Frequently Asked Questions

What is natural progesterone?

Natural progesterone comes from plant sterols. The most common source today is the Wild Mexican yam.. It is processed to match the chemical composition of our body’s own progesterone, in other words “bio-identical”. The natural progesterone is micronized and therefore capable of passing through the skin into the blood stream. Synthetic progesterone is called progestin and is manufactured by pharmaceutical companies. Products that contain Wild Yam extract alone without micronized progesterone are not natural progesterone.

Who may benefit from natural progesterone?

Those who may benefit from the use of natural progesterone are women with:

  • PMS symptoms
  • Perimenopausal symptoms
  • Estrogen Dominance symptoms
  • Menopausal symptoms
  • Osteoporosis

How does natural progesterone help?

During peri-menopausal or menopausal stages, monthly cycles occur wherein women do not ovulate. Without ovulation, the ovaries do not produce progesterone. Progesterone levels get lower, while estrogen levels may stay the same. This fluctuation in hormone levels may result in hot flashing, night sweats, insomnia, changes in bleeding patterns and other menopausal symptoms. Adding progesterone can help restore the bodies balance and alleviate symptoms.

What do I look for in a natural progesterone creme? How much should I use?

Look for a crème that contains 1000 mg micronized USP progesterone per 2oz jar. This supplies 20 mg of USP Progesterone per 1/4 tsp. Using a 1/4 tsp. twice daily results in a total dosage of 40mg. per day which is more than adequate for most women. Women with severe symptoms can use more until symptoms subside.

How do I use natural progesterone?

The general instructions are to massage 1/4 tsp. into your skin twice daily. Apply to inner arms, wrist, palms of hands, face, or neck. These areas are most absorbable and the progesterone absorbs through the skin in one to two minutes. See “Instructions for Use” below for more specific directions for specific issues: Menstruating women, Non-Menstruating, Irregular Cycles, and Weaning off Synthetics.

How soon can I see results?

Depending upon your individual body, your experience may not be the same as the next person’s. Some notice immediate results, while others take days for it to work into their system. Still, it may take up to 3 months to notice maximum benefits. Don’t give up! Since it is a natural substance, it may take longer for the body to respond than a powerful synthetic.

How are natural hormones different from synthetic hormones?

Synthetic hormones are made from substances that are not natural in the human body. For example, Premarin is made from a pregnant mare’s urine. It is important to note that a study on synthetics by Women’s Health Initiative of the National Institute of Health was prematurely halted due to deleterious long-term effects on women’s health, specifically breast cancer, blood clots, and stroke. Natural hormones are bio-identical to the body’s own hormone molecules.

What symptoms can be alleviated by natural progesterone?

There are 35 symptoms of hormone imbalance that can be helped. Hot flashes, night sweats, insomnia, weight gain or “muffin top”, fuzzy thinking, feeling depressed or anxious and hair loss are among the most common. You will be surprised at some of the others, including itchy crawly skin and brittle nails. Email us for the full list! barbara@askbarbarahoffman.com There are also many medical conditions that can be helpe such as fibrocystic breasts, ovarian cysts, uterine fibroids, endometriosis, and osteoporosis.

How safe is natural progesterone?

The safety of natural progesterone is well established. A pregnant woman may make up to 300 mg of progesterone per day, so obviously it is not harmful to a developing fetus. Excessive use may cause drowsiness, but this would involve using large amounts known as mega-doses.

Why is transdermal absorption so good? Can’t I take a pill?

Natural hormones are small, fat soluble molecules which are easily absorbed through the skin. They pass into the subcutaneous fat layers, then into the blood stream in one to two minutes. Progesterone in a pill goes directly to the liver and about 20% is absorbed. Thus it is necessary to take 100 mg of progesterone in a pill form to get approximately 20 mg into your cells. You need 200 mg to get 40 bio-available mg. Women complain of feeling bloated, constipated, and/or drowsy.

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Specific Instructions for Use:

Menstruating Women

The first day of bleeding or menses is Day 1. Start the crème on Day 12 and continue through Day 26.

