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Progesterone Fertility Guide

Progesterone Fertility Guide

Article Overview

Hormonal Balance is an important factor when it comes to healthy fertility and getting pregnant. Throughout the menstrual cycle various hormones are working together in a complex symphony to trigger the 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 approximately 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 starts to break-down 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
  • 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

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 produce excess estrogen.

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
Excess bleeding during menses
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

Click here to learn about Fertilica™ Natural Progesterone

Hormone Testing

Hormone testing can be performed by a medical doctor, naturopathic doctor or by an at-home testing service. Testing options range from charting your menstrual cycle to determine the length of your luteal phase, to basal body temperature tracking during your luteal (consistently low BBT may indicate low progesterone production), to taking saliva or blood tests to find out your progesterone levels. The questionnaire above helps 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. There will be a slight, steady rise in temperature after ovulation has occurred and progesterone has increased. An irregular or consistently low BBT may indicate low progesterone and luteal phase defect.

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 or by using 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 certain times 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.

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 (for example, for a 28 day cycle, day 21 progesterone testing 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 (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 its 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 axis (hormonal feedback loop), correcting the problem at the source.

Yale trained MD, Midwife and Herbalist Aviva Romm shares in her podcast 5 Ways Vitex Can Help Your Hormones that “In one trial, 48 women (ages 23 to 39) who were diagnosed with infertility took vitex once daily for three months. Seven women became pregnant during the trial, and 25 women experienced normalized progesterone levels – which may increase future chances of pregnancy.”

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.

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 allow progesterone dissolve slowly 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.

Click here to learn about Fertilica™ Natural Progesterone Cream

Progesterone use should begin directly after ovulation, which is usually day 14 in the cycle (day 1 is the start of your period), and end 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. Excessively thin women lack both estrogen and 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 through early pregnancy to make sure your levels are high enough.

A 2017 study published in the journal Fertility and Sterility found that for 59 women who’d experienced recurrent pregnancy loss (at least 2 previous losses), using vaginal micronized progesterone in their luteal phases prior to pregnancy carried healthy pregnancies.

Working with a healthcare practitioner is helpful as they can help to monitor your hormonal levels and determine the best dose of the form of progesterone you wish to use.

Make sure to have at least two bottles of natural progesterone cream on hand if this is your preferred form, 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 and 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 using 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 14 of your 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 14. 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 controlling symptoms within six months. Once the outbreaks of endometriosis are tolerable reduce the usage to day 14 until your menstrual cycle begins.

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 shop for Fertilica™ Natural Progesterone Cream


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


  • Lee, John, M.D. (2006) Hormone Balance Made Simple. Werner Books: New York, New York.
  • Lee, John, M.D. (1999). What Your Doctor May Not Tell You About Premenopause. Grand Central Life & Style – Hachette Book Group: New York, New York.
  • Hobbs, Christopher, L.Ac. (2003). Vitex The Women’s Herb. Healthy Living Publications: Summertown, Tennessee.
  • Trickey, Ruth. (2003). Women, Hormones, and the Menstrual Cycle. Giffen Press: South Australia.
  • Weed, Susun. (1986). Wise Woman Herbal for the Childbearing Year. Ash Tree Publishing: Woodstock, New York.
  • Romm, A. (October 27, 2018). 5 Ways Vitex Can Help Your Hormones. Retreived from
  • Stephenson, Mary D. et al. (March 2017). Luteal start vaginal micronized progesterone improves pregnancy success in women with recurrent pregnancy loss. Fertility and Sterility, Volume 107 , Issue 3 , 684 – 690.e2. Retrieved from
  • Schettler, T., M.D., M.P.H.; Solomon, G., M.D., M.P.H.; Kaplan, J., M.E.S.; Valenti, M. (n.d). “Generations at Risk: How Environmental Toxicants May Affect Reproductive Health in California.” California PSR and CALPIRG. Retrieved from:
  • Dalton, K. (1968). Ante-natal progesterone and intelligence. The British Journal of Psychiatry, 114(516), 1377-1382. doi: 10.1192/bjp.114.516.1377 Retrieved from:


Let your voice be heard... Leave a brief comment or question related to this article.

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  1. Avatar

    Hello. I recently started the emerita progesterone cream and have already experienced side effects including nausea, diarrhea, dizziness, and brain fog. They have improved with a lower dose, but still present. My serum progesterone levels have always been in normal range (11-16), and I have luteal phase of 12-14 days with BBT 98+. I tried the cream because a fertility coach recommended it, but I am wondering if my levels are now getting too high or the E2/P is imbalanced. Any thoughts? Do you have guidelines for supplementation? Also, how does adding the cream affect P production by the corpus luteum? Will the ovaries respond to higher serum levels by producing less endogenous P?

    • Dear Jessica,

      I am not sure given what you’ve shared that progesterone cream is warranted. Do share what you are going through with the fertility coach you are working with. This very guide shared preconception usage guidelines, but we often don’t suggest its use if testing shows normal ranges. I am curious why it was suggested to you. Are you presently pregnant and have you had past losses as a result of low progesterone?

      The symptoms you shared of are common in early pregnancy if you are, yet, although rare, can also happen to some women who begin progesterone supplementation after a long period of deficiency. They are all estrogen dominance symptoms, which can be exacerbated when first applying progesterone cream. It is also rare that I hear of such symptoms from women with normal progesterone levels who try progesterone cream anyway. What is the dose you used and the now lower dose exactly? It seems that maybe you were/are using too much.

      Transdermal application of bio-identical progesteorne offers the body progesterone that it recognizes as its own, so would supplement or add to corpus luteum production of progesterone. It is recognized the same as the ovary-produced progesterone. Although it’s effects on the ovaries natural progesterone production aren’t clear, it seems theoretically possible that if one takes or uses hormone replacement therapy and levels get high enough, the ovaries could be effected through a negative feedback loop involving the brain.

      It seems completely warranted to question the practitioner you are working with to be clear and adjust usage or pause it by weaning off (that is if you aren’t pregnant).

