To learn more about using progesterone for fertility visit the Fertility Progesterone Guide.
1. Q: How should you use progesterone if you are trying to conceive?
A: The basic rule is to follow the instructions on the bottle. You want to mimic your natural cycle as much as possible.
For most uses you would begin to use progesterone by using this calculation:
Figure out the first day of your period. Subtract two weeks. That day would be the first day you start using the progesterone cream.
The general suggested use for progesterone cream is 40mg of cream daily, applied in a split dose, 20mg in the morning and 20mg in the evening during the two weeks before your period. If actively trying to conceive, it is best to test for pregnancy before stopping progesterone cream a day or two before the expected period. Progesterone cream should be continued if pregnancy is confirmed while using it (with the guidance of your healthcare provider).
Example: An average cycle length is 28 – 30 days. In this case you would begin using progesterone around day 14 of your cycle, counting the first day of your period as day 1. If your cycle is shorter or longer than the given example you would start two weeks before day one of when your period is due. If you have no period at all then you would choose a date and work from there.
2. Q: I have found out that my progesterone is low. What does this mean to my reproductive health?
A: When saliva hormonal tests show low progesterone levels, that could indicate that you have not ovulated or that you are not producing the proper amount of progesterone after ovulation – which is called luteal insufficiency. The correct amount of progesterone after ovulation is very important for maintaining a healthy pregnancy.
In a study published in the Lancet, a group of 18 regularly cycling women, average age 29, seven of them (39%) were found to not be ovulating and were not producing progesterone.
3. Q: If someone has PCOS and/or doesn’t have a regular menstrual cycle, how do they know what days to take the progesterone on?
A: In cases where your cycle is an 18 or 32 day cycle, starting on day 12 or 14 would not be good. To figure out when would be the best time for you to start and end your progesterone use get out a calendar…
Figure out what day 1 is of your cycle (this is when your next period is due). This is based on what your cycle is. What is normal for you. Then count backwards two weeks. That is when you start using the progesterone cream.
This works because despite the length of a cycle, the days between ovulation and day 1 of the period is consistently two weeks.
4. Q: Does progesterone cream benefit those of us with PCOS, without a regular cycle? Or are we better off just taking Vitex and/or Maca?
A: With PCOS progesterone supplementation can help to make a big difference with PCOS. It can seem confusing when you should use it since usage is based on a menstrual cycle. In this case choosing your own cycle can help to establish a pattern. Mimicking a general cycle is best. Following the same suggested usage as someone who has a cycle, just choose your own and mark it on the calendar.
Vitex works great in conjunction with progesterone cream. Vitex is working on the the underlying imbalance (which takes some time) while the progesterone helps in the current cycles.
5. Q: If I have an irregular cycle and don’t menstruate sometimes, how should I use progesterone cream?
A: Figure out what day 1 is of your cycle (this is when your next period is due). This is based on what your cycle is. What is normal for you. Then count backwards two weeks. That is when you start using the progesterone cream.
If you do not menstruate at all then you may want to check out our article on bringing your period back and talk with your health care provider to find out what the imbalance may be.
6. Q: I know that I am ovulating. Do I still need progesterone? Could my progesterone levels still be low?
A: Depending on what your fertility issues have been in the past. Many women ovulate and then have a drop in progesterone levels after ovulation (the luteal phase). This may be the cause of recurrent miscarriages or the inability to get pregnant. One way to tell if this is happening is to start fertility charting.
Fertility charting or Basil Body Temperature charting can help to determine the availability of progesterone in the luteal phase. You can learn more about BBT Charting here. There will be a slight rise in temperature after ovulation has occurred and progesterone has increased and stay increased until the period is about to begin. It will then drop. If you are pregnant the temperature will stay at its increased amount.
7. Q: Is it possible to conceive if I have low progesterone levels?
A: It is possible to conceive with low progesterone, but may be more difficult. It may be hard to maintain a pregnancy if you have low progesterone. Please read the answer to the question before this one.
8. Q: How do I know if I have low progesterone?
A: There are a couple of different ways to find out if you have low progesterone.
Hormones testing can be administered by a doctor, naturopath or through labs online. There are a couple of test options. Tests range from charting you menstrual and basal body temperature, finding out the length of your luteal phase, or taking saliva tests to find out your progesterone levels. This preogesterone questionnaire on this page can help 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. You can learn more about BBT Charting here. There will be a slight rise in temperature after ovulation has occurred and progesterone has increased.
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, ovulation detector strip tests.
Saliva Hormone 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). This is because a blood test may not show an accurate picture of available hormones. Most of the time the hormones in your body are not usable. They are tightly bound to proteins in the blood stream. Only 1-2% are bio available at a time to enter the tissues of the body. Blood tests measure only the total level of hormones in the bloodstream. Dr. Lee suggests saliva testing is more accurate because of the saliva glad being the one of the tissues that bio-available hormones enter.
You can order an “at home” saliva test that you will take at a certain time 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.
9. Q: Can I have both low progesterone and low estrogen?
A: Yes. This sometimes shows up as a luteal phase defect.
10. Q: What is the difference between natural progesterone cream and progesterone that is prescribed by a doctor?
A: Natural progesterone cream contains “bioidentical hormones”. These are hormones that are identical to the ones in your body. Most of the progesterone prescribed by doctors has been molecularly altered to created a kind of “pseudo-hormone” or a synthetic hormone. This is done so the drug is patent protected. Natural progesterone can not be patented as they are natural. Since the structure of the progesterone has been altered in prescribed progesterone, it will not act the same in the body as natural progesterone and may cause dangerous side effects.
11. Q: Can I use wild yam cream instead of progesterone cream?
A: Wild yam cream is not the same as progesterone cream. 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. Your body is not able to turn diosgenin directly (from wild yam cream) into hormones itself.
12. Q: What is the difference between Fertilica Progesterone and Emerita Progesterone?
A: We sell two different kinds of Progesterone Cream, the Fertilica (our brand) contains other herbs which we find important for hormonal balance and Emerita which is just plain progesterone cream.