Irregular Cycles

If you have just had a cycle, use the crème from day 12-26 of your cycle. Then stop. If your period does not come within a week, consider the last day you took the progesterone as day one of a new cycle. Then begin on day 12 again.

If periods stop for 3 consecutive months, begin to use the crème for 25 days of each month.

Non-Menstruating Women

Use the crème for 25 days per month. Take 2-5 days off to allow receptor sites to remain active.

How can I wean off synthetic hormones onto natural progesterone?

According to physicians who use natural progesterone in their practices, the instructions are as follows:

1st Month: Use crème as directed. Take synthetic estrogen pill every other day or cut estrogen patch in half.

2nd Month: Use crème as directed. Take synthetic estrogen pill every third day or cut estrogen patch in quarters

3rd Month: Use crème as directed. Take synthetic estrogen pill every fourth day. If using the patch, go totally off it.

4th Month: Use crème as directed. Off all synthetic hormones.

While weaning do not take breaks in using the crème.

I have had breast cancer. Can I use natural progesterone?

Yes. According to Dr. John Lee, it is a good choice, because excess estrogen is thought to be a major contributing cause to increasing numbers of breast cancers in the U.S. Progesterone balances estrogen levels in the body. Several studies have revealed important mechanisms by which natural progesterone may play a role in preventing breast cancer or its reoccurrence. However, you must consult with your doctor to be sure he will agree with you.

Why do I have so much insomnia?

Insomnia in women over 40 is usually associated with hormonal changes of peri-menopause and menopause. Often there is too much estrogen relative to progesterone in the body. Remember estrogen is a central nervous system stimulant and progesterone has a calming effect on the brain. Some women experience excellent results when they rub 1/4 to 1/2 tsp. on the back of their necks for their evening dose.

I am Post-menopausal, Will I start menstruating again if I use natural progesterone?

Occasionally, some women will experience some break-through bleeding when they begin to use natural progesterone. This is rare itself, but it does happen. The progesterone can cause the body to rid itself of excess estrogen that is stored in the endometrium, which leads to uterine shedding. This is temporary and should stop after 3 months. Any bleeding that persists should be reported to your doctor.

I have facial hair, especially in the upper lip area.

Excessive growth of facial and body hair is called hirsutism and can be indicative of hormonal imbalance between estrogen, testosterone and progesterone. Natural progesterone may help this condition. Many women report facial hair decreases or disappears after 4 to 6 months of progesterone use, often rubbing some directly on the hair.

Can natural progesterone help with “fuzzy thinking”?

This is a very common complaint. Hormonal imbalance is a primary cause of short-term memory loss or “fuzzy thinking”. Progesterone has been found to be highly concentrated in the brain cells. The mechanism is not known, but it is suggested that it serves an important purpose. Many women report clearer thinking within 3-4 weeks.

Can I use natural progesterone if I have Osteoporosis?

Dr. John Lee who studied the effect of progesterone on osteoporosis concluded that progesterone may help build new bone by stimulating osteoblastic activity.

Can natural progesterone help Polycystic Ovarian Syndrome?

Natural progesterone can be utilized to treat PCOS as it suppresses the luteinizing hormone and therefore ovarian cysts are not stimulated. In many women, cysts may then shrink with the passage of several menstrual cycles. Barbara has 3 PCOS videos on her YouTube Channel, Hope For Your Hormones, that explain the mechanism and also offer other aids to combat PCOS.

Can natural progesterone help with fibrocystic breasts?

One common factor in women with fibrocystic breasts has been found to be higher circulating estrogen. In many women, fibrocystic breasts respond well to progesterone therapy in about three to four months. Natural progesterone may be rubbed directly on the breasts.

Will natural progesterone help uterine fibroids?

Estrogen dominance can result in uterine fibroids. Fibroids are non cancerous lumps that grow in the uterus. Estrogen stimulates their growth & the lack of estrogen causes them to atrophy. Studies have shown that when sufficient natural progesterone is replaced, fibroid tumors may no longer grow in size and often decrease. Protocol for using natural progesterone is from day 8 through day 26 of the menstrual cycle.

