Settling the concern over progesterone cream

There are many options, and much confusion, about hormone therapies.  There is a lot of fear about taking any form of hormones, after the Women’s Health Initiative study ended abruptly due to increased risks of blood clots and breast cancer that were becoming apparent.

My first recommendation is always to start with diet and lifestyle adjustments.  So much can be accomplished with these often overlooked interventions.  Because they seem so simple, they are easily ignored.  

There are several natural ways to create balance in your hormones.  The most important factor in all of these is consistency.  Using natural means of relief can not be expected to be a quick fix.  Although, it doesn’t require 100% adherence.  But, with a reasonable degree of diligence, you can expect to see benefits after a week or two.

Give these changes a try:

1.  Increase your intake of fiber, which will bind with excess estrogen and you will more rapidly excrete it.

2.  Stress reduction techniques.  This helps relieve the estrogen dominance that is brought on by the release of cortisol by the adrenals during stress.

3.  Exercise.  Although excessively strenuous exercise can actually decrease progesterone levels, low and moderate levels of exercise are effective in creating hormonal equilibrium.  

According to a study published by Cancer, Epidemiology, Biomarkers and Prevention, moderate exercise was shown to positively change the way that estrogen is metabolized.  Their findings show that, in addition to the other many benefits of regular moderate movement, exercise possibly reduces the risk of breast cancer.  This due to the increase in “good” estrogen, and decrease in “bad” estrogen.   

4.  Limit sugar and refined carbohydrates. Eating these foods increases estrogen as a result of the spike in insulin released in the bloodstream.

5.  Herbs and supplements.  I will refer you to The Wisdom of Menopause, by Dr Christiane Northrup for specific recommendations.  This book is a classic, having been updated and reprinted multiple times.  It is a great reference to have during this stage of life.  It is Dr Northrup discusses complementary and alternative therapies to support menopause health.  


As every woman responds differently to these practices, I encourage you to be patient and flexible when you attempt these treatments.  You may need to try several different modalities or combinations before finding the one that suits you.


That all being said, I hear these questions about progesterone so often, that I did some research to find out if there is any benefit to the progesterone creams one can obtain over the counter.  What I found is encouraging for many women who have serious menopausal issues.

First, some basics.

Unlike what most women believe, the first signs of perimenopause result from a low progesterone level, not low estrogen.  As ovulation decreases, so goes the progesterone.  Therefore, the closer a woman is to menopause the lower her progesterone level becomes.  However, later in perimenopause estrogen decreases as well.

You see, progesterone is meant to always be in balance with estrogen.  In fact, in The Hormone Survival Guide for Perimenopause Nisha Jackson, Ph.D. states that one of progesterone’s most important jobs is to prevent excess estrogen.

With the initial decline of progesterone, estrogen attempts to compensate by increasing.  So, you are actually faced with estrogen dominance, as Dr John Lee refers to this phenomenon.

This results in many of the symptoms of an uncomfortable menopause, including:
Heavy periods
missed periods
weight gain
mood swings

Progesterone has a profound effect on mood.  In fact, low levels have been blamed for PMS as well as postpartum depression.  

With your doctor’s help, and proper testing, when symptoms persist progesterone cream is an option.

Prior to experimenting with progesterone cream, Dr Christiane Northrup recommends having your doctor take a blood sample to test hormone levels.  Because of the instability of estrogen and progesterone during perimenopause, it may be necessary to take two separate samples to compare. 

If you are still fairly regular, you may check the levels one week before your anticipated period, or 18 to 21 days after the first day of your last period.

By checking your hormones first, you can rule out illnesses that convincingly mimic perimenopause, and prevent the delay of their treatment.

Dr Northrup cautions against the use of synthetic progesterone, which can cause or worsen symptoms.  She also reports that the use of wild yam, a common and easily obtained supplement, is ineffective as it only provides the inactive precursor of progesterone.

The over the counter 2% natural progesterone creams available can often provide all the hormone replacement that is necessary to relieve symptoms.  There are also more concentrated dosages available by prescription.  It is recommended that the creams not be used continuously throughout the month.  

Nisha Jackson recommends 2 protocols.  You can discuss which is appropriate for you with your doctor.

a.  Apply from day 14 of your cycle until the next cycle begins.  You can even adjust this to a shorter period up to just the last 2 to 3 days of your cycle.

b.  With more severe perimenopausal discomfort, or the absence of menses, you may apply daily, taking a 5 to 7 day break monthly.

One effect of higher progesterone is drowsiness, so if taking twice daily, ask your doctor if a smaller morning dose is appropriate.

Please let me emphasis, you should seek the guidance of your doctor when attempting to balance your hormones.  The same is true for using herbs or supplements.  Although many doctors are unfamiliar with complementary therapies, they will certainly be able to advise about how they can adversely effect your specific health conditions, or interact with any medication you are taking.

I hope to have cleared up some of the confusion around progesterone.  Please comment below if you have any questions.

I would be honored if you found this to be useful, and would share it with your friends.  By being informed, we can better advocate for our own health.