Progesterone Cream

Progesterone is one of the natural hormones produced by the ovaries from puberty through to menopause. It affects the uterus and plays a role in both the menstrual cycle and in conception.

As a medicine, progesterone is prescription-only. However, you may have seen progesterone available to buy in the form of a skin cream. If it's not a medicine, what is this cream used for?

There's no proof that progesterone-only menopause treatment works – there is not enough evidence to suggest that progesterone can help with treating menopausal symptoms. While doctors will sometimes prescribe medicines that contain hormones including some similar to progesterone, for menopause it is actually the oestrogen-like hormones that help the most.

A number of small studies have shown that using progesterone cream to treat menopausal symptoms is no better than using a dummy cream with no hormones in it.

It may not be absorbed through the skin effectively – even though some studies have analysed the absorption of progesterone through the skin, it’s not completely clear what dose of progesterone would be necessary to obtain similar levels as when taken orally.

Bear in mind that progesterone creams on sale for treating menopausal symptoms are sold as cosmetics or complementary therapies. They are not licensed medicines, which means their quality, purity and ingredients may be unknown.

What is menopause? - Menopause is the stage of a woman's life when menstruation permanently stops. When your menopause is approaching, you’re likely to start experiencing symptoms caused by changes in your hormonal levels. It is possible that your symptoms might only last for a couple of years, but half of all women experience symptoms that last seven years or longer.

If you are looking for something to help with your menopause, you can get an assessment from an online doctor or you can speak with your doctor face-to-face and ask for their advice. Depending on the type and severity of your symptoms you may be able to start or continue menopause treatment online.

It‘s not possible to prevent or delay menopause, but it's possible to treat the symptoms:

• Hot flushes
• Night sweats
• Mood changes or depression
• Sleep disturbance
• Joint and muscle aches and pains
• Vaginal discomfort and dryness
• Pain during sex
• Less interest in sex
• Frequent urinary tract infections

There is not enough evidence to say whether using progesterone cream will affect your fertility. Without further research, nobody can say for sure if your fertility will increase, decrease or stay the same when using the cream.

Progesterone is a natural hormone that is vital for conception. If your doctor recommends fertility treatment, it is possible that progesterone will be one of the medicines that they use during the process. However, progesterone used during fertility treatment needs to be given at precisely the right time, and it will usually be given by injection, capsule or a vaginal preparation.

Progesterone in the form of a cream is not a reliable method of increasing your progesterone levels. Some scientists think that the amount absorbed into the body is too small to make a difference.

Female infertility – many things can cause fertility problems in women. These include:

• ovary problems
• thyroid problems that prevent ovulation
• scarring on the fallopian tubes from a past surgery or infection
• scarring of the cervix from a past surgery
• mucus in the cervix that is too thick
• growths around the uterus (fibroids)
• uterus lining growing in the wrong place (endometriosis)
• an infection in the uterus, fallopian tubes or ovaries
• using certain medicines or drugs

Male infertility – it is possible that your partner has a problem affecting his fertility. If this is the case, attempting to boost your own fertility may be a wasted effort. Reasons for fertility problems in men include:

• a low sperm count
• sperm cells that are abnormal or cannot move properly
• infection, cancer or surgery of the testicles
• abnormal or injured testicles
• difficulty ejaculating during sex
• low levels of testosterone
• using certain medicines or drugs

If you haven't been trying for long, remember that 84% of couples will conceive within a year of trying if they have sex once every two or three days without needing any treatment at all.

If you're having problems trying to conceive, you and your partner should speak to your doctor. They'll be able to offer advice and carry out tests to try and determine what the problem might be.

Endometriosis – it is not known whether or not using progesterone cream could achieve the same effect as other endometriosis treatments. Endometriosis is a condition where endometrium (the lining of the uterus) grows in the wrong place. It can cause pain and reduce fertility. It is not known what causes endometriosis, but hormones are suspected to play a role. If you've been diagnosed with endometriosis, your doctor will usually recommend painkillers and/or hormonal treatments.

Hormonal treatment options for endometriosis include:

• Combined oral contraceptives
• Progestogen-only contraceptives
• Medroxyprogesterone
• Norethisterone

All four of these medicines contain a progesterone-like medication. We think they work by counteracting the levels of oestrogen, another hormone produced by the ovaries.

Acne vulgaris – it's the oestrogen-like hormones that help with acne, so it’s unlikely that using progesterone by itself will help. Acne is caused by blockage or swelling of the hair follicles or glands, usually on the face, back or chest. Around 80% of people experience acne at some point between the ages of 11 and 30. It often begins during puberty as increasing levels of hormones cause the skin to become greasy.

Women are sometimes prescribed a combined oral contraceptive pill to treat their acne. Combined pills contain both an oestrogen-like and progesterone-like medication. There is good evidence that this works to improve the condition.

One option for treating acne without a prescription would be benzoyl peroxide. This is an over-the-counter medicine with a good amount of evidence to suggest that it works.

Some women that have used progesterone cream have reported being able to lose weight easier or get a better night's sleep. This could be due to improved menopausal symptoms such as fewer night sweats, aches and pains, or mood changes. However, there is no evidence to suggest that progesterone cream can actually help you lose weight or sleep better.

