leveldose
A woman turning down the covers in a quiet lamplit bedroom at night

Women's Health · prescription telehealth

The other half of hormone therapy, taken at bedtime.

progesterone capsules · one at bedtime · prescription only

For perimenopause and menopause. Progesterone capsules, prescription only: one at bedtime, prescribed when a licensed clinician confirms it fits your history — to protect the lining of the uterus if you take estrogen and still have a uterus, to bring order to erratic cycles, and taken at night because it can make you drowsy, which many women find welcome. 1 2 Estradiol is prescribed here too, on its own page; your clinician decides whether progesterone alone, or alongside estrogen, is the right piece for you.

Start the intake See plans on this page

About eight minutes. A licensed clinician reviews every answer — and can say no.

Care

a licensed clinician decides — and can say no

Timing

one capsule at bedtime, because it can make you drowsy

Terms

the whole price and the renewal terms shown before you pay

About Progesterone

What progesterone does, and what to expect.

What it does

Progesterone is the hormone the ovary makes after ovulation; micronized progesterone is structurally identical to it. 2 Its job in menopause care is specific. Estrogen taken on its own thickens the lining of the uterus over time and raises the risk of endometrial cancer; progesterone prevents that, which is why every woman with a uterus who takes systemic estrogen should also take a progestogen. 1 2 Taken for a stretch of nights and then stopped, it also brings on a bleed — the basis for its use when periods have stopped or turned erratic. 1

How it's taken

One capsule at bedtime, with a little food if you like — food increases how much is absorbed. 1 Your clinician sets the pattern: every night, or a stretch of nights each cycle, depending on whether you take estrogen, whether you still have periods, and what is being treated. 2 Bedtime is not a suggestion: the capsule can cause drowsiness and dizziness for a while after you take it, so it is taken as a single dose at night. 1

What to expect

If you take estrogen, the benefit is the one you don't see — a lining that stays healthy — and the signal your clinician watches is your bleeding staying predictable; unexpected bleeding is always reported, never waited out. 1 2 In small placebo-controlled trials, women who took it at night fell asleep sooner and most reported better sleep; the effect is modest and the trials were small. 3 4 Breast tenderness, headache, drowsiness and dizziness are the most reported effects. 1

Every fact on this page carries a numbered source; the list is at the foot of the page.

How the schedule is set

The pattern follows your situation, not a template.

There is no dose ladder to climb here: the strength is set at the start. What your clinician calibrates is the pattern — when you take it and for how many nights — and that is decided from your history, in this order.

01

Your history, read properly

Whether you still have your uterus. Whether you take estrogen, in what form, and who prescribes it. Whether you still have periods, and how regular. Any bleeding that hasn't been explained; any history of breast cancer, blood clots or liver disease; whether you could be pregnant; whether you're allergic to peanuts. Each answer changes what is safe to prescribe. 1

02

The pattern

With estrogen and a uterus: progesterone every night, or for a stretch of nights each cycle — both protect the lining; the every-night pattern avoids a monthly bleed, which is why many women on long-term therapy choose it. 2 Without estrogen, in perimenopause: a cyclic pattern to make bleeding predictable, when a clinician judges progesterone the right tool. 1

03

The first weeks

Drowsiness after the capsule is expected and is the reason for bedtime; breast tenderness and headache are the effects most often reported. 1 Bleeding that doesn't fit the pattern your clinician set is reported straight away — it is the one signal that gets checked rather than reassured. 1

04

Reviewed, on what matters

No blood test measures whether progesterone is doing its job; the review is your bleeding pattern, your symptoms and your risks, reassessed periodically, as the Menopause Society asks. 2 If you start estrogen, stop it or change it, your progesterone pattern is revisited with it — with notice before anything about your plan changes.

If progesterone isn't the right piece for your situation — because what you need is estrogen, a different route, or a menopause specialist in person — your clinician says so. That's what the consult is for.

The other routes

What you may have tried, and why it stalls.

