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Why Do I Do Better on Micronized Oral Progesterone than Compounded Cream??

by Judy
(USA)

Hello Wray:

Wondering if you can explain this. I have taken micronized oral progesterone in the past. I wanted to give the cream a try (since oral makes a first pass through the liver), so my doc prescribed a ten percent compounded cream. I used it for two weeks out of the month (and tried it for three months). Each time I used the cream, I broke out in horrible cystic acne. Also, when I was on the micronized, my period arrived like clockwork a day after I stopped it while on the cream, it took four to five days before I got it. Needless to say, I am back on micronized as it seems to work better in my particular case. Can you explain possible reasons why some women like myself do better on micronized while others do better on the cream? Are there some women out there that don't absorb the cream properly? I guess in the end, it doesn't really matter what form you take the natural progesterone...as long as it gets in your system and you get the benefits (and of course, as long as it is NATURAL!)...do you agree?

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Aug 20, 2012
 Why Do I Do Better on Micronized Oral Progesterone than Compounded Cream??
by: Wray

Hi Judy Oral progesterone is the least effective Delivery system. So the amount you are getting is very low. The 10% is a high strength cream and as progesterone is absorbed very well topically, you were getting much more than via the oral. Although you don't say how much of either you were using, this is the reason you had the adverse reaction. Progesterone stimulates oestrogen, but before this can be made, testosterone is first secreted, and then the oestrogen converted. Testosterone is responsible for the Acne outbreak. If you'd used about 200mg/day of the 10% cream i.e. 2ml of cream, possibly more and continued it for longer, the acne would have subsided, as progesterone suppresses testosterone. Not only that but if bound to SHBG (sex hormone binding globulin) testosterone becomes inactive, progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone. You'll notice in the study amounts of 1200mg/day oral progesterone were used, I'm not sure if you're using that much. SHBG drops if sugars are eaten, even those found in all grains, legumes, dairy and sweet starchy fruits and vegetables. Fructose, sucrose and glucose, reduce SHBG by 80, 50 and 40% respectively, see here. It's best to avoid all the foods and sugars mentioned. But the bottom line is if you are feeling fine on the oral, then continue taking it. And I do so agree with you about using progesterone and not the progestins. Take care Wray

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