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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 just did my embryo transfer. My progesterone is a little low, so I went to my friend’s midwife to pick up progesterone cream. I was hoping she carried Emerita. I remember Hethir saying Fertilica is not preferred for pregnancy support. The midwife only had NOW Foods Natural Progesterone liposomal skin cream.

    This is our 9th & final IVF cycle. I want to do everything in my power to increase implantation. The midwife said this is mineral-oil free. Do you think this NOW brand is okay for pregnancy support? Thank you kindly!

  2. Avatar

    Hi there, hoping you can help. I’ve been bleeding for almost 1.5 months. My saliva levels do show low estrogen and low progesterone. I was diagnosed with endometriosis years ago. I’m currently taking vitex (500mg) and maca (1/4tsp) in hopes to regulate my cycles (for the last 2 weeks). I know it’s not recommended to take vitex and progesterone together. So, should I drop the vitex and use the progesterone cream? I’m experiencing a lot of heavy bleeding. For now, my blood tests (took them on Monday) show I am not anemic.

    I’d like to start TTC in the next 3-4 months. I am 32 years old as well.

    • Hello Nikki!

      Vitex can be taken while using natural progesterone cream. It is fine to combine them.

      I do want to share that general suggested use of Vitex is 900-1000mg per day each day of the menstrual cycle and of Maca is 1000-3000mg per day each day of the menstrual cycle. Consider adjusting the dose to take the general suggested amount.

      Has it been determined that endometriosis is still a culprit? I suspect, given recent testing, that you have spoken with your doctor about what might be contributing to this for you. Endometriosis can cause heavy menstrual blood loss, yet is typically indicated by high levels of estrogen with low levels of progesterone.

      A longer period may be an indication of hormonal imbalance or nutritional imbalances. Progesterone secreted by the body after ovulation normally helps to stop excess bleeding and if estrogen is high or progesterone low, bleeding may continue longer than usual. Vitex and Slow Flow are herbal therapies that have been traditionally used for balancing longer periods.

      Vitex is a female fertility health herb that supports the hypothalamic-pituitary-ovarian axis (hormonal feedback loop) helping to support overall hormone balance.

      Do take care!

  3. Avatar

    Yes that article was helpful, thank you. If I am on a loading dose of 80 mg per day and I get pregnant, I have to continue on that 80 mg dose? I don’t want to decrease this dosage to the regular dose of 40 mg correct?

    • Dear Fara,

      It is going to be best if pregnancy is confirmed while using a loading dose of natural progesterone cream to talk with your healthcare practitioner about continuing progesterone cream through the first trimester of pregnancy, at a dose that is appropriate for your personal needs.

      All my best!

  4. Avatar

    Thanks Elizabeth. if I got my positive opk on the 15th and i ovulate 12-24 hours after, do I start the progesterone cream on the 16th (the day I ovulate) or the 17th, the day after O? Also my progesterone is very low, I read on another site that you can apply 3 times a day, 20mg each app. What are your thoughts on this method for a loading dose..? Thanks

  5. Avatar

    My ovulation calendar says that my fertile window is cycle days 14-19 in my 30 day cycle. I just got a positive OPK on day 15 and know that I may ovulate in 12-24 hours. If I apply the cream after ovulation on day 17, then am I hindering the other days in my fertile window. Will I have given up chance of getting pregnant on day 18-19?

    • Dear Fara,

      The Fertile Window is actually the two days prior to ovulation and day of ovulation. Some resources will share that it’s worth trying to conceive the day after as well. Given this and what you have shared, on cycle days 18-19 the Fertile Window may be over and conception is not likely to happen. Progesterone cream could them be started.

  6. Avatar

    I have been off birth control for 1 yr. now and have not had a period, nor gotten pregnant. My doctor tested my blood & said FSH levels were high meaning I am not ovulating, going through early menopause. My Uterus is fine, ovaries a little small. I recently read that progesterone shots can help one get pregnant? Doctor gave me 2mg of estrogen to help with the early menopause, but said very very small chances of getting pregnant. Is it ok to take my estrogen and progesterone shots to try and ovulate?

    • Dear Sylvia,

      I can not know for you if estrogen and progesterone injections may be helpful. If concerned about the safety of using them, please ask your doctor or pharmacist. It may be most helpful to consider working with someone who can help you address the underlying hormonal imbalance that has led to early menopause. We have a fertility herbalist on staff who offers this through a one on one personalized Fertility Consultation.

      Take time to learn the role follicle-stimulating hormone (FSH) plays in female fertility, including information on natural options to promote healthy FSH levels in the body in the article FSH Levels and Your Fertility.

      All my best!

  7. Avatar

    I have been struggling with PCOS for over two decades and through research (no doctors have ever recommended this) found using progesterone to re-establish cycle rhythm (I have none). Since I haven’t had a period since May 2013 (gave birth March 2014 and my cycle hasn’t come back since weaning) I’m trying the suppression method referenced above and ‘day 7’ was July 20. I’m doing 40mg in the morning (2 pumps) and 60mg at night (3 pumps). I’ve read in several areas that the best way to use the cream is vaginally, and I’m wondering if this is true because as soon as I apply it I break into a sweat like I just ran a marathon. Shirt soaked. Is this normal?

    • Dear Amanda,

      Fertilica Natural Progesterone Cream and Emerita Pro-Gest (the two that are sold in the Natural Fertility Shop) are not to be used vaginally and I wouldn’t do so with any progesterone cream unless being guided in doing so by your healthcare provider.

      Transdermal application allows for the progesterone to be absorbed through the skin into fat cells from where it is slowly dispersed into the capillaries (blood stream). It may be that through vaginal application, the progesterone cream is being absorbed too quickly and directly into the blood stream resulting in the symptom being experienced. It may also be that 100mg is too much for your needs right now.

      It may be most helpful to reach out to your healthcare provider or compounding pharmacist to receive further guidance.

  8. Avatar

    Dear Mrs. Willett,

    I’m taking Maca and Vitex for about a year now, but recently found out through a saliva test that my progesterone still is low in the luteal phase. I would like to start with the progesterone cream to maintain a pregnancy (in the past I have had several early miscarriages).

    But what dosage is right for this purpose? On another website they gave the advice to apply 100-400 mg a day. This seems like a lot to me. Somewhere else they prescribed 40 mg a day. These doses are very far apart. What would you recommend to maintain a healthy pregnancy?

