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Limited evidenceWomen's health

Progesterone Cream

An over-the-counter transdermal cream whose absorption is erratic and whose clinical record is one small trial from 1999. It should not be relied on to protect the uterine lining when taking estrogen.

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What the science says

  • Hot flashes Limited evidence

    A single randomized placebo-controlled trial in 102 postmenopausal women reported that transdermal progesterone cream improved vasomotor symptoms. It has not been convincingly replicated in the quarter century since.

  • Bone loss Limited evidence

    The same trial found no effect on bone mineral density, and a critical review of transdermal progesterone creams concluded that blood levels achieved are generally too low and too variable to produce reliable systemic effects.

Dosage & safety

Studied doseThe trial used a cream delivering about 20 mg of progesterone applied daily to the skin. Retail products range from trace amounts of wild yam extract, which the body does not convert to progesterone, to 20-40 mg per measured dose.
SafetySkin irritation and breast tenderness are reported. The important risk is misuse: OTC cream has not been shown to reach levels that oppose estrogen's effect on the endometrium, so it must not substitute for prescribed progesterone in women using estrogen therapy with an intact uterus. Products labelled only as wild yam contain no progesterone at all.

How to take it

TimingOnce daily, usually in the evening, rotating the application site.
With food?Not relevant — it is applied to the skin, not swallowed.
Worth knowingIf the label says only wild yam or diosgenin, there is no progesterone in it at all; the label must state progesterone USP in milligrams.

Interactions

With medications

  • estrogen therapy (HRT) in a woman with an intact uterus

    Over-the-counter cream has not been shown to reach levels that protect the endometrium from estrogen. never substitute it for prescribed progesterone — this is an endometrial cancer risk, not a preference

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does progesterone cream help hot flashes?

The evidence is limited: a single 1999 randomized placebo-controlled trial in 102 postmenopausal women reported that progesterone cream improved hot flashes. It has not been convincingly replicated.

Is over-the-counter progesterone cream absorbed?

Absorption of over-the-counter progesterone cream is erratic: a critical review concluded blood levels are generally too low and too variable for reliable systemic effects. The main trial also found no effect on bone density.

Can I use progesterone cream with estrogen HRT?

Never use over-the-counter progesterone cream instead of prescribed progesterone if you take estrogen and have a uterus. The cream has not been shown to protect the endometrium, so substituting it is an endometrial cancer risk.

Does wild yam cream contain progesterone?

No: products labelled only as wild yam or diosgenin contain no progesterone, and the body does not convert wild yam into progesterone. A genuine product must state progesterone USP in milligrams; the trial cream delivered about 20 mg daily.

Scientific references

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