  2. Avatar


    My wife and I have been trying to have a baby for 5 years or so. About 2 years ago, my wife conceived, but then miscarried. We don’t know why. We suspect it was because of a fibroid. So she got a myomectomy. We had to wait for 6 months to a year to try again. Long story short, we think she might be pregnant. A nurse friend of mine told us about progesterone. However, she is currently on day 32 or so of her cycle, and we have not taken any progesterone. Is it okay to start now? Thanks! -Chris

  3. Avatar

    Hi – My RE told me that many women over 40 become estrogen dominant due to an increase in irregular ovarian cysts that emit estrogen. He says that these cysts are “textbook” and very normal. Estrogen dominance is associated with many negative health effects, including breast cancer. So why isn’t emphasis placed on regulating the cycles of perimenopausal women to prevent these cysts (e.g., by using vitex)? No amount of avoiding parabens, etc. will address this problem.

    • Dear Karen,

      Cycles do shift as a result of natural hormonal shifts for women who enter and travel through their 40s. This is true. We cover perimenopause is other guides on Natural Fertility Info. A woman who does not ovulate each menstrual cycle is not necessarily starting menopause. This happens at a different pace for each of us.

      Avoiding contributors to hormonal imbalance can prevent cyst formation and help women in their 40s have more ovulatory cycles or anovulatory cycles without cysts forming. No matter ones age, avoiding xenoestrogens and toxins can have a positive impact on our overall health.

    • Avatar

      Thanks. What is the best way to stop these cysts? Why aren’t they focused on in discussions of estrogen dominance and progesterone deficiency? This issue seems deserving of much more attention.

    • Dear Karen,

      If a woman is in her 40s and experiencing periodic ovarian cysts, she can and would still want to support hormonal balance beyond cleaning up diet and lifestyle possibly with herbs, progesterone supplementation and by promoting healthy circulation to the ovaries and reducing inflammation throughout the body. There are general suggestions, but each woman’s natural fertility program if she chooses this route can be different.

      I am not able answer your why questions. I’m not sure if you mean the doctors of the author (and if I knew, I still wouldn’t begin to guess). What I do know is that we are limited in guides for many reasons, so are required to elaborate on specific topics in perhaps multiple guides.

  4. Avatar

    Hi, this is all very helpful. Thank you. One question I have is that I usually have anovulatory cycles, but menstruate on day 27 or day 28 every month. I want to kick start ovulation through progesterone cream. I can’t figure out from the guidance above what I should do as it seems both the loading dose instructions (double dose on days 14 through to mensuration) and the suppression dosage instructions to induce ovulation (regular dose on days 5 – 26) are relevant. Should I do a few months of suppression first and then the loading dose, or vice versa or just one of these? Many thanks

  5. Avatar

    Good Morning, Elisabeth!
    I’d just like to ask how long (in general) does it take for the body to get used to Progesterone cream? This month, I’ve upped to 2X 1/4 teaspoons/ day and it brought back some breast tenderness (as opposed to last month when I applied 1 tsp only/ day and had no tenderness). This month I’ve also done the Fertility Cleanse which I thoroughly enjoyed. The teas are really delicious and they felt like a treat to me! Also, when booking a consultation, can the client choose who to go with or the case is assigned to a practitioner based on the specifics of the client? Thank you very much, Daniela

    • Dear Daniela,

      In general we see these symptoms of estrogen dominance that can reappear subside within three months of use of progesterone cream. Each women is different though.

      When booking a consultation, an herbalist is assigned by us based on availability and case load.

  6. Avatar

    Thank you very much, Elisabeth!

  7. Avatar

    Dear Elisabeth,
    That was such useful info! Thank you very much! I just saw the newest comment and I’d like to ask are there any side effects to taking too much natural Progesterone cream? I was afraid to take the general suggested dose ( 2 times/ day, that is, 40mg/day) and decided to start slow (20mg/day in the morning only). It’s been only 1 month since I applied the cream. I will start the Fertility Cleanse tomorrow and think that maybe I should up it to the general suggested use for this 2nd month. Would that be okay or b/c I’ll be doing the F. Cleanse I should keep it to the 20mg/day as I’ve had it so far and up it AFTER finishing the Cleanse?
    Thank you very much, again!

    • Hello again Daniela!

      I only hear of positive side effects when following the general suggested use of natural progesterone cream. Very rarely are there negative side effects and the few times I’ve worked with women who feel they’re experiencing an unwanted side effect, it either goes away with continued use or is a result of something else entirely. How you use it is up to you ultimately.
      Because you have been using progesterone cream for a cycle(+) prior to cleansing, it can be continued while cleansing.

  8. Avatar

    Dear Elisabeth,
    I’m estrogen dominant and after some years of Birth Control pills (Yaz) to control this, my period started to become inexistent, so I stopped taking them 7 months ago. Now my cycles are short ( 3 weeks instead of 4 like before ) and my periods last only 3 days max (instead of 5-6 like back in the day). I started used Vitex 5 months ago with not results to lengthen my cycle, and this month I’m trying progesterone cream once at night 20 mg and I can see great results in therms of my mood, skin, fluid retention, but still my cycle is stating at 3 weeks. How should I use the cream for archiving 4 week cycle instead of 3? may be twice at day? use it for 3 weeks instead of 2 weeks?

    • Dear Roxi,

      I can only suggest the general suggested use as is shared in this guide. It has to potential to be effective when using it during the luteal phase (for two weeks). Applying prior to ovulation will stall ovulation preventing conception that cycle.
      Yes, natural progesterone cream is to be applied two times or twice a day; one 20mg application in the morning and one 20mg application in the evening, rotating application sites.

