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Confused about dosages

I cannot thank all of you who run this site enough. I have learned so much and feel I'm finally understanding and starting to get the benefit of progesterone. Like another poster, I have drastically increased my dose and am feeling so much calmer, which I needed due to not only biological anxiety but also many real life stressors that are no doubt contributing to my decline in progesterone.

It's interesting that back in the 90s, I listened to a cassette tape of Dr. John Lee's "What Your Doctor May Not Tell You About Menopause" book. I did not feel I needed the information at that time, but I most definitely need it now.

I have read Dr. Lee's instructions and also Dr. Dalton's instructions on progesterone use. Dr. Lee was much more conservative with his dosing instructions and I have been following them until a couple of days ago. I finally decided to try a higher dose, as Dr. Dalton would advocate, and am feeling much better quite quickly.

One thing Dr. Lee said concerns me, because I want to be sure I can use progesterone and continue getting positive effects from it, for as long as is necessary, even if that means decades, since I am now in menopause.

I would love to hear comments form those who run this site, since you have much more experience than I.

PLEASE COMMENT ON DOSAGE ISSUES RAISED IN THE INTERVIEW EXCERPT BELOW

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EXCERPT FROM DR. JOHN LEE INTERVIEW

"You will find that when you start someone on a larger amount, like the whole jar the first month, ****mg. She will tolerate it very well. She may tolerate it for 3 months or 6 months but then you know something funny happens. It begins not working or she begins to get estrogen like effects.

And what happens is, when you have more progesterone than you need, it doesn't hurt anybody but what it does is to down regulate all of the progesterone receptors. They cannot tolerate the excessive overload that's occurring and they just shut down. And all of the sudden progesterone starts to not be as beneficial as it use to be.

So I am recommending to you that your selling point on your cream (xxxxxxxxxx) is that one jar is worth 4 or 5 months of use. The first month you could get away with using the whole jar but then it should be tapered down to normal physiological doses."

Note: Dr Lee does not endorse a particular brand of progesterone cream.

Comments for Confused about dosages

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Sep 01, 2020
 Confused about dosages
by: Joy

Hi there

I am so pleased that progesterone has helped you, it will if used correctly as explained on the How to use Progesterone Cream page.

Dr Lee's knowledge on progesterone is excellent, although he is a bit off when it comes to dose. Dr Dalton gave excellent advice too, lower amounts of progesterone are not very effective and cause issues. She prescribe high doses for those suffering from severe PND. I am sure that you have read this.

Starting on a higher dose helps to overcome Estrogen Dominance, as well as those terrible adverse symptoms quicker. Once you feel stable, then you can slowly reduce the amount of progesterone to a level that suits you. Should symptoms return, then you need to increase again. As you have probably read between 100-200mg progesterone is needed, more if symptoms are severe. Anything less will aggravate estrogen receptors and one would then think that progesterone is not working There is no quick fix, time and patience is needed. As mentioned so many times, one will have to experiment to see what suits them. We are all different, what suits one, may not suit another.
Sep 02, 2020
 Thank you / clarification
by: Anonymous

Dear Joy,
Thank you very much for the info.

I'm still confused about one thing.

My main question is,

"Can I continue progesterone at 100-200mg/day indefinitely or at some point am I going to have to decrease my dose to the 'Dr. Lee' levels of 20-40mg/day, in order to continue seeing benefits?
Sep 07, 2020
 Thank you / clarificaiton
by: Joy

Hi there

As mentioned many times on this website and explained on the How to use Progesterone Cream page, nothing less than 100mg is needed. Using anything less will aggravate estrogen receptors making adverse symptoms worse. So to answer your question, yes use between 100-200mg, or more depending on how severe symptoms are. You could always try using less of course, that would be up to you to experiment but so many have tried without success.
Sep 12, 2020
 Thank you Joy
by: Anonymous

Joy,
Thank you for the clarification. I have read so much at this site and elsewhere but still couldn't conclude whether the progesterone would continue working indefinitely or if the receptors would eventually not respond as well (as Dr. Lee mentioned).

I have just entered menopause and was thinking of potentially 30+ years of needing to use progesterone, hoping it would not diminish in it's effectiveness over time. I pray not. Thank you.
Jul 30, 2025
 Need further clarification
by: Also Confused

The OP quoted the Dr. John Lee interview, stating: "She may tolerate it for 3 months or 6 months but then you know something funny happens. It begins not working or she begins to get estrogen like effects.

