Health Benefits of Progesterone Cream

Does the popular hormone cream live up to the hype?

Progesterone cream is a form of hormone replacement therapy (HRT) designed to help relieve menopausal symptoms, reduce signs of skin aging, and prevent bone loss that could lead to osteoporosis.

Progesterone cream is available over the counter and made with natural plant-based progesterone derived from either soybeans or wild yam (Dioscorea villosa). It may be a viable alternative to the progesterone pills, suppositories, vaginal gels, and transdermal patches commonly used for HRT, especially among women who want to avoid synthetic progesterone.

Health Benefits

Progesterone is a type of hormone produced mainly in the ovaries whose role it is to help regulate menstruation and pregnancy. During menopause, progesterone levels will drop precipitously, triggering a cascade of physical and emotional symptoms. The depletion can also lead to bone loss and the deterioration of skin elasticity, firmness, and strength.

Progesterone cream may help improve the lives of women with menopause by:

  • Reducing hot flashes and vaginal dryness
  • Fighting fatigue
  • Improving mood and sleep
  • Alleviating skin dryness, wrinkling, and thinning
  • Preventing the loss of bone density (osteopenia)
  • Increasing libido
  • Fighting weight gain

Despite the health claims, research into the use of progesterone cream has yielded mixed and often contradictory results.

Menopause Symptoms

In a review of studies published in the Journal of Obstetrics and Gynecology in 2007, the researchers concluded that progesterone cream remains an "unsubstantiated treatment option" for women undergoing menopause. Their conclusions were based largely on the lack of quality evidence rather than an outright failure of the products themselves.

Another study published in 2009 in Menopause International concluded that progesterone was ineffective in treating menopausal symptoms. The study involved 223 postmenopausal women with severe menopausal symptoms, half of whom were given an oil-based product known as Progestelle (in either a 60-, 40-, 20-, or 5-milligram concentration) and half of whom were provided a placebo.

After 24 weeks, the progesterone group experienced no fewer menopausal symptoms (such as hot flashes and night sweats) than the placebo group. Despite the shortcomings, the conclusions may have been limited by product used.

By contrast, another progesterone cream known as Pro-gest has shown promising results in recent studies. A 2018 study published in the Journal of Clinical Pharmacology found that Pro-gest, applied twice daily for 12 days, delivered the same level of progesterone to the bloodstream as a once-daily, 200-milligram dose of oral progesterone.

The impact of Pro-gest cream on serum progesterone levels was so robust that researchers have questioned whether it is even appropriate as an over-the-counter product.

Skin Health

The use of progesterone cream for skin care has rendered slightly more positive results. A 2005 study published in the British Journal of Dermatology reported that 2% progesterone cream was superior to a non-progesterone cream in improving skin firmness and elasticity in 40 peri-menopausal and post-menopausal women

The four-month study concluded that progesterone cream improved four key measures compared when compared to regular skin cream:

  • Greater reduction in wrinkle counts (29.10% vs. 16.50%)
  • Greater increase in skin firmness (23.61% vs. 13.24%)
  • Greater reduction in eye wrinkle depth (9.72% vs. 7.35%)
  • Greater reduction in "laugh lines" wrinkle depth (9.72% vs. 6.62%)

Neither skin hydration nor surface lipids differed between the two groups, bringing into question how much the emollients in the progesterone cream triggered the changes and how much hormonal activity was actually exerted.

Other Benefits

There is little in the way of evidence of how much progesterone cream can prevent or slow osteopenia compared to oral progesterone. With that being said, the role of progesterone in preventing bone loss has even been questioned in recent years.

In fact, a 2010 review of studies published in the Journal of Osteoporosis concluded that progesterone on its own did little to improve bone mineral density in postmenopausal women. While it did appear to offer improvement for pre- or peri-menopausal women, it was generally more effective when used in combination with estrogen than on its own.

The same study suggested there was no difference in bone mineral density in women who used progesterone cream when compared to women provided a placebo.

Possible Side Effects

The side effects you can experience while using progesterone cream may differ by the product used. Some women will be very sensitive to the active ingredient; others will not. In some cases, progesterone cream may promote moderate weight gain and trigger a number of low-grade side effects, including drowsiness, nausea, headaches, and breast pain.

However, it would be unwise to presume that progesterone cream is "weaker" than oral progesterone, particularly with long-term use. Some women have been known to develop PMS-like symptoms or experience oily skin, acne, excessive body hair growth (hirsutism), depression, anxiety, and abnormal blood clotting after using the cream for several months.

Since repeatedly applying progesterone cream to the same area of skin can lead to irritation, rub the cream into different areas with each use.

As an over-the-counter remedy, progesterone cream is not strictly regulated by the U.S. Food and Drug Administration (FDA) and does not need to undergo the testing required of pharmaceutical drugs. As such, the quality of the various preparations can differ, including the types of inactive ingredients and plant-based progesterone used.

Be especially careful if you have a soy allergy. While the soy proteins will be largely denatured in the processing, it may still be wise to choose a wild yam-based product instead.

Be advised that the safety of progesterone cream has not been established in pregnant or breastfeeding women. As with all medications, advise your doctor if you are using or planning to use progesterone cream. Progesterone cream should never be used on children.

Dosage and Preparation

Progesterone cream is sold in various strengths, ranging from 25 milligrams per microliter (mg/mL) to 250 mg/mL.

While recommendations can vary based on brand and who you speak to, many doctors will tell you that a daily application of 25 mg/mL is enough to manage hot flash symptoms. By the time you reach 75 mg/mL, you will be approaching progesterone levels equivalent to a 150-mg or 200-mg oral dose.

If using progesterone cream to prevent hot flashes and other menopausal symptoms, some doctors will advise you to apply the cream once daily for six days and to skip every seventh day. You can apply the cream to your neck area, inner thigh, forearm, lower abdomen, or vaginal/labial area.

If you are using another topical hormone, such as intravaginal testosterone for vaginal dryness, you will not want to apply the progesterone cream to the same part of the body.

Use the progesterone cream only as prescribed, and never exceed the recommended dosage. As is the case with any form of hormone replacement therapy, more is generally not better.

What to Look For

Progesterone cream is readily found online and at many retail drugstores. When selecting a progesterone cream, only purchase those with "progesterone USP" on the label.

It is important to remember that products like progesterone cream are not regulated by the U.S. Food and Drug Administration (FDA) in the same way that pharmaceutical drugs are. The FDA does not review them for safety or efficacy before they reach drugstore shelves.

Despite their increasing popularity, it is too soon to recommend progesterone creams or ointments for health purposes. If you're still considering using progesterone cream, speak with your doctor to fully understand the benefits, risks, and limitations of treatment.

Other Questions

The progesterone used in topical products is derived from a plant-based estrogen known as diosgenin found in wild yam and soy. The diosgenin must then be chemically converted to progesterone in a lab.

Some manufacturers have tried to promote wild yam products as natural progesterone "boosters." Despite claims to the contrary, the body cannot convert diosgenin into hormonally active progesterone. Avoid these products.

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