  9. Avatar

    You are so kind, Elisabeth! Thank you!
    Since I stopped the EOs, it looks like I’ve had WAY less breast tenderness after ovulation and less pain in lower abdomen (it’s only been 1 mth). The tenderness was quite uncomfortable. I thought it was a normal sign of progesterone in my body and continued to take the EO.
    Also, is spotting (1 day before period) always a sign of lower progesterone? And is that day considered day 1 of cycle or day 1 is the actual bleeding day? Is it ok to take Vitex with Maca for balancing hormones? Is there any situation when NOT to take Vitex? My cycle’s become shorter since my miscarriage 2 yrs ago. Used to be 3 days (spotting not included). Now it’s 2 days. Thank you

    • Hi again Daniela!

      I’m glad to hear those troublesome symptoms have stopped.

      One day of spotting before menstruation isn’t immediate cause for alarm. The first day of more “normal” bleeding is considered cycle day 1. Vitex and Maca are fine to combine and take to help the body achieve hormonal balance. I wouldn’t immediately suggest Vitex is there isn’t hormonal imbalance, if a woman has a history of depression or is allergic to it, or was on a prescription medication.

      A 2-day period is considered short. Consider learning through the article 12 Weeks to Improving Your Period ways to transform the quality of your menstrual blood, length of bleeding time, and the health of your uterus in 12 weeks, through 6 simple steps. The article includes how Vitex can be supportive.

      I hope this is helpful!

  10. Avatar

    Dear Elisabeth,
    First, a sincere THANK YOU for your hard work! Then my?:
    1)does low progesterone always suggest a sign of short luteal phase?
    2)Can one take Vitex if ratio Estrogen/Progesterone not good, but LP is normal?
    3)I’m 47 yrs old, have been using essential oils to balance hormones (YL Progessence and Geranium, have avoided soy, and plastics, have eaten organic, but still the DUTCH test showed higher Estrogen/lower Progesterone). Is that b/c of my age? I took Estroblock for 3 mths as per my Fx nutritionist. I stopped the EO and took Emerita cream. I started slow 20 mg/day. Is it ok to up it to 40mg same cycle or better in the next? I’ve tried to conceive naturally my2nd for 2 yrs.

    • Dear Daniela,

      You are welcome and I hope the direct email from Sonia and I was helpful!

      1) Not necessarily, but it can. The sure fire way to know if the luteal phase is short is to simply could the days from ovulation until menstruation begins.

      2) Yes, Vitex can be taken for hormonal balance support no matter one’s luteal phase length.

      3) It entirely possible that your hormonal ratio is due to age. I’m curious the changes you’ve felt/seen since stopping the essential oils.
      I truly can only suggest the general suggested use of bio-identical progesterone cream. If you are wondering how much is necessary for your needs, testing with and guidance from a trained healthcare provider is key.

      I hope this too is helpful!

  11. Avatar

    Hi, I have been trying to conceive naturally for 6 cycles. I have an history of endometriosis & large endometrioma removed from my left ovary. Fertility doctors have suggested going straight to IVF, due to low ovarian reserve & my age- will be 35 soon. My periods, since being off birth control (stopped Dec ’18), have been shorter & less regular (used to be 28 days, now 19 to 26 days). I recently saw a Dr of eastern medicine, & he suggested that I take natural progesterone cream beginning at cycle day 7, only stopping if I get a period. He advises this for 2 months. I have read mixed reviews- is this safe? do some people start a period during this ovulation suppression? Thank you!

    • Dear Mary,

      That suggested use is explained in this very guide for women with endometriosis based on Dr. John Lee’s work. It is suggested for several months, after which usage is changed slightly. During the use of progesterone cream this way, additional support could be considered, support which is explained in our guide 5 Steps to Reversing Endometriosis Infertility.

      Ultimately it is up to you which way you use the cream or what natural therapies you choose. The best advice I have it to find reputable sources of information to educate yourself so you can make the best choice for your needs.

      My best!

  12. Avatar

    I was hoping you could provide me with some insight; I have read rumors that you can delay your ovulation due to progesterone cream? is this even a thing? or is it more likely that if used incorrectly you just wont ovulate at all? While i dont regularly track my ovulation with CM (i use an app and blindly trust that) I believe i ovulated on day 25 of my cycle this month. i assume that would mean my period will be late too?

    • Dear Anna,

      Using progesterone prior to ovulation effectively suppresses ovulation that cycle, meaning you aren’t likely to ovulate at all that cycle.
      Your period could still start “on time” and may not be late. If you ovulated late and your period starts on time, this means the luteal phase this cycle is short.

    • Avatar

      Dear Elizabeth,

      I got some information from a doctor that for PCOS the usage of progesterone cream would be: from cylce day 1-10. use 20mg at night, and then from day 11 till the start of your period use 20mg in the morning and 20mg in the evening. So it seems you never stop with the cream. Have you heard about this? I have PCOS and also estrogen dominance and now Im trying this method of using the cream. I started using the cream 4 days ago 2x20mg and today I started to have my period. So that cycle was 19 days long. Usually why do we have to stop with the usage of the cream if our period starts? Thank you!

    • Dear Jessica,

      I have heard of a variety or suppression protocol with progesterone for women with PCOS.
      Progesterone stalls menstruation (as is what happens when pregnancy occurs) and it is a dip in progesterone that causes menstruation to start naturally or when progesterone cream is stopped.

  13. Avatar


    I’m 32 years old and I have PCOS. I have no clue if I ovulate at all. I started using a natural progesterone cream because I had some brown spotting and some very bad cramps during my period in April. I never really had regular normal cycles either. Basically my chinese doctor told me I should try a progesterone cream.

    I started using the progesterone cream for the first time on May 16 on the 22. day of that cycle to at least establish a normal cycle. I used it for 12 days and my period started basically 3 days before I finished applying the cream for 12 days. Was that I good idea to keep using the cream for 12 days even though my period started meanwhile? That cylce was 31 days.

    • Dear Jessica,

      When bleeding starts, progesterone cream is to be stopped. The first day of bleeding is counted as cycle day 1. Progesterone cream can be started again around cycle day 14. Know that the start and stop days may change from cycle to cycle as the body begins to balance.

