Question: Hello. I am forty-five, perimenopausal diagnosed by blood work. I have my uterus and I am taking 200 milligrams of bioidentical progesterone each night orally by capsule. I do not take anything else for hormone balance other than evening primrose oil and some adrenal support. Neither of these is new to my regimen. What is new is the administration of the progesterone orally. Previously, I was using a progesterone cream, 40 milligrams per night. All nights of my cycle, no break. Doc suggested that I needed to be more cyclical with my administration and then I try oral progesterone instead. I am doing this. I go to sleep well but toss and turn a bit more than I used to, then wake up around four thirty-five and cannot sleep any longer. My body temperature seems to be all over the place. At some nights around that same time, I wake up hot, not really a hot flash per se but just hot, but the very next night, I can have on the same bedclothes, sheets, house temperature, et cetera, and will not get hot. She has me doing fourteen days, fourteen to twenty-eight, taking the oral progesterone. My trouble is the fourteen days I have to wait to take it, I have all the trouble sleeping and all the other symptoms while I am waiting for that fourteenth day to come so I can take my oral progesterone. My question, can I take it full-time during my cycle and never take a break or does that go against all medical wisdom and/or would be bad for my body not to have a break?
Short Answer: Based on a woman’s physiology, it does make sense to only take progesterone during the second half of the month. Typically, progesterone is produced from ovulation to the period and usually peaks around day 21 of the cycle. However, many women feel better when they take oral progesterone all month long. Oral progesterone helps reduce irritability, reduces anxiousness, and can improve sleep. Because of this, we most often prescribe progesterone to be taken all month long. Sustained Release Oral Progesterone is usually very well tolerated, but sometimes it can change a woman’s cycle. Based on how the cycle changes will determine if the dosage needs to be cycled or not. For example, we might prescribe 50 mg for the first half of the month and then increase to 100 mg during the 2nd half of the month. Then we have our patients stop the progesterone during menstruation.
PYHP 101 Full Transcript: 
Download PYHP 101 Transcript
Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Prog