    Thank you very much for answering my question!

    p.s: my dokter doesn’t “believe” in progesterone cream so no help there

    • Dear Donna,

      Thank you for asking!

      General suggested use of Fertilica Natural Progesterone Cream, based on the clinical practice and teachings of Dr. John Lee, while trying to conceive is is 40mg daily, divided into one 20mg application in the morning and one 20mg application in the evening, during the two weeks before menstruation begins. There are more details and a wonderful video in this very article about How to Use Progesterone Cream properly.

      The use of natural progesterone cream differs in pregnancy and te most important questions and answers to properly continuing natural progesterone cream in pregnancy are here in the article Natural Progesterone Cream Use in Pregnancy.

      I am sorry your doctor is not supporting you in using progesterone cream. Know that you can seek the advice of another. You are entitled!

      All my best!

  9. Avatar

    I read on another site that if you are applying the cream with your palm or fingers that some of it will be absorbed there as well. We only have two hands lol so no rotation there. Is this okay or is there a better method of applying?

    • Dear Nina,

      While trace amounts may be absorbed in the palm, the cream spends so little time there that this is not cause for concern. Consider putting the dose of natural progesterone cream on your finger tips where the skin is a bit thicker and applying immediately if there is concern.

  10. Avatar

    Once pregnant, if a woman has a healthy progesterone level but starts taking progesterone supplements, can too much progesterone be an issue?

    • Dear Kelly,

      Too much of anything in the absence of need is not suggested in most situations. By taking progesterone supplements, you are taking a bio-identical hormone, a form of hormone-replacement therapy. It is our opinion that you shouldn’t use something you don’t need.

      We know progesterone to be vital for a healthy pregnancy and responsible for a variety of functions throughout pregnancy. Increased levels of progesterone in pregnancy are believed to be the cause of nasal congestion, mood swings, headache, constipation, breast tenderness and fatigue. In theory these symptoms could be exacerbated from supplementing too much progesterone in addition to what the placenta produces.

      This being said, the female body can withstand very high levels of progesterone. The National Progesterone Advisory Network shares that an overdose of progesterone is unlikely because the placenta will be producing levels of around 400mg per day in pregnancy. It is important to know though that over time progesterone may build up and store in body fat. You would not want that to happen.

      The need for and use of progesterone supplementation in pregnancy is a decision that is best made by you and your health care provider together.

  11. Avatar

    I got my saliva test back for progesterone levels and seems im very deficient. I purchased the pro-gest and would like to start this cycle. My cycles are about 32 days. So I count backwards 14 days from my next expected period and start the cream then? Another question is do I stop progesterone when I get my period (will it happen while still on cream) or do I have to stop the cream day before to get my period the following day? Also, if I know I ovulate a little late in my cycle, do I wait to ovulate and then apply the cream? What happens if I apply the cream before ovulation, will I risk getting pregnant that month? Can you please advise. i love this website, it is so helpful!! TY!!!

    • Dear Nargis,

      Yes, counting backwards 14 days from your expected period start date is the suggested way to determine when to begin using natural progesterone cream. Natural progesterone cream is not to be used during menstruation, so it is to be stopped upon the start of menstruation. Some women get their period as normal while using natural progesterone cream while the many others have to stop its use for menstruation to start.

      Applying natural progesterone cream prior to ovulation, may suppress ovulation. When in your cycle to you ovulate? Do you know how long your luteal phase is? If the luteal phase is shorter than 12 days, it may be worth considering learning more about Luteal Phase Defect.

      I also emailed you directly last week and I hope you got that! It may be easiest to continue to ask questions there. Direct emails make for easier back and forth?

  12. Avatar

    I’m 35 years old with a history of recurring miscarriage. My last one 8 years ago was a stillbirth. Going to be ttc again very soon and HR-OB wants me on progesterone shots starting at week 16. No testing on my current progesterone levels from her. I did a saliva test last week on my own and am awaiting results. My periods are very regular with plenty of CM. Do I want to start this cream now and jeopardize timing of my cycle? Can I just start the progesterone cream once I find out I’m pregnant? My issue is an immunological one as I have Lupus. I just started Wobenzym N/Serrapeptase and Maca and am praying that will be enough. What do you think of Dr. Wright’s Naturone progesterone cream that is applied vaginally?

    • Dear Nargis,

      The proper use of natural progesterone cream is not known to jeopardize the timing of the menstrual cycle. We feel it would be best to know if you have low progesterone levels or not before beginning the use of natural progesterone cream. You would not want to work to increase progesterone levels if you don’t need to.

      This being said, it is also going to be best to work with your healthcare provider, or a natural healthcare provider near you, if interested in using natural progesterone cream instead of progesterone injections. These vary in strength and of course us. One is not easily substituted for the other without guidance. Your doctor can help you determine the best dose and timing of use for your personal needs.

      I do not know Dr. Wrights; Naturone Progesterone Cream so can not speak to it use.

      All my best!

  13. Avatar

    Hi! I was tested for progesterone and the test showed I was at the bare minimum, which the doctor said was “within range”. I’ve been supplementing with Emerita natural progesterone for 5 months now, starting after I ovulate and I’m not sure if I’m using to much or to little? But in the past two months, it’s had me start spotting with ovulation and spotting more then I ever have after sex and my periods happen exactly when predicted, but then kinda drag out at the end. I was diagnosed with cervical erosion and had it cauterized a few months ago, but I’m wondering if my spotting on the natural progesterone cream is a sign one way or another? I don’t currently have the funds to be testing my levels again or I would be. 🙁

    • Dear Casandra,

      Spotting when using natural progesterone cream often means that either the dose is too high or the timing of its use is off. Natural progesterone cream is best used for the two weeks prior to the start of menstruation and the general suggested dosage is 40mg daily, divided into one 20mg application in the morning and one 20mg application in the evening.

      It could be that your progesterone levels have normalized and that the dose needs to be adjusted which only testing can help you determine. There are FDA-approved home female hormone tests that may be worth considering.

  14. Avatar

    I recently had a miscarriage and my midwife gave me progesterone to take. She told me to take it after I ovulate. The problem is, I’m not sure when I do ovulate. I take ovulation tests, but they are always negative. I apparently ovulate, since I got pregnant and had a subsequent miscarriage. My question is, when do I take the progesterone? Do I wait and see if I get a positive pregnancy test and start it then, or wait and see if an ovulation test comes up positive to start taking it?

    • Dear Kim,

      I am sorry for your loss!