What causes PMS (Pre-Menstrual Syndrome)

PMS is a disorder characterized by a set of hormonal changes that trigger disruptive symptoms in women for up to 2 weeks before menstruation, generally a lack of progesterone in relation to estrogen. Symptoms may be both physical and emotional. They may also vary month to month. Symptoms include: headaches, migraine, weight gain, anxiety, depression, tension, mood swings, cramps and low libido. Many women have noticed significant improvement when they use natural progesterone from day 12-26 of their cycle. Often within 1-3 months.

Can natural progesterone help with my hot flashes?

A study found that 83% of women had a decrease in frequency and/or severity of their hot flashes while using natural progesterone. Studies have also indicated that progesterone can eliminate up to 75% of all hot flashes in many women.

How else can I fight these hot flashes?

Vitamin E has a long history of reported benefit in women experiencing hot flashes. When actually having a hot flash, many women report that applying 1/8 to 1/4 tsp of creme every 15 minutes for 1 hour during and following the episode is very helpful. We have a hot flash hand-out with other supplements and tips. Email us: barbara@askbarbarahoffman.com or watch our hot flash videos on the YouTube Channel, Hope For Your Hormones.

Will natural progesterone help endometriosis?

In What Your Doctor May Not Tell You About Pre-Menopause, by Dr. John R. Lee, he states that he has treated many endometriosis patients with natural progesterone and observed considerable success. This is because excess estrogen can cause proliferation of the endometrial cells that grow outside the uterus, which is an extremely painful condition. His recommendation: use 1 oz of natural progesterone from day 6 of the cycle per week for 3 weeks. Often, over 4 to 6 months the pain gradually subsides as healing of the inflammatory sites occurs.

How will I know if I’m using too much natural progesterone?

If you are using too much, you may feel drowsy. As progesterone causes a calming effect, in excessive amounts it may cause drowsiness. Some women notice abdominal bloating. Simply cut back on your dosage. Natural progesterone usually increases energy, you should feel energetic, not lethargic.

What is Phyto-Estrogen?

“Phyto” means plant. A source of Phyto-Estrogen is Red Clover. Red Clover may help elevate and balance moods, improve sleeping patterns, reduce menopausal symptoms such as hot flashing, improve libido, support cardiovascular health and promote maintenance of bone mass. Red clover contains four main isoflavones: Genistein, diadzein, biochanin and formononetin. Isoflavones cause weak estrogenic activity and thus can safely alleviate menopausal symptoms.

I have had a hysterectomy, but still have my ovaries. Should I still use natural progesterone?

Following hysterectomy, the blood supply to the ovaries is significantly reduced and therefore so is their ability to produce progesterone. Within 2-5 years of the hysterectomy, production usually falls to postmenopausal levels. Supplementation can help you avoid severe menopausal symptoms.

Is Progestin the same thing as progesterone?

No. Progesterone refers to the hormone produced in the body or from a plant source, but chemically identical to human progesterone. It is bio-identical In contrast, Progestin is a synthetic progesterone that differs in structure to the body’s own progesterone. The body does not know exactly what to do with it and harmful metabolites can be released into the sensitive areas like ovaries and breasts.

If I do not have the symptoms of PMS or menopause, do I need natural progesterone?

If you do not have any symptoms, you still get benefits from using natural progesterone. Three main benefits include: hormone balance, protection against breast cancer, stroke, lowering of triglycerides, more youthful skin, better memory, better sleep, normalization of weight and new bone growth.

What exactly is menopause? If I am still having periods, am I actually in menopause?

No, Menopause is the point at which you are have gone twelve (12) consecutive months without a menstrual period. The average age of menopause is 50-51 years of age.

What is peri-menopause?

Peri-menopause usually begins in your early 40s. It can include up to 10 years before your periods actually stop. You will still have menstrual periods, but you may notice changes. These changes can be in the amount of bleeding during your cycle. You may also skip periods. Other symptoms can begin in some women, such as anxiety, insomnia, hot flashes, night sweats, mood swings, depression and heart palpitations.

