Progesterone is a steroid hormone made by a woman's ovaries when she ovulates and in smaller amounts by the adrenal gland. A menstruating woman will typically produce about 20 to 30 mg of progesterone a day during the luteal or last phase of her menstrual cycle.

While menopause doesn't typically occur until age 50 or later, many women can start going out of balance in their 30s or even earlier. This decline in progesterone is not trivial for as women age into their fourth, fifth, and sixth decade, their progesterone levels continue to fall.  By the time they reach peri-menopause as much as 75% or more of their youthful progesterone secretion may already be missing.

Estrogen Dominance
Many if not most women in our culture are estrogen dominant. Some of the reasons that estrogen is frequently in excess in many women are:

  1. Overproduction of estrogen.
    Ovarian cysts or tumors can lead to excess estrogen production. Stress also increases production, but probably the most common cause is obesity. All body fat has an enzyme which converts adrenal steroids to estrogen, so the more fat you have, the more estrogen is present.
  2. Inability to breakdown estrogen.
    Excess estrogen is generally removed by the liver.  Diseases of the liver like cirrhosis or decreased enzyme activity can lead to increased estrogen levels. Vitamin B6 and magnesium are necessary for the liver to neutralize estrogen. Increased sugar intake will also excrete magnesium and interfere with its ability to breakdown estrogen.
  3. Exposure to pesticides in foods.
    Most of us eat foods that have pesticides on them. These and many other unnatural chemicals share a common structure with estrogen and serve as "false" estrogens which further stimulates the body's estrogen receptors.
  4. Estrogen supplementation.
    Clearly any additional estrogen given by prescription will increase the level unless it is properly balanced with natural progesterone. To minimize your risk of cancer never take any supplemental estrogen without taking natural progesterone (see description below).  Taking synthetic versions like Provera will actually increase your risk of cancers and heart disease.
  5. Decreased production of progesterone.
    Progesterone is necessary to counterbalance estrogen. If women do not ovulate during their cycle they will not produce any progesterone that cycle. This happens commonly and worsens the already disturbed progesterone/estrogen balance. Decreased progesterone levels are one of the most common reasons for miscarriages.

Progesterone Balances Estrogen
Progesterone can offset the effects of estrogen when it is in proper balance: it is a natural diuretic, it helps use fat as energy and keep it off the hips, it facilitates proper thyroid function, it increases bone building, increases libido, is a natural mood elevator, and much more.


Natural Progesterone
Natural progesterone is very useful to balance excess estrogen, which can be a major risk for breast cancer.  Natural progesterone is also different from estrogen in that your body can use it as a precursor or starting material to make other hormones such as adrenal hormones. It can even convert it into estrogen or testosterone if your body needs it.

Supplemental progesterone cream is sold without prescription. Natural progesterone is made from a substance called diosgenin - commonly extracted from wild yams or soybeans.  (Even though it may be extracted from soy, this highly purified hormone has no remnants of soy substances.) Natural progesterone is identical to the progesterone produced in our body.

Synthetic and prescription-only progesterone, e.g. Provera, is NOT a natural progesterone and can produce severe side effects including increased risk of cancer, abnormal menstrual flow, fluid retention, nausea, depression increased risk of heart disease and stroke.

Side effects are extremely rare with natural progesterone. The only one of concern is that it can potentially alter the timing of your menstrual cycle.

Two Ways to Supplement with Natural Progesterone – Apply directly to skin or to mucous membrane.

The common way to apply progesterone creams has been to the soft tissues of the body like the abdomen, the inside of the arms or thighs, or any soft and hairless area.   The application site must be varied as any site will tend to “load up” on progesterone and absorption will be decrease.   Some physicians now believe that this tendency of progesterone to accumulate in the skin makes this a less desirable form of application.  

A new way to apply progesterone as espoused by Jonathan Wright, M.D.1 is directly to mucous membranes (excluding the mouth).    Be sure the brand of progesterone cream you are using is appropriate for mucous membrane application.    
If you apply the cream to your mucous epithelial membranes that line your uterus and vagina you obtain a virtually ideal administration system. Not only is absorption through these membranes more complete than through your skin, but hormones absorbed through your vaginal membranes enter the very same pelvic plexus of veins that your ovaries normally empty into.  From here the hormones are carried to your heart and lungs and distributed to your tissues just as if your ovary had actually produced them.

Hormones carefully measured and formulated in an appropriate cream or gel need only be rubbed once or twice a day into your mucous (epithelial) membranes.

Timing and Dose of Progesterone Cream
For most pre-menopausal women the usual dose is 15-24 mg/day for 14 days before expected menses, stopping the day or so before menses.  So you would use the cream for twelve days and then stop. Typically this would mean you would start on day 12 of your cycle and stop on day 26.

The abrupt lowering of your progesterone level is the primary stimulus for your period to start.  Hopefully when it starts any PMS and painful periods will be dramatically reduced.
When a woman is in menopause she may only need 15 mg but taken for the first 25 days of the month, then take 5 or 6 days off and restart on the first of the month.

For most women a single daily application will work. However, because the half-life is relatively short, some women find that they get a more satisfactory response by splitting the daily dose in two, half in the morning and half in the evening. If you are only taking the hormones in the morning and begin to feel symptoms later in the day, splitting the dose in two should solve this problem.2   

1To learn more about bio-identical hormones we suggest the new book by Dr. Jonathan Wright (M.D.), Stay Young and Sexy with Bio-Identical Hormone Replacement.

2 Mercola, Joseph M, DO.  Stay Young and Sexy With This Ingedient that Reduces PMS.  September 18, 2011.