    • Avatar

      Hi, Thanks for the quick answer. So my method is now to use the cream for 12 days and then stop for 16 days cause thats what they suggested to establish a normal cycle. This will my third cycle now using the cream. So if I understand well then I just have to stop using the cream when the bleeding starts even if I didnt finish the 12 days of applying the cream? My last cycle in June was only 26 days. If I finish this cycle and start the new one should I just apply the cream from cycle day 14.? Thank you! Jessica

    • You’re welcome Jessica!

      The expert we follow the guidance of, Dr. John Lee, guides to not use progesterone cream during menstruation. You may want to double check your healthcare provider’s suggestion.

      The proper way to calculate use of progesterone cream is to note the first day of your last menstrual period. Then, count back 12 days on the calendar and begin progesterone application on that day this cycle. It should be used after ovulation, as if it’s used prior to ovulation it will suppress ovulation preventing a chance of conception.

    • Avatar

      Dear Elizabeth, So for an example in June my period started on the 21., If I count back then 12 days its June 9 then. So it means in this month I have to start using the cream on the 9th as well? which is exactly today for me here in Europe. Sorry for all my questions but I want to get this clear finally. Thank you very much! 🙂

    • Dear Jessica,

      No apologies. That is the correct use based on Dr. John Lee’s protocol/advice. Progesterone would them be used for 12 days, stopping when menstruation starts or upon confirming you are not pregnant (when actively trying to conceive).

    • Avatar

      Dear Elizabeth,

      I just had a cylce of 27 days, my previous one was 26 days long. It looks like the length of my cycles are improving. I have a question: before my period I felt normal. When my period started in this cycle I found myself craving for sweets and I felt like I need to eat every hour something. I’m currently still in my period which is very light, but Im having sometimes very bad mood swings. I mean usually women have PMS symptoms before their period and not during or at the end, right? Can this also be a side effect of the progesterone cream? This time I stopped using the cream when my period started. Can also the progesterone cream cause a very light period? Thank you!

    • Dear Jessica,

      PMS symptoms can continue through menstruation. This could also be a case of estrogen dominance symptoms getting a bit worse before they get better. 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 (PMS-like symtpoms) such as breast tenderness and swelling, spotting, fluid retention, dizziness, hot flashes, fatigue, headaches and nausea, etc. This can be very worrisome, but should level out and go away over the next couple of cycles, as progesterone levels increase.

      Most women’s periods taper toward the end and are light.

    • Avatar

      Dear Elizabeth,

      Thanks for your answer! Yes I agree, it could be the estrogen dominance symptoms getting worse. Actually this was the 3. cycle when I used the progesterone cream. So hopefully a few more cycles after applying the cream the estrogen dominance symptoms will be gone!? Should I increase the dosage or just stay at 2x 20mg a day? Since Im using the progesterone cream I have very light periods, basically it lasts for 4 days and I use one pad a day. Is that still normal? Thank you!

    • I hope so too Jessica! I can not suggest an alternative dose, but it could be time to check in with your doctor to test/check levels to see if you might more or less, or perhaps none at all anymore.

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    I was reading there were some studies linking prenatal progesterone use to genital malformations in baby boys. I also saw a study done in Denmark theorizing a link between prenatal progesterone intake affecting sexual identity of the babies. Then there are studies saying the opposite. Any thoughts on these studies?

    • Dear Sarah,

      I have not seen these studies, and venture a guess that if they were true that there would be many more cases of genital malformation and the medical institution would not prescribe it as frequently. Progesterone is very necessary for conception and maintaining a healthy pregnancy. A woman’s body naturally produces it in order for both. It is only in cases where a woman’s body can not produce adequate progesterone in order to conceive or to maintain her pregnancy, that we would suggest using bio-identical progesterone cream (or prescription progesterone for that matter).

      You will always see studies that say one thing and others that say the opposite. This is the nature of scientific research and interest groups trying to prove someone else wrong.

    • Avatar

      Thanks for the reponse!
      These two studies reference a possible link with progesterone and sexual identity:
      This study below is the study of the link between hypospadias (genital malformation) and prenatal progesterone.

    • You’re welcome Sarah!

      I have taken a moment to look at the two studies (the first two shared are the same one) and wanted to offer my thoughts…

      – The study shared of regarding sexual identity and progesterone, plays with the notion that an individual’s genetic makeup plus environmental conditions causes their behavioral choices around sexual orientation. Worthy of note it that the study states, “Although prenatal hormones are theorized to influence sexual orientation in humans, evidence is sparse”… “theorized” and “sparse”. No sound conclusion is being made.

      – In the hypospadias study, Mothers were asked several questions including, “(4) Did you use any birth control pills or morning after pills? and (5) Did you use any other method of contraception?” about which the researchers shared that the “Contraceptives were further categorized as containing (1) combinations of progestins and estrogens, (2) progestins only, or (3) having unknown contents.” Contraceptives are synthetic and contain synthetic progestins, as I am sure you know. The charts show that the progestins with the most effect or correlated cases according to the researchers were of ‘“progesterone NOS” meaning progesterone not otherwise specified’, which is frankly too vague to simply state that all or any progesterone can cause hypospadias. This also raises question about whether these cases were mostly of women who used oral contraceptives or synthetic progestins for any amount of time or during the time they conceived (it’s rare, but does happen). Two other questionable statements from the study are “some of the stratum-specific ORs [odds ratios] were relatively imprecise” and that “data regarding several aspects of progestin intake were limited.”

      My opinion is that this is simply another attempt and figuring out a potential cause to hypospadias that is not confirmed. There will likely be many more attempts.

      In most cases, the exact cause of hypospadias is unknown. Sometimes, hypospadias is genetic – gene variations in sperm, the egg or the combination of both that may play a role in disruption of the hormones that stimulate formation of the male genitals. Studies link it to maternal age (over 35) and subsequently egg health, as well as maternal exposure to pesticides (like Glyphosate) and industrial chemicals (environment).

