Progesterone Fertility Guide

Progesterone Fertility Guide

Article Overview

Hormonal Balance is an important factor when it comes to healthy fertility and getting pregnant. During the course of a menstrual cycle various hormones are working together in a complex symphony to trigger the various components of ovulation and menstruation.

Progesterone is one of these key hormones. After ovulation progesterone production is triggered by Luteinizing Hormone (LH) which stimulates the corpus luteum (the remnant egg sac) in the ovary to produce progesterone. One of the main actions of progesterone with fertility is to help support a developing embryo.

If pregnancy occurs, the production of progesterone from the corpus luteum continues for about 7 weeks (it is then produced by the placenta for the duration of the pregnancy). If pregnancy did not occur, the period begins 14 days after ovulation. When fertilization does not occur the corpus luteum disintegrates, which causes the level of progesterone to fall and the endometrial tissue to disintegrate and shed as menstruation.

Menstrual Cycle

What Does Progesterone Do?

  • Progesterone maintains the lining of the uterus which makes it possible for a fertilized egg to attach and survive
  • Makes cervical mucous accessible by sperm
  • Allows the embryo to survive
  • Prevents immune rejection of the developing baby
  • Allows for full development of the fetus through pregnancy
  • Helps the body use fat for energy during pregnancy
  • Prevents secondary sexual development
  • Increases libido around ovulation
  • Activates osteoblasts to increase new bone formation
  • Protects against endometrial, breast, ovarian and prostate cancer
  • Normalizes blood clotting

Are You Progesterone Deficient or Estrogen Dominate?

Too much estrogen in the body

One of the main reasons women are progesterone deficient is because they have too much estrogen in the body. Estrogen dominance can happen for many reasons:

  • Commercially raised meats and dairy contain large amounts of estrogens, and consuming them can cause hormonal imbalance.
  • Pollution and stress mimic estrogen at the estrogen receptor sites.
  • Eating a large amount of processed soy products can also mimic estrogen.
  • PCOS and endometriosis can also have an estrogen dominate action.

Symptoms of estrogen dominance:

Allergy symptoms like asthma and hives
Breast cancer
Breast tenderness
Decreased sex drive
Depression with agitation and/or anxiety
Dry eyes
Early onset of menstruation
Fat gain, usually around the middles
Sluggish metabolism
Foggy thinking
Hair loss
Increased blood clotting
Fertility issues
Irregular periods
Polycystic ovaries

Not enough progesterone in the body

There are many signs that may show up in the body if you do not have enough progesterone in your system during the correct times of your cycle.

Symptoms of progesterone deficiency:

Recurrent early miscarriage
No period
Not ovulating
Cramps during menses
Blood clotting
Swollen breasts
Fibrocystic breasts
Loss of libido
Water retention
Low thyroid
Facial hair
Hot flashes
Night sweats
Vaginal dryness
Foggy thinking
Memory lapse
Sleep disturbances
Heart palpitations
Bone loss

Hormone Testing

Hormones testing can be diagnosed by a doctor, naturopath or by tests. There are a couple of test options. Tests range from charting your menstrual and basal body temperature, finding out the length of your luteal phase, or taking saliva or blood tests to find out your progesterone levels. The questionnaire above help to point out signs of progesterone deficiency while these tests help to confirm it.

BBT Charting
Basil Body Temperature charting can help to determine the availability of progesterone in the luteal phase. You can learn more about BBT Charting here. There will be a slight rise in temperature after ovulation has occurred and progesterone has increased.

Length of luteal phase
If the date of ovulation is fewer than 11 days before your period, this could suggest luteal phase defects. You can detect ovulation using BBT charting, ovulation detector strip tests.

Saliva Hormonal Testing
Dr. John Lee was very adamant that testing for hormones and progesterone should be done through saliva testing, not blood testing (almost all doctors will test the blood).

You can order an “at home” saliva test that you will take at a certain time during your cycle and then send away to a lab for analysis. They will then mail back the results so you can find out if you have any hormonal imbalances. You can order FDA approved home female hormone tests here.

Blood Hormonal Testing
While Dr. Lee was adamant about getting progesterone testing through saliva, it may be more helpful to work with your doctor to get your progesterone tested so they can explain the test results to you, even if it is a blood test. You most likely will also have other hormones tested at the same time which can give you insights to your entire hormonal profile.

When to Get Your Progesterone Levels Tested
The most appropriate time to measure serum progesterone is mid luteal phase (either 7 days after ovulation, or 7 days prior to expected menses). This is when you’re most likely to catch the peak progesterone level. This day will vary according to a woman’s cycle length however (for example, for a 28 day cycle, a day 21 progesterone is appropriate; but for a 35 day cycle, progesterone would ideally be measured around day 28).

How to Support Progesterone Levels

1. Reduce your exposure to xenohormones

We have become an estrogen dominate society from all of the excess estrogen in our foods and environment.

Reduce your exposure by avoiding these xenohormone producers:

  • Solvents and adhesives
  • Meat from conventionally raised livestock (non-organic)
  • Car exhaust
  • Almost all plastics
  • Petrochemically derived pesticides, herbicides, and fungicides
  • Emulsifiers found in soaps and cosmetics
  • PCD’s from industrial waste

2. Vitex for hormonal balance

Vitex angus castus. Photo by Sten Porse.

