Progesterone
Progesterone, in the form that suits you. The same progesterone your body makes, compounded in the strength your provider sets: an extended-release capsule made without peanut oil or any oil, a tablet that dissolves under your tongue, or a troche. Around menopause, some women take it at bedtime for night sweats and sleep, an off-label use. If you take estrogen and still have your uterus, the evidence for protecting its lining is for FDA-approved progesterone capsules, so your provider will usually prescribe those unless you can’t take them.
- Compounded in the strength your provider sets
- Capsule made without peanut oil or any oil
- Capsule, under-the-tongue tablet or troche
Capsule, tablet or troche · from $55/mo. Prices are preliminary.
How to use it
- Take it at bedtime, on the schedule your provider sets: every night, or for part of each month.
- Capsule: swallow it with water. Rapid-dissolve tablet or troche: let it dissolve under your tongue or against your cheek, without chewing or swallowing it whole.
- It can make you drowsy or dizzy, so don’t drive or drink alcohol after taking it. Tell your provider about any bleeding that’s new or doesn’t settle.
- Form
- Extended-release capsule (made without peanut oil or any oil), rapid-dissolve tablet (under the tongue) or troche
- Strength
- Compounded to the strength your provider sets
- Typical use
- At bedtime, every night or for part of each month, as your provider sets
- Who it’s for
- Women in perimenopause or menopause, for night sweats and sleep (off-label), if a provider decides it’s right for them
One active, made to match your own.
- Progesterone (Strength set by your provider): The hormone your ovaries make after ovulation, identical to your body’s own. It balances estrogen’s effect on the lining of the uterus, and it can make you drowsy, which is why it’s taken at bedtime.
What the research does and doesn’t show
With estrogen: in a 3-year trial, FDA-approved progesterone capsules taken by mouth (200 mg at bedtime, 12 days a month) kept the uterine lining from overgrowing in women taking estrogen. No study has tested whether compounded progesterone, as a capsule, an under-the-tongue tablet or a troche, protects the lining the same way.
On its own: in a 12-week trial of 133 women in early menopause, 300 mg at bedtime eased hot flashes and night sweats more than a placebo. A trial of 189 women in perimenopause didn’t show a clear overall benefit, though women reported fewer night sweats and better sleep. Small studies suggest it may help some women fall asleep.
So progesterone on its own may help night sweats and sleep around menopause, an off-label use, and for protecting the uterus the evidence is for FDA-approved capsules.
Studies: Writing Group for the PEPI Trial, JAMA 1996 (596 women; hyperplasia with estrogen plus micronized progesterone similar to placebo; PMID 8569016); PEPI, JAMA 1995 (PMID 7807658); Hitchcock & Prior, Menopause 2012 (133 women, 300 mg for 12 weeks; PMID 22453200); Prior et al., Sci Rep 2023 (189 perimenopausal women; primary outcome not met; PMID 37277418); Nolan et al., J Clin Endocrinol Metab 2021 (meta-analysis of 9 trials, sleep; PMID 33245776); The Menopause Society 2022 hormone therapy position statement (PMID 35797481); National Academies 2020, compounded bioidentical hormone therapy (PMID 33048485).
What to expect
- The first nights
- Many women feel drowsy, which is why it’s taken at bedtime. Breast tenderness, bloating or mood changes can happen at first and usually settle.
- The first months
- Any effect on night sweats or sleep shows over a few weeks. Spotting or changes in your periods can happen; tell your provider.
- Ongoing
- Your provider checks in, asks about bleeding, and adjusts the strength, form or schedule. Refills ship on schedule.
Important safety information
Before you start
Your provider reviews your health history, medicines and allergies before prescribing, and prescribes only if it’s right for you. Tell your care team about any side effect, and get emergency care for chest pain, trouble breathing, or swelling of the face, lips or throat.
Side effects, and when to get help
The most common are drowsiness, dizziness, headache, breast tenderness, bloating, mood changes and spotting. Get care right away for changes in vision or speech, a sudden severe headache, chest or leg pain, sudden shortness of breath, trouble walking or feeling very confused after a dose, or swelling of the face, lips or throat. Call your provider about any new, heavy or unexpected bleeding.
Rules that keep it safe
Take it at bedtime, and don’t drive, drink alcohol or take sleep medicines after a dose. Don’t use it if you’ve had breast cancer, a blood clot, a stroke or a heart attack, or have liver disease, unexplained vaginal bleeding, or are pregnant. If you take estrogen and have a uterus, you need a progestogen with evidence for protecting the lining, usually FDA-approved progesterone capsules; take every dose as prescribed. Tell your clinician before surgery or a long stretch of bed rest.
Is it FDA-approved?
No. StackRx’s progesterone is compounded: prepared by a licensed pharmacy for you, and not reviewed by the FDA for safety, effectiveness or quality. FDA-approved progesterone capsules exist, approved to protect the uterine lining in women taking estrogen and to bring on a missed period; they contain peanut oil. A 2020 National Academies report found little good evidence on compounded “bioidentical” hormones, and advised compounding them only for an allergy to an ingredient in an approved product or a form that isn’t available.
About Progesterone
Do I need progesterone with estrogen?
Yes, if you still have your uterus. Estrogen on its own makes the lining grow, which over time raises the risk of endometrial cancer, and a progestogen protects against that. The evidence is for FDA-approved progesterone capsules taken by mouth. Compounded progesterone, including StackRx’s, hasn’t been tested for this, so your provider will usually prescribe FDA-approved capsules, and offer a compounded one only if you can’t take those, such as with a peanut allergy.
Can I take it without estrogen?
Some women do, at bedtime around menopause. In a 12-week trial of 133 women in early menopause, 300 mg of progesterone at bedtime eased hot flashes and night sweats more than a placebo. A trial in perimenopause didn’t show a clear overall benefit, though women reported fewer night sweats and better sleep. Using it this way is off-label, and your provider checks any change in your periods first.
Which form should I choose?
Choose the one you’d rather take. The extended-release capsule is swallowed and releases progesterone gradually. The rapid-dissolve tablet and the troche dissolve under the tongue or against the cheek. None of the compounded forms has been tested for protecting the uterus. Your provider confirms the form that fits your plan.
Does it contain peanut oil?
No. FDA-approved progesterone capsules are made with peanut oil, so they aren’t used with a peanut allergy. StackRx’s extended-release capsules are made without peanut oil, or any oil.
Will it make me sleepy?
It can. That’s why it’s taken at bedtime. Don’t drive, drink alcohol or take sleep medicines after a dose, and see how it affects you before relying on being alert the next morning.
Is this the same as a progesterone cream?
No. Progesterone creams, especially ones sold without a prescription, haven’t been shown to protect the lining of the uterus or to help like progesterone taken by mouth. This is prescription progesterone taken by mouth or under the tongue.
Is it FDA-approved?
No. Compounded medications are prepared for an individual patient and aren’t reviewed by the FDA for safety, effectiveness or quality. FDA-approved progesterone capsules are also available (they contain peanut oil), and your provider can prescribe those instead.