How much progesterone is typically in an over-the-counter cream?

Most contain 20 mg per quarter-teaspoon, but actual absorption can be 10–70 % depending on skin and formulation.

Can I use progesterone cream if I’m trying to conceive with PCOS?

You can, but apply only after confirmed ovulation; using it too early can blunt the LH surge needed to release an egg.

Are bio-identical progesterone creams safer than synthetic progestins?

They may have fewer mood and lipid side effects, but safety depends on correct dosing and monitoring, not just the source.

Will progesterone cream help my acne and facial hair?

Probably not; these symptoms stem from high androgens, which progesterone cream does little to lower.

Can I measure progesterone levels from saliva when using a cream?

Saliva tests overestimate levels; blood serum on day 21 is the reliable method clinicians use.

Do I need to cycle off progesterone cream periodically?

Yes, most protocols advise 12–14 days of use per month to mimic a luteal phase and avoid continuous exposure.

Does insurance cover compounded progesterone cream?

Coverage is uncommon; many plans consider it cosmetic or experimental unless prescribed for a diagnosed hormone deficiency.

Can I keep the cream in a hot bathroom?

Heat degrades progesterone; store it below 77 °F (25 °C) and discard after the labeled expiration date.

How soon should I expect my periods to regulate?

If the cream is effective, withdrawal bleeding often appears within one or two treatment cycles.

Does progesterone cream really help treat PCOS?

Can a skin-absorbed progesterone cream stabilize PCOS cycles?

Progesterone cream delivers hormone through the skin, aiming to mimic the natural rise of progesterone after ovulation. In PCOS, many cycles are anovulatory, so progesterone stays low and the uterine lining overgrows. Creams may induce a withdrawal bleed, but absorption varies widely.

Topical absorption is inconsistentStudies show serum progesterone after a standard 20–40 mg cream dose ranges from 0.5–20 ng/mL—enough for some women, sub-therapeutic for others.
Cream cannot trigger ovulationProgesterone given after day 14 only substitutes for the missing luteal phase; it does not fix the lack of an LH surge that causes anovulation in PCOS.
Short-term bleeding control is possibleSmall trials report up to 70 % of women achieving predictable withdrawal bleeds within three months of nightly 20 mg topical progesterone.
Expert insight clarifies limits“Topical progesterone can protect the uterine lining, but it should be seen as symptom control, not disease-modifying therapy,” notes Sina Hartung, MMSC-BMI.
Standard regimen is 15–20 mg topical progesterone nightly from day 14–28AllonHealth advises applying 15–20 mg progesterone cream each evening during the luteal window and continuing for at least six months, together with lifestyle changes, to gauge benefits for PCOS cycles. (AllonHealth)
Case report shows oral micronized progesterone restored monthly cycles in PCOSA Clue case study describes a woman whose periods became regular after starting nightly oral micronized progesterone, illustrating progesterone’s ability to regulate bleeding even when ovulation remains inconsistent. (Clue)

When is progesterone cream unsafe or inadequate for PCOS?

While generally well tolerated, progesterone cream can mask more serious problems or be outright risky in specific scenarios. Recognizing red flags helps you know when to seek medical care instead of self-treating.

Heavy bleeding lasting more than 7 days needs a doctorEndometrial hyperplasia or polyps, not just low progesterone, can cause prolonged bleeding and require ultrasound or biopsy.
Rapid weight gain and mood changes suggest excess dosingCream users who absorb hormone efficiently may climb above 25 ng/mL serum progesterone, leading to bloating, depression, and fatigue.
Abnormal nipple discharge warrants imagingGalactorrhea can signal high prolactin or pituitary disease; progesterone cream will not address these causes and could delay diagnosis.
Team perspective on safety“Any abnormal uterine bleeding over age 35 should be evaluated before starting progesterone, even if PCOS is already diagnosed,” advise the team at Eureka Health.
Progesterone receptor resistance can blunt cream’s effect“Progesterone receptor resistance reduces the effectiveness of progesterone,” so even standard topical doses may fail to oppose estrogen, leaving PCOS patients at ongoing risk for endometrial hyperplasia and cancer. (PCOSDiva)
Capsules often outperform creams for heavy or prolonged bleedingLara Briden notes that progesterone cream is “generally not as effective as progesterone capsules,” making it inadequate for controlling significant PCOS-related bleeding in some women. (Briden)

Which self-care steps boost progesterone’s benefits in PCOS?