Vitex Extract (Chaste Tree Berry) is one of the most powerful herbs for women’s fertility and menstrual health. There are numerous studies and testimonials of Vitex and it’s effects on the body. One of the reasons Vitex is so effective and popular is because of its ability to balance hormones while not containing hormones itself. Vitex supports hormonal balance in the body by having an effect on the hypothalamic-pituitary-ovarian axins (hormonal feedback loop), correcting the problem at the source.

Directions for use
Capsules: 1,000mg a day is the suggested amount to use. Take vitex all month long.

Tincture: 90 drops in water or juice, first thing in the morning. All month long.

However, unlike powerful hormone drugs, vitex works slowly to normalize the body. Maximum benefits are often achieved after 6-12 cycles with vitex.

3. Use Natural Progesterone Cream

Natural progesterone cream can help to supplement your body’s own progesterone levels and lead you back to a state of natural balance.

Natural progesterone cream comes from plant fats and oils called diosgenin which is extracted either from Mexican Wild Yams or soybeans. In the laboratory diosgenin is chemically synthesized into a molecular structure that is identical to real human progesterone.

The United States Pharmacopoeia (USP) denotes a recognized standard of purity and strength. It is sometimes referred to as “human-identical” or “bio-identical” progesterone, which differentiates it from synthetic progestins or progestogens.

How to Use Progesterone Cream

Transdermal application (through the skin) has been found to be one of the most effective ways to use natural progesterone. It is absorbed through the skin into the underlying fat which helps to slowly allow progesterone into the blood. This way of application helps the progesterone to be “time released” into the blood stream. To closely mimic the body’s progesterone cycle, it is best to use progesterone cream twice a day.

How to Use Progesterone Cream for Fertility

Natural progesterone cream is easily and quickly absorbed into the body through the skin (within seconds). So you can apply it essentially anywhere as long as you rotate locations of application.

The best areas for application are places that have capillary blood flow such as:

  • Face
  • Neck
  • Upper Chest
  • Breasts
  • Inner arms
  • Palms of hands and feet

When it comes to dosage, more is not better. Too much progesterone may cause hormonal imbalances, just like too little progesterone can. General suggested dosage is 40mg daily, divided into one 20mg application in the am and one 20mg application in the pm, during the two weeks before your period.

Progesterone use should begin directly after ovulation, which is usually day 14 in the cycle (day 1 is the start of your period), and ending usage once menstruation begins. The best way to know exactly when to begin progesterone cream is to track ovulation with fertility charting. There are several ways to detect ovulation, such as OPK test strips, Ovulation Microscope and Basal Body Temperature (BBT) charting. Once ovulation is detected, progesterone cream would be started the following day.
General application of progesterone cream
What To Do Should You Become Pregnant
Once you become pregnant, stay on the progesterone and contact your healthcare provider. Read below for pregnancy instructions.

Loading Dose
A loading does is useful for women who have had many months or years of anovulatory (no ovulation) cycles, which can create extreme progesterone deficiency. Each cycle that passes without ovulation can increase estrogen dominance as progesterone stores are depleted. Very thin women who have little body fat can become estrogen dominant very easily as there is no fat to store extra progesterone. In either of these situations Dr. John Lee recommends a higher dose of progesterone the first one to two months of progesterone cream use. This helps to replenish the progesterone stored in the fat of the body. After 2-3 months the dose can be lowered to the usual ‘regular’ dosage.

Note: Some progesterone creams come in a squeeze tube, like Emerita Pro-Gest, which uses teaspoons as a measurement for dose. 1/4 teaspoon of Emerita Pro-Gest equals 20mg of progesterone cream. Others, like our Fertilica Natural Progesterone come with a pump. Each pump measures out exactly 20mg of progesterone cream.

Loading dose: 40mg twice a day, one 40mg application in the morning and one 40mg application at night, for a total of 80mg of natural progesterone a day. Apply for two weeks before your period (about day 14 in the cycle), up until menstruation begins.

Regular dose: 20mg twice a day, one 20mg application in the morning and one 20mg application at night, for a total of 40mg of natural progesterone a day. Apply for two weeks before your period (about day 14 in the cycle), up until menstruation begins.

Inducing ovulation using progesterone
Dr. Lee had a number of patients in his practice that had been unable to conceive because they were not ovulating. For two to four months he had them use natural progesterone from days 5 to 26 in the cycle (stopping on day 26 to bring on menstruation).

Using the progesterone prior to ovulation effectively suppressed ovulation. After a few months of this, he had them stop progesterone use. If you still have follicles left, they seem to respond to a few months of suppression with enthusiasm — the successful maturation and release of an egg.

His patients, some of whom had been trying to conceive for years, had very good results conceiving with this method. To learn more about this type of application, please read Dr. Lee’s book What Your Doctor May Not Tell You About Premenopause.

Preventing Miscarriage & Progesterone
Low progesterone during pregnancy can be one cause of recurrent miscarriages. Progesterone is responsible for creating a healthy environment in the womb by maintaining the uterine lining. It also reduces the chances of blood clots and the immune system responding to the fetus as if it was a foreign substance. Progesterone is one of the main pregnancy hormones.

If you feel this might be your situation, talk with your doctor or healthcare practitioner and get your hormone levels tested before using progesterone as well as intermittently to make sure your levels are high enough. Working with a healthcare practitioner is helpful as they can help to monitor your hormonal levels.

Make sure to have at least two bottles on hand, because running out could cause a big drop in progesterone which may cause the menstrual cycle to begin. Contact your doctor or midwife once you become pregnant so they can monitor your progesterone levels during pregnancy.

