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Natural Progesterone Cream Use: 10 Things You Should Know

Natural Progesterone Cream Use: 10 Things You Should Know

Every woman who is considering, or is already using natural progesterone cream should know these 10 important tidbits of information about this bio-identical hormone cream. We find many women use the cream incorrectly, or are worried about how they are using it. The more you know about natural progesterone cream, the better able you will be able to support your progesterone levels correctly.

1. Apply natural progesterone cream correctly. If you are not applying it correctly it may not be effective. The best areas for application are places in which capillaries are dense and close to the surface of the skin, such as:

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

Avoid putting NPC on the fattiest areas of the body, as this may inhibit proper absorption. Fat will store the progesterone, rather than allow it to move into the bloodstream, circulate and be utilized by the body. In addition, rotate where you apply the cream each time you use it to avoid saturation.

2. Estrogen dominance may become worse when first beginning natural progesterone cream. When first introducing progesterone back into the body after an extended period of progesterone deficiency, the estrogen receptor sites ‘wake up’ (are stimulated), enhancing the action of estrogen for a short period of time. This is a sign that the body is responding well to the progesterone, even though at the beginning it can exacerbate estrogen dominance symptoms such as breast tenderness and swelling, spotting, fluid retention, dizziness, hot flashes, fatigue, headaches and nausea. This can be very worrisome, but should level out and go away over the next couple of cycles, as progesterone levels increase.

3. Stress affects progesterone levels. How? Stress increases cortisol levels. Cortisol competes for progesterone receptors; the higher the stress the more cortisol the body produces. This means that those receptor sites may be occupied by cortisol rather than progesterone, which may require temporary increase in progesterone supplementation. If you are not managing your stress levels, the natural progesterone cream you are currently using may not be effective because of elevated cortisol levels. Make stress reduction part of your plan to balance hormone levels.

4. Severe progesterone deficiency requires more time to increase progesterone levels with progesterone cream supplementation. It takes anywhere from 4-12 months to bring progesterone levels back up in women with very low progesterone levels. Following a loading dose protocol may help to bring the levels up quicker, but consistency of use over an extended period of time is best. For women who are trying to conceive, a realistic plan is going to help achieve pregnancy and prevent miscarriage due to progesterone deficiency. Give yourself many months of progesterone cream supplementation before even trying for a baby, to help prevent the likelihood of miscarriage.

5. Is it okay to use natural progesterone cream if you don’t know if you have low progesterone levels? It would be best to know if you have low progesterone levels or not. You would not want to work to increase progesterone levels if you don’t need to. Over time, using progesterone cream when it isn’t needed may create a situation in which too much progesterone is in the body. That being said, there are many clear signs of progesterone deficiency and testing is relatively easy. There are at-home saliva hormone tests and your doctor can test your levels as well.

6. A one-time overdose of progesterone cream is virtually impossible. That being said, it does not mean you should use more than the suggested dosage. It does mean that the female body can withstand high levels of progesterone in the body relatively well, because during the last trimester of pregnancy, the placenta is producing 300-400mg of progesterone a day. If you accidentally use too much or apply the cream more than 2 times in a day, you should be fine. Even if you used a whole bottle in a day, it may just make you feel very sleepy. Be sure you always stay within the recommended dosage guidelines recommended by your healthcare practitioner, or on the label of the product you are using.

7. Split dosage up between morning and nighttime application. Apply the cream once in the morning and once in the evening before bed. Using it before bedtime may help some people to sleep better. Splitting the dosage up ensures 8-12 hours of sustained delivery. If you apply it all at one time, only once a day, it will still only last 8-12 hours, leaving the other 12 hours where you are not receiving any. The split dosage ensures optimum progesterone levels are maintained.

8. Each cycle, stop using natural progesterone cream only when you have confirmed you are NOT pregnant. This means if you are trying to get pregnant while using NPC, be sure to continue it until you have definitely confirmed you are not pregnant. If you get a positive pregnancy test result, continue on with the progesterone cream. Be sure not to skip a day of use of NPC in pregnancy. Doing so may result in a sudden drop of progesterone levels, which may cause a miscarriage. Have two bottles on hand at all times to ensure you don’t run out.