The progesterone in both products are formulated from a substance found in Mexican wild yams. 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. USP classifies the progesterone as the highest quality available. Both progesterone creams contain USP grade natural progesterone.
Fertilica Natural Progesterone cream contains 20mg of USP Progesterone per full pump. The bottle contains approximately 70 pumps. It also includes additional hormone balancing herbs.
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.
13. Q: Which is the best to take if I have low progesterone… progesterone cream, maca or vitex?
A: It depends on what is happening in your body. Here are some general guidelines to how each works:
Progesterone cream is a direct way to increase progesterone levels. This is helpful in the case of luteal phase defect, preventing recurrent miscarriages and reversing conditions such as endometriosis and ovarian cysts.
Maca is a nourishing food for the endocrine system, aiding both the pituitary, adrenal, and thyroid glands (all involved in hormonal balance.) Maca has the ability to affect key hormones in both women and men without containing hormones itself. In women maca has been shown in studies to help regulate estrogen and increase progesterone (if that is what the body needs). In men It has been shown to regulate estrogen and increase libido and sperm health.
Vitex has been found to help normalize ovulation, improve a short luteal phase and reduce Polycystic Ovary Syndrome (PCOS), all known fertility inhibitors. In one study, vitex helped normalize progesterone levels and increased the luteal phase from 5.4 days to 11.4 days. In addition, two double-blind studies show vitex extract increases a woman’s fertility and chances of successful conception.
14. Q: Can you use both progesterone cream and vitex or maca?
A: Yes, progesterone starts to have an effect the cycle that you start taking it. Vitex and maca both take time to have their effect. The previous question explains in detail the difference of the three. It is also not necessary to take all three. Every situation is unique and different.
15. Q: If I am using Maca to boost my progesterone should I stop taking it once I become pregnant?
A: Maca has been used for thousands of years by the peoples of Peru, and they eat it daily; even during pregnancy. Acute toxicity and cytotoxicity studies have shown no potential toxicity for Maca. Hundreds of thousands of people have used maca with no reported side effects. That does not mean that maca should be continued into pregnancy though. There are currently no studies to prove that maca is safe for pregnancy, so it may be best to avoid taking it if you are pregnant. If you are already taking maca and are pregnant or plan on becoming pregnant, you can learn how to safely discontinue taking maca in early pregnancy by clicking here…
16. Q: I am using Vitex to increase my progesterone levels should I stop taking it once I become pregnant? Is it safe to take during pregnancy?
A: Botanical Medicine for Women’s Health by Aviva Romm, MD states that vitex may be used safely in pregnancy up to the second trimester to help prevent miscarriage due to low progesterone levels. A placebo controlled study was performed on pregnant rats, to see if taking vitex in pregnancy had a teratogenic or mutagenic effect on offspring. Results showed that even with vitex levels administered 74 times the dosage typically consumed by humans, no toxicity nor aberrations in fetal development of the rat offspring were seen. The Botanical Safety Handbook provides no contraindications to use vitex during pregnancy. To learn when and how to safely wean off of vitex in pregnancy, please click here…
While Vitex can be used to help a miscarriage that is acute, it is best to use at least 3 months prior to conception for pregnancy preparation. Once pregnancy is confirmed, it would be best to contact a natural health care practitioner to help determine where progesterone levels are at. If your doctor feels that you need extra progesterone support, they can help you transition from vitex use to natural progesterone cream use, which is a more reliable way to maintain stable progesterone levels.
17. Q: I have been taking progesterone and am now pregnant. How much progesterone should I use for pregnancy and how long should I use it for?
A: While pregnant it is best to work with your health care provider to help monitor and guide your progesterone usage. When you do become pregnant and you have been using progesterone you want to make sure you do not stop taking it. A drop in progesterone levels can cause a spontaneous abortion (miscarriage) to occur.
In the first trimester of pregnancy progesterone production is the sole responsibility of the ovaries, 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.
Synthetic progesterone drugs, not being natural progesterone, have side effects that if used to maintain the pregnancy may do damage to the baby.
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.
18. Q: Is progesterone cream safe to take while on the Fertility Cleanse?
A: If you have been taking progesterone cream before starting the Fertility Cleanse, than continue to use the cream as you have been.
If you are starting the Fertility Cleanse and progesterone cream at the same time I would suggest that you wait and begin the cream after your cleanse. The reason for this is that the Fertility Cleanse has a lot of different herbs that are going to be working on the endocrine system. It will be hard to monitor yourself and see how the progesterone is affecting you. Starting the progesterone cream the cycle after you have completed the Fertility Cleanse makes it easier to see how you are doing with the progesterone.
19. Q: Does it matter whether natural progesterone cream is made out of soy or wild yam?
A: No. 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. Your body is not able to turn diosgenin directly into hormones itself. So taking just a soy supplement or using wild yam cream will not have the effects that progesterone cream does. It can be confusing because of soy’s phytoestrogen ability to have estrogen-like effects. But those come from a different part of the plant which is accepted by your body.
20. Q: What is the difference between progesterone and progestins?
A: Progestins are a synthetic form of progesterone. While progesterone found in progesterone creams is natural and identical to the progesterone in your body. Natural progesterone is much safer to use than progestins which can have serious side effects. During the third trimester of the pregnancy the placenta naturally produces 300-400mg of progesterone daily. If progestins were given to the mother in that same dosage, serious birth defects could occur.
21. Q: Are there any side effects from using progesterone cream?
A: It is rare but, yes, there can be. Large doses (100mg) of progesterone can cause side effects, sleepiness, loss of libido, mild depression, exacerbated symptoms of estrogen deficiency, and serious hormonal imbalances.
If you take progesterone out of phase then it may cause the timing of your period to change or spotting to occur.
The best way to avoid these side effects is to make sure to use the progesterone cream as directed, at the correct time of your cycle and not to exceed the recommend amount (10-30mg per application) or to work with a health care practitioner so your progesterone levels can be monitored.
