7 Superpowers of Progesterone

Superpowers of progesteroneProgesterone is a startlingly beneficial hormone, and almost all of us could do with more than we have.

Progesterone acts on your breasts and uterus, so it’s essential for healthy reproduction and periods. It also acts on your brain, immune system, and detoxification enzymes. Progesterone does a lot more for you than just fertility and easy periods. It soothes, nourishes, energizes, strengthens, and rescues your body in ways you never imagined.

Benefits of progesterone

  1. Boosts energy by stimulating the thyroid and heating up metabolism. That’s why your body temperature goes up half a degree when you make progesterone after ovulation. It also stabilizes communication between the hypothalamus and adrenal glands, and so can relieve symptoms of HPA dysregulation.
  2. Soothes mood and rescues sleep thanks to its metabolite allopregnanolone (ALLO). ALLO is a neurosteroid that interacts directly with GABA receptors in the brain and promotes sleep. Progesterone also up-regulates the DAO enzyme, and so relieves the anxiety symptoms of histamine intolerance. Finally, progesterone stimulates sleep centres in the brain and can relieve premenstrual and perimenopausal insomnia.
  3. Nourishes hair and clears skin because it reduces male hormones (androgens) by inhibiting the enzyme 5-alpha reductase. The result is faster-growing hair, less skin oil (sebum), and fewer skin break-outs.
  4. Lightens periods by thinning the uterine lining.
  5. Reduces the risk of autoimmune disease by modulating immune function and reducing inflammation.
  6. Builds bones and muscle by stimulating osteoblasts (bone-building cells) and the growth of new muscle.
  7. Reduces the risk of cancer by counteracting estrogen’s stimulating effect on breast and uterine tissue. It may even have a future role as a treatment for breast cancer.

Conditions associated with progesterone deficiency:

  • PCOS
  • heavy periods
  • fibroids
  • acne
  • hair loss
  • endometriosis
  • autoimmune disease
  • premenstrual syndrome (PMS)
  • premenstrual migraines
  • infertility
  • perimenopause
  • menopause
  • osteoporosis

Physical signs of progesterone deficiency:

  • A short luteal phase, which is the time between ovulation and your period.
    It should be at least 11 days.
  • Low temperatures during the luteal phase.
  • Fertile mucus in the luteal phase.
  • Premenstrual spotting.

How to get more progesterone

There are two ways to obtain progesterone:

  • Make more yourself by ovulating regularly, which means correcting underlying issues such as inflammation, insulin resistance, and thyroid  (to name just a few). For more information about how to ovulate, see my book Period Repair Manual and my blog post: Road map to progesterone.
  • Take body-identical or natural progesterone, which is available as either a transdermal cream or a capsule. Progesterone cream is adequate for general symptoms, but capsules are better for perimenopausal sleep problems (oral has greater conversion to allopregnanolone).

 Tip: There’s NO progesterone in any type of hormonal birth control. In fact, the biggest problem with hormonal birth control is that it causes progesterone deficiency. Read The crucial difference between progesterone and progestins.

Read Professor Jerilynn Prior’s series of articles: Preventive powers of ovulation and progesterone.

Dr Lara Briden

294 thoughts on “7 Superpowers of Progesterone”

  1. Hi Lara, just wondering what might be the reason/s for pelvic area pain when using prometrium vaginally? Oral was fine, but thought Id try vaginally for better and more direct absorption. My issue is VERY heavy periods.

  2. Hi Dr. Briden, I have started on continuous 100 mg of prometrium and I cannot sleep whatsoever. I am trying to toughen it out, but it’s been 10 days and the insomnia won’t improve. Should I take it in the morning, or is this a sign of some imbalance? My headaches have greatly improved while on it, so don’t want to quit. I am 35 having mostly anovulatory cycles.

  3. I have been on Utrogestan for ten days and I feel awful. I tried it before at 100mg and it made me feel out of my skin anxious so I’m now on a higher daily dose of 200mg which is better.

    At first, I felt really groggy in the mornings, almost hungover. Now I feel like I have PMT x10 – I’m ratty, tearful (so much so that I’m unable to work) and generally over reactive.

    My specialist has advised to persevere with it for at least 4 weeks to see if the side effects pass but I’m in two minds.

    Does anyone have experience of a bad reaction initially but then progesterone helping? I could use some positive stories!

    My history is complex: I am 46, have PCOS (but have always had regular periods and no raised androgens) and in the last 2 years have developed disabling ‘post’ menstrual syndrome similar to PMDD. I did not tolerate body identical oestrogen as it made me depersonalised and anxious.

    • About 1 in 20 women experience a paradoxical anxiety reaction to progesterone, which is sometimes better at 200 mg but sometimes not. If the side effect persists (and you need progesterone for another symptom like bleeding), then taking it vaginally can reduce the mood side effects. If your reason for using it has been mood, then it might be time to switch strategies. For more information, see my blog post Why progesterone is both good and bad for mood and my upcoming new PMDD blog post which I hope to release early next week.

  4. I have been prescribed progesterone 100 mg and I’m scared of it because cancer runs in my family and my doctor knows this. I have anxiety, hot flashes, can’t sleep, dryness, etc. What are your thoughts?

  5. Hello Lara, Im 67 years old and I was dignosed with Graves about 6 years ago. My thryroids are in normal range ever since. My endocrinologist wants me to take Progesterone because of my hair loss and sleep problem. My antibodies are high. Do you think taking Progesterone wont upset my throrids? Please advice me.
    Thank you
    Sarah R.

    • In this article, they’re speaking specifically about compounded formulas of bioidentical hormones from compounding pharmacists, not body-identical conventional hormone therapy.
      These days, most (not all) modern mainstream hormone therapy is body-identical or bioidentical. In Australia, “body-identical” is the term doctors prefer to differentiate conventional hormone products from customised hormone formulas dispensed by a compounding chemist.

      To put it another way: body-identical hormone therapy is what most doctors prescribe these days — but without calling it that. See my blog post What are bioidentical or body-identical hormones?.

    • Thanks Lara. I do have the hormone repair manual so I guess I will take the steps advised in your book to ask my Dr for it , even for the cream? . I’m 38 with bad pms for 2 weeks and didn’t respond well to magnesium b6 or taurine Or St. John’s wort or ashwaghanda So I guess that’s my next option.

      • Are you in Australia? Progesterone cream is not available over-the-counter in Australia.
        As I describe on page 313 of the Australian edition of Hormone Repair Manual, progesterone can be obtained as 1) the prescription item Prometrium or 2) progesterone cream from an overseas dispensary.

  6. Hi, Liked your article very much,
    My endocrinologist just prescribed Progesterone ( generic for Prometrium) for sleep and hair loss. I’m 66 years old with Graves. My throids level have been normal for over 5 years. I do not take Throids meds. Do you think taking Progesteron in this form is not going to harm my autoimmune system ? or throids?
    I will appreciate you answering my question.
    Thank you
    Sarah R.

  7. Hi Lara my doctor always prescribes progesterone as a troche instead of capsules. Can you please tell me if this is also ok or would I be better off trying it as a capsule?

  8. Hi I started prometrium 100mg day 14-28 last month however it’s seems to push up my levels really high. My mood has been much better and calmer but my joints are soo painful and I have developed this itchy throat and cough which happened last month as well but I didn’t pay too much attention to it? Is this a thing?

  9. Hi there! In Australia, where can I get natural progesterone? I have adenomyosis and after going off the pill, I have had incredibly heavy periods. I read your book, the Period Repair Manual, which is helpful, and hoping progesterone might help me. I also have insomnia around my period, which makes me feel low. I also read that DIM may be able to help me… thanks!

  10. Hi… this is a hole new area for me so I have lots of questions, but I’ll just ask one. I managed to get through peri menopause and menopause like a walk in the park… a few hot flashes and some night sweats. I thought I had it made. I’d never heard about post menopause until I started getting quite a few nasty symptoms and a friend mentioned it might be post menopause….what??? I think the worst is the nonstop sweating and constant hot flashes where the sweat completely soaks my hair, runs through my skimpy eyebrows and into my eyes. I seem to be having most of the menopause symptoms now, although I haven’t had a period in about 8 years and I’m 65 years old. I still have all my organs with the exception of my gallbladder. I’ve always been a bit warmer than most people, but not like this. I do have days where there isn’t too much sweating, but most are. I don’t have breakouts on my skin, however the rate of aging on it seems to have sped up. So I suppose I’d like to know if taking this hormone might be a good idea. Thanks a lot.

    • It’s unusual for severe sweats to start so many years after menopause. Probably best to check with your doctor just in case it’s something else such as a thyroid problem.

  11. Hi Lara, what is a “pulsed fashion” if no periods ie after hysterectomy?? I’m taking prometrium 100mg continuously. Only been 12 days so far. Thanks

  12. Just came to report back that I did try progesterone cream and that it did, as feared, exacerbate my gum issues (apparently even our own progesterone is responsible for the gum issues some women have with PMS). Very frustrating because I’m sure I need progesterone, and I was otherwise doing well on it. Dr. Briden, do you have any idea how to get around this issue or have any thoughts you could share?

  13. Hi Lara,
    Is progesterone able to help with Hair Loss from pcos?
    Is it also possible it would work for seborrheic dermatitis that part of the pcos?
    I have heard mixed things about sebum production with progesterone cream.
    I am worried the progesterone cream will create more testosterone or DHT.

    I am desperate to stay off of things like spiro! But I don’t want to lose more hair.

  14. What are you thoughts on taking micronized progesterone after a hysterectomy with the removal of both ovaries and uterus? I don’t do well taking estrogen. It gave me insomnia and anxiety. I’ve read about progesterone helping prevent osteoporosis which runs in my family. I’m 44 and had my hysterectomy two years ago bc I had my only ovary left encapsulated by endometriosis and it was painful.

  15. Hi, how much progesterone is too much to prevent conception or ovulation? I am on 200 mg vaginal progesterone for 14 days at the end of each cycle. Can vaginal progesterone be an obstacle for conception l wonder.

  16. Hi Lara- is 15 too young to start micronised progesterone ? Symtoms, insomnia, anxiety, acne, weight gain and hirsuit , PMS. Tried most herbs, zinc, cortisol lowering drugs, have done DUTCH – but feeling at a loss. Desparetly trying to avoid OCP.

    • ooh, yes. I think 15 is a little young for micronised progesterone. Do you know if you have insulin resistance? Because it’s the most likely explanation. Have you looked at magnesium and inositol? Probably my two favourite supplements patients in your situation.

