- Most women have estrogen dominance (too much estrogen relative to progesterone), which drives weight gain around your cycle, but taking progesterone cream incorrectly or at too high a dose can actually cause weight gain instead of fixing it.
- Use bioidentical progesterone cream, not synthetic progestins or oral forms, applied during only the last 2 weeks of your cycle at 20-40mg daily. Taking it correctly prevents side effects like water retention, bloating, and paradoxical weight gain.
- Progesterone works best if you have low serum progesterone levels, are menopausal, or have hypothyroidism or insulin resistance creating estrogen dominance. Check your levels first before supplementing.
- Your thyroid and stress hormones affect progesterone production, so treating hypothyroidism and supporting your adrenals will improve your natural progesterone levels without needing supplementation.
- High cortisol from chronic stress initially raises progesterone but then depletes it over time, which is why stress management is critical for hormone balance and weight loss.
When you think of progesterone most of us are conditioned to think that it causes weight loss.
But the truth is that progesterone can cause both weight loss and weight gain, depending on the situation of who is using it.
Not only that but how you take progesterone and at what dose may determine if it helps with weight loss or weight gain.
Progesterone and Your Weight
Healthy and normal levels of estrogen and progesterone are required for a woman to maintain a normal weight.
The problem comes from understanding this balance and how to achieve it using supplements and creams.
You can think of estrogens (including estrone, estradiol, and estriol) as growth hormones.
Estrogens make your cells bigger, whether that be your fat cells, uterine cells, or breast tissue.
Progesterone, on the other hand, helps counteract these effects of estrogen (1).
In this way, progesterone is a natural way that your body balances estrogen levels.
So even though most women gain some weight during their menstrual cycle, that weight is lost once your hormones even themselves out.
So how does weight fit into this picture?
What I’ve just described is how the system is SUPPOSED to work, but that doesn’t mean that it works this way in every person.
Most women (at least in the United States) have trouble with too LITTLE progesterone and too MUCH estrogen.
This results in an imbalance known as Estrogen dominance, meaning you have too much estrogen relative to progesterone.
Most women know if they fall into this category because they present with symptoms like these:
- History of endometriosis
- History of fibrocystic breast disease
- History of PMS or PMDD
- Severe depression or anxiety around menstruation
- Perpetual weight gain surrounding menstruation
- Hormonal acne that changes with your menstrual cycle
- History of migraines related to your hormones
- Breast tenderness, heavy menstrual cramps, or mood swings
If you fall into any of the categories above then chances are high that you do indeed have an imbalance of estrogen to progesterone in your body.
You can find more information about how to treat these symptoms using supplements in this post.
Does that mean that you should automatically take progesterone to balance the high estrogen?
Not necessarily, and this is what gets people into trouble.
The answer to high estrogen is not to dramatically increase your progesterone level.
In fact, taking progesterone if you have normal levels of progesterone, to begin with, is what causes weight gain in many people.
Another important factor has to do with how you take progesterone and how MUCH you take (more on this below).
You have to consider that each person
Most of the weight gain from progesterone comes from excessive or high doses.
But how do you know if you are getting too much progesterone?
Follow the symptoms!
Symptoms of excess progesterone in your body:
- Weight fluctuations(usually mild weight gain of 5-10 pounds)
- Drowsiness
- Depressed feeling but not overt depression
- Slight dizziness
- Waking up groggy or “on edge”
- Bloating
- Sense of physical instability
- Feeling of a spinning sensation
- Discomfort or pain in the legs
- Water retention
- Anxiety or just feeling “tense”
- Changes to libido(usually decreased sex drive)
- Not feeling like yourself
These symptoms indicate that you have TOO much progesterone in your body, and if you are taking progesterone and experiencing these symptoms then chances are you might also be gaining weight.
This weight gain may stem from the dose you are taking, HOW you are taking the medication or the frequency with which you are taking progesterone.
It doesn’t necessarily mean that you need to stop taking the medication ASAP.
Let’s take a closer look at how to make sure you are taking progesterone correctly:
How you take progesterone matters
Remember there are really only two ways you should be using progesterone:
- Bioidentical progesterone cream
- Bioidentical oral progesterone (Prometrium)
You should NOT confuse these types of progesterone with synthetic or fake pharmaceutical forms of progesterone that most physicians prescribe.
Pharmaceutical companies don’t like to make bioidentical hormones because they can’t patent the medication and therefore they can’t make very much money.
Instead, they slightly alter the progesterone molecule and brand it with a new name.
But you want to stay away from these types of progesterones (called progestins or progestagens) because they are NOT metabolized in the same way as normal progesterone.
These synthetic and fake types of progesterones are responsible for a lot of weight gain that many people experience as well.
In fact, some studies have shown that some women may gain several pounds (2) while taking progestin-only birth control medications.
So we know that taking fake and synthetic progesterone is out of the question, but what about taking bioidentical progesterone pills? Is that okay?
Whenever possible it’s always best to mimic nature when you are replacing hormones.
For progesterone that means the following:
- Making sure that any progesterone you take bypasses the first metabolism from the liver (normally, progesterone is secreted straight into your bloodstream) -> this means a preference for creams/gels instead of oral progesterone
- Taking progesterone when it would naturally be high during the menstrual cycle (during the last 2 weeks or the luteal phase)
- Avoiding synthetic formulations of progesterone (use only bioidentical forms)
- Taking only enough progesterone for YOUR body (the dose that each person needs will be different)
If you aren’t following these guidelines, even if you are taking bioidentical progesterone, your dose may be simply too high or you may be taking it the wrong way.