22. Q: Can too much progesterone cause a light period?
A: It is hard to say, as there are many factors that can affect your cycle. The timing of when you use progesterone is very important. Taking it the wrong time can cause the cycle to be different. The best way to make sure you are using the cream at the right time is to calculate your progesterone start date by counting two weeks backwards from when your period is due.
23. Q: I have been using progesterone and am now spotting between periods. This never happened before? What is happening? Is it the progesterone?
A: Spotting could be from a variety of reasons… The most common is a too high dose of progesterone.
The second common is that your timing may be off. If your cycle has been 24 days for years and changes to a 28 day cycle after you’ve began using progesterone cream this could be a sign of changes happening or a confused body. The best way to make sure you are using the cream at the right time is to calculate your progesterone start date by counting two weeks backwards from when your period is due.
The third common reason for spotting is that when the body is making hormonal shifts it sometimes gets out of wack for a cycle or two as it is shifting to its new cycle.
24. Q: Can I use progesterone cream if I am on birth control pills?
A: We do not know for sure, but it would be best to not mix hormones or use herbal products that can have an impact on your hormones while on birth control. An educated guess is that the birth control would block the progesterone from the receptor sites, but we do not know.
25. Q: I am preparing for an IVF and will be taking medications. Can I use progesterone cream?
A: We would not recommend it. When you are preparing for IVF you will be prescribed a very specific hormonal protocol. It would be very dangerous to use anything with hormonal effects during that time. Speak with your doctor if you feel you have low progesterone levels.
26. Q: I am breastfeeding, can I use progesterone cream? What is the recommended usage?
A: Progesterone cream is not generally recommended postpartum or while breastfeeding. It has been shown to be helpful for the baby blues/postpartum depression though. Talk to your doctor about this, especially if you are breastfeeding as some evidence shows that progesterone can effect lactation from occurring.
27. Q: Can using progesterone cream prevent menopause from happening?
A: No.
To learn more about using progesterone for fertility visit the Fertility Progesterone Guide.
Click here to purchase natural progesterone cream
Have a question? Contact us or leave a comment down below and one of our herbalists will respond as soon as possible.
References:
1. Lee, John, M.D. Hormone Balance Made Simple. 2006
2. Lee, John, M.D. What Your Doctor May Not Tell You About Premenopause. 1999
3. Hobbs, Christopher, L.Ac. Vitex The Women’s Herb. 2003
4. Trickey, Ruth. Women, Hormones, and the Menstrual Cycle. 2003
5. Weed, Susun. Herbal for the Childbearing Year. 1986
6. California PSR and CALPIRG. “Generations at Risk” Chemicals and Reproductive Health.PDF
7. Romm, Aviva. Botanical Medicine for Women’s Health. 2009
Hello!
After two miscarriages, we discovered that I have low progesterone. I began using progesterone cream (as instructed by this wonderful resource) right after ovulation through day one of my period. When I fell pregnant this time around, my Doctor put me on progesterone suppositories (200mg, 2x a day totaling 800mg. I am nearing the 12 week mark and he told me I could stop completely. I am terrified to quit cold turkey – any advice on either 1. tapering 2. using progesterone cream when I run out of suppositories for good measure?
Thank you and I REALLY appreciate all the terrific and informative information on your site.
Dear Stephanie,
Congratulations! I am so happy for you!
Your fears are valid! I think it will be best to first discuss how terrified you are with your doctor and the pros of weaning off of the suppositories. Our research led up to suggest progesterone be used through week 20 of pregnancy, but we are not medical doctors. Perhaps our guide Natural Progesterone Cream Use in Pregnancy will be helpful to review.
I hope your fears are eased soon!
Hi! I discovered that I do not ovulate by myself when I got back low progesterone test results. My doctor’s suspicion is that I have probably never ovulated in my life since my periods have always been irregular. My periods are between 25-33 days and sometimes heavy and sometimes light. Every couple years, I will get a very heavy bleed that causes me to become severely anemic. I don’t have endometriosis or PCOS. I’ve tried 3 Clomid and 1 injection round. I’ve also tried acupuncture. My FSH, LH, TSH, prolactin, AMH are normal. Would you recommend trying progesterone cream with Maca and Vitex or going straight to IVF? I am almost 35 y/o and have been trying to conceive for 4 years. Thanks!
Dear Jean,
If your heart is set on trying a natural plan, then I would suggest considering it. If you Clomid and injections haven’t worked in the past, it may help to support the body naturally for at least three months prior to trying IVF. I can’t really answer your question as this is very personal and a decision best made by you and your partner/husband.
With that, consider reading our guides
Getting Ovulation Back on Track
5 Simple Ways to Promote Regular Ovulation
My best as you think thru your options!
Hello Friends!
My husband and I have decide to get pregnant again, and like with my son we are using Clomid (PCOS). I have been charting my CM and it told me to go for it.. and had some brown spotting about a week ago. My DR. had my blood drawn for my HCG levels, but I also got Progesterone 200mg for 10 days to jump start my period, followed by Clomid…Should I wait for the lab results or is it safe to start taking the Progesterone? I don’t want to to miscarry.
Thanks, Megan G.
Dear Megan,
Our best to you! Please contact your doctor or talk to his nurse to discuss starting the progesterone. They need to be the ones to guide you properly.
Dear Elizabeth,
Thank you for this wonderful resource! We just started trying to conceive and I have a strong suspicion that my progesterone is not as high as it should be. I was diagnosed with PCOS and, with weekly acupuncture, have had 2 years of a regular 28 cycle (!) with ewcm on day 16. But using OPKs for the first time I found out I only ovulate 48-72 hours post ewcm. That is, my luteal stage is not 12 days like I thought, but more like 9-10 days. I also have spotting before every period, and have a hard time sleeping around ovulation. My Dr looked at me like I was crazy for thinking about supplementing Progesterone. Am I? And will it be crazy to start using a natural cream on my own?
