Are progesterone creams safe?

Complications with progesterone creams, and how to raise progesterone naturally.

Have you heard the buzz about progesterone creams? Promoted by alternative health researchers, like Ray Peat, and doctors like Dr. John Lee, progesterone creams purportedly offer the be-all-end-all relief for hormonal problems like PMS, infertility and menopausal symptoms. Is progesterone cream safe and does it live up to the claims?

Progesterone: The Powerhouse Hormone

I’ve heard progesterone called the “sexy hormone.” Progesterone is an antagonist to estrogen, a hormone that can fly out of control due to a poor diet, stress and toxins in our life. This common scenario is called estrogen dominance. Progesterone helps to combat the unpleasant symptoms of estrogen dominance.

Some of the roles of estrogen and progesterone (read more at East West Healing):

Progesterone

  • Stimulates fat-burning
  • Facilitates thyroid
  • Helps prevent breast cancer
  • Reduces bloating
  • Protects against fibroids in breasts
  • Supports blood sugar balance

Estrogen (in excess)

  • Increases fat storage
  • Impairs thyroid function
  • Causes breast tenderness
  • Leads to endometriosis
  • Increases risk of breast cancer
  • Creates bloating

Progesterone Creams and Bioidentical Hormones

First, let’s make the distinction between hormone replacement therapy (HRT) and bioidentical hormone replacement therapy (BHRT). The difference is whether the hormone is molecularly identical to that produced by the human body. For example, the estrogen extracted from the urine of pregnant mares (Premarin), commonly prescribed in HRT, contains types of estrogen that are not known to the human body. Premarin has been shown to cause colon cancer, stroke, and blood clots.

Bioidentical hormones are molecularly identical to human hormones and natural hormones are made from naturally occurring plant sterols. These hormones are manufactured in a laboratory and purportedly behave exactly like the correlating hormone your body produces naturally. We cannot forget, however, that the endocrine system cannot be simplified into molecular equations. The human body is infinitely complex: every system, cell and atom in the body is inextricably tied to other physical and emotional aspects of the body. In my opinion, a hormone produced in the lab is absolutely not the same as a hormone produced by the body.

This post relates to bioidentical, natural progesterone creams.

Why do progesterone creams work?

Now that we know the qualities of progesterone, it makes sense that taking progesterone into the body ameliorates so many symptoms. Here’s a quick summary of how progesterone creams work:

  1. We have hormonal issues (PMS, endometriosis, menopausal symptoms, etc) because a. we aren’t making enough progesterone, b. we have too much estrogen in our system, c. are cells aren’t responding to progesterone, or d. a combination of any of these.
  2. Progesterone creams are absorbed through the skin and deliver progesterone to our cell receptors. In many cases, this sudden influx of progesterone jolts any desensitized progesterone receptors. The increased progesterone ameliorates many symptoms.
  3. Over time, the dose of progesterone often looses its efficacy because the cell receptors are becoming resistant and the dose of the hormone must be increase to again “jolt” the receptors.
  4. Symptoms may be managed, but are the underlying issues really addressed?

Here’s why I encourage careful thought before using progesterone creams:

1. Progesterone creams only treat a symptom, not the cause

If you are a frequenter of my blog, then you probably support the philosophy that, in order to reach optimal wellness, we must address the root cause and not just the symptom. This is news for many people because we are brainwashed by mainstream medicine and the media to just look at symptoms. For example, constipation. “Just take some phylum husk,” you’ll be told. But constipation is only a symptom of poor digestion and poor diet.

In the same way, dolling out progesterone cream is a band-aid for a symptom. Hormonal problems are a symptom and not the foundational health issues! So where do hormonal issues like PMS and menopause originate? Diet, digestion, toxic burden and lifestyle. Therefore, it makes the most sense to focus on correcting diet, digestions, toxic burden and lifestyle.

2. Chaos with the negative-feedback loop

Perhaps you remember the idea of negative feedback from your high school biology. Maybe you don”t (that’s okay!). As a refresher, most of the hormones in the body are governed by negative feedback, which works like your household thermostat. Say you set your thermostat to 72 degrees and the room temperature is 69 degrees. The heater kicks in to warm the room up.  When the temperature reaches 72 degrees, the heat shuts off until the temperature drops again.

Administering hormones can actually shut off our body’s hormonal negative feedback loop. It’s like heating a room by a space heater and the furnace shuts off because it isn’t needed. That means taking progesterone creams can cause reliance on the product because the body is too confused to monitor hormone production when we have hormones coming into our body.