It’s important to discuss these nuances because it might just be that progesterone isn’t your problem, but it’s more about how you are taking it.
We will go over in detail how to use progesterone below, but for now, let’s talk about who should seriously consider using progesterone for weight loss.
Who should use Progesterone for Weight Loss:
#1. Patients with low serum progesterone levels
This should go without saying, but if you have LOW progesterone then you are a great candidate for progesterone replacement therapy.
As long as you use bioidentical progesterone therapy with a transdermal application, at the right dose, there is a very low chance that you will have negative consequences such as weight gain.
But how do you know if you have low progesterone?
It’s actually quite easy to test your blood levels of progesterone. All you need to do is ask your doctor for a “serum progesterone” blood test.
Make sure you get tested on days 19-21 of your menstrual cycle (assuming a 28-day cycle).
If your serum progesterone is low when you test on these days then you are likely not creating ENOUGH progesterone or you are having anovulatory cycles.
This is also where things start to get interesting:
Progesterone levels obviously fall off dramatically during menopause (after ovulation ceases) but what you might not have realized is that progesterone naturally reduces around age 35 as well.
Both estrogen and progesterone decline around this time, but progesterone declines more rapidly.
This process leaves a relatively high concentration of estrogen relative to progesterone and this is why many women begin to suffer from the symptoms of estrogen dominance.
Starting at age 35 you may consider using progesterone IF your levels are low.
#2. Women who are menopausal
The second reason to use progesterone is due to a deficiency from menopause.
Once a woman hits menopause (whether that be from chemicals, hysterectomy, or the course of time) she is no longer ovulating.
Because ovulation is the biggest source of progesterone in women, the reduction of ovulation almost always results in VERY low progesterone levels.
It’s worth pointing out here that you can hit menopause early if you undergo removal of your ovaries due to surgery, or if you take certain medications (like those for breast cancer).
Both of these conditions create an early menopause-like syndrome which results in near zero progesterone levels.
The problem with menopause is that while progesterone levels drop to nearly zero, estrogen doesn’t always follow that trend.
Why?
Because your body can take androgens (DHEA and testosterone) and turn those into extra estrogen through your fat cells.
This process is known as aromatization (3) and it occurs in both men and women.
This creates a very interesting and troublesome scenario in many menopausal women:
If they have extra fat on their body they may create much more estrogen than normal while they have virtually zero progesterone.
This may, in part, help explain why menopausal women tend to gain weight (on average about 15 pounds).
The bottom line?
If you are menopausal you can almost guarantee that your progesterone level is very low and replacing those low levels may help with weight loss.
#3. Women with Estrogen Dominance should consider it
We’ve been talking about this idea of having too much estrogen during menopause but what about other women? Do they deal with the same issue?
And the answer is yes.
The following conditions may result in excess estrogen AND low progesterone levels:
- PCOS or being on the PCOS spectrum
- Insulin resistance, diabetes (either type I or type II), or issues with blood sugar
- Hypothyroidism
- Obesity or weight gain from any cause
- Eating disorders, binge eating, emotional eating, etc.
- High stress or a history of adrenal problems
- Exposure to xenoestrogens or endocrine-disrupting chemicals (4)
These conditions result in a scenario where estrogen levels remain high while progesterone levels may be artificially lower than normal.
Women who fall into any of these categories may benefit from using progesterone ASSUMING their levels are low.
You might also notice that many of these conditions are associated with weight gain in some form.
The use of progesterone in this setting may ultimately help with weight loss, but don’t count on it.
Also, do remember to check your serum progesterone level prior to supplementing as sometimes serum progesterone levels (even in these conditions) may be normal or high.
It’s possible to have more than 1 hormonal abnormality going on at once.
#4. Women with hypothyroidism should consider using Progesterone Cream
Next on the list is worth mentioning a second time:
Women suffering from hypothyroidism.
Why?
First of all, hypothyroidism is very common, and worse than that it is misdiagnosed by many physicians.
This creates a scenario where many women are walking around with hypothyroidism and low progesterone without even knowing it.
In addition, thyroid hormone plays a special role in helping maintain normal progesterone levels and normal ovulation.
Low thyroid hormone results in decreased ovulation and therefore decreased progesterone.
This relationship helps explain why women with hypothyroidism suffer from infertility and difficulty maintaining pregnancy until they are treated.
You can see the complete list of thyroid symptoms in this post where you can also learn how to be properly tested.
#5. Women with severe fatigue or adrenal fatigue
Lastly, there is a strong connection between cortisol, stress, and progesterone.
The unifying theme here is that these hormones all interact with one another and therefore must ALL be considered if you have a hormonal imbalance in your body.
The connection between stress and progesterone is sinister because it is often ignored or missed.
High levels of stress lead to high levels of cortisol.
As you can see from the diagram below, cortisol has an impact on multiple systems in your body (pretty much every cell):
This impact extends to your sex hormones like progesterone and estrogen.
Higher cortisol levels initially may stimulate high progesterone levels (leading to weight gain), and if the stress is maintained it may ultimately lead to low progesterone levels (5).
You’ve seen this relationship at play if you’ve ever had your cycle delayed or altered due to high-stress levels (relationship problems, finals at school, etc.).ย
The point is to make sure you address your adrenals with certain supplements which can dramatically improve your progesterone levels.
You can find out how to treat your adrenals and lower stress levels in this guide.
Cream vs Oral Progesterone (Prometrium)
If you decide to use progesterone (because you fall into the categories listed above) there are 2 options for you that are both bioidentical.