      • Thanks for your reply – have been on magnesium and tried inositol and Berberine- already gluten dairy and sugar free – short of going keto , I am at a loss as we really have given everything a good nudge so wonder if progesterone must be a better option than OCP ??

        • I also wondered about using micronised progesterone for a 15 year old. Has all the symptoms of low progesterone due to chronic stress. She has done the DUTCH test also. I read an article by Dr Prior that suggested taking 300mg each night for a young teenager with infrequent periods so thought this would be a safe alternative to OCP and drugs such as metformin. We are working on reducing her stress which is going well but she has gained weight, acne is worse and still has depressed mood. Wanted to give her a boost and helping hand to get things moving for her as I know her oestrogen/progesterone balance has been out for 2 years now. What about the cream? Would that offer a gentler approach?

  17. This sounds so hopeful for me. But one concern is that perimenopause has trashed my gums. I figured this would help since it reduces inflammation, but I’m reading that bleeding, swollen gums are a side effect caused by progesterone?! Is that right? Is there a way around it? Should it still happen if you’re only taking it during the luteal phase (which I think is what you recommend)? I can’t afford for my gums to get worse. Thank you!

    • Sorry, did a little more research and wanted to add another thought. Apparently recent studies prove estrogen use helps post-menopausal women save their teeth, helps with gum disease, etc. I wonder if a perimenopausal woman with gum issues (who never had a problem before, has great diet, oral hygiene, etc.) may need estrogen as well as progesterone? I’m only 40 but believe I’ve been in peri for about 5 years. I also always looked very young until this past year, when I suddenly began to get significant facial skin sagging, like all the plumpness of my face is just gone. I wonder if that, too, suggests a need for more estrogen? I still have periods, but fairly irregular cycles and only 3-day bleeds, and those are getting lighter and are basically just clots.

      And is there an ETA on your menopause book? My credit card is totally burning a hole in my pocket! Thanks again, Dr. Briden!

  18. Hi!
    Do you recommend taking progesterone cream (now foods) during the first trimester of pregnancy?If so, when and how much?
    I’ve always had low progesterone and know that it’s helps to help prevent a miscarriage,
    Any advice would be wonderful:-)

    • Ita, my holistic functional medical doctor did recommend using Progesterone cream daily through the first trimester, which would be the first 3 months. He said to continue using Progesterone cream until you can feel the baby kick. Hope this helps you, as I see your comment is from January 2020!

  19. How do you test levels when you are taking bio identical progesterone? My levels were 25 before supplementing. I took progesterone for 3 months to see if I can easy heavy periods. My hair got much better – no need to wash it everyday as its not so oily any more, the redness and dry flaky skin was gone and my histamine intolerance is much better. After 3 months I took a break for 2 months and did blood test (21 day) and it came back as 9.5?? Does taking progesterone suppresses body’s own production? In those 2 months that I took break the bad hair and bad skin came back so Im back on progesterone again. I also bought vitex as my period is still heavy. Any idea why the blood test showed lower levels? Im 43 years old. Thank you.

  20. I’m confused. It progesterone in theory can convert to androgens, but not in the body, then where does the theoretical conversion take place?

  21. Hi Lara,

    I’m curious your thoughts… With both of my babies I have experience hives right around the 10.5 month mark, when I’m weaning. With my first, they carried on for over a year and within that time I had two miscarriages. With the first pregnancy the hives subsided so my naturopath put me on progesterone, seeing a link. That seemed to help, but with the second pregnancy they came raging back. I miscarried again and she up upped my progesterone dosage. I eventually became pregnant with my daughter and with the help of a chiropractor my hives subsided, I thought for good. But here they are again, literally at almost there exact same time they occurred with my son. I see an ongoing hormonal connection. Should I try to the progesterone again? It seems this is somewhat common… ? Thanks for any insight.

  22. Dear Lara,
    My 17yo daughter has PCOS and was prescribed the pill, loestrin, by her dr. and took it for 6 mos. After buying and reading your book, I took her off the pill (against her doctor’s advice) a month and a half ago and started her on zinc and PCOSitol. She got her first period 23 days later but her progesterone level is very low, .7. She’s due for her 2nd period in a few days but it’s obvious with this low progesterone that she didn’t ovulate. You say in your book that it takes 100 days for healthy ovaries to ovulate. Should we start seeing an increase in her progesterone within the next couple of months? What if we don’t? She also has hashimoto’s.
    Thank you,
    Mary Beth

  23. Hello Lara, I am finding your blogs very interesting. However, I just wondered what evidence you have for the claim that progesterone reduces male hormones (androgens) by inhibiting the enzyme 5-alpha reductase? I cannot find anywhere in the literature where this is demonstrated.
    Many thanks.

  24. Hi Lara,
    Any recommendations for using progesterone cream for an irregular cycle? I’ve read using the cream can establish and/or suppress your cycle.
    Thank you!

  25. Thank you so much for sharing this info. It’s a good article. I have PCOS and low progesterone has played a major roll in my health, fertility, and was a key factor in 4 of my 5 miscarriages. I’ve found an awesome, natural progesterone supplement that has changed my life. I only wish I had known about it 2 years ago. It would have saved me a lot of heartache. Which is why I’m so passionate about sharing it with others.

    • Even with adrenal PCOS, progesterone can still have an anti-androgen effect by inhibiting 5-alpha-reductase and blocking androgen receptors.
      Its LH-lowering effect is not important for adrenal PCOS.

  26. Hi Lara,

    I read that progesterone cream can be anti-androgenic, but I also read that progesterone can convert into testosterone in the body which seems conflicting. Can you please explain?

    Thank you!

    • Progesterone is anti-androgen. Yes, in theory, it can convert to androgens, but it does not do that in the body. Instead, it acts as progesterone to inhibit 5-alpha-reductase and blocks androgen receptors. Read The 7 best natural anti-androgens.

      Also, (in the case of PCOS) progesterone lowers LH and therefore reduces the ovarian production of androgens.

      Many progestin drugs, on the other hand, are androgenic and cause testosterone-like side effects.

  27. thanks so much for your care of women. I am on HRT estrogen patch and I take natural micronized progesterone vaginally (off label use OK per MD). I see you mentioned a 50 mg capsule. Do you mean compounded? I can only see that there is 100mg lowest dose avail. I do not like to pulse or use progesterone sequencially due to mood swings from it, continuous is better for me–also it tames the effects of the estrogen patch which makes me sort of wired, bloated and puffy. I feel the 100mg vaginally every day is a heavy dose though. I am wondering how to get 50mg without popping the gel cap and squeezing half out, which I have considered! thanks so much. HRT has saved my life, as I had a peri-menopause induced depression and psychosis which nearly robbed me of my life.
    Health and happiness to all women, everywhere!!

  28. I have a ? Yes progesterone is good and needed but what of you have an adrenal problem and you have a progesterone steal situation … I feel lole shit when I take progesterone… joint pain scalp pain bloating and I am 45 so perimeno if not further

  29. Hi, I realized that after the intake of bioidentical progesterone at night (postmenopausal hormone balance), I have to get up throughout the night more often than I already have to, due to its diuretic effect. That side effect offsets the improved capacity to sleep. Will that last or is better to take the pill in the morning instead of in the evening?

  30. Hello, I wonder if you can explain to me why it is that taking progesterone pills, 150mg, makes me get acne but the cream does not. My gynecologist insist I take the pills to protect against cancer but I don’t want to anymore because dealing with acne and dry aging skin at 50 is not good. By the way I take care of my skin and am well educated in the field of dermatology. I’m wondering if I get acne because of estrogen dominance.
    Also, I’m the one who asked my doctor a few months ago to switch to cream and while taking the progesterone cream my skin was great but she insisted I take the pills instead and along with it came the acne.

  31. Hi Lara,

    I love this article, I’m going to print it out and give it to my doctor. Thank you.
    I have hashimotos, I’m on T4, my doctor is monitoring my TSH frequently. I’m seeing results in weight and skin, but not the hair thinning, or my anxiety which I find is now causing me fear and depression, I find I’m not thinking straight, things that never bothered me before suddenly bother me. It’s like I have someone elses brain. This was triggered by PMS, the moment it started, my mood changed completely, and I suddenly lost all confidence. And it seems that since my hypothyroid journey started, the PMS and periods were always a major issue, always being super stressed during PMS and menstruation. I suspect progesterone is definitely the issue. Once PMS starts, anxiety is full fledge, sleepless nights, and then it’s hard to get out of this funk, it can go on like this for months before I gain any mental clarity at all. In 2012 I had a cantaloupe sized fibroid, then doctor told me I had adenomyosis, I started eating a Paleo diet, to be more specific, The PHD diet which is Paleo but WITH carbohydrates and complete proper nutrition and supplements. I don’t dare eat dairy, but I seem to do fine with butter. It’s helped me a lot in many ways, I’ve improved so much but heavy periods and pms, and menstruation pains are still the same, mental state is not well. I now have this permanent nervous cough. I suspect I have a histamine intolerance because of reactions I get with many high histamine foods, I tend to get rashes with them, not all the high histamine foods, but most of them do. I don’t seem to react with lacto-fermented foods or fresh tomatos.. I started taking ashwagandha, I think it’s helping, it’s only been a week and a half that I’ve been taking it, I think it’s helping me cope a little so far. Do you know if prometrium is available in Canada by prescription. My doctor wants to start me on HRT therapy, I’m worried he’s going to put me on estrogen, I want to be armed with info when I see him.

    After my surgey for the fibroid removal back in 2012, I noticed that I had many food allergies that began, I may have sibo. I’ve tried many probiotics and many give me a rash, is their one you would recommend for someone like me?

    Thanks so much for all your time.
    God bless,


  32. Hi Lara,

    I’m beginning my 11th week of bleeding, which fluctuates: spotting, normal-for me, heavy, and flooding. I get only a day or two break before bleeding begins again. No cramping during this prolonged bleed and an ultrasound showed nothing. Can progesterone cream stop the bleeding? Vitex? Both?

    I’ve consumed no dairy or eggs for at least 12 years, no red meat for 20. I eat lots of greens, fruits, and veggies and successfully used raw ginger for new-to-me cramps during the past 2-3 years during regular cycles prior to this new phase of perimenopause. Interestingly, I’ve actually had no cramps since beginning iodine/iodide nearly a year ago, when periods were still regular.

    Thank you!

    • If this bleeding is due to perimenopause, then your doctor might want to offer you Prometrium (micronized progesterone capsules).
      Check out the heavy bleeding section in Chapter 10 of the pink Period Repair Manual. (the perimenopause chapter)

  33. Dear Lara, you mention in the above article that progesterone can help prevent autoimmune diseases…can it help for someone who has Crohn’s disease?