3. Perceived deficiency in the state of excess

Progesterone cream can cause progesterone resistance due to the concept of “deficiency in the state of excess.” When there is excess of any hormone, cells can get immune to it. The hormone is bombarding the cell receptor for that hormone and so the cell receptor shuts its door. Then, the body senses a deficiency of the hormone and orders the release of more of that hormone… which just exacerbates the vicious cycle of hormonal resistance. A common example to illustrate this phenomena is the case of insulin resistance. The pancreas pump out too much insulin and the cells shut down their response to this hormone.

4. Progesterone creams are often used without professional assistance

Dietary, lifestyle, and supplementation changes are potent solutions for hormonal issues and can be utilized (in many cases) without a professional’s help. These changes support the adrenals, lower chronic cortisol and give the body tools to produce and utilize progesterone… addressing the whole system.

The dosing of progesterone creams should be precisely regulated and customized for the individual. Dr. John Lee, a pioneer in the use of progesterone creams, explains the obstacles in determining the dose of hormone therapy:

“As might be expected, we have learned that hormone levels differ between individuals; what is normal for one person is not necessarily normal for another. Further, one must be aware that hormones work within a complex network of other hormones and metabolic mediators, something like different musicians in an orchestra. To interpret a hormone’s level, one must consider not only its absolute level but also its relative ratios with other hormones that include not only estradiol, progesterone and testosterone, but cortisol and thyroid as well. (Source)”

Unfortunately, progesterone creams are frequently used without the guidance of an experienced professional who can take the proper tests and adjust the dosage accordingly. This can cause or exacerbate the previous issues I discussed.

How to raise progesterone naturally

So, are progesterone creams bad? I think that there are certain cases when progesterone cream, under the guidance of an experience professional, can be useful and beneficial. But casual use of progesterone cream carries a host of potential problems.

A more holistic alternative to progesterone creams is to raise progesterone levels naturally. This ensures that we are addressing the root cause so it provides a potent and long-term solution. Raising progesterone naturally requires a dietary, supplemental and lifestyle approach. I discuss this all in detail in my book Quit PMS: End Your Menstrual Misery.

Have you used progesterone creams? Do you struggle with progesterone/estrogen balance?

Some of the ads on this site are served by AdChoices and, as a result, I do not necessarily recommend the advertised products. The revenue from the ads makes it possible for me to continue blogging, so I appreciate your understanding.

Comments

  1. says

    This is so good to know! I definitely deal with hormone imbalance and perfectly fit the definition of someone with estrogen dominance. The root cause is a toughie but I’ve been reading your book, and it’s been helping me a ton in taking the right steps to healing my hormones!

  2. Stephanie says

    I began seeing my holistic counselor as a result of severe anxiety. I showed signs of adrenal fatigue as well. We did a full detox and a 60-day elimination diet. I have eliminated gluten and other allergens, and increased supplements to offset my deficiencies (such as low Vit D).

    I have been using the cream now, not a synthetic, under the watchful eye of my holisitic counselor and a partner RN for 3 months; however before using it I had my labs run (doing a 4-cycle saliva test) which showed I was low progesterone and as a result estrogen dominant. I have a short cycle, so I only use a very small dab daily, the second half of my cycle, as prescribed.

    I agree- it should be done under a medical professional and not simply picked up at a drugstore (which might I add are highly synthetic and are loaded with chemicals and additives).

    I have seen a slight improvement, but I would not go as far as saying it is a miracle. I feel that it is one small spoke on the wheel of my wellness program.

    • says

      Thanks for sharing your experience! You bring up great points, like it is only a small part of a wellness protocol. Diet, like an elimination diet, can be a great place to start!

  3. k says

    i use bioidentical hormones under the supervision of my really wonderful DO. he is very careful to measure all the hormone levels and keep track of everything. when i first started, some of my deficiencies were pretty pronounced. i am now able to cut back or eliminate some of the things. i feel MUCH better, and would definitely recommend finding someone to test your hormone levels and help you through the process of healing-by way of BHRT, diet and/or herbal means. i had severe fatigue, migraines, and mild depression during cycles, and i have had a huge upsurge in energy and mood with all the changes made with food, vitamins, etc.

  4. Sherry says

    After having a hysterectomy I have been using BHRT (including progesterone) for 6 years under the guidance of a doctor. It changed my quality of life so severely that I cannot sing its praises enough! All my hormones as well as vitamin, mineral and other blood levels were checked prior to beginning BHRT. This along with necessary dietary changes and specific supplementation have helped to improve all my measured levels significantly.