Progesterone & PCOS
Progesterone cream can help to oppose the estrogen dominance that occurs with PCOS. By using progesterone cream you are able to mimic a natural cycle and help the body to establish its own cycle, including ovulating, again. Dr. John Lee believed that with progesterone cream, changes to the PCOS specific diet and exercise, PCOS could become obsolete.

Progesterone Cream & PCOS

How to use progesterone for PCOS
There are two ways to use progesterone cream for PCOS. The first is the Suppression Cycle. To suppress the cycle one would use progesterone cream on cycle days 7-26. If you do not have a menstrual cycle you would choose a date on your calendar and mark it as day 7. Suppressing the cycle allows the body to rest by stopping the cycle of eggs not being released and estrogen/androgen dominance. Dr. John Lee suggests to use 60-100mg of progesterone cream a day during the suppression cycle and to repeat this for 3-4 months for best results.

Establish a cycle with progesterone cream
To help your body create a cycle including menstruation and ovulation, use progesterone cream on day 12 of cycle and continue until day 26. By stopping on day 26 your progesterone levels will drop, helping to start your menstrual cycle. If your cycle does not start, just treat your cycle like you are having one and start again on day 12. It is best to use a calendar so you can keep track of everything. After 3 or so months it is suggested to take a break for 1 month so you can see if your cycle has jump started itself.

Progesterone Cream & Endometriosis

Progesterone & Endometriosis
If you have endometriosis, Dr. John Lee recommends using progesterone from days 8 to 26 of your cycle, to reduce the effects of estrogen on the body (estrogen stimulates endometrial growth). Take a short week off to refresh your receptor sites. He has had success with this controlling symptoms within six months. Once the outbreaks of endometriosis are tolerable reduce the usage to days 12 till menstrual cycle.

Progesterone Use During Pregnancy

Progesterone Use During Pregnancy
Natural progesterone is safe to use during pregnancy with the consent of your doctor or midwife and may likely prevent many first trimester miscarriages that are due to low progesterone but should be used with caution when nursing as it may stop lactation.

In the first trimester of pregnancy progesterone production is the sole responsibility of the ovaries, but they often fail to produce sufficient levels to maintain the pregnancy. By the second trimester, the placenta itself is responsible for producing progesterone, and it hikes the level of this hormone to 486% higher than the non-pregnant norm.

If you are taking progesterone and get pregnant, you must continue taking progesterone until at least the 16th week. I personally would not stop if I had seriously low levels to begin with. But it is best to work with your health care practitioner if this is the case. They will continuously monitor your levels to make sure they are healthy for pregnancy. Click here to learn more about proper use of natural progesterone cream use in pregnancy…


Healthy progesterone levels are important during conception and pregnancy. You can find out if your levels are where they should be by getting tested. If you do find your levels are low there are many natural ways to promote healthy progesterone levels such as:

1. Reducing Xenohormones
2. Using Vitex
3. Applying progesterone cream

If you become pregnant, continue to use the cream and consult with your doctor or midwife right away.

Progesterone Q&A

Progesterone Q&A

Related Articles

1. Lee, John, M.D. Hormone Balance Made Simple. 2006
2. Lee, John, M.D. What Your Doctor May Not Tell You About Premenopause. 1999
3. Hobbs, Christopher, L.Ac. Vitex The Women’s Herb. 2003
4. Trickey, Ruth. Women, Hormones, and the Menstrual Cycle. 2003
5. Weed, Susun. Herbal for the Childbearing Year. 1986
6. California PSR and CALPIRG. “Generations at Risk” Chemicals and Reproductive Health.PDF
7. The British Journal of Psychiatry (1968) 114: 1377-1382 doi: 10.1192/bjp.114.516.1377


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  1. Thank you for such a great site. A vital site for so many of us. I am using progesterone cream for the past 2 months, secondary to severe PCOS and discontinuing birth control pills.(I was never able to discontinue them, until progesterone cream, it was unbearable) I felt some positive results as far as mood and sense of well being very early on. Then, may be three weeks in, I began to menstruate, and very heavily as well. Cant tell you when my last cycle was, even on the pill. Now I feel worse than ever, I am taking Vitex, but hearing very conflicting reviews on Vitex/ Prog. together. Is it the Vitex or wake up crisis I read so much about that set me back? Phytoestrogen needed? Thank you!!

    • Elizabeth Willett, MA, CH

      Dear Lauryn,

      We support the use of Fertilica Vitex and Fertilica Natural Progesterone Cream together to support healthy progesterone levels. Have you had your progesterone levels tested recently to know if natural progesterone cream is needed any more or if your dose may need to be adjusted? Are you working with a healthcare provider who can guide you with the proper dose for you?

      I am sorry you are not feeling well! This is so hard. What exactly do you mean by feel worse than ever? Have you stopped using your progesterone cream while bleeding? It would be best to do so. You might appreciate the tips offered here about supporting normal menstrual flow.

      I would be better able to help you if I knew a bit more.

      I do wish you well!

  2. I recently found your website and after reading the info was pretty sure I’m estrogene dom. I started a natural progestone creme I found over the counter and spoke with my Dr. About taking it about 4 days before my cycle was going to start to try to help avoid the bad migraines I get with my cycle. She said it was fine and to take it thur day 5 of my cycle but if I find out I’m pregnant to stop taking it! Well I started creme 4 days before and surprise I never got my cycle and I am pregnant! It’s very early only 2 days late but 2 tests + .So now I’m concerned about stopping the creme. Bloodwork done before this showed I was within range but after reading the best test is with salvia. Help!