  34. I’ve read recently that progesterone supplementation is NOT recommended for uterine fibroids….what are your thoughts?

  35. I had my first period in almost 3yrs last month. If tracking correctly, I would have already ovulated. I had one even of bright pink, very light spotting before ovulation. I’m not lightly spotting. More like a tinted pink mucus. Would this maybe mean no ovulation and low progesterone? I sleep horrible. Is it bad to try progesterone to see if it helps? If not, when is best time to use? Thanks for any direction/help.

  36. Hi Lara, I’m so glad I found you.
    I’m going through the change and have started taking a little valerian for sleep, turmeric for overall health and hormone balance, as well as magnesium, b6, vitamin c, & zinc. I’ve learned to be very in tune with my body, so these supplements were kinda intuited and they are helpI got tremendously with the night sweats and palpitations, occasional panic, fatigue, & mood swings. I also drink tons of organic pressed cucumber, celery, lemon, kale, spinach, parsley juice, and I moderately exercise every day and go to bed early to ensure ample time for rest between any wake ups.
    Recently, I think as I’m nearing closer to menopause, my periods can get very long and heavy; during these types, there seems to be little to no luteal phase. Would over the counter yam based progesterone possibly help? Or is this just to be expected near menopause?
    Thank you so much for any insight on this.

  37. I’m trying to get off of the mini pill. Progestin only in the form of norethindrone . I do not like this pill and it’s giving me menopausal symptoms and has depleted me of Many hormones. But my brain is sensitive and I’m slowly cutting the daily dose but still very sick . I think my brain is used to being on some form of progestin/progesterone . Would taking Prometrium help the withdrawal? I have it on hand in cream and oral. 100mg.

  38. Thank you for this info! I have used natural progesterone cream before (purchased at the health food store) I would begin using it on the 12th day after my period would start, use it for 14 days then stop until the next month. I am now post menapausal and haven’t used it for quite sometime, I had read it causes weight gain and I struggle with that already. Do you have any insight on this? Thank you in advance!

  39. Hi Lara,
    I’m having difficulties with my cycle right now. I am 15 months PP and took antidepressants for a couple months after the birth of my son. Since then, I have had horrible spotting from ovulation all the way until my period comes. My OB thought I could have polyps but my uterine lining looks smooth and thin in ultrasounds. I am taking Provera this cycle and it seems to be helping as the spotting finally stopped. I know this could be masking the problem and I’m not sure what to do. It looks like my body needs progesterone but I’m not sure how to get a boost. My naturopath has me on some supplements too. I’m not sure why my progesterone would be so low. What do you recommend? All this spotting cannot be normal. I’m tempted to get a sonohysterogram just to make sure I really don’t have polyps. Thanks.

  40. Hey Lara!

    In general is there a brand of the peonie/licorice combin you like for PCOS? Furthermore, do you like to stick with a specific dose?

  41. Just started taking 50m g mg of oral biodentical progesterone and I’m breaking out. Could this be an initial response that gets better? Hoping so.

    • That is not a reaction that I often see with my patients. Could it be anything else? have you recently stopped the pill?

    • Hi Erin, just reading your comment. I am a retired herbalist but still always researching. I think I read the other day that some people if they have a certain gene mutation are more likely to convert progesterone down the androgen pathway than others. That seems to be why certain people break out and do worse on progesterone while those without this gene mutation find progesterone really beneficial. I just thought I would share that incase you wish to rresearch further. If anyone else has heard of this let me know??

  42. Hi Lara, First many thanks for all of your blog posts and your excellent book. The balanced approach you take has completely changed my approach to women’s health.

    Do you have any thoughts on pregnelone supplementation for patients with low progesterone and DHEA-S?

    My teenage daughter has endometriosis, and was recently fortunate to have an expert excision surgery which is a major cornerstone to managing pain. Unfortunately surgery doesn’t really change her underlying chemistry!

    She has fatigue, insomnia, and heavy menstrual bleeding which requires iron supplementation.

    She has made diet (dairy and gluten free) and basic supplement (magnesium and zinc) changes which have helped. But I’ve been wondering about bio-identical progesterone or possibly pregnenolone supplementation. (We live in US where we can get both of those OTC.)

    I’ve never seen any reference to pregnenolone in your writing, so thanks in advance for any thoughts.

    • Thanks so much for your feedback! I have never used pregnenolone with my patients, so that’s why I’ve never written about it. In general, progesterone can be helpful for endometriosis BUT I think for a teen with endometriosis, it’s much better to start with turmeric and/or N-acetyl cysteine. They can give great relief and they’re non-hormonal, which is even better. (Because endometriosis is not a hormonal condition.)

  43. This is wonderful information. Thank you for putting it together. My life has changed since kicking HBC and starting FAM. I absolutely am passionate about charting for health and seeing the difference that balancing hormones makes. The horror stories I now see and hear as I talk about hormone health with women are everywhere.
    Whenever I have a cycle with a Progesterone struggle I supplement with Vitex (from estimated ovulation day) the next cycle. It works so well for me. Boost my LP temps and reduces any PMS to nothing.
    I love having the power to help myself and see how any change effects my hormones as revealed in my charts.

  44. Hi Lara, I really hope you can help me because I’m struggling to find any information on what to do when you are ovulating but bbt rise only lasts a few days, progesterone is low and you get premenstrual spotting. I got your book and have started eating more protein and fats as I was mainly eating carbs, I’ve been taking vitex, iodine, selenium, zinc, vitamin d3, algae omega 3 oil, iron, milk thistle and berberine. I eat whole foods and lots of veggies. Your book talks about boosting progesterone through ovulating but what if you’re already ovulating? Please let me know! X

    • It’s about ovulation quality which is ultimately to do with egg quality and keeping the eggs happy for all their 100 days to ovulation. I mention it in Chapter 5 where I discuss Low Progesterone and a short luteal phase. It’s called a “luteal phase defect.”

      It’s possible your treatments just need more time.

  45. Dear Lara, I am addicted to sublingual, bioidentical Progesterone, 650 mg. every night and I’m miserable, have
    seen doctors to try to detox but so far no help. I had been addicted to Benzos for sleep but was able to detox,
    miserable experience. Insomnia was worse after the detox and my doctor prescribed the Progesterone. The
    pharmacist kept telling me to increase the dose until I got some sleep. At 650 mg. I get 5-6 hours of sleep. If I drop it 25 mg. I don’t sleep at all. Periodically I have to skip sleep altogether to help alleviate the extreme brain fog, head pressure and misery in general. Any suggestions would be greatly appreciated. Toni

    • Have you put in place other things for sleep such as magnesium, glycine, and low-histamine diet? With that strategy, you might find you can get away with a lower dose of progesterone.

  46. Hi, Having read your book I have found a DR who can prescribe bio-identical progesterone. I am trying it for my severe endometriosis and migraines. I am taking 50mg lozenge twice daily throughout my cycle. I am 3 weeks in and my symptoms seem to be getting worse, endometriosis pain during luteal phase has been full-on.

    Can you get upregulation of oestrogen receptors when first starting progesterone treatment aggrevating symptoms? I think I read something about this somewhere? How long do you give it with starting progesterone treatment to see if it is helping? Is a higher dose needed to stop ovulation in severe cases of endo?

    • There are different ways to use progesterone. Yes, some doctors look at using a high dose all cycle to try to suppress ovulation. With my own patients, I prefer to use a lower dose during the luteal phase only.

      And in answer to your question, yes, progesterone seems to have an estrogenic effect in some women. It could be related to dose and timing, or it could be that you have a relatively common variant of the progesterone receptor that makes you more sensitive to progesterone, and therefore that progesterone is not the right thing. Please also make sure you also have inflammation and histamine-reducing treatments in place.

  47. Hi Dr Briden, I read The Period Repair Manual a few months ago, and bought one of the recommended brands of progesterone cream. However, I’m having an odd problem with it. Every time I use it, it makes me start my period almost two weeks early. I’ll try using it fourteen days before my period is supposed to come, and I’ll start spotting the very next day, then my period will arrive the day after that. Any idea what might be causing this?

    • That can happen if you’ve been having anovulatory cycles. Are you fairly confident that you’re ovulating? If so, then you want to start progesterone about 3 days after ovulation. If you’re not ovulating, then you want to figure out why not, and treat that.

      • Hi Dr. Briden,

        I love your website & your blog! Thank you so much for sharing your education & insight with us women!

        I have spotting for days after my period ends, and I am wondering if it is an issue with Progesterone or Estrogen?

        I currently have Hypothyroidism that is being adequately treated, & I use Bioidentical Progesterone (day 8 until Day 25 or so, otherwise I have major bleeding & cramping), & I occassionally use the Progesterone cream during menstruation because of flooding (I read an article you referenced about Perimenopausal flooding during the period). I also take Zinc, Iron, & follow a gluten-free & dairy-free diet due to food allergies.

        I would appreciate any insight you may have for me!

  48. My progesterone level is only 1 after the blood test results came back my physician recommend I take 50mg to 100mg I’ve been taking 50 would it be alright just to take the hundred mg

  49. Can I please ask a question about progesterone receptors? Basically, I’ve managed to downregulate my receptors by taking 200mg progesterone cream without a break for 4 mths. (It’s not a question of ‘dermal fatigue’ or it being absorbed as I’ve also tried pessaries and lozenges to no avail. I’ve also tried increasing the dose even up to 500mg and my body is just not responding.) Do you know how long a break from the cream I’d have to take to upregulate the receptors again? I have CFS and sadly if I take a break from the cream I become bedbound within a couple of weeks but this is something I’ll have to resign myself to.

  50. My progesterone was low on a blood test and estrogen high. Dr prescribed 100mg capsules bio identical progesterone. I started to take it by my face broke out in hives. Is it some temporary too much estrogen situation? Thank you

    • Hi Zina, I experience a similar thing (quite severe facial rash/bee-stung eyes) when I first took oestrogen. There are specific oestrogen receptors on the face and as oestrogen increases histamine, I linked that cause and effect together. I have to say this is just a theory as I’m a high histamine person at the best of times and for me, with this particular hormonal-rash, antihistamines didn’t seem to work as effectively as normal (potentially another immune related reason mentioned below).

      But after stopping oestrogen, several weeks later I started a trial of 100mg progesterone, and the exact same reaction happened, lasting for about 48hrs/2 days. I also noticed 100mg which is pretty standard for most women would knock me out for 2 days, but then would feel ok and the rash would go. I experienced the same effects on only 50mg progesterone. So perhaps on an individual basis, there’s a sensitivity to progesterone or a receptor site issue (I’m also a naturopath and have had women on 300mg progesterone that doesn’t even touch the sides!)

