Progesterone

Progesterone is a hormone that plays a vital role in your hormone therapy plan. If you have a uterus and are taking estrogen, progesterone is required to protect your uterine lining. Without it, estrogen can cause the lining to thicken, which increases the risk of uterine cancer.

Many patients notice they fall asleep faster within the first few nights and it can help create a sense of calm and stability.

The compounded oral progesterone Midi offers is an excellent choice if you need a specific dose that is not available commercially or need to avoid common ingredients like peanut oil or gelatin.

1. Take at bedtime: Progesterone has a natural calming effect. Taking it right before bed helps you rest and avoids feeling drowsy during the day.
2. You can take this with or without food, but try to do it the same way every night. Food can change how much of the hormone your body absorbs and being consistent means you’ll absorb the same amount every day.

Take your capsule every night as directed by your clinician. This is often preferred for better sleep and to avoid a monthly period.

Take your dose for only 12 days out of the month as directed by your clinician. This usually triggers a monthly "withdrawal bleed" similar to a period.

If you miss a dose: Take it as soon as you remember. If it is almost time for your next dose, skip the missed one. Do not take two doses at once.

Keep your medication in its original pharmacy container with your name on the label. Store at room temperature in a dry place, away from extreme heat.

Most patients tolerate progesterone well, but you may notice:

• Common: Drowsiness, dizziness, bloating, nausea, or breast tenderness. These often improve after 2–4 weeks as your body adjusts.
• Mood changes: A small number of patients (3–8%) may feel anxious or tearful.
• Warning: If you experience severe depression or any thoughts of self-harm, contact your primary care provider or emergency services immediately.

Clinicians recommend using caution. Both alcohol and progesterone affect the brain’s relaxation centers. Combining them can lead to extreme drowsiness or coordination issues.

Please tell your clinician if you take anti-seizure medications, certain antibiotics, or herbal supplements like St. John’s Wort.

Please mention the following before taking this medication:

• Unexplained vaginal bleeding (this must be evaluated first).
• Severe liver disease.
• A history of certain cancers (such as breast or uterine) without specialist approval.
• If you experience any side effects, please alert your clinician but if you experience severe depression or any thoughts of self-harm, contact your provider or emergency services immediately.

Do not stop taking progesterone while you are still taking estrogen unless instructed by your Midi clinician.