    • Elizabeth Willett, MA, CH

      Dear Tina,

      Congratulations! This is wonderful news!

      You are going to want to speak with your healthcare provider and share your concerns, even share what you have learned about using natural progesterone cream into pregnancy from this guide.

      In general we do not suggest just stopping the use of natural progesterone cream when you learn of pregnancy. It is important to have your levels tested, and then have your doctor suggest an exact dose of progesterone based on your needs.

      I hope you are able to connect with your doctor, or find a healthcare provider who can support you in using natural progesterone cream during this time.

      Again Congratulations!

  3. Hi, I am 28 and hoping to conceive my second child. I have PCOS. The first pregnancy was achieved with fertility drugs but the whole thing was an unpleasant process. Shortly after I finished nursing i became pregnant again and miscarried. With my docs approval I started taking Vitex (1000 mg once a day) and for the last two and a half cycles, I’ve been using the progesterone cream on day 12-26 of my cycle. I use a saliva microscope to track ovulation. For the first tow months I seemed to have great cycles. I had normal periods starting on days 31-35 and it seemed like I was probably ovulation. This cycle about a week after ovulation and starting my progesterone cream, I started to see ferns on my saliva test. I know this can be a sign of too much estrogen in my system (it’s how I figured it out last time). Should I increase my progesterone dose beyond the 20mg twice a day or could something else be causing all these new ferns on my microscope?

    • Elizabeth Willett, MA, CH

      Dear Darcy,

      It would be best for you to have your progesterone levels tested, so your doctor can suggest an exact dose of natural progesterone cream based on her needs. Regarding the “ferning” you see, learn more in this article and video about using the Ovulation Microscope…

      I can’t be sure for you because I can’t see the pattern you are having. You may also want to contact the manufacturer of the product to be sure.

      We also suggest Charting for Fertility by charting your basal body temperature or BBT. We have found combining two methods of charting helps to eliminate confusion and pinpoint your most fertile time/ your fertile window.

      I hope this is helpful!

  4. Hi I’m 26 yrs old and diagnosed in Feb. with PCOS. Cycles were very irregular for 6 1/2 yrs, and my doc had me take prog. pills for 2 mths (end of Feb & of Mar) to shed excess uterine lining. I tried to continue the prog. supplementation myself with cream following a similar schedule to try to establish a cycle up thru end of July. It was working pretty well, w/me getting my period after around 10 days of being on the prog. each month, until last month. Did the same thing as usual, but no period after 10 days when it usually starts on its own. Had a temp dip after stopping but then temps went up again higher than b4. Am on 8 days now w/high temps and no period. Did I O? Maybe preggo? Help!

    • Elizabeth Willett, MA, CH

      Hello Liz!

      Do you usually get your period 10 dpo? How long is your luteal phase normally? High temps for only 8 days may be a bit soon to confirm pregnancy. Are you charting your BBT? If you are, here are some images of charts of women who achieved pregnancy (yours will not look exactly the same)… .

      BBTs do typically rise in the second half of the cycle known as the luteal phase. This happens as the uterus prepares for implantation.

      It may also be a good idea to contact your healthcare provider to chat in the event you are pregnant you can then be monitored to ensure your progesterone levels stay where they need to be to sustain your pregnancy.

      Best wishes!

  5. Hi, thanks for this site! Very useful information! I am trying to conceive my second child at 44. Only tried one month so far and not successful (no surprise). I am still nursing my first baby who is 21 months old. I’ve had four cycles since his birth (the last four months) . My last cycle (normally 28 days) was only 26 days. Can breastfeeding interfere with conception after you start ovulating again? I can’t find any information on this online. I don’t want to wean but if it means I won’t get pregnant I’m willing. Would love to hear from you. Also I’m going to start taking Vitex and wild yam cream as described above. Many thanks for the tips.

    • Elizabeth Willett, MA, CH

      Hello Joan!

      We are happy you found us!

      Pregnancy is probably not going to happen if you are exclusively nursing on demand, offering the breast whenever your baby wants it. Breastfeeding on demand has actually been shown to be more effective than any other birth control technique, including the pill and condoms. Does that mean that you have to wean before trying to conceive again? The answer is no, but it does mean that it is extremely rare for exclusively nursing moms to get pregnant.

      Most often, we do not recommend using our Fertility Programs for breastfeeding moms. Each program may contain supplements which may have some herbs not suitable for breastfeeding. They may also contain other supplements that may not be suitable for breastfeeding… wild yam cream is one of these.

      While I understand your desire to conceive again, greatly consider the needs of your baby. Are you and baby ready for weaning and moving to full time food and other milk choices? My colleagues have shared that they have found that by night weaning, or cutting nursing times in half, fertility may be greatly increased. Your hormones are focused on creating breast milk for your child and not on being balanced to support another pregnancy and healthy menstrual cycle. Weaning may also support your efforts to balance your hormones and reset your cycle if in fact you do decide to continue trying to conceive.

      Congratulation on the birth of your baby! I wish you well as you consider the best option for you and your child!

  6. I have been taking natural progesterone cream for 3 months. I took 100 mg my first month because my doctor said my levels were very low and I needed to build it up. I took it all month long. The second month I started with the 100 mg and then got high anxiety and my breast were very sore so my doctor decreased my dose to 50 mg all month long. It helped and I felt better. This month she said I could change to only using the cream starting on day 14 and ending on day 25. I am on day 18 and I am bleeding. Could this be my period or is it break through bleeding? If it is break through bleeding how do I stop it? What is your suggestion? Also can I still get pregnant if I take it all month long?

