This episode we respond to a reader question.  Jayme had sent us a question earlier in the year based on an article we wrote.  Now she has additional questions about taking progesterone as part of her BHRT. Jayme has had a hysterectomy and wasn't sure what dose of progesterone is best for her.  Or for that matter, if she should even be taking it.
Also, she has questions about her lab work and her estrogen dose.  We really like Jayme's question, because we get similar concerns often.  By answering Jayme's question, we hope to help other listeners understand a bit more about BHRT dosing, labs and progesterone with or without a hysterectomy.   
Just to throw it out there, this is not meant for medical advice and intended for educational purposes only…
Jayme's question: 
Dr. Maki, Thank you for answering me. Recently my doctor increased my biest to 4mg twice a day. I also stopped my progesterone to see if it was making any difference and I felt exactly the same, so I have not continued it. I had a complete hysterectomy, do you have thoughts on taking progesterone? I was taking compounded progesterone 200mg/day. Before my biest increase, I had my labs taken twice in one day: morning and late afternoon because I was feeling like they wore off. I was correct:
Jayme's Labs:
Total estrogen 112 morning and 60 evening
Estradiol 35.4 morning and  <5 in evening
My estradiol has never gotten above 35.4.
Any new insight would be so appreciated. Jamie

We wanted first to address the progesterone.   If a woman has a uterus and is taking estrogen, she absolutely needs progesterone.  Estrogen thickens the endometrial lining. This can increase the risk of uterine cancer without sufficient progesterone.  But there is a theory in the medical community that if you do not have a uterus, then you do not need to take progesterone.  Whether a woman has a uterus or not, we never give unopposed estrogen.
Progesterone helps to balance estrogen.  Estrogen is a beautiful hormone but can have side effects.  Some being weight gain, increasing breast density, moodiness, and even anxiety in some cases to name a few.  Progesterone is great at balancing these negative side effects of estrogen. Progesterone itself is very helpful for many symptoms.  
It is great for helping a woman fall and stay asleep.  When the progesterone levels drop during perimenopause and menopause, can make staying asleep difficult.  Often women will complain of either waking up multiple times in the night or waking up for hours in the night.  Adding in a little progesterone at night can really do wonders for sleeping. Progesterone can also be great for mood and irritability as well.  When progesterone levels are low, women often remark that their patience has disappeared. Their tolerance levels have dramatically dropped. Progesterone can have a remark