The Power of Progesterone!

imagesIt’s time to talk about progesterone, the most splendiferous, stupendous hormone around.  Ok, I’ve  been watching the Tigger Movie with my 2 year old, but progesterone is great.  And, it is also probably the most ignored of the bioidentical hormones even though it may be the most important.

What is progesterone?  It is the hormone that a woman’s ovaries produce in the second half of her menstrual cycle.  Look at the diagram below.  In the first 14 days of the cycle, estrogens dominate.  Estrogens (like estradiol) grow the cells of the uterus to prepare it for implementation of a fertilized egg.  At day 14, presumably when ovulation occurs, estrogens wane and progesterone kicks in.  Progesterone’s job is to slow down the growth of the endometrial cells and to develop their function.  If a fertilized egg does implant itself, progesterone levels will continue to rise.  If not, progesterone drops signaling the start of menstruation and the whole process starts over again.

apr2006_report_prog_02_big1So, basically progesterone slows the growth of cells stimulated by estrogen and develops their function.  But progesterone does a whole lot more.  Progesterone receptors have been discovered in the blood vessels , the liver, breast tissue, the bone, and the brain, and has an important influence in the functioning of all those parts of the body.

Now, here’s the key point with regard to menopause.  Progesterone is only produced by the ovaries.  That means, when your ovaries slowly wind down their functioning through the menopausal years, progesterone production slows down right with it.  Estrogens, however can be produced by other cells in the body besides the ovaries, namely adipose cells (or fat cells) that convert testosterone into estrogens.  So, during menopause, progesterone is dropping but estrogens may not be, leading to a condition called estrogen dominance.  This basically means that you don’t have enough progesterone to balance out the activity of the estrogens still floating around in the blood stream, not to mention the fact that you don’t have as much progesterone to have all of its beneficial effects on the blood vessels, bone, brain, etc.

This can lead to lots of symptoms like hot flashes, sleep disturbances, mood swings, and breast tenderness.  Sound familiar?  Yeah, these are menopausal symptoms.  And, for the past 30 years, what has the medical establishment been giving to women who have these symptoms? Estrogens!  Does this make sense – no!  We should be giving them progesterone.

I have worked with hundreds of women with menopausal symptoms and I have never seen one who didn’t have some level of estrogen dominance on their hormone tests.  So progesterone is the key.  And the best part is that bioidentical progesterone is safe, easy to use and often resolves symptoms without the need for much estrogen, if any.

I hope this information is helpful.  As always, I welcome your comments and questions.

Live well!

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37 Responses to “The Power of Progesterone!”


  1. 1 Andrea March 13, 2009 at 2:42 pm

    Absolutely loved this article, I plan to send my Holy Hormones! blog readers over to read it! Also loved the picture of Tigger, I am “mother” to two stuffed Eeyores, but I love all the Pooh characters (and firmly believe they all need hormonal balance, Piglet and Pooh are absolutely estrogen dominant—just look at them!)

  2. 2 Jacqueline March 26, 2009 at 4:27 pm

    I agree with Holly, great post. As I try to decide whether or not I want to take bioidenticals, I am reading more about xenoestrogens and the role they play in creating these hormonal imbalances. Before I add something else (progesterone), I want to make sure I am giving my body the best chance possible to balance itself by getting rid of any xenoestrogens in my body. I am reading Dr. John Lee, but also found this article from Women to Women to be pretty helpful Estrogen dominance —
    is it real?
    . If you have any thoughts on this, I would love to read them! Thanks!

    • 3 thecompounder March 29, 2009 at 7:54 pm

      I think xenoestrogens are a legitimate concern and, most likely, it is impossible to avoid exposure to them entirely. There are certainly things you can do to limit your exposure to these powerful estrogen-like toxins, for example eating organic fruit and vegetables and avoiding plastic packaging when possible (at least not microwaving anything in plastic).

      I’m a big believer in using hormone balancing to treat symptoms and improve quality of life. If you are having symptoms of estrogen dominance (hot flashes, difficulty sleeping, migraines, fluid retention, etc.), progesterone may be very helpful for you. If you are not experiencing these sympotoms, I would recommend keeping your focus on maintaining a healthy lifestyle (good nutrition and exercise).

      I hope that’s helpful.

  3. 4 Jacqueline March 29, 2009 at 8:41 pm

    Thanks for the response! I think for right now I am going to go the organic diet/exercise/no plastic packaging route to reduce xenoestrogens. I look forward to keeping up with your blog.

