Progesterone

Progesterone

the Master Hormone in Women

Oral Progesterone

Before You Decide...

The Core Issue (in plain language)

Progesterone taken orally is metabolized as a drug.

Progesterone used topically is used as a hormone.

That single difference explains almost everything below.

What Happens When Progesterone Is Taken Orally

When progesterone is swallowed, it must pass through the liver first. This is called first-pass hepatic metabolism.

During that process:

  • 80–90% of the progesterone is converted into metabolites
  • The dominant metabolites are neurosteroids, not progesterone itself
  • Blood levels of actual progesterone remain low and inconsistent
  • The liver is forced to repeatedly process a hormone it was never designed to metabolize this way

Short-Term Effects (What Women Often Notice Quickly)

Some women feel temporary “relief,” but it’s important to understand why.
Common short-term effects
  • Sedation or sleepiness
  • Feeling “calmer” or emotionally blunted
  • Dizziness or brain fog
  • Mood flattening
  • Grogginess the next day
Why this happens
These effects are largely due to allopregnanolone, a progesterone metabolite that:
  • Acts on GABA receptors (similar pathway to benzodiazepines)
  • Has sedative and anesthetic-like effects
  • Does not represent true hormone restoration

This is symptom suppression, not hormonal correction.

Long-Term Consequences (This Is the Critical Part)

Over time, oral progesterone can create new imbalances rather than resolving the original one.
  • Tissue levels of progesterone remain low
  • Estrogen dominance is often not resolved
  • Symptoms may return or worsen over time
  • Chronic liver processing of progesterone increases metabolic load
  • Can alter cholesterol metabolism
  • Can interfere with detoxification of other hormones and chemicals
  • Repeated exposure to calming metabolites can:
  • Reduce natural GABA sensitivity
  • Increase anxiety when doses are missed
  • Create a subtle dependency pattern in some women
  • Oral progesterone does not reliably reach:
  • Bone
  • Breast tissue
  • Uterine lining
  • These tissues are where progesterone’s protective effects matter most

Why Topical (Transdermal) Progesterone Is Different

Topical progesterone:

  • Bypasses the liver
  • Immediately Enters the bloodstream as progesterone
  • Distributes directly into tissues
  • Mimics the body’s natural delivery method

Long-term benefits of proper transdermal use

  • True opposition to estrogen
  • Support for bone density
  • Protection of breast and uterine tissue
  • Improved cycle regulation
  • Support during perimenopause, menopause, and pregnancy

This is why route matters more than dose.

Why Oral Progesterone Is Still Prescribed

Not because it’s superior, but because:

  • It behaves like a drug (predictable sedation)
  • It fits pharmaceutical approval models "$$$"
  • It produces immediate, noticeable effects
  • It is easier to standardize for mass prescribing

None of those reasons prioritize long-term female physiology.

Bottom Line (No Softening)

  • Oral progesterone mask symptoms
  • It does not reliably restore hormonal balance
  • Long-term use can perpetuate estrogen dominance
  • The liver and nervous system bear unnecessary burden
  • Topical progesterone aligns with how the female body uses progesterone