      In general natural progesterone cream use should begin two weeks prior to the beginning of a period. So, one way to determine when natural progesterone cream could be started is to figure out when the first day of menstruation will be and then count backwards two weeks. You can do this based off of a previous menstrual cycle. Our Progesterone Fertility Guide may be helpful to read through as you learn more.

      It may help to closely read the instructions of the ovulation test purchased to ensure they are being used exactly as instructed. Some can be effected by the littlest variances from exactly how they are to be used. Indeed ovulation has to have occurred in order to conceive. It may help to learn more about how to detect ovulation through Fertility Charting.

      I hope this is helpful!

  15. Avatar

    What is the dosage recommended for a woman with PCOS to use to get pregnant? Trying to figure out which creams I should be using, but don’t know what the dosages mean. Thanks!

    • Dear Amanda,

      There are two different kinds of Progesterone Cream we support using, Fertilica Natural Progesterone Cream that contains herbs which we know to be important for hormonal balance when preparing for pregnancy and Emerita Pro-Gest which is just plain progesterone cream for use in pregnancy.

      General suggested use of each is as follows:
      1. Fertilica Natural Progesterone cream contains 20mg of USP Progesterone per full pump. The bottle contains approximately 70 pumps.
      2. Emerita Pro-Gest cream contains 450 milligrams (mg) of USP Progesterone per ounce (900 mg per two-ounce tube). Each 1/4 tsp contains approximately 20 mg of USP Progesterone.

      In general it is best to follow the suggested use of the progesterone cream you purchase or ask your healthcare provider to help you determine the proper dose for your specific need. Consider revisiting the section of this article titled How to use progesterone for PCOS.

  16. Avatar

    Thanks for your information and I have one question! Last three month, i objected my period and found that I don’t have luteal phase. I started my menstruation the very next day of ovulation. (and my period is too short, 21days. ) Do I have to use progesterone cream after ovulation or 14 days before menstruation? or do I have to use it from day 7 to day 26?

    I am foreigner so sorry for my English if you can not understand well. Thank you for reading!!

    • Dear Hera,

      Thank you for reaching out to us!

      Help me understand, you have a 21 day menstrual cycle (from day 1 of your period to the start of the next period) and menstruation begins the day after ovulation? I need a bit of clarification so I can guide you to the most helpful information.

      General suggested use of Fertilica Natural Progesterone Cream is for the two week before menstruation, but not before ovulation (in most cases). So, I am not yet certain it is the best product to start with in your case (with a completely absent luteal phase). There may be other herbs and nutritional supplements to consider as well.

      I look forward to your reply.

  17. Avatar

    I am 26 from India,

    We are trying to conceive since last one year. Recently I had ultrasound. It resulted that my left ovary is not producing eggs. The eggs produced by the right ovary were found swollen and doctor said those eggs contained water. My doctor has prescribed me progesterone tablets of 200mg for 10 days. Will I be able to conceive and can you tell me what is the detailed outcome of my ultrasounds as explained above.

    • Dear Rikita,

      While, I think you for reaching out to us, I can not interpret your ultrasound results for you. This can only be done by a qualified medical healthcare professional. Consider asking this of your doctor, or whomever preformed the ultrasound.

      Will you be able to conceive? I can not know this either. Egg health is critical for healthy fertilization, conception and a healthy baby, and there are many factors that impact the health of the ovaries and eggs they produce. Learn more here in the article How to Increase Your Egg Health in 90 Days.

      I hope this article gives you hope!

  18. Avatar


    Thank you for your info on progesterone cream. My husband and I have been ttc for 3 years and my gynaecologist just informed me that I’m low progesterone. I bought some cream but I’m unsure of when to start using it. I rarely ovulate so when in my cycle should I start using it? Thanks in advance!

    • Dear Jolene,

      General suggested use it to begin progesterone cream use by using this calculation:
      Figure out the first day of your period, or use the first day of your last period. Subtract two weeks. That day would be the first day you start using the progesterone cream.

      All my best!

  19. Avatar

    Hi Elizabeth – So sorry. I put the wrong end date of prog cream. 20 mg, BID, was taken from 3/23 thru 4/4 (NOT 4/14). I stopped 10 days ago and period has not started. Currently day 37 of cycle. I am not preg. I made an appt with fertility specialist but cant get in until the end next week at the soonest. Would it make sense to do this-tomorrow is technically my day 12: To help your body create a cycle including menstruation and ovulation: “Use progesterone cream on day 12 of cycle and continue until day 26. By stopping on day 26 your progesterone levels will drop, helping to start your menstrual cycle.” Any advice would be great. Thanks so much!

    • Hello Josie!

      No apologies! Thank you for clarifying this for me.

      General suggested use of natural progesterone cream is for the two weeks prior to menstruation. Given this, it appears natural progesterone cream wasn’t used incorrectly in terms of general use. If menstruation does not begin, it is often suggested to continue as if is would have and start using natural progesterone cream again for the two weeks prior to menstruation.

      The way to do this is to figure out what day 1 of your menstrual cycle is or should be (this is when your next period is/was due to start), then count backwards two weeks. That day is when you start using the progesterone cream. This may be different than cycle days 12-26 depending on how long your menstrual cycle is.

      I hope this is more helpful!

  20. Avatar

    Hi – Having a bit of Progesterone Cream Drama! HX: 44yo; BMI: 20, abnormal menstrual cycle+ an-ovulation. Tried to jump start my cycle but started on wrong days. Can you review & make a suggestion to get back on track? Heres what happened: Day 1: March 9, Ovulation-3/23 (unclear), then began 20mg Progesta-care BID days 3/23-4/14. I should have started period on 4/6/15 but as of today (Day 36) there’s nothing. What can/should I do? My MD wants to do an ultrasound but I’m in the midst of changing insurance…just want to get back on track! Also wondering what you think about Dr. Lee’s “Inducing Ovulation” protocol and if it could be worked into my current scenario. Thanks in advance
    PS – Trying to get pregnant. Have a 3 year old currently….

    • Dear Josie,

      Natural progesterone cream should be stopped if it has not already been. I see your email came to us on April 13th, but the end date shared of using natural progesterone cream is April 14, so I am bit unclear. Stopping the use of the progesterone should cause progesterone levels to drop and menstruation to being. It is however very important to be sure you are not pregnant before doing this. I understand anovulation is being experienced, but it’s better to be sure pregnancy did not occur because as I am certain you know, during pregnancy a drop in progesterone levels may cause miscarriage.