  4. 5 Wendy April 21, 2009 at 7:34 pm

    So are the over the counter creams ok? Or do I have to find a dr that will prescribe one?

    • 6 thecompounder April 21, 2009 at 10:05 pm

      I think they are OK. The OTC progesterone creams have a low dose of progesterone and do not have micronized progesterone so they may not absorb through the skin as well as the compounded creams. But I have recommended them many times to women who have had symptoms of hormone imbalance, specifically estrogen dominance, and who are not able to afford to see a doctor or aren’t sure that bioidentical hormone replacement is right for them and want to start with something easy and inexpensive.

      Clearly, taking an OTC progesterone is not going to give you as comprehensive and customized a treatment as the compounded hormone will, and I do recommend at least taking saliva test to see if you really need the progesterone. Other than that, the OTC creams are certainly safe and if you have mild hormonal imbalance, they can be quite effective. Apply 1/4 teaspoonful to forearm nightly at bedtime for best results.

  5. 7 Kristi September 19, 2009 at 6:01 pm

    Hi! I am perimenopausal, 49 and had hormones checked ( by blood). I was told I was estrogen dominant, high testerone, very low progesterone. I was started on low dose of oral progesterone 25mg day 1-14, then 50 mg day 15-period. My periods were 21 days apart ( used to be 28) and very heavy. Was retested after 6 months, progesterone still very low . C/o of anxiety, insomnia, heart palps, hot flashes,insomnia, fatigue and hx of PSVT ( on 12.5mg atenolol), hypothyroid on 37.5 synthyroid).
    Dr has increased progesterone to 75 mg day 1-14, 150mg day 15- period. I have been on for 1 1/2 months and still not feeling much better. How long does it take for significant change in symptoms??? And now my breasts seem to be swollen and tender in latter 1/2 of cycle.
    If and when should levels be rechecked?? Dr said to call in 2-3 months and discuss it. But I still feel like “crap” and am considering antidepressant or such if this is not going to get better.
    Please help!!!!!!!!

    • 8 thecompounder September 21, 2009 at 2:56 pm

      Kristi,

      I would recommend doing a saliva test sooner rather than later. If your symptoms are getting worse as you continue on the hormones, that’s something you should talk about with your doctor and see about adjusting your dose. Your progesterone dosage doesn’t seem terribly high for an oral dose, but as I’ve mentioned in previous posts, everyone’s needs are very indivudial. What’s normal for one person, may be high for another.

      There is another topic that I haven’t talked about much in my blog, but I am planning to discuss more, which is the topic of chronic stress or adrenal fatigue. If the adrenal glands are not functioning properly through chronic stress or environmental contitions (i.e. exposure to pesticides, etc.), the bioidentical hormone replacement therapy will be far less effective that it can be.

      Something to think about. If you are not getting the care you need from your regular doctor, it might be a good idea to get a second opinion or talk to a naturopathic doctor.

      Take care.

    • 9 Ikeke October 14, 2011 at 3:04 pm

      If you haven’t already seen this, you might find this article by Dr. Mercola’s useful regarding progesterone. http://www.mercola.com/article/progesterone/cream.htm

  6. 10 Vicki March 24, 2010 at 7:57 am

    Does progesterone play a role in postmenopausal vaginal dryness, discomfort, and atrophy?

    • 11 thecompounder March 29, 2010 at 5:16 pm

      Hi Vicki,

      Those symptoms are generally associated with estrogen deficiency although since progesterone influences the activity of estrogens, it is possible that a progesterone deficiency could contribute to those symptoms. The most effective treatment I’ve seen for this is estriol vaginal cream (0.5mg to 2mg inserted vaginally nightly at bedtime for 2 weeks, then 2 to 3 times weekly thereafter).

      I hope that helps.

  7. 12 Diane May 20, 2012 at 4:53 am

    Hi, I am 62 and decided to see a Doctor who prescribes bioidentical creams.
    I have been post menopausal for about 5 years. I looked into the bioidentical creams due to sleeplessness, joint pain, weight gain, low libido etc. etc. etc. I eat healthy and exercise at least 1/2 hour a day or walk.

    For two months I have been on Progesterone Cream 75Mg/ml (7.5%) – applying 0.2 ML twice a day. Along with Estriol cream ml. One GM inserted daily for 14 days then every other day thereafter. I experienced weight gain, water retention and my breasts were larger and more sensitive.