Dear Li,
I am thankful this resource has been helpful! I am the last person who will say you are crazy! 😉 I believe women can know when things aren’t quite right. That said, it truly is best to have progesterone levels tested before using natural progesterone cream. It is correct that the luteal phase should be at least 12 days and there are other natural ways to support its healthy length, ways that can be just as effective as progesterone cream. We share of them in our guide Luteal Phase Defect: Natural Treatment Options. I hope this helps you choose what you feel is right for you!
Hi Elizabeth. Ive been on and off progesterone cream for years, it goes too high after ive been onit for a while and goes too low if i come off. However my estrogen is generally low, but this is estradiol with estrone being at a higher level. I have taken dim in the past but i dont know if this is a good idea when estrogen is already low. Progesterone cream when it gets too high seems to exaggerate my low estrogen symptoms. Please advise what you would do to bring estradiol up? i cant take maca the increase in testosterone from this gives me hormonal acne. i take licorice, liver support progesterone cream and holy basil so far, and inositol. Thanks
Dear Lynsey,
Can I know more about you? Do you have a regular menstrual cycle and ovulate each month? Do you have a known fertility health issue? May I know your age? Why have you chosen the supplements/natural therapies you are using now? If you’d rather reply in private, please email me here…
I have a tricky situation, I seem to have an estrogen dominance issue – long story, short: I have had chronic hives for 10 months, they went away when I got pregnant in January and I unfortunately miscarried. My ND put me on progesterone and the hives did not come back. She put me on 8mg first half of cycle and 16mg second half. The first cycle I don’t think I ovulated. The second cycle I had six days of EWCM, and after what I thought was ovulation I had a huge surge of hives (perhaps an estrogen surge?). My ND has now upped my dose to 16mg first half and 32mg second half and the hives have disappeared. She knows I’m trying to get pregnant. Will this suppress ovulation?
Dear Jenny,
I can not know for sure for you. It may, but we also heard from a few women who confirm ovulation while using progesterone cream before ovulation. This would be a great conversation to have with your ND and perhaps tracking for ovulation (BBT or basal body temperature charting) will help you know for sure.
I have been trying to get pregnant for 5 months now and I have PCOS, so doctor suggested progesterone pills. I started on day 16th of my cycle and today is the day 24th, I’ve been spotting since last night? is it normal? could it be implantation bleeding or is it just a side effect?
Dear Manu,
This could be your period trying to start, or is you actively tried to conceive, perhaps implantation spotting. It would be best to test for pregnancy before stopping the progesterone when your doctor suggested it be stopped. If pregnancy occurred progesterone is best continued into early pregnancy under the guidance of your doctor or midwife.
I’m a little confused about using ProGest cream for fertility. You recommend to use the cream between ovulation and stop a few days before menstruation, however, if you have already conceived (and you don’t know that you have) and you stop the cream, surely this could trigger an early miscarriage? If you continue to use the cream up to the day of your due period just in case you may be pregnant, and your period is then delayed (is it possible that the cream can delay a period?) how do you know what to do? I am a day late, but have a BFN result, but have all preganancy symptoms. Should I stop with the cream? I had two miscarriages recently… Thanks!
Dear Tiffany,
Yes, when actively trying to conceive one should test for pregnancy before stopping progesterone cream. And yes, progesterone cream can delay menstruation for some women.
I cover the following in another Q&A on NFI.com, but will share it here for ease… If a period is late when actively trying to conceive, choose a pregnancy test that is designed and marketed to detect an hCG level as low as 25mIU/ml, such as the Babi One Step HCG Urine Pregnancy Test Strips. The reason this is important is because a woman’s level of hCG when she becomes pregnant starts at nearly zero and doubles every 48-72 hours. At 7-10 days after ovulation, a pregnant woman’s hCG levels should be up to 50 mIU/ml. Testing for pregnancy can begin 7-10 days past ovulation which means you need to be tracking ovulation.
Senior Herbalist, Dalene Barton-Schuster, shares, “If the test comes back negative while testing this early, know it may be a false negative due to very low hCG levels. It may be due to late ovulation. Wait 3 days and then test again. An early negative can also lead to feelings of sadness and depression. So, even though you can test this early, it may be best to wait longer, that way you will give the placenta more time to raise hCG levels.”
In the absence of pregnancy, if a cycle does not start, stop progesterone cream and treat this as a new menstrual cycle and start progesterone cream use again on cycle day 14 (or after ovulation). Or when in doubt talk to your healthcare provider!
I hope this helps clarify things and I will make a slight edit to the information here for clarity as well. Take care!
I am 35 and just recently been put on progesterone. I had my first pregnancy 2 years ago which ended in miscarriage within 2 weeks of finding out. I have tried 18 years so far. My progesterone levels has been basically Zero to 4. I switched drs and this one just put me on femara and progesterone 100mg vaginally. If my prog. levels are that severely low will the progesterone help me get it up? This first round didn’t work and my cd21 level was a pathetic 0.1 🙁 So this progesterone she has me on now. Do you think I will ovulate and my progesterone increase and if so how long does it usually take for it to go up?
Dear Amanda,
Your doctor should be adjusting the dose of progesterone as your body needs. While it should help raise them, I can not know how much or how quickly. It may be worth considering natural support for the endocrine system to help the body realize or relearn that it can naturally make progesterone. Do you know why your progesterone levels are so low? It is related to age, excessive exposure to xenohormones or plastics, perhaps chronic high levels of stress? Learning possible causes may be helpful as you create a supportive fertility program.
Thank you I will ask my dr about changing the dose of progesterone. She did labs
on me with DHEA Testosterone etc and said all those things came back normal for my
age. I do think I have high levels of stress because I am very impatient lol and stress
about everything. Is there anything I could do for that besides trying to reduce stress best
way I can? Anything that can be taken for that naturally while taking femara?
Hi again Amanda!
Sounds like a great plan!
There are many tools to consider when trying to handle stress… learning to quiet the mind and not let stress affect us is the hardest, yet most beneficial way to manage it. With that here are our Top 10 Mind and Body Therapies to Help With Fertility Stress.
