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.
Studied, labeled, or reported-use context: 100-200 mg PO at bedtime (sleep/endometrial protection) or 100 mg vaginal daily — Rx; not individualized guidance.
What the evidence says
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)
Studied, labeled, or reported dose & route
100-200 mg PO at bedtime (sleep/endometrial protection) or 100 mg vaginal daily
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
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Common questions
- What does the evidence show about Progesterone (micronized / oral / vaginal)'s effects?
- 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.
- What safety findings are reported for Progesterone (micronized / oral / vaginal)?
- Progesterone (micronized / oral / vaginal) has a low risk profile in the database. Low (well-tolerated; sedation from oral route is feature or side effect; progestin-specific breast/VTE signal largely confined to SYNTHETIC progestins — MPA, not bioidentical progesterone) Legal status: Rx (Prometrium oral; vaginal compounded).
- What doses or routes are reported for Progesterone (micronized / oral / vaginal)?
- 100-200 mg PO at bedtime (sleep/endometrial protection) or 100 mg vaginal daily This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- 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.