What’s the Deal with Prometrium (Progesterone)?

You’ve asked about progesterone therapy so I thought I would do a quick FAQ on Prometrium as it's so commonly prescribed.

Prometrium®️ = micronized progesterone that is "chemically identical to progesterone of human ovarian origin."

This means it's a bio (or body) identical hormone therapy. 🙌

It is not a progestin (synthetic). 👎 The prescription progestin medication is Provera. It’s also called medroxyprogesterone acetate. Despite the word ‘progesterone’ in there - it’s not.

Quick Notes on Prometrium:

• The pills come in 2 doses: 100mg or 200mg only

• The typical dose is: 100-400mg

• It also contains: peanut oil, gelatin, glycerin USP, lecithin, titanium dioxide USP, D&C Yellow No. 10, and FD&C Red No. 40 or FD&C Yellow No. 6.

• Some forms have sunflower oil instead of peanut oil but peanut oil is most common.

• Tell your practitioner if you are allergic or sensitive to any of those ingredients.

• When you swallow it, 10-20% of the progesterone is absorbed.

• It's absorbed BETTER when you take it with food per the FDA insert and this study. But both Canada and Australia write-ups say to take it on an empty stomach. 🤷‍♀️

• After it's done, it's mainly excreted in your urine and some in your stool.

• Common uses: address menstrual irregularities, improve PMS, improve perimenopausal and postmenopausal anxiety and insomnia, and protect the inner layer of the uterus from hyperplasia (thickening).

• You can take it alone. You do not have to take it with an estrogen but...

• If you are on estrogen AND have a uterus, it's highly suggested to also do 200mg of Prometrium at least 12 days/month or 100mg daily to protect the uterus lining from hyperplasia (thickening).

• The pharmacy handouts and online information mixes Prometrium (a bioidentical progesterone) with progestins (synthetic). They are NOT the same. I wish pharmacies would get with the times.

• Side effects to watch for: fluid retention, headaches, breast pain, acne, dizziness, "feeling drunk," fatigue, and drowsiness. This is why many women opt to take it before bed.

• Prometrium is listed as a Pregnancy Category B (you may have been on progesterone yourself when pregnant!)

• Source: here

If you are allergic to peanuts or food dye, you are likely on a different progesterone such as a compounded micronized progesterone. This is made at a compounding pharmacy. Other than the first 3 bullet points, the rest still apply to compounded progesterone!

You can download my Hormones 101 Cheat Sheet here or watch a my video on progesterone here!