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natural progesterone cream

What Is It?
Health Benefits
Forms

Dosage Information

Guidelines for Use

General Interaction

Possible Side Effects
Cautions

References
Evidence Based Rating Scale

What Is It?

Natural progesterone cream starts with a plant base--often either soybeans or Mexican wild yam. When wild yam is used, for example, a molecule called diosgenin is extracted from the plant and converted in the laboratory to create a molecule exactly like human progesterone. The new substance is then added into a cream for topical application to the skin. The hormone is believed be absorbed through the skin and pass into systemic circulation throughout the body.

Unlike oral natural progesterone (Prometrium is the only brand) and other synthetic progestins (many different formulations and brands) that are sold in pill form and regulated as prescription drugs, the cream form (which is only applied topically) is sold over-the-counter because of a loophole in the FDA's regulations. Many women going through perimenopause or menopause think of it as safer or more natural than prescription formulations; however there is little data to confirm this.

Health Benefits

For many women, natural progesterone cream appears to provide significant relief from symptoms related to shifts in the female hormones estrogen and progesterone. For younger women, such imbalances are often associated with Premenstrual Syndrome (PMS) or with endometriosis and bring on symptoms such as irritability, breast tenderness, and pelvic pain. For older women entering menopause, decreasing supplies of estrogen and progesterone can cause hormonal imbalances, producing hot flashes, mood swings, urinary urgency, and poor concentration.

Specifically, natural progesterone cream may help to:

Relieve symptoms of menopause. Preliminary findings regarding progesterone therapy to treat symptoms of menopause began as promising. In a study of 102 women suffering from hot flashes, nearly 83% found relief with the daily application of one-quarter teaspoon of progesterone cream. (1) However, some conflicting evidence exists. A 2003 study of 80 women at the Menopause Centre at the Royal Hospital for Women in Sydney, Australia found no difference between progesterone cream vs. placebo in blood progesterone levels or in relieving biological or physical symptoms of menopause, including, mood and quality of life. (2) A statement released by The North American Menopause Society (NAMS) in 2004 regarding recommended treatment for vasomotor symptoms associated with menopause indicates the data is insufficient to rate progesterone cream in treating these symptoms. (3) A large, double-blind, randomized, placebo-controlled study in 2009 also found progesterone cream was no more effective than placebo in relieving biological or physical symptoms of menopause. In the study, more than 200 healthy peri- and post-menopausal women between the ages of 40 and 60 who complained of severe menopausal symptoms were randomized to apply three-quarters teaspoon, one-half teaspoon, one-quarter, or one-fifth teaspoon (5 mg) of progesterone cream or placebo cream daily for six months. No statistically significant changes were observed between any of the treatment groups compared to placebo in components of the Greene Climacteric Scale, which evaluates biological, physical, and psychological symptoms. (4)

Of note, a small 2005 study of 40 peri- and post-menopausal women showed that applying a 2% progesterone cream topically to skin of the face and neck may help to slow the aging process after the onset of menopause by increasing the elasticity and firmness of the skin. Applying progesterone cream for 16 weeks led to a greater decrease in wrinkle depth and a higher increase in skin firmness in the treatment group, compared to placebo cream. Rising levels of progesterone on blood tests indicated that there was systemic absorption of the hormone. (5) More research is needed. 

Slow bone loss in osteoporosis. A primary factor contributing to osteoporosis (the gradual loss of bone mass and strength) in women after menopause is the drastic change in hormone levels. Preliminary studies showed that progesterone therapy may help to slow the gradual loss of bone mass and increase bone mineral density (BMD). A report by leading researcher John R. Lee, M.D., showed that applying progesterone cream over a 3-year period increased BMD by an average of about 15% in postmenopausal women. (6) However, in a study with conflicting results, the topical progesterone cream did not diminish bone loss in a group of women with a mean age of 52 years. (1), Lee subsequently amended his claim, saying progesterone cream works only in older postmenopausal woman (with a mean age of 65) who are past the period of rapid postmenopausal bone loss. A later double-blind study showed progesterone cream had a modest bone-sparing effect in postmenopausal women with osteoporosis but resulted in a negative interaction with soymilk (a major source of the isoflavones important in preventing bone loss). (7) A 2009 study of 131 healthy menopausal women between 50 and 75 years of age found that applying one-quarter teaspoon of progesterone cream twice daily for three years did not affect progressive decreases in bone density. (8)  

