How to use progesterone cream

Learning how to use progesterone cream is not difficult for a woman once she understands it in relation to her cycle. For men its even easier... anytime, anywhere!

A woman's cycles can vary from as little as twenty one days to as long as thirty six. The average being twenty eight days. This is the reason that manufacturers of The Pill and HRT pack their product in twenty eight day batches.

The following guide is also based on 28 days, but please bear in mind that if your cycle is longer or shorter, follow that, rather than the average.

To give you some idea, all women, irrespective of the length of their cycle, should start ovulating fourteen days before they start bleeding again. This means that you should start using the cream either at ovulation, if you know when it happens, or fourteen days before your next period is due. If you don't ovulate or have a period, stick to the 28 day cycle, choosing any day to start.

A twenty one day cycle - Ovulation should occur on day seven
A twenty eight day cycle - Ovulation should occur on day fourteen
A thirty six day cycle - Ovulation should occur on day twenty one

Most web sites and books advise starting the cream on day 14, they are wrong!

The cream should only be used from ovulation, for the last 14 days of the cycle

This is the key to understanding how to use progesterone cream. If used earlier than ovulation, it will prevent ovulation. In other words it will prevent a woman from making her own progesterone. The idea behind the cream is to supplement the low level of endogenous progesterone i.e. what your body makes during the luteal phase.

The first day of the cycle is the first day of bleeding. There are some women who have what is known as a defective luteal phase, which means that they start bleeding again before the fourteen days are up. A defective luteal phase is often the cause of a failed conception or miscarriage. If this is the case, using progesterone can help to lengthen it.

Supplemental progesterone usually stops the food and alcohol cravings, depression, painful breasts, cramps, tiredness and anger that occur just prior to bleeding.

Please be aware that bleeding could be heavier for the first one to two months when first starting the cream. Don't be alarmed, as its the progesterone cleaning out the lining that has built up in the uterus.

The cycle can also be disrupted. If spotting should occur continue using the cream. If a full period should occur early, discontinue the cream counting the first day of bleeding as day 1. Bleeding may also be delayed for a few days. When this occurs, count the first day of bleeding as day 1. Start using the cream again at ovulation or for the last fourteen days of the cycle.

Estrogen dominance symptoms can also be experienced. For full details of this condition and its symptoms please click here (a new window will open).

Please note: Stress drops progesterone levels sharply, so if you find symptoms returning it could be you're going through a particularly stressful time. The reason for this is cortisol, the stress hormone, is made from progesterone. The stress response is a survival instinct, so the body will use any available progesterone and convert it into cortisol to overcome the stress, be it acute or chronic. You should increase the dose of progesterone you are using if symptoms return and then reduce it once the stress has passed.

A skin cream is the most user friendly of all the ways progesterone can be taken. Oral is wasteful and costly as 80-90% is destroyed as it passes through the gut and the liver and the dose has to be high which causes drowsiness. Injections are painful, buccal drops or pills are very bitter and suppositories are not much fun!

One of the key benefits of understanding how to use progesterone cream is that the cream can be applied anywhere... in the vagina or nose for dryness, on piles, painful or achy areas, burns (its amazing on burns), wonderful on the face and so on. Please note: do not use the cream on only one small patch of skin. The continual rubbing on one spot can lead to irritation. The cream will not absorb well either. 1ml (1/5th tsp) will cover both feet and both legs, or both arms, stomach and chest/breasts. Although many people believe the thin skinned areas absorb best, a study has shown progesterone is absorbed well by the hair follicles, so it can be used anywhere. It's best to rotate the area daily.

NB: Progesterone cream is best applied twice a day to keep levels up, so split whatever daily dose is chosen. Some women prefer to use more at night, less in the morning, but it’s up to the individual.

All the successful studies done on progesterone indicate between 100mg to 200mg should be used each day. This equates to 3ml to 6ml of a 3.33% concentration cream (such as Natpro) per day. Some studies used 400-600mg/day, one study used 1200mg/day as it was oral progesterone.

