Guide to Natural Progesterone

How to use natural progesterone.

Body-identical progesterone (also called bioidentical, natural, or oral micronized progesterone) can be an effective treatment for a range of women’s health conditions, including PCOS, PMDD, migraines, endometriosis, adenomyosis, and perimenopause.

To be clear: progesterone is a real hormone (identical to what the body makes) and usually requires a doctor’s prescription. Depending on your country, brand names include Prometrium, Utrogestan, Teva, and Famenita. In some countries, progesterone cream is available over the counter. Cream can help with mild symptoms, but it’s generally less effective than capsules.

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How Science Got It Wrong About Progesterone

Progesterone is important for women's health.

Progesterone is important for women’s health. Yet for decades, it has been ignored or wrongly blamed for side effects it doesn’t cause. How did that happen?

A missed opportunity

Progesterone was discovered shortly after estrogen, missing the chance to be included in the simplified narrative of “testosterone for men and estrogen for women.” To complicate things further, progesterone couldn’t initially be made into an oral medication, so it was sidelined in favor of synthetic progestins.

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Pain Is Not a Symptom of PCOS

PCOS pain

According to a 2017 study, pain is the most frequently reported symptom of PCOS, even though pain is not a symptom of PCOS.

The solution to this paradox is that both PCOS and period pain are common, so it’s easy to have both a PCOS diagnosis and pelvic pain. But, importantly, the PCOS diagnosis can only explain irregular periods or symptoms of androgen excess (e.g., facial hair). It can’t explain the pain!

Also, PCOS cannot be diagnosed by ultrasound.

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