      Progesterone has on average a 25-50hr half life meaning it’s out of your system after 1-2 days and progesterone also sensitises oestrogen receptors so initially, you can end up with high oestrogen/histamine symptoms from progesterone that should die down in that 1-2 day time-frame.

      Most will say to keep dosing the progesterone and the symptoms eventually disappear but if you’re looking and feeling like you’ve walked into a hornet’s nest, that’s not useful advice! 🙂

      So, personally, I’ve been working on a low-histamine protocol for several weeks and have just started back on 50mg of progesterone which I plan to take only every 2nd/3rd day. I’ve trialled one night so far and it was good! But only time will tell.

      There is still a missing piece of the puzzle for me in that I have the exact same reaction on myo-inositol. I’m yet to find out the relationship there (may have something to do with phospholipids/liver) but I’ll keep searching.

      There is also a condition called Autoimmune Progesterone Dermatitis which could be missed in the irregular cycling of women’s hormones .. there’s one paper here but there’s more info out there: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC509283/
      https://www.tjog-online.com/article/S1028-4559(14)00141-7/fulltext (this wouldn’t explain the similar reaction to oestrogen if the OCP resolved the issue stopping endogenous progesterone, but it’s interesting..)

      Love to know your thoughts Lara x

      • Thank you so much for commenting, Kate! That’s similar to thoughts I’ve had about it. And good to bring up the possibility of progesterone dermatitis.

      • Hi Kate,

        Thank you for your reply. I have had mild histamines intolerance my whole life and if I really over do it with high histamines food I get a bit of eczema on my face but never had hives before. Initially my Dr gave me progesterone cream 50mg which I applied for 3 cycles (14-26 days of my cycle) and had no physical reaction although I felt very emotional and wanted to cry a lot which I thought was funny as normally I very rarely cry : ) It has been 14 days since I took the last capsule but the hives come and go and I have to take anti histamines every day. Today i should start taking it again but wonder if I should give it a miss this month until my body calms down. I have been stressed a lot in last few weeks plus I changed the type of my thyroid medication so maybe it has been too much for my body.

  51. Hello! Thanks for the information. My problem is that I have PCOS, I have 3 months of being taking Inositol and D-Chiro Inositol (ratio 40:1) and also I‘m taking Metformine (780 mg per day). I also drink one cup of spearmint and green tea daily. I‘ve seen major improvements; I almost have no more acne and my hair lasts more time clean. But in terms of hair, I’ve seen no improvements.
    Now that I‘ve read this article about progesterone, I want to try it. Would you recommend me to try it or I better wait more?
    I‘ve changed my diet, now I eat more vegetables, fiber, antioxidants, etc and less carbs than before. I exercise by walking aprox 20km per week. Thanks!

  52. Hi Lara, Thanks for wonderful advice in book.

    I am trying some of the recommendations for endometriosis and migraines. I have severe migraines onset with period which continue until after I ovulate (10-12 days long migraines!!) my labs show very high oestrogens and normal to slightly raised progesterone in luteal phase. I show sypmtons of both oestrogen excess and low oestrogen at different times on the cycle, huge swings! I have tried most natural remedies over the years seeing herbalists or functional medicine practitioners, not much makes a difference.

    It is hard to function with endo and migraines and so my question is when i talk to GYN/OBS consultant what are good, least side effect options to discuss……is this one of the times when the pill is appropriate to pause it all? Is there one which is preferable? also can micronized progesterone be taken all month to reduce endo and migraines?


    • HAve you tried strictly avoiding cow’s dairy, gluten, and eggs? That seems to get results with many of my patients. Also, the supplements zinc and NAC as described in my book. And also, yes, micronized progesterone can be taken for a big part of the month. But I always like to have at least a few days off to prevent attenuation of its effect.

      • I been gluten free for years and off cows dairy for a year, even off sheep last 6 months. Might try off eggs. Yes taking zinc, glutathione, turmeric, calcium d glucarate etc. Endo in upper abdomen and migraines seem to be when im withdrawing from oestrogen at ovulation and with period and follicular phase.
        Do you find good results with low dose 100mg prometrium or is 300mg daily to surpress cyle necessary?

        thanks again!

  53. Hello!
    I started taking progesterone cream 3 months ago for estrogen dominance. It really helped alot, especially with depression and energy. But I used much more than 20 mg a day on most days, because I read about “a loading dose” from several sources. Now I have many undesirable symptoms including terrible insomnia, dizziness, tight chest, headaches, stomach problems… How would I be able to get the excess progresterone out of my system? I really feel bad.

  54. Hello Dr. Briden, I am reading you book and really enjoying it, thanks for shedding light on these things giving hope to women like me with PCOS. I am about to undertake IVF – I am currently on the contraceptive pill to prevent the formation of cysts and plan the start of the cycle. I understand that by taking the pill I can’t do the progesterone test – so wonder whether you recommend I anyway take the progesterone cream USP or whether since I am about to start the IVF I should hold-on. As part of my IVF protocol the luteal phase is supported with the use of intravaginal micronized progesterone tablets (200 mg three times a day). Thanks for the hope you give all of us! Sabrina

  55. Hi Lara,

    I’ve been using progesterone cream for about a month now – my naturopath prescribed it to potentially help with hair loss, acne, and sebum overproduction on my scalp. I haven’t seen any improvements yet, and in terms of negative reactions I only noticed some spotting on day 4 and 5 of my period this month (usually I have a three day cycle). Do you think it’s okay to continue? Should I expect it to help with the sebum and scalp oil? I’ve been dealing with it for 2 years, since stopping birth control -sometimes it feels like that stupid pill permanently enlarged my sebaceous glands or something….any thoughts on how soon I can expect improvements from prog cream? Thanks!

  56. Such a useful article! I have just been prescribed a progesterone cure to help with my fertility, I have a crazy dream: to procreate a beautiful baby with the love of my life, who I met at 44….God (and progesterone) help us ❤

    • Started taking bioidentical progesterone cream after 4 days pain and tenderness in breast increases. Does intital use of progesterone cream makes estrogen dominance worse and increases the pain?

      Please reply !!

      • Progesterone can temporarily upregulate estrogen receptors. Which is the explanation usually put forward to explain why some women develop breast tenderness on progesterone. However. With my own patients, I am not comfortable with breast tenderness. So, I would usually start with iodine (if appropriate) to downregulate hormone receptors and protect the breasts. Please read my article: Why I prescribe iodine for breast pain. And then, I start with a low dose of progesterone.

    • Yes, it’s the same hormone our bodies produce. Progesterone cream is available in some countries over-the-counter. It’s also available as a prescription capsule such as Prometrium or Utrogestan.

  57. Hi Dr. Briden! Thank you for all the work you do to help women’s health! Do you have any advice for women who have only one ovary left? I’m 37 and lost one 4 years ago and am finding my periods getting shorter, lighter, and closer together. Thank you for any insight you have!

    • thanks for your comment. The good news is that one ovary should be able to do the job of two. And something to keep in mind is that those kinds of changes are common in our late 30s anyway. My best advice would be to continue to support your body in what it needs to ovulate. That is according to the different factors I discuss in my book: Nutrients for ovulation (such as zinc, iodine and vitamin D), and addressing any underlying issue (such as thyroid or insulin resistance) that can impair ovulation.

  58. Hi lara, im 5 months postpartum and ive been getting on and off insomnia since baby was 3 months.i only breasfeed my baby no formula. I went to a naturopath and did a blood test and my porogresterone is 1.2 nmol estrogen 161 pmol. She gave me this progresterone cream to put every night, i was wondering if this cream will help because i still sometimes have this insomnia also i have dry skin, losing some hair and dry vagina. Please help me because i live in a country where they dont know whats going on, is this because of breastfeeding or estrogen dominat? Thank you and waiting for your reply

  59. Hi Lara – I’m really interested in your approach re. Hormones. I’m 55 years old approximately 5 years post meno. I currently use oestrogel 1.5mg per day and am struggling to find the correct dose of progesterone. I’ve been prescribed utrogestan capsules 100 mgs x 7 days per month for uterine protection but that dose just floors me. Do you have any suggestions? I prefer to use progesterone than a progestin although I understand that dydrogesterone is almost identical. Your thoughts would be much appreciated.


    Dawn Campbell

    • Utrogestan is natural progesterone. What do you mean by “floors you”? It’s very sedating so should always be taken at bedtime.

      • Apologies for taking so long to reply, I’ve had a tough time recently with menopause. By ‘floors’ I mean it wipes me out; during 7 days of progesterone night sweats return, joints ache, very low mood, digestive disruption, water retention and bloating. I could go on…. I’ve come across studies on 100mg utrogestan alternate day dosing on a continuous basis alongside my 50mcg oestradiol patch. What’s your opinion on this type of dosing?

  60. Hi Lara ! Thank for all your info you share with us. I have a question concerning onkomarkers..Last year I was diagnosed with hemoraghic cyst (maybe endometrial, gynecologist is not sure, no laparoscopy was done)..onkomarkers were in range. Now, 1 year later, cyst is still the same but onkomarkers went up – Ca125 is 323 (range is 0-35) and Ca72-4 is 19,9 (range is 0-7). Is it a sign of endometriosis or anything else ? My gynecologist propose a laparoscopy. I don´t have any sign of endometriosis…just irregular cycle, low levels of progesteron and estrogen. I have Hashi and hypothyroid. Please, let me know what these onkomarkers mean a nd what should I do or check before I decide for laparoscopy. I´m 37 and haven´t been pregnant yet. Thank you so much.

  61. Hello! I have found your site so helpful! I have RA and was just diagnosed with severe endometriosis. I just had surgery for the endo last week and my doctor is recommending that I start birth control to manage it until we are in a place to try to conceive. I am NOT excited about doing hormonal birth control. Is it possible to use natural progesterone instead of the normal progestins found in birth control for this? Is this even an option that I can discuss with my doctor?

    • ashleyrosanne,

      Yes, it is possible to use natural Progesterone for menstrual issues, but please understand it is not a form of birth control. If you look on this website, Dr. Briden has several blog posts she has written about Endometriosis, supplements that are helpful, & even a link to an Ovulation Research website discussing the need for higher dosages of Progesterone in patients with Endometriosis to manage pain & excessive bleeding. Another website you could check out is “Nancy’s Nook” on Facebook, which is a members-only group. Nancy is a retired nurse with medical connections who suffered with Endo herself, has written & published a plethora of information about treating & managing Endometriosis, & has published an international list of doctors & surgeons who treat Endo with Excision (cutting the Endo lesions out, which removes Endo from the root, vs. Ablation, which just burns the top layer off & leaves the roots to probably regrow). I myself wonder if I might have Endo, have done all these steps I am mentioning to you, & have an appointment to meet with a surgeon on Nancy’s List. I hope this information helps you!

