TAKE 15% OFF Matcha, Chamomile & Spearmint Tea. USE CODE: TEA15%OFF



A majority of women with PCOS take birth control pills to regulate their monthly cycles and to control androgen excess. Yet, studies have shown that some formulations of the pill may actually increase insulin resistance See my blog post. Furthermore, some women experience negative side effects of the pill such as mood swings and loss of libido. This leaves many wondering, is there a safe alternative to produce monthly cycles and decrease male hormones?

Dr. Jerilynn Prior, a physician-researcher and professor of endocrinology at the University of British Columbia, actually prefers to treat her PCOS patients with natural progesterone rather than the pill. She believes that the underlying problem of PCOS is that the body does not produce enough progesterone for two weeks during the menstrual cycle.

Dr. Prior explains, “Progesterone is the hormone made by the ovaries after an egg is released. This lack of progesterone in women with PCOS leads to an imbalance in the ovaries, causes the stimulation of higher male hormones, and leads to irregular periods and trouble getting pregnant. Progesterone is usually missing – replacing it, therefore, makes sense.

“Progesterone talks back to the hypothalamic and pituitary (brain) hormones that control the ovaries and stops them from stimulating the ovaries to make too much testosterone.”

Dr. Prior recognizes that the pill, with its synthetic type of progesterone, does help women with PCOS to a certain degree. But her goal for PCOS patients is, “to return the brain/ovary system to a normal balance. The goal of the Pill is the opposite – it must suppress the brain-ovary system to prevent pregnancy.”

To help her PCOS patients achieve a normal hormonal balance, she prescribes oral micronized progesterone (trade name Prometrium) which is a bio-identical hormone. Taking this natural progesterone for two weeks every month (called cyclic progesterone therapy) may help the brain to develop the normal cyclic rhythm that is missing in PCOS.

Interestingly, Dr. Prior believes there is another benefit of cyclic progesterone therapy. She explains, “most doctors don’t realize progesterone antagonizes and inhibits the enzyme (called 5-alpha reductase) that is needed to make testosterone into dihydrotestosterone. Dihydrotestosterone is the powerful male hormone that talks hair follicles into making coarse hair and too much oil that causes acne.”

The late John R. Lee M.D. was an international authority and pioneer in the use of natural progesterone. He stated that “Natural progesterone should be the basis of PCOS treatment, along with attention to stress, exercise, and nutrition.” He recommended using 15 to 20 mg of progesterone cream daily during the last two weeks of your cycle and to give the treatment at least six months in conjunction with a diet and exercise program. If symptoms begin to fade, Dr. Lee suggested easing off the progesterone by reducing the dose by half with the goal being to return your body to its own “hormonal rhythms.”

Natural progesterone cream has been part of my PCOS regimen on and off for the last few years.  I use a cream that is made by my local compounding pharmacy.  It is a pharmaceutical-grade natural progesterone cream and I use 2 pumps 2x a day.  I rub it on the inside of my upper leg.  If you are interested in exploring the use of Natural progesterone for your PCOS, I have included some links below.  If you would like more information on the cream that I use, you can contact my pharmacy.  If you are interested in purchasing, they do ship.  The name of the pharmacy is Medicine World and their phone number is (603) 881-9500

For more information on natural progesterone therapy to help control PCOS please visit:

Last Post

BOOK REVIEW - The Hormonally Vulnerable Woman

Next Post

MENU PLAN March Week 1

  1. I am hoping someone will read this reply and draw some encouragement. I have had PCOS since I was 14 years old and have had over ten surgeries including a hysterectomy at age 29 that left part of one ovary that had never had a cyst. Now at 42, I have also had a thyroidectomy due to Hashimoto’s Disease and cancer. I have always been a proponent of natural therapies, and whereas I do have to take Synthyroid, I do find relief from numerous symptoms with the progesterone cream. With decent diet habits and my membership at Curves – I am able to maintain a size 10. I strongly suggest trying the cream – it lessons headaches and tiredness which enables you to work out more and feel well enough to want to monitor your diet!
    I JUST found out that after 13 years, the remaining ovary now has a cyst and I have recently added a few pounds on. However, I am thrilled to have found this site with menu plans and great articles to encourage and motivate! I promise – if you have PCOS you don’t have to be infertile – I have 3 children – you don’t have to feel bad all the time – supplements really help – and you don’t have to be fat! You just have to eat the right things 🙂 and get out and move you body. Try Curves – it is only 30 minutes!!!! Can’t get easier than that.