Exercise daily, avoid consuming too much sugar, alcoholic beverages, smoking or taking drugs (including many medications). There are also adaptogen herbs, but it really is best to be guided in combining them with Femara by your doctor. Some to consider learning more about are Maca, Ashwagandha, Schisandra, Rhodiola, Reishi and there are more… The Stress Company has a wonderful line of products (again only combined with Femara with approval from your doctor).
I hope you find a few tools to help!
I am 38 years old and my husband just had a vasectomy reversal. We have 4 year old twins and a two year old. We are really hoping for a 4th. I am scared because my last two cycles have been 35 days long. Does that automatically mean I am perimenopausal? Could stress be a factor? My husband has been gone a lot (active duty Army). I have started vitex and have progesterone cream but dont know what day I should start it since my last two cycles have been long? In the past I have been 28-29 days. I stopped nursing the two year old last March. Thank you so much!
Dear Erin,
Having a cycle shift post stopping breast feeding does not immediately indicate perimenopause to me. Stress does indeed have a factor in menstrual cycle health. We share in great detail how in our guide Stress and Your Fertility.
General suggested use of Vitex is 900-1000mg daily during the menstrual cycle and that of progesterone cream is during the two weeks prior to the start of menstruation. So, mark on the calendar the first day of your last period and count back two weeks. That day would be the day to start progesterone cream the following cycle. Know that these days may shift as the body begins to adjust to the added progesterone. If you actively try to conceive, do test for pregnancy before stopping progesterone cream. In the absence of pregnancy at that two week date, progesterone cream would be paused and restarted again two weeks before menstruation begins.
how can i found out if im pregnant while taking progestrone?
Dear Ashiya,
If using progesterone and menstruation does not start, is late, do test for pregnancy before stopping its use. If you did not have a period before starting progesterone cream and aren’t sure when menstruation is supposed to begin, consult your healthcare provider about testing for pregnancy and pausing progesterone use.
Can I use progesterone cream if I just found out I’m pregnant?
Dear Jenna,
Congratulations on your pregnancy!
All pregnant women should talk with their healthcare practitioner about starting progesterone cream in pregnancy, at a dose that is appropriate for their personal needs. So, please do reach out to your doctor to discuss this!
I know you get hundreds of emails but I hope you can help me. should take this progesterone cream or take the fertile cleanse you offer. I am 31 & since I turned 30 I have had abnormal periods (ex every 35-40 days) recently I started bleeding out of nowhere for 30 days straight heavy bleeding with very larges clots (3-5 per day) Went to the Doctor he said my hormones levels were off he said the only way to fix it was to be on birthcontrol the rest of my life & I cant have any kids WHAT! I refuse to believe there is no other way on the face of this earth to stop this bleeding and help me Ovulate again. should I try the progesterone cream or the fertile cleanse please Im desperate 🙁
Hello CG!
I am sorry for what you are experiencing!
Both natural progesterone cream and Fertility Cleansing may be useful pieces of a natural fertility program, but neither are to be used while bleeding. I am not sure is you saw a OB/GYN or fertility specialist, but it may be best to ask for a referral to a specialist who can do more in-depth testing to determine why your hormones are so imbalanced and if any fertility health issues are contributing to this prolonged bleeding. Thyroid health and stress, even blood clotting disorders can be contributors, fertility health issues like uterine fibroids, ovarian cysts, PCOS and endometrial hyperplasis are some examples of those that can cause prolonged menstrual bleeding.
While birth control can effectively stop symptoms for many women, it is not addressing the underlying imbalance or issues causing the bleeding. This is important to do if you wish to conceive.
Back to diet and lifestyle, consider learning more about a Fertility Diet, being sure to consume adequate amounts of vitamins C and A, and astringent herbs known to help the body regulate menstrual blood flow. Slow Flow for example uses astringent herbs, uterine tonics and nutrients to support normal menstrual flow.
I hope this is helpful and that you are able to seek additional testing to determine why this is happening for you.
I’m currently still breastfeeding my 10.5 month old daughter and actively TTC. I’m almost certain that I had a chemical pregnancy this past cycle and am now wondering whether it was because I wasn’t on natural progesterone. I was on Emerita Pro-Gest during my last pregnancy and think it would be safest to take this again. However, I see that you don’t recommend it while nursing. Is that just due to concerns over a drop in milk supply? If so, I guess it’s just a matter of weighing the pros and cons. I just want to be sure there are no other concerns such as any harm to my nursing daughter through breast milk exposure. Thanks for the helpful info as always!
Dear Jamie,
I am very sorry for your loss!
It is important to weigh the pros and cons yes! We do not suggest progesterone cream use in general without first testing to determine progesterone levels are low, which they may be and are likely to be when breastfeeding (which is normal). Its use is also not suggested because it may impact breast milk production and because with transdermal application there is a chance a child could come into contact with an application site (your skin with progesterone cream on it) and be exposed to the progesterone cream.
That all said, if interested in using natural progesterone cream while breastfeeding, it would be best to talk with your healthcare provider about it and a dose specific to your needs.
We address the causes of very early miscarriage and offer support in moving forward with trying to conceive after a chemical pregnancy in our guide to Chemical Pregnancy – Experiencing Very Early Miscarriage.
You may also find our guide to Important Tips for Trying to Conceive While Breastfeeding helpful.
All my best!
Can progesterone cream help to regulate ovulation in PCOS? If someone is not ovulating, can progesterone cream help to “jump start” it? It does give periods when they normally don’t come, which makes me think it’s similar to the pill in that it gives false bleeds from building up the uterine lining and shedding it, but not periods resulting from an unfertilized egg leaving. I would really like to know how to get ovulation working again. Also, I normally start bleeding during use of the cream, giving me early “periods”. Is that normal? Shouldn’t the stopping of progesterone cream cause a period from the drop of hormone levels and not during using it?