Reduce pain in endometriosis. In this condition, cells like those in the uterine lining (endometrium) grow in other parts of the abdominal cavity and sometimes elsewhere in the body: estrogen and other hormones cause these cells  to thicken with blood each month just as the uterine lining does leading up to menstruation. While the uterus sheds the engorged endometrium during menstruation, the wayward cells create blood that has nowhere to go causing scarring, painful adhesions, and cysts (endometriomas--also known as chocolate cysts because of the brown appearance of the old blood). Proponents of progesterone therapy believe it may help to counteract the effects of estrogen, thereby stopping further proliferation of endometrial cells. In a well-known preliminary study, women with endometriosis applied natural progesterone cream from day six of the cycle to day 26 each month (using one ounce of the cream per week for three weeks, stopping just before their expected period). Using the cream resulted in reduced pain and bleeding and, after about four to six months, healing of inflammatory sites. (9) More research is needed. 

Reduce breast cancer risk. Progesterone seems to promote apoptosis, or programmed cell death, which is an important function in the prevention of cancer. (Cells that do not go through apoptosis become cancerous.) The growth and development of most breast cancers, is at least in part, related to levels of both estrogen and progesterone. Therefore, researchers believe balancing hormone levels is important in preventing the development of some breast cancers. In the first double-blind, placebo-controlled, randomized study using estrogen and progesterone creams on women undergoing breast biopsies, results showed the two hormones have opposing effects on cells, with progesterone cream significantly reducing cell proliferation. (10) Another double-blind, randomized study of the breast epithelial cells of 40 healthy postmenopausal women found that applying progesterone cream for 14 days reduced proliferation of those cells. Progesterone was more effective than placebo cream, estrogen cream (estradiol), or a combination of estrogen and progesterone creams. (11) More research is needed. 

Relieve symptoms of PMS. Proponents of natural progesterone cream believe it acts to balance the hormonal fluctuations that contribute to many Premenstrual Syndrome (PMS) symptoms. However, studies have found progesterone does not work better than placebo in relieving symptoms of PMS. (12, 13)

Forms

  • cream

Dosage Information

When selecting a product, inspect the list of ingredients carefully; the ingredient list should include progesterone at a concentration of at least 400 mg per ounce to be effective. The general recommendations below for specific amounts of cream are based on this progesterone concentration: adjust amounts if using a different concentration.

If the label lists only Mexican wild yam without mention of progesterone, there will be no progesterone effect. Substances in wild yam and soy can be converted into progesterone in the laboratory, but the body cannot make this conversion. This is sometimes referred to as “the great yam scam”. 

For breast cancer prevention: No dosage has been established for humans.

For endometriosis: Applying one-half to one teaspoon(40 to 80 mg) of progesterone cream once daily from days six through 26 of menstruation (the first day of menstruation being day one) for four to six months has been used.

For menopause symptoms: Applying one gram (approximately one-quarter teaspoon) of progesterone cream daily to the face and neck has been used for facial wrinkling.

For osteoporosis: Applying one-quarter teaspoon daily has been used. 

Guidelines for Use

  • For general use, smooth cream onto the relatively thinner skin on the tummy, breasts, inner thighs, or inner forearms, avoiding the thicker skin on other parts of the body, such as the hands, for example.

  • Absorption may vary from one site to another due to underlying fat deposits, thus for consistent dosing use the same site routinely.

  • Use of other creams or emollients may affect absorption. Use only on clean skin.

