Questions about using progesterone cream flood our email inboxes weekly. What seems particularly challenging is the proper use of progesterone cream with an irregular menstrual cycle. Its use in these instances is probably one of the most confusing given that menstrual cycle starting and ending dates fluctuate, and the timing of ovulation may change from month to month.
I hope this Q&A of frequently asked questions is helpful to those wondering how to use natural progesterone cream with an irregular menstrual cycle. While there are general suggested use guidelines, it is best to determine proper timing of use based on your menstrual cycle.
The “general suggested use” of natural progesterone cream is to “Figure out what day 1 is of your cycle (this is when your next period is due). This is based on your cycle; what is normal for you. Then count backwards two weeks. That is when you start using the progesterone cream.”
The goal in using natural progesterone cream is to mimic a natural menstrual cycle and help the body to establish its own cycle, including regular ovulation.
1. Q: I understand that it is to be used right after ovulation and ended when the period starts, so on and so on, but I have irregular cycles, so how would I use progesterone cream? I sometimes go many months without a period, which is one of the reasons I would like to use progesterone cream; to ensure fertility. Am I able to use progesterone cream even though I’m irregular?
A: Yes, women with irregular menstrual cycles could use natural progesterone cream, but it is best to first address the underlying cause of why menstruation is or has become irregular with other herbs, nutritional supplements, and natural therapies.
Think about what has led to this or is contributing to the irregular cycle. Could it be a result of:
- an underlying hormonal imbalance
- fertility health issue
- use of contraceptives or fertility medications
- deficient diet
- excessive exercise
- being sedentary (no exercise)
Once you determine this, it is going to be easier to find out what can be done naturally to help you get your menstrual cycle back on track.
I understand that you want to balance your cycle and conceive naturally. First, learn the root cause of the irregular cycle and then consider creating a natural fertility program that includes herbs shown to promote a regular menstrual cycle. Some examples are Vitex, FertiliCare Phase 1 & 2, or Fem Rebalance. Herbs work to support hormonal balance on so many different levels – systemically. Progesterone cream works only to increase progesterone levels. Upon determining through testing a need to boost your progesterone levels, progesterone cream could be considered as a part of a natural fertility program; however, progesterone cream alone is not very likely to solve the problem.
Know that the days you will apply the progesterone cream may fluctuate from cycle to cycle until the body adjusts and begins to balance and hopefully begins to menstruate on a more regular schedule. Expect the body to acclimate to progesterone therapy over 4 menstrual cycles, although it may take longer.
Natural progesterone cream use begins the day after ovulation. Learning how to determine when you ovulate each cycle will be most helpful. There are a variety of tools available from OPK Tests and tracking cervical mucus changes, to charting Apps, but we find learning about all types of Fertility Charting is going to help you determine which ovulation tracking method fits your needs.
2. Q: I’m using this product for ttc. I have PCOS and do not regularly ovulate or have a normal cycle. I start applying the cream on day 14, but should I end on day 26? What if I become pregnant? Is day 26 the day I test and if I get a BFN (negative test) do I discontinue? I am not sure if I am ovulating regularly, but I am hoping this will do the trick. The cream is working to induce my periods though.
A: While I can help guide you with the general use of progesterone cream, (it can be one helpful part of a PCOS natural fertility program) the following areas need to be addressed as well…
- diet to improve digestion and support healthy insulin levels
- lifestyle to decrease exposure to toxins and for healthy stress and weight management
- hormone balance to support the body in achieving balance
It is critical to naturally support the body versus just rely on progesterone cream! This is true to the degree that Dr. John Lee shared and believed (we believe too) that changing one’s diet to the PCOS-specific fertility diet, along with participating in regular moderate exercise and using progesterone cream, PCOS could become obsolete. However, progesterone cream alone does not address all of the complexities of PCOS. It only addresses low progesterone levels.
Regarding general use of progesterone cream, its use is suggested from cycle day 14-26, based on the work of Dr. John Lee, as a way to help the body establish a menstrual cycle. By stopping on cycle day 26, progesterone levels will drop. A drop in progesterone levels is what helps to start the menstrual cycle.
When actively trying to conceive it would be best to test for pregnancy prior to stopping the use of progesterone cream. Choose a pregnancy test that is designed and marketed to detect an hCG level as low as 25mIU/ml, such as the babi One Step HCG Urine Pregnancy Test Strips. The reason this is important is because a woman’s level of hCG when she becomes pregnant starts at nearly zero and doubles every 48-72 hours. At 7-10 days after ovulation, a pregnant woman’s hCG levels should be up to 50 mIU/ml. Testing for pregnancy can begin 7-10 days past ovulation which means you need to be tracking ovulation.
Senior Herbalist, Dalene Barton-Schuster, shares, “If the test comes back negative while testing this early, know it may be a false negative due to very low hCG levels. It may be due to late ovulation. Wait 3 days and then test again. An early negative can also lead to feelings of sadness and depression. So, even though you can test this early, it may be best to wait longer, that way you will give the placenta more time to raise hCG levels.”
In the absence of pregnancy, if a cycle does not start, just treat this as a new menstrual cycle and start progesterone cream use again on cycle day 14.
3. Q: I am considering purchasing Natural Progesterone Cream. I read that if you are not ovulating to suppress it for a while, but what if I am ovulating sometimes (some months and not others)? Do I still suppress it or take it after ovulation if ovulation occurs that month?
A: We provide information about the work of Dr. John Lee who worked one-on-one with his patients. It may be most helpful to find someone you can work with one-on-one. However, we find that working with herbs that support ovulation such as:
- Tribulus (Tribulus terrestris)
- Vitex or Chaste Tree Berry (Vitex agnus-castus)
- Saw Palmetto (Serenoa repens)
- or the biphasic herbal blend FertiliCare
is a healthier approach to promote regular ovulation, prior to trying natural progesterone cream first or by itself.
I really think it would be best to learn about anovulation and to learn more about naturally supporting a healthy menstrual cycle in our Natural Guide for Menstrual Health. Understanding why anovulation occurs and how to prevent it from happening in the future through natural therapies and healthy lifestyle choices really is the best way to approach this fertility issue.
If you are struggling with fertility health issues or natural progesterone cream use, the very best way to receive a holistic natural fertility program designed specifically for your fertility health needs (which may include natural progesterone cream) is to have a Fertility Consultation. We are here to help you as best as we can!
- Barton-Schuster, D. (n.d.). Six Things You Should Be Doing During the Two Week Wait. Retrieved from: http://natural-fertility-info.com/two-week-wait.html
- Lee, J., & Hopkins, V. (2006). Dr. John Lee’s hormone balance made simple: The essential how-to guide to symptoms, dosage, timing, and more. New York: Warner Wellness.
- Rodriguez, H. (n.d.). Progesterone Fertility Guide. Retrieved from: http://natural-fertility-info.com/progesterone-fertility-guide