Natural Progesterone: What You Need to Know

Natural progesterone (also called body-identical progesterone) is the same hormone your body makes. In the U.S., it’s most often prescribed as Prometrium®, an oral micronized capsule, or it can be compounded through a specialty pharmacy. Over-the-counter creams exist but are generally less effective.

Why it’s different

Synthetic progestins (like medroxyprogesterone or levonorgestrel) are not the same as progesterone. They often act more like testosterone and can cause side effects such as acne, weight changes, or mood symptoms. Real progesterone, on the other hand, has calming effects and can support more natural hormone balance.

How it may help

Natural progesterone can be useful for:

• Heavy or painful periods

• Endometriosis and adenomyosis

• PCOS (by lowering androgens and supporting ovulation)

• Menstrual migraines

• Premenstrual mood symptoms (PMS/PMDD)

• Perimenopause (sleep, night sweats, heavy bleeding)

• Menopause (alongside or sometimes instead of estrogen)

Talking to your doctor

In the U.S., Prometrium® is FDA-approved for use in menopause, but many women benefit from it “off-label” for heavy bleeding, PCOS, migraines, and more. If you’re interested, ask your provider about Prometrium® (oral micronized progesterone) and be clear you’re requesting progesterone—not a synthetic progestin.

💡 Good to know: Real progesterone does not increase the risk of breast cancer or blood clots, unlike many synthetic options.