Micronized progesterone (and, separately, synthetic progestins) used with estrogen to protect the endometrium, and sometimes for sleep. Prometrium-type progesterone is not the same molecule as medroxyprogesterone acetate used in WHI.
Progesterone therapy in HRT almost always means giving a progestogen so estrogen does not thicken the lining of the uterus unchecked. The product that matches human progesterone is micronized progesterone (often oral at night). Progestins such as medroxyprogesterone acetate (MPA) are related drugs, not the same molecule. WHI’s breast and heart headlines were about CEE+MPA, not automatically about every progesterone capsule.
What it is for
Endometrial protection with systemic estrogen if the uterus is present. Cyclic or continuous regimens both exist. Night-time micronized progesterone is sedating for many people—useful if sleep is part of the complaint, annoying if it causes grogginess. It is not a standalone “longevity hormone,” and peanut-oil capsules matter for allergy. People without a uterus generally do not need progesterone for endometrial reasons.
Limits
Compounded topical progesterone is poorly standardized for endometrial protection; do not assume a cream equals an oral 100–200 mg labeled dose. Progesterone will not cancel estrogen’s other risks. Abnormal bleeding still needs a workup. Dydrogesterone and levonorgestrel IUDs are other endometrial strategies in some practices—ask which job you are buying.
Hysterectomy status, peanut allergy if using oil-based capsules, and a bleeding diary. Tell the clinician about depression history—progestogens can affect mood.
Take oral micronized progesterone at night if it makes you sleepy. Do not drive until you know how you react.
Drowsiness, dizziness, mood change, bloating, spotting, and rare allergic reactions to capsule excipients. Inadequate progestogen with estrogen risks endometrial hyperplasia. Progestins have their own metabolic and breast-risk profiles—do not mix study results across molecules.
NAMS 2022 hormone therapy position statement (Menopause, 2022).
https://doi.org/10.1097/GME.0000000000002028Rossouw J.E. et al. WHI estrogen plus progestin (MPA) (JAMA, 2002).
https://doi.org/10.1001/jama.288.3.321FDA label: Prometrium (micronized progesterone) capsules.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/019781s026lbl.pdfACOG. Compounded bioidentical menopausal hormone therapy.
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2012/08/compounded-bioidentical-menopausal-hormone-therapy© 2026 Longevity Clinic Finder. All rights reserved.
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People on systemic estrogen who still have a uterus, or selected other gynecologic indications. Not a default sleep pill for eugonadal patients.
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