Bioidentical Progesterone is Pretty Safe

What Dose of Progesterone Cream Do I Use for Treatment?

The therapeutic range for bioidentical hormone progesterone cream treatment is quite large. During a normal menstrual cycle, a woman produces 20-40 mg/day during the latter half of her cycle. During one day of third trimester pregnancy, a woman produces 400 mg/day of the natural hormone. It is also interesting to note that a woman's bone density always remains the same during the entire course of pregnancy. This means that the natural hormone may help to keep the bone density high.

So if you used an entire tube of 1000 mg of bioidentical progesterone on the body all in one day and assuming a 50% absorption rate, this is about 1 day of 3rd trimester pregnancy.

What do we know about women that are pregnant multiple times? Their rate of endometrial cancer and breast cancer is less!

So in general natural progesterone treatment is pretty safe. The exception to this is if you are taking the bioidentical natural hormone to prevent miscarriage, and you forget to take it one day, then the dropping progesterone levels will generate a miscarriage. Also if you take the natural hormone before ovulation, it will stop ovulation and any conception that you are trying to accomplish.


Normally, the dose for topical progesterone is 20-60 mg/day. If you do not want to conceive immediately, then you may take the natural hormone any time you do not have a period. If you take too much of the natural hormone during your period, it will stop the period. This is why progesterone is used to stop miscarriages. 15% of all recognized pregnancies are miscarried and 80% of these miscarriages occur during the 1st trimester. It may be that most of these first trimester miscarriages are completely preventable with the application of progesterone during the first trimester. After the first trimester, the woman may taper off the natural hormone dose VERY slowly. If you are using topical the natural hormone to prevent a miscarriage, then you need to be under the care of a health care provider.

Progesterone taken by mouth, rectally or vaginally is 10 times less in potency than a topical progesterone dose. This is because the natural hormone taken by mouth is 90% inactivated by the liver. Those 90% metabolites, I have never seen an in depth study about what they do. I do know that those metabolites will make you very sleepy. I did have one patient that took 400 mg of oral progesterone and drove to Wal-Mart. She called her husband and he had to pick her up because she was too sleepy to drive home. Vaginal and rectal areas of the body are drained by the portal vein, and the portal vein goes straight to the liver. So the potency of vaginal and rectal suppositories is 10 times less than that of topical progesterone cream. In contrast, the topical natural hormone cream goes straight into the body. Anything put on the skin bypasses the liver and goes straight into the body.

PMS and Fibrocystic Breast Disease and Menstrual Cramps Treatment

For a 120lb woman, 20-40 mg/day of progesterone cream is enough. For a case of PMS or fibrocystic breast disease, I usually recommend taking this between days 12-26 where the first day of the period is day 1.

Ovarian Cysts, Endometriosis, and Adenomyosis Treatment

Taking progesterone cream from days 6-26 will suppress ovulation. Normally, a follicle is produced on the ovary. The follicle produces estradiol. The follicle pops out an egg. The used follicle becomes the corpus luteum. The corpus luteum produces progesterone. Taking progesterone before ovulation suppresses ovulation and follicles don't grow. No follicles means no estradiol.

Estradiol stimulates fibroids (myomas) endometriosis and adenomyosis to grow. So by suppressing ovulation and estradiol stimulation this tends to "starve" the myomas, endometriosis, and adenomyosis. There is no longer any stimulation for them to grow. Suppression of the ovary from ovulating and fooling the ovary into thinking you are pregnant takes about 60 mg/day in a 120 lb woman. Thus, for endometriosis, adenomyosis, and myomas, I recommend taking 60 mg/day of progesterone from days 6-26, any time you do not have a period.

Menopausal Symptoms

Menopausal symptoms are thought to be caused by high GRH trying to "goose" the ovary into producing estradiol. In this case 20-60 mg/day 3 weeks our of 4 weeks usually convinces the brain to stop "screaming" at the ovaries with elevated levels of GRH. Use the minimum of the natural hormone to get the job done. The reason why I recommend taking 7 days off of the natural hormone is that the body will get used to the elevated levels of progesterone and become less sensitive to the natural hormone. Taking 7 days off prevents this "down regulation". However, pregnant women have high levels of progesterone throughout the entire pregnancy for nine months, and they do fine. So if you need to take the natural hormone for hot flashes and menopausal symptoms you can take it for months without a break. The trick is to slowly taper off the natural hormone over a period of 6 months to a year and then you won't need the natural hormone after that. If you stop the natural hormone slowly, then the brain won't start screaming at the ovaries with high levels of GRH and you won't have hot flashes. Suddenly stopping the natural hormone will induce the brain to start "screaming" with high levels GRH. But if you slowly taper off the the natural hormone, the brain gets used to the slowly diminishing levels of the natural hormone and all is well and you will not get hot flashes and menopausal symptoms.

Migraine Headache Progesgterone Protocol

For migraine headaches that vary with the menstrual cycle there is obviously a hormonal component. Usually, the migraine headache occurs just before the period. You can increasingly build up the dose so that on the day of your headache you reach a maximum dose of progesterone. When the pain is most intense you can rub the progesterone cream on your temples. If you have a progesterone oil, you may put this under your tongue. If the migraine headache gets worse when you take the natural hormone, then this means you have to eliminate xenoestrogens or phytoestrogens in your environment. Usually, it takes about 1-3 months for the xenoestrogens and phytoestrogens to wash out of the body. So you may have to eliminate environmental estrogens 1-3 months before using progesterone. Migraine headaches that do NOT vary with the period are NOT improved by progesterone.

Usually but not always, migraines are created by decreased serotonin levels and increased histamine levels. This is how the leading drug for migraines works Imitrex. Imitrex blocks histamine and elevates serotonin. What emotions lead to decreased serotonin. Serotonin is decreased by feelings of guilt. What emotions increase histamine? Fear/stress/anxiety increases histamine. So many times, women have increased fear of conflict. This increases histamine. Then after the argument, they have guilt about the conflict. This guilt decreases serotonin. Increased histamine increases artery size. Decreased serotonin decreases artery size. A migraine headache is born.

Osteoporosis - Low Dose Progesterone Does NOT Work for Most

After 10,000 patients and 10 years, I have seen only 1 patient with increased bone density when I have been giving 20-60 mg/day of progesterone. All the other patients did not report increased bone density. This one patient had severe allergies and hypersensitivity to smell. Anyone with chemical sensitivity, has fear stress and anxiety and will have increased allergies and impaired ability to excrete all chemicals including environmental estrogens. So she also did not excrete the natural hormone I gave her as well. I suspect that you need to take 80 mg/day or more of the natural hormone for a 100 lb woman to increase bone density. I had a 100 pound woman 70 year old woman that claimed to have the bone density of a 20 year old. She also had chemical sensitivity and claimed that she after taking 80 mg/day of the natural hormone she actually had a bone density increase. I suspect that the current alternative medicine approach to bone density is actually too low for a normal non allergic woman. The natural hormone dose to increase bone density may be 80 mg/day or higher for a 100 lb woman.

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