    The doctor reduced me to half the dose of both the above. I am not sleeping again and the water retention is noticeable as per my husband even in my face. I feel much heavier, especially around my middle and rear. I have never been a big person.

    I have just seen the Dr. again and he has adjusted after two months and I am now taking Progesterone Cream 50mg(5%) – taking 0.2ml twice daily and he has put me on Biest (80:20) cream 2mg (VC) – taking this intravaginally (0.2 mls) once daily. (have been on this dosage for 2 days so far)

    I still have the water retention, but the last two days have notice sweating more – is this normal with the Biest cream added. Should the water retention stop? I am still not sleeping as I would like and feeling drowsy.

    Blood tests were done at the beginning and thyroid and others not bad, except Vitamin D very low which will be adjusted through vitamins.

    Not sure what to do about the water retention.

  8. 13 Tracie June 27, 2013 at 6:31 pm

    My dr wrote me for 100 mg of progesterone at night and 4mg of testosterone cream for an. No estrogen at this time. I’m 46 and very perimenopausal. Is 100 mg a lot??? Seeing others on it , they are on 25 mg… Is 100 over kill? I haven’t started taking it yet. Will I gain weight tooo as a side effect?

    • 14 thecompounder June 27, 2013 at 6:41 pm

      Thank you for your comment. Because each individual’s treatment plan needs to be worked out in dialogue with her doctor and her pharmacist, I cannot give specific treatment recommendations through this blog. I wish you the best as you work out the best possible treatment plan with your practitioners.

    • 15 Dawn July 29, 2013 at 3:19 pm

      Hi
      I too was prescribed 100 mg Bioidentical progesterone. I am Estrogen dominant due to chronic stress, which I understand is because raw progesterone is used up making adrenaline when you’re under stress constantly. Well 100 mg just felt like too much, so I cut in half myself. I am sleeping good for the first time in MANY years. I now feel like I may go back up to 100 mg. I’m getting bloodwork done after 3 mos. I think you should be closely followed with bloodwork to assure your levels are optimal. Thanks for sharing everyone!!

  9. 16 Marli July 28, 2013 at 10:16 pm

    Premature menopause started at 37 y.o., now at 43 y.o. taking bHRT, progesterone 200mg oral daily and Biesf (80/20) 2,5mg/ml cream daily. While taking progesterone I feel a lot of pain on the pubic and inguinal area. Is it normal as side effect of progesterone? I will have FIV in October and I am wondering if this can help to prepare the body for the treatment.

  10. 17 Lily August 1, 2014 at 1:31 am

    You mention receptors for progesterone being found on blood vessels…to do what….is this why pregnant women develop varicose veins…MY WORRY AS IM ABOUT TO TRY PROG AGAIN…..I have tried progesterone several times and spoke out for it…but was glad to stop when I bloated, felt slow and lethargic. Now through menopause and considering some again ..bio identical (and also a little oestrogen..which if it been given during menopause ..would have saved my relationship). I listened to all the stuff on progesterone. MY WORRY NOW AS I HAVE BEEN PRESCRIBED 50MG PROG WITH THE FIRST PRESCRIPTION FROM A GOOD ALTERNATIVE DOCTOR, IS MEMORY OF VARICOSE VEINS AND THE HASSLE I HAD WITH THOSE AND 3/4 TREATMENTS FOR THEM. LAST WAS IN 2011. MY LEGS ARE NORMAL AGAIN AND I HAVE ENERGY (I stareted menopause at 44..FSH dropped,, and it was a 10 year trial..with progesterone being used to try to help then me coming off it as continuing meant build up of above symptoms..and not a lot of help with vaginal/intimacy issues) MY MAIN CONCERN NOW IS..Will the progesterone and tiny bit of oestrogen wreck my veins again.? i WOULD VERY MUCH WELCOME YOUR VIEWS AND KNOWLEDGE AROUND THIS

    • 18 thecompounder November 12, 2014 at 3:08 pm

      Hi Lily,
      Thanks for writing your question here back in August. Peter is not able to respond to patient-specific questions in this online format,but I’ve noted your general question about progesterone and blood vessels for Peter to address in a future blog post.
      We have found at our pharmacy that patients often have the best outcomes when they have strong relationships with both their doctor and pharmacist so that they can give you sound recommendations based on a full review of your labs and information gathered through in-person visits. To find a good pharmacist who can be a part of your health care team, we recommend the website http://www.pcab.org of the Pharmacy Compounding Accreditation Board, which allows you to search for compounding pharmacies by state that have met the highest standards in the field of customized medications.
      I hope this information is useful for you, and thanks again for posting this question about progesterone.
      Krista Shaffer, Outreach Director at Koshland Pharm, http://www.koshlandpharm.com

  11. 19 Candace Laidig August 5, 2015 at 1:47 pm

    My health care physician has given me 25mg of Pregnenolone to take daily. She is saying before we consider progesterone cream. Also a compounding pharmacy prescription for oxytocin ( spelling might be ‘off’) .Any thoughts on these?