And what happens is, when you have more progesterone than you need, it doesn't hurt anybody but what it does is to down regulate all of the progesterone receptors. They cannot tolerate the excessive overload that's occurring and they just shut down. And all of the sudden progesterone starts to not be as beneficial as it use to be."

I have been taking 300mg/day (150 a.m./150 p.m.) for many months, but recently started having heart palpitations that have been keeping me awake at night, during naps, etc. Process of elimination seems to indicate progesterone as causing the palps, which on this site it says is a symptom of estrogen dominance. I tried reducing my progesterone and immediately had no palps...but then started having other symptoms because the reduction was too quick (I was desperate to get rid of the palpitations).

I'm just wondering about the quote above, that says "It begins not working or she begins to get estrogen like effects" and "when you have more progesterone than you need [...] what it does is to down regulate all of the progesterone receptors" and "They cannot tolerate the excessive overload that's occurring and they just shut down."

So now I'm wondering if I'm in progesterone overload, causing the palps since a reduction in progesterone lessened them? I know there are many women who are progesterone intolerant (despite many arguments to the contrary on this site) and/or progesterone sensitive. I have a lot of sensitivities myself so I can't help but wonder if I've reached a saturation point & need to reduce progesterone, but at what specific rate? FYI I'm 10 yrs post-menopausal, age 61.
Jul 30, 2025
 Also Confused
by: Joy

Hi there.

Thank you for reaching out. The late Dr John Lee was extremely knowledgeable when it came to progesterone. Sadly, he was incorrect on a few things.

It sounds like your progesterone level has dropped.

Some Main Reasons that could cause Progesterone levels to drop:

* lack of or drop in Vitamin D3 levels
* high estrogen
* high testosterone
* high LH
* high FSH sugars of any kind
* large meals
* alcohol
* stress
* insulin resistance
* high level of phytoestrogens in the diet

Diet is so very important. Wheat is particularly bad, as is sugar; in fact, all carbs should be avoided as much as possible.

Stress causes so many issues. More progesterone and various nutrients are needed during stressful times.

Progesterone doesn't accumulate in the body, which is why we need to supplement. Levels start to drop after 12 hours of use.

In our case, something has caused your progesterone level to drop, allowing estrogen to become dominant again. As mentioned many times on this website, when adverse symptoms return, up your dose until you feel stable again. The amount would be up to the person to experiment with to see what works best.

Heart palpitations indicate estrogen dominance and can be very scary. Progesterone, if used correctly, can help these palpitations. Estrogen causes prolongation of the QT interval, which results in palpitations, arrhythmia, and Torsades de Pointes. Whereas progesterone shortens the QT interval, see here and here. You could also be suffering from Anxiety, which can cause palpitations.

You are not 'in progesterone overload', you need more to resolve this. Once things revert to normal, you can slowly start to reduce to a level that suits you.

You can of course, try to reduce and see how you get on with that, but this will cause estrogen dominance, causing heart palpitations. As mentioned, experiment and see what works best for you.

All the best.
Jul 30, 2025
 Re Joy's response
by: Also Confused

Thank you, Joy, for your comments.

I will try upping my dosage to see if that helps, though I will say that in my research I have found many women who cannot tolerate higher doses of progesterone, and the symptoms of intolerance/sensitivity are the same as those for estrogen dominance. It's very confusing.

Oh, how I *wish* I could find a gynecologist who understands all this and is a proponent of natural methods rather than "slice & dice" as I've encountered in my experience! If anyone has any suggestions for finding such a doctor, please let me know. I do live in a major U.S. city, but so far I've only found ob/gyns who are part of the insurance system, and their reviews are literally horrific.

Joy, maybe I missed it, but how *exactly* does one reduce to a maintenance dose? I'm using Ona's Luna 5, which is 50mg/pump. (I developed an allergy to NatPro so had to switch brands.)

Once my symptoms are under control, do I reduce from 300mg/day to 250mg/day? For how long? A week, a month? How long before reducing the dosage again?

I've searched this site but so far have only found "reduce the amount gradually," which is really vague. I'd appreciate a little more guidance. Thanks!
Jul 31, 2025
 Re Joy's response - found it!
by: Also Confused

Finally found some specific info on reducing gradually, in your response to Kristen here:

https://www.progesteronetherapy.com/progesterone-stopped-my-perimenopausal-flooding-acne-and-other-symptoms-of-imbalance.html

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