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Pregnancy

Natural Progesterone Cream Use in Pregnancy

Dalene Barton - Certified Herbalist, Birth Doula
July 22, 2021
Reviewed by Christine Traxler, MD

Natural progesterone cream is a very effective way to help women with low progesterone to achieve and sustain pregnancy. This supplement is one of the only over-the-counter ways to directly help a woman support her progesterone levels. Progesterone is the early pregnancy hormone. It is necessary in the right amounts to sustain a developing embryo. Progesterone levels are a delicate balance and should a woman with low progesterone find she is pregnant, miscarriage is a possibility without finding a way to supplement the body’s own progesterone.

We work with many women that have low progesterone who have chosen to support their progesterone levels through application of progesterone cream, with great success I might add. Once a woman finds out she is pregnant while still using progesterone cream, the use of the progesterone cream must not stop and continued support with proper education on the correct use in pregnancy must be in place.

This question and answer post was born out of the most common questions we receive from women who are pregnant and are using natural progesterone cream. If you are using progesterone cream or are thinking of using it, this is a very important read!

Natural Progesterone Cream Use In Pregnancy Q&A

1. Q: I just found out I am pregnant and I have been using your natural progesterone cream. I read on your forum that product contains herbs that are not safe for pregnancy. Should I stop taking Fertilica Natural Progesterone Cream? I am scared that if I stop using it, I might miscarry. What should I do? Please help.

A: You are correct, our Fertilica Natural Progesterone Cream contains supportive herbs that are very supportive of preconception health, aiding the body in achieving pregnancy naturally through hormone balance support, namely progesterone. Most of those herbs are not suggested to be continued into pregnancy. What is more important than discontinuing those herbs in early pregnancy though, is continuing to apply the natural progesterone cream, twice daily as directed, until you can switch over to a pure progesterone cream, like Emerita Pro-Gest. Suddenly stopping application of progesterone cream may potentially cause a sudden drop in progesterone levels, which may increase the risk of miscarriage.

Go ahead and continue the Fertilica Natural Progesterone Cream until you can switch over to a pure progesterone cream. Remember to keep two bottles of progesterone cream on hand, so you don’t run out. It is also a good idea to contact your doctor or midwife to help you with good prenatal care and proper guidance for use of progesterone cream in pregnancy.

2. Q: I watched your YouTube video on using progesterone cream in pregnancy. You said to increase the dose to 100mg by the 20th week of pregnancy. My question is, how will I know when to increase the dose and how do I do that? I am currently 5 weeks pregnant and I have been using 20mg in the morning and evening.

A: I think for women using progesterone cream in pregnancy, this is one of the scariest aspects of use; applying the correct dose at the right time. You are not alone, we get this question quite often! There is a general guide to increasing dose and it is important to realize that it is just that – a general guide – not set in concrete. All pregnant women should talk with their healthcare practitioner about continuing progesterone cream through the first trimester of pregnancy, at a dose that is appropriate for their personal needs. In addition, be sure to check the measurement specification for the progesterone cream you are using.

General guide to increasing dose of progesterone cream in pregnancy:

Note: dose 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.

3. Q: I am so excited to let you guys know that I am almost 8 weeks pregnant. While I am so happy, I know it is still early, and I have had several miscarriages due to low progesterone levels. I want to continue the progesterone cream, but at my first prenatal appointment my doctor said he wants to put me on prescription progesterone suppositories. I am really worried about having another miscarriage, but don’t want to take synthetic drugs. Which is safer and a better choice, natural or synthetic? If I choose to take the suppositories, when should I stop the progesterone cream?

A: Your fears are completely valid, but fortunately for this pregnancy you planned ahead, by working to support adequate progesterone levels before trying to get pregnant. Good for you! If you wish to continue the progesterone cream, I would recommend that you ask your doctor to test your progesterone levels, to see if you need to adjust the dose to meet your needs. Sometimes women with a history of very low progesterone need to increase their dose greatly, more than is suggested as a general guideline. Knowing your progesterone levels will help your doctor to suggest a correct dose. If your doctor is unfamiliar with natural progesterone cream application, but you desire to continue the cream, rather than take the prescription, you might want to find a naturopathic doctor who is well versed in proper use of progesterone cream, or ask your local compounding pharmacist to direct you to a progesterone cream-savvy doctor to work with, alongside your current doctor.

It is completely safe and fine to continue the progesterone cream up until you are ready to switch over to the prescription progesterone, should you choose to go that route. You would just apply your last dose of progesterone cream 12 hours prior to beginning your prescription progesterone.

As far as which one is safer, I think that really depends on who you talk to. Progesterone cream does have to be applied correctly and at the correct dose to be effective. On top of that you need to use the highest quality pure progesterone cream you can find. Think of this this way, both are designed to support progesterone production in your body in order to help you sustain pregnancy. I think that it is a personal choice, going the natural route requires you do your homework, be your own advocate, and find a practitioner who supports you. Most doctors are not familiar with working with natural progesterone cream, which is why they offer the services they are trained in – prescription medications. I know that progesterone cream can be just as effective as prescription progesterone because we have had many clients use progesterone cream to support early pregnancy, with great success.

4. Q: I plan on continuing progesterone cream into pregnancy, but do I really need to? Should I get my progesterone levels tested in early pregnancy to see if I need the cream? What kind of test should I ask for?

A: Great question. Any woman who has been using natural progesterone cream prior to pregnancy, should continue applying the cream through early pregnancy because discontinuing the cream suddenly may cause a drop in progesterone levels, which puts her at risk of miscarrying.

As soon as you find out you are pregnant, contact your doctor to make an appointment to get your progesterone levels tested. This is not a routine early pregnancy test. If your doctor or the receptionist at the office questions why you want this test, simply explain to them you are using natural progesterone cream, you have a history of low progesterone and you are wanting to make sure your progesterone levels are adequate enough to carry a pregnancy. There are two types of tests, saliva and blood. Blood tests are more common at a doctor’s office.

A progesterone test in early pregnancy is going to tell your practitioner where your levels are currently at, which will help them determine if you need to continue on with the progesterone cream, and if so, at what dose. If your doctor is unfamiliar with natural progesterone cream dosing, contact your local compounding pharmacist and have them direct you to a doctor who does. That way you will be given the right dose for your needs.

If it is determined through testing that your body is producing progesterone on its own just fine and your doctor sees no reason why you should need to continue progesterone of any kind, simply wean off of the progesterone cream over a week, applying less and less in a split dose morning and evening.

References

  • Rodriguez, H., C.H., CMT. (n.d.). Progesterone Fertility Guide. Retrieved from: http://natural-fertility-info.com/progesterone-fertility-guide
  • Rollins, Catherine P. Progesterone & Pregnancy – A guide to Using Bioidentical Progesterone to Facilitate Fertility and Support Pregnancy, 2010. Making Plans Production, Natural-Progesterone-Advisory-Network.com

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About the Author

Dalene Barton - Certified Herbalist, Birth Doula

Dalene Barton - Certified Herbalist, Birth Doula

Practicing natural health and herbalism for over 18 years, Dalene received her training and herbal certification under the guidance of Lynn Albers at Yarmony Mt. Herbal College in Colorado in 2000. She went on to become a Certified Birth Doula at Birthingway College of Midwifery in Portland, Oregon in 2007. As a Birth Doula, Dalene has helped to bring many new lives in to this world. Dalene has written 280+ fertility articles and with her vast array of herbal and holistic healing knowledge has helped 1000's of women on their journey to Motherhood.

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