9. Discontinue use of progesterone cream by weaning off of it over time. When you decide it is time to stop supplementing with natural progesterone cream, simply reduce the amount you use each time you apply it. Do this on the last cycle you plan on using it. If you are pregnant, do not do this until at least the 16th week of gestation, when the placenta takes over progesterone production.

10. There are certain health conditions in which natural progesterone cream supplementation should be avoided. If you have a history of gestational pemphigoid (dermatosis of pregnancy), jaundice of pregnancy, severe active liver disease, hepatitis, rotor syndrome, Dubin-Johnson syndrome, or unexplained/abnormal vaginal bleeding you should not use natural progesterone cream.

Want to know more? Be sure to read over our complete Progesterone Fertility Guide and our Progesterone & Fertility Q&A!

References:
1. Rollins, Catherine P.(2007). 10 Things Every Woman Should Know About Natural Progesterone. A Making Plans Production. www.Natural-Progesterone-Advisory-Network.com
2. Taber’s Cyclopedic Medical Dictionary. (1997). pp. 1431. Philadelphia: F.A. Davis Company.

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[-] 106 Comments
  1. Hi,

    I have been using natural progesterone for a while now and it really helps with not only PMS symptoms but mood during the rest of the month and acne. I had very bad painful hormonal acne that went away after using the cream but everytime I stop using the cream like you’re supposed to I break out all over again and then when I start it up again my face clears up. Would it be okay to use it every day in a small dose?

  2. I’m 62 post hysterectomy and oophorectomy for the past 12 years. In the past 3 months I have started to use progesterone cream at 20 mg/day (emerita brand) It helps my sleep well but my breasts are enormous. I do have an anxiety condition which I receive counseling for and I take clonazepam prn and 88mcg of levothyroxine . Do I cut back on progesterone to 10 mg? or should I continue on for a few more months as my body adjusts to not having any hormone supplementation since 2005. I want to have increased libido, and more vaginal moisture but with the enormous breasts I feel like it’s the days of pms all over again. I’m also very teary but I don’t know if that’s also part of the anxiety.

    • Dear Cynthia,

      Post menopausal hormone support is actually not our area of expertise. You could try decreasing the amount of progesterone used, but in all honesty it would be best to have the help of a practitioner who can guide you in using it based on your needs and what you are experiencing.

  3. Hi
    I’ve been without a cycle for over a year Andy have PCOS. I’ve been reading about natural progesterone and stated taking it the beginning of September along with other natural supplements to help bring on a cycle. Long story short I got a period a couple weeks after and stopped the progesterone during this time. Since I don’t have a normal cycle I stopped, the progesterone until day 12 and stated it up again days 12-26 and again my cycle started. Now should I continue to take the progesterone or do I stop when menses occurs. I am ttc but am still working to regulate my cycle and see if I can start ovulating. Any input would be great, thanks

    • Dear Misty,

      Progesterone cream is best stopped again during menstruation until ovulation or cycle day 12 again. When you begin to track ovulation to pinpoint exactly when it happens, the cycle day you begin progesterone cream application may shift and this is just fine.

  4. Im 45 years old and TTC, I just started using an over the counter progesterone cream this cycle. My levels came back 4.3 which I understand is really low to sustain or even become pregnant. Im unsure if I should stop using the cream at CD 27, (I have a 28 day cycle) as the package instructs, or wait for my period to begin before I discontinue use? What if I become pregnant and the sudden loss of progesterone causes miscarriage? If I continue with the cream will my period begin on its own if Im not pregnant? Where I live pregnancy tests are expensive so taking a few HP test every cycle is not in my budget. What other options are there? Help!

    • Hello Sondra!

      Deep breaths! I’m here to help!

      Progesterone cream is best stopped at cycle day 28 unless you try to conceive. If you actively try to conceive it will be best to test for pregnancy before stopping progesterone cream, or be charting your basal body temperature (BBT) which costs only the amount of a proper thermometer. For some women in the absence of pregnancy, a period will start on its own while using progesterone cream, but for others it does not. There are women who need to stop progesterone cream for menstruation to start. When using progesterone cream, it is best to continue it into early pregnancy with the support of your healthcare provider or midwife.

