Progesterone Therapy in the Treatment of PCOS

Dr. Julia Christensen, ND

Polycystic Ovarian Syndrome (PCOS) is a multi-faceted condition encompassing multiple hormonal and endocrine imbalances resulting in a multitude of symptoms.  A PCOS diagnosis is often made clinically based on symptoms as well as with consideration of the results of specific lab tests.  Once the specific imbalances and symptoms are determined (ie. infertility, lack of a regular cycle, acne, unwanted facial hair growth, weight gain, hair thinning or loss, dysregulation of blood sugar, and high testosterone) treatment can be implemented to restore balance in the specific areas that have excess or deficiency.  There are many treatment options to consider for PCOS and they may include lifestyle recommendations, nutrition changes, supplements, and herbal medicine.


In some cases, a prescription for progesterone may also be helpful for restoring regular cycles with multiple added benefits specific to PCOS.  Progesterone therapy in PCOS has been found to be protective against endometrial cancer, can decrease the amount of lutenizing hormone (LH) which is often high in PCOS which then indirectly decreases testosterone, helps to support regular menstrual bleeding, and it has been shown to decrease the hormone associated with causing acne and hair growth on the face.


For someone who is pre-menopausal; cyclical progesterone may be recommended which means that progesterone is used for daily for two weeks and then discontinued for two weeks.  This can be repeated for multiple months until the period is restored and progesterone therapy may be discontinued at that point (a health care provider will help to determine this).  Progesterone is typically prescribed topically as a compounded cream or in the oral micronized progesterone form; and is typically taken at night before bed. An oral form of progesterone has the added benefit of enhancing deep sleep.  An additional added benefit of cyclical progesterone is to improve bone density.


Dosing and form of the progesterone prescribed will be determined on a case by case basis, and will account for symptoms, lab testing, and any relevant past medical history. Be sure to inquire with your healthcare provider if you think that progesterone therapy could be a possible avenue to explore in your treatment of PCOS.