  62. I can’t find the hair loss blog of yours i wanted to post this on but this might still be relevant. For the past year I’ve been dealing with a whole bunch of new problems and I don’t know what’s up. I moved to a small town two years ago and my doctor blames it all on anxiety and says I’m a healthy chick. So here goes. Derealization (sometimes lasting 8 hours), hair loss in upper back of scalp, hair growth on chin and thighs, cysts on underwear line and law line, fatigue, migraines, tiny moles popping up all over and tension headaches. Also increased astigmatism, allergy eyes, sensitivity to light, heart palpitations and low blood pressure(and feeling faint) and tinnitus really bad. I had my Mirena removed last week. I’m taking some supplements. Not sure if this is all hormonal. Just looking for insight and any ideas about how to balance hormones if that’s likely to be the problem.

    Thank you!

    • You poor chick, that sounds horrible. My heart goes out to you.

      I was also told I had severe anxiety and was given a SSRI script. I never took it because the non stop bleeding was my sign something else was going on causing the anxiety. So I followed this blog with a fine tooth comb, bought the book and made the changes and I am mostly happy again with no signs of anxiety and zero symptoms (except I’m a little too relaxed and brain foggy during my high progesterone part of my cycle – which is now – so sorry if some of my comment can’t be understood).

      Stress (physical, mental and emotional) /nervousness/anxiety whatever word people use to describe that negative feeling that is built around fear actually causes hormonal problems so the Dr’s diagnosis may not be incorrect (but how they handle those symptoms may be). There are so many possibilities to what is causing your issues. You can take years to work it out on your own like I did or make an appointment with Dr Briden to get a resolution much quicker.

      Tinnitus happened to me as a result of an imbalance with my hormones same with skin tags (not moles)
      Headaches/Migraines/Eye irritation, light (and sound) sensitivity were from high histamine (again linked to high estrogen)
      (I once had cysts on my bottom and my Dr’s all tested for insulin)
      The hair issues seem to be linked to excess androgens like I see in my friends with PCOS.

      If your Dr’s are right and you have a form of anxiety, then that anxiety is stealing the happy hormone progesterone from you leaving you even more anxious and then that stress you’re experiencing will stop you ovulating next month causing many symptoms you have that I also once had…nasty vicious cycle because the anxiety keeps getting worse and worse.

      So you have to put a stop to what is causing any stress be it relationships, where you live, work and even what you think about and one most shocks people is low carb and over exercising (walk should be all you do with anxiety). Maybe think about moving to the small town as a place you’re meant to go to for quiet and peace to work out all this about your body? It’s all about our perspective that alters our life. I would rather be delusionally positive than delusionally negative (which is what all negativity is about)

      Your body, depending on how old you are, may even be lacking amino acids, vitamins, minerals that Dr Briden can assist you with. Her book is easier to go through then each blog.

      First step is to eliminate what makes you feel yuck. Yep your emotions want your attention.
      Next step is go and see the creator of this blog. Have faith in Dr Briden. Hand over your worries to her and start trusting that everything will unfold perfectly for you.
      Sleep. Do anything in your power to sleep earlier even a few minutes every night will benefit you.
      Go get a full blood test to rule out insulin, thyroid, day 21 of your cycle progesterone (I think they test estrogen then too) and take your results to her.

  63. My luteal phase is approx 8 days and I have low temps and fertile mucus in the luteal phase. I have never had any spotting though? I have been trying for a baby for two years and having seen your website am wondering if vitex, under some guidance might be the way forward? Any tips greatfully received. Thank you

    • Possibly Vitex can help in this situation, but please make sure everything else is in place for a healthy ovulation: adequate zinc, adequate nutrition including carbs, healthy thyroid function, no PCOS. See my book for more info.

  64. I took it for like 4 months I believe! I’m thinking of just going in to have my testosterone checked to see if that is even the problem! What are the normal testosterone ranges for functional medicine? Since I know labs have wide reference ranges!

  65. What is normal range for total testosterone and free testosterone? I’ve taken zinc but I think it raises mine because my skin gets worse!

      • I took it for like 4 months I believe! I’m thinking of just going in to have my testosterone checked to see if that is even the problem! What are the normal testosterone ranges for functional medicine? Since I know labs have wide reference ranges!

  66. Hi Lara, I’m so glad I found your website it has answered so many questions, I wish I’d found it years ago when I started getting acne at the age of 24. I would have never gone on the pill! Now I’m too scared to come off it. I still get acne even though I’m following all the right steps. Could I take bioidentical progesterone whilst on the pill or will it not work? I have PCOS, and am 28 now. Slim and healthy, gluten, dairy, soy and sugar free diet and I take magnesium, zinc, turmeric, metformin and B complex. Also, what are your thoughts on metformin?

      • Yeah I’ve read all your articles, I can’t go on DIM as I am still on the pill. I was just wondering if I can take bioidentical progesterone while on the pill to help with my acne. I do intend to come off the pill and when I do I will try DIM, however I can’t come off it until next year when I’m in a more stable person, I can’t handle post pill acne just yet on top of current life problems…Will metformin help regulate my periods when I come off the pill?

  67. Hi Lara,

    I’m 42 and continuously spot (thin brown blood, with occasional stringiness) for 7 days before my period starts. This started at age 39, and the only thing that has helped stop the spotting is taking birth control pills, unfortunately. After reading your book, I stopped taking the birth control pills but of course the spotting returned. I then tried ashwagandha and magnesium supplementation for several months according to your recommendation, but it only helped a little and only during the first two months. Then I tried vitex for three months but that has not seemed to help either. I really want to stop the spotting, and I am on the verge of going back on the birth control pill to do so, but I don’t want to for the sake of my general well-being. Would you recommend I try progesterone cream? Any advice is appreciated.

    Thank you so much,

    • Kay,

      Based on previous blog posts Dr. Briden has written about Progesterone, this spotting of brown blood for 7 days before menstruation indicates low Progesterone levels. Please check out some of Dr. Briden’s other blog posts about this. I, too suffer from this issue at times, & I am already on high doses of Bioidential Progesterone cream. Other causes can be the need for supplements like Zinc, DIM (to decrease Estrogen levels), or other diet tweaks, as recommended by Dr. Briden. I hope this helps you!

  68. Hi Dr Lara – I’m halfway through your book and I’m ready to chuck my birth control out of the window.

    I started the Pill 8 months ago because I have hairloss (likely from iron deficiency) and doctors told me it was good for hair. I had regular periods before the pill.

    Q: Is there anything I can do to avoid the post-pill hairloss? I’m wondering if I start taking half doses of my remaining pills, would that be a gentler hormonal change and maybe I could keep some hair?

    • A lot of women ask that same question: Whether it works to “wean down” birth control? The problem is that by taking any birth control, you may then prevent your own ovulation and making of progesterone. And natural progesterone is the best treatment for hair!

      But I will say that before you stop birth control, you’ll want to have blood tests for all the things that hair needs: thyroid, iron, and zinc. Did you see my post 9 Things to Know about Female Hair Loss.

  69. Hi, am 43 trying to cinceive. Took DIM 250 mg for 1 month and my cycle increase from ca 25 days to 28 days. Now longer lutheal phase. Still spotting 2-3 days before my period. After DIM I have suffered from insomnia for 2 months now. My doctor suggested Melatonin 2 mg daily and I tryed for 1 month with no results. Still can stay asleep during the night. Wake up and cant fall back to sleep again. Suggested also other stuff but I dont want to bc I am trying to conceive. Do you have other suggestions? My lab works are normal, dont have problems nor too much stress. Right now 2 weeks on vacation to see if sunshine and a good daily sunrise/sunset routine will help me..i think it was DIM, have not taken any thing else. Not started on Vitex either. Thank you! Kind regards, Kerstin

    • Interesting thanks for sharing your story, Kerstin. I’ve just had a couple other women comment on my blog that DIM has caused what seem like estrogen deficiency symptoms. Did the DIM lighten or reduce your menstrual flow? (amount of estrogen = amount of menstrual flow)

      It’s possible it affected your thyroid. Has your thyroid been checked?

  70. Dear Lara,

    I just posted my experience else where on the blog about the post-pill acne I suffered from after coming off my birth control (nearly 4 years ago).

    I had terrible cystic acne and what really helped was yarrow tea which is a progesterone-like plant. However, the diffuse hair loss which started after coming off the pill never stopped and despite the wonderful results on my skin I continued to have some breakouts from time to time.

    The weird thing is I stopped my yarrow supplements and vitamin supplements in April 2016 and my skin and especially my hair got better on their own. Within a few weeks my hair got so much thicker and fuller until…. I got pregnant late June!

    The hair loss was awful during the first trimester of my pregnancy and it has now slowed down a little.

    I am taking pregnancy vitamins, iron and a so-called natural treatment for my low thyroid (Thyroid Erfa). All my blood results are ok. And yet my hair is still shedding and it is thinner than ever… I used to have long beautiful thick curly hair….

    I wonder if this hair loss is not due to the high levels of progesterone?

    Could it be that I am now over-sensitive to progesterone and could this be due to taking excessive amount of yarrow supplements over the past years?

    My skin is nice though…

    Thanks a lot for any insight you may share about this! 😉

  71. Hi Lara,

    I have been ovulating every month since stopping the pill a year ago, so I know I’m making progesterone. My naturopathic did a comprehensive hormone test and found my progesterone levels to be about half what they should be. Is there something else I can be doing, or do I just need more time to catch up and stabilize my body? I am struggling with bad hair loss and sebum overproduction on my face/scalp.

  72. Dear Lara, Thank you so much for sharing your blog! I am 39 and several of your posts have helped me tremendously. I was especially helped by the post about the curious connection between estrogen and histamine. I started taking natural progesterone and occasionally Claritin and experienced a huge relief in symptoms. But then here and there my heart would start racing or pounding…sometimes for an hour or more. I stopped taking the Claritin, but I still sometimes have this experience . Is it a common side affect?