      Could you purchase pregnancy tests online for less than they cost at your local stores? Would you consider using progesterone cream as a part of a complete natural fertility program for a minimum of three cycles before actively trying to conceive to see if the body relearns to maintain progesterone levels on its own? If it does, then you may not need to use progesterone cream the cycle you begin trying to conceive which would alleviate the worry about sudden drops in progesterone causing miscarriage.

      …just sharing my thought to hopefully help you think thru the options as you continue on your journey. I hope this helps!

  5. Hello, After dieting and exercise and losing weight and my cycle still not starting. I decided to start NPC on September 1, instead of the synthetic kind.My period started 2 weeks after using 1 pump twice a day. I got my first period after a year of not having a period. After reading the article I realized I should have started a loading dose (2 pumps twice a day) for three months to establish a regular cycle.After my next period I started with 2 pumps twice a day for a week but the symptoms were really strong so i went back to one pump. After 3 days of going back to 1 pump twice a day my cycle started 2 weeks early. Did I do something wrong? Should I go back to 2 pumps after this period

    • Dear Christ-Lynn,

      Switching from two pumps to one could have been the reason for your cycle starting early. It is a drop in progesterone whether it happens naturally or when progesterone cream is stopped that cause menstruation to start. It seems your body responded better to using only two pumps daily, so without knowing more about you, I would suggest going back during the two weeks before your period starts.

  6. Hi. I really need to know which is the best progesterone cream and if it helps in a high vaginal atrophy problem. I just don´t want to continue using synthetic hormones.Thanks

    • Dear Patty,

      It is going to be best to seek the support of a healthcare provider familiar with bioidentical hormones or natural progesterone cream. It is my understanding that vaginal atrophy is caused by lowering levels of estrogen as is common for women nearing the end of perimenopause or moving through menopause.

  7. I started using Progesterone Cream and it was really helped with my PMDD symptoms. This is my first month using it and have been 9 days late on my period. Is this a symptom of using the cream? Should I stop it in order to begin my period?

    • Dear Briana,

      If you have not tried to conceive (ttc) and know you are not pregnant, progesterone cream can be stopped. Some women need to stop its use for menstruation to start. When actively ttc and using natural progesterone cream, do be sure to test for pregnancy before stopping it.

  8. I have been using progesterone cream for about 6 months. I’m in my early 50’s, no ovaries, have uterus. I’m on a estrogen patch also. My concern is does the progesterone cream lose its efficacy over time? Also, I’ve heard varying opinions that a woman with a uterus on estrogen should stay on the cream and take no days off versus taking 3 to 5 days off. Just curious what your take is on that. Thank you. : )

    • Dear Sher,

      I think continued use of progesterone is best determined through hormone tests or symptom review with a qualified healthcare professional. Replacement hormones don’t usually lose effectiveness, yet in general less is often better (everyone’s needs are different). I am not sure I would agree with the opinions to not stop progesterone cream use each month. I am not an expert however. Dr. John Lee suggests a monthly break from it’s use. Have you discussed this with your healthcare provider?

      Have you thought about supporting adrenal health as well? The adrenal glands work to shore up hormone production when the ovaries slow down with age (or are removed).

  9. Hello, I am confused with when to stop the progesterone cream and why it needs to be stopped during menstration. I use Nuvaring for birth control. My question is do I stop using the progesterone cream once my menstration is here or once I take out the Nuvaring for the week for my period to begin?

    Also I am afraid to stop using it because before I started using it I was a total raving mad woman, crying and angry and just pushing people away. I don’t want to be that women again for 7 days out of the month.

    • Dear Vicky,

      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. Progesterone is typically not produced in large quantities by the body during menstruation. Using natural progesterone cream prior to ovulation is likely to stop ovulation.

      Does your doctor know you’re using progesterone cream with NuvaRing? Could it be the NuvaRing that is making you so emotional?

