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From prescription bioidentical progesterone pills to over-the-counter cream experience

by Carol
(United States)

I was told I had osteopenia, so I went to a doctor who prescribed bioidentical hormones. The doctor did the usual blood tests, including hormone tests for estrogen, progesterone, and testosterone. He put me on compounded pharmacy cream for estrogen and also progesterone pills, both bioidentical. I was with him for three years, dutifully taking these compounds at my own expense because insurance said they wouldn't pay for them. My cost was over a hundred dollars a month for the two prescriptions. The doctor tested me every few months. During the time I had him, my ratio was never in balance. The lab suggested that a ratio should be at least 100 pg, but I was never above 30. Even with a doctor, it's guesswork as to how much hormone should be used. I decided to give up going to the doctor and start taking over-the-counter creams, which were cheaper and more convenient to use, and decided that I'd do my own testing using the same lab the doctor did.

I already had an idea of what I was using and needed, so fortunately I had a baseline for taking the new prescription. My uncharted territory was changing from a progesterone pill to a progesterone cream. I read and found out that the 200 mg of progesterone in the pill could be met with about 75 mg of cream, so I used that. I also did a full pump of bi-est estrogen that seemed to be the equivalent of the pump I used from the pharmacy. To a degree, I didn't have much confidence that the over-the-counter stuff would work as well, but to my surprise, it worked extremely well. My hormones were in balance. I felt fine. That lab test was in January, 2023.

Fast forward to October, 2023, our current month and year, and I have found that I suddenly no longer have a tolerance for the creams. I tried adjusting the amount I took, even balancing it out over two sessions so that I was not slammed with so much hormone at once. I tried cutting it way back, only using a pea-sized amount with a ratio of 2:1 (P:E2) and still have symptoms of intolerance. I even tried the three-day break that was suggested by a doctor.

It could be that since I have taken hormones for 4 years and 3 months that my body has developed an intolerance to them. During my three-day break over the past 3 days, I found that I felt calmer and slept better. I don't like the idea of giving up on the cream, but I don't want to go on living with the physical stress that the hormones have brought onto me.

Comments for From prescription bioidentical progesterone pills to over-the-counter cream experience

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Oct 10, 2023
 From prescription bioidentical progesterone pills to over-the-counter cream experience
by: Joy

Hi Carol

Did anyone bother to test your vitamin D3 level? If you had/have osteopenia I would say your vitamin D3 level is too low, please have a test done. If you study this website you will see that we do not believe that any woman needs to take extra estrogen and testosterone. There are well over 100 estrogen mimics in our Environment as it is why take more and this on Testosterone. Estrogen and progesterone will compete against each other and the aim of progesterone therapy is to make progesterone the dominant hormone at all times. This is why you are experiencing intolerance and would explain your symptoms then and now and why you have been through a roller coaster of hormonal emotions. Please read Estrogen Dominance.

All forms of oral progesterone is not the best Delivery Method as around 95/96% get destroyed by the gut and liver see here. Creams are far better provided it is organic and a 3% cream such as Natpro. Suppositories and injections are also good delivery methods. Unfortunately many compounded progesterone creams contain parabens which we should all try to avoid. Between 100-200mg progesterone should be used using a 3% cream. See How to use Progesterone CreamHow to use Progesterone Cream. The ratio between progesterone:estrogen should be around 600:1 read the Hormone Testing page.

You don't state your age, you could be in Peri-Menopause which starts are around 35. Progesterone should be used every day with NO breaks unless you are wanting to conceive. If progesterone is used correctly you will enjoy it's benefits.

Going back to Vitamin D3. A deficiency reduces the benefits of progesterone. It is connected to every single functioning cell in our bodies, making it vital. This would include osteopenia. Equally important are cofactors.
Dec 08, 2023
 Dose
by: Anonymous

Will an even higher dose than 200mg help prevent the spotting? Is it better to up the dose or to wait it out? I assume adjusting the dose can cause periods to disappear in the meantime?
Dec 08, 2023
 Dose
by: Joy

Hi Anonymous

That would depend if you are in Peri-Menopause (PM) or not.  Please read the PM page given in this thread.  If not please read the Menstrual Cycle and How to use Progesterone Cream pages. PM brings on spotting/heavy bleeding/clotting.  There is a protocol that we recommend for this. Otherwise stick with 200mg and see how you get on.

Heavy Bleeding Protocol:
400-500mg Natpro Progesterone Cream per day
2000mg N-Acetyl-Cysteine (NAC) per day
2000mg Taurine per day
5000iu's Vitamin D3 per day
1000mg Bioflavanoids or Vitamin C per day  

Progesterone therapy is not easy, it takes 2-6 months of the correct use before one notices a difference.  It also depends on your Vitamin D3 level, see link given.

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