Thyroid UK
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oral vs dermal progesterone?

After receiving my latest lab results, I have a question about the efficacy of oral vs dermal progesterone (all the so called Hertoghe doctors prescribe Estrogel only, as that is said to spare the liver, but some, like my doctor, will put you on progesterone pills Utrogestan).

These were my lab results on day 21 of cycle (recently turned 48), when using two pumps of Estrogel and 200 mg of Utrogestan daily (the former from day 5-25 of cycle, the latter from day 15-25); when I went to the lab, I had not used any Estrogel for 24 hours, but had taken 200 mg of Utrogestan 12 hours earlier:

Estradiol: 101 pg/mL (ref luteal phase: 21-312)

Progesterone: 4.3 ng/mL (ref luteal phase: 1.2-15.9)

I think both look lowish, but progesterone levels look really low to me, especially given the fact that I had taken 200 mg of Utrogestan 12 h before going to the lab...or am I reading too much into this???

Anyway, I think it's safe to say that, without hormone supplementation, my E and P levels would look much worse...strangely enough, I am still having regular periods, so I am not sure how to interpret these lab results...any input would be greatly appreciated.

3 Replies

Symptoms are the best guide regarding sex hormones. Female hormones are very complicated and bidding tests only give a result for that day so it depends on where you are in the cycle. Also what is "normal" it depends on how you feel. We all have different body compositions, different fat levels, bone density, height, muscle mass, activity levels, so there is no normal. Personally I use bioidentical creams as I have digestive problems and liver congestion due to low cortisol.


Thanks for your input! Yes, it's a bit surprising those doctors will prescribe progesterone pills but insist estrogen should only be used as cream, and never taken seems many hypothyroid patients have digestive problems, so cream may be an interesting alternative to pills when it comes to progesterone as well. There seem to be many good brands out there, for instance Natpro and ProgesterAll.


Also, I have read that, while progesterone levels will start to drop drastically already in your mid-30s, your estrogen levels will remain more or less the same until menopause when they in turn drop drastically...which causes estrogen dominance in most women between 35 and menopause. So, it seems no woman who is still having periods should use estrogen, only progesterone...

I am definitely not menopausal as I am still having regular periods, and menopausal means no period for 12 consecutive months.

I have to admit it's confusing. I was put on both hormones at age 42 by this hormone doctor who claimed both levels were lowish according to lab, I know more than I knew back then (six years ago) so, if I was told the same thing today, I am not sure I would have started using least not before menopause. Now, however, it seems impossible to wean off it. I have tried twice, but felt miserable and had to go back on it and, sure enough, symptoms resolved within 24 h.

I will, however, switch to dermal progesterone and see if that makes a difference compared to oral P. I am surprised I was put on oral P to begin with, although many claim 80-90% of the pill/capsule is not absorbed by the body but goes to waste...I am curious to see if dermal P makes a difference compared to oral P. I have even been thinking that, taking E gel but P capsules, maybe I am making estrogen dominance (if indeed I am suffering from that) even worse, if all of the E is absorbed through the skin, but only 10-20% of the P is absorbed from the stomach/intestines...

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