In answering the question 'how to use progesterone cream' it must be made clear that there is actually no right or wrong way as it depends on the problem or symptoms one is trying to resolve.

If a woman still has a cycle to follow, then its advisable to follow it, otherwise it can be disrupted. Having said that, if symptoms are severe, the cream can be used every day to get rid of them first and then revert to following the cycle.

Menopause is easier as there are no cycles to follow. In this case the cream can be used every day without a break. If used at the normal daily dose, the body does not become de-sensitised to progesterone.

When to use progesterone cream

The cream is best applied twice a day, to keep levels up.

Day 1 to ovulation No cream
Day 1 after ovulation 4.25ml
Day 2 4.25ml
Day 3 4.25ml
Day 4 4.25ml
Day 5 4.25ml
Day 6 4.25ml
Day 7 4.25ml
Day 8 4.25ml
Day 9 4.25ml
Day 10 4.25ml
Day 11 4.25ml
Day 12 4.25ml
Day 13 4.25ml
Day 14 4.75ml (remainder of tube)

Total 60ml / 2oz

Menstruation should start within a day or two of stopping the cream.

How to use progesterone cream in pre-menopause

14 days
2,000mg of progesterone (one tube of Natpro), divided by 14 days gives 142.7mg progesterone per day. This equates to 4.25ml/day or almost 1 (one) teaspoon.
The cream should only be used during the last fourteen days of the cycle, that is from ovulation till the period starts. It should not be started on day 14, unless you have a 28 day cycle.

How to use progesterone cream in peri-menopause

Learning how to use progesterone cream during peri-menopause is complicated by the facts that cycles become very erratic, bleeding can be very light to flooding, 2 weeks apart to 3 months apart, clots, spotting, sometimes pain.

Peri-menopause is the time when progesterone is vital for well being. Levels start dropping from the age of thirty five, whereas oestrogen remains at normal levels until menopause, when they drop sharply.

It's the unbalanced ratio of the two that causes the symptoms.

It's best to ignore the cycle, as it is now too erratic, and use the cream every day. Supplemental progesterone used before ovulation will prevent this occurring and prevent endogenous progesterone from being made. However, as anovulation (failure to ovulate) is the norm during peri-menopause, causing progesterone levels to drop, you need not be concerned about using it every day without a break.

How to use progesterone cream in menopause

As there is no cycle choose any day to start. The following amount of progesterone is based on 28 days to give some idea of the amount of cream to use, but if symptoms are severe more will be needed.

Contraceptive and HRT users

Oral contraceptives and HRT are packed in 28 day cycles. The first half comprises oestrogen only, the second half is a progestin, possibly combined with placebo pills. Supplemental progesterone should only be used in the second half of the Pill or HRT cycle. The same applies to users of the patches. For other forms of contraception or HRT, ie. progestin only, injections, implants, IUD’s, etc., progesterone should be used every day.

2,000mg of progesterone (one tube of Natpro), divided by 28 days = 71.4mg progesterone per day.

This equates to 2.15ml of cream per day or almost 1/2 a teaspoon.

1 ml (1/5th tsp) of Natpro cream contains 33.3mg of progesterone
2ml (2/5th tsp) contains 66.6mg of progesterone
3ml (3/5th tsp) contains 100mg of progesterone
4ml (4/5th tsp) contains 133.2mg progesterone
5ml (1tsp) contains 166.5mg progesterone
1/8th teaspoon (0.625ml) contains 20.8mg progesterone
1/4tsp (1.25ml) contains 41.6mg
1/2tsp (2.5ml) contains 83.2mg
3/4tsp (3.75ml) contains 124.8mg progesterone
1tsp (5ml) contains 166.5mg progesterone
1ml (1/5th tsp) will cover both feet and both legs, or both arms, stomach and breasts.