Most women arrive here having tried something first. Here is what each route can and can't do — plainly, without pretending the alternatives don't exist.

What you have tried

Why it stalls

What clinician-prescribed progesterone does

What you have tried

Estrogen on its own

Why it stalls

If you still have a uterus, estrogen without a progestogen thickens the lining and raises the risk of endometrial cancer — a risk that grows with dose and years of use and persists after stopping. 1 2 Some women are on it that way because nobody asked.

What clinician-prescribed progesterone does

The intake asks. If you take estrogen and have a uterus, progesterone is the piece that protects you — prescribed to sit alongside the estrogen you already have, on a pattern set for you. 2

What you have tried

Over-the-counter progesterone creams and "balancing" supplements

Why it stalls

Sold as cosmetics or supplements, so the amount you actually absorb was never measured for you, and none of them is approved to do the one job that has to be done properly — protecting the lining of the uterus.

What clinician-prescribed progesterone does

Prescription progesterone at a labelled strength, dispensed by a licensed U.S. pharmacy, on a pattern a clinician chose because of your uterus, your estrogen and your history. 1

What you have tried

Sleeping pills and sleep supplements

Why it stalls

They treat the symptom, and the usual sleeping pills tend to suppress deep sleep. 4 None of them looks at why a woman in perimenopause is awake at three in the morning.

What clinician-prescribed progesterone does

Progesterone at night is not a sleeping pill: in the sleep laboratory it left undisturbed sleep alone and restored deep sleep when sleep was disrupted. 4 And if sleep is your only complaint, your clinician will say whether it is the right tool at all — that use is off-label. 2

What you have tried

Multi-hormone blends, pellets and troches

Why it stalls

Blends of several hormones in untested combinations, or delivered by untested routes such as pellets and troches. The Menopause Society's advice is that preference alone shouldn't decide for them when regulated products exist. 2

What clinician-prescribed progesterone does

One hormone, on its own, at a labelled strength, prescribed for a reason your clinician can name — and dispensed by a licensed U.S. pharmacy that is named on your label. 2

What you have tried

Saliva and urine "hormone balance" kits

Why it stalls

Kits that promise to dose you from spit or urine. The Menopause Society calls that testing unreliable and doesn't recommend it; even blood testing is rarely needed to make this decision. 2

What clinician-prescribed progesterone does

A decision made from your history, your symptoms and your bleeding pattern — which is how the guidelines say it should be made — with a test only when it would change the answer. 2

What you have tried

Waiting it out

Why it stalls

Perimenopause can run for years. Estrogen without progesterone accumulates risk quietly with time 2, and sleep that is broken month after month has costs of its own — mood, memory and cardiovascular risk among them. 2

What clinician-prescribed progesterone does

An intake that looks at the whole picture, a clinician who says whether progesterone is the right piece — or whether you'd be better served by a menopause specialist in person — and treatment that starts when it is appropriate.

Not one of those routes asks whether you still have a uterus or what estrogen you take. The intake here does — because that is what decides whether progesterone is protection or just a capsule. 2

What you can't feel working still has to be done properly.

A principle of the house

How care works

Medicine, measured.

Results are personal, so treatment shouldn't be one-size. Here is the whole process, plainly.

01

An intake worth reading

About eight minutes of real questions — your bleeding pattern, whether you still have your uterus, every hormone you take and who prescribes it, your history, your allergies. It is the basis of every decision that follows.

02

A clinician decides

A licensed U.S. clinician reviews your answers and decides whether progesterone is appropriate for you, and on what pattern. Sometimes the answer is no — you'll hear it straight, and you'll hear why.

03

Filled and delivered

If prescribed, your capsules are dispensed by a licensed U.S. pharmacy — named on your label — and shipped in plain, unmarked packaging.

04

Reviewed over time

Your care doesn't end at delivery. Tell your clinician how the first weeks go; the pattern is revisited with you, and any change comes with notice before anything about your plan changes.

