start my labs

CAPSULEprogesteronerandomized trial evidence

progesterone and estradiol

micronized progesterone, with estradiol where your panel indicates it. drawn at the same point in your cycle each month.

what you get: micronized progesterone, estradiol where indicated
how you take it: at night, through the luteal phase
dosing: set to your mid-luteal levels
dispensed by: a licensed US compounding pharmacy
reviewed at: three cycles, drawn at the same point

$149/mosee if you qualify

a physician decides what is right for you. if this is not a fit, your first panel is on us.

compounded to the dose your panel indicates. both are approved molecules.

300mg

oral micronized progesterone at bedtime, the dose used in the phase III trial

randomized placebo-controlled trial, 189 perimenopausal women aged 35 to 58, three months

what this does for you

nights thatsettle down

the phase III trial reported less intense night sweats and better sleep quality on 300mg at bedtime, with no rise in depressive symptoms.

a luteal phasewith support

progesterone dosed to what your mid-luteal draw actually shows, seven days after ovulation rather than on a calendar date.

hormones readat the right moment

the same cycle point every month, so a change in your numbers is a real change and not an artifact of when the blood was taken.

the trial's primary endpoint, a composite vasomotor score at month three, did not separate from placebo. several secondary endpoints did. that pattern is familiar in vasomotor research, where composite scores are noisy and individual response varies widely. it is an argument for reading your own hormones and tracking your own symptoms rather than assuming the group average describes you.

why we measure it, and what we are reading

a prescription without a follow-up draw is a guess with a receipt. every marker below has a direction we expect and a date we check it, and all of it is read against your own baseline rather than a population range.

progesteronemonthly

drawn mid-luteal, roughly seven days after ovulation. drawn at the wrong point in the cycle, the number means nothing.

estradiolmonthly

read as a ratio against progesterone. the balance between them explains more than either value alone.

LH and FSHquarterly

rising FSH is among the earliest markers of the perimenopausal transition, often years before cycle length changes.

SHBGquarterly

determines how much of your sex hormones circulate free. it is why a normal total can sit on top of a functionally low free level.

prolactinfirst panel

a common and highly treatable cause of anovulation. if this is the finding, you need a physician rather than a prescription from us.

TSH and ferritinquarterly

thyroid disease and iron deficiency reproduce nearly every symptom of hormonal imbalance. both are excluded before anything is prescribed.

what happens, and when

before you start

a full panel timed to your cycle. if your cycles are irregular we establish ovulation timing first rather than drawing on an arbitrary day.

the full hormone panel, plus thyroid and iron

cycle 1

progesterone through the luteal phase, unless your panel indicates otherwise. sleep usually changes first.

mid-luteal progesterone and estradiol

cycles 2 to 3

dose adjusted to the mid-luteal levels we measure, drawn at the same cycle point each month.

progesterone, estradiol, symptom record

cycle 3

the review point. three cycles is the shortest interval that gives a reliable read on a hormone. one cycle is noise.

the full panel against your baseline

this is a fit if

irregular cycles, difficult luteal weeks, PMDD, postpartum changes, or early perimenopause
you have been told your labs are normal without being told what they were
you want your hormones read at the right point in your cycle
you can draw at the same cycle point each month

this is not for you if

you are pregnant or actively trying to conceive
you have a history of hormone-sensitive cancer, venous thromboembolism, or unexplained vaginal bleeding
you smoke and are over 35, which compounds the thrombotic risk estradiol carries
you are on hormonal contraception, which stays with the prescriber who wrote it

the detail

progesterone rises after ovulation and falls in the days before your period. that fall is what the difficult week is made of. micronized progesterone at night supports the luteal phase, and its metabolite allopregnanolone acts on GABA-A receptors. that is why sleep is usually the first thing to change. estradiol is added only where your panel shows a deficit. treating one of these without reading the other is how most prescribing in this area goes wrong.

nothing here is offered before it is measured.

start my labsall treatments

Prior et al., oral micronized progesterone for perimenopausal night sweats and hot flushes: a phase III Canada-wide randomized placebo-controlled 4 month trial. Scientific Reports, 2023. n=189.

compounded medications are not FDA-approved and are prescribed at the discretion of a licensed physician. this page is information, not medical advice. prova does not replace your primary care provider.