Healthcare professionals typically start a person on the lowest dose of progesterone in hormone replacement therapy (HRT). They then monitor and increase the dosage as required.

HRT can help manage menopause symptoms. People take hormones during HRT to replace those their body no longer makes as menstruation ends. There are several different types of HRT where people take different hormones or combinations of hormones.

When a person starts HRT, healthcare professionals prescribe progesterone at low doses before increasing them.

Researchers are also investigating the role of progesterone in gender-affirming hormone therapy (GAHT). GAHT is a form of HRT that more closely aligns a person’s sexual characteristics with their gender identity.

Progestogen is the name for the group of hormones that include progesterone and progestin. Progestins are artificial forms of progesterone.

This article discusses the lowest dose of progesterone, why a person may need progesterone HRT, and the different types of HRT for menopause. It also considers how long someone needs to take progesterone HRT and possible side effects.

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During HRT, a person experiencing menopause should generally take progesterone along with estrogen. Progesterone is a hormone with several important functions within the body. A person may take it during HRT in combination with another important hormone called estrogen.

Healthcare professionals typically prescribe the lowest progesterone dose at the beginning of HRT. They then slowly increase a person’s dosage until they reach the lowest dose that relieves symptoms.

For example, the recommended dose of progesterone (Prometrium) is as follows:

  • For people who are postmenopausal: 200 milligrams (mg) daily for 12 days each 28-day cycle.
  • For people who have not had a period for at least 3 consecutive months: 400 mg daily for 10 days.

Healthcare professionals will then monitor the effects of HRT and may increase lower doses as needed.

To treat a person with a form of HRT that has Food and Drug Administration (FDA) approval, healthcare professionals usually use artificial progesterone, called progestin. This HRT treatment usually takes the form of capsules called oral micronized progesterone.

It is important for a person to take the medication as a doctor prescribes.

Learn about the uses and types of HRT.

A person may need HRT to help manage menopause symptoms. Healthcare professionals may recommend forms of progesterone HRT to:

Progesterone in HRT can reduce a person’s risk of some side effects from taking estrogen alone. These risks include:

If a person has had a hysterectomy, they do not typically need progesterone in HRT to reduce these risks. Also, some types of estrogen-only HRT do not affect the uterus. A person does not generally need to take these types of HRT with progesterone.

Researchers are also investigating the use of progesterone in GAHT. A 2023 study concluded that progesterone may have a role in breast development for transgender females. The researchers recommended further studies.

Learn more about GAHT.

The FDA has approved certain types of HRT for menopause that have different types of hormones or combinations of hormones:

  • estrogen only (EO)
  • progestin only (PO)
  • combination estrogen and progestin (CEP)
  • combination estrogen and other medication (CEO), such as bazedoxifene

Which type of HRT healthcare professionals prescribe depends on whether a person has had a hysterectomy. They usually prescribe EO or CEP. However, they will first discuss which type is most appropriate with the individual.

How long a person needs to take progesterone HRT can vary with each individual. Healthcare professionals will discuss and create an individualized treatment plan.

Most treatments do not last more than a few years. Most people taking HRT usually stop treatment after about 5 years.

Learn about how long a person can take HRT.

As with most therapies, HRT has potential benefits and side effects. Healthcare professionals will discuss possible side effects with a person before they start HRT.

Progesterone HRT over time may cause some common side effects, including:

More severe side effects may include:

HRT can help relieve menopause symptoms by replacing hormones the body no longer makes as menstruation ends. People may take progesterone HRT alone or combinations of progesterone and other hormones. The type can depend on whether a person has had a hysterectomy.

Healthcare professionals usually prescribe the lowest dose appropriate for a person before later increasing it. This lowest dosage can vary from person to person.

Researchers believe progesterone may also be able to play a role in gender-affirming hormone therapy. This is a type of HRT to help align a person’s sexual characteristics and gender identity.

Progesterone HRT can have side effects over time as well as benefits. Healthcare professionals will discuss these with people before starting HRT.