    My doctor does want me to start metformin for PCOS – does anyone know anything about this?

    1. Thank you for your comment – I completely agree with you! You may want to look at my post about Apple Cider Vinegar. It helps control blood sugar and may be worth a shot before you start metformin. Lot of women (including me) have trouble tolerating metformin – terrible GI issues.

      1. Amy, is it ok to take the ACV with Metformin you think? I have started taking Met again as of yesterday because I really need to get this PCOS under control…I am too hormonal and emotional all the time and I was to have children someday….

    2. also was recently diagnosed with PCOS, though looking at the common symptoms I’ve had it for years… I’m on a no-carbs diet (to control my insulin) and a bio-identical progesterone cream — it’s doing wonders after only 3 weeks. My hair has started to grow back in its natural blonde, skin is healthier, etc etc. And I’ve finally gotten my period…

    3. My daughter is 14 and we just found out that she has PCOS. We went in to get her weight issue checked and the next day ended up in the emergency room due to her having a kidney stone. She had an CAT scan and ended up finding a 7.6cm cyst on her ovary. OMG…I can’t believe it has taken 4 years for someone to finally tell us why she has been gaining weight and not losing it. My poor girl. She is in volleyball, basketball and track and every year at physical time she is up another 20 pounds. So frustrating. Now the hard part. They have her on the HCG diet to get some pounds off, fine, but the diet after that….I am scared about. Does anyone have any good advice for me, what to cook, you favorites…that a 14 yr. old would like. I will do what it takes for her, just need some “been there, done that” advice. Thank you!

      1. I don’t think that the HCG is an appropriate way to lose weight. I believe it causes more issues. There is no short cut to creating a healthy lifestyle. I have been there but have also been able to turn my health around so I now thrive with PCOS and I help women all over the world manage their PCOS symptoms through diet, exercise, supplements, self care and positive thinking. If you want more info on my programs, please email me

  2. Thankyou so much for sharing all this! I am due at my specialist next week and I ll be bringing up the suggestion of progesterone to help me as nothing else seems to be working.
    I love your site too, you’re an inspiration!

  3. Can I use progesterone cream and birth control pills simultaneously? Would this cause unintended side effects? I am currently taking Yaz, but I would like to stop using BC and transition to a completely natural approach to treat my PCOS. Is it okay to go “cold turkey” and stop using BC or do I need to slowly wean myself from the pills? Any advice would be much appreciated.

    1. Robyn-
      This is tacken from

      “At Women to Women, we think less is more when it comes to synthetic (non-bioidentical) hormones. So, taking your individual needs and health history into account, we encourage women in their late 40’s who have been on the Pill for a number of years to think about discontinuing. Some of our patients have been taking the Pill for 30 or more years — it seems inconceivable to them to do anything else! But going off the Pill is easier than you think, and can be done with minimal symptoms if you start supporting your body before you go off.

      We suggest that a woman in perimenopause who’s on BCP’s continue taking the Pill for a month while she establishes a healthy foundation of nutrition, supplements, and exercise.

      Natural progesterone at this time is also a good idea because it helps jump-start your natural hormonal synthesis (progesterone is a building block for all three forms of estrogen, among other hormones) and supports hormonal balance. There is also some indication that the synthetic progestins in birth control pills actually lower levels of natural progesterone (the body resists making its own when an easy substitute is at hand), so having a bioidentical supplement can be helpful while weaning off the Pill.

      We suggest using a low-dose topical progesterone cream on days 7–21 of the pill package (days 14–28 of your cycle), when your body would naturally be high in progesterone, or during the second and third week of the NuvaRing or Evra patch. At the end of that pill package, patch, or insert time span, stop taking the Pill or remove the hormonal devices and continue the rest of your routine, which should include another, nonhormonal birth control method as back-up.

  4. Thanks! I am 23 years old and have been on/off BC for the past 4 years. I was recently diagnosed with PCOS and when I’m off BC, I don’t cycle. I heave read contrdictory statements about taking progesterone cream with BC, but I will trust this article, and try it. I am hoping that I can beat this with changes in diet, exercise, and supplements.

    Thank you for your support.