      I hope this is helpful, even if in a small way. If you are concerned about your reproductive wellness or exposure to a synthetic hormone or toxin, do discuss this with your healthcare provider. My hope it that they can also help ease your worries.

      My best!

    • Avatar

      Hi Sarah,
      You must be referencing the studies linking progesterone with hypospadias. My doctor told me that link is with synthetic progestins and there is no link with malformations using bio-identical progesterone–my doctor used Hilgers studies which show absolutely no link ( As for the sexual identity those studies have very small sample size and are part of a small group of “genetic determinists” set on proving theories. Two of my doctors actually laughed out loud when I referenced the links between sexuality and progesterone. Anyways, I used bio-identical progesterone for my sons and both are healthy!

    • Thank you for offering support and sharing or your experience Jamie!

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    Hello – I am 16 mo PP and have had super weird cycles since they returned post-baby. My luteal phase is only 9 or 10 days and after a blood test it was confirmed that I do have low progesterone and estrogen. I have been taking progesterone supplements the last few months and have had very painful ovulation and back aches around my period since I started taking them. My practitioner recommended hcg injections but I would like to regulate my hormones naturally first if possible. I have been looking into Vitex but my little guy is still nursing like a champ – will it have an effect on the nursing/him? I would love to take a more holistic approach to getting things back to normal if possible!

    • Dear Samantha,

      That you are still breastfeeding strong, your cycles may stay irregular. This is known to happen for many women who are breastfeeding. Vitex can be used at low doses, but may not be effective at cycle regulation given you are breastfeeding.

      Has it been determined that the pain is a result of the hormonal imbalance or can it be linked to the progesterone supplements? If you have not yet learned of a supplement called UteriCalm, that may be worth reading about. It could be used as needed during ovulation or on days of discomfort. Magnesium may offer relief.

      We also offer this guide Is it Safe to Breastfeed and Take Herbs for Fertility? with additional considerations and tips.

      I hope this is helpful.

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    How do I know when to start progesterone cream. I am due to ovulate on 6/9-6-13. I have my period regularly and do ovulate. I have simple hyperplasia and have been prescribed Provera 10 mg. I am supposed to take one pill a day for 10 days to raise my progesterone levels. The problem is that it cuts my ovulation time down to 3 days and by the time I am supposed to test its so late to start it again. When do I start the cream and how much to use? Also when do I stop it? I do know when I get my periods. I use an ovulation calendar to help me keep track. Thank you

    • Dear Stephanie,

      We do not suggest combining progesterone pills/prescription with progesterone cream. It’s going to be best to take the pill as your healthcare provider suggests and have them explain why they’re suggesting it be taken when. In general, it should be started the day after ovulation. Ovulation happens on only one day, yet a woman’s fertile window is typically around 5 days. This is the time frame in which a woman can naturally conceive each cycle. I’m not sure I understand what you mean by “The problem is that it cuts my ovulation time down to 3 days and by the time I am supposed to test its so late to start it again.”
      Can you clarify that please?

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    I had my 2nd mc in early March and my 1st mc in Dec. Both pregnancy were around 5 and 6 was only. I have never had my progesterone checked, my doctor is not helpful. I have purchased Emerita Pro-gest from the US and have been using after ovulation. Do you think it is possible I have low progesterone hence I had the mc? I have a lot of the symptoms on the site.

    • Dear Selina,

      Low progestorone is a common cause, yet many women don’t know why they experience pregnancy loss. It seems possible, but the true way to know is testing. Might you search for a doctor who will be helpful?

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    I had my 2nd mc on Apr 25th (first was a mmc in October 2018 – this was a chemical pregnancy at 4.5 weeks). On Apr 30th my progesterone levels were tested at 0.2nmol/L (this would be day 6 of cycle) and ovulation tests are now showing that I am ovulating today. Would the progesterone level be considered low? I’d like to start taking progesterone cream but my doctor is out for the next 2 weeks and I’m worried by the time we test my levels again it may be too late!

    • Dear Meghan,

      I am very sorry for your losses. Cycle day 6 progesterone levels will be low Follicular phase progesterone is thought to be around or (less than) <3 ng/mL. Progesterone levels are more accurately measured on or near cycle day 21. Might your doctors nurse or your pharmacist be able to assist you in determining if you need progesterone support?

    • Avatar

      Thank you! My doctor has been hesitant to start progesterone – doesn’t feel it is warranted. I will be doing blood work again on Tuesday next week (cycle day 20). I was just worried about waiting to start progesterone cream until after that and being too late!

    • Dear Meghan,

      I see no reason not to trust your doctor. I know that the worry is real though!
      Testing progesterone when you go in will give you a clearer idea if you need to support progesterone levels as this is the proper time of the cycle to test.

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    I ordered cream and received it in the mail today. I didn’t read the instructions properly and applied it. I am on cycle day 8 and have not ovulated yet. I will stop applying until ovulation but will this one dose cause issue for this cycle?

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    Im newly pregnant with pcos I don’t have cycles nor do I ovulate. I am blessed but I’m not sure how many weeks I am due to no periods. My doc is monitoring hcg levels but doesn’t think progesterone needs to be tracked. We did check it twice and it seems to be dropping while my hcg levels are rising. Im 4099 for hcg and progesterone is 6.7 then dropped to 6.0 all w/in 2 days. I had to beg her for Prometrium 200mg and i bought the cream that Heather recommend. Isn’t progesterone just as important as hcg levels. My doc doesn’t seem to think so. Also, is that normal to have high hcg levels and low progesterone? This my 2nd pregnancy the last 1 ended in a miscarriage.

    Thank you!

    • Dear Tyra,

      Congratulations on your pregnancy!

      Yes, progesterone is the pregnancy hormone. I have heard of doctors being opposed to testing or supporting progesterone levels in early pregnancy. It’s good that your doctor agreed to help you and guide you in using prometrium if you feel you need it. That said, we can not suggest combining prescription progesterone with progesterone cream unless your doctor guides you in doing so and will help you know a proper dose of each.

