What it is

Micronized progesterone is body-identical progesterone: exactly the same molecule your ovaries make, not a synthetic progestin.¹ It comes as a soft capsule that you swallow. Both strengths contain the same ingredients.² Your doctor prescribes the dose based on your symptoms and whether you also use estrogen.

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How to take it

• Take it every night at bedtime, on an empty stomach. It can make you sleepy or dizzy within 1–3 hours, so we only give it at night, never in the morning.³ Taking it the same way every night, without food, keeps its effect steady, because food changes how much you absorb.³
• Take it every night, including the days of your period. There is no need to count days.
• Take exactly the capsule strength and number written on your label. We have two strengths, so always check the strength on your label.
• If you also use estrogen, start the capsules on the same day you start estrogen, so the womb lining is protected from the first day.
• Set a reminder on your phone and keep the capsules by your bed. Missed doses are a common cause of breakthrough bleeding and of weaker protection of the womb lining.^4,5

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If you miss a dose

Skip the missed dose and take the next one at your usual bedtime. Do not take two doses to make up, because a double dose makes you sleepier. Progesterone stays in your body for many hours, so one missed dose is not a problem.³ Missing doses often can cause spotting. If you often forget, tell us. If you use estrogen and still forget often, we may suggest a hormonal coil instead, because it does not depend on remembering a capsule.⁴

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If you stop

• If you also use estrogen and have a womb, please do not stop progesterone on your own. Estrogen without progesterone makes the womb lining grow, which raises the risk of cancer of the lining.^4,6 Talk to us first.
• You may have a bleed after stopping. A fall in progesterone is the signal for the womb lining to shed, just like a period.⁷

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Please stop

• Progesterone creams. A cream on the skin cannot protect the womb lining, so it must never replace your capsules.^4,8
• The combined contraceptive pill. It already contains estrogen, so with our hormones you would get estrogen twice, and its risk of blood clots rises from about age 40. Talk to us about contraception that works with our hormones.⁹

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Tell us if you take

None of these means you cannot take progesterone. Some medicines and progesterone affect each other, so knowing what you take helps us look after you more closely.

• Seizure medicines, such as carbamazepine, phenytoin, phenobarbital or topiramate, tuberculosis medicines such as rifampicin, the herbal remedy St John’s wort, or some HIV medicines. These can lower the level of progesterone in your body, and the guideline asks us about them whenever bleeding changes. We take this into account when we look at your symptoms and bleeding.^3,5
• Some antibiotics, such as amoxicillin, ampicillin or tetracycline, and other medicines such as rifabutin, oxcarbazepine, eslicarbazepine, primidone, perampanel, bosentan or aprepitant. These can also lower the level of progesterone.³
• Some antifungal medicines, such as ketoconazole, itraconazole, fluconazole or voriconazole. These can raise the level of progesterone in your body.³
• Some statins, such as atorvastatin or rosuvastatin, and tacrolimus or selegiline. These can also raise the level of progesterone.³
• A blood thinner of the warfarin type. Progesterone can change how well it works.³
• Ciclosporin (a transplant medicine) or tizanidine (a muscle relaxant). Progesterone may raise their levels. It can also weaken the effect of bromocriptine.³
• Upcoming blood tests. Progesterone can change some results of liver and hormone tests, so please tell the doctor or laboratory that you take it.³
• Diabetes medicines. Progestogens can affect blood sugar control, so your diabetes treatment may need adjusting.³
• Sleeping tablets or other medicines that make you sleepy, including melatonin. Progesterone also makes you sleepy, so we ask how you feel in the morning.³
• Contraception of any kind. We check that it works safely with our hormones.
• Other hormones, or herbal products for menopause, from anywhere else. Some are sources of estrogen, and guidelines ask us to check for them every time, because they can change your bleeding pattern.⁵
• Any new medicine you start while taking progesterone, so we can check that the two work well together.

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Contact us if you notice

Our way of giving progesterone is very safe, and we have not seen these problems in our patients. We tell you about them because it is our duty to give you complete information, so that you can help us watch out for yourself.

• Feeling sleepy or dizzy, especially in the morning. This can mean the dose is more than you need. We may adjust how you take it.³
• Sore or tender breasts. This can mean your body is not yet comfortable with the dose. We adjust your treatment.⁴
• Low mood or mood swings. Please tell us before you start if you have had depression, because the label asks us to watch more closely. These feelings have many causes. We will talk with you and check, and refer you if low mood is severe.³
• A new migraine. You do not need to stop progesterone, because migraine is linked to rising and falling estrogen. Your doctor reviews your treatment; if you also use estrogen gel, the gel is the part we stop. The product label is more cautious and says to stop; your doctor will explain why we decide differently.
• Any bleeding that worries you (see “Bleeding while you take progesterone” on the progesterone page).
• Yellowing of the skin or eyes, a big rise in blood pressure, blurred or double vision, or bulging eyes. Stop the capsules and contact us that day. These are uncommon, but the label lists them as reasons to stop first, for safety.³

These symptoms usually have other causes, and we will check to be sure. Go to a hospital the same day if you have: sudden loss or change of vision; pain and swelling in one leg, sudden chest pain or sudden breathlessness, which may be a blood clot; sudden weakness of an arm or leg, or difficulty speaking; or sudden, very heavy bleeding.³

Planning major surgery? Tell your surgeon which medicines you take. We do not ask you to stop before surgery, but if the surgical team asks you to pause, follow their advice and restart once you are fully up and walking again. The surgical team judges the risk of blood clots for each operation and arranges prevention.³

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How to store it

• Store below 30°C.²
• The unopened pack keeps for 3 years. Use it before the expiry date on the box.²
• Keep it out of the sight and reach of children.

Medically reviewed by Dr. Chontirot, MD · Medical licence no. 36583 · Last reviewed: 31 October 2026

References

1. The North American Menopause Society. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767–794.

2. Package insert (Thailand): oral micronized progesterone 100 mg and 200 mg soft capsules. Besins Healthcare; 2013.

3. Summary of Product Characteristics: oral micronized progesterone 100 mg capsules. Besins Healthcare (UK) Ltd; emc, UK; updated 2025.

4. Panay N, Fenton A, Hamoda H, et al. Recommendations and Key Messages on Women’s Midlife Health and Menopause. International Menopause Society; 2026 (summary published in Climacteric, 2025).

5. British Menopause Society. Management of unscheduled bleeding on hormone replacement therapy (HRT). BMS Guideline. 2026.

6. Package insert (Thailand): estradiol gel 0.06%. 2021.

7. Maybin JA, Critchley HOD. Menstrual physiology: implications for endometrial pathology and beyond. Hum Reprod Update. 2015;21(6):748–761.

8. Stute P, Neulen J, Wildt L. The impact of micronized progesterone on the endometrium: a systematic review. Climacteric. 2016;19(4):316–328.

9. Faculty of Sexual and Reproductive Healthcare. Contraception for Women Aged Over 40 Years. 2017, amended May 2025.

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