From the Research
For perimenopausal symptoms, topical progesterone cream is typically used at a dose of 20-40 mg per day, applied to thin-skinned areas like the inner wrists, inner arms, or neck, as supported by the most recent study 1. The dose can be started with 20 mg daily (about 1/4 to 1/2 teaspoon of a 2% cream) for the second half of the menstrual cycle (days 14-28) if periods are still regular, or for 14 days per month if periods are irregular. If symptoms persist, the dose can be increased to 40 mg daily. For severe symptoms, some practitioners recommend continuous daily use. Apply the cream at the same time each day, preferably in the evening, and rotate application sites to prevent skin irritation. Results may take 2-3 months to become noticeable. Topical progesterone helps balance estrogen dominance common in perimenopause, reducing symptoms like hot flashes, mood swings, and sleep disturbances, as noted in 2. It works by binding to progesterone receptors throughout the body, helping to restore hormonal equilibrium. Consult with a healthcare provider before starting treatment to ensure appropriate dosing for your specific symptoms and medical history, considering the benefits and risks of hormonal therapy discussed in 3, 4, and 5.
Some key points to consider:
- The optimal route and dosage of progestin monotherapy have not been established, as highlighted in 1.
- The available literature is heterogeneous in terms of formulation and dose of progesterone, with administration ranging from 5 to 60 mg of transdermal progesterone, as seen in 1.
- Side effects, such as headaches and vaginal bleeding, can be significant and lead to discontinuation of treatment, as reported in 1.
- A beneficial effect was reported in some trials with the transdermal route at longer duration and with oral treatment at higher doses for vasomotor symptoms, as noted in 1.
Overall, the use of topical progesterone cream for perimenopausal symptoms should be individualized and guided by a healthcare provider, taking into account the latest evidence and the specific needs and medical history of each patient, as emphasized in 3, 4, and 5.