An intake form and a fountain pen beside a plain shipping box, in morning light

Plans & pricing

Straight terms, before you pay.

Each plan includes the clinician evaluation, the prescription if appropriate, the pharmacy fill, shipping and follow-up. No visit fee, nothing billed on top — what you see here is what you're agreeing to.

100 mg · monthly supply

Progesterone 100mg

The same nightly capsule on either plan — month by month to start, or three months at a time once you and your clinician have settled the pattern.

$49 / per month

renews at $49 per month · cancel anytime

  • Progesterone capsules, one at bedtime, prescription only
  • Protects the lining of the uterus if you take estrogen and still have a uterus
  • Pattern set by your clinician — every night, or a stretch of nights each cycle
  • Filled by a licensed U.S. pharmacy, named on your label
  • Plain, unmarked packaging
  • The whole price shown — cancel from your account before your next billing date
100 mg · 3-month supply

Progesterone 100mg

The same nightly capsule on either plan — month by month to start, or three months at a time once you and your clinician have settled the pattern.

$129 / every 3 months

renews at $129 every 3 months · cancel anytime

  • Progesterone capsules, one at bedtime, prescription only
  • Protects the lining of the uterus if you take estrogen and still have a uterus
  • Pattern set by your clinician — every night, or a stretch of nights each cycle
  • Filled by a licensed U.S. pharmacy, named on your label
  • Plain, unmarked packaging
  • The whole price shown — cancel from your account before your next billing date

The price shown is the whole price. One strength, two ways to pay: month by month, or three months at a time. Plans renew at the price and cadence shown until you cancel — from your account or by emailing support before your next billing date — and nothing further is charged or shipped after that. Your card is authorized at checkout and charged for medication only once a clinician prescribes; if the answer is no, the authorization is released and you're told why. HSA/FSA payment accepted on eligible plans.

Eligibility

See if it's appropriate. That's the consult.

Progesterone is prescribed to adult women in perimenopause or past menopause when a licensed clinician confirms it fits their history. The intake asks what a careful menopause clinician would ask.

You may qualify if

  • You're an adult woman aged 18 or over, in perimenopause or past menopause
  • You take estrogen — from any prescriber — and still have your uterus, and want the lining protected [1] [2]
  • Your cycles have turned erratic in perimenopause and you want them predictable, if a clinician agrees progesterone is the tool
  • You're waking in the night and a clinician judges progesterone at bedtime worth trying as part of your care
  • You can tell us the whole picture: your bleeding pattern, every hormone you take, your personal and family history
  • A clinician confirms it fits your health history and the medicines you take

May not be suitable if

  • You have vaginal bleeding that hasn't been diagnosed [1]
  • You have, have had, or are being investigated for breast cancer [1]
  • You have or have had a blood clot in a leg or lung, a stroke or a heart attack [1]
  • You have liver disease [1]
  • You are or may be pregnant [1]
  • You're allergic to peanuts — the reference product's capsules contain peanut oil; say so in the intake and your clinician checks the exact product before deciding [1]

This is not an exhaustive list — your clinician reviews your full history before any prescribing decision. If what you need is estrogen, or a menopause specialist in person, you'll be told that too.

Safety & honesty

What it feels like, what to watch for, and what we won't promise.

Progesterone has decades of use and a prescribing label that states its risks in full, boxed warning included. Here it is without the small print, so you know what the first capsules may feel like and when to stop.