Hi Jessica,
According to our work and the work of John Lee, MD, yes, progesterone cream can help to regulate ovulation, not only in women with PCOS, but other causes of anovulatory cycles as well. I think it is extremely important to first know if you have low progesterone levels before deciding to apply progesterone cream. You might find our article 5 Herbs You Should Know About That Help Regulate Ovulation helpful.
In your particular case, I am not sure why the progesterone cream is causing “early periods”. This could be a possibility:
Not all women get enough of a progesterone drop when stopping the progesterone cream at the end of the cycle to bring on a period.
I hope that helps answer your questions.
Can progesterone cream be taken even if one does not ovulate in a particular month?
Dear Yemi,
Fertilica Natural Progesterone Cream can be used in the absence of ovulation. This is fine. General use is still the same, starting application two weeks prior to the start of menstruation.
Thank you for this article. I want to make sure I am understanding exactly how to use the cream for both fertility and to have a regular cycle. I have been trying for a baby for ten years now, and throughout those ten years, I have been having weird cycles (twice a month, and sometimes three times a month).
So, to make my own cycle, I should start using the cream two weeks prior to when I want it to start, right? Also, I am supposed to stop it a day or two before when it is due, right? Then I would pick back up using it two weeks prior to my next period, right? Lastly, I should keep taking it even when I discover that I am pregnant, right?
Thank you in advance for your reply!
Dear Meechie,
General suggested use of natural progesterone cream is for the two weeks prior to day 1 of menstruation, day 1 of the cycle. This is often after ovulation until menstruation. It truly would be best to first determine through testing if your progesterone levels are low and what is contributing to you having multiple periods a month.
The Q&A I wrote on the Use of Progesterone Cream with an Irregular Menstrual Cycle may be helpful and learn how to establish a cycle with progesterone cream here…
I hope this is helpful!
I am 24 years old and I’ve had irregular periods my entire life. Only twice a year from ages 12 – 18, standard 5-7 days, then completely sporadic after that. Sometimes 1 every month, sometimes 2 – 4 months in between. Sometimes my period will last 9 days, sometimes 21 days. I just got my last one after 3 months, and it was 17 days long it ended on the 23rd. I have the progesterone cream, but I have no idea when to start it because I have no way of anticipating my next period. Should I just try to force a “normal” cycle by starting the cream now and then stopping after two weeks, or just use it indefinitely until my next period? As I said, though, that could be some 4 months from now. Thanks
Hello Katherine!
Do you have a natural fertility program in place to support menstrual regularity beyond just natural progesterone cream? We feel this is the place to start and then natural progesterone cream could be considered. It truly is best to determine through testing need for progesterone supplementation, whether through a doctor or at-home saliva testing.
I have written a Q&A on using progesterone cream with an irregular menstrual cycle that I think will be a helpful place to start.
If you are still unsure of where to begin, or how to proceed, please consider working one on one with our fertility herbalist who can lay out an entire natural fertility program for you based on your specific fertility health needs through a Fertility Consultation.
All my best!
I have hashimotis thyroiditis, can progesterone cream adversely affect the thyroid? Overstimulate it possibly??
Dear Kim,
If using progesterone cream when it is not needed (progesterone levels are not low) whether you have Hashimoto’s, or not one can create a situation where there is too much progesterone in the body which is not good. I have read that an overabundance of progesterone can exacerbate the symptoms of Hashimotos Thyroiditis. It is important if you wish to use progesterone cream to be guided in using the proper dose for your needs and then be monitored while using it to adjust the dose as need be.
Consider the Natural Thyroid Support Plan here… as you learn whether natural progesterone cream might be right for you.
All my best!
question – I had my mentrual on the 23rd of October. Do I start the progesterone on ovulation day or on day 14 of my cycle?
Dear Charity,
General suggested use of Fertilica Natural Progesterone Cream 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. Progesterone use should begin directly after ovulation, which is usually day 14 in the cycle (day 1 is the start of your period), and ended once menstruation begins.
I have two questions please. First, do I apply the cream until the cream is totally saturated by my skin? For example with a 50 mg application, it’s quite a lot for one area and sometimes remains white. Do I keep rubbing until its gone? My second question is, if I apply in the morning and go for a swim or shower a little later is that okay? How long does it take to completely absorb the cream? Should i stay away from water? Thanks!
Dear Fara,
General suggested use of Fertilica natural Progesterone Cream is to apply 20mg in the morning and then 20mg in the evening. While, it is always best to follow the suggested use of the cream purchased, or of your healthcare provider, 50mg may be too much in one application (unless pregnant already in which use differs from the general suggestion).
It is important to gently massage in the cream until almost completely absorbed which happens fairly quickly, within a few minutes of application. Showering or swimming after application is fine. There is no need to avoid water.
Can you use too much progesterone cream during pregnancy. I am 4 weeks and taking around 120mg which I know is more than the recommended dose but if I try to lower the dose will I miscarry?
Hi Cynthia,
First, congratulations on your pregnancy! Second, are you using prescription progesterone from your doctor or natural progesterone cream? Some experts feel that high doses of natural progesterone cream are safe up to around 400mg per day, as this is about how much progesterone is produced by the body at the end of pregnancy, so the body can tolerate pretty high levels of progesterone. That being said, it really would be best to talk to your doctor about this and have them suggest the right amount for your needs. As long as you are supplementing with progesterone and not stopping, you will be supporting your pregnancy, what the right dose is for you, not sure. I do know that prescription progesterone is giving at higher amounts that what is suggested for natural progesterone cream use. I think a Q&A I wrote on the subject may also help you, you can read it here: Natural Progesterone Cream Use in Pregnancy
Best Wishes!
Hi! I have very low progesterone. I use progesterone cream after ovulation and up to start of menses. Out of curiosity, why do we stop using cream during menses? Is it okay to use it during? Would it help to continue to increase levels? =Thanks!
