We take natural estrogen, natural progesterone, and bio-identical testosterone deficits seriously in our women patients. But not in a simplistic approach of putting a pellet in your butt, which my labs often may show are the cause of excessively high amounts Also, it is usually good to have a good amount of natural progesterone, which does not need blood levels, but only awareness of your alertness as you rise for the day. Do you have sleepiness when you wake up 9 hours after your bedtime dose? For example, if you go from 200 to 300 mg at bedtime tonight, what does it mean if you are sleepy after 8-8.5 hours of sleep? It means you must lower the dose back to 200 mg at bed. How long does it take to notice this am grogginess, just 8 hours after you swallow the progesterone? One night at a higher dose. Period. It does not take days to feel sleepy--only one night.
Also, some healers try to fix hormones using the premenopausal or menopausal blood or saliva ranges as the "correct" blood levels. Huh? So the goal is embracing elderly levels? No. You should have 25-30-year-old progesterone levels (and natural testosterone, which requires only 1-7.5 in ladies--a small fraction of the male dose). Progesterone grows bone about 1% a year. And Zava in his book Breast Cancer shows natural progesterone lowers this cancer risk.
Some doctors love saliva hormone levels. I do not oppose them. I only share that when I blinded saliva lab companies, the results did not fit the low or high hormone dose, and saliva companies gave different results. Therefore, I typically find extensive lab blood results beneficial in my medical company over the past 31 years.
You may be taking a synthetic progestIN if your progesterone has anything attached to any part of the partial word progest-. Per drigs.com, progestins are synthetic steroid hormones that activate the progesterone receptor, but each individual progestin has its own distinctive effect. Synthetics are not our topic. These synthetics have uses outside our scope.
Finally, hot flashes can be helped with black cohosh at 2 am and evening. Remifemin is a respected brand I have used for 31 years, and my OB/GYN father used it in the 1960s.
The black cohosh package suggests 2 per day for hot flashes. But I have found 2 am and night work much better, and do not expect instant help--give it 6–8 weeks before calling it a failure.