Rankings / Hormones & Endocrine
Progesterone (micronized / oral / vaginal)
Hormones & Endocrine · Progesterone replacement
Tier A
Bottom line
Read Off Label grades Progesterone (micronized / oral / vaginal) as A (8.0/10) based on strong evidence, moderate benefit magnitude, and a low-risk safety profile.
Bioidentical micronized progesterone (Prometrium) has a distinct safety profile from synthetic progestins (MPA/medroxyprogesterone acetate) that drove WHI breast cancer signal.
Typical use: 100-200 mg PO at bedtime (sleep/endometrial protection) or 100 mg vaginal daily — Rx.
What this is
Bioidentical micronized progesterone (Prometrium) has a distinct safety profile from synthetic progestins (MPA/medroxyprogesterone acetate) that drove WHI breast cancer signal. ESTHER and E3N cohorts suggest bioidentical progesterone does not elevate breast cancer risk materially. Oral dosing benefits sleep via CNS conversion to allopregnanolone.
Mechanism
Endogenous progestagen; balances estrogenic endometrial proliferation; GABA-A positive allosteric modulation via allopregnanolone metabolite (sleep/anxiolytic effect at oral doses)
Dose & route
100-200 mg PO at bedtime (sleep/endometrial protection) or 100 mg vaginal daily
Citations
- https://pubmed.ncbi.nlm.nih.gov/23993739/
- https://pubmed.ncbi.nlm.nih.gov/18657220/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5313437/
- https://europepmc.org/article/PMC/10437816
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Progesterone (micronized / oral / vaginal) work?
- Read Off Label rates the evidence for Progesterone (micronized / oral / vaginal) as Strong and the benefit magnitude as moderate, producing an overall grade of A (8.0/10). Bioidentical micronized progesterone (Prometrium) has a distinct safety profile from synthetic progestins (MPA/medroxyprogesterone acetate) that drove WHI breast cancer signal.
- Is Progesterone (micronized / oral / vaginal) safe?
- Progesterone (micronized / oral / vaginal) has a low risk profile in published human data. Legal status: Rx (Prometrium oral; vaginal compounded). This is not medical advice — see the disclaimer.
- What is the typical dose for Progesterone (micronized / oral / vaginal)?
- 100-200 mg PO at bedtime (sleep/endometrial protection) or 100 mg vaginal daily
- How does Progesterone (micronized / oral / vaginal) work?
- Endogenous progestagen; balances estrogenic endometrial proliferation; GABA-A positive allosteric modulation via allopregnanolone metabolite (sleep/anxiolytic effect at oral doses)
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.