I have been told that I have very low estrogen levels, yet I fit into the symptoms of estrogen dominance. How can this be?

Estrogen dominance, the phrase coined by Dr. John Lee after his extensive research in women’s hormones, describes a condition in a woman’s body where she has deficient, normal or excessive estrogen, but has little or no progesterone to balance its effects in the body. Therefore, even a woman with low estrogen levels can be estrogen dominant. Natural progesterone creme can help to restore hormonal balance.

Can I use natural progesterone if I plan to become pregnant or if I am pregnant?

Early miscarriages are becoming more frequent. Adequate supply of progesterone to uterine lining may help prevent miscarriages. Dr. John Lee recommends using natural progesterone for the first three months of pregnancy. After 3 months, the placenta makes high amounts of progesterone, therefore after the third month, the reduction of natural progesterone should be gradual to avoid any abrupt drop in progesterone levels.

Recall that progesterone was initially used for women with frequent miscarriage. The name means “Pro Gestation”. Visit our Fertility Shoppe on this site for more help with fertility issues.

Why do so many menopausal women gain weight?

Remember, you can be estrogen dominant even with LOW estrogen levels, if you are not making progesterone. Excess estrogen in the form of estrogen dominance can do the following:

  • Convert food calories into fat instead of energy
  • Alter Thyroid function, changing metabolism
  • Interfere with insulin function to convert calories into energy
  • Cause estrogen to be stored in fat cells; then the fat cells make more estrogen and you enter the vicious cycle that keeps you fat! The more fat a woman has, the more estrogen she produces.

The weight gain caused by both water retention and fat deposition on hips and thighs may be reduced in many women by using natural progesterone crème. After using progesterone, the body utilizes fat for energy.

Many women have reported “losing their spare tire” with consistent natural progesterone use.

How and where is progesterone made in the body?

When your menstrual cycles are regular and functioning at optimum levels, your ovaries release an egg into your fallopian tube every month This is called ovulation. The egg has responded to hormonal signals from the brain.. Next, the tissue surrounding the egg enlarges and matures into a follicle. As the follicle enlarges, it begins to make estrogen. Estrogen is the dominant hormone for the first week or so after menstruation. Upon ovulation, the follicle bursts, releasing the egg into the fallopian tube.The now empty follicle becomes the “corpus luteum”, a small yellow body on the surface of the ovary. The corpus luteum is now the site of abundant progesterone production which dominates the second half of the menstrual cycle. The increase of progesterone at the time of ovulation causes a rise of body temperature of about one degree Fahrenheit, which is often used to predict ovulation. If pregnancy does not occur within 10-12 days following ovulation, estrogen and progesterone levels fall abruptly which triggers menstruation. If pregnancy occurs, progesterone production increases and the shedding of the lining of your uterus is prevented.

Note: In anovulatory cycles (no ovulation) no progesterone is made and estrogen dominance can prevail. Due to stress, environmental influences, diet, and past use of birth control pills, great numbers of women are not ovulating and therefore not producing progesterone.

Can progesterone help with Osteoporosis?

Osteoporosis is a disease of bone loss. It is basically a metabolic disorder characterized by bone resorption exceeding bone deposition. The result is weakened bones that are easily fractured. Osteoporosis is most common in women and bone loss can begin prior to menopause.

According to the Health & Science Research Institute, U.S.A, Women using transdermal progesterone creme experience an average 7-8% bone mass density increase the first year, 4-5% the second year and 3-4% the third year.

My teenage daughter has heavy or irregular periods. Can she use natural progesterone?

Yes. For teenagers who are irregular, progesterone will help to regulate to a 28-day cycle. With continued use, periods should become regular and heavy bleeding and cramping will be alleviated. This sometimes takes 3-4 cycles.

Can I mix synthetic estrogen with natural progesterone?

If you are unwilling or unable to discontinue your synthetic estrogen, try adding natural progesterone to your daily regime. It can decrease your cancer risk.

Please email for our free hand-out “Top 10 Reasons To Get Off Synthetic Hormones” You might want to show it to your doctor. It contains studies.

