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Progesterone

What is progesterone?

Hormone sometimes used in conjunction with oestrogen therapy.

It's also known as Utrogestan.

Another type of medication related to progesterone is progestogens. Progestogens can be used for contraception and reducing periods; see contraceptive pill, contraceptive injection, contraceptive implant.

What does progesterone do?

Who can have progesterone?

  • People with a uterus as a part of post-menopausal HRT

  • This is not normally available on the NHS for other purposes

How long does progesterone last?

Oral progesterone (pills) are taken as a daily dose; depot injections normally last around 12 weeks.

How do I stay safe?

Warning

Progesterone may increase your risk of breast cancer.

Studies have suggested that progesterone may lead to an increased risk of breast cancer 1, p.174;2. Using micronised progesterone may result in a lower risk 3 but this may not remove all risk 4.

Warning

Re-using needles puts you at risk of infection.

If you’re taking this as an injection, it’s important to use sterile needles that are disposed of properly. If you are injecting yourself, you can find lots of safety information on our self-injection page.

If your injections are being done by a doctor or nurse, they should make sure the needles are sterile and dispose of them properly.

Why might you want to use progesterone?

For post-menopausal women with a uterus, progesterone is sometimes used as part of post-menopausal hormone therapy, and may reduce the risk of endometrial cancer.

Some clinicians have suggested that progesterone may have positive effects on breast development and libido as part of feminising hormone therapy 5.

Why might you not want to use progesterone?

There is not currently any good quality evidence that progesterone has any positive effect on breast development 6, and some authors have suggested that progesterone may in fact negatively effect breast growth 7.

There is not currently good evidence that progesterone has a positive effect on libido. If you are unhappy with your sex drive and wish to increase it, low dose testosterone gel may help improve sex drive 8;9 and is sometimes recommended for this purpose by NHS endocrinologists 10.

Some people describe improvement to their mood while taking progesterone, while others describe strongly negative effects on mood.

The majority of gender clinics in the UK do not prescribe progesterone for use in feminising hormone therapy 10;11;12, and this treatment is currently experimental. Studies of its effects as part of feminising hormone therapy are in progress but have not yet reported any results.

What kinds are there?

The most common form of progesterone used in the UK is micronised progesterone pills. Other prescribed forms of progesterone are pessaries and gel. Depot injections are not normally available from UK pharmacies, but are sometimes purchased from outside of the UK.

Where can I learn more?

There are a number of detailed articles written about progesterone by community members on the Transfeminine Science website.

References

  1. 1.
    Collaborators, Million Women Study and others (2003) “Breast cancer and hormone-replacement therapy in the Million Women Study.” The Lancet, 362(9382), pp. 419–427. Link
  2. 2.
    Seal, Leighton J (2007) “The practical management of hormonal treatment in adults with gender dysphoria,” in Barrett, J. (ed.), Transsexual and other disorders of gender identity: A practical guide to management, Radcliffe Publishing, pp. 157–190. Link
  3. 3.
    Asi, Noor, Mohammed, Khaled, Haydour, Qusay, Gionfriddo, Michael R, et al. (2016) “Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis.” Systematic reviews, 5(1), pp. 1–8. Link
  4. 4.
    Stute, P, Wildt, L and Neulen, J (2018) “The impact of micronized progesterone on breast cancer risk: a systematic review.” Climacteric, 21(2), pp. 111–122. Link
  5. 5.
    Prior, Jerilynn C (2019) “Progesterone is important for transgender women’s therapy—applying evidence for the benefits of progesterone in ciswomen.” The Journal of Clinical Endocrinology & Metabolism, 104(4), pp. 1181–1186. Link
  6. 6.
    Wierckx, Katrien, Gooren, Louis and T’sjoen, Guy (2014) “Clinical review: Breast development in trans women receiving cross-sex hormones.” The journal of sexual medicine, 11(5), pp. 1240–1247. Link
  7. 7.
    Randolph, John F. (2018) “Gender-Affirming Hormone Therapy for Transgender Females.” Clinical Obstetrics and Gynecology, 61(4), pp. 705–721. Link
  8. 8.
    Cocchetti, Carlotta, Ristori, Jiska, Mazzoli, Francesca, Vignozzi, Linda, et al. (2021) “Management of hypoactive sexual desire disorder in transgender women: a guide for clinicians.” International Journal of Impotence Research, pp. 1–7. Link
  9. 9.
    Kronawitter, Desiree, Gooren, Louis J, Zollver, Hendryk, Oppelt, Patricia G, et al. (2009) “Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study.” European Journal of Endocrinology, 161(2), pp. 363–368. Link
  10. 10.
    The Tavistock and Portman NHS Foundation Trust (2021) “Shared Care Prescribing Guidance for Treatment of Gender Dysphoria in People Assigned Male at Birth Transitioning to a Feminine Gender Identity.” Link
  11. 11.
    Greener, Helen (2021) “General Guidelines For The Use Of Hormone Treatment In Gender Dysphoria.” Link
  12. 12.
    Sheffield Gender Identity Clinic (n.d.) “Progesterone Treatment To Facilitate Breast Development In Trans Females.” Link

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