I am 45, going through perimenopause. Was still having estrogen dominance symptoms on 200mg and 400mg of oral bio-identical progesterone taken daily (no breaks). In the middle of October my Dr prescribed me 600mg oral, daily. After that I got my first period on 11/4 for 7 days (normal), then next one on 11/22 (too soon) and I am still bleeding and spotting on and off since then (12 days). I went to my Dr. today, and she said that it is "normal" for perimenopause (which I read about too), but what bothers me that when I asked her if I should switch to cream, since it's more efficient, she said that I would have to apply it all over me, since I need a big dosage. From what I've read, I would need a smaller dosage of cream than oral, so I am not sure if I can trust her knowledge and now I don't know
-if I I should keep taking 600mg of oral and wait maybe it'll settles down in a cycle or two;or
- switch to cream (not sure how to convert pills dosage to cream dosage;or
-just add some cream to 600mg of oral;or
-something else.

Please-please help, I am confused.
Thank you so much

Comments for Lana

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Dec 04, 2015
Silly doctor
by: Anonymous

You can apply Natrpo anywhere on your body. It absorbs really quickly just like any body lotion would. There's lots of info here about dosage too. Hope you begin to feel better soon.

Dec 04, 2015
Oral vs cream
by: Diane

Hi Lana~
I am on 300mg cream. I suspect your dr does not switch you because he/she may not understand absorption of the different routes of P. Also, orals are driven by pharma where as cream RXed by doctors is made at compunding pharmacies. My insurance does not cover cream one cent.
Having said all of the above.. I too have been in perimenause now for 2 years.. I also now lately have two periods a month, both very light though. My dr who I absolutely love (she is functional medicine MD GYNO) says that irregular bleeds are the nature of peri menopause..
The idea with bio progesterone is to relieve symptoms as much as possible.. Will it do it 100%? No. But what I have achieved with P is amazing results. I rarely now experience insomnia, anxiety, wicked PMS (moodiness, irritablity). It has saved the quality of my life.
Im not a fan of orals because of the lack of absorption. It is not as protective as cream against reproductive cancers when estrogen dominant. A doctor once put it this way to me. He wrote:

The reason these doctors might think oral is superior to creams is because oral progesterone (allopregnanelone) is misinterpreted on lab tests as progesterone. Since it is not able to attach o progesterone receptor sites, the level in the blood stream is higher than with creams. Progesterone given through the skin very readily and quickly attaches to progesterone receptor sites. Once progesterone is attached, it cannot be measured. This gives the false impression that oral progesterone provides more progesterone

Lana, I hope this helps.

Dec 05, 2015
Thank u!
by: Lana

Thank you so much for your comments!
I feel confident now to switch to cream. Now I just need to figure out how to convert 600mg of oral to cream dosage, because of different absorption rate and if I need still to use it every day. Looking forward to feel better :)

Dec 06, 2015
Cream vs oral
by: Diane

Hi Lana~
I can understand the confusion... Standard cream dose is 100-200 to start but I suspect you would be more like me around 300.. I know women who are actually using both.. 100mg cream AM, 100mg cream PM, AND 100mg ORAL bedtime for sleep. You can ask your provider what would be best. Keep us posted.

Dec 15, 2015
Cream vs Oral
by: Joy

Hi Lana

As Anonymous said ….. silly doctor! Yet another progesterone misconception by misguided people, who have not bothered to study the research papers. However, she is correct in advising you that your erratic periods is normal once in Peri-Menopause. Any form of oral progesterone is not the best delivery method as 96% gets destroyed by the gut and liver, so you can work at exactly what progesterone you have been absorbing using oral, virtually nothing. Please read How to use Progesterone Cream and Estrogen Dominance.

You might consider switching to a cream which has the correct progesterone concentration, if you continue with oral you will be doing yourself no favours at all, plus the amount used is just enough to stir up estrogen receptors which will in turn cause adverse symptoms.

Do you know what your Vitamin D3 level is? A deficiency reduces the benefits of progesterone and is connected to every functioning cell in our bodies.

I hope that this has helped to clear things up for you.

Jan 15, 2016
Still figuring it out
by: Lana

Thank you so much for your advises! Would it be injustice to drop 600 mg of oral and switch to just a cream? Right now I am using both: 20mg of cream morning and evening; 600 mg of oral on the evening and STILL spotting daily.

I am afraid that when I drop the oral completely, it will cause big change of amount of progesterone in the body. If it's safe to drop oral, how much cream should I use. Considering that all over the counter creams consist 20mg of USP Progesterone per serving, looks like I need to use half of bottle/jar a day?

Second concern, even though I needed use less cream than oral, I am petite women and have only that much of inner areas of legs, arms, check bone, or face. Sounds like I almost need to apply it all over the body, so I am afraid that cream will eventually accumulate under the skin instead of going through bloodstream... Any advise would be greatly appreciated.

Jan 16, 2016
Oral vs cream
by: Diane

Hi Lana.. I understand your concern about the quanity of cream you would need to apply.. Is there any way your doctor would RX you the cream to a compounding pharmacy? I pay about 50$ a month for my RX. If your dr wont Rx cream then you can go to a functional medicine md who will Rx ..yes you may have to pay out of pocket but atleast then he or she can Rx the P to you. They can make the concentration per gram be far higher so that when you apply 300mg daily it would be really a small amount in comparison to over the counter P... Also, you needto use atleast 200mg CREAM per day and you can supplement 100mg oral at night. You do not need to ease into a higher dose of cream. You are using far too little cream.. Please read about Estrogen dominance on this website.
Keep us posted, Lana. Our greatest wish here is that women feel better:):)

Jan 21, 2016
by: Lana

Thank you so much, everyone, for your advices and support! My Dr. finally prescribed be Progesterone from Compounding Pharmacy! Yay! Today will be first day, I am going to use it. Holding my breath and keeping my fingers crossed :)

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