    • Elizabeth Willett, MA, CH

      Hello Laurel!
      It sounds as though your doctor had you on a loading dose of progesterone cream. This helps to replenish the progesterone stored in the fat of the body. After 2-3 months the dose can be lowered to the usual ‘regular’ dosage which we suggest is 40mg each day (split into two 20 mg doses).
      Mid-cycle spotting or breakthrough bleeding when using progesterone cream can mean one of three things; that you are applying it at the wrong time in the cycle, you may be using too much progesterone cream, or a sign your body is adjusting to as increase in progesterone levels. You may want to speak with your healthcare provider again about your spotting and possibly testing your progesterone levels again (if you have not done this recently) to see if you in fact need 50mg per day or possibly not at all anymore. The progesterone test results will help her to determine an exact dose for your needs.
      And regarding your last question, if you use progesterone cream all month long without taking a break it can disrupt the timing of menstruation and possibly delay ovulation or cause anovulation which would hinder your ability to conceive.
      I would suggest giving your doctor a call!

  7. I am 38 years old. I got the depo shot March 2013 and as due the beginning of June 2013. I never got it done. We decided that we would try to see if we could get pregnant. I am very frustrated because the only thing that has happened is my cycle is way off. I just went almost 5 months with my period. My Dr says my hormone levels are perfect and that I should just enjoy not having them. There is something obviously not right somewhere. I just got done reading the depo shot can stay in your system for up to 18 months. I do not want to take a pill to regulate my cycle because I don’t want to take the chance of having more then 1 baby. Plus I don’t believe in taking pills. Any help or info??

    • Elizabeth Willett, MA, CH

      Hello Natalie!

      I am sorry this has been so frustrating for you!

      Any time between when you stop using birth control and up to a year afterward is considered a normal time frame in which it will take your body, on it’s own, to regulate your hormones and start a regular menstrual cycle. When it comes to hormones and their proper function, it is a delicate balancing act.

      Consider the guidance offered in here in How to Balance Your Hormones After Birth Control.

      Take care!

  8. Ever since my miscarriage in October at 6wks (I think from low progesterone—blood test measured ~1.6 about 18 hours after I started bleeding), my periods have been all out of whack. I had one in Jan & April, nothing in between, just started a really light/spotty one this week (finally!) after taking 400 mg Vitex capsules twice a day for the last 4 weeks or so. I don’t know if that’s what’s helped me or not, but I’m trying to get on track to conceive again. I’m 31 and fit—never been overweight, so PCOS doesn’t seem likely. I’m so confused and frustrated! I’d really appreciate any advice or suggestions. I bought some shatavari but it takes weeks to make a tincture- is there another way?

    • Elizabeth Willett, MA, CH

      Dear Victoria,
      I am very sorry for your loss and that you are confused and frustrated!
      There are many links between hormonal imbalances and miscarriages. The hormonal system is an intricate orchestra of hormones that runs on a very specific schedule. If one of these hormones is out of balance it can affect the entire cycle, possibly impacting early pregnancy. It is also important to note that miscarriages due to random genetic defects are natures way of helping to ensure healthy babies. I don’t mean to sound crass at all, but random genetic defects can not be controlled or changed by the parents of the child or medical professionals.
      Were you able to learn what may have led to your miscarriage? Have you had hormone testing post miscarriage to learn if you have any fertility issues that may need to be addressed?
      Vitex is a very supportive herb of female hormone balance. It should be taken long term, as many as 6 months or more and at a dose of 900-100mg per day which is the general suggested use. If you feel Shatavari may be supportive of you, you could purchase it is capsule form to use until your tincture is ready. You can see Shatavari here….
      You may also appreciate learning 5 Steps To Decreasing the Chance of Recurrent Miscarriages.
      I wish you well!

  9. Is it ok to use vitex and progesterone cream at the same time? What will be the dosage if both used? Im suffering from hormonal imbalance. Thank you

    • Elizabeth Willett, MA, CH

      Dear Thess,

      You can take Vitex and natural progesterone cream together.
      Vitex is generally suggested to be taken once a day in the morning on an empty stomach (half an hour before breakfast) and Vitex should be used all month long without a break. In capsules for suggested use is 900-1,000mg a day.
      General suggested dosage of natural progesterone cream is 40mg daily, divided into one 20mg application in the am and one 20mg application in the pm, during the two weeks before your period. Please watch this great video on How to Use Progesterone Cream.

  10. Hey
    Bethany, I read this article and thought you might want to read it also.

    • Hey Trish, did you have a question? I see you added your friend Bethany’s email address, perhaps not realizing this would post. Let us know if you need any help.

  11. how long does it take to get pregnent with these natural treatments? I am 27 now and want to get pregnant asap. Also want to know where will i get these herbs and how to use them.. Kindly help!

    • Elizabeth Willett, MA, CH

      Hello Harshada!
      There is no simple answer to this question. It is different for every couple dependent on diet, health history, stress levels, existing health conditions or imbalances, how well they stick to the program, and how severe the fertility issue is. If you are on one of our health programs, you should begin to see changes within 1-3 months. These changes could be increased energy, improved cervical mucous, ovulation, correction in cycle length, etc…
      You are welcome to explore and order from The Natural Fertility Shop at any time or by contacting our customer care team for assistance.

