Is Prometrium Safer Than Progesterone? | PYHP 088

Donna’s Question: 
Hello. I’m 62 years old with a uterus. Recently my nurse practitioner switched me from 6% progesterone cream to Prometrium capsules. The amount of cream I was using was 1/4 teaspoon two weeks out of the month. She also added in the Intrarosa vaginal inserts instead of the estradiol cream for vaginal discomfort. I do not have many symptoms other than occasional sleepless nights and occasional hot flashes. My question is are the Prometrium capsules safe? And is the cream safer than the capsules? Thank you, Donna.
Short Answer:
Both Prometrium and bioidentical progesterone are safe to take. However, many women do not seem to tolerate Prometrium very well. Prometrium is instant release, which seems to make it less tolerable for some women. In most cases, we prefer to us sustained-release progesterone, which is typically better tolerated by most women. This is important for women taking estrogen who still have a uterus. Estrogen causes the uterine lining to thicking and oral progesterone inhibits this thickening. Progesterone cream does not inhibit the growth of the uterine lining, which is why we prefer to prescribe oral progesterone for our patients.
PYHP 088 Full Transcript:
Download PYHP 088 Transcript
Dr. Maki: Hello, everyone. Thank you for joining us for another episode of Progress Your Health podcast. I’m Dr. Maki. 
Dr. Davidson: I’m Dr. Davidson. 
Dr. Maki: How you doing this morning? 
Dr. Davidson: I’m doing great. Thank you. How are you? 
Dr. Maki: Pretty good. Pretty good. You were surprised by that question?
Dr. Davidson: Yes, a little bit [laughter]. 
Dr. Maki: Why are you surprised?
Dr. Davidson: Because we’ve been hanging out all morning. [chuckle] Now you’re asking me how I’m doing.
Dr. Maki: Well, we had to start over on this podcast a couple of times, so that’s okay. That’s…
Dr. Davidson: I felt like I had rocks in my mouth. So I’m like, “Just stop it. Let’s start it over.” So I think this one will be the one [chuckle].
Dr. Maki: Yes, yes. So this one is a question we have from Donna. So why don’t you go ahead and read it?
Dr. Davidson: Oh, okay. So yes, this is a listener question from Donna, it says, “Hello. I’m 62 years old with a uterus. Recently my nurse practitioner switched me from 6% progesterone cream to Prometrium capsules. The amount of cream I was using was 1/4 teaspoon two weeks out of the month.” So it looks like they were trying to cycle the progesterone or cycle the hormones. “She also added in the INTRAROSA vaginal inserts instead of the estradiol cream for vaginal discomfort. I do not have many symptoms other than occasional sleepless nights and occasional hot flashes. My question is are t