Dr. Helene Leonetti Answers a Question about Progesterone Cream and Skin Absorption

Q: My doctor has me taking natural progesterone sublingual pills—twice a day because she says the progesterone cream can build up under the skin. What do you say to that?

A: Your doctor’s concern about natural progesterone building up under the skin is a good one, as in the past I have seen some colleagues use very high concentrations, as much as 5% or 10%, which amounts to 100 to 200 mg per dose! I will only use a 2% cream, which amounts to 20 mg per dose. Natural progesterone cream is very efficiently absorbed through the skin where it hitches a ride onto the red blood cell membrane and from there into the general circulation. This all occurs within a matter of minutes of applying the cream.

I found the higher doses to be disruptive to the body’s balance with estrogen. High doses of natural progesterone can also alter cortisol levels, as progesterone and cortisol compete for the same biochemical pathway.

Three reasons why I do not see high doses of natural progesterone cream build in the circulation:

1) Proper dosing,

2) Rotating sites (thin-skinned areas closest to where we blush such as the inner arms and upper chest),

3) Stopping its use for at least two days a month to down-regulate hormone receptor sites.

With these considerations, I have rarely seen the problem your doctor describes.

  Dr. Helene Leonetti