      Moving forward, it may be best to work one on one with a practitioner who can help you learn if progesterone levels are in fact low and to determine the best dose for your needs and the proper cycle days to use it.

      The articles Getting Ovulation Back on Track and 5 Simple Ways to Promote Regular Ovulation may also provide helpful tips as well.

      Best wishes!

  21. Avatar

    Thank you so much – this site is extremely helpful! I started 200 mg of progesterone on day 12 (I ovulate right around then, and b/c I apparently use up all my progesterone in the first few days past ovulation, I was having the usual symptoms – water weight, mood swings, etc… and decided to start 2 days earlier than i was supposed to) and to make a long story short, my husband’s condom broke on day 12 (of all days!)… my question is – Should I continue the progesterone for the rest of the month, or stop it so there is less of a chance of me getting pregnant? I am 42 and I know the chances are slim, but I want to be extra cautious 😉 I also REALLY want to regulate my hormones! TY!

    • Dear Alexandra,

      Skipping a day of using natural progesterone cream if pregnant may result in a sudden drop of progesterone levels, which then may cause a miscarriage.

      I can not help you decide whether to continue or stop using natural progesterone cream. This is something to discuss with your husband and for the two of you to determine given your wishes and where you are on your fertility journey.

      All my best!

  22. Avatar

    Hi, I’ve been so lost. I’ve taken the progesterone cream since our miscarriage in Dec. I tried to do as it says. but it’s now starting my periods anywhere from 3-5 days sooner than my tracker shows me to expect my period to start. Based on my averages, it shows me having a 29-day cycle and a 15 luteal phase. I’m using a small dap morning and night. What am i doing wrong? My husband and I truly want to conceive and the doctors here have been of no help, telling me I shouldn’t trust natural therapies because its not FDA approved. So I’m kind of on my own, any help? Thank you!

    • Dear Cassandra,

      I’m sorry you aren’t getting the support you’d hoped for and for our loss!

      It may be time to check your progesterone levels to determine if levels are low or not. One wouldn’t want to use natural progesterone cream if there wasn’t a need. You can order FDA approved home female hormone tests here.

      Without knowing which progesterone cream you are using, the amount each day and which cycle days, it is a bit hard to guide you. If the Progesterone Fertility Guide hasn’t been helpful, it would be best to consider a one on one Fertility Consultation with a fertility herbalist who can help you determine the best herbs, nutritional supplements and natural therapies for your specific needs and the proper doses of them.

      I hope you will consider!

      In the meantime, our article 5 Steps To Decreasing the Chance of Recurrent Miscarriages may be helpful as you move forward.

      Lastly, to touch on the FDA-approved piece of the world of herbs, supplements and natural therapies, while your doctor is correct, we, the Natural Fertility Company, suggest supplements and herbs that are of the highest quality, GMP certified (3rd party FDA mandated), whole food and organic when possible.

      I hope to have been helpful!

  23. Avatar

    Hi. I had 7 miscarriage and no doctor told me the reason. Finally one of the doctors told me my progesterone level is down. What should I do to increase my level beside medicine?

  24. Avatar

    Hi! I want to try the progesterone cream, but am not sure how to use it. After ttc for 4 years, 7 months ago I gave birth to my son at 24 weeks. He is now my angle in heaven. They gave me the ok to start trying again. My periods are between 32 to 48 days. Is this a very irregular period?

    • Dear Lucy!

      I am very sorry for what you have gone through!

      There are a variety of ways to use natural progesterone cream as you have read in this guide. It is best to have determined low progesterone levels prior to using natural progesterone cream. This can be done by your doctor or by using an at home saliva test.

      General suggested use of Fertilica Natural Progesterone Cream is during the second half of your menstrual cycle, for the two weeks prior to menstruation. Day 1 is the first day of menstruation.

      Based on a 28-day cycle (we understand many have shorter or longer cycles and use may vary cycle to cycle)…
      Cycle days 1 – 14: do not use progesterone cream – Cycle days 15 – 28: use one pump two times each day.

      Our Natural Guide for Menstrual Health may be helpful, as may the article 12 Weeks to Improving Your Period.

      All my best!

  25. Avatar

    Good day,
    My Dr. might think I have PCOS however because I don’t have all the common symptoms we are unsure at the moment. After 8 months since coming off the pill I still haven’t received my period. She prescribed 2x 100 mg of prometrium at bedtime for 12 days. I was just wondering if I used the progesterone pump how many pumps you would recommend to reach this equivalent. Also, is promethium very different then the progesterone pump offered on your website. I am a very health consious person and only want the best for my body.

    • Dear Jessica,

      In general natural healthcare providers and some doctors believe that transdermal application of progesterone cream has the most benefit for hormone balance. This being said, many doctors proscribed oral progesterone as they believe it is better to deliver a standardized dose. There are many resources that share that taking oral progesterone is tasking on the liver.

      Honestly, it will be best for you to speak with your doctor about the proper dose of natural progesterone cream for your needs, or the pharmacist from which you picked up the prescription. Since the structure of the progesterone has been altered in a prescription progesterone, it is not likely to act the same in the body as natural progesterone.

      All my best!

  26. Avatar

    I am 20 years old and have been prescribed progesterone 100mg for 12 days out of the month. I have not started it yet, but if I was to start taking the progesterone at least 48 hours before having sex, and continue it for the rest of the 10 days after having sex, would it effectively act as a birth control? I am hoping this is the case as I am seeing my boyfriend this coming weekend after some time apart, and had very little notice (I was planning on getting an IUD, but that will take several more weeks.)

    • Dear Aria,

      There is a theory of thought that using natural progesterone cream before ovulation MAY suppress ovulation. I do not know if your plan will work as “birth control”. This being said, it is best to follow the suggested use of the prescription progesterone you were given and to follow your doctors advice for use, or ask him this question.

      It may be better to use alternative contraceptives (condoms, sponge, etc.) and learn your fertile window, the three days prior to and day of ovulation (even the day after), to abstain from or avoid unprotected intercourse if pregnancy is not wanted.

  27. Avatar

    I am a male and my wife used progesterone cream a few years ago. We made love and I noticed my left breast is bigger than the right.

    • Dear Courtney,

      I have not heard of increased breast size in men as a result of temporary exposure to natural progesterone cream used by his wife. It this is causing concern, it would be best to speak to your healthcare provider.

  28. Avatar

    Hi there,

    I have been diagnosed with ovarian failure/premature menopause at age 38, I am now 39. My last period was January 2014.