  12. I am 41…have been ttc for 3 years. No child, but 2 miscarriages. Low progesterone (had the shots when preg). Also, tested positive for lupus anticoagulant so I take low dose aspirin each day. Do you have any advice or product that could help me? Thanks so much!

    • Elizabeth Willett, MA, CH

      Dear Renee,
      It is difficult for me to answer your questions based on just a small piece of the bigger picture of your health. I’m sorry to hear about your losses! You may want to book a Fertility Consultation. Once you book the consultation, there will be a form for you to fill out that will give our senior herbalist a clear holistic perspective on your situation to analyze and assess properly. It is helpful for her to know your lifestyle, health history, fertility challenges and detailed questions.
      This wonderful service provides you with a personalized written guide and audio recording describing to the best natural therapies, herbs and supplements for your unique fertility issues.
      Be Well!

  13. I have a luteul phase defect. My doctor told me I was low in progesterone as well. I have been using vitex and fish oil for about 6 months, and progesterone cream and vitamin c for 3 months. Each month I have used progesterone cream my luteal phase has gotten shorter and shorter. This month I started spotting on day 7 post ovulation, and that is my shortest luteul phase in a year. Is there a chance the cream is making my lpd worse? Any help is appreciated!! Thanks!

    • Hi Katherine,

      Have you thought of just supplementing with one or the other, meaning just the vitex, or just the progesterone cream? It may be one of these isn’t working for you or for your particular situation, aren’t working well when combined. There are other supportive supplements and therapies for luteal phase defect to also consider, which you can learn about in our article on Luteal Phase Defect.

      By chance are you over 40? I am not trying to pry, but age may be a consideration when it comes to the luteal phase shortening over time. It may become shorter and shorter for women over the age of 40, as follicle health and count declines and no longer responds well to hormone levels in the follicular phase, which causes less progesterone to be produced. If this doesn’t apply to you, I apologize.

      Consider ditching either the vitex or progesterone cream and just use one to see if that improves anything. Be sure you have also ruled out anything else that could be causing mid-cycle spotting.

      Let us know if you have other questions and have a great day!

    • Elizabeth Willett, MA, CH

      Dear Katherine,

      I have never heard of natural progesterone cream use shortening a luteal phase. How much Vitex and natural progesterone cream are you using and are you using our Fertilica brand products? There could be other factors at play here as well like low body weight and low cholesterol levels, etc.

  14. Hello,
    This is a very good article.
    I am 31 years old and suffering from PCOS since 5 years. I have been trying to have a baby but i do not ovulate. I started using Progestrone cream since 2 months – start on 12 day and stop on 26 day of my period cycle. Am i doing it right? why dont i ovualate? Please advice.

    Thanks & Regards,

    • Hi Pragnya,

      It is very common for women with PCOS to not ovulate. Here is why:

      What the menstrual cycle is typically like in a woman with PCOS…

      In women with PCOS the cycle begins irregular, with the hypothalamus releasing GnRH in a higher than normal pulsatile frequency. This allows for increased LH and decreased FSH, this in turn leads to excessive production of the androgens androstenedione and testosterone. This causes the follicle to only mature some, but not enough to achieve full maturity. This also allows for continued increase of estrogen, primarily estrone. During the development of the reproductive stage and during reproductive years for females, estrone is relatively low. Typically we think of estrone to be associated with menopause, not women of reproductive age. The higher levels of androgens and estrogen creates a chronic state of low to very low progesterone.

      It takes many months for the body to build up progesterone levels with progesterone cream supplementation. Anywhere from 4-12 month is a normal amount of time to build the progesterone stores with natural progesterone cream. Since it has only been 2 cycles, be patient, you are applying it correctly, it just may take some time to build up the progesterone stores. Be sure you are also eating a PCOS specific diet and consider supportive herbs for PCOS, that help promote regular ovulation and hormone levels.

      Blessings :)

    • Thank you so much Dalene :)
      I will try to be patient. i am already taking vitex, multivitamins and doing regular 30-minutes exercise and also following a healthy diet.


  15. Hi,
    is possible to use the cream after 3 months when I stoped hormonal therapy with estrogen? The name was Trisequens. I have 53, have stoped menstruation and have the myoms, which dont do problems(I appologize for my english I live at Czech republic). Where is possible to buy cream Dr. Lee, in our country I cannot buy it. Maybe by internet, please can you recommend me steps or adress how to do?
    Thank very much for answer. Galina

    • Elizabeth Willett, MA, CH

      Dear Galina,
      We do not advise combining Natural Progesterone Cream with hormonal therapy, but if you have completed this therapy and know that you have low progesterone levels, you might try natural progesterone cream. You are welcome to order Fertilica Natural Progesterone Cream. We can ship to you in the Czech Republic. Should you need further assistance with ordering please contact our Customer Care team here…

  16. Can natural progesterone be used to treat ovarian cysts if you also have Factor IV Leiden clotting disorder.

  17. Hi, I am 37 and have just had my third miscarriage in the last year. The first at 16 weeks, then 12 weeks then the last at 8 weeks. I also had an ectopic 5 years ago and lost a tube. It only took me a month to fall pregnant each time but they are just not hanging in there. The specialist put me on progesterone and increased my thyroxine (I was not taking thyroxine for the first pregnancy) due to them both being a little low. I am wondering if my hormones are totally out of wack? Thinking that I a cleanse might help normalise the hormones and the progesterone? I have stopped taking the supository progesterone tablets since the last miscarriage, am a little worried that I might do more harm than good if I keep doing things that are wrong for my body. I am also doing accupuncture and have started Yoga in the last couple of days but am really looking for anything else that might help.
    Do you think the fertility cleanse and progesterone cream might help create a good home for the baby?