Your default should be to use the cream FIRST and then do a trial of the oral progesterone if the cream fails (some people just don’t absorb as well as others).
Who should use progesterone cream:
- Those who have not tried progesterone previously
- Those who do not tolerate the cream or have a hard time finding their optimal dose
- Those who can’t find a physician willing to prescribe them oral progesterone
- *Note: Progesterone cream can be purchased over the counter without a prescription but oral progesterone requires a prescription.
How to Supplement with Bioidentical Progesterone
- If menstruating: Use 20-40mg per day on days 14-28 of your cycle (the latter half of the month)
- If in menopause: you can use 20-40mg per day either 6 days per week (with rest on the 7th) or 26-28 days per month (with 1-3 days off per month)
- Make sure to monitor your symptoms while using and discontinue use if you experience any negative side effects
- Discuss the use of bioidentical hormones with your physician
Get bioidentical progesterone here.
Your next option is to use oral progesterone which comes as the brand name Prometrium.
The problem with using oral progesterone is that it is not metabolized the same way that transdermal progesterone cream is.
The metabolism of oral progesterone leads to high levels of pregnanediol which is not normal for the body.
Having said that some women do benefit tremendously from oral formulations of progesterone.
Who should use oral progesterone?
- Those who have failed progesterone cream
- Those who need very small doses of progesterone
- Women who forget to use progesterone cream daily
- Women who are also using multiple other transdermal hormones
- Women who suffer from insomnia
Remember, if you need to use oral progesterone make sure you get bioidentical progesterone (Prometrium) and NOT a synthetic progesterone.
Back to you
Progesterone, depending on how it is used, can cause either weight loss or weight gain.
The problem with using progesterone is that you must be using the right type, the right dose, and use it in the right way (preference on a cream or transdermal application).
If you follow these instructions and only use them when it is necessary, you will benefit tremendously from their use.
Now I want to hear from you:
Are you using progesterone? Is it helping you with weight loss?
Has it caused weight gain?
Share your story and leave your comments below!
Scientific References
#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964851/
#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951762/
#3. https://www.ncbi.nlm.nih.gov/pubmed/234975
#4. https://www.ncbi.nlm.nih.gov/pubmed/18942551
#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288428/
Hi there,
I have had a hysterectomy and have been left one ovary. My doctor has just prescribed me progesterone pills. I also have hypothyroidism and am on aurmor thyroid and lyvoxcil medication for that. I have gained about 20 pounds in the past 6 months and am afraid to take more medication and the fear is more weight gain. Is this a good medication addition or not?
I have been taking medroxyprogesterone 2.5 mg/day and Estradiol 1 mg/day for a few years with no weight gain or loss. About 4 months ago I stopped because I ran out of my RX supply and was waiting to get into the doctor to have it renewed. When I got it renewed (I think it was probably about a month later), I began taking the same drugs, the same dosage again. At some point during this- I think it must have been about two months ago- I noticed slight weight gain, even though I had zero change in diet or exercise patterns. I’m now frustrated and unhappy with this weight gain, although it’s not a huge amount, and am wondering whether the brief hiatus from the hormones could have caused it? I stopped taking them again a couple weeks ago, thinking they were CAUSING it. Can you help me figure this out?
Hi, I was told I have extremely low progesterone so a naturopath prescribed 50mg natural progesterone pill daily to start. Iโm likely perimenopausal. She also thought it might help shrink my large fibroid because of the hormonal imbalance. Anyway, the first week it made me extra anxious. That got better the second week but my stomach is huge! Iโve gained some weight overall but especially in my stomach to the point where clothes donโt fit and Iโm embarrassed. This is not normal for me. Iโve been exercising more and eating less but doesnโt seem to matter. Iโm really fed up. If I have such low progesterone why is my stomach getting so fat? Itโs been 2 weeks. Shouldnโt I level out by now?
My doctor prescribed 100 mg of bioidentical oral progesterone since the transdermal did not absorb well. Is that too much?
Dr. Childs, what if your cycle is extremely erratic and you can’t determine the best days to test (i.e. 19-21)? Since having my thyroid removed due to thyroid cancer 11 years ago my cycle has never been regular. I will go for 6 months without a period and then have 3 heavy ones in two months. I may then go three months without and have another two in one month, and then I’ll go another 6-8 without. My OB/GYN has tried testing, but we’re shooting in the dark. I tried progesterone cream with no change and ended up blacking out after my doctor continued to recommend increased doses. I am currently taking 25mg of pregnenolone daily to see if it helps regulate things, but it only seems worse. I switched from Synthroid to NDT 3 years ago and that hasn’t seemed to help either. My thyroid panel seems fine. I’ve seen numerous doctors and no one seems to have any clue what to do. My OB/Gyn eventually recommended ablation and possibly hysterectomy. I do not want to do that because it will only address the bleeding symptoms but doesn’t address the underlying and systemic issue. I’m desperate for suggestions. Thank you in advance for any you may have, and thank you for all of the wonderful information you provide.