    My hormone levels and scan indicated that I have severely low progesterone levels and a womb lining of 1.1mm! After being diagnosed with POF, following no periods for 8 months, I suddenly began my cycles again, but as I mentioned, it stopped again in Jan 2014.

    My FSH is 70, but I have normal LH and oestrogen. I was wondering, will taking progesterone cream help me to get my cycle back and induce ovulation? I still have cyclic pain, but no periods and I used to have endometriosis, so the pain can be quite strong. Can this help me?

    • Dear Nassy,

      The use of natural progesterone cream is not known to reverse menopause, but may help with symptoms. It may be best to consider working one on one with a natural healthcare practitioner near you or an herbalist specializing in fertility, whom we have on staff, to determine the best natural fertility program for your needs. Learn more about a Fertility Consultation here…

      A natural progesterone cream dose for your needs may be different than the general suggested use and a healthcare provider is best able to determine this. Severe progesterone deficiency requires more time to increase progesterone levels with natural progesterone cream supplementation as well.

      As you educate yourself and seek further guidance, it may also help to learn even more about Premature Ovarian Failure.

      All my best to you!

  29. Avatar

    Hi there!

    I have been using Emerita Progesterone cream for moderately low progesterone. My ND ran a blood test to check levels. She recommended a dose of 1/4 tsp. once per day. She also recommended that I stop the cream on day 26, regardless of pregnancy or not because it would only be “a drop in the bucket of the progesterone a normal pregnancy would produce” so I stopped on day 28 this cycle after a day miss-count and I am now at day 31 with no period and suspect pregnancy, but I am concerned about having stopped the cream after information I have heard from other resources, including this website. Should I resume, or follow my doc’s advise? I don’t want to risk a miscarriage. Thanks!

    • Hello J Koehler!

      It is going to be best to talk with your ND about your concern and follow his or her advice. He knows your need best and can guide you best in the use of natural progesterone cream should need be determined.

      All my best!

  30. Avatar

    Is it safe to take vitex and progesterone cream at the same time? I usually take vitex during my entire cycle and am interested in now starting the progesterone after ovulation. I have been taking vitex for about 4-5 months and my cycles have gone from 33 days to 28 days and my ovulation day has gone from day 21 to 18. I just realized I wasn’t taking enough (only 500 mg) and am increasing to 1,000 this month. Should the vitex continue helping and bring my ovulation day closer to day 14? And can I use the progesterone cream in combination with vitex after I ovulate? I typically have a drop in temperatures during my luteal phase and I have been told my progesterone is low by doctors.

    • Dear cslorraine,

      Fertilica Vitex and Fertilica Natural Progesterone Cream can be used together to support health progesterone levels. It is best however to confirm through testing that progesterone levels are low before using natural progesterone cream. Over time use of natural progesterone cream can create contribute to excess progesterone in the body which will create hormone imbalance.

      Many do see positive benefit and enough support for healthy progesterone levels from using Fertilica Vitex alone.

      Take care!

  31. Avatar

    I took birth control for 1 year and a half. I stopped taking it because I was uncomfortable with the side affects. Now it has been a year and my period is completely irregular, and I have been trying to get pregnant for about 8 months with no success. How should I use the progesterone cream to help me ovulate? Please answer me…

    • Dear Camila,

      It is best to verify through testing, either at-home or with your healthcare provider, low progesterone levels before using natural progesterone cream. Using is when not necessary may create a situation where there is too much progesterone in the body furthering hormonal imbalance.

      The article How to Balance Your Hormones After Birth Control written by our senior herbalist may offer better insight into how to support the body in having a regular, healthy monthly menstrual cycle after stopping hormonal birth control use.

      I hope this is helpful!

  32. Avatar

    I am 40 yrs old and as of yesterday (03/10/2015) my fertility doctor did a no menstrual cycle blood work for Progesterone level and Estrogen Level, the Progesterone level was 11.4 and the Estrogen level was at 133. They have me taking Provera that I started last night before bedtime. But the nurse never really said that my levels were low or normal so I am just a little bit confused. Please help with any clarification.

    • Dear Kristy,

      It would be best to reach back out to your doctor or his nurse for clarification. I am not able to interpret test results given I am not a doctor and each lab runs tests and reports numbers differently.

      If you learn more specific details about what these numbers mean for you and wish to naturally support your body, reach back out to us.

      Take care!

  33. Avatar

    I am 39 yrs old and have been trying to conceive for > 2 years. I was found to have low post-ovulation progesterone levels. I do not have a short luteal phase, my cycles are regular (28 days), & I have NOT been diagnosed w/ PCOS. I tried femara, had good sized follicles but did not conceive. My progesterone levels remain low even on the femara. I stopped the femara. I did an ultrasound on day 12 this month (no medications) to see what happens & I only had small follicles. I started Vitex but have only been on it 10 days. I am wondering if I should start progesterone cream this month, even though I do not have any good sized follicles? Will it help to improve follicle size next month?

  34. Avatar

    I started taking Emerita Pro-Gest for fertility improvement, but I am worried I am having some negative side effects, such as sleeplessness, night sweats, etc. I am taking 1/4 tsp twice a day. I am also 4’10” and only 85 lbs. I am wondering if I can stop using natural progesterone cream 4 days past ovulation without harm to a potential pregnancy? Or if I can reduce the amount I am taking and only take it in the morning, again without harming a potential pregnancy?
    Thank you!

    • Dear Christina,

      If there is a chance of conception while using natural progesterone cream it is best continued into early pregnancy. It should not be stopped. Natural progesterone cream is time-released and that is suggested use is twice daily with about a 12 hour window between applications. If there is a potential for pregnancy it would be best maintain the dose used and to not decrease it unless being guided in doing do by a qualified healthcare provider.

      Talk with your healthcare practitioner about continuing progesterone cream through the first trimester of pregnancy as well – at a dose that is appropriate for your personal needs. In fact this would be good to do even if pregnancy does not occur. Given your height and weight, 1/4 tsp. twice per day, which is 40mg per day, may be too much for your individual need. The article Natural Progesterone Cream Use in Pregnancy may be helpful as well if pregnancy is confirmed.

      All my best!