  • The cream matrix (also known as vehicle in pharmaceutical terminology) into which progesterone is mixed varies from one manufacturer to another. Absorption and drug activity, even with the same dose of progesterone, may be inconsistent between different brands.

General Interaction

There are no known drug or nutrient interactions associated with natural progesterone cream.

Possible Side Effects

There have been no long-term studies on the safety of using progesterone cream, but risks and side effects seem to be minimal.

Cautions

  • Don't use the cream during pregnancy or while breast-feeding unless specifically recommended by a physician.

  • Large amounts of the cream--in excess of commonly recommended dosages--can cause spotting in postmenopausal women. If this happens, see your physician. 

References

1. Leonetti HB, Longo S, Anasti JN. Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss. Obstet Gynecol. 1999;94:225-8.
2. Wren BG, Champion SM, Willetts K, et al. Transdermal progesterone and its effect on vasomotor symptoms, blood lipid levels, bone metabolic markers, moods, and quality of life for postmenopausal women. Menopause. 2003 Jan-Feb;10(1):13-8.
3. North American Menopause Society. Treatment of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Menopause. 2004 Jan-Feb;11(1):11-33.
4. Benster B, Carey A, Wadsworth F, et al. A double-blind placebo-controlled study to evaluate the effect of progestelle progesterone cream on postmenopausal women. Menopause Int. 2009 Jun;15(2):63-9.
5. Holzer G, Riegler E, Hönigsmann H, et al. Effects and side-effects of 2% progesterone cream on the skin of peri- and postmenopausal women: results from a double-blind, vehicle-controlled, randomized, study. Br J Dermatol. 2005 Sep;153(3):626-34.
6. Lee JR. Is natural progesterone the missing link in osteoporosis prevention and treatment? Med Hypotheses. 1991 Aug;35(4):316-8.
7. Lydeking-Olsen E, et al. Soymilk or progesterone for prevention of bone loss: a 2 year randomized, placebo-controlled trial. Eur J Nutr. 2004 Aug;43(4):246-57.
8. Benster B, Carey A, Wadsworth F, et al. Double-blind placebo-controlled study to evaluate the effect of pro-juven progesterone cream on atherosclerosis and bone density. Menopause Int. 2009 Sep;15():100-6.9.
9. Lee JR, What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone, New York, NY: Warner Books, 1996, 117-28.
10. Chang KJ, Lee TTY, Linares-Cruz G, et al. Influences of percutaneous administration of estradiol on human breast epithelial cell cycle in vivo. Fertil Steril. 1995 Apr;63(4):785-91.
11. Foidart JM, Colin C, Denoo X, et al. Estradiol and progesterone regulate the proliferation of human breast epithelial cells. Fertil Steril. 1998 May;69(5):963-9.
12. Freeman EW, Rickels K, Sondheimer SJ, et al. A double-blind trial of oral progesterone, alprazolam, and placebo in treatment of severe premenstrual syndrome. JAMA 1995;274:51-7.
13. Wyatt K, Dimmock P, Jones P, et al. Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review. BMJ 2001;323:776-80.

Evidence Based Rating Scale

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies and what our clinical advisors have found to be efficacious in their personal practice into a visual and easy to interpret format. This tool is meant to simplify the information on supplements and therapies that demonstrate promise in the treatment of certain conditions.

 

Condition

Rating

Explanation

 

Cancer prevention

   

Preliminary research suggests stimulation of appropriately timed death of breast cells, without which cancer risk is increased. More research is needed. (10, 11)

Endometriosis  
A preliminary study indicates potential efficacy to improve symptoms. More research is needed. (9)
Menopause  
Preliminary results indicate potential to improve signs of skin aging after menopause. More research is needed. (1-4, 5)

Osteoporosis  
Conflicting evidence exists, but several studies indicate lack of efficacy. More research is needed. (1, 6-8)
PMS  
Studies indicate lack of efficacy. (12, 13)

 


Date Published: 04/19/2005
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