Bio-Identical Progesterone

Progesterone is a C-21 steroid hormone that plays an important role in pregnancy, the menstrual cycle, as well as embryogenesis of humans and other species. It is a member of a class of hormones known as progestogens. In fact, it is the major natural human progestogen.

It is usually manufactured from substances found in Dioscorea, a member of the yam family that can produce a steroid known as diosgenin, which in turn can be converted into progesterone via laboratory processing.

Progesterone is sometimes confused with progestins, synthetically produced progestogens.

Plant Sources
Aside from originating in humans and certain animals who can produce this hormone, progesterone-like steroids can be found in Dioscorea mexicana—this is a plant, found in Mexico, that comes from the yam family. Dioscorea mexicana has a steroid named diosgenin that can be removed and converted into progesterone. Progesterone and diosgenin can also be found in other Dioscorea species.

Dioscorea pseudojaponica is another plant that can be used for the manufacture of progesterone. Found in Taiwan, this plant contains saponins (steroids) that are convertible to diosgenin.

There is also a wild yam named Dioscorea villosa that contains steroids that may be converted through this process. Dioscorea villosa has been shown to contain 3.5% diosgenin. In addition, a new species called Dioscorea polygonoides has been subjected to extensive lab analysis and found to have 2.64% diosgenin. Many Dioscorea species grow in countries with tropical and subtropical climates.

Progesterone Levels
The black line in the chart shows progesterone levels during the menstrual cycle.

Ovulation Cycle

In women, progesterone levels are relatively low during the preovulatory phase of the menstrual cycle, rise after ovulation, and become elevated during the luteal phase. In general, progesterone levels are < 2 ng/ml prior to ovulation and > 5 ng/ml afterward. If pregnancy occurs, progesterone levels are initially maintained at luteal levels, but levels start to rise with the onset of the luteal-placental shift in progesterone support of the pregnancy, and can reach 100-200 ng/ml at term. Progesterone levels fall dramatically after delivery of the placenta and during lactation.

In children and postmenopausal children, progesterone levels are relatively low. The progesterone levels of adult males are similar to those of women during the follicular phase of the menstrual cycle.

Effects in the Reproductive System
Sometimes termed the "hormone of pregnancy,” progesterone plays a number of important roles during fetus development.

Progesterone converts endometrium into a secretory substance to prepare the uterus for implantation. Simultaneously with this process, the progesterone alters the vaginal epithelium and cervical mucus, which results in rendering the mucus thicker and impermeable to sperm. If pregnancy fails to occur, the progesterone levels will decrease and menstruation will resume. Normal, healthy menstrual bleeding is basically progesterone withdrawal bleeding.

During the implantation and gestation phases, the presence of progesterone appears to decrease the natural immune response and allow the acceptance of the pregnancy.

Progesterone decreases the contractility of uterine smooth muscle. Furthermore, the presence of progesterone inhibits lactation in pregnant women. Following birth, the drop in progesterone levels helps trigger the production of milk. It is also speculated that lowered progesterone levels may aid in facilitating the onset of labor. The fetus metabolizes the placental progesterone during the production of adrenal steroids.

In general, the human body does not absorb progesterone products well when they are administered orally, unless they are micronized and taken with oil or fatty foods. Progesterone does not dissolve in water. For these reasons, it is common to use products such as Utrogestan, Prometrium, Microgest, and Minagest, which are capsules containing micronized progesterone in oil. Be aware that these progesterone products commonly contain peanut oil, which can trigger an allergic reaction in certain individuals. To avoid this problem, some pharmacies elect to use alterative substances when concocting these kinds of products.

Another alternative is rectal and vaginal application. One product used for this is ENDOMETRIN (progesterone) Vaginal Insert 100 mg, which was approved by the FDA in 2007 as an aid in embryo implantation and early pregnancy. Other products are PROCHIEVE and CRINONE bioadhesive progesterone vaginal gels, the first FDA-approved progesterone products intended for use during pregnancy. Another is Cyclogest—basically progesterone in cocoa butter.

Progesterone may also be administered via injection, but this must be done on a daily basis to ensure effectiveness of the treatment.

There is no prescription required for "natural progesterone" supplements that have been derived from yams. Wild yams contain a plant steroid named diosgenin, but it has yet to be demonstrated that the human body is able to metabolize this substance into progesterone. However, diosgenin can be converted into progesterone through a chemical process undertaken in a laboratory.

"Natural progesterone" products derived from yams, do not require a prescription. Wild yams contain a plant steroid called diosgenin, however there is no evidence that the human body can metabolize diosgenin into progesterone.[28][29] Diosgenin can however be chemically converted into progesterone in the lab.[30]


Types of Progesterone
Sublingual Liquid - Highly absorbable, no toxic tag-alongs. Each drop is 1 mg progesterone.

Creams - Use as directed. Natural progesterone creams can bioaccumulate in soft tissue and make dosage very hard to keep accurate.

Do You Need Hormones?

Here are general guidelines, each individual varies.

  • Day 0-15 – no progesterone
  • Days 16-17 – 8 drops ProGest 3 times daily; after breakfast, lunch and before bed
  • Days 18-19 – 10 drops ProGest 3 times daily; after breakfast, lunch and before bed
  • Days 20-21 – 12 drops ProGest 3 times daily; after breakfast, lunch and before bed
  • Days 22-24 – 14 drops ProGest 3 times daily; after breakfast, lunch and before bed
  • Days 25-26 – 8 drops ProGest 3 times daily; after breakfast, lunch and before bed
  • Days 27 – 4 drops ProGest 3 times daily; after breakfast, lunch and before bed
  • Days 28 – 0 drops ProGest
    • Tend to be low in estrogen and progesterone.
    • Could use PhytoB or PhytoEstrogen products to replace the estrogen.
    • Use a graduated cyclical augmentation program for progesterone. For a standard 28-day cycle, menses is day 1.
    • Can use Pregnenolone and DHEA to prime the hormone pathways.

Cycling Female

      Start slowly and build up to full dose.


      Adjust dosage if your cycle when you were younger.


      Still cycling but the cycles are beginning to vary in length and duration.


      Start slowly and max out around 100 mg daily.

Not Certain What To Do Next?

If you can’t decide which products or programs to use or which tests to select, if you have questions about hormone or testosterone replacement therapy, or if you need additional help:
  • Contact us with your questions.
  • Schedule a phone consultation with Dr. Forrest at (408) 354-4262