  5. I was diagnosed with PCOS about 3 years ago. I’m not on the pill so of course I don’t see my period regularly. Last time I got it on its own was March 2, 2011 and as of today nothing. If I want to use the Natural Progesterone Cream how would I have to use it if it states to use it at the last 2 weeks of ur cycle?

    1. You can start it 3 weeks on and 1 week off for a few months. This is what many women in perimenopause do to regulate their hormones. It should kick-start your period. Once you have a period and then you can reduce to days 14-28 of your cycle. Keep up the clean eating and exercise. That is the most important element.

  6. Amy,
    I really love your blog… I just sorta stumbled onto it looking for pcos snack ideas. Do you have to have a prescription for your compounded progesterone cream? I’m using a cream (Progensa) now but it’s not working. I’ve had a period every other week for about six weeks now. About the time I start the cream-day 14- I usually start spotting. I only use 1 pump 2x daily for 10 days. My periods will do okay for awhile and then get crazy. I have been to the doctor… BC pills, hysterectomy or something else… Maybe she called it ablation? (where they cauterize the lining of you uterus) seem to be what I’m hearing as my options. I don’t want to use BC. I’m not ready for the other two. I was diagnosed with pcos 20 years ago… I’m 39.

    1. Hi Angie-
      I’m 39 too! I get my progesterone cream from my local compounding pharmacy – Medicine World in Nashua, NH without any prescription. They ship all over the U.S. I use 2 pumps 2x day from day 14-28. It has really helped me. Do you have endometreosis too? That is why they would cauterize I think. How is your diet?

      1. Amy,
        I am going to check out the cream… As far as I know I don’t have endometreosis. I go today to the doctor. I think she is probably going to want to schedule me for an ultrasound. I think they want to cauterize because I have such frequent periods. If I didn’t use the progesterone cream I wouldn’t have a period at all. Did you have to do a saliva test? How did you decide to use 2 pumps 2x day? Maybe I’m not using enough… I have really been watching what I eat lately… this past week. That’s how I found your site. It’s hard because my diet consists mostly of pb & j, grilled cheese… and other kid type meals. (we have 4 kids) Also, I am addicted to sugar and carbs. And I LOVE to bake. I had a horrible food day yesterday… I ate healthy but I had a headache all day and was sorta mad that I can’t eat what I want. I ended up walking (stomping angrily) around our field. I’ve just come to this point that I know I have to do it… I have to eat healthy, exercise… take care of myself.
        I’m having a hard time planning meals that everyone will like. I’m also aware that I may pass this down to my daughters… so I want to teach them to make wise food choices.
        Reading your site… looking at the menus… and all your advice makes me feel not so alone:)

  7. Hi Amy,

    Thanks for this awesome, helpful site !
    I have been using progesterone cream for the past two months (whilst still on the pill) & this is now my first month (currently on day 18 of my cycle) off the pill using just the cream & i have and still just feel bloated. any advice ?

    Thank you
    Shanna (South Africa)

    1. Hi Shanna-
      I would give it a couple months. I have found that when I avoid gluten I also get rid of a lot of bloat. You might try that as well.

      1. thanks Amy !

        i dont touch gluten, but i was also thinking i need to give it a couple of months.

        thank you so much x

  8. Hi Amy… I really love your page… its jam packed full of terrific information for all us women who struggle with this complicated disorder. I am 38, have three beautiful kids and have been managing PCOS for well over a decade now. I was on the pill for three months to re-regulate my period and attempt to control the excess testosterone.. on it, I lost my libido and become progressively depressed. After I went off of it, I noticed a dramatic change in my hair.. normally my hair has always been abundant and very healthy.. after going off the pill, it became drier, more coarse and began falling out… I have about half as much now. I asked my physician to try me on natural progesterone .. but she felt that my system would reregulate itself again being off the pill and that my hair would likely thicken up again and so refused to try progesterone in fear that it would only complicate my endocrine system more . She checked my thyroid and said it was normal but low normal.. my question is.. : can adding progesterone to my daily health routines, aggravate the rest of the hormone cascade ??? I considered using saw palmetto to reduce the testerone.. was wondering what your opinion of this supplement is ?? Thanks for your help !!

    1. Karri-
      Take a look at my blog post regarding hairloss. When I came off the pill the same thing happened. It is so frustrating. But the good news is that your hair will grow back, maybe not as thick as it once was, but you will see new growth. I am very happy with the natural progesterone cream. Like you I am also in my late thirties. (39.5) Many women use progesterone cream as they enter peri-menopause because it helps with the hormone changes.
      I have recently read that maca helps with PCOS and maybe even hairloss. I will post when I learn more.

