Progesterone Pill or Cream?

Virginia Hopkins Health Watch

January 2011

Progesterone cream works best for most hormone balancing, but the progesterone pill can be more effective for treating insomnia and catamenial epilepsy.

The hormone progesterone can be delivered to the body via a pill, cream, troche (dissolved in the mouth) injection or vaginally. There are advantages and disadvantages to each delivery system, depending on why it’s being used. Although progesterone cream is the superior delivery method for achieving hormone balance, the progesterone pill (Prometrium) can work better for insomnia and seizures.

Progesterone Pills

Conventional doctors treating hormone imbalances tend to be most comfortable using progesterone in pill form (Prometrium) because they believe they are delivering a standardized dose. However, in truth, it’s a highly unreliable way to deliver progesterone. When progesterone is swallowed, most of it is delivered to the liver, where anywhere from 60 to 80 percent of it is either broken down into metabolites (by-products) and/or eliminated. How much progesterone reaches the tissues depends on individual biochemistry and how hard the liver happens to be working that day. Thus, a doctor will generally prescribe 100 mg, of which 20 to 40 mg is actually delivered.

Progesterone Pills for Sleep and Epilepsy

Many doctors have found that a progesterone pill can be more effective than the cream for treating insomnia and catamenial epilepsy (seizures related to the menstrual cycle). This is because the metabolite allopregnanolone, created in large amounts when progesterone is processed in the liver, stimulates GABA receptors in the brain, which promotes relaxation and helps balance the nervous system. If insomnia is hormone-related, a 100 mg progesterone pill taken an hour or so before bedtime can make a big difference.

Progesterone is well-established as an effective treatment for most catamenial epilepsy, and for the same reasons it works for insomnia, the progesterone pill works better than the cream to reduce or eliminate these types of seizures.

For mild insomnia, or the occasional night when it’s hard to drop off to sleep, Dr. John Lee recommended a dab of progesterone cream on the side of the neck where the carotid arteries are located, which he theorized would quickly deliver progesterone to the brain. Judging by the emails we received, his theory was accurate!

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Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.