Hello. After not being able to lose 1 pound after giving birth I was confused so I got my hormones tested. The test showed that I was estrogen Dominant. My doctor gave me promethium (Teva progesterone) 100mg. I took it on day 14-28 for four months and didnโt see 1 pound of weight loss. I went to a different specialist and he recommended taking 100 mg of promethium AND 80mg of progesterone cream everyday of the month. Iโve been taking this for one month and still no wight loss ( or weight gain ). Can you explain why Iโm seeing no difference? If I am estrogen dominant (which could explain the weight gain and why Iโm unable to lose any weight) then why when I take progesterone is it not helping?. I am a personal trainer and a holistic nutritionist so I take very good care of my body
Hi Ingrid,
I just wrote a post about postpartum weight loss using an example which you may find helpful. The post goes over the most common issues that cause weight loss resistance after giving birth: https://www.restartmed.com/postpartum-weight-loss/
I’m one of those few women that did very well on the depo shot, other than some acne, I lost weight, no other sides. I quit due to age and worries of osteoporosis. However I have been suffering hormonal issues for years, I’m now 46 and have endometriosis, hyperplasia and severe pelvic congestion. I tried natural progesterone cream immediately gained weight, which had to be fluid retention. My stomach and breasts were very engorged and painful. Also made me even more tired than I already was, and that was a huge issue already. I played with the dose, lasted 3 cycles and quit. Tried it again with same results. Then I tried Mirena IUD, same exact result but worse because it tore through my uterus. Had it out in emergency room e weeks later, within days I was back to normal. Now I’ve developed IC painful bladder syndrome and the pain is too much to take. My gyno wanted me on megace and I said no way. I decided to try the shot again. I’m very fit and a good weight but I also have to eat very little and very healthy while working out a lot. I’m on 45 mg armor thyroid for over 3 years. 2 days post shot no reaction and a noticeable decrease in appetite and sugar cravings.
Can you explain this? Everyone says depo is so bad and yet I do better on it than on natural progesterone? I will do another biopsy in 3 months and I will consider bio oral progesterone. But if I’m doing good on depo then I may just go another round.
Hi Maria,
I was wondering if anyone has ever mentioned your hormone issues including your thyroid dysfunction to your use of the DEPO Provera injection in your younger years?
I started back on bio-identical hormones in Jan. took them for the entire month. The cream is 2 clicks a day, 2 times a day, morning and night. It is E-2 Estradiol 0.7, E3 Estriol 2.8, Progesterone 100 and Testosterone 2. At the end of the month, I dropped ten lbs, leaving me very much on the thin side. I was also on a beta blocker which I had stopped 2 weeks prior. I stopped the hormones instantly. Needless to say, I feel like I need them. Could this hormone cream cause this much weight loss in a month? I have had blood work done and all my blood work is fine, not sick. I did ask my doctor for hormone patches and have not started them yet, I came across your board and wanted to know what you think but I do need to be on one or the other hormones. I just don’t want to lose any more weight. Thank you.
Hello Dr Childs
I am transitioning into Menopause and at 45 I feel like I am 60!
I am on the following supplements to try and curb my weight gain and very low Testosterone (1) and Progesterone (0.8) and ESH (60).
0.5% Testosterone bioidential every night
2% Progesterone bioidentical every night
1000 mg x 2/day of liquid Berberine
800 mg x 2/day Alpha Lipoic Acid
Pyrrole tablets x 2/day
Vitamin C 1000mg x 1/day
Ultimate Omega 1000mg x 3/day
Activated B x 1/day
Activated Sublingual B12 x 2/day
Priobiotic
Vitamin D Bone Builder Powder (1 scoop in water)
Alka Magnesium Powder at night 5g/night
I started the berberine and alpha lipoic acid as you mentioned on your website that this will help with weight gain. Am I safe to take the Progesterone and Testosterone together every night? Do I need all of these supplements?
Please help! I have been on this journey for 4 years and I have seen 3 top GP Naturopaths who can’t seem to stop this awful experience. Have you heard of Panacea Protocol?
Thanks.
Hi Luana,
There really is no substitute for a knowledgeable physician to help guide you so I would recommend that you seek out someone to help you. It can be very difficult to try and figure out hormone balance without some help.
Did you ever figure out a solution? Did you do the panacea protocol by chance?
Hello Dr. Childs,
I began having hormone problems after being prescribed an experimental birth control while in the Navy. I had a hysterectomy at 29 but kept my ovaries. I am 39 now. I had/have one ovary that seems to work okay and one that is troublesome. I have seen many doctors of many types in the last 10 years. At one point, a holistic doctor had me on 600 mg of progesterone cream daily. Yes, you read that right. Needless to say I went down hill quickly. Thyroid tanked. 40 pounds of weight came on rapidly in two 20 pound sets. I went off everything years ago but have kept progesterone around as a rescue treatment during bad PMS months. I have healed my thyroid with probiotics, prebiotics, and low carb/ketogenic eating.
This month I am having what I know is very elevated estrogen in relation to progesterone. A close friend reminded me to dust of the progesterone cream. I have been taking 15 mg twice daily for a few days and feel remarkably better. This morning though, I got the telltale fatigue and lightheadedness of too much, so I think 20 mg or less, at night, will be my sweet spot. My question is: How do women with ovaries, but no menstration to guide them because of a hysterectomy, dose? During the bad months I know when I need it (breast tenderness, PMS, lack of sleep, etc.). Thank you.
Hi Tiffany,
You can try to find your “normal” by testing your labs on a “normal” month, but otherwise, the best way to do it is via your symptoms.
That’s what I figured. I’ll just need to get a mind set of okay I need it rather than a schedule. Thank you again. Have a wonderful day.