      My best!

  21. Avatar

    Hi, I have a friend who has used Progrest Cream for several years and we both really appreciate the guidelines and information you posted. Can I please ask on average if a women who is using Progest Cream and is over 30 is pregnant, how often would you recommend getting her Progestrone Level tested through a salivia test? I understand that she should continue using the cream but we were unclear on the frequency of getting tested. Can you please help?

    • Dear Anna,

      This would be best discussed based on her case and pregnancy health history with her healthcare provider or midwife, or perhaps the testing company. With that, the placenta takes over progesterone production and by the 12th week of gestation, the placenta should have taken over producing adequate amounts of progesterone. After the 12th week through roughly the 20th week most women are in the clear of having a miscarriage due to low progesterone levels. Testing would only be necessary throughout the first 12-20 weeks of pregnancy.

      Congratulations to your friend if she is presently pregnant.

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    I have never used progesterone cream.Lately,I had a failed IVF/doctors were using progesterone injections as part of IVF Regimen.I am planning to undergo another IVF in next few months&trying all the possible things to prepare my body.Wanted to know-would u recommend to use this product ONLY if I find that my progesterone levels are low after a hormone testing.Or would u recommend me to take this as a part of preparation of IVF(without going for hormone-progesterone level testing).Cant I use this without having my levels checked.I want to try this as read about good/positive reviews from your clients.I hope it wont do bad if I try this in preparation for my next IVF.

  23. Avatar

    I just started using progesterone cream on days 14 to 26 to regulate my cycle. Will I still be able to get pregnant while taking progesterone? Or is it only when I stop taking progesterone?
    Thank you

    • Dear Chris,

      Pregnancy can still happen when using progesterone cream during the luteal phase of the menstrual cycle. If you actively try to conceive during a cycle you are using natural progesterone cream, it is important to test for pregnancy before stopping the cream. If pregnancy is confirmed, consult your doctor or midwife for support in weaning off of the cream or continuing it in early pregnancy.

  24. Avatar

    Hello, I have been using Dr. John Lee’s progesterone cream twice daily, however, my acupuncturist has told me to use it every day, from day 1 to the next day 1 of my cycle. My progesterone is on the lower end of the normal range at 82 with the range on my saliva test being from 75-270 pg/mL. I have always had a luteal phase that is about 11 days, so again, just shy of being classified as a luteal phase defect. History of 1 miscarriage. Any thoughts on using progesterone cream daily instead of only during luteal phase would be much appreciated. Thank you!

    • Dear Holly,

      It would be wise to ask your acupuncturist why he/she has suggested this use. Using progesterone cream from day 1 to day 1, all cycle long will stop ovulation in the cycles you do that. It is not suggested this way by Dr. Lee or us.

  25. Avatar

    Hi there,
    I’m 12 days past Embryos Transfer. On day 7 after ovulation my progesterone tested at 9.75 then the next day at 6! That night I took an Utrogeston 200mg because it was all I had, and then the following night after Dr.s prescription I took a Crinone 90mg. Then I realized it contained mineral oil (gross!) so I then made a decision to just stick with the natural stuff. I’ve been using Progest now for a few days. In any case my temp has gone way up and now I had a couple faint lines on the pregnancy strip! I want to continue with the Progest. Its so difficult to determine how much is enough with the tube. Q: is two dime size dollops equal to 1/2 a teaspoon? I’ve been doing this x2 day

    • Dear Alexandra,

      What a journey and how exciting for you! It is going to be best to both have help from your doctor in determining the best dose of cream for your needs and until them finding a 1/2 tsp. measuring spoon as you would use when baking/cooking and measure the dose for each application. It’s best not to guess or “eyeball” it.

      Take care!

  26. Avatar

    Is it possible to ovulate half cycle on the 3rd progesterone assisted cycle if you miss it by a few hours? I had stopped on cd 26, now it’s cd 32 so I’m now hoping if I am pregnant that stopping didn’t damage anything. Kind of alone when it comes to doing this, had bad experiences with Drs not wanting to treat my PCOS effectively. Going to start again tonight. Unless I get told differently

    • Dear Shara,

      I am sorry for the delay in replying. I was away from my office. I’m also sorry I am not exactly clear on what you mean by “if you miss it by a few hours”…

      Did you start the cream again? Have you confirmed pregnancy or not?

  27. Avatar

    Is it ok to start progesterone cream 5 days after ovulation?

  28. Avatar

    I am 33 and have had one succesful pregnancy 8 years ago. My first pregnancy ended in miscariage. I was fine up until about 2 years ago, I took a progestin only pill for a short 4 months. I started loosing hair and my mood was all over the place. I stopped taking the pill and all of a sudden I ended up with melasma, moods still all over the place, tired all the time, cry at anything. I literally have 1 good week a month. I knew something was off when I developed melasma and I never had that with my 2 pregnancies! I want to try to balance my hormones but wondering if anything natural will make my melasma worse?! my saliva test showed really low progesterone, that of a 90 yr old woman…….not sure how I still cycle? Anyone have any ideas if herbal therapy would help my situaton?

    • Dear Ashley,

      I’m sorry for all you’ve been through!

      When during your cycle was progesterone measured?

      It is my understanding that melasma is triggered for some in pregnancy, others due to birth control use, and can also be caused by adrenal fatigue. So, it is important to both work to support hormonal balance and reduce stress. We can not know if anything natural will make the melasma worse. There aren’t direct links that I have ever seen. That said, there is such a thing as what is called a “healing crisis” where for some symptoms seemingly get worse before they get better. This is rare, but can happen with natural progesterone cream. I have worked with only one client in my time here thus far who has experienced darker skin spots after application of a progesterone cream (it was not Fertilica Natural Progesterone Cream).