  35. Avatar

    Hi I have a question- this is my first month using progesterone cream (Emerita). My cycles are 29-35 days long. I started the cream on Day 8, but I don’t know when to STOP using the cream this month. Will my period still come if I’m applying the cream every day? Or do I need to make a complete stop on a day that I decide? We have been ttc for 6 yrs, and I have just had a negative pregnancy reading this morning (Day 31). Will my period come on the day I stop using the cream? I ovulated on Day 15 (I always feel ovulation pain). thank you : )

    • Dear Ev,

      Natural progesterone cream is to be stopped at cycle day 26 to bring on menstruation. While there are several ways to use natural progesterone cream, general suggested use is during the two weeks prior to menstruation, which for many is just after ovulation until menstruation begins.

  36. Avatar

    Hello! I have a question about starting progesterone cream but can’t seem to figure out the answer for my situation. I’ve been tracking bbt for two cycles now and noticed that while I get menstrual bleeding, I have not ovulated either cycle. So, I have bleeding, but no ovulation. How would you go about using progesterone for this situation? I don’t necessarily need to “bring on” a bleeding cycle, but I also don’t know when I would start given that I don’t have a date of ovulation since it doesn’t happen. Also, my cycles aren’t necessarily the same length. The first cycle was 44 days and I’m on day 33 of this cycle with no typical symptoms of getting my period. Help!!

    Thanks in advance!

    • Dear Stacey,

      General suggested use of Fertilica natural progesterone cream is for the two weeks prior to menstruation. To know when to begin using natural progesterone cream, count backwards two weeks (fourteen days) from the first day of your last menstrual period and this cycle day is the day of the current cycle to start using the cream. The cycle day to start natural progesterone cream may change each cycle until they regulate.

      Is this helpful?

  37. Avatar

    Hi! I took a saliva test that relived I have very very low progesterone. I came off birth control at the end of July 2014 and have not had a period since the withdrawl bleed. I was on femaprin for 2 months but now I am on bio-identical progesterone and chaste berry since January and nothing seems to work. I started taking maca as well. All I want is my period back so that my husband and I can conceive and have a baby. I’m not sure what else to do. I have done a detox and cleanse of the liver, kidney, and lymphs. Any suggestions? This is the only thing I stress about!

    • Dear Jackie,

      I am sorry this even has to be a source of stress for you!

      Are you working with a practitioner who suggested the bio-identical progesterone, Vitex (Chastetree berry) and Maca to you? If so, it may be worth reaching out to him to evaluate the doses you are taking/using. While we know natural progesterone cream to be rather fast acting, clinical research shows that Vitex may start working within 10 days, but full benefits may not be experienced until 6 months or longer.

      It may be worth considering the information provided in the article How to Balance Your Hormones After Birth Control as well. We also offer one on one guidance from our fertility herbalist who will evaluate your diet, lifestyle and fertility health concerns to help determine areas that may need to be addressed. This experience is called a Fertility Consultation. This may be helpful!

  38. Avatar

    I am 33 years old and have not been able to have kids. Every time I get pregnant, my progesterone levels are low so they have given me progesterone suppositories, or injections. My pregnancies go as far as 6-9 weeks and then I have a miscarriage. I have tried asking to check my levels of progesterone and to be prescribed progesterone before I get pregnant. I believe that by the time I find out I’m pregnant, get an appointment and get the prescription it’s not enough time to raise my progesterone levels and I end up loosing my pregnancy. I am so frustrated… My first pregnancy was a stillborn at 7 months due to blood clots and since then have had miscarriages. What can you recommend I do? Last year my gynecologist did a progesterone level test and said I may have a deficiency, and told me to contact her as soon as I ovulate, but it was hard to figure out when I ovulate because my periods are very irregular. Now I have not had my period since 3 or 4 months ago.

    • Dear Mabel,

      I am sorry this journey has been nothing less than frustrating and sad for you. I am very sorry for your loss.

      Progesterone levels have proven well supported while trying to conceive by the female fertility herb Vitex and Fertilica Natural Progesterone Cream. Fertilica Vitex is also supportive of hormone balance when menstrual cycle irregularities are present. Both are discussed in this article. There are even FDA-approved home female hormone tests to consider trying.

      Consider also learning more about Systemic Enzyme Therapy to support fertility health as well as the 5 Steps To Decreasing the Chance of Recurrent Miscarriages.

      I hope this is a helpful place to start!

      You may also want to consider a Natural Fertility Consultation. Our email consultations provide you with a personalized written guide and audio recording from a fertility herbalist, explaining the best natural therapies, herbs and nutritional supplements, dietary and lifestyle tips for your unique fertility issues.

      All my best!

  39. Avatar

    I am 40 years old, have PCOS. My period has been irregular due to my low progesterone level. I just started Fertilica progesterone cream this month. I picked my day 12 (on Jan 28) and started having spotting/light bleeding on day 23. Do I need to continue using the cream till day 26 (which will be Feb 11) OR do I need to stop it right away and wait for the new cycle? Need your advice.

    • Dear Julie,

      Spotting when using natural progesterone cream could mean that either the dose is a bit too high for your needs, or that it has been used on the wrong cycle days. Did you continue natural progesterone cream until today, Feb. 11th?

      The other thing to know is that estrogen dominance may become worse when first beginning natural progesterone cream. This can cause concern, but should go away over the menstrual cycle or two as progesterone levels increase. What does this mean though? Our Senior Herbalist Dalene shares that “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 one of which is spotting…”

      I hope this is helpful!

    • Avatar

      Hi Elizabeth,
      Yes, I used it till today, and still having light spotting/bleeding. I use 80 mg per day, divided 40 mg each morning and night. Should I reduce it? Also, can I use my 1st day of spotting as 1st day of period? (since I haven’t had period for months prior using fertlica cream). Need help to determine the date for my next cycle.

    • Hello Julie!

      General suggested dosage of Fertilica Natural Progesterone Cream is 40mg daily total, divided into one 20mg application in the am and one 20mg application in the pm, during the two weeks before your period when working to establish a menstrual cycle How to use progesterone for PCOS; Establish a cycle with progesterone cream. This being said, 80mg may be just fine for you.

      It sounds as though this may be a menstrual period given it has lasted now 4 days. It seems that your body has responded to the Fertilica Natural Progesterone Cream. That is great! Cycle day 1 could be considered February 8th then.

      I hope this too is helpful!

  40. Avatar

    Are there natural ways to increase progesterone like thru diet versus using the cream?

    • Dear Pei-Lu,

      There are herbs, like Fertilica Vitex, that support healthy progesterone levels and hormone balance. You may have heard of foods like Wild Yam increasing progesterone levels, but Wild Yam taken internally or used as a cream will not increase progesterone levels in the body. I am not aware of other foods that do so either.