Hi, hoping you can please give me some advice. I’m 49 and haven’t started menopause yet. I have been gaining weight, especially over the last few months, and nothing I do seems to shift it. I’ve been diagnosed as having extreme adrenal fatigue and have low counts of both testosterone and progesterone. My doctor has prescribed me creams for both and I’ve been told to use one pump each day of each for a few days and then increase to two pumps to see what feels better. For the progesterone I only use this from day 14 to day 25 of my cycle. I’m not sure how to tell which dose is more suitable for me as I’m not sure exactly what effect each one has on the body. I’m desperate to get this weight off as it is causing problems with my feet. Could you please offer any advice on what sort of dosage I could try that might help to get things properly balanced so I feel better and the weight starts coming off? The doctor just tells me that when we get the balance right the weight will shift but I don’t know how to get this balance right. Any help you can give me would be greatly appreciated. Thankyou
Hi Lina,
I can’t really recommend dosages unless I have all of the information and that would require blood tests, an interview and so on.
I am 44 and on 200mg bioidentical progesterone a day (oral) and 5mg DHEA cream, for early menopause. I was on conventional HRT for a year (estrogen gel and oral progesterone) but went off that regime 6 months ago as I was concerned about the risks of estrogen supplementation, and also I had gained almost 10kg in the year I was in it. I have now been on the bioidentical progesterone for 6 months and still cannot loose weight. I am not obese by any means (I am 1.78m and weigh 73kg) but really do not like carrying the extra 10kg I have gained. The progesterone definitely does help with my sleep though. Do you think it’s the dosage that is causing the weight gain?
Hi Michelle,
It’s certainly possible, but many other factors could be contributing as well.
Hi, I am 48 years old. My doctor put me on 100mg of promethium once a day (bedtime). He did not test my progesterone levels prior but I was having hot flashes and headaches every day. I feel much better, but Iโve gained 6 pounds and my stomach is bloated! I look like Iโm 4 months pregnant. Does this mean that the dose is too high?
Hi Kari,
It’s certainly a possibility.
How much biodentical oral progesterone is ok? It has been helping me sleep so much better since I upped my dose. 150 mg at night. I will be getting my levels tested soon but was wondering if this was super high dose.
Hi Marsi,
The dose that each person needs is different.
I had my estradiol, progesterone, cortisol, FSH, and LH tested on day 26 (no one, not even my ND, said there was a preference on what day to test).
Hopefully, this results will still be useful.
Anyway, looking at the scale, time in cycle, and my numbers:
I have low progesterone (over 4 points past the low end of the scale)
low estradiol (in range)
high LH (almost off range)
low end of range FSH
low end of range cortisol (and yes I know serum cortisol isn’t very reliable).
I’m also on T3 and T4 for hypothyroid (low end of ‘normal’)
I also have Lyme disease.
My reason for taking these tests is that within the last 6 mos, I’ve gained 15 lbs and I’m a small person, thin all my life, to begin with. From 125 to 140.
Have you seen these types of relationships between range results? I’m assuming all this accounts for my sudden (relatively) weight gain? And yes I’ll be checking with my docs.
Hello,
I am a healthy and fit 47-year-old female but have had terrible PMS for the last few years. After a few erratic cycles last winter, both my Ob-Gyn and Naturopath doctor prescribed me 100mg of OMP (not Prometrium but a generic brand of micronized natural oral progesterone) that I take day 15-25. Since I started, my PMS has simply gone away and my cycles are back to being regular (i.e. ~28 days). I have also taken DIM for years, but its a bit hit-or-miss on this one, but the combination with OMP seems to work well. The other helpful things I’ve noticed, are reducing the intake of coffee (tea seems ok), as well as a minimal amount of alcohol (2-4 servings per week max).
Hope this helps!
Hi Nathalie,
Thanks for sharing and glad it’s working well for you!
Hi, not sure if this discussion is still going. But I take the pills based on having endometriosis. Doc stated I need to continue the pills or risk the disease coming back. But I am basically dealing with all the side effects. Bloating, weight gain, mood swings, tenderness on tummy, depression.
Anything special to reduce this effects?
I’m sorry, I came here for information but every time I see a male medical person medicalize my premenstrual emotions and the natural activity of my uterus they lose credibility to me. Sadly, I think you will make a lot of money medicalizing natural processes in women. I hope you end up having a daughter who is smarter than you.
Hi HH,
I’m sorry to have offended you.
I would recommend you take a look at this study which may shed some light on the situation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5138621/
I hope this helps!
Iโm 32 years old and diagnosed with โmenopausal syndromeโ by my Dr. He ran a handful of blood tests, and my estradiol, progesterone, and testosterone were all low. (5.0 for est, 0.15 for pro, and 7 for test). First, how do I determine if I am estrogen dominant? Secondly, would a progesterone cream possibly be beneficial for me and aid in weight loss? The low hormone levels were discovered because I havenโt been able to lose weight since having my son 3 1/2 years ago. He has me on a testosterone cream and phentermine right now but I still have night sweats and hot flashes and in 2 months of the test cream and phen Iโve only lost maybe 3lbs.
Hi Kathleen,
I would take a look at this blog post for more information about estrogen dominance: https://www.restartmed.com/estrogen-dominance-symptoms/
I have been taking progesterone orally 100 mg and estrogen gel .06% 2-3 pumps daily for many years. I also had started taking thyroid meds Synthroid 125 mcg after I had my 3rd child, at age 38 because my thyroid stopped working. Since I started going into menopause, at age 45 and I have gained 40 to 50 lbs. I was never over weight until I started this and can’t seem to control it. Before this, I was always slim 120 lbs. What can I do, I’m also wondering what normal hormone levels should be.