Why doesn’t my doctor know more about Natural Hormone Therapy?

Most of the mainstream medical doctors read materials such as the Journal of America Medical Association, The New England Journal of Medicine, and other top-of-the-line medical journals that do not cover naturopathic topics such as the use of natural hormones.

Natural hormone use isn’t always taught in medical school and is never promoted by a pharmaceutical company (the other major source of information for nearly all “conventional” physicians).

Almost all doctors see only studies of the benefits and risks of Premarin®, Provera®, and other patentable “hormone” studies which the pharmaceutical industry has conducted itself or underwritten. An examination of the medical literature on HRT reveals hundreds of articles about patentable HRT for every one about natural hormone replacement. But that is all changing! Women are becoming more and more willing to confront their doctors with information about the safety of synthetics.

What if I have no symptoms? Do I still need natural progesterone?

Even if you don’t have menopausal symptoms and have a good diet and exercise regularly, the use of natural progesterone is still recommended. Studies show that bioidentical progesterone lowers triglycerides, glucose levels, CRP, and cortisol levels. Progesterone also decreases anxiety and depression which is why we call it the “feel good” hormone!

Should estrogen be taken without progesterone?

No! It is recommended that natural progesterone be used with any form of estrogen, natural or synthetic. Estrogen without progesterone can cause endometrial and vaginal carcinomas as well as breast cancer. Estrogen alone can block thyroid and block water retention. It can also cause fibrocystic breast disease and even fibroid tumors and cysts.

What if I don’t have a uterus and am taking estrogen? My doctor says I do not need progesterone.

Although this is the conventional medical approach, it is very misguided according to bio-identical hormone experts and researchers. With or without a uterus, you should always take progesterone along with estrogen due to the increased risk of breast cancer associated with estrogen dominance. Estrogen must be taken if you have a uterus because estrogen alon can cause uterine cancer. If it is that powerful to cause cancer when used alone, why would any woman want to do it? Progesterone protects the heart, the breasts, strengthens bones and is stroke-preventative. So, even if you do not have a uterus, you still have a heart, breasts, bones and a brain! Use progesterone along with any estrogen.

What about blood tests for hormones?

Many physicians measure progesterone levels with serum (blood), but this measures only protein-bound progesterone. When progesterone is absorbed transdermally, it is not protein-bound, and travels in the blood on red blood cell membranes where it is loosely bound and readily bio-available. Saliva hormone testing is the proper way to measure this non-protein-bound progesterone. Because many physicians use only blood tests, they are very apt to say that natural progesterone is “not working”. This is not true. Saliva or blood spot (capillary blood) tests are the most effective way to test your hormone levels. Serum blood tests will not show the bio-availability of your transdermal hormones.

What are the Characteristics of Estrogen Dominance

  • Weight gain
  • Insomnia
  • Fatigue
  • Memory loss
  • Irritability
  • Acne
  • Cramping
  • Irregular menstrual flow
  • Depression
  • Panic attacks
  • Osteoporosis
  • Cold hands and feet
  • Breast tenderness
  • Hair loss
  • Thyroid imbalance
  • Increased breast cancer risk
  • Fluid retention (bloating)
  • Blood clots

What else can Progesterone Do?

Progesterone Use Can Help:

  • Utilize fat for energy
  • Restore normal sleep pattern
  • Restore proper cell oxygen levels
  • Help with concentration
  • Normalize blood sugar levels
  • Protect against fibrocystic breasts
  • Help prevent breast cancer
  • Act as a natural anti-depressant
  • Act as a natural diuretic
  • Assist thyroid hormone action
  • Normalize blood-clotting
  • Maintain the secretory endometrium
  • Increase libido
  • Normalize period
  • Aid in skin disorders
  • Stimulate bone mineral density
  • Restore oxygen to cells
  • Normalize Zinc and Copper levels
  • Relieve cramping

Didn’t find your question here?

Our Barbara Hoffman wrote, and has continuously updated her renowned “purple book” since 2001 on Natural Progesterone. It is available here as a free PDF download.

Email Barbara: barbara@askbarbarahoffman.com We care about you!