What is a period?
The period also known as menstruation is a woman’s monthly bleeding. When you menstruate, your body discards the monthly buildup of the lining of your uterus (womb). Menstrual blood and tissue flow from your uterus through the small opening in your cervix and pass out of your body through your vagina.
During the monthly menstrual cycle, the uterus lining builds up to prepare for pregnancy. If you do not get pregnant, estrogen and progesterone hormone levels begin falling. Very low levels of estrogen and progesterone tell your body to begin menstruation.
What is the menstrual cycle?
The menstrual cycle is the monthly hormonal cycle a female’s body goes through to prepare for pregnancy. Your menstrual cycle is counted from the first day of your period up to the first day of your next period. Your hormone levels (estrogen and progesterone) usually change throughout the menstrual cycle and can cause menstrual symptoms.
The typical menstrual cycle is 28 days long, but each woman is different. Also, a woman’s menstrual cycle length might be different from month to month. Your periods are still “regular” if they usually come every 24 to 38 days. This means that the time from the first day of your last period up to the start of your next period is at least 24 days but not more than 38 days. Some women’s periods are so regular that they can predict the day and time that their periods will start. Other women are regular but can only predict the start of their period within a few days.
However, certain conditions can disrupt this balance and create problems for a woman. Examples of menstrual problems include periods that occur less than 21 days or more than 35 days apart, missing three or more periods in a row, the menstrual flow that is much heavier or lighter than usual, and several other problems.
What is progesterone?
Progesterone belongs to a group of steroid hormones called ‘progestogens’ (which are hormones that have a similar action to the natural hormone progesterone). Synthetic hormones that have a similar action to progesterone are called ‘progestins’. Progesterone is mainly secreted by the corpus luteum in the ovary during the second half of the menstrual cycle. It plays an important role in the menstrual cycle and in maintaining the early stages of pregnancy.
During the menstrual cycle, when an egg is released from the ovary at ovulation (approximately day 14), the remnants of the ovarian follicle that enclosed the developing egg from a structure called the ‘corpus luteum’, which literally translates as ‘yellow body’ due to its appearance. This releases progesterone and, to a lesser extent, oestradiol. The progesterone prepares the body for pregnancy in the event that the released egg is fertilized. If the egg is not fertilized, the corpus luteum breaks down, the production of progesterone falls and a new menstrual cycle begins.
If progesterone is absent or levels are too low, irregular and heavy menstrual bleeding can occur. A drop in progesterone during pregnancy can result in a miscarriage and early labor. Mothers at risk of giving birth too soon can be given a synthetic form of progesterone to delay the onset of labor.
Lack of progesterone in the bloodstream can mean the ovary has failed to release an egg at ovulation, as can occur in women with polycystic ovary syndrome.
Progesterone treatment for periods
Progesterone medications used for medical uses are called progestogens. They are available in two forms: synthetic versions (progestins) and another version derived from plant sources, which is nearly identical to the body’s own hormone and is often called “natural progesterone.”
Oral micronized progesterone (Prometrium®, generic, or the same hormone “compounded” in oil by a pharmacist) is identical to your own hormone (or bio-identical). Because it may cause sleepiness, only take this medication on your way to bed. Three 100 mg capsules are the dose that keeps progesterone levels in the normal range for 24 hours.
Medroxyprogesterone (MPA) is synthetic, a progestin that has been used for over 40 years. As a pill, it does not provide contraception like DepoMPA and doesn’t have the same side effects while on it or difficulties when stopping it. It is stronger than progesterone so the dose that creates a progesterone-like effect is 10 mg a day. Avoid the use of cyclic MPA if you have personal risks for or a family history of breast cancer.
When Do I Take It?
The first day of menstruation is called “day 1.” If you get a period regularly and your cycles are usually 27-30+ days long, start progesterone on the 14th day after flow began and take it for 14 days or until cycle day 27. If your cycles are regular but shorter (for example, if your period starts every 21–26 days), then start cyclic progesterone/MPA on cycle day 12 and continue it for 14 days or until cycle day 25.
There are also other administration methods that you may prefer if the progesterone pill and vaginal suppositories aren’t the best options for you. Progesterone cream is a particularly popular alternative, as it may produce better results and be easier to use for some women.
How to Use Progesterone Cream for Irregular Periods
Most women know that progesterone cream can be used as a treatment for menopause symptoms, but it is also commonly used to correct menstrual irregularities in younger women and during perimenopause. However, be aware that over-the-counter “natural progesterone creams” may not contain a dose of progesterone that is appropriate for all women. As such, consulting a professional to determine if progesterone replacement therapy is appropriate, getting access to safe, effective products, and continuing to be monitored over time is essential.
Generally, using progesterone for irregular periods is a simple process:
1. Assume “Day 1” is the first day of your cycle.
2. Begin using the progesterone cream after ovulation (typically around day 14 of your cycle). The cream can be applied to your neck, forearm, lower abdomen, or inner thigh.
3. Continue using the cream until around day 28, after which your period should start.
The amount of cream you use will depend on your individual needs. Your healthcare practitioner can adjust your dose as necessary to ensure optimal efficacy and minimize any side effects. Many women prefer custom bioidentical progesterone therapy to conventional HRT because it can be formulated according to your exact specifications rather than relying on standardized dosing, potentially improving results and tolerability.
Progesterone cream can do wonders for women suffering from low progesterone levels and irregular periods.
How long after taking progesterone will I get my period?
The effects of progesterone are different for every woman. In general, topical progesterone takes two to three months to reach the peak therapeutic effect while progestin pills can work immediately if the person takes it between days 1 and 5 of their menstrual cycle. In other words, they should take the first pill in the first 5 days after a period has begun. These pills take 2 days to work if the person has a short cycle or starts taking the pills after day 5.
Although progesterone plays a key role in menstruation, it can also delay your period and increase the chances of pregnancy. You can expect your period to come around the 28th day if the drug’s full therapeutic effects have resulted in the normalization of your period.
You might not look forward to your period, but you want your body to be regulated, to be in rhythm with itself, and to be in balance. With the right progesterone product, you can achieve just that.
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