    I do have to say that not all BHRT creams are the same though. I found that when changing pharmacies some creams were not properly absorbed into my body and even though I used the creams my levels dropped below what they were when I started. So I have to say that one needs to knpw their body and if they are not getting enough improvement on a specific cream, they may need to get their levels retested and possibly have a different base cream used in the rx.

    If you are looking for a quality professional to help with hormone creams you could check out .a4m.com/directory.html. That is where I went to find someone close to me.

    • k says

      i agree with the fact that all BHRT preparations are not the same. finding a dr. to properly test you is important, but so is finding a compounding pharmacy that knows what they are doing!! luckily, where i live there is a choice, and for me, it took 3 tries to find the right place.

  5. says

    I have used BHRT in the past w/ an over the counter progesterone cream. Within a week of starting it, I felt differently. My first period was like none other: no sore breasts, no heavy bleeding, very mild cramping, and less bloating that my normal periods before. I also experienced some weight loss. After using the cream for a few months, I got lazy (because of a move and major home remodel) and stopped using it. Just yesterday, I bought another bottle of it and have started again. My naturopath has trained me to use applied kinesiology on myself, and after testing myself, I determined that the reason for my weight gain in the past 10 months (how long I’ve been off the cream), tender breasts, and cramping during my periods are all because I stopped using the cream.

    I eat a VERY nourishing diet (stopped drinking sodas and eating refined sugars YEARS ago, eat pastured eggs, raw milk, don’t drink coffee, don’t eat gluten), and my hormonal issues HAVE NOT fixed themselves. I am buying the e-book bundle now and am willing to try anything if it means fixing the underlying cause of my hormonal imbalances. I am also hypothyroid and have suffered adrenal exhaustion, constipation, and most recently parasites. All this WHILE eating a NT-type diet. Any ideas on why?

  6. amber says

    I understand the concerns about using hormones and upsetting the bio-feed back. I appreciate that you mention casual use and advocate a good doctor. I also get nervous reading this that some who DO need replacement hormones might not get the help they need because they read this. So glad that you point out that people need to treat the underlying issues. But for some of us, even on the special diets and supplements, the damage has been done and I sincerely hope no one feels less because they need this treatment or that their doctor is completely uninformed by suggesting it.

    • says

      What a great point. I believe diet/supplements/lifestyle should be the first step, but if there isn’t enough progress (or if too much damage has been done, as you put it) then supervised progesterone cream use is extremely helpful!

  7. says

    Lauren,
    I bought the e-book bundle specifically for your book, Quit PMS, and for the book The Sleep Solution. I made the Salted Cinnamon Ice Cream last night, and it was DIVINE! I’m not even an ice cream person, and I could have eaten 5 bowls! Thankfully, I doubled the recipe so we still have plenty.

    Along the lines of my first comment, I’ve been having major hormonal issues ever since a traumatic event occurred in my life a little over two years ago. You can read about what I’ve experienced in my body here: http://todayindietzville.blogspot.com/2012/03/what-ive-been-avoiding.html

    Anyway, I was just wondering if you’d be willing to e-mail me? I’m not asking for medical advice, but I’m at the point where I feel like I’ve done everything, and I’m still having trouble sleeping, gaining belly fat, PMS symptoms, lump in my throat. Maybe you could offer me some insight on something I haven’t yet tried? My e-mail is lindseyryon (at) gmail (.) com. I’d really, really appreciate it!

    Thanks again for that fab book, too! I’ll be eating Salted Cinnamon Ice Cream til the cows come home!

  8. Jess says

    Speaking of progesterone…I think few people on primal/natural/etc. diets realize that dairy products (especially high-fat ones) are the richest food sources of progesterone. I realized this from reading a scientific study on steroid hormones in common foods…the researchers found that dairy products (especially butter) has way more progesterone than all other foods tested…even conventional beef & pork products! This is because pregnant cows naturally have high progesterone in their blood…and it readily passes into milk & is fat-soluble. I’ve read that dairy farmers even test the high progesterone levels in milk to determine whether a cow is pregnant. Butter has 133-300 ug/kg progesterone, as compared to steer fat (from castrated male cows—obviously non-pregnant/lactating) which has only 4.5 ug/kg progesterone. So as part of my paleo diet I’m trying to eat more grass-fed beef suet/tallow instead of butter (even though I love the taste of butter/dairy…I wonder if the bacteria in cultured butter helps to degrade some of the progesterone? I wish there was a study about that.) And on the reverse side, eating lots of veggies (especially leafy & cruciferous) helps balance estrogen levels.

