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Prometrium dosing for topical use

by Jane
(Canada)

Hello Wray
I have stumbled upon your site and am finding a wealth of such helpful (and calming) information.
I am perimenopausal...47 years old, have had several years of heavy periods (i thought they were normal, but...they were actually quite heavy) that left me with very low ferritin and hemoglobin levels - and then about 2 years ago my heavy but regular periods started getting terribly irregular, and sometimes horribly heavy with flooding that left me so depleted I would end up in bed for a few days. I have now basically bled continuously for almost 7 months - with a few flooding episodes thrown in for good measure.
I have been working the past couple of years to get my iron up and that is definitely on the upswing and I will continue taking an iron supplement until my levels remain steady. I recently was given a prescription for Prometrium (just 200 mg, orally, 10 days / month) after a bit more research, I went back to my GP and asked for a daily prescription of 300mg. I have been on that for almost a month... had a rough few days of flooding and large clots at the onset, but that let up. I am still bleeding daily...some days quite light - moderate, others like a regular period, but for maybe only half a day? I did have one episode of about 4 days that seemed like it could be a 'period' as it was a bit more consistent but I am so muddled now I really don't know if I'm coming or going.
After reading some of your articles here...I am questioning the oral route, and would like to use all of these pills I have topically or vaginally (I have a few months worth and it has been a big expense, so I feel that I need to use them all up)
My question is...given how much is lost taking these pills orally....how many pills should I be using topically to get the results I need (a cessation of daily bleeding and some sort of 'regular' period) How long do you recommend daily use for? And what to you recommend after a course of daily use?

I would so appreciate any insight.
with gratitude...

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Oct 28, 2014
 Prometrium dosing for topical use
by: Wray

Hi Jane Thanks so much for the kind words. We've found 400mg/day topical progesterone is needed to stop heavy and/or continual bleeding. So I suggest you open the caps, add the contents to a small amount of skin cream and rub it on your skin. It doesn't matter where, it can be used vaginally too. See our page on Peri-menopause for more info, also How to use Progesterone Cream. And as you are heading towards Menopause, this page too. Having helped many women with heavy bleeding, I've discovered an effective protocol to take in addition to progesterone. It often means less progesterone is needed than the 400mg/day. You'll find the supplements on our page about Menstruation, but they are N-acetyl cysteine, taurine, vitamin D and the bioflavonoids. I would ask you to have a Vitamin D test done, you live in Canada so will probably have a very low level. A lack of this reduces the benefits of progesterone, and can lead to heavy bleeding. 'How long' is impossible to answer, but certainly until a few weeks after the heavy bleeding has stopped. Then reduce the amount slowly, no more than 16-33mg per reduction, staying on that a few days before reducing further. Take care Wray

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