Most reported, usually mild

  • Drowsiness or dizziness after the capsule — expected — it is why the dose is taken at bedtime, and why you don't drive or operate machinery after it 1
  • Breast tenderness — the effect most clearly tied to the capsule in the clinical trial 1
  • Headache — common — and nearly as common on placebo 1
  • Bloating or fluid retention — progesterone can hold some fluid; tell your clinician if you have a heart or kidney condition 1
  • Low mood — reported more often than on placebo; worth telling your clinician early 1
  • Vaginal discharge, nausea, joint aches — less often, and usually passing 1

Stop, and seek care straight away

  • Bleeding you weren't expecting — any bleeding that doesn't fit the pattern your clinician set, or any bleeding after menopause, is checked — never watched 1 2
  • Leg pain or swelling, chest pain, sudden breathlessness — a possible clot — treat it as an emergency 1
  • Sudden weakness or numbness, trouble speaking, a severe headache — a possible stroke — treat it as an emergency 1
  • Sudden loss of vision, double vision, a bulging eye or a new migraine — stop, and be examined before taking any more 1
  • A new breast lump — examined promptly 1

Not prescribed if

  • Undiagnosed abnormal vaginal bleeding 1
  • Known, suspected or past breast cancer 1
  • An active blood clot, or a history of clots in the legs or lungs 1
  • A stroke or heart attack, now or in the past 1
  • Liver disease 1
  • Known or suspected pregnancy 1
  • A peanut allergy, where the dispensed product contains peanut oil 1

Medicines that need care

  • Estrogen from any prescriber — not a conflict — the reason. Tell the intake the form and the strength so the pattern is set with it in mind 2
  • Ketoconazole, and other medicines that block the same liver enzyme — may raise progesterone levels; how much that matters in practice is unknown, so your clinician weighs it 1
  • Anything else you take at night — the capsule's own drowsiness is enough to plan around — tell your clinician what else you take in the evening 1
  • Other hormone products, including creams and pellets — listed one by one, so nothing doubles up

Monitoring

No blood test tells your clinician whether progesterone is protecting the lining. The signals are your bleeding pattern and your symptoms, reviewed periodically — the Menopause Society asks for individualized, periodic reassessment of the benefits and risks of continuing. 2

What it is for, and what it isn't

Progesterone alone is not the treatment of choice for hot flushes — estrogen is — and it isn't a sleeping pill. 2 The reference product is approved to protect the uterine lining alongside estrogen and to bring on a bleed when periods have stopped 1; taking it on its own for flushes or for sleep is off-label, with no long-term safety studies behind it 2. Your clinician tells you which reason you're being prescribed for.

If you stop

Nothing to taper. But if you take estrogen, don't stop the progesterone without stopping or discussing the estrogen — the lining loses its protection the moment the progesterone goes. 2 Any bleeding after stopping is reported.

Results vary. No outcome is guaranteed — your clinician will discuss what's realistic for you.

The boxed warning on the reference product's label comes from the Women's Health Initiative: estrogen plus a synthetic progestin, taken together for years, raised the risks of blood clots, stroke, heart attack and invasive breast cancer, and of probable dementia in women over sixty-five. 1 Those findings concern hormone therapy as a whole, and they are the reason a clinician — not a form — decides whether it is right for you, and when. 2

What happens next

From the intake to the first capsule.

No waiting room, no counter. Here is the path, step by step, and what shows up at your door.

01

Today: the intake

About eight minutes. Your bleeding pattern, whether you still have your uterus, every hormone you take and who prescribes it, your history of clots, cancer and liver disease, your allergies. Every question is there because it changes what is safe to prescribe.

02

A clinician reviews

A licensed U.S. clinician reads your answers and decides whether progesterone is appropriate for you, and on what pattern. You'll hear by email either way — including if the answer is no, or if you'd be better seen in person.

03

Filled by a licensed U.S. pharmacy

If prescribed, your prescription goes to a licensed U.S. pharmacy — the one that fills it is named on your label. Nothing is made or handled by us.

04

Delivered, unmarked

Your capsules arrive in plain packaging with nothing on the outside — no medication named, no clinic named.

05

The first nights, then the review

Take the first capsule at bedtime on a night you don't have to be up early. Tell your clinician how the first weeks go — the drowsiness, any tenderness, and above all any bleeding that doesn't fit the pattern. The pattern is revisited with you, with notice before anything about your plan changes.