    • 20 thecompounder May 20, 2016 at 11:53 am

      Hi,
      Thank you for writing into the blog last year. These are great questions for a future blog post for Peter – about pregnenolone and oxytocin. I have noted those two hormones so he can discuss them in a future post. Thanks again for writing,
      Krista Shaffer, Outreach Director at Koshland Pharm

  12. 21 Linda August 30, 2015 at 8:47 pm

    I am 54 and haven’t had a period in 9 months. Dr put me on progesterone SR. 75 mg After 3 doses I got another period and it was painful. Is progesterone supposed to make you have a period?

    • 22 thecompounder May 20, 2016 at 11:57 am

      Hi,
      Thanks for writing into the blog last year. While Peter can’t respond to patient-specific questions in this online format, I’ve noted a general question you’ve raised here that he could write about in a future post, which is about whether progesterone can cause a period.If you need a good resource for finding a compounding pharmacist you could consult with in addition to your doctor, we recommend the Pharmacy Compounding Accreditation Board, http://www.pcab.org, which allows you to search for compounding pharmacies by state that have met the strictest national standards for quality.
      Thanks again for writing. All my best,
      Krista Shaffer, Outreach Director at Koshland Pharm

  13. 23 Mistich September 12, 2015 at 6:54 pm

    Hi I’m currently taking bio identical progesterone cd 14-28 I started at 100mg and was still feeling tired and bloated. So we decided to up the dose to 150mg last month I felt great more energy I could feel the water retention being alleviated. But this month I started on cd 14 but this month I have had some serious stress and what I noticed is after I took my pill and while I slept I woke up with panic attacks and continued to have anxiety the next day. Around the middle of the day I start to feel better. Then after I take my pill it happens again. My question is there a time when maybe your body is producing enough progesterone and taking it can cause anxiety? Should I stop please help Thk u

    • 24 Renee W October 28, 2015 at 10:48 am

      I personally find progesterone helps anxiety. W

    • 25 thecompounder May 20, 2016 at 11:59 am

      Hi,
      Thanks for writing into the blog last September. While Peter can’t respond to patient-specific questions in this online format, I’ve noted a general question you’ve raised here that he could write about in a future post, which is whether progesterone can cause anxiety.
      This would also be a great question for the compounding pharmacy you work with. If you need a good resource for finding a compounding pharmacist you could consult with in addition to your doctor, we recommend the Pharmacy Compounding Accreditation Board, http://www.pcab.org, which allows you to search for compounding pharmacies by state that have met the strictest national standards for quality.
      Thanks again for writing. All my best,
      Krista Shaffer, Outreach Director at Koshland Pharm

  14. 26 Eloise Parker November 7, 2015 at 12:38 pm

    I am on 150 mg of Progesterone by compounded pill and .5 mg of estrogen cream. I always feel that my breasts are swollen and I have water retention too. I actually don’t feel balanced at all. Do you think I should drop the estrogen or take less Progesterone??

    • 27 Susan November 16, 2015 at 6:24 am

      Hi all,

      All I can say progesterone cream saved my life.

      Read her story how she (Wray) saved her life and where I received my knowledge of dose of progesterone. ..very important.

      Here is the site: http://www.progesteronetherapy.com

      Thank you and God bless
      Susan

    • 28 thecompounder May 20, 2016 at 12:19 pm

      Hi,
      Thanks for writing into the blog last November. While Peter can’t respond to patient-specific questions in this online format, this is an important question for the compounding pharmacist and doctor that you work with. I’ve noted the general question you’ve raised about whether progesterone and/or estrogen cream can cause swollen breasts and/or water retention so that Peter can discuss this topic in a future blog post. Thanks again for writing. All my best,
      Krista Shaffer, Outreach Director at Koshland Pharm

  15. 29 Lisa January 5, 2016 at 9:53 pm

    Hi, thanks for your article. I have a question for you. I had a saliva test done that showed I’m no longer making estrogen or progesterone, but I am still making testosterone. I’m having a lot of issues with fatigue and weight gain. My doctor prescribed 25 mg of bio identical progesterone in capsule form. Should I be taking estrogen as well? Is progesterone alone recommended?
    Thanks for your feedback.