Hi Jane,
I would take a look at this article here for more information on menopausal weight gain and how to treat it: https://www.restartmed.com/menopause-weight-gain/
Hi Dr.
Iโm on my first month of progesterone orally (day 14-28). I have estrogen dominance. Iโm 40 and have a regular cycle. Iโm also taking cytomel for hypothyroid. Very active, eat well (vegetarian and clean) but suffer from inability to lose weight. Can you recommend a part of your blog or any reference that follows a patient through the first few months on progesterone? Side effects, weight loss (or gain) etc. Iโm noticing strange side effects and it would help me to feel less alone if I could follow along with someoneโs journey. Thanks.
Hi Carrie,
I don’t really have a blog post on that topic but I will add it to my list to create in the future!
Hello,
I have A Mirena IUD with 2mg progestatif release/day since April 2017.
I also have endometriosis Stage 3 that’s been excised in last February 2018.
Since the excision surgery, I’ve been put on 5mg PO DIE (Norlutate) because we want to slow the process of Endo lesions forming but at the same time, not put me in a complete menauposal state because I’m 42 yo and I want to still be able to reverse to a fertile state when I’ll try to get pregnant. If if were younger, my body could of bounce back from a GnRH antagonist.
Basically,I have gained 30-35 pounds in the last year and I was wondering if the progesterone might be at fault?
Thanks in advance,
Vรฉronique
Hi Veronique,
The short answer is that yes it certainly could be.
Hi Dr. Childs,
I have 2 questions:
1. I have been on the patch and progesterone for 6 mo, and Spironolactone for hair loss for 2 mo. Do I need to reduce the patch dose, given that Spiro will also increase my estrogen level, which will make me “estrogen dominant”?
2. I was on progesterone 200mg for 14days and recently switched to 100mg daily, because I just stopped monthly bleeding. Should I continue with the 14 days pattern 2-3 years after menopause, whereas I am only few months into it. What is the drawback for daily dosing?
Thank you,
Mona
I realize I’m a little late to this thread, but I need some advice. My doctor has prescribed progesterone for me. I take one in the morning and two at night. She actually recommended me adding a third at night to see if the breast tenderness went away, she said it could also get worse. I just have to see how my body responds. My progesterone is made by a compound pharmacy and are 25mg caps. She also has me on testosterone (.5mg troch)I just started the testosterone a week ago. I’m taking both of these because of estrogen dominance. However my weight over the past three months has blown up! I’ve gained 6 lbs and I am a very active person. I workout 4-5xs a week, I have a healthy diet, I do not eat gluten, processed foods, no grains, legumes & I try to go easy on the dairy. Before I toss my progesterone in the trash & just embrace the cramps & migraines I get with my period I’m wondering if my body is just in hormone shock & if my weight will go back down after awhile of adjusting. Does that happen? I’m short so every pound counts.
Finally an article that gets me! Started on troches and instantly gained 5 pounds. I’m up to 7 now. It’s been 12 weeks. I was tired all the time, not sleeping well, over all blah feeling. My weight was about 130 at 5’2″. Since starting the troches, I am sleeping better, a little less anxious, have more energy. But the weight gain is killing me. I hike and exercise. I’ve been doing a 16 hr fast. no food from 8pm – 12noon, 5 days a week. My doctor modified my next batch, so hoping for the best! If this doesn’t work, I may switch to the creams and try that. Supposedly I’m in full menopause and I still have an IUD. – it is a few years old. Would removing that make any difference at all?
Hi Ang,
I see continuing to use an IUD beyond menopause as a potentially big problem (especially if it contains hormones). It would be a good idea to consider removing it if possible!
Hi there, I didn’t see a dose range suggestion for the oral Prometrium. Did I miss it or can you give a little detail about dosing for that? I see the 20-40mg for transdermal.
Many thanks!
Barbara
Hi Barbara,
I would take a look at this article for more information: https://www.restartmed.com/progesterone-pills/
Dr. Childs,
I have been taking 200 mg of bioidentical progesterone nightly which has made me sleep really well however I do notice that when I take it I feel drunk and can barely walk…so I’m thinking my dosage is too high and my doctor is lowering my dose but wants me to go off for a couple of weeks. I’m not sure if I have gained but if I have will the weight just come off by removing the bioidentical progesterone? Just curious about your thoughts.
Hi Dayna,
Sometimes reducing the dose is enough to normalize the weight but I don’t find this to be a common occurrence. Meaning many women who drop their dose still maintain the new weight that they have gained.
I am 36, I want to have children, but I am having some serious problems with my cycles right now. I currently weigh 315 pounds on 5’8″ lean frame. Two years ago I weighted 260 pounds but through time I gradually put weight on. I’m trying to diet to get rid of the weight, but it is slow going and takes time. It is much easier for me to gain weight then to loose it. After each 10 pound weight gain starting after 280, I began to suffer irregular menstrual bleeding. When I went to the women’s doctor I had an ultra sound done, and found out the lining in my uterus was extra thick. I don’t have insurance and can’t go back to my doctor. I saw a youtube video where a doctor said that problems with weight, can cause problems with progesterone and cause a thick lining. In the video he said that he often prescribes progesterone to help correct the problem. Since I can’t go to a doctor I ordered a cream from Amazon haven’t tried it yet. I’m wondering if I should.
Hi, I am perimenopausal and have very low progesterone and average estrogen but have gained a lot of middle weight because of the imbalance despite my limited paleo diet. However I tried taking natural compounded oral progesterone per a naturopath, 50mg a day, and within 2 weeks gained a ton more weight in my middle that I can’t get off. I felt better mentally but it made my weight much worse.