    • Hi Lisa,

      I am sorry to hear of your recurrent pregnancy losses! You must feel very exhausted and frustrated with all the information and options out there, that is why we offer consultations. Our fertility consultations help to guide you in the right direction, based on your personal needs.

      A Fertility Cleanse is always the best place to begin, but it is not the solution to all the issues. It is a way to create a healthy foundation for hormone and reproductive health. My thoughts about progesterone supplementation, it is best to use this only if you know for sure you have low progesterone levels and that is the cause of the miscarriages. There are many things that may cause recurrent miscarriages and if you don’t have low progesterone, supplementing with it is not going to help sustain a pregnancy that is being caused by other reasons. Click here to learn more about recurrent miscarriage… May you go on to have a full term healthy pregnancy in the near future!

  18. Hi! Thanks for this post. I had a previous mc at 8-9 weeks due to low progesterone. Now pg again and 3-4 weeks along. Using your UteriCalm and a natural progesterone spray. I just purchased the pro-gest cream. My question is how much to take and if transdermal application is enough or if I should consider trying to find an oral or suppository form (any suggestions for natural forms of these?) and if the cream will work, do I keep increasing the amount or just stay at a certain dosage until after 16 weeks? Thanks!!

    • Hi Ally,

      Congratulations on your pregnancy! I have a new article coming out on 6/17 that answers your questions perfectly, but here you go, I pulled a piece from it:

      General guide to increasing dose of progesterone cream in pregnancy:

      Note: measurements are based on Emerita Pro-Gest guidelines

      • 1/8 tsp. contains approximately 10 mg progesterone
      • 1/4 tsp. contains approximately 20 mg progesterone
      • 1/2 tsp. contains approximately 40 mg progesterone

      Week 3 (just past ovulation to week 5): 40mg per day
      20mg applied once in the morning and 20mg once in the evening.

      Week 5 through 7: 60mg per day
      30mg applied once in the morning and 30mg once in the evening.

      Week 8 through 10: 70mg per day
      35mg applied once in the morning and 35mg once in the evening.

      Week 11 through 13: 80mg per day
      40mg applied once in the morning and 40mg once in the evening.

      Week 14 through 16: 90mg per day
      45mg applied once in the morning and 45mg once in the evening.

      Week 17 through 20: 100mg per day
      50mg applied once in the morning and 50mg once in the evening.

      How and When to Discontinue Use After the 20th Week:
      By the 20th week of gestation, the placenta should have taken over producing adequate amounts of progesterone. By the 20th week most women are in the clear of having a miscarriage due to low progesterone levels, so stopping the cream suddenly should not be an issue. If you are worried though, it is also fine to slowly wean off of the cream, using less and less each day over a week, until you are no longer applying it.

      It is best to confirm your progesterone levels with your doctor or midwife, if you have a history of low progesterone, so they can suggest the proper dose for your needs. Progesterone cream works just fine and we have had many women use it successfully in pregnancy. If you are worried, you may want to talk to your doctor about prescription progesterone options, which are not natural, but are what doctors work with and are also helpful. Really it is up to you!

      May you have a happy and healthy pregnancy!

    • That is perfect!! Thank you so very much. Exactly what I needed! I really hope things work out this time. Love your site :)

    • Hi Ally,

      My fingers are crossed for you! Here are some additional articles on pregnancy you may be interested in reading…

      What to Eat During Pregnancy:
      Ten Tips for a Healthy Pregnancy:
      Nutritional Supplementation for Pregnancy:

      Keep us posted on how it all goes!

  19. Hi,
    I’ve been diagnosed with PCOS and didnt have a period for a while. I began using progesterone cream last month by just picking day 12 and starting. My period came on by day 20 and the doctor said I should stop when it begins. I started again this month on day 12 counting the 1st day of my period as day 1. My period came on again at day 20. Am I supposed to count the first day of my period as day 1? My period is starting too early and at this rate I’ll have more than one period in a month. Should day 1 be the last day of my period. Or should I start using the cream later?

  20. Hi there,
    I have been undergoing fertility treatment for 3+ years now, my specialist has put me on prometrium which is a synthetic form of progesterone. I have also been taking vitex, is it safe to take the two together? I’ve had recurrent miscarriages and an ectopic pregnancy and am looking for a way to prevent these thing from occurring

    • Elizabeth Willett, MA, CH

      Hi Ashley!
      We do not advise combining prescription progesterone (synthetic progesterone) with herbs that have an affect on the hormones, including Vitex.

  21. Dear Hethir,
    Progesterone test done on day 21, result 55. I had this done last year at age Oct 2013. Unexplained fertility, examination showed I have 2 small intramural and 1 pedunculated fibroids found in April 2013. Also LH 3.5 IU/L and FSH 3.5 IU/L done in early 2013. Should I take Vitex or progesterone? For how long and ishould I take during or after fertility cleanse? Thank you

    • Elizabeth Willett, MA, CH

      Dear Leena,
      Each lab’s results differ. There is no way of me knowing what a result of 55 means. Also, October was a bit over 7 months ago. If you have been working to support your fertility in this time, it may be worth considering another test. If you have not, then waiting to test again is okay.
      The goal is to support hormone balance as a whole. In general, we find it best to start by trying herbs to see how the body responds on its own. It may balance the hormone levels on its own. This is where the herb Vitex shines!
      Natural progesterone cream is only going to directly increase progesterone levels, not aid the body in supporting all hormone levels.