    • 30 thecompounder May 20, 2016 at 12:29 pm

      Hi,
      Thanks for writing into the blog a few months ago. While Peter can’t respond to patient-specific questions in this online format, I’ve noted a general question you’ve raised here that he could write about in a future post, which is whether progesterone is ever recommended alone, and what in general can help with fatigue and weight gain.
      This would also be a great question for both your doctor and the compounding pharmacy you work with. If you need a good resource for finding a compounding pharmacist you could consult with in addition to your doctor, we recommend the Pharmacy Compounding Accreditation Board, http://www.pcab.org, which allows you to search for compounding pharmacies by state that have met the strictest national standards for quality.
      Thanks again for writing. All my best,
      Krista Shaffer, Outreach Director at Koshland Pharm

  16. 31 Care n October 31, 2016 at 8:41 pm

    I am taking a break of boo identicals for a month. I have been on them for two years, after getting very depressed from my hormones crashing DPSD? I was prescribed bio identical progesterone cream 10% fine for a year and a half???then felt out of whack again and had blood test???got bio of identical biest 10% and a bio identical testosterone cream….but on the blood test I had high SHBG levels…which one doctor said my body thought I had high levels of estrogen, when in fact I had very low levels…and was told that taking more estrogen would increase hot flashes and night sweats…..but my doctor prescribed it to me….and after three or four months…sweats were worse than ever. I asked someone else today and he said taking the progesterone etc for so long had caused my high SHBG levels, and my body needs to take a break, as it is not responding to the hormones. I am to only stay on the testosterone. Have you heard of this happening?

  17. 32 Jakki February 4, 2017 at 3:50 pm

    Incredible article. I started taking biodentical hormones 1 month ago. I did have estrogen dominance. Extremely high.. I am so greatful for my my Bodylogic Dr. progesterone is a miracle. I don’t have mood swings so much energy. I feel like I did before , peri menopause happened.. for those off you questioning about Biodentical Hormones. It is so worth it..😘

  18. 33 Karen Anagnostou February 27, 2017 at 11:00 am

    Hi Jakki. I have recently started taking biodentical hormones too, and have had a very difficult time figuring out the proper dosage for me. Do you take progesterone alone or with estrogen?

  19. 34 Glenda February 28, 2017 at 11:07 pm

    Is progesterone still helpful even if a woman has had a complete hysterectomy. I heard that without a uterus or ovaries all it does is raise chances for breast cancer. I’m confused! Where can I read up on this?

  20. 35 Kook May 23, 2017 at 2:38 pm

    hi if progesterone is great why does medication like depo provera come with so many negative side effects. what do you recommend to cleanse the system of progesterone?

  21. 36 Evyan Donch June 4, 2017 at 1:48 am

    Hi all. This seems to be an older post/blog but I will still put in my two cents. I have been off and on BHRT for about 4 or 5 years. The times I have been off due to not obtaining prescription for refill in timely manner, I have suffered so much. Without my BHRT’s first to come was the anxiety which for me was mostly influenced by the estriol sublingual tablets which I take twice a day. Second without my BIEST cream – and I kid you not – I age about 10 years. My face gets squarish, more wrinkly and the skin on my body begins to get crepey … you know what I mean if you are peri or in menopause. Lastly I found that I really don’t need the progesterone unless I am in a very stressed state because it makes me so tired. I’ve researched the necessity of it and even had my hormone tests done and as a naturally Testosterone dominant woman – small breasts, more muscle than fat – the progesterone at this point seems not to be a priority for me. Maybe in the future it will change but for now this is my two cents. I think we have to know our bodies and recall when we felt “right” and even keeled. I also take DHEA, about 5 – 10 mg before I go to sleep and the next day I feel wonderful. Vitamin D, Selenium, Omega 3-6-9’s alternating with only 3’s and 6’s, Vitamin C and either ALA or Asaxtasin and a good Multivitamin. Hope this helps.

  22. 37 Debbie Talbot June 13, 2017 at 2:28 pm

    Please please help me, iv read so much on hrt and yours is the first that answers lots of my questions I’m on 2mg of estrogen and I need to go on progesterone But how Much progesterone Do I need to take, iv got an appointment tomorrow with my Gp and need to have clear what I need, Thank you X


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