybe I just need more time with the treatment (magnesium, taurine)? Are the very light, short periods an indication that my periods may just fade away? Thanks so much for your help and your generosity with your advice and guidance.

  76. Thank you!! I want to test my Progesterone. Do I stop using the progesterone cream beforehand? How much before? I will re-find the test window you wrote about as well. Could you please send a link for that? Thank you!!

  77. Is it OK to take 200mg oral progesterone every day with no breaks long term and use the cream daily also? This is what I have been prescribed but every thing I read is about taking it cyclical – not every single day long term with no breaks.

  78. I had a hysterectomy in September and the lady doc said I should absolutely not take progesterone since I don’t have a uterus anymore so she gave me synthetic estrogen patches I feel so crappy

  79. Prometrium is incredible! I’m 54, had horribly heavy, irregular periods for years, so my Dr prescribed 100MG/night with 400 MG Magnesium Glycinate and my period finally stopped. It’s been 4 years and I have no plan of stopping! Thank you so much for putting this information out there and giving us something to physically give our doctors so they might believe in it!!


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