      Take care!

  41. Avatar

    My husband and I have been TTC since 08/13 (when I stopped birth control and using condoms). We are in our 20’s. Five years ago, I had my period for 9 weeks straight – heavy bleeding and painful. After dropping 80 lbs, my doctor put me on BC and called it an iron deficiency. He never ran any definitive tests. After stopping, my periods have been somewhat regular. Start dates lately have been way off… 11/16/2014 to 12/20/2014 and then 1/30/2015. Not sure what is happening, stopped trying a month ago from the stress of disappointment. Now we want to try again and don’t want to be put on any medications. I am going to start tracking BBT and CM again this cycle. Help? Advice? Next step? Much appreciated.

    • Dear A.J.

      While I am not certain when exactly you stopped the birth control your doctor prescribed when he deduced there was an iron deficiency, I think an place to start educating yourself is our article How to Balance Your Hormones After Birth Control.

      Carrying excess or too little weight, nutrient deficiencies, hormone imbalance, stopping hormonal birth control, indeed stress and even travel can cause the menstrual cycle to shift. Consider also reviewing our Natural Guide for Menstrual Health to learn what it means to have a “normal” menstrual cycle and how to naturally support having one.

      I hope this is helpful!

  42. Avatar

    I think I may have had a miscarraige this month. My period was due on the 3rd, but never started. I track everything now and I had noted a tiny bit of spotting had occurred on Dec. 30th. I’ve been regular for 7 months so the thought was hopeful. But I never do a pregnancy test until I’m very late… too many let downs. On the 12th, I began getting cramps that were more painful than normal, but no period. The cramps continued and on the 15th, I started bleeding. It was heavy and very bright for 4 days then lightened and stopped like a period would. Is it possible to noticed implantation bleeding even if implantation fails? I am so happy I found this sight. For years I’ve thought I was having early miscarriages.

    I thank you for such great info. I believe I have found out why I have not had a pregnancy, but rather many undetected early miscarriages. I will be starting progesterone ASAP.

    Is it safe to use Vitex and Fertilica together? Someone mentioned that Maca is also a great idea. What would you recommend as my best and safest option? I am 35 and really hopping to get pregnant before it is too late.

    • Dear Julia,

      I am thankful this information is helpful! Thank you for sharing a bit of your story.

      I can not know if what you experienced was a miscarriage. By “tracking everything” are you using a fertility tracking App, charting your basal body temperature (BBT), or simply keeping a journal? I ask because if using an App or charting BBT, these would have shown elevated BBTs after ovulation which is an indication of pregnancy. It may be possible to experience spotting as a result of the embryo trying to implant even if implantation does not happen. To be honest, I am not certain if anyone understands how much repeated effort an embryo puts into implanting if the first try doesn’t work. Does that make sense?

      Regarding supporting healthy progesterone levels by using natural progesterone cream, know that while there are many signs and symptoms of progesterone deficiency, it really would be best to confirm low progesterone levels before using natural progesterone cream. It is not wise to work to increase progesterone levels if not needed. Over time, using progesterone cream when it isn’t needed may create a situation in which too much progesterone is in the body. Testing is easy and as stated in this article, can be performed by your doctor, or by using an at-home saliva hormone tests.

      When you ask, “Is it safe to use Vitex and Fertilica together?”, do you mean Fertilica Natural Progesterone Cream? If so, Fertilica Vitex and Fertilica Natural Progesterone Cream can be used together and they both can be used with Fertilica Maca as well.

      We are happy to recommend the best natural fertility program for you. We do this through a Fertility Consultation. I hope you will consider working one on one with our master fertility herbalist in creating a personalized lifestyle program complete with the herbs, nutritional supplements and natural therapies best suited for your specific fertility health needs.

      I hope this too is helpful!

  43. Avatar

    My Gyno told me i Have a mild case of PCOS and that i have Low Progesterone. She subscribed me progeterone pills called utrogestan which i must take on the 10th day of my cycle till i bleed and Vitex1000 everyday . For 3 months… What are my chances of getting pregnant. I m healthy weight and 31 years old.

    • Dear Guilia,

      How wonderful that your gynecologist supports using Vitex to support hormone balance and healthy progesterone levels. I hope you are experiencing positive menstrual cycle changes. In addition to herbs, nutritional supplements and natural therapies, diet can have an incredible impact on fertility health for women with PCOS. Learn more about the PCOS Fertility Diet here…

      I wish I could have an answer to your question, but I do not. My hope for you is that by committing to changing your diet and lifestyle, and sticking to your fertility health program your chances of conception will be great.

      All my best!

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    I have had 4 miscarriages in one year and gained 40 lbs. I’ve been to several doctor who have done all sorts of test. My gut says it is a hypothyroid which leads to low progesterone. Although any test they have done come back normal. My current doctor is a reproductive endocrinologist, she has me on 200mg of progesterone. Yet a few weeks ago I miscarriaged again. All of this is becoming exhausting. Any advice?

    • Dear Lindy,

      I am so sorry for all you have been through!

      Were you able to learn if inadequate progesterone levels was a factor in your losses, or given any reason for them happening? How disheartening and great to have tests come back normal. Have you considered working with a reproductive immunologist to determine if there may be an immune issue? Consider learning more through our article Immune Infertility: Natural Options for Immunological Fertility Issues.

      It may also be most helpful to consider a Fertility Consultation. Our Fertility Consultations provide you with a personalized written guide and audio recording from a fertility herbalist explaining the best natural therapies, herbs and nutritional supplements for your unique fertility issues.

      It would be great to hear back from you and take care!

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    I have PCOS, but have been ovulating. According to my temp charts it looks like I ovulate on day 17 and have 33 day cycles. Should I use the cream days 12-26 or start the day after ovulation (day 18) through day 33? Would this keep me from getting my period? It’s pretty much like clock work since being on metformin. Also, my day 21 progesterone checks have been 14.5 and 10.5. Do you think I need progesterone? Would the pills work just as well? Thank you”

    • Dear Amanda,

      Thank you for asking, but because you are on Metformin and I am not able to interpret test results, it will be best to speak with your healthcare provider about your need for progesterone supplementation. He can help you know what test results mean and help you know the best dose of progesterone for your needs.

      If it is determined that progesterone supplementation is necessary, general suggested use of natural progesterone cream is during the two weeks prior to menstruation, which is typically after ovulation until the nest menstrual period begins. Using natural progesterone cream prior to ovulation may suppress ovulation.