  73. I was really impressed with your blog! I am very interested in moving the conversation in health care in this country towards Naturopathic Medicine and nutrition. I have recently started a blog and I am trying to reach out to like-minded people. It is https://themodernrevolution.com/

    On Wednesdays I would like to feature guest bloggers. Please let me know if you’d be interested in contributing. My name is Peter Deeley and my e-mail is [email protected]

    If you would consider a link back to me in a blog post – I am doing my best to do the things I have been advised to do – in order to cultivate my new baby 🙂

  74. Hello Lara,

    I am really worried about my hair loss, taking vitamins and dieting does not seem to bring any improvement. I am thinking to go to the trichologist. This particular one offers Minoxidil which is mixed with a hormone called Medroxyprogesterone (MPG) in Minoxidil 4 and 5% solutions. They say that this “helps to prevent the hormone derivative ‘dihydrotestosterone’ from interfering with the hair follicles function. Do you think I should invest in such treatment? Do you know any side effects from Minoxidil or Medroxyprogesterone?

      • Thank you for the reply,

        I have the ovulation strips but never seen them positive. I have polycystic ovaries and my period comes every two – three months. I don’t ovulate regularly, but my thyroid is in a normal range – FT3- 5.35, FT4 15.86 TTH/TSH – 1.610, antibodies ATPO – 7.86, E2 – 185.600, insulin – 57,cholesterol – 4.68, LH – 18.28, PG – 1.76, Fe – 16.99. D3 – 125.50,

        I do have a diagnosis of hair loss from trichologist, but she was unable to help me to come up with solutions apart from Minoxidil and other clinic is offering a patented solution of Minoxidil mixed with Medroxyprogesterone. Do you think these medicaments are safe to use? I am worried I cant see to many studies on their side effects and also they are prescribed for life.

        I would like to buy a progesterone cream and try it for one year. We don’t have these over the counter in UK. Could you recommend some respectable brands?

        Thank you for your help Lara,


        • The best solution is to correct the underlying PCOS, and so ovulate regularly, and so make progesterone.
          For treatment ideas, please see my PCOS post and Chapter 7 of my book.

  75. Hi, Lara,

    Is Vitex a good herb for women with adrenal PCOS and low Progesterone & Estrogen? Can it be used in conjunction with an Adrenal blend such as the Gaia Adrenal which blends Rhodiola, Holy Basil, Ashwagandha, Schisandra, Milky Oats? Thank you

  76. Dr Briden, I have endometriosis and am trying to treat it naturally (gluten free dairy free magnesium) but the pain is unbearable…would a progesterone cream help at all?

      • Thanks so much for getting back to me! Yes I’ve been following everything on your list besides the berberine for 3 months since I stopped loloestrin.

        I’ve currently been bleeding for 19 days now which is why I wondered maybe if progesterone would make it stop. My obgyn wants me to start yaz or mirena but I’m holding out and seeing if these methods work first.

        Any other tips for endo?

        Thank you so much. You’re awesome!

        • For the record, I think Mirena is a reasonable treatment option for endometriosis (as I explain in my endometriosis post).

          And it can work well to combine natural treatment methods with conventional treatment such as Mirena. I’m worried that you say the pain is unbearable. Please don’t let it get too bad, or you’ll end up facing surgery.

          As for your question about natural progesterone capsules, please see Prof Prior’s post Endometriosis and Natural Progesterone.

  77. Hi Dr. Lara,

    Is it possible for Insulin Resistance to be the cause of high Adrenal Androgens? Testosterone is normal, so not sure what to think. Also, is ovulating a factor of a “normal period”? I was diagnosed with PCOS, but don’t have irregular periods, they come each month and last about 7 days. However, I don’t think I ovulate. My doctor said she doesn’t think I ovulate every month, although I don’t know why she said that. I don’t make ovulation mucous, though. I did once long ago while I took D-Chiro-Inositol for about a month, but discontinued due to financial reasons. I went to the doctor when it happened, because I had never seen it before and was told it was ovulation, so I’m pretty certain I don’t ovulate.

  78. Hi, Lara. Do you know why Evening Primrose Oil causes breast growth in some women? I want to take it for Endometriosis, but I don’t want my breasts to grow. Is there any way to prevent this?

  79. Hi Lara,

    I am needing to stop vitex due to worsening of acne and not helping my cycles after 3 months. Should I wean off of it? Or can I stop cold turkey? And when I stop it should the acne go away? I’ve read it can get worse after stopping it…

  80. Dear Lara,

    Thank you for your knowledge and the wonderful book Period Repair Manual. I hope you can help me out, a young woman desperately trying to save her hormonal health.

    I am 22 and experience severe androgen excess symptoms – scalp hair loss and hirsutism. I have lost 40% of hair volume due to miniaturisation. I do not have PCOS according to my doctor, as I do not have elevated testosterone on my blood test (0.6nmol/L). However, in 2014, my SHBG was low (due to high fasting insulin reading at 13) but my recent test has shown improvement of both SHBG (now 73nmol/L, was 29) and insulin (now 6) since I eliminated high glycemic foods from my diet and lost about 5kg. My current BMI is 22.3.

    I had low iron stores and have been on iron supplement for a couple of years. Iron reading is now normal however Ferritin level is still borderline low. Why is it that I am only able to raise Iron but not Ferritin?

    I have always had quite heavy periods, does it mean high estrogen? However, I often experience vaginal dryness during sex. I believe I ovulate regularly, I have never been on any birth control and I have regular 28-day cycles. My recent day-21 progesterone level is 41, but I believe this is not optimal. You mentioned in your book that stress steals progesterone to make cortisol, I am easily stressed and have had severe anxiety, panic attacks and insomnia.

    Lastly, I would like to ask about my TSH level of 0.42, do you think this would mean a hypo or hyper thyroid condition?

    Since reading your book, I have started taking magnesium glycinate, turmeric, probiotics and rhodiola. What other natural treatments would help me recover my hair, reduce hirsutism and restore hormonal balance?

    I sincerely hope to hear a reply from you dear Lara, many thanks.

  81. Hello Lara, I’m brazilian and I purchased your book earlier this year, and because my progesterone levels were low (I dropped the pill last year) I started taking a little bit of bioidentical progesterone. But now, my breasts hurt and I have abdominal bloating, ist very uncomfortable, its been this way for almost 40 days, I dropped the progesterone, but is there anything that will make this go away? Because I am kind of depressed because of this… And I would like to know when my body be normal again. Please answer my comment Lara, I am a big fan of yours! Sorry for my bad english.

      • Yes Dr., I do ovulate! I am 24 years old, and even with all the progesterone in my sistem I am still ovulating, I detected it through the basal temperatura and discharges.

        • If you ovulate, then you are probably not progesterone deficient. It might just be that you tested progesterone at the wrong time in your cycle. I’m about to write a new post on progesterone testing.
          The effects from the progesterone supplement should wear off quickly. And you could consider iodine as treatment for breast pain. Please see my post: Why I prescribe iodine for breast pain.

  82. Lara,

    So, what is the verdict? I am confused. Do you recommend Progesterone cream or only progesterone prescriptions? My worry with creams is transferring the hormones. What are your thoughts?


  83. After I went off bcp for 7-8 years ago I’ve had acne. I’ve seeked all kind of professional help. I’ve been on all kinds of supplements since. Could the supplements cause my acne? Would it be clever to just discontinue them all and see what gappens?

  84. Lara, can you please advise if you think it is safe to take either Tagamet or Oral Nizoral to prevent and hopefully reverse androgenic alopecia, due to PCOS? I read on the site that you do not think spiro is safe and that it can throw off the natural cycle, but I need an alternative to lower androgens and apparently both of these drugs have been tested and proven to be anti-androgenic, just off-label. I cannot afford a naturopathic or bio-identical doctor at this time to see about getting a prescription for Progesterone cream. I have been using a supplement that has saw palmetto and beta sitosterol and I don’t think it is helping or at all effective. I need something to stop the hair loss as well as the hirsutism.

    Can you please also tell me if you think that Progest E is safe and effective? I believe it is an oral progesterone that you rub into your gums.

    • My favourite androgen blockers are progesterone, DIM, and zinc. One day, I’d like to see research that compared them to pharmaceutical androgen-blockers.

      I don’t have a strong opinion about Tagamet or Nizoral, although I have concerns about side effects of both. In particular. Tagamet suppresses stomach acid (after all, it is a stomach acid medicine), and thereby impairs absorption of minerals like iron and zinc that you would need for hair.

      Progest E is very low dose bioidentical (natural) progesterone. I think it’s 3 mg per drop, which is lower than the standard over-the-counter progesterone cream which is 20 mg per dose.

  85. Is it possible to have estrogen deficiency at age of 30? My naturopath says that I’m progesterone deficient and have excess of estrogen. But when I take supplements to boost progesterone (b6, magnesium, sink, dim, b-kompleks) I get serious hot flashes. I also have acne, and they have not improved after starting these supplements. I also don’t eat sugar, wheat og cow’s milk. I have problems with my bladder (had for years, and pee quite often. It’s worse at night). I also have sleeping disorders (insomnia). Never get a good night sleep, and always wake up wide awake in the middle of the night. When me and my husband get intimate I always have to use something cause I feel dry. I also get a new pimple every day, and their cystic. Please help me Lara, I’m desperate…

      • I have a 28 day regular cycle. But I don’t know if I ovaluate every month. Brfore I always felt symptoms when I ovulated, but lately I have not had any. How do I find out if I ovulate? I also have realy dry eyes. They are worse at night, and my eyedoctor says their fine.

        • Simplest way to know if you ovulate is to track your basal body temperature. If you do ovulate, then you should be making enough estrogen, although some women do tend to lower levels (which I discuss in Chapters 5 and 9 of my book). The best test for estrogen is the number days of menstruation and the amount of menstrual fluid. More estrogen = more menstruation. Less estrogen = scanty menstruation.

          And just for the record, DIM does not boost progesterone, but it does reduce estrogen, and can reduce it too much.

          • I will keep track from now on. I don’t get the discharge I used to. The slimy one. I always had a lot of that. Now I have none. I’ve been taking DIM supplements for over a year now (estroblock pro). Maybe I should take a break from them. But I’m so scared that my face will be worse if I cut them out. Could u recommend another supplement for my acne, or do you think it will be fine on the supplements i’m taking? I know you can’t give that kind of advice, but hypothetically speaking.

          • But one more thing Lara. My periods have been sparingly for many months now. I have bleed, but not much more than 3 days. And I could use panty lines. But last time of my period I was shocket cause there were literally two big clumps (half of a fist) in my panty lines, and I bled through my jeans. I bleed like this 1 1/2-2 days and then it was sparingly again. What causes that kind of blood flow?

