From the FDA Drug Label
How should I take Progesterone Capsules? 1 Prevention of Endometrial Hyperplasia: A postmenopausal woman with a uterus who is taking estrogens should take a single daily dose of 200 mg progesterone capsules at bedtime for 12 continuous days per 28-day cycle.
The recommended dosage and usage of progesterone (micronized) for hormone replacement therapy (HRT) in menopausal women is 200 mg per day for 12 days per 28-day cycle to prevent endometrial hyperplasia in women with a uterus who are taking estrogens 1.
- Key points:
- The dosage is 200 mg per day.
- The treatment duration is 12 continuous days per 28-day cycle.
- The medication should be taken at bedtime.
- This regimen is for postmenopausal women with a uterus who are taking estrogens.
From the Research
For menopausal hormone replacement therapy, micronized progesterone is typically prescribed at 100-200 mg daily for women with an intact uterus who are also taking estrogen. The standard regimen is 200 mg taken orally each evening or at bedtime for 12-14 days per month in a sequential regimen, or 100 mg daily in a continuous regimen. This recommendation is based on the most recent and highest quality study available, which suggests that micronized progesterone is effective in reducing vasomotor symptoms in postmenopausal women 2.
Key Considerations
- Taking progesterone in the evening is recommended because it can cause drowsiness, which becomes a beneficial side effect at bedtime.
- Progesterone must be used alongside estrogen therapy in women with a uterus to protect against endometrial hyperplasia and cancer, which can develop from unopposed estrogen.
- The micronized form offers better absorption and bioavailability compared to other formulations.
- Common side effects include breast tenderness, bloating, and mood changes.
- Progesterone should be taken with food to enhance absorption.
Dosage and Administration
- Women should start at the lower dose (100 mg) if side effects are concerning, and can increase to 200 mg if endometrial protection is inadequate or breakthrough bleeding occurs.
- The dosage and administration of micronized progesterone may vary depending on the individual patient's needs and medical history, and should be determined in consultation with a healthcare provider.
Supporting Evidence
- A systematic review of randomized controlled trials found that progestin therapy, including micronized progesterone, can improve vasomotor symptoms in postmenopausal women 2.
- Other studies have also demonstrated the efficacy and safety of micronized progesterone in hormone replacement therapy 3, 4, 5.