Dear Nina,
The goal in using progesterone cream is to closely mimic the body’s progesterone cycle. It is during the luteal phase (from after ovulation until menstruation) when progesterone levels should begin to rise on their own and if not, progesterone cream can be used to support this. There is a really great graphic of the hormone fluctuations in a normal menstrual cycle in our Natural Guide For Menstrual Health. Take a look!
Using progesterone cream during menstruation is not necessary and its use prior to ovulation is very likely to suppress ovulation (which Dr. John Lee has seen support the return of normal ovulation). Rather than use progesterone cream longer than is suggested, a load dose might be worth talking to your healthcare provider about. Learn more about a loading dose of progesterone cream in our Progesterone Fertility Guide.
I hope this helps!
Having not had a menstrual cycle for nine months, and experiencing the early stages of menopause, I have recently started to use progesterone cream twice daily. I find I am now having a period. Is this normal ? should I stop using the cream altogether ? I am a bit concerned. It has helped with the hot flushes and mood swings and I am sleeping a lot better.
Dear Denise,
Bioidentical hormone creams, like natural progesterone cream, are often used to alleviate symptoms of perimenopause and menopause, and can help the body create a cycle including menstruation and ovulation.
Stopping the cream depends on your goals, although its use should be paused during menstruation.
I know that using the progesterone cream can suppress ovulation. Can you tell me if it is pointless to have sexual intercourse during the part of the cycle when you are applying the progesterone cream. Is there no chance of conception when applying the cream, even if you have not ovulated yet in your cycle, when ovulation may be later that month? I’m sorry, I hope this makes sense.
Dear Nina,
Ovulation will not occur if following the suppression cycle protocol for using progesterone. Suppressing ovulation is suggested for only three cycles in a row before changing progesterone cream use to the two weeks prior to the start of menstruation. This is typically after ovulation until menstruation begins.
While sexual intercourse certainly can be engaged in during suppression cycles, conception is not likely to happen until healthy ovulation has been restored.
Consider referring to our Progesterone Fertility Guide for further guidance and additional tips.
I hope this answers your question.
If I am using progesterone throughout my entire pregnancy, how much do I use after the 20th week? The article about progesterone cream use during pregnancy only stated up to 20 weeks and advised you slowly wean off the cream. I plan to use it for my entire pregnancy, how do i do this?
Dear Jewell,
Natural progesterone cream is not often suggested all the way through pregnancy. By the 20th week of gestation the placenta takes over progesterone production adequately. Please refer to the article Natural Progesterone Cream Use in Pregnancy for more information.
Congrulations on your pregnancy! May it be happy and healthy!
Can I use progesterone cream to help with pms? pmdd? If so.. at what time during my cycle?
Dear Sophie,
Natural progesterone cream is not intended for use unless progesterone levels have been confirmed through testing. If they have been confirmed low, learn more about the general suggested use of natural progesterone cream in our Progesterone Fertility Guide.
The article PMS: 5 Natural Ways to Feel Better Now may be helpful to read through prior to starting natural progesterone cream.
I hope this is helpful!
Hi,
I have been taking progesterone and my period was late by two day, guess it’s because I didn’t know there was a right way to start taking progesterone. My doctor gave me 50mg to take in the evenings. Do I have to change now, or should I just watch my cycle if it starts a new norm? I have started drinking coconut cream in my tea and it’s delicious! Thanks so much for the info!
Dear Khekhe,
It is going to be best for you to reach out to your doctor with your questions/concerns because the use of natural progesterone cream is different than prescription oral progesterone. I hope you are able to contact him, so he can best guide you.
It is also important to not stop using progesterone, in any form, if there is a chance you could be pregnant. Your doctor is also best able to guide you in its use in pregnancy.
Hi. I just started using 20 mg/2 x a day Emerita Pro-gest after two chemical pregnancies. It’s my first cycle to use it, and my question is will my period start while taking it, or do I have to stop in order to get a period? I am trying to figure out if I need to have a blood pregnancy test every month before halting the progesterone, or if my period will begin per usual (if not pregnant) without stopping the cream. Thank you.
Dear Toni,
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. Natural progesterone cream is not to be used during menstruation, so it is to be stopped upon the start of menstruation.
It is best to test, either a urine test or blood test, for pregnancy if menstruation does not start while actively trying to conceive and using natural progesterone cream. If conception occurs while using natural progesterone cream, it should be continued into pregnancy. Our Progesterone Fertility Guide offers more insight.
I hope this is helpful!
Hi! My periods are very wacky! I went on the pill 3 years ago and JUST got my first period (after 3 years of amenhorrea) in December 2014. Then another one in February, March, and TWO in April and ZERO in May. I was using progesterone cream properly until April when I had 2 periods and was spotting in between. Since my periods are so off, I do not know when I will start another cycle and therefor I have no clue when to start the cream. Any suggestions? Thank you! 🙂
Dear Carey,
Spotting while using natural progesterone cream is often an indication that it is being used either at the wrong time of the menstrual cycle or in too high of a dose. It really is best to determine through testing that progesterone levels are low prior to trying natural progesterone cream. We feel one would not want to raise progesterone levels when this isn’t needed.
While it has been some time since stopping birth control and it appears from what you have shared the body is working hard to detoxify and re-balance, consider learning about Natural Remedies To Bring Back A Healthy Menstrual Cycle. Diet and lifestyle changes, in addition to herbs, nutritional supplements and natural therapies work to support the body in re-learning balance and/or supporting continued balance for the body.
Know that we also offer one on one guidance. The very best way to receive a full plan designed specifically for your fertility health needs is to participate in a Fertility Consultation.
I hope this is helpful!
Hi – you reference Dr John Lee’s publications below your article but you do not mention his creams over your recommended ones. I was looking at purchasing his – what is better about yours than his? I wish to buy a natural cream but only if it is truly effective.
Dear Byrnsey,
Thank you for your patience in my reply!
When the research for this article was being done, Dr. John Lee’s website did not have a progesterone cream for sale. It does now, but we are thinking this must have been formulated by his family or his company because he passed away many years ago.