Hormone therapy works better when paired with lifestyle measures that tackle root drivers like insulin resistance and inflammation.

Aim for 150 minutes of moderate exercise weeklyRegular activity improves insulin sensitivity by up to 30 %, allowing ovaries to ovulate more consistently.
Prioritize 25–30 g of protein each mealBalanced macronutrients blunt post-meal glucose spikes that worsen androgen excess.
Track cycles with a period appRecording bleed patterns helps your clinician adjust progesterone days and dose—data the cream alone cannot provide.
Consider inositol supplements after medical okRandomized trials show myo-inositol restores ovulation in roughly 40 % of PCOS women at 2–4 g daily, complementing progesterone’s endometrial protection.
Expert quote on synergy“Progesterone cream is a band-aid unless you also lower insulin and androgen levels,” reminds Sina Hartung, MMSC-BMI.
Focus on zinc, magnesium and vitamin B-6 foods dailyPumpkin seeds, dark chocolate, salmon and other mineral-rich choices supply the cofactors the corpus luteum needs for progesterone synthesis, making diet an easy adjunct to hormonal therapy. (BelleHealth)
Treat insulin resistance to restart ovulationWomen ultimately make more of their own progesterone when they ovulate regularly; Lara Briden emphasizes that calming insulin and inflammatory signals is the fastest route to restoring those cycles in PCOS. (Briden)

What lab tests and prescriptions matter before starting topical progesterone?

Baseline and follow-up labs ensure you treat the right problem and dose safely.

Total testosterone and DHEAS expose androgen excessIf these are high, anti-androgen or combined oral contraceptive therapy may be more effective than progesterone alone.
Fasting insulin or HOMA-IR quantifies metabolic driverValues above 2.5 for HOMA-IR point to metformin or GLP-1 agonists rather than progesterone as first-line therapy.
Transvaginal ultrasound checks the endometriumA thickness greater than 12 mm in premenopausal women suggests hyperplasia that might need cyclic high-dose oral progesterone or even biopsy.
Serum progesterone confirms absorptionDraw 6–8 hours after cream application on day 21; target 10–20 ng/mL for adequate luteal support.
Quote on testing value“Measuring levels turns guessing into evidence-based dosing,” state the team at Eureka Health.
Fasting glucose or HbA1c reveals early insulin resistanceMayo Clinic guidance for PCOS includes checking baseline blood sugar (fasting glucose or hemoglobin A1c) so insulin-sensitizing therapy such as metformin can be added alongside or instead of progesterone when dysglycemia is found. (Mayo)

Is progesterone cream the right first step or just part of a bigger PCOS plan?

For many women, topical progesterone is a useful interim tool, but it rarely addresses weight gain, fertility, or hair growth alone. Consider it one spoke in the wheel rather than the whole treatment.

Combine with insulin-lowering therapy for fertility goalsOvulation rates double—from about 25 % to 50 %—when progesterone is paired with metformin in small cohort studies.
Evaluate every 3–6 monthsIf cream hasn’t regulated cycles or improved spotting by cycle 4, guidelines favor switching to oral cyclic progesterone or a combined pill.
Lifestyle remains foundational5–10 % weight loss can cut androgen levels 20–30 %, an effect cream alone cannot match.
Use objective metrics to decide next stepsTrack waist circumference, Ferriman-Gallwey scores for hair, and fasting glucose to see broader progress.
Quote on long-term outlook“Think of progesterone cream as a helpful start, but keep an eye on the whole syndrome,” remind the team at Eureka Health.