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Fertility Q&A: Progesterone, Pregnancy & PCOS

Fertility Q&A: Progesterone, Pregnancy & PCOS

1. Q: I have a question about progesterone cream during pregnancy. How much do you use when you pregnant? Does it differ from what you do before? And it would be taken daily with no breaks?

A: To be safe it is always best to find and work with a professional healthcare practitioner who can monitor your progesterone levels regularly, who also supports the use of natural progesterone cream.

The general guide for natural progesterone cream use during pregnancy: regular daily suggested dosage of 20mg a day in the beginning of pregnancy, gradually increasing to 100 mg up through 20 weeks gestation. Natural progesterone cream would need to be used every day, missing a day may potentially cause a sudden drop in progesterone which may cause miscarriage. Because of this, having 2 bottles on hand at all times is something very important to take into account. Never self-prescribe natural progesterone cream; be sure to see your professional healthcare practitioner to help guide you through this transition.

If you would like more information, please watch our video at this link: Progesterone Use During Pregnancy

2. Q: Why should I supplement with natural progesterone cream if I have irregular menstrual cycles due to PCOS?

A: Women with PCOS who do not have regular cycles may not be producing enough progesterone to balance estrogen. 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. Some women with PCOS do not ovulate. In women who do not ovulate, the body may not produce as much progesterone. No ovulation = no signal to increase progesterone production. Natural progesterone cream supplementation may help to support the body’s natural progesterone levels, which may help to oppose estrogen dominance and aid the body in regulating hormonal balance and the entire menstrual cycle.

3. Q: I have PCOS and I also have sickle cell trait. I missed my period in Nov, Dec, and January. It came on February 26 and finished March 2nd, but it returned on the 20th of March and I am still bleeding. Today is April 16th and I am not sure how to get the bleeding to stop. I have been on birth control pills from the age of 17 and stopped taking them two years ago. I am now 32 yrs of age. About a week and a half ago, I started taking Maca, Vitex, Cinnamon capsules and Progesterone cream hoping it would stop the bleeding but still no luck. Am I doing the right thing by taking them or should I stop taking them since the bleeding is still there? If not is there anything else I can take to stop the bleeding? I am trying to get a cycle of my own because I want to start having kids as well.

A: Menstrual bleeding long-term is not normal. It would be best to see a doctor about this. We do not recommend using natural progesterone cream during menstruation. Cinnamon has been shown to help reduce heavy menstrual bleeding. You can learn how Cinnamon is used to reduce heavy menstrual bleeding by reading our article Cinnamon Benefits PCOS, Endometriosis, Uterine Fibroids & Menorrhagia

We have another great article to help you learn about natural ways to support a healthy menstrual bleeding time long-term. You can learn why heavy menstrual bleeding may happen and natural ways to support a healthy menstrual flow by reading our article here: Do You Have Heavy Menstrual Bleeding? What You Can Do About It…

4. Q: There are several herbs that appear to be good for PCOS. I’m am currently only taking Evening Primrose oil, Flaxseed oil, and a multivitamin. I have read that the following herbs may also be good for PCOS as well: Vitex, Saw Palmetto, DIM, Maca, and Wild Yam. Not knowing where to start I’ve kind of said to myself, “Okay I’ll just buy all of it and see what happens.” I am wondering if this is a bad idea and if you could provide some guidance. Oh also, I don’t have insulin resistance, but I love cinnamon so I tend to eat a lot of it.

A: I find that researching each herb thoroughly prior to use is best. You could write down all the symptoms you have associated with PCOS. Then you could make a short list of the herbs you are interested in using and key actions that have been shown to be helpful in supporting issues associated with PCOS.

PCOS is tricky, because it has so many different symptoms associated with it. Question why each herb would be supportive of the body’s natural, normal functions and how it supports the body in bringing about that balance.

Here are some simple examples…

Symptoms I have:
Irregular menstrual cycle
Heavy menstrual bleeding
Hormonal imbalance
Facial and Body Hair
Weight Gain

Herbs I am interested in:
Vitex- hormonal balance, may promote regular cycles and ovulation
Evening Primrose- uterine tonic, hormonal balance, proper cell growth, omega 6
DIM- estrogen balance, removal of xenoestrogens
Maca- stress support, hormonal balance, nutritive
Saw Palmetto- proper cell formation and growth, inhibition of DHT production
Cinnamon- balance for blood sugar levels, may help to support healthy weight

It may seem like a lot of herbs to take daily- a whole bunch of different ways to manage symptoms. The goal is to support and guide the body to remember how to function properly on its own again. PCOS is one of the many fertility issues that is a sign that the body has become imbalanced. The use of herbs may be a useful tool in supporting healthy balance once again. I find that use of just a few herbs at one time may be helpful at first. This will give the body time to adjust to those herbs first. It will also help to see how effective just those few are. Sometimes hormonal balance support, diet changes and healthy lifestyle management are all some people need, while others will find they need more support for excess body hair growth, or insulin resistance support, and so on.

People tend to want to overload, which may be confusing for the body at first. Over time, a person will be able to tell what is working and what is not, what needs to be left behind or added. Remember herbs should never be used in place of dietary and lifestyle changes.

Dr. Christine Traxler M.D., OB/GYN
Dr. Christine Traxler M.D., OB/GYN

Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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  1. Avatar

    I have recently been taking been taking progesterone after confirmed ovulation and have been taking my basal body temperature, and have noticed an increase in my temp after starting the progesterone cream. I would like to know if the Progesterone cream is causing the increase in BBT.

    • Hello Jessica!

      Progesterone is naturally produced by the corpus luteum (egg sac that remains) after ovulation. Progesterone raises core body temperature. So, when supplementing natural progesterone with bioidentical progesterone (as is Fertilica Natural Progesterone Cream), yes BBT could and should rise. Is the increase you see in BBT a concern?

  2. Avatar

    Hi There, Just wanting to know if you could offer me some advice..
    I have been dignosed with PCOS and have been having little to no periods for many years.. About 5 weeks ago i started progesterone cream, Because i dont have a cycle the Doc that i went to see said take the cream once daily weekdays, morning and night weekends and from days 1 – 6 of the calander month stop with the cream (I guess this was to mimic a period) which is what i have done but my question is that afew days ago i started my monthly (YAY) so now i am unsure when i start back with the cream.. do i wait until my monthly is finished or do i start back today as its the 7th? Just alittle confused.. Thanks 🙂