Micronized Progesterone (Prometrium)

Micronized progesterone (such as marketed under Prometrium) is a bio-identical form of progesterone that offers a gentler alternative to synthetic progestins for progesterone supplementation in hormone therapy. When used alongside estrogen, particularly in individuals who still have a uterus, it helps protect the endometrium from hyperplasia and cancer due to unopposed estrogen. Micronized progesterone may also support sleep, mood and possibly bone health when used appropriately. The tablets are typically taken at night and timing relative to estrogen therapy matters. As with all hormone therapies, patient-specific factors (such as risk of thromboembolism, breast cancer, cardiovascular disease, liver function) must be evaluated. Regular monitoring of symptoms, side-effects (including sedation, breast tenderness, breakthrough bleeding) and periodic assessment of bone density and cardiovascular/metabolic parameters is advisable. Because it is closer to the body’s natural hormone, some clinicians prefer it for those seeking a more “physiologic” approach.