    • Jess says

      Another thing to keep in mind…animals that are consistently milked are consistently impregnated, to keep up milk production (and progesterone is a natural side-effect). Poor conventional dairy cows have a relatively short time between pregnancies. Whereas hunter-gatherers eat a lot of male animals too & non-pregnant female animals…and only occasionally consume pregnant/lactating animals…and some cultures even have taboos against eating pregnant animals! So I think progesterone should optimally be quite low in our diets…as delicious as butter is ;-)

  9. Marisa Ruffolo says

    I’m not sure if you still look at the comments from this post as it goes back to September 2013, but I’ve been reading through all your blog and learning so much.

    My daughter (19 yo) and I both have PCOS (polycystic ovarian syndrome), and hers is much more severe than mine. She doesn’t produce any progesterone on her own at all, while I have very low progesterone (as well as other symptoms of PCOS, like high testosterone levels). Anyway, my husband and I scraped together the money to go see a naturopathic doctor and he has put us both on a very low dose of the bio-identical progesterone cream. Also, we are on a pill that has amino acids and other herbs like saw palmetto that our doctor tells us will help our livers process the extra estrogen in our bodies.

    I’m trying to save up the money to buy your ebook–seeing this doctor has pretty much drained us–the saliva test for me was over $200, plus the cost of all the supplements, etc. Back in July I had to quit my job because I was severely exhausted; turns out I have adrenal fatigue; but on top of that, I am also iron deficient, although not anemic.

    Everything you suggest makes so much sense; however, finances being what they are for us, there is no way we could afford to buy organic herbs and spices (don’t know about America, but they cost a fortune here in Ontario, Canada). We can’t even find grass-fed butter anywhere. We can’t even afford to buy an organic chicken to make the bone broth with.

    Clearly, it’s much better to eat completely organic, etc. However, for those of us who can’t, maybe you could do an article on what are the most important things to buy organic, and what we can get away without buying organic. It’s true, everyone says how important health is, and I don’t deny it, but there simply is NO money to get these things with. It’s not like we have a savings account or we go on vacation every year, or whatever. We just don’t have the means right now. I’m sure there are lots of people in the same position as us.

    Is there any way you could suggest what you would feel is most important for my daughter and I? Perhaps we’re better off putting our money into this supplement or food instead of that one, if you know what I mean. Could you give us some guidance? I would appreciate it more than you know. As you can imagine, I’m exhausted most of the time, and don’t even know how to think straight, lately.

    Thanks so much.

  10. belle says

    Hi Lauren, i have subserous fibroids , what do you recommend? please they told me they had to remove them with surgery

  11. emjay says

    Great post, thank you. I have a question: If one stops using progesterone cream will the feedback loop right itself or is there a chance it will break down all together? I have been on P. cream for a year after having a test that showed I had very low levels of progesterone, Dhea, and high levels of cortisol. Now my levels are better (and my lifestyle is also healthier) but estrogen and testosterone are rising. I want to stop the cream – is this going to be problematic?

    • says

      The feedback loop will usually right itself with the proper nutritional and supplemental support, so that’s why I would only recommend stopping/starting/changing progesterone cream under the guidance of a nutritional therapist, naturopath or another holistic healthcare provider.

  12. Debbie says

    I was interested in using BHRT but find that the cost (without health insurance help) is much too high for me to afford. I’ve read Dr. Lee’s books, along with Dr. Christina Northrups books, which give information about the right kind of progesterone and estridol creams to buy, so could I administer these products myself without the help of a BHRT doctor?
    I live in southern California and found a few local BHRT doctors who charge $250 for the first 1 hour consultation, $75 for every additional appointments, which would be every 3 and/or 6 months after initial appointment. They take the blood and/or saliva tests, and distribute the creams, etc. (not sure how much these will cost yet) that I’ll need to purchase with them.
    Is there any other options for me?

  13. Emily says

    Hey Lauren,

    I’m curious about your thoughts on wild yam cream. I used diet, lifestyle change and lunaception to correct my hormone imbalance from coming off of the BCP and it worked! I started tracking my cycle using the Fertility Awareness method and recognized signs still of progesterone deficiency (40 day long cycles, short luteal phase, zig zagging temperatures around ovulation. I read Alissa Vitti’s book Women Code and she recommends it but I want to know what you think.

  14. Heather says

    I bought this cream for my mom who is suffering very bad with menopause insomnia. Never in her life has she had insomnia until menopause hit. She sleeps for 2-3 hours and wakes up and can’t fall asleep again. I am desperately trying to help her find a solution. Because it is related totally to the menopause I figured progesterone was the answer. Then I read it could lead to cancer, stroke, etc :(
    Does anyone else have ideas?

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