  86. I am 27 years old, and I’ve never had regular periods. I think my PCOS probably started right from puberty. Started getting hair on my belly and lip around 13 (much worse now). I’ve never been on the birth control and am hesitant to mess with my hormones by adding any exogenously, but over the past year I have been experimenting with progesterone cream cyclically. From the very first dose I was amazed at how different I felt- it’s difficult to even describe. Like, “Wow, so THIS is what it feels like to have some lady hormones!” I have been trying so hard for years to help restore my body to health so that I can ovulate on my own, but I am honestly not sure it’s possible. I feel lost. I don’t want to prevent ovulation from happening by using the progesterone cream, but when I don’t take it my period doesn’t come until….whenever. 50-60 days.
    Again, Lara, thank you so much for being such a kind, holistic source of information and support to women who need help and love.

    • Low dose progesterone cream shouldn’t suppress ovulation. In fact, when it’s taken later in the cycle, it can sometimes help to promote ovulation the following cycle (because progesterone suppresses LH).

      Have you worked out the underlying cause of your PCOS? Do you have insulin resistance?

      • Am I mistaken? As I understood from reading, progesterone taken before (accidentally) ovulation could impede ovulation. Since my “cycles” are so long/unpredictable I assume that I don’t ovulate, but on the off chance that I might I don’t want to inhibit it. For example, today is day 17 of my cycle, and I am hesitant to start progesterone cream (bioidentical, 20mg) in case I haven’t yet- but might- ovulate.

        Goodness, I wish I could work out my underlying cause. I am 95% sure that I am not insulin resistant based on multiple fasting insulin tests, fasting glucose, A1cs, body fat percentage, diet and lifestyle. I have been diagnosed with CIRS, so my best guess is inflammatory PCOS- proving very recalcitrant.

        All the best to all of you ladies 🙂

        • You’re not eating low-carb are you? Has your thyroid been checked?
          Progesterone in the follicular phase “can” impair ovulation, but usually won’t at a low dose of 20 mg.

        • That said, I usually try to not give progesterone in the follicular phase. If there’s no cycle, I often cycle 2 weeks on, 2 weeks off.

          • That is good to hear. I have not been successful in tracking ovulation because my morning basal body temp is constantly fluctuating (and low). My thyroid hormones have been borderline low to low, but my TSH has always been around 1.0, so it seems there is some peripheral problem. Antibodies negative. I think you would probably consider my diet low-carb. Most carby foods-especially starches- give me significant digestive upset.

  87. Lara,

    I have PCOS with adrenal based androgens and I currently take Myo-Inositol, D-Chiro-Inositol, Multivitamin and Magnesium. It has been about three weeks I have been taking these and slowly riding myself of sugar (which I had extreme carvings for until I stated the supplements) yet I am still SO fatigued with no motivation whatsoever. I know it is early yet, but I just feel my energy levels would be better or I would feel more motivated, but nothing has changed except my sugar cravings are gone and now I crave starch and protein and feel very snacky. Prior to supplements my TSH was 3.88, but both doctors I saw said they wouldn’t give me thyroid meds with that number. Do you think my fatigue and lack of motivation is my thyroid? Maybe it my adrenals…or both. I just feel so burnt out and like I’ll never recharge and feel energetic or motivated or productive or happy. Please help.

  88. Hi Lara,

    is it normal to have headache when supplementing with Selenium?
    I tried Selenium Chelated (100mcg) for 2 days and had headaches both days. I rarely have headaches.
    I’ve been taking magnesium, zinc and B6 for a while but still having 10 days luteal phase.

  89. I understand from your interesting article that progesterone can both boost energy but can also stimulate sleep centres in your brain.

    I am using natural progesterone cream made from my local chemist, I normally use at 3% and normally put it in the evening on different parts of my body, but last time they have raised at 10% and I’ve realized that it was difficult for me sleep well and only when I read your article I understood why.

    When is it better to put the cream in the morning or in the evening before going to bed, and also what is the optimum value to be reached in menopause?
    Last exam my values were:
    – Progesterone 1.01ng / ml
    – E2 estradiol <5 pg / ml

    • Hi Viviana, Generally progesterone is sedative, so should always be taken at bedtime.
      Even higher dose should promote sleep, rather than disrupting sleep. Could your sleep change be due to anything else?
      As for post-menopause blood levels, I don’t like to see them rise very much at all with progesterone. When they do, that is usually a sign of overdose. The most important thing is to take breaks from progesterone. ie. Not take it every day. Of course, please speak to your doctor.

      • Thank you so much Lara for your kind reply! My doubt raised by the fact that I have read that it can also boost metabolism, but probably the reason why I did not sleep well is different.

        I would like to see my progesterone value at least at 2.0ng/ml so if I understand well that could be all right as long as I do not reach this value all of a sudden and that I make breaks (I really stop putingt it the first 7 days of the month).

        Your point of view is very much appreciated, thank you very much!

  90. If I have PCOS and bad acne, always cold, irregular cycles, and unstoppable weight gain would bioidentival progesterone cream help with at least 1 of these issues I have? I have eaten vegan, paleo, gluten free, and months of other crazy diets with no weight loss just more gain. My dr keeps telling me I need to lose weight but everything I try doesn’t seem to be effective. I stopped the pill over 14 months ago. I’m just curious if it would potentially help.

  91. Hi Lara,

    I have been struggling with oral candida, low progesterone, off the chart estrone 1 (as verified by a saliva test), severe PMS and adrenal fatigue (as confirmed by a saliva test). I started off fine and then one day started getting panic attacks, severe anxiety, short temper and no tolerance for any sort of stress. Then, I felt like went into the next stage and now cannot work as I very little energy (I am not bed-ridden thankfully). Life is not much fun at the moment.

    I am now on a Candida diet and taking Calm X (magnesium, B5, calcium, B6, other vitamins), also a liquid fish oil. Surprisingly, eating lots of broccoli and brussel sprouts helps. Would you recommend taking liquid Vitex drops to lower the estrogen and to promote progesterone? Also, it has been a good 7 months (I feel better). How long do you think the recovery period would be?

    • There are really only two options, and both by prescription: 1) Prometrium, or 2) compounded micronized progesterone (from compounding chemist).

  92. Greetings Lara,

    Can you please suggest something to clear up vaginal yeast and vaginal bacteria when healthcare is not available? Been taking the Jarrow Fem Dophilus for 7 days now, but not clearing the infection.

    Ciao, Justine

      • Greetings Lara,

        Thank you. I would, but I don’t have a doctor. I have no insurance and cannot afford to see a physician or believe me, I would. Does boric acid clear both yeast & bacteria? Does it burn sensitive skin? I am extremely sensitive.

        Ciao, Justine

        • Do you have a compounding pharmacist in your area? You should be able speak to the pharmacist about your particular needs, and get some more details about the treatment.

          • Alright, I will try that. Is there anything in particular I can bring up with them other than the Boric in case they don’t offer anything?

  93. I have low progesterone and androgen fatigue according to my naturopath and blood tests. I’ve been following her advice using vit a (betacarotene), estroblock, vitamin c, gtf chromium, vitex, primerose oil, b6, zink (p5p) and magnesium glycinate to boost progesterone. I have acne. Cystic (jaw, chin some forhead). I’ve had acne for years. I’m 29, and my acne ruins my life. I don’t know what to do. I’ve been following my naturopaths advice for some months now. But it does not get better. I also dont eat sugar, gluten or ant kind of milk (only goat sometimes). Is there something wrong with the supplements i’m taking, Lara? What should I do? I feel that nothing is helping. It only gets worse. I would highly appreciate your help. Thx.

    • I’ve also bought your book, but i’ve seriously tried all kinds of things and supplements. I’ve had a strickt diet for years… this is realy getting the best of me… i’ve many times thought of going on th bcp, but i just wont do it. Cause i know it will ruin my hormonal system.

      • My cyclus are regular 28-30 days. And my testosterone was 1,2 when I got bloodtests done this summer. But i was on dim and vitex then too. But now a days I can’t sleep properly. i wake up many times during night. And always wake up at 3 at night. I also often pee at night. My heart raises at the evening and often at night i wake of it pounding fast. It hurts. I have very dry eyes too. I have new cystic acne every day all along my chin and jaw. And now it’s worse than ever. There are not any naturopaths here I live in norway. Only doctors wanting to solve everything with bcp and accutane. Lara could u please help me?

        • The naturopath that got me on these supplements was online. She saw over my sympoms and bloodtests. But this method has not worked.

        • My progesterone: 3
          Estrogen: 0,19
          Testosterone: 1,2
          Prolaktin: 173
          Shbg was very high: >180
          Lh: 6, earlier blodtest 4 (taking vitex at the blodtest with 6)
          Fsh: 7, earlier bloodtest 8
          T4: 21,1, but on an earlier bloodtest a few months earlier is showed: 16,4
          Tsh: 0,98, earlier 0,57
          T3: 4,4

          • When did your period come after this blood test? Were you on the Pill at the time of the test? (Because that would explain the high SHBG). The other reason for high SHBG is low-calorie dieting. You don’t restrict calories or carbohydrates, do you?

          • No I have not been on the bcp since I was 21, and i’m now 29. I’ve had problem with acne since I went off and have tried all kinds of natural methods getting rid of them. I don’t restrick calories or carbohydrates by purpose. I just fint it hard sometimes to eat so healthy not eating wheat, cow’s milk and sugar. But I have my regular period (28 days), I’ve always been regular expect the 2-3 times I have went om vitex (cause my naturopath said I should stick it out more than 2-3 months). But every time my skin gets worse or it gets longer between my periods. My periods have been light for a while now. But got my period 3 days ago and it was very heavy. Never had that kind of period before. Had to shift tampoon every other hour. And my acne got worse on my chin and neck right before my period this time. Long time since it has been like that. I had breastpain, headaches and was weepie, depressed, craving for sweets,back pain, cold feets, fast heart beat, tired, problem sleeping at night. Waking up between 2-4 p.m. So I had almost every pms symptom. I have read your book several times, and I can see that maybe the pms is what I have. But since I’ve had horrible acne for years (since going off bcp). I’ve been leaning towards pcos. I’ve paid so many naturopaths to help me, but my acne has been there stand by through it all. So frustrating. Do you think I should keep on using vitex?

          • I took these blood tests on june 21 (my period app says this should be the second day of my ovulation), and got my period july 8 (my period before that was 1-3 june). My cyclus that month was long (I think because of vitex), and lasted 35 days :-/

          • Your period came 17 days later, which means you were in your FOLLICULAR (pre-ovulation) phase at the time. It’s normal for progesterone to be low before ovulation. So your test does not show progesterone deficiency. You may have progesterone deficiency, but the only way to know is to test it at the right time: about 5-9 days BEFORE the period (peak luteal phase).