What arrives

Outside

An unmarked box. No medication or clinic named.

Inside

Your capsules in the pharmacy's own labelled container, with its leaflet.

On the label

The pharmacy that filled your prescription, your name, and how and when to take it.

Prescription products require evaluation by a licensed clinician, who determines whether treatment is appropriate.

Certified

LegitScript-certified healthcare merchant

Private

HIPAA-compliant platform · discreet, unmarked packaging

Clinician-led

licensed U.S. providers review every case

Your pharmacy

filled by a licensed U.S. pharmacy, named on your prescription label

Questions, answered plainly

Questions about progesterone

Do I need progesterone if I take estrogen?

If you still have your uterus, yes. The Menopause Society's position is that a woman with a uterus taking systemic estrogen should take adequate progestogen, because estrogen on its own thickens the lining and raises the risk of endometrial cancer. 1 2 If you've had a hysterectomy, you generally don't need it for that reason 2 — and your clinician will say whether there is another reason to prescribe it.

Do you prescribe estrogen too — and how does this fit?

Yes — estradiol tablets have their own page here. This page is progesterone on its own. If you already take estrogen from another prescriber, tell the intake the form and the strength — your clinician sets the progesterone pattern to sit alongside it. If what you actually need is estrogen, or a full menopause regimen, your clinician says so rather than prescribing around it.

Will it help me sleep?

It may. Progesterone can make you drowsy — the label warns about it, which is why the dose is taken at bedtime. 1 In small placebo-controlled trials, women who took it at night fell asleep sooner and most reported better sleep, and in the sleep laboratory it left undisturbed sleep alone and restored deep sleep when sleep was disrupted — which is different from how sleeping pills behave. 3 4 The effect is modest, the trials mostly used a higher nightly strength than the one on this page, and prescribing progesterone for sleep on its own is off-label. 2 Say sleep is your concern in the intake, and your clinician tells you straight whether it is the right tool.

What about hot flushes and night sweats?

Estrogen is the most effective treatment for them, and it has its own page here. 2 Progesterone on its own reduced hot flushes and night sweats compared with placebo in postmenopausal women, on the Menopause Society's reading of the evidence 2; in the largest trial in perimenopausal women it didn't beat placebo on the flush score, though the women taking it reported fewer night sweats and better sleep. 5 It is not the first-line answer, and that use is off-label. 2

Will I bleed?

It depends on the pattern. Progesterone taken for a stretch of nights each cycle and then stopped brings on a bleed — that is the point when cycles are erratic. 1 Taken every night alongside estrogen, the aim is no monthly bleed, which is why many women on long-term therapy choose that pattern. 2 Bleeding that doesn't fit your pattern, or any bleeding after menopause, is reported to your clinician straight away and checked — it is the one signal that is never waited out. 1

What kind of progesterone is this?

Micronized progesterone — structurally identical to the progesterone your own ovaries make, and the form the Menopause Society's statement discusses by name. 2 It is dispensed by a licensed U.S. pharmacy named on your label, at a labelled strength, with a prescribing decision behind it. It is not a cream, a pellet, or a blend of several hormones. 2

I'm allergic to peanuts. Can I take it?

Maybe not. The reference product's capsules contain peanut oil and must never be used by anyone allergic to peanuts. 1 Say so in the intake; your clinician checks the exact product the pharmacy would dispense before deciding, and if it isn't suitable, you'll be told.

Can I take it with my other medicines?

List everything — including hormones from other prescribers, creams and pellets. Ketoconazole, and other medicines that block the same liver enzyme, may raise progesterone levels 1; anything sedating is planned around the capsule's own drowsiness. Your clinician checks each one before prescribing.

Is it safe? The boxed warning worries me.