      I found interesting information linking the dark spots more to sun exposure, hormonal imbalance and adrenal fatigue perhaps than the progesterone cream itself. The information is from Carol Petersen, RPh, CNP – Women’s International Pharmacy

      “Melasma is hyperpigmentation of the skin associated with hormone disturbances, especially with pregnancy and birth control pill use. Sun exposure may trigger melasma, or make it worse. However, the underlying hormone responsible is melanocyte stimulating hormone (MSH). This hormone increases the production of melanin, which is responsible for darkening the skin.The upper lip is a frequent location, but you may find dark spots in other areas as well. These are sometimes called liver spots, age spots, or sun spots. An increase in areas of darkened skin can actually be related to adrenal fatigue. As you become stressed, your body produces more and more cortisol to help cope with the stress. As more cortisol is produced, the precursor hormones like progesterone and pregnenolone are depleted, which leaves the estrogens in an unbalanced situation. This extra estrogen stimulation actually increases MSH, which in turn increases the amount of melanin deposited. Re-establishing hormone balance and relieving stress can help prevent this, and may even help reverse it.”

      Using natural progesterone cream is helping re-establish hormone balance. Most notice that the discoloration ends once hormone levels stabilize.

      Beyond that, there are many herbs to support hormonal balance. Vitex and Maca are most well known. Royal Jelly is amazing, I feel. So, learn about those. But first a healthy foundation for fertility must be set.

      If it might be most helpful to have help in setting the foundation and learning the best natural therapies for, we offer the opportunity to work one on one with a fertility herbalist through our Fertility Consultations Program.

  29. Avatar

    Any insight into dealing with progesterone for pregnancy at advanced maternal age. I am 48 and still have very regular periods. I am on oral progesterone and have been for about 9 months. Does this mean I have likely been suppressing ovulation? I feel like I have been ovulating. I have grown children and I know my chances are very low at this point but my fiancé’ and I want to see if it is possible. Thoughts?

    • Dear Lea,

      Progesterone (oral or transdermal) is only known to suppress ovulation if used prior to ovulation. It will not suppress it if used the two weeks prior to the start of menstruation. It is in menopause and after that progesterone cream usage guidelines may shift some, but until then the suggestions we share in this guide are known to be universal.

      My best!

  30. Avatar

    I have had three miscarriages and have experienced infertility for the past 18 months. Based on extensive hormonal testing done by my doctor it has been found that I have low progesterone. I’ve been on progesterone suppositories equalling up to 400mg a day for about 6 months with no result as of yet. Thinking of trying the route of natural progesterone cream, vitex, and maca…In your opinion would the natural progesterone cream be enough of a supplement? I see that it is 20mg? Wondering if it works in a different way though, and if the combination of the three items will actually help my body to make its own progesterone for the long haul?

    • Dear Jessica,

      Can please have “no result as of yet” clarified? Do you mean progesterone levels have not increased, or that you haven’t yet conceived? Do you know your estradiol and progesterone levels as well. Can you share what in more detail what your experience of “infertility” is like (what are your cycles like, do you ovulate, do you have a 12 day luteal phase, etc.?

      I look forward to offering continued support.

  31. Avatar

    This is so informative! I had a MC May 2018, and it has taken a while for my cycles to return to my normal. I generally ovulate CD23-25, and have 35-39 day cycles, but they are regular. Since the MC, it took a while to come back down to my usual length, but I noticed my CM wasn’t drying up post O, and I chart everything, as I have for over a year.

    So, I am going through the checklist, and realize that I have more symptoms of high estrogen. my luteal phase is usually 12-13 days. I had my progesterone tested (obgyn sid 7-10 days post ovulate), I tested 3ng at 9 days post ovulation. How do you determine which you have, low prog or high estrogen? Thank you!

  32. Avatar

    Thank you for all the lovely information 🙂 I have a questions, we are trying to get pregnant and I was told not to stop using the progesterone cream until I get my period just in case I get pregnant. My period is now late (day 33) and the pregnancy test is still too early show. Is it possible the progesterone cream will delay the period if I don’t stop using it? What should I do, carry on using it until I retest? Thanks

  33. Avatar

    I’ve been trying to conceive for 5 years, with no luck. 6 IVF +1 frozen cycle. After the last treatment I haven’t got my period back. It’s been 2 months now… Should I start progesteron cream? If yes, does it matter when?
    Thank you.

    • Dear Anita,

      I am so sorry to her of what you’ve been through! We only suggest progesterone cream if progesterone levels have been found to be low. Has your doctor been able to tell you why he/she thinks IVF has yet to be a success?

  34. Avatar

    Will using progesterone cream to help with endometriosis cause my body to stop making it’s own progesterone? Also, if I were to become pregnant while using the cream and continued using it as outlined in the article and video above, how would a doctor know based on test results of my progesterone levels at 20 weeks, if it is safe to take me off of the cream? Is there a way to know that the placenta is truly taking over and producing progesterone? My concern over guessing at this would be a miscarriage at such a late stage in a pregnancy.

    Thank you for this great source of information. Any feedback would be really appreciated.

    • Dear Serena,

      Using natural progesterone cream will not stop the body from making it’s own. But it’s use is to supplement and body that can’t make it’s own well enough for whatever reason. By using progesterone cream, one is directly offering the body progesterone is recognizes as its own. Do talk to your doctor about how he/she would know that progesterone can be weaned off of at the suggested time in your pregnancy. There are likely tests or markers he or she will use to determine this. It is around the 14th week of gestation that progesterone production will happen solely by the placenta, rather than the ovaries. When this happens, progesterone production naturally slows down. Progesterone cream use is proven effective in pregnancy under the care of a professional who will guide and monitory you, and ease any concerns.

  35. Avatar

    Should progesterone cream be used in the same way for menopausal women.

    • Dear Barbara,

      Our site focuses on guiding women who have not yet begun menopause. It would be best to find a resource for guidance that focuses on women in menopause. Dr. John Lee or Dr. Christianne Northrup may be two to look into.

      My best!

