Instructions on how to take it and advice on best practice
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Read the Patient Information Leaflet:
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However it is important to consider this leaflet is typically produced with cis women using progesterone for birth control, and so much of the information may not be applicable or appropriate for you.
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If there is conflict between what your healthcare provider has told you versus what the leaflet says, it’s generally best to follow your provider’s advice given that they will be aware of your transness and personal reason for using progesterone.
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However if you have any concerns about which information is best to follow, you can always double check with your provider or another healthcare professional.
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Dosage:
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Your prescribed dosage will be stated on your prescription and in the UK will be printed on the label stuck to your medication box.
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Starting doses typically fall within a standardised range, and then your dose may be adjusted in accordance with blood test results and the effects you are experiencing.
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Timing:
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Take your dose at the same time each day to maintain consistent hormone levels.
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If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose (within the next 5 hours), skip your missed dose and start afresh with the next regular dose.
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Taking your progesterone:
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Take it at bedtime
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It should be taken at least 2 hours after food.
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Swallow the pill whole with a glass of water.
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Do not crush, chew, or break the tablet.¹
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What Are the Specific Benefits of Taking Progesterone Alongside Oestrogen?
The typical additional benefits include:
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Increased fat redistribution
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Increased breast growth
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A change in breast shape (typically a rounder breast shape opposed to a more conical one that is more frequently seen in patients prescribed only oestrogen)
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Increased sex drive
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Improved ability to get/stay erect
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Better sleep
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Improved bone density/lowered risk of osteoporosis
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Protection of cardiovascular health
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Improved mood and reduced stress
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Reduction in oily skin
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Reduced “male-pattern” body odour
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Regrowth of hair that was lost as a result of of androgen-induced baldness
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Increased anti-androgen effects¹
You may already experience these effects from oestrogen alone, however progesterone may increase the extent to which you experience them.
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On the other hand, there is no guarantee progesterone will produce these effects for you: as with all hormones, whether you experience effects will vary greatly between individuals.
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Also, the time effects take to develop can also vary significantly, and sometimes you just need to be patient for a little while, even if this is very hard.
Other Things to Note:
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Anecdotally, there is some concern progesterone can worsen existing poor mental health or conditions.
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So it may be advisable to proceed with some caution if you have a personal and/or family of mental illness.
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Much of the understanding of progesterone and its effects come from shared community knowledge, which is incredibly powerful but often goes overlooked by doctors.
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There is a lack of official studies, especially in comparison to what is available for oestrogen and other hormonal medication.
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This may contribute to an unwillingness to prescribe by many medical professionals, but that doesn’t mean it isn’t worth approaching those responsible for your care and explaining why you want to try progesterone (for example: explaining the side effects of oestrogen you’re experiencing that progesterone has been known to alleviate in some people)
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Community knowledge does generally seem to suggest that many people do feel better on a combination of oestrogen and progesterone, opposed to just oestrogen alone.
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For some people this is the result of a lessening of side effects experienced whilst on oestrogen only.
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For others, they didn’t have any side effects in need of relief, but progesterone offered added benefits they hadn’t experienced on oestrogen alone.
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It may also come from lessened dysphoria when progesterone addresses a source of dysphoria that oestrogen had been unable to alone.
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Others describe simply feeling more balanced and calm.
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Can I access progesterone in the UK?
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Progesterone is mostly unavailable under the NHS, as it is not part of the standard GIC HRT regimen.
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However, if you trust your HRT provider, especially if they work outside of a GIC, you can still ask them to consider prescribing you progesterone, and explain why you think it would help you, as there is technically not anything to stop them prescribing it.
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While there is not a huge amount of research, it is not entirely absent, and so directing your doctor towards the papers that are out there on the topic may be a good idea.
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Some examples of research papers regarding progesterone and its benefits for transfeminine individuals include:
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Like all HRT, it is only available for trans patients as an “off-label” usage, but “off label” prescriptions are incredibly common in the UK, so this is not a reason for them to deny you a prescription.
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For example, one study found that the majority (64%) of medicines used in neonatal intensive care during the study period were unlicensed or off-label, despite the intense vulnerability of this group.¹
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Progesterone is more commonly prescribed by private providers than by those working within the NHS, so if you are very keen for a prescription for it but your NHS provider won’t offer it, you can consider working with a private trans healthcare provider.
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Although even amongst private providers there is no guarantee they will prescribe progesterone! So if this is what you are seeking from a private provider, check this is something they are willing to offer before spending significant amounts of money going through their initial stages.
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Gender GP is one service that believes in access to progesterone for their patients, as illustrated here, so that is one private option you may want to consider.