      We aren’t able to suggest progesterone cream use with hormonal medications without a doctors guidance. It may be best to ask him/her when it is best to use/stop. With that, progesterone cream used to support a healthy menstrual cycle is suggested only for the two weeks before menstruation starts not during a period or before ovulation.

  10. Dear Elizabeth, Am a 50 y. old male and was advised to apply progesterone cream (1%) for a few weeks. Is there a difference between p. cream for women and for men? What is the danger of developing ‘moobs’ should I apply the cream 6x p. week for 2 months?

    • Dear Diversey,

      This would be a better question asked of your doctor or pharmacist. I am honestly not certain of the dangers for progesterone cream use for men. It is probably going to be best to choose a pure natural progesterone cream that does not contain herbs. Emerita Pro-Gest is but one of I am certain many on the market.

      My best as you naturally support hormonal balance!

  11. Can i take progesterone cream and vitex at the same time?

  12. Hello. Can you tell me what test results should look like when testing for progesterone?
    Thanks.

    • Hello Gin!

      The most appropriate time to measure serum progesterone is mid luteal phase (either 7 days after ovulation, or 7 days prior to expected menses). In general for women, most resources say that progesterone levels tested mid-cycle should fall in the range of 5 to 20 ng/mL or 15.90 to 63.60 nmol/L.

  13. I have read through the Progesterone Cream Uses and I think it will be useful to me. The problem is that I don’t know where I could it. Please help.

  14. I have started to use Progesterone (in cream) 3 weeks ago. I’m 52 (pre-menopause) . Now I have my period (for 4 month I hadn’t it) . Should I stop to use progesterone during my period (5 days) or continue? Thanks for your attention!

    • Dear Paola,

      Natural progesterone cream is best stopped during menstruation, yes. You may appreciate the book What Your Doctor May Not Tell You About Menopause (TM): The Breakthrough Book on Natural Hormone Balance.

  15. I wanted to know if it is safe to use a progesterone/estrogen facial cream while taking birth control pills, I’ve been using a progesterone/estrogen cream 3 days so far, I’m 29 and using birth control pills and I want to know if there is any risk of lowering the effectiveness of the pill while using the cream.

    Thanks in advance,

    • Dear Natalie,

      I am not a doctor or pharmacist, nor have I heard of progesterone/estrogen facial cream to be honest. Please reach out to your doctor or pharmacist (a simply phone call may do). If you are concerned about the effectiveness of birth control and having intercourse, perhaps an additional form of protection would help ease the worry.

  16. Hello,

    I had my progesterone was confirmed low at 79.18pg/ml via a saliva test. My question is what dosage of progesterone do I use? I have read anywhere from 20mg to 250mg. I started using it this past month and noticed 5 days out from when I was supposed to start my period that I had brown spotting and some cramping. I reduced down to 40mg and all the symptoms went away. My period came about 9 days late. Was what I was experiencing normal and should have continued at the 80mg?

    Thank you!

    • Dear Kristina,

      Your doctor is best able to tell you the correct dose of progesterone for your needs. Do call him or his nurse. The dose may differ if you are taking an oral progesterone supplement versus using a progesterone cream.

  17. So I’ve been using the Emerita cream twice daily for 2 cycles now after an early miscarriage. My first cycle used it from day 14 until my period appeared. This 2nd cycle I’m 3 days late, but have had 2 negative pregnancy tests. I do ovulate later than day 14, and had a short luteal phase prior to starting the cream. I’m worried I’ve just tested too early since I’m only 12 dpo. How do I know when to stop the cream?

    • Dear Lauren,

      Did you begin progesterone cream before ovulation this cycle? Was the luteal phase the first cycle you used progesterone cream normal, meaning that it was at least 12 days long? Some women to have to stop progesterone cream use for menstruation to begin. This can differ from cycle to cycle as well, as the body adjusts to it and anything else you are doing to support fertility health. If you actively tried to conceive, it may be best to wait to test again before stopping the cream, but it you started progesterone cream before ovulation, ovulation may have been suppressed.

      If you would like to share more with me in private, do contact me here…