  36. Avatar

    I read on another fertility website to take a break from Vitex for a few days every month. If you have irregular cycles, I read that you take take 5 days off from DAy 1 of your cycle, take Vitex for 25 days, then take 5 days off (depending on when your cycle happens…)

  37. Avatar

    Dear Mrs. Willet,

    I was wondering how long you can use natural progesterone cream safely? (in months)
    Is it possible to get hormone imbalances when you use it for a longer period at a time? I was pointed out by someone that it might be harmful in different ways and can cause illness or negative side effects. So now I am worrying a bit about that. I thought that maybe it might be wise then to take a pause every couple of months when pregnancy does not occur. (I have progesterone deficiency) Thank you so much for answering my question.
    Warm regards,

    • Dear Donna,

      What we know is that it can take anywhere from 4-12 months to bring progesterone levels back up in women with very low progesterone levels. In general we suggest its use, while following a holistic natural fertility program, for a minimum of three months, up to 6 months while paying attention to how the body is responding/shifting before making a change to said program. It would also be a good idea to have progesterone levels monitored during this time to know how levels are shifting and if you might need to adjust the dose, or if you can wean off of progesterone cream. Each woman will be different, so the length of safe use for you will likely be different from the length of safe use for me or another.

  38. Avatar

    Hi! Thanks for the great article!

    I’m just about to embark on my next Embryo Transfer. I haven’t ovulated yet but am thinking of taking the cream after ovulation. Although, I did progesterone testing on my last two cycles, the first with a level of 16ml and last month at 17ml. Is my body already producing enough to sustain a health pregnancy without the cream? Or will taking a little bit “extra” be beneficial in some way?
    Side note: I do have PCOS with long cycles. However, when I ovulate, my progesterone blood levels are in the normal range.

    • Dear Alexandra,

      I can’t support using progesterone cream with normal progesterone levels or during this time without your doctor knowing and guiding you. Please talk to your doctor or at least his nurse before starting progesterone cream during this time.

      We share other ways to prepare for embryo transfer in our guide 5 Steps to Preparing for a Frozen Embryo Transfer should that be helpful!

      My best!

  39. Avatar

    I bleed from the day after my LH surge till I get my (heavy) period. The first two days after my LH surge are moderate bleeding (I need to wear a panty liner and there are small clots, no pain). I’ve been taking vitex for 6 mo. due to no or late LH surge, now I have a normal LH surge (day 14), but lots of spotting after. I feel that this is due to low progesterone. I have regular cycles, 26-28 days, but I’m not convinced that I’m ovulating. I read that Vitex can increase your estrogen and that I should probably take break from it. Any advice on what to do about vitex? Progesterone cream? (I worked nights as an RN for 2.5 yrs, I think thats what messed up my hormones)

    • Dear Emily,

      Vitex is known to help the body increase LH production and stimulate the formation of the corpus luteum. The corpus luteum is responsible for the secretion of progesterone. We know it to be best taken consistently for 6-12 months for optimal effect. That said, there may be more to consider, such as progesterone cream, dietary and lifestyle changes, a whole food multivitamin, omega-3s and B vitamins (a B complex maybe). Maybe our guide Mid-Cycle Spotting – Should You Be Concerned? will share some helpful tips/info as well. I do hope so!

  40. Avatar

    Hello, I have PCOS and started to take progesterone cream on day 12 of my cycle. Today is day 21 and I started bleeding and cramping a little. I’m not sure if it is a period or just spotting, but should I continue taking the progesterone cream until day 26 ? Can you tell me what should I do if it is just spotting, and what should I do if it is a period ? Thanks a lot.

    • Dear Sarah,

      If this is just spotting, progesterone cream can be continued as instructed. If menstruation starts, progesterone cream is best stopped and started again as instructed. It is okay that the start date of the cream shifts should this be menstruation. It may until the body shows regularity and balance again.

      It’s great that you’ve seem some shifting already!

  41. Avatar

    I have stage 4 endometriosis diagnosed via laparoscopy.We have been ttc for 17 months and then took a break as my docter have put me on Visanne(dienogest).I started bleeding on 20 march and got a positive HCG test on 1 April and the next three days negative HCG test? My docter says the bleeding is from my body that is still “settling” from the Visanne. We have tried Vitex, OPK, BBT, Charting and everything to conceive with no luck.I have endometriosis on my ovary and pelvic wall lines.I don’t know if I ovulate.My doctor said my tubes are fine after my lap but never tested if they are blocked or not. 6 months after excision surgery i had an endometrioma back again.Any ideas on to conceiving?

  42. Avatar

    If you increase your potential to have progesterone can you start ovulating again? Thanks

  43. Avatar

    I have spotting for 3-5 days prior to day 1 of my cycle. I have been told by my RE that I have low progesterone, though I still don’t know why, and have been struggling with infertility for almost 3 years. As we gear up for our 3rd round of IVF, we’ve been ttc naturally. I had left over Crinone progesterone suppositories that I began 3 days after ovulation twice a day (last cycle). Unfortunately, I ran out after 4 days and thought I had more but didn’t. My menses started soon after I stopped and was about 3 days early. I’m trying to find a progesterone cream that could help me conceive. I’m confused though by the cream containing soy. I thought I’m suposed to avoid soy?

    • Dear Anna,

      Processes, GMO soy (not so much fermented soy or non-GMO whole edamame sparingly) is best avoided when battling infertility. Regarding bio-idential progesterone creams however, there is a substance called diosgenin in soybeans and wild yams that is extracted and then modified in a the laboratory to create the progesterone found in progesterone creams. It is no longer the soybean or mexican wild yam, as a whole plant, but rather just one chemical part of the plant. Only the diosgenin from the soy would be converted to bio-identical progesterone and there would be no trace of it’s other chemical make-up such as the phytoestrogen content or isoflavones that you will most often read about related to female fertility.

  44. Avatar

    Dear Elizabeth,
    Thank you so much for your wonderfull work. What can you advice when you have Endometriosis and PCOS and want to get pregnant?