Fertilica Natural Progesterone Cream was formulated by our site’s founder for quality assurance for use when preparing for conception. We also carry Emerita Pro-Gest for use when pregnancy occurs, under the supervision of a doctor, because it is a high quality, pure progesterone cream.
What can happen if you take progesterone for 30 days. Can it harm you?
Dear Mary,
It is not suggested to use natural progesterone cream straight for 30 days or all cycle long without taking a break. This would very likely lead to there being to much progesterone in the body, hormone imbalance, and using natural progesterone cream before ovulation may suppress ovulation.
It would be best to follow the suggested use guidance in the Progesterone Fertility Guide or seek help with proper usage for your specific need from a qualified healthcare provider.
Take care!
Hi Hethir,
38 yo, 5 weeks pregnant (IVF & applying 8% natural progesterone 90mg gel daily since Day 14)
I read on different websites ”Keep using the natural progesterone until 10-12 weeks” You says ”…until the 16th weeks.” Could you please explain why you are recommanding to keep using it so long?
I’m so scared. My gynecologist accepted to prescribe more natural progesterone but normally prescribes it only until the 30th day! His nurse says to keep it at the same level but will it be enough when its level should rise up in my body to 400mg in ”day 90”?
We waited 8 years, my husband is quadraplegic and I had fibroids… I’m so scared.
Thanks anyway for all your informations 🙂 .
Dear Florence,
Congratulations! This is wonderful news! I hope that this finds you happy and well in your first trimester.
The suggested use of natural progesterone cream in pregnancy is this long because by the 20th week of gestation, the placenta should have taken over producing adequate amounts of progesterone. Click here to learn more about proper use of natural progesterone cream use in pregnancy…
It will however be best to continue to be guided in using progesterone gel by your healthcare provider and have him/her monitor your need for progesterone supplementation as the weeks go by.
All my best!
Hello! My Husband and I have been ttc for 6 years. We went through multiple cycles of Clomid up to 200 mg and no success. Progesterone levels always came back at 0.2 – 0.6. I have currently been on Vitex 1600 mg for a month as well as Metformin 2000 mg. I don’t have periods and clearly not ovulating. Any suggestions or advice?
Dear Kayla,
Thank you for reaching out to us!
I am not certain I know enough to best guide you, so the very best way we can support and guide you in through a Fertility Consultation. This process allows you to share as much information as possible about your overall and fertility health with our master fertility herbalist and in return to receive a natural fertility program designed for your specific fertility health needs. I hope you will learn more and consider this invaluable service.
In the meantime, consider learning about natural progesterone cream and how it has been used by Dr. John Lee to establish a healthy menstrual cycle including menstruation and ovulation. Our Progesterone Fertility Guide will help you learn more.
All our best!
Hello there! My fiancée and I have been trying to conceive for 5 months. I am 39 years old and started taking vitex 2 cycles ago. I have been dealing with pre-period spotting for a few months and was curious about when best to start the progesterone cream. My cycles range from 25- 28 days and can fluctuate. Since on the average I have about a 27 day cycle should I start the cream on day 12 or 13? My pre-period spotting can last 3-4 days prior to my actual period which is why I think I have a luteal phase defect. My Ob-Gyn is not overly concerned with the pre-period spotting, but I am. Should I also consider taking Maca? Does it take as long as the Vitex to be effective?
Hello Heather!
I suspect you have also received an email from me as well, but I also wanted to reply here as your questions are valuable and may be helpful to others.
First, to answer your question, natural progesterone cream is to be for the two weeks prior to menstruation – from just after ovulation until the first day of normal menstrual flow. Now, if the luteal phase is short, this length of time may be less than two weeks for a few cycles.
Are you charting your basal body temperature (BBT) to learn exact luteal phase length? This is very likely to help you determine luteal phase length and know if you have need to consider supplementing to support a healthy luteal phase. I am also wondering if you have had testing to determine if your progesterone levels are low? We suggest doing this because one wouldn’t want to increase progesterone levels if there was no need to do so.
Now, all this being said, there are very easy changes that can be made to the diet, in addition to nutritional supplements that have been shown to impact and support healthy luteal phase length that we suggest considering before using natural progesterone cream (especially if you have not determined you have low progesterone levels).
Fertilica Vitex may also support luteal phase length. Vitex is an herb known to take 6 months or longer in order to experience its full benefits. It can be taken with Fertilica Maca which may be faster acting, has hormone balancing effects, and offers a bit different set of fertility benefits than Vitex.
I hope this is helpful!
I had a solid positive natural pregnancy for 4 weeks and 6 days @36yrs and then with spotting my progesterone level shown was 0.2 and hCG 7. Doc has ordered for another blood work to see where the hCG goes next but implied it is not very positive. Also please confirm the usage of NPC during pregnancy eg start NPC immediately after ovulation till periods and if pregnancy is achieved then till the first trimester is over, is that correct. Can good levels of hCG be maintained and grown using NPC in early pregnancy or is it that NPC would only help if hCG levels are healthy in the first place. I was wondering what brought down the good hCG level, was it the low progesterone/unhealthy fetus/other
Dear Shelly,
It is going to be best to have your doctor test your progesterone levels and seek his guidance in supplementing progesterone, even natural progesterone cream, while pregnant. He is the only one who can determine your need to support your progesterone levels, how to best do so and can also determine the best dose for your needs.
HCG is a protein hormone produced by the placenta that is immediately released after implantation of a fertilized egg and is required to sustain pregnancy. During the early weeks of pregnancy, HCG stimulates natural progesterone production by signaling the corpus luteum (the mass of cells that remains in the ovary after ovulation) to continue to release progesterone, which causes a woman to miss her menstrual period. Production of HCG increases steadily, doubling about every 48-72 hours, during the first 10 weeks of a healthy pregnancy.
There isn’t a single “normal” hCG level for every woman in early pregnancy and there is a very wide range of hCG values as pregnancy progresses. I can not know what exactly caused this drop in progesterone or HCG levels for you.
I wish you well and send positive energy!