Guide to Using Progesterone for Women’s Health

How to use natural progesterone.

As I describe on this blog and in my books Period Repair Manual and Hormone Repair Manual, bioidentical progesterone is a viable treatment for women’s health conditions such as PCOS, PMDD, migraines, endometriosis, adenomyosis, and perimenopause.

Progesterone is available as “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, this post is about real progesterone—not 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.)
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 new book Hormone Repair Manual and my blog post Rescue prescription for perimenopause. If you need help obtaining the script, 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 new book and my PMDD-progesterone blog post. See also my blog posts about PMDD and histamine, PMDD and prolactin, and PMDD and iodine.

Finally, PCOS as described in my new peer-reviewed paper and Professor Prior’s protocol for cyclic progesterone therapy. Progesterone works by lowering androgens and helping to restore ovulation. Stay tuned for a future blog post.

Of course, progesterone is only one aspect of treatment. It works best when combined with other treatments such as magnesium for migraines, inositol for PCOS, and immune treatment for endometriosis.

Ask me in the comments.

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

  1. 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!

    Reply
  2. 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.

    Reply
  3. 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.
    Thanks!

    Reply
  4. 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?

    Reply
  5. 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!

    Reply
  6. 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.

    Reply
  7. 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!

    Reply
  8. 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!

    Reply
    • 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)

      Reply
  9. 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 🙂

    Reply
  10. 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

    Reply
  11. 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?

    Reply
  12. 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 😊

    Reply
  13. 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?

    Reply
  14. 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.

    Reply
  15. 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?

    Reply
    • 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).

      Reply
  16. 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.

    Reply
  17. 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

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

    Reply
  19. 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!

    Reply
  20. 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.

    Reply
  21. 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.

    Reply
  22. 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!

    Reply
    • 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

      Reply
  23. 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.

    Reply
    • 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)

      Reply
  24. 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?

    Reply
  25. 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

    Reply
    • 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.

      Reply
  26. 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.
    -Maya

    Reply
  27. 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

    Reply
  28. 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.

    Reply
  29. 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?

    Reply
    • 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.)

      Reply
  30. 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.

    Reply
  31. 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!!

    Reply
  32. 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.

    Reply
  33. 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

    Reply
  34. 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!!

    Reply

I welcome your comment!

Send this to a friend