  9. I was wondering how much is the progesterone that is compounded for you? And when you call, what should I ask for? thanks

    1. Heather-
      It is $25 a bottle. A bottle usually lasts me about 3 months. I would just ask them for their own progesterone cream. It is a popular item locally, so they should know exactly what you mean. It is in a green pump bottle.

      1. Thank you so much! I ordered some today! Can not wait to get it and start! I just stopped my BCP and I am going crazy with the emotional roller coaster and fatigue!!

  10. Malky-
    Progesterone cream is just one part of my PCOS Diva Lifestyle. Hirtuism is the result of high testosterone. You can lower your testosterone by balancing your overall hormones and adding progesterone helps but so does eating a clean whole foods diet and exercise.

  11. Hi Amy,

    this post is exactly what I needed today! I am forced to get off BC effectively today because I can’t get an appointment with my gyn/ob in and she won’t give me a new prescription before I see her – which I was told yesterday. It’s not too bad as I was planning on getting off anyway, hoping to get pregnant sometime after the wedding, but not being too optimistic.

    I have an appointment with my endocrinologist next week and will talk with her about the Progesterone Cream!

    Thanks for all your tipps and recipes – we LOVE them!

  12. I have questions for Amy about the Integrative Nutrition program that she took and about her health coaching practice. I’ve had PCOS for 2 years and am realizing that I have much to learn, but have a similar story to yours. Would love for her to be my graduate coach/mentor for the program 🙂


    1. Hi Rebecca-
      Thanks for the kind words. You are going to love IIN. I don’t think I will be mentoring students but please let me know how you are doing in the program from time to time.
      Good luck!

  13. I’m happy to have read this. I’ve suffered from hidradenitis suppurativa for the last six years, and have been on Yaz for three years to keep the flare-ups under control. Turns out, what triggers PCOS (excess androgens) also triggers HS in many women and the anti-androgenic progestin in Yaz helps with the suppression. Yaz has saved my life in many ways, but I hate being on BCP especially now that I’m experiencing a laundry list of pre-menopausal symptoms (just turned 40) while on it. I now wondering if I could benefit from progesterone cream…? Birth control isn’t a concern, as my husband had a vasectomy 7 years ago. That was why I went off the pill…then my HS introduced itself.

    BCPs have killed my libido and my energy level, which is frustrating because I love my husband and I’m a distance runner. Plus, no one wants to seem to be around me for two weeks out of the month. LOL. I suspect a change is in order. 🙂

    1. Stacy- Read my post about Maca too. I think you might find it to be helpful with your cycles and your libido. I find that it works in conjunction with NPC.

  14. Hello, I bought some natural progesterone cream made by Source Naturals. But I just noticed that the ingredients list “natural progesterone USP from soy.” Is this a problem? I thought we were supposed to avoid soy. Do all/most natural progesterone creams derive from soy, or should I look for a different one? Thank you!

      1. I also use plant-derived progesterone cream. I’ve heard that it’s actually better for you in some ways than progesterone that is completely bio-identical because it is less likely to inhibit your body’s own progesterone production.

  15. Hi again Amy, not sure why my post from a few weeks back still says “comment is awaiting for moderation” in the hairloss blog but it still hasnt been answered. I’ll repost here and hopefully get some advice re progestrone cream. Hoping to still get help on this. Dont really need the help for the fetility but more for progestrone for hair loss. Again any response would be appreciated! Thanks!:

    My biggest issue is high androgens and hair loss and insomnia. My periods have always been regular, taken no bcps, may have an insulin issue but whenever docs did the GI test, always came out normal. I wanted to incorporate progestrone to help calm androgens but I am really confused about how to use the cream. You had a great blog about how to use progestrone, but I am confused as I do get my periods on a normal 28-30 day cycle. I picked up some Emerita progestrone (hope that’s ok to use) but not sure when to start as I have only read tips on how to use for women who DONT have periods or are TTC or are getting off BCPs. I also was afraid that taking them on the last two weeks of period will stop me from getting my period. So as you see, I am very confused. Thanks for any insight!

    1. Paola-
      My advice to you is to contact my compounding pharmacy – Medicine World – I think I cite the number and website in my post and talk to Carmina I am not an expert on progesterone cream like she is.