If you are struggling with your weight or sleeping, you should speak to your doctor. They will be able to offer advice or recommend a treatment that may work for you. It is unlikely that they will recommend using progesterone cream as this is not a recognised use of this hormone.

Progesterone cream is available from various online health and wellbeing websites, usually for around £15 to £30. It is unlikely that you will be able to find it on the high street as the sale of hormone-containing products is generally not accepted in the UK.

Effective progesterone treatment requires a prescription – all medicines containing progesterone are strictly prescription-only. This means any progesterone cream for sale online is actually a cosmetic product or complementary therapy and not a medicine. The rules for making these are not as strict as those for medicines so their quality cannot be guaranteed in the same way. The ingredients and manufacturing process is not held to the same high standards as licensed medicinal products.

Discuss with a doctor if you want to start using it – although you do not need to see a doctor to buy progesterone cream, you should speak to your doctor before you start using it. It is likely that there will be a more suitable treatment option for you.

Be aware that 'natural progesterone' is only called this because it is identical to the hormone produced in the body by the ovaries. Progesterone cannot be directly extracted from plants, it is always made in the laboratory.

No plants produce progesterone, and there are no known foods which naturally contain it. There are some supplements that are linked to progesterone production in your body.

Wild yam – is a plant that grows a vine with an underground tuber similar to a potato. It contains a substance called diosgenin which can be converted to progesterone in the laboratory, and products containing wild yam extract are available as menopause remedies. However, current evidence suggests that the body is not able to convert the product into progesterone. A trial into whether or not it could help with menopausal symptoms and weight loss did not show any benefit.

Vitamins – vitamins such as B6, C and E as well as minerals like magnesium and zinc are linked with the production of hormones like progesterone. Taking a routine multivitamin tablet may help support your general health and can reduce the symptoms of many conditions. However, it’s not recommended to take an excessive amount of vitamins. If you feel you need to take vitamins, we recommend that you discuss it with your doctor.

Homeopathic progesterone products – these are available, but they offer no benefit.

For menopause the best treatment is an HRT (Hormonal Replacement Therapy)– this can treat many of the symptoms of menopause and some can reduce the risks of osteoporosis, which can lead to bone fractures.

Other menopause treatments – these include:

• Antidepressant medication
• Medicines to help you sleep
• Lubricants or moisturisers for vaginal discomfort and dryness

Antidepressant medicines may also be used to help with hot flushes and night sweats, as well as mood changes and depression. Complementary therapies that may help include isoflavones and black cohosh, though their safety is not well known.

Lifestyle changes for menopausal symptoms

For hot flushes and night sweats:

• Regular exercise
• Weight loss
• Lighter clothing or cooling the room at night
• Reducing stress
• Avoiding triggers (like caffeine, cigarettes, alcohol or spicy foods)

For sleep disturbances:

• Go to bed at the same time every night
• Avoid exercising late in the day

For mood changes or depression:

• Make sure you're getting enough sleep
• Regular exercise

Alternatives for fertility:

• Limiting your alcohol intake
• Quit smoking
• Weight loss if you are obese
• Gaining weight if you are underweight

Your doctor may also recommend:

• Hormonal drugs for the man
• Surgical correction of blockages in the man
• Medicine to stimulate ovulation in the woman
• Surgical correction of abnormal tubes or uterus in the woman
• Directly inserting sperm into the uterus (intrauterine insemination)
• Introducing sperm to an egg in the laboratory – in vitro fertilisation (IVF) or intracytoplasmic sperm injection
• Donor sperm or egg

Generally speaking, fertility treatments are very successful. If you are worried about infertility you and your partner should talk to your doctor – they will be able to offer specific advice to suit your needs. Current guidance about complementary therapies is that there is no evidence to suggest that they help with fertility problems.

The risks are unknown – some studies have found that the actual amount of progesterone absorbed into the blood after using a progesterone skin cream is very small. However, a recent study found the amount of progesterone in the blood after using progesterone cream twice a day to be similar to the amount found after taking oral tablets.

This could explain why some women report having better symptoms, but it means the risk of side effects is not something you should ignore.

The most commonly reported side effects of progesterone cream are headache and vaginal bleeding. Other possible side effects include:

• constipation
• diarrhoea
• drowsiness or dizziness
• itching
• tender breasts
• vomiting

Some women have reported experiencing side effects even after they stop using progesterone cream. As progesterone is an oily substance, it is possible that it could dissolve in the fatty layers under your skin and accumulate there. It could then continue to be absorbed by the body even after stopping. It is not known if or when this might happen. There are no studies assessing the long-term use of progesterone cream.

Progesterone can be harmful if used with certain health conditions, so you should speak to your doctor before using it if you have:

• asthma
• cancer
• depression
• diabetes
• epilepsy
• gallstones
• high blood pressure or fluid retention
• migraines
• problems with your blood such as bleeding or clots
• problems with your ears
• problems with your liver

You should also speak to your doctor if you’re taking:

• bromocriptine
• ciclosporin
• medicines for depression, anxiety, insomnia, or epilepsy
• barbiturates
• carbamazepine
• phenytoin
• St. John's Wort
• medicines for infection
• Ampicillins
• Griseofulvin
• Ketoconazole
• Nelfinavir
• Rifampicin
• Ritonavir
• Tetracyclines (including doxycycline)
• Phenylbutazone
• Spironolactone