          • Thanks Lara! I will get a new bloodtest. What kind of tests should I say to my doctor he should test me for? Would it be possible to work with you Lara when I get my new results back through e-mails or skype if my symtomps not are related to thyroid or pcos?

          • No I’m not a vegeterian. I eat meat to almost every meal. But Lara until I have gotten my new blood test should I just discontinue all my vitamins?

  94. Hi Lara, I enjoyed reading this article. I get really bad insomnia the week before my period. I use progesterone cream (I am 34), but if doesn’t seem to help my sleeping at all. Maybe I need the higher strength capsules? I am hypothyroid, and have also had my gallbladder removed, I was wondering if my liver is now having a harder time getting rid of the estrogen from my body? I never used to get pms at all, but now I dread the week before my period.

    • Magnesium would be the first thing to try, if you haven’t already. It’s essential treatment for sleep, PMS, and it also helps to raise progesterone.

  95. Dear Lara,

    I am a 54 year old woman suffering from horrible insomnia and anxiety literally overnight! I just stopped sleeping from 6-7 hours a night to 3 maybe 4 hours if I am lucky. I wake up all through the night and it seems like hours before I settle back to a restless sleep again. Is that common in menopause? I went to my OBGYN and she put me on the low dose combi patch of HRT progesterone/estridiol… it did not help with my sleep and it actually made things worse, I had a lot of bleeding and my fibroid started to grow again so I stopped HRT after 3 awful weeks. I recently went to an endocrinologist and had my estrogen levels tested . I was not on any HRT at the time. Levels read

    Esterone 33pg/ml,

    Estridiol 34pg/ml,

    Estriol <0.10 I was told to me was that my estrogen was low.

    I also am having difficulty gaining weight w/tinnitus and tingling sensations through my body. I do supplement with magnesium bis-glycinate occasionally. (doesn't really help w/sleep)!

    I tend to believe this is ALL hormonal! I started to supplement w/ evening primrose 500mg x2 a day and vit D….My diet is free of alcohol & sugar, I meditate,walk and do yoga 3x a week to help alleviate symptoms.

    Incidentally I had a saliva test when all this started back in February the results of that were
    Estridiol 13,
    Estriol 6(depressed),
    Progesterone 44,
    Testosterone was normal 29, and
    DHEA 3.

    I tried just using the natural progesterone cream 10mg am/pm I felt calmer during the day, but stopped because I wasn't sure if was making things worse. My doctor doesn't really have any answer to this. They just said to go on an anti depressant, would the progesterone cream help in my case with the blood test results?

    Can you make any suggestions given my blood test results? Do I have HIGH or LOW estrogen? Would using a progesta care plus estriol be a good idea? I do questioning the estriol part of the cream ingredients if I really need it as I don't know if I need estrogen or not. OR would it be more beneficial to use just a natural wild yam progesterone cream (which I have) 1/4 tsp delivers 20mg of progesterone….. directions say x2 a day morning and night for 23 days 7 off……… Your thoughts on this…..I SURE could use some help. Thank you 🙂


    • As I say in the post, progesterone in capsule form can be highly effective for the insomnia of perimenopause and menopause. Please see my post: Help for Hormonal Sleep Problems, and also this article: FDA Approved Bioidentical Prometrium for Insomnia: It Works (For Me).

      Also, keep in mind, magnesium is the #1 treatment for sleep. Often no hormonal treatment will work until magnesium is in place.

  96. After reading that a raw carrot a day (30 minutes before dinner) can help with estrogen dominance, I started to take it (some acne in my chin, fluid retention). My skin was pretty clear but after a while my hair started to fall and my breast is very sensitive and I think my pms is heavier.
    I do not understand, some simptoms are excess of estrogen (breast, pms) and some others are a defect like hair loss …
    Could it be that Im cleaning so much estrogen?? or a carrot can not be so strong and it just my imagination?
    Whatever, I stopped last week and my skin is a little worse everyday … dont know what to do.
    Thank you!!

    • One carrot would not make a significant difference to estrogen either way.
      Also, estrogen does not cause acne. Estrogen is very good for skin.
      Did you see my acne post? Or my PMS post? You’ll find some answers there.

      • https://empoweredsustenance.com/raw-carrot-a-day/
        There must be something with eating a carrot a day, if I stop eating it for a week pimples start appearing in my face and back and I have headaches every single day. I started again after a week and pimples are dissapearing and no headaches …
        Anyway, Im confused cause Im having simptoms of both excess and low estrogen (breast pain, weight gain, bloated: Excess and Hair Loss: low) or maybe my Hair Loss is due to high estrogen?
        Totally confused.

  97. Hi Lara,
    I could really use some advice here. I have hashimotos/hypothyroidism. I had a normal 32 day cycle and ovulated before pregnancy not on meds but after I had my baby 6 months ago my cycles have been all wonky (not breastfeeding). I had them tested with saliva and blood and low estrogen and progesterone but high testosterone… taking thyroid meds I’ve heard raises testosterone (and seem to make my acne way worse). I know you need your thyroid levels good to ovulate and such (and I wonder if I have pcos as well), but doesn’t it contradict itself to take thyroid hormone if it’s also raising my testosterone and making my acne worse? I want to have my period and such but I also don’t want to take meds that make my skin much worse..

    • The right dose of thyroid hormone should help with ovulation, and should not increase your testosterone above normal.
      Your first step is to ask your doctor to test your testosterone on blood test because a saliva test is not an accurate way to measure testosterone (it often shows false elevation).

      • My free testosterone on a blood test was raised as well. To like 5.5 I believe. But I was also 6 months pregnant at that time. If I had normal cycles before could I have developed pcos after pregnancy? How do I tell if it is both pcos and thyroid diesease or just thyroid disease? Thank you so much! I’m at a loss.

          • No I haven’t! I’ve had the insulin and glucose testing and LH and FSH. Which were all normal range (LH was like 2.8 and FSH like 8). So my doctor said I don’t have pcos… but I have the acne and oily skin like I do! And no irregular periods after my daughter. If my testosterone is high would that mean pcos?

          • IF your testosterone is elevated on blood test, that can suggest PCOS, but nothing that you’ve said so far suggests PCOS. And your doctor doesn’t think you have it. Probably best to go ahead with your doctor’s advice for thyroid treatment. That could help your skin. Also please see my acne post.

          • Thank you! I’m on an herbal tonic with the following herbs:

            · White peaony
            · Licorice
            · Chaste tree/berry
            · Dandelion
            · Bupleurum
            · Schizandra
            · Globe artichoke
            · Milk thistle

            I’m scared because even though my LH was under 3 I worry about taking vitex and my skin hasn’t gotten any better in two months on these herbs! How do you know if vitex is working for you or not?

          • If your thyroid needs treating, then THAT is the place to start. Vitex can’t work until you fix an underlying thyroid problem.

  98. Where do you recommend applying the Progesterone cream? For someone who has a regular period, but doesn’t ovulate, how long should the cream be used in all, generally? Is there a time to quit or take breaks from use?

      • I am 24. Yes, I am sure. My temperature doesn’t move up, I have no fertile mucous, my LH & FSH never move up or down, they stay the same, my Estradiol on a 24 hour collection was 3.7 mid cycle. I also have PCOS.

        • First of all, are you using a proper ovulation thermometer? Because sometimes cheap fever thermometers don’t detect the temperature change.
          If you truly have not been ovulating, then your primary goal is to ovulate. That will give you much better results than just taking progesterone. And at 24, you should be able to achieve ovulation quite easily. You can do it by addressing the underlying cause of your type of PCOS. Please see: Treatment for 4 Types of PCOS

          • I’m not sure what the correct thermometer is, but I use an oral thermometer. My hormones are so low do you feel I could benefit from both treating PCOS and using Progesterone cream?

          • Ask your pharmacist for an “ovulation” thermometer. They’re not expensive.
            I rarely recommend progesterone cream for someone so young.

  99. I’m curious what your opinion is about how important ratio of progesterone to estrogen is when dosing progesterone. I’m almost 50 and this past year have had maybe 5 periods, none the last 3 months. My last test came back very low estrogen consistent with menopause, and still “low” progesterone, but quite high in relation to the estrogen, assuming due to the cream. My functional medicine doc told me to then stop it, but after a couple months I restarted an over the counter natural cream, which immediately improved my hot flashes and insomnia. My gut feeling is I need it, I’m doing just one small pump at night for 3 weeks each month. Do I need to be concerned about that rario?

    • Short answer: No, I don’t look at blood ratios in that way. And I don’t diagnose “progesterone dominance”, if that was the idea.

      I assess each hormone estrogen and progesterone individually. For example, I ask: Is there estrogen excess or deficiency? (deficiency in your case). Is there progesterone deficiency? or in the case of taking progesterone: Is there progesterone overdose? (Overdose is the only kind of progesterone excess that ever occurs)

      I certainly think it is possible to take too much progesterone. For example, I don’t like to see it rising too much on blood test, because even a few points can suggest excess. (The only time a serum progesterone reading would ever go up significantly is after ovulation.)

      The risk of progesterone overdose is why I try to stay low with the dose, and also take regular breaks from it.

      One more thing to consider: Progesterone relieves symptoms of estrogen deficiency. So, if you were feeling well on it, there’s probably no reason to stop completely. But please speak to your doctor, of course.

      • Hi Dr. Briden,

        Yes, a number of years ago I tried progesterone cream, and felt the estrogenic effects. How does progesterone impact estrogen receptors to create this? For me, it was dangerous because of a high breast cancer risk. It makes me confused why progesterone creams are recommended for breast cancer risk when they have this effect, too?

        Do the adrenal glands create any progesterone after menopause? That is, would increasing adrenal health during the cycling years help women with progesterone overall?

        Thank you for being a voice of clarity for women.

  100. Hi Lara, thank you for publishing so much great information – many of the things you describe I have experienced first-hand. Things all started going haywire for me and I was prescribed ‘the pill’ at 16 to address periods so heavy I was anaemic. Now in my late 40s, I am living on a very restricted diet with intolerances to a ridiculous number of things (foods, fragrances, grass, animals, you name it). So detoxification issues – you bet! Have also experienced 2ndary infertility with medical specialists at a loss – now clear that there are HPA issues underlying. Progesterone supplementation allows me to have a reasonable quality of life, but I still have no natural resilience and cannot ever ‘let my hair down’. I wish more young women were educated about the impact of these chemicals that so many of them willingly take. There needs to be more conversation about the potential impacts in the longer term. Keep the information coming!


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