      Take care!

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    Hello I am 30 and have been TTC for 18 months now. Starting IUI with Femara next cycle, but recently took a test and discovered very low progesterone and estradiol. I saw where you don’t recommend using progesterone cream in combination with fertility meds, but I want to level out my horomones to support uterine lining and prevent miscarriage. What do you recommend?

    • Hi Stephanie,

      If you are wanting to use natural progesterone cream, it would be best to talk to your doctor about this, get his approval and have him suggest an exact dose based on your progesterone test results. Remember, supplementing with progesterone is only going to help increase progesterone levels, not estrogen levels. So, that would need to be addressed as well. You said you took a hormone test and progesterone and estradiol were low, did your doctor mention anything else? We do not recommend combining the two without strict supervision and approval from your medical doctor, as there may be an interaction. I wrote a list of points and questions to consider when wanting to combine herbs/natural therapies withe medications for fertility, this may help you make a decision, read it here:

      All the best to you!

  47. Avatar

    I have PCOS and experience no period for 10 months. I had the saliva test last month and showed that my progesterone level was low and my estrogen level was in normal range. I would like to use natural progesterone cream to trigger my period. My ultrasound showed that endometrium increased to 10.4 mm.My ob/gyn doctor said that I should use some medicine to trigger a period ASAP. I have viewed the instruction of instruction video of how to use progesterone cream for PCOS in your website. So I mark tomorrow as my day 7 and then continue to use the cream until day 26. What dosage do you recommend for my case? I know normal dosage is 40 mg per day, 20 mg each. How many cycles should I try?Thanks

    • Hello Shelly!

      Dr. John Lee suggests to use 60-100mg of progesterone cream each day during the suppression cycle (from cycle day 7-26) and to repeat this for 3-4 months for best results.

      It may be worth speaking to your healthcare provider about the best dose for your individual needs is he/she is willing to support you in trying natural progesterone cream prior to taking a medication.

      Consider also learning how to support your body in re-learning balance by promoting healthy hormonal balance, a healthy uterine lining, regular ovulation, improved estrogen metabolism, reduced cravings for sweets and improved digestion. We have learned that dietary and lifestyle changes specific to PCOS are as equally as important as any herb or nutritional supplements one can take when dealing with this fertility health issue.

      Best wishes!

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    Hi I’ve taken progesterone cream for almost 5 years at only a 20mg dose per day I started it because of my heavy periods and endometriosis. It initially helped but the last two years has stopped helping as my periods are heavy and flooding. Anyhow I just upped my dose to 80mg per day (divided) and am due to start my menses Saturday (it’s currently Tuesday) anyhow I have dark brown spotting right now which is early for me to start, should I keep taking the cream or stop as if my flow has started (even though it’s just brown at this point). And has upping the cream made me start early?? Thanks so much and I am blown away how you answer ever question back that’s refreshing to see!

    • Hello Dani!

      My apologies for taking a few days to reply. How are you doing?

      Have you considered having your progesterone levels tested to see where they are given you have been using natural progesterone cream so long? It may be time to do so to determine the best dose for your needs. 80mg may be too much, but only testing will help you know this. Spotting and a shift in the timing of menstruation while using natural progesterone cream can be a sign of using too much at the wrong time of your cycle.

      As you have read in this guide, 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. Natural Progesterone cream can be continued until normal flow begins.

      Consider learning how to support healthy uterine lining growth by supporting the body’s natural ability to remove excess estrogen from the body, in maintaining its natural inflammatory response, providing it relief from occasional discomfort in the reproductive system and encouraging normal circulation, helping to bring fresh blood and oxygen to the reproductive system as well.

      I wish you well!

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    My periods are irregular so I have been using progesterone cream since August to regulate and induce ovulation as per the instructions above under progesterone and pcos. I ovulated for the first time last month. I am currently on day 30 without any ovulation and still taking progesterone because I started taking it on day 16. Do I continue taking it or do I stop it as per the instructions in this article?

    • Dear Nevie,

      It is best to stop the use of natural progesterone cream as per the instructions in this article after two weeks of using it.

    • Avatar

      Hi Elizabeth,
      Another question regarding the use of progesterone cream and PCOS. My periods have always been irregular and as per my bbt charting I don’t ovulate. I have been using progesterone cream since September and have been able to achieve three periods with ovulation. I have been starting it on day 12 and finishing on day 26 as per the instructions on this website. When would you suggest I start weaning myself off progesterone cream? Or would you recommend my trying to use it two weeks before my period is due to see if I still ovulate? I am trying to conceive so I want to make sure I am doing this correctly. Thanks for your help.

    • Dear Nevie,

      How wonderful that you have received this support from natural progesterone cream support.

      If you are actively trying to get pregnant while using natural progesterone cream, it needs to be continued until you have definitely confirmed you are not pregnant. If you are pregnant, natural progesterone cream should be continued without skipping a day of use in pregnancy.

      If you are not yet actively trying to conceive and wish to wean off of natural progesterone cream, it may be best first to speak with your healthcare provider about your need to support healthy progesterone levels. If it is determined there is no longer need, simply reduce the amount you use each time you apply it. Do this on the last cycle you plan on using it.

      Regarding continued use, the cycle days it is used depends on the length of your cycle. To determine when it is best to use natural progesterone cream for you, based on your cycle, figure out what day one is of your cycle (this is when your next period is due to start), then count backwards two weeks. That cycle day is when you start using natural progesterone cream.

      I hope this is helpful!

  50. Avatar

    Hi there, I had another question. I am using Progesterone Cream in order to conceive. I have PCOS so I have been using it to regulate a cycle and induce ovulation so I am applying it on Day 12 and ending on Day 26. If I am trying to conceive do I carry on with this trend or do I continue taking Progesterone until I actually ovulate? Thanks for your help.

    • Dear Nevie,

      Ovulation typically occurs mid cycle – with a 28 day cycle, ovulation is around cycle day 12 to 14. Just after ovulation is when natural progesterone cream is started and then it is used through the luteal phase (from ovulation until your period starts, which is cycle day 1). Natural progesterone cream can be used during this same time in the menstrual cycle when trying to conceive and if pregnancy is confirmed used into early pregnancy as well.

      How long are your menstrual cycles? Do you know when you ovulate? Is this typically after cycle day 26? Thank you for allowing me questions. I just want to be sure that I am helping you as best as I can.