How much should I use?

by Linda
(Sanford FL)

I really hope you can advise me what to do. 

After being diagnosed with uterine fibroids and fibrocystic breasts I decided to see an alternative dr to figure out my hormone balance. I'm 42 and still have regular periods.

My progesterone was 31L with the ZRT saliva test and my estrogen within range. So we decided to do bio identical Hormone therapy. I'm on 3% cream day 14-27 1ml 1 x daily. 

The first and second day were just awful. Within the hour I put it on I started feeling very dizzy. Fog head. Could barely stand on my feet. Bloated. And sleepy. Day 2 the same. And day 3 these symptoms didn't occur. Still I don't feel comfortable. Sleepless, irritable, bloating and I'm afraid it might work adverse on me which makes me worry the fibroids might increase as my fibrocystic breasts seem worse!

Can you tell me if I'm doing something wrong? Should I stop taking it? Do I need a lower dosage? I'm going back to my alternative dr. but I would like more than one opinion so I really hope you can send me a reply. 

Thank you so much. 

Comments for How much should I use?

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Aug 10, 2010
How much should I use?
by: Wray

Hi Linda The amount of progesterone you are using is far too low! If you're only using 1ml of a 3% cream it means you are only getting 30mg progesterone per day. Progesterone should always be used a minimum of twice a day, as levels drop after about 13 hrs. Secondly that low dose is merely stimulating your oestrogen receptor sites, hence the adverse symptoms. You should have been warned this could happen, for more info please see our page on Oestrogen Dominance. You don't give your oestrogen level, but if the two hormones are out of balance, all hell can break loose. Progesterone should be at least 300, if not 600 times higher than oestrogen to feel well. To find the ratio divide your progesterone result by your oestrogen result. Both fibroids and fibrocystic breasts are caused by excess oestrogen, which also explains why you reacted so badly to the progesterone. Please see our page on Fibroids for more information. Try rubbing the cream directly on your breasts as this helps considerably. Please see the following paper here for more info on fibrocystic breasts. The cream should only be used from ovulation, so if you ovulate on day 13, and you have a 27 day cycle, then what you are doing is fine. But if your cycle is shorter or longer you should follow it. Please see our page on How to use progesterone cream for more info. Take care Wray

Aug 11, 2010
How much?
by: LindA

Thank you wray! I've been waiting for your response:) No the dr actually told me to lower the dose, but what you wrote makes absolutely more sense! That dr also said she never heard of such bad symptoms??

Anyway what would you suggest? Twice daily how much ML?
The cream seringe is in ML and it's quite confusing with mg or gram which is talked about more you this site. I hope you can give me an indication how much to use day 14 till 27 ( that is my cycle). And it's safe right to up the dosage??! Also the compound pharmacy said NOT to rub it directly on breast. Wow I need To change dr and pharmacy;)

Thank you very much for helping us all with these questions!!!

Aug 11, 2010
Forgot my estrogen level
by: Linda

Sorry Wray here is what it says on the zrt result;
Estradiol in range 3.3
Cortisol 3.1
Units are pg/ml
Thank you again for your advice!

Aug 11, 2010
Difference between natpro and ....
by: Linda

Sorry here I am again, been reading alot on your site but what is the difference between pharmacy compound 3% bioidentical hormone cream and Natpro?
Thanks again;)

Aug 14, 2010
How much?
by: Wray

Hi Linda I'll answer all three queries in one! Many people, doctors included, do not know progesterone can initially stimulate oestrogen. There are plenty of papers on the oestrogen dominance web page I gave you. It can be a shocking experience to anyone when it occurs, as they are expecting symptoms to get better, not worse! The more oestrogen a person has, the worse the symptoms. It matters not whether it's our own endogenous oestrogen, or synthetic from HRT or contraceptives, or xeno-oestrogens found in the environment. I generally recommend between 100-200mg/day progesterone, but it's entirely dependant on symptoms. The worse they are, the more is needed, it's trial and error for all of us. The ml is a volumetric measure, the mg is weight. 1 ml of water weighs 1g or 1000mg. So when an amount is given in ml it's referring to the cream. The mg is referring to the amount of progesterone in the cream. So 1ml of of a 3% cream contains 30mg progesterone. If you wish to increase to the amount I suggest you will need to use between 3.3ml to 6.6ml of cream. If the syringe output is 1ml each time, then you can only do 3ml to 6ml. But it's not critical, what is are the symptoms, are they better with the amount you are using? That's all you have to think about, if not then more progesterone is required. Once they've been resolved reduce till you find the optimum. Remembering too that stress drops progesterone levels so symptoms can come back, in which case increase the amount again. Having found myself that progesterone helps sore breasts by directly rubbing the cream on them, and helping many, many women who've done the same, all I can say it works! It should do as it's oestrogen causing the pain and swelling. No need to change your doctor or pharmacy. They gave you what you needed, so maybe you can advise them on oestrogen dominance so they can advise future patients. You gave me your progesterone as 31L, which makes no sense to me. It's normally measured in ng/ml, whereas oestrogen is normally measured in pg/ml. But ZRT seem to measure in pg/ml for progesterone. So assuming this to be the case your ratio is 9.4:1, far too low. I've found women feel better when it's well over 300:1, better if it's 600:1. I can't help on the difference between the two creams, as I don't know the ingredients of the pharmacy one. The Natpro is slightly stronger at 3.3% progesterone. Per 2 oz, the standard container size, the pharmacy 3% contains 1800mg progesterone and the Natpro contains 2000mg. Take care Wray

Jan 10, 2011
post menopausal writer
by: Anonymous

I took estrogen and progesterone for over 25 years, but then when all the recent research on estrogen showed health deficits, I stopped.

I would like to start taking Natrpo. I ordered a tube of 60 grams. How many teaspoons should I use twice a day? This is supposed to last a month, I believe.

Jan 15, 2011
post menopausal writer
by: Wray

Hi there I'm pleased you've come off the HRT, incidentally the 'progesterone' used is a synthetic version with many adverse side effects. It's difficult for me to advise on how much to use, as it's dependant on symptoms. If you used 1 tube a month the amount would be ±2.1ml per day, or just under 1/2tsp. Or approximately 1ml twice a day. I recommend 100-200mg/day, which is 3-6ml per day. Some women find the 70-80mg that 2.1ml would give is sufficient, but many find they need more. For instance hot flushes need about 400mg/day for 4-5 days before they are under control. Heavy, continual bleeding needs between 400-600mg/day, before that diminishes. And initially Oestrogen Dominance can occur, in which case much more is needed to overcome this. I wish I could be more helpful, but we are all so different, I can't. It is a question of trial and error, and to use it as and when needed. The amount I use varies daily, some days I need more, some less. Stress drops levels, so more is needed to prevent symptoms returning. Please read our page on Menopause for more info. Take care Wray

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