What is the right way for me to take progesterone to balance my hormones and not gain more weight? I can’t seem to find a doctor that has a clue about how to balance female hormones. Thanks.
Hi,
I had a hysterectomy 7 years ago. I have my ovaries. I am now 38. Since the hysterectomy I have not felt the same a significant amount of my hair has fallen out and not come back and I have terrible migraines, fibrocystic breasts, insomnia a bit of acne. I have started taking Prometrium 100 mg for a couple of weeks I didn’t really notice a difference so I bumped it up to 200 mg. Since taking the 200 mg it makes me extremely tired which is good because I actually sleep at night. But I have been having terrible breast pain, tired and lethargic all day and now I’m noticing chest pain after taking it. I started taking one pill in the morning and one pill at night to divide it up. I’m still having these symptoms. My question for you is is this helping me? Should I just give it some more time? Or try something totally different? Thank you for your help.
Hi Dina,
All of those symptoms would indicate that your dose is off and should be adjusted. Breast pain/tenderness is never a normal side effect that women should experience when taking hormones and should be addressed.
You wrote in bold to take progesterone when it is naturally high in the cycle. That’s confusing. Were replacing it, so we should take it when it’s low, no matter what time of the cycle.
And as for the cycle information, that means to start taking it beginning on approximately day 16. At that time, it will be low for those of us with estrogen dominance.
Hi Jane,
You are certainly welcome to take it however you please, just beware of side effects as you stray from these recommendations.
My dr just increased my progesterone because I tested low and I suffered from insomnia. I take 6.25 mg of Estradiol cream also. I am sleeping great now but I have gained 8 pounds. I need to sleep well but I am concerned about the weight gain and I don’t know what to do?
Hi Pam,
It seems as if your doses may be too high which may be causing your weight gain.
I’m 51 and in perimenopause. I’ve been prescripted oral progesterone to reduce my very heavy bleeding. I take it on day 2 of my cycle, trying to maintain my energy & iron stores. The doc suggested taking it 10 days, but I hate how it makes me feel. Could I be causing myself problems if I take it only on days 2-6 of my cycle?
Is it true that progesterone receptors are only on the breasts and thatโs the only place you should apply the cream?
Hi Diane,
And nope! That is definitely not true. There are progesterone receptors in the brain, breast, uterus, etc.
Hi, I just came across this and Iโm 37 and have been on Bioidentical progesterone cream for about four months now. Taking 50mg twice a day 1-15 of the cycle and taking 100mg twice a day 16-28. Before my estrogen-progesterone ratio came out as only 75 and having estrogen dominance symptoms. Was tested two months ago and ratio went up to 200. Now I have had trouble sleeping, depression, anxiety, no libido at all and have gained about 8 pounds so not feeling well. Please let me know your thoughts.
Hi,
My doctor recommended DIM to balance hormones, I have gained 30 lbs in 6 years. My estradiol and progesterone are very low. So it’s not always high. To get your hormones balanced you have to check your blood every 4 to 6 months to see wat te hormones are doing. After 4 months of using Testosterone, it was too high. and estradiol, progesteron stil to low. So she makes this dose higher. and test lower.
I never thought of my estradiol would be low until I tested.
I recently started bioidentical hormones, including progesterone (post-menopause). Iโve not changed my diet or exercise but have lost weight, which I actually donโt want to do. On the contrary, I would love to gain 5-10 pounds. I recently came across an article that stated progesterone can increase basal metabolism. In your opinion, is this true? If thatโs possible in some situations, how can I take progesterone to gain weight? Currently I take 200 mg. of oral micronized progesterone daily after dinner. Thank you.
Hi Susan,
It can but only slightly and typically not enough to notice a huge difference.
I have a question, take every 3 months a lab test and my progesterone and estrogen where both low . i gained 30 lbs . i have seen on the bioidentical cream the estrogen is getting better 0,25 % a day
and the progesterone is stil low on 2x 30%. can ik take more progesterone 50 in the morning and 20 in the evening?
I started to have irregular periods that lasted weeks in November 2019. I am 43, my gynecologist did a biopsy and the results were hormone imbalance, low progesterone . I was prescribed Provera Progestrone tablets, the tablets stopped the bleeding. I gained 10lbs since November. My menstrual period has improved but itโs not normal yet but I am not bleeding for weeks. January and February were irregular. Would using a progesterone cream be beneficial? I have tried losing weight but itโs not working. I am wondering if itโs hormone related.
Hello Dr. Childs,
This comment thread may not be valid anymore but hopefully Iโll get an answer:). Iโve commented at other times about having Hashimotoโs and you have been very helpful.
Tonight I came across this very helpful info. I have recently been prescribed CD/BIEST/PROG 5/200MG/GM. At first I was able to sleep alright and fell happy and clear headed. Recently, I have been feeling dizzy, nauseous, raging headache, my legs ache terribly, and sometimes irritable. How much should I really be taking? Plus Iโve never had a hormone test. What type of test do you recommend.
Hi, I’m completely baffled by my symptoms I’m going through the menopause and have PCOS too . I have had very rapid subcutaneous fat loss (extremely disfiguring) and muscle wasting, are these menopause symptoms? I feel I have a thyroid condition but my doctor says I dont. I have antibodies and my results are borderline according to the NHS guidelines. There is less if me eveyday when I wake up. I’m worried, I feel lost as to know what to do now.
