What it is
If you take estrogen and still have a uterus, you need progesterone. Estrogen alone thickens the uterine lining over time, and that raises the risk of uterine cancer. Progesterone keeps the lining thin.
Dr. Mueller prescribes micronized progesterone. It is FDA-approved and the same molecule your ovaries made. It is a capsule taken at bedtime.
Bedtime is deliberate. The capsule makes many women drowsy, which turns a requirement into a benefit.
Who it can help
- Women starting systemic estrogen who still have a uterus
- Women in perimenopause with heavy or unpredictable bleeding
- Women whose sleep is light or broken (many feel drowsy on it)
- Women who tolerated synthetic progestins in birth control poorly
What starting it involves
- 1
Paired with estrogen
It is added whenever systemic estrogen starts and you have a uterus.
- 2
History review
Dr. Mueller checks for peanut allergy: the capsule contains peanut oil.
- 3
One capsule nightly
You take it at bedtime, every night.
- 4
Watch the bleeding
Spotting is common at first; bleeding that persists gets looked at.
- 5
Follow-up
You review sleep, bleeding, and side effects at 8 to 12 weeks.
- 6
Yearly review
Dose and need are revisited once a year with your estrogen.
Questions people ask
- Do I need progesterone if I had a hysterectomy?
- Usually not. Without a uterus, estrogen can be taken on its own.
- Is progesterone the same as progestin?
- No. Progestins are synthetic cousins used in birth control pills. Micronized progesterone matches the hormone your ovaries made.
- Will it help me sleep?
- Often, yes. It is taken at bedtime partly because it makes many women drowsy. That is a side effect, not its main job.
- What are the side effects?
- Drowsiness, dizziness, and breast tenderness are the common ones. Taking it at bedtime handles most of the drowsiness.
- Can I take it without estrogen?
- Sometimes. Dr. Mueller may use it alone for heavy perimenopausal bleeding or for sleep. That is a case-by-case decision.