Progesterone

[progesterone]

Rev: 2025.12

Summary

Optional addition to feminizing HRT, helps with breast development.

DESCRIPTION

Bioidentical progesterone is sometimes added to feminizing HRT regimens. Its role in breast development is debated scientifically, but many report subjective benefits including improved breast shape (especially areola development), mood improvements, and better sleep. Typically added after initial breast development has begun (6-12 months).

DOSING GUIDELINES

Route	Dose Range	Frequency	Target Levels
Oral	100mg – 200mg	Daily at bedtime	2-25 ng/mL (highly variable)
Other	100mg – 200mg	Daily at bedtime	10-40 ng/mL

DETAILED NOTES

Oral

Oral micronized progesterone (Prometrium or generic). Largely converted to neurosteroids in liver, causing drowsiness - take at bedtime. May improve sleep. Oral has lower bioavailability than rectal. Use micronized progesterone, NOT synthetic progestins.

Other

Rectal administration of oral capsules bypasses first-pass liver metabolism, resulting in significantly higher serum progesterone levels than oral. Insert oral capsule rectally. Better for achieving physiological levels. Still causes some drowsiness.