I will leave my two cents here just in case it helps anyone here. I was taking 20mg To 40mg Progesterone cream from my late thirties to the age of 51 and then bam! My estrogen went from slowly decreasing to dropping extremely low within about two months. (Hello menopause!) I just happen to have had my blood tests done at these times to witness this. This drop caused auto immune Hashimotos and severe menopausal symptoms. I had to eat every half hour during the day and get up at least two or three times at night to eat. Heart palps, weight gain, no sleep, all over body pains, you name it. It was horrible. At first I stopped all supplements including the pro cream because I thought I did something wrong. But soon I realized that I simply needed more of everyhting!
I started increasing progesterone cream Until my symptoms improved – all the way up To 600mg at night! I had also tried estrogen patches but they made everyhting worse. I took 600mg of pro cream for three years straight until I felt like it was getting too much. (Thank god for the companies that make high dose creams. I had also tried bio identical pro in pill form and just got panic attacks from it.)
After that I slowly weaned myself off. Iโm still on a small amount now. (I found this site because I was searching for info about staying in it or trying to wean all the way.) My gyn said Iโm one of several of her patients who canโt handle estrogen at all. She attributes it to thyroid issues (which are associated with estrogen dominance) and genetics. The good thing for me was that taking the progesterone normalized my weight again and it kept me pretty stable. But man was that hormone drop horrible In the beginning. So many things I had read about menopause were just trivializing it and reducing it to feeling unwell or having hot flashes. My experience with menopause was a severe health crisis.
Anyway, higher doses of progesterone cream were my life saver. I have no idea what I would have done without that. My gyn kept testing my hormones. My estrogen has been stable every since that crazy hormone drop at 51. And my progesterone, despite taking these huge amounts never went past 2 which my doc was ok with. (Just for comparison, During pregnancy progesterone is 200 and up)
I guess the lesson of my story is to Make sure you find a doc who keeps testing you and is open for you to try things that are different from the norm. Because until we have personalized medicine that takes our genetic makeup into consideration we will have to accept the fact that we will have to expect to experiment until we find what works. Good luck and stay strong everyone! In the words of my gyn โmenopause is not for wussiesโ ๐
Also wanted to Add that eventually I went on the AIP (auto immune paleo) diet for my auto immune issues. It helped me drop the antibodies way down! Highly recommended.
I know this post is old, but it is super helpful, as I have gained weight taking oral bioidentical progesterone cream. My serum levels were very low and I have adrenal/stress issues. I do not menstruate. I am 38 years old and for 10+ years struggled with Hypothalmic Ammenorhea. Now, I’m not sure if that is why I am still not menstruating. My question is, should I still cycle on and off the progesterone – 14 days on and 14 days off? I did this for a while, actually, and when I went to continuous, that is when I gained weight… I may have just answered my own question, but would like your take on it.
I have been using a “natural” progesterone cream, but it does not say bioidentical anywhere on it. Could this be the problem? I have gained weight the past few months, pretty much since I started using this and nothing else has changed. I started using it for my hot flashes, and it does help with that tremendously. Is a “natural” progesterone the same as a “bioidential” progesterone?
Hi Kellie,
If the active ingredient is progesterone USP then it is bioidentical.
Hi there! My name is Sarah and Iโm turning 30 this week. I had my progesterone checked and it was low so I started taking bioidenticle cream around 3 months ago at 20mcg. My breasts grew triple the size they were (very tender to the touch,) I put on about 15 lbs and Iโm showing signs of puffiness and water retention I think. My doctor says this may be a sign I need MORE?! Iโm scared and thinking I should stop…. please help me dr. Childโs.
I am 48 years old, still menstruating but perimenopausal symptoms. My cycle has been off and short since removing my second mirena, which I did early b/c it was worsening/the onset of perimonopausal symptoms. But, ever since my cycle returned (was dormant due to mirena for at least 7 years), it has been in the 23-26 day range, more often falling closer to 23.
I have tested often in the middle of ovulation and when I expect to get my period and THINK my progesterone is low.
How would you define “low” progesterone for a menstruating but pre-menopausal woman? What range would be considered low?
Mine has been in the range of 1.2-4.2 and this is monitoring from 2019. There are two instances in which it was 6.8 (this ended up being 3 days before cycle start) and 7.4 (this was dead middle of luteal phase), but the first of which however I was taking Vitex. The vitex seemed to help but I am also hypothyroid taking NP Thyroid medication and I became HYPERthyroid in my bloodwork and had severe anxiety. It seemed the only changed factor was the vitex so I stopped it.
These progesterone numbers in ratio to my estradiol taken at the same time reflect estrogen dominance. I am back on the vitex at a lower dose than previously. But wondering what is the optimal progesterone range for my age and still menstruating.
So wouldn’t people who take birth control also be low progesterone if they don’t ovulate?
Hi TeeVee,
Women who take birth control pills have basically zero progesterone and estrogen due to the suppression of FSH and LH in the pituitary gland from the synthetic hormones found in the pill.
I’ve been on norethindrone for over a year now. I started at 5mg to try and stop my period (I’m a ftm trans male with really bad cramps). It worked at first, and then I started having breakthrough bleeding. My doctor then switched me to .7mg after about eight months and that completely stopped my period. Why is that? It has also caused me to gain 25 pounds, and it doesn’t seem to be stopping. I’ve completely cut out sugar, and still I gain weight. My metabolism used to be very fast, is it possible that it’s caused my metabolism to slow down? I’m also on weekly testosterone injections and my levels are that of a cis male (on the lower side of normal). Could that be influencing the weight gain?