For a long time we didn’t have any research to show the benefits of bio-identical progesterone for women that were TTC. Now we know that both oral and vaginal micronized progesterone can increase the chances of live birth and prevent miscarriage, especially for women that are experiencing spotting at the beginning of pregnancy. The research is mixed on whether or not taking progesterone in the cycles leading up to conception matters. We think this depends on the person and their health history

Who Should Consider Progesterone When TTC?

We typically recommend progesterone to the following:

• Women with a history of low progesterone or know they currently have low progesterone.
• Women with a history of gut health issues since this tends to lower progesterone levels.
• Women with a history of endometriosis.
• Women with a history of PCOS.
• Women with a history of miscarriage.
• Women with a history of hypothyroid.

The benefits of progesterone are that it is cost effective, non invasive, and there are typically minimal side effects. We think most women can use progesterone safely when TTC. If you have concerns, we recommend talking with your provider.

What Kind Of Progesterone Is Best?

Most of the research we have points to oral micronized progesterone as being superior to vaginal progesterone, but we think it depends on the person. If a woman is pregnant and experiencing bleeding, the research shows that vaginal micronized progesterone suppositories are the best option. Regardless of oral or vaginal, we want the form to be micronized progesterone because it has a much higher absorption rate.

How Do I Get Progesterone?

Oral micronized progesterone can be purchased over the counter. This is our favorite brand.

Vaginal progesterone requires a prescription for a license medical professional. Most of our clients get this from their OBGYN.

Tips For Supplementing

When it comes to supplementing with oral micronized progesterone, we ensure that our clients are consuming it with food. Why? We need glucose in order to effectively get progesterone inside the cell. Consuming it after a meal increases the absorption as well.

The amount each woman needs will depend on her current progesterone status and health history. If you are considering supplementing with oral micronized progesterone without testing, we typically recommend starting with 5-10 drops (25-50mg) and slowing working up to 1ml (100mg). You can break up the dose to be 3x a day to help with absorption. Some women do best taking it all at night after dinner to support sleep.

Research/Resources

Research articles for further learning/to help advocate for yourself with your doctor:

• ​https://pubmed.ncbi.nlm.nih.gov/32008730/
• ​https://pmc.ncbi.nlm.nih.gov/articles/PMC11294403/​
• ​https://pmc.ncbi.nlm.nih.gov/articles/PMC10929293/
• ​https://pmc.ncbi.nlm.nih.gov/articles/PMC10003391/
• https://www.sciencedirect.com/science/article/pii/S0015028216560312#:~:text=Conclusions,10%25%20compared%20with%20intramuscular%20P.
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8155417/#:~:text=the%20selected%20women.-,CONCLUSION,the%20findings%20of%20this%20study.%E2%80%8B

Here are some other great resources to check out regarding the health concerns mentioned above that may affect progesterone levels:

Gut health 101 podcast episode
Nutrition for Endometriosis podcast episode
PCOS Handout
Free thyroid mini course

​Want support on your fertility journey? We would love to support you via our Nurture Your Fertility program. You can get all of the program details here and apply here.