Progesterone

• Support for the menstrual cycle³
• Address menopause related concerns ^2,3
• Support for uterine health^1,3
• Support for a healthy immune response³
• Support for the pregnancy journey^1,3

When considering a compounded progesterone regimen, it's important to tailor the approach to the patient's clinical condition, route of administration, dosing goals, and potential risk factors. Here are key considerations:

• Cyclic vs continuous dosing
• Timing: Oral progesterone capsules are often taken at night due to their sedating properties, which may support sleep.^1,2
• Patient-specific factors: age, menopausal status, reproductive goals, and personal/family history should be considered when selecting dosing regimen

Potential Side Effects

• Drowsiness or fatigue (especially with oral formulations)
• Headache
• Bloating or abdominal discomfort
• Breast tenderness
• Mood swings or irritability
• Acne or oily skin (rare, more common in high doses)

• Commercial progesterone capsules often contain peanut oil, which may pose a concern for patients with known allergies. Compounded progesterone can be prepared without peanut oil and may be an option for patients with documented sensitivities, as prescribed by a provider. Be sure to document any allergies on the prescription to ensure the appropriate formulation is dispensed.

Progesterone exerts its effects by binding to intracellular progesterone receptors, which then act as transcription factors to regulate gene expression in target tissues like the uterus, brain, and breast. ^1,3These interactions are associated in published literature with physiological processes including endometrial changes, uterine muscle activity, and mood and immune related pathways.^1,3

Oral progesterone is absorbed through the gut and metabolized by the liver, producing neuroactive metabolites including allopregnanolone.³ These metabolites cross the blood-brain barrier and act on GABA-A receptors, which are associated with relaxation and sleep-related physiological pathways.^2,3

Q: Who can take progesterone?

A: Men and women can take progesterone as part of their hormone replacement regimen. Despite being traditionally viewed as a female hormone, progesterone at lower doses in males serves several important functions.

Q: Why is progesterone used in HRT?

A: Compounded progesterone is sometimes prescribed alongside estrogen as part of a hormone support regimen to support uterine health.^1,3 It may also be included in a care plan to support sleep-related concerns, as determined by a prescribing provider.^1,2

Q: What is the difference between bioidentical progesterone and synthetic progestins?

A: Bioidentical progesterone (micronized progesterone) is chemically identical to what your body produces and is believed to be well tolerated. Synthetic progestins such as medroxyprogesterone acetate differ in chemical structure. The two have distinct pharmacological profiles; a prescribing provider can help determine which option may be appropriate for an individual patient's needs.^1,3

Q: What is the best time to take progesterone - day or night?

A: Oral progesterone capsules are often taken at night to help promote sleep.

Disclaimer:

Compounded medications are specially prepared for individual patient needs based on a valid prescription and, as such, are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or efficacy. These statements have not been evaluated by the FDA.

This information is for educational and informational purposes only. It is not medical advice, diagnosis, or treatment recommendation. Always consult your healthcare provider before starting any new medication to determine whether it is appropriate for your individual circumstances. Contact your healthcare provider with any questions regarding a medical condition.

References

1. Progesterone. (2025). In Lexi-Drugs. UpToDate Lexidrug. UpToDate Inc. Retrieved June 3, 2025, from https://online.lexi.com
2. Spark MJ, Willis J. Systematic review of progesterone use by midlife and menopausal women. Maturitas. 2012 Jul;72(3):192-202. doi: 10.1016/j.maturitas.2012.03.015. Epub 2012 Apr 25. PMID: 22541358.
3. Nagy B, Szekeres-Barthó J, Kovács GL, Sulyok E, Farkas B, Várnagy Á, Vértes V, Kovács K, Bódis J. Key to Life: Physiological Role and Clinical Implications of Progesterone. Int J Mol Sci. 2021 Oct 13;22(20):11039. doi: 10.3390/ijms222011039. PMID: 34681696; PMCID: PMC8538505.