  22. I Love your Progesterone videos! Thank you :-)

  23. Thanks for the article! I am 33 and wanting to get pregnant. I’ve charted the past 5 (unsuccessful) cycles and noticed that I ovulate anywhere from day 19 up to day 22. Also new, is that I spot 3-4 days prior to my period (never used to do that). One last thing that I thougth was interesting, is that not only did I sometimes get multiple pos. OPKs with a day or two in between them registering neg, it could be up to a 48+ hrs before I would get BBT rise after the last positive. I went to my doctor to ask for Progesterone testing but she states that it is not necessary b/c charting shows issue and wants me to do “Chlomid Induction” w/ two other hormones (progesterone and something else) b/c progesterone alone won’t do anything. She did do basic hormone/blood levels right after my period and said all looked good. Is it really necessary to take all those meds? I do have a small fibroid and have a past history of hormone dysfunction though no issues for about 5 years now. Otherwise, I am very healthy and eat VERY healthy. Meds messed me up in the past and now that I have control of my body, I would hate to pile on meds again. Also, husband sperm analysis turned out great. Any advise?

    • Hi Angela,

      If what you want for your body doesn’t align with your doctor’s plan for you (what they are trained to do with medications only), then you may want to seek out the advice and support of a different kind of practitioner. There are herbalists, naturopathic doctors and holistic nurse practitioners, or perhaps a medical doctor that practices integrative medicine. You could do you own at-home progesterone saliva testing during the second half of your cycle to see if you are in fact progesterone deficient. I feel it is best to work with someone who is going to listen to what you have to say, rather than say no, and move on to an aggressive drug plan.

      We offer consultations via email. There is a comprehensive intake form, which shows us areas that need supported in order to improve reproductive health. The intake form also includes an area to submit your fertility charts, so the herbalist can review and note signs of menstrual cycle/hormone imbalance. Learn more about our consultations here:

      In the mean time I urge you to learn about biphasic herbal blends. These support both the follicular phase and luteal phase, with two specific herbal formulas for each phase. 1 to support regular, on-time ovulation in the first half of the cycle and 2 to support the uterus and progesterone levels in preparation for implantation, or healthy menstruation. Learn more here:

  24. I was having issues and was tested and diagnosed with low progesterone. I was put on progesterone cream. It helped me feel so much better, and I got pregnant and was able to stay pregnant. My son is now 10 months old and my cycle hasn’t returned and I’ve noticed some symptoms return, like hair loss, weight gain(I lost all my pregnancy weight and now gaining again!), etc. This is my 5th child and I’ve nursed them all. My son is still nursing, but my cycle has never taken this long to return. Can I take progesterone cream while nursing? Is it probable that progesterone is low if it hasbeen low in the past? Thanks for the help!

  25. I have had 2 chemical pregnancies. without testing my progesterone levels, my doctor prescribed progesterone (pill form)to take during luteal phase. She told me it can’t hurt, even if my levels are not low. Is this true? Would you recommend I only take supplemental progesterone if I get my levels checked and find they are low? Or is it oOK to continue? After reading this article, I would want to at least switch to the cream. tHanks for your help; I have little confidence in my doctor at this point.

    • Hi Nina,

      I am sorry your practitioner feels being a guinea pig is okay for them and YOU! Consider seeking a second opinion and yes, get some hormone testing done. Chemical pregnancy may be due to other reasons besides low progesterone. Common cuases:

      Uterine abnormality
      Hormonal deficiency
      Fetal chromosomal abnormality
      Uterine Fibroids
      Inadequate lining of the uterus

      There are many natural ways to prepare for pregnancy. I am not sure of your age or other fertility related conditions, so I am not sure where to suggest you begin other than focusing on diet and cleansing. We do offer personalized guidance through our consultations.

      I am sorry for your losses. May you go on to be successful!

  26. I am a 33 years old female . I was on depo provera shot for almost 2 years after I had my first child.I was having a period every 35 to 40 days without any problems before my son was born I stopped having periods for almost 3 years after I stopped depo and then had bleeding for almost 30 days or 40 days in once every 2 years for past 4 years .Bleeding is also moderate.. Today is day 24 since I started bleeding myself after about 2 years .Its not associated with pain but mild fatigue that I can tolerate. but I am just annoyed now. I wish it had come in regular intervals. I had consulted gynae and they diagnosed PCOS. I was given birth control pills several times in the hope I will be regular.last time I took provera was in December 2013 and I bled for 7 days, and this time I bled without any medication but it is just not stopping.I am 5.6″tall and 170 pounds.Can you help me with what I should do? I dont want to be on any more hormones and I want one more baby before I turns 35. I found your informations very useful but appreciate to guide me appropriately .Please help me…

    • Hi Priya,

      I am sorry to hear of your struggles! It is important to keep in mind that hormonal medications, including birth control, is giving your body a command, that is not natural/normal for when your body would send its own natural hormones (commands) out. Does that make sense?! This is confusing to the body and can disrupt your own natural menstrual cycles because it has been told what do do for so long by the synthetic hormones you were given. A great place to learn more about this and where to begin would be to read our article on birth control recovery. You may also want to consider a consultation with one of our herbalists.