    2. I know this is really late ,but did you ever try the progesterone . I have massive hairloss and acne ,since going off the pill and not willing to put anymore synthetic hormones in my body . Did it help with your hair ?

  16. i am taking 500mg of metformin 3x a day w meals. its primary purpose is to help with insulin resistance. My insulin levels have stabilized, i am no longer in pre-diabetic rating , and along with no white/processed foods and exercise i have lost 40lbs since end of October. I never get a period but for last 2 months it has come naturally w. out the help of progesterone tablets (10 days) and its amazing but i’m hoping this time my body will tell it when tostop bc last time it was waaaaay out of control. but naproxen sodium is what the e.r. docs prescribed to make the lining stop shedding. So we shall see butmy body is definitely changing and the food change has brought about the biggest results. o btw 1500/2000 cals a day. i was exercising formonths prior an lost only a few lbs but since dietary counsel we’re on a roll! I’M MELTING & I LOVE IT

  17. Hi Amy,

    I have been using the progesterone cream for several months now, not last month but the one before I never had a period. I wanted to ask – should I count the very next day after day 28 when I stop the progesterone cream as day 1 and then obviously start with the cream again on day 14 or must I wait until I actually start to bleed to count that as day 1 ? I was hoping to avoid skipping a period again like I did the month before.

    Thank you 🙂

  18. Amy,

    This is great information! Doctors do not give you this information and instead push all the meds on you, most of which cannot be tolerated. I just turned 40, and was diagnosed with PCOS at 25. I have conceived in the past, as implantation spotting was seen, but my luteal phase was too short to sustain the pregnancy (8 days instead of the ideal 12). I am thinking about using progesterone cream to lengthen this phase, allowing the pregnancy to progress instead of me spotting too early. My doctor may not agree with this, but I must do something. Even if I go on to IVF, it may not take without this crucial phase.

    Also, do you have any advice on lowering DHEAS? Mine is 355, over the limit of 325. This is another symptom of mine, as well as anxiety and depression, on and off. This is a crazy syndrome, but I believe I (and others) can control its nastiness and actually have a baby if I do the right things.

    Your advice is greatly appreciated!

    1. You may want to look for a new doctor. Many women with PCOS are low progesterone and have that same issue in pregnancy. I would focus on a more plant based diet to reduce DHEA. If you want more specific info on lifestyle change to support fertility I offer support through my private health coaching program. You can email me for more info.

  19. Will that not interfere with my cycle, what if I use the cream on what I’v counted as day 14 but I’m not actually ovulating ?
    Thank you Amy 🙂

  20. Still hoping to also get a response also regarding how to use the cream on what is day 14 but not ovulating? Thanks.

  21. My husband and I have been trying to have a baby for about 3 years now. I have PCOS. I’ve been on Metformin for about a year taking 500mg once a day and I was also taking Progesterone 50mg everyday. Then, This past January, I went back to my Gyno…and she upped my Metformin to 750 mg 2x a day. But, when I asked her about the Progesterone…she said that the Progesterone would do absolutely nothing for me until I was actually pregnant? So, now I am taking 750 mg 3x a day and still having irregular periods. She said she just has to keep upping my Metformin, but the highest does is 2500 mg a day, and I’m already on 2,250 a day. I don’t see how 250 mg more a day will help? I just feel like there is something else she should be doing. She wouldn’t even do blood work last month to check my hormone levels and sugar levels! Advice?

    1. I would find a new Doctor Brooke – you need to be your own advocate. I agree with your rationale she should at least be running tests 1x a year to check hormones, blood lipids and sugar/insulin.

  22. Hi Amy,
    You use 2 pumps 2 X per day of progesterone cream, so how many mgs is that equal to ? In South Africa my cream says 2 pumps per day which equals 30mgs of progesterone. So if i up it to 2 pumps 2 X per day that will be 60mgs per day, is that not too much ?
    Thanks, Shanna 🙂

  23. Hi Amy!
    I just got my results back from my blood test and I have high testosterone levels. I will be going back on friday for a pelvic ultrasound to see if I have pcos. Will natural progesterone cream help lower testosterone? Or are there any other supplements you would recommend?

  24. Can I use progesterone cream while on the pill? I have PCOS and horrible acne. I’m too scared to come off the pill because of the bad breakouts I will get. Will progesterone cream help to control my skin oil production or will the pill stop it from having any effect?