The boxed warning is real, and it comes from the Women's Health Initiative, where estrogen plus a synthetic progestin taken for years raised the risks of clots, stroke, heart attack and invasive breast cancer, and of probable dementia in women over sixty-five. 1 The Menopause Society's reading: for women under sixty, or within ten years of menopause, with no contraindications, the balance for treating bothersome symptoms is favorable; starting later, it is less so — which is why timing, your history and periodic review matter, and why a clinician decides. 2 Whether micronized progesterone carries the same breast-cancer risk as the synthetic progestin studied in the WHI has not been settled in trials. 2

Will anyone know?

The box is unmarked, with no medication or clinic named on it. Your information sits on a HIPAA-compliant platform and goes to the clinician who reviews your case and the pharmacy that fills your prescription — no one else.

What if I'm not approved?

Then you aren't charged for medication. Your card is authorized at checkout and charged only when a clinician prescribes; if the answer is no, the authorization is released and you're told why — including when the right next step is estrogen, or a specialist in person.

What if I want to stop, pause or change?

Cancel or change your plan from your account, or email support before your next billing date — no call needed; nothing further is charged or shipped after that. Stopping the capsule needs no taper. But if you take estrogen, don't stop progesterone without telling the clinician who manages the estrogen — the lining loses its protection. 2

How does the telemedicine process work?

You complete an online intake, a licensed provider reviews your case, and if appropriate your treatment plan is prescribed and delivered directly to your door.

Do I need to visit a doctor in person?

No. All consultations, prescriptions, and follow-ups are handled 100% online through our secure telehealth platform.

Are the doctors licensed?

Yes. Every provider in our network is licensed and experienced in evaluating patients through compliant telemedicine workflows.

Is my personal information secure?

Your information is protected through secure systems and privacy-first processes designed to support HIPAA-aligned care delivery.

How is my medication delivered?

Approved medications are shipped discreetly to your home, with updates and follow-up support handled online for convenience.

Sources

What this page is based on.

5 sources showhide

Facts about what progesterone does, what it feels like and who shouldn't take it come from the prescribing information for the reference product, the Menopause Society's position statement, and the peer-reviewed trials behind the sleep claims. None of it promises what you will get.

  1. Prescribing information for PROMETRIUM (progesterone capsules, USP), the reference product — Virtus Pharmaceuticals, revised December 2024: boxed warning; indications and usage; contraindications (including the peanut-oil excipient); warnings and precautions (dizziness and drowsiness, fluid retention, vision); adverse reactions; drug interactions; clinical pharmacology (food effect); dosage and administration (bedtime dosing). dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a451784e-f6a0-414a-8409-3407f1d1d086
  2. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767–794. doi:10.1097/GME.0000000000002028 — progestogen indication and endometrial protection; progestogen regimens; sleep; progestogen-only use and its off-label status; custom hormone preparations, pellets and troches; hormone testing; benefit–risk by age and time since menopause; shared decision-making and periodic reevaluation. menopause.org/wp-content/uploads/professional/nams-2022-hormone-therapy-position-statement.pdf
  3. Nolan BJ, Liang B, Cheung AS. Efficacy of micronized progesterone for sleep: a systematic review and meta-analysis of randomized controlled trial data. Journal of Clinical Endocrinology & Metabolism. 2021;106(4):942–951. doi:10.1210/clinem/dgaa873 pubmed.ncbi.nlm.nih.gov/33245776/
  4. Caufriez A, Leproult R, L'Hermite-Balériaux M, Kerkhofs M, Copinschi G. Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women. Journal of Clinical Endocrinology & Metabolism. 2011;96(4):E614–E623. doi:10.1210/jc.2010-2558 pubmed.ncbi.nlm.nih.gov/21289261/
  5. Prior JC, Cameron A, Fung M, et al. Oral micronized progesterone for perimenopausal night sweats and hot flushes: a phase III Canada-wide randomized placebo-controlled trial. Scientific Reports. 2023;13:9082. doi:10.1038/s41598-023-35826-w pmc.ncbi.nlm.nih.gov/articles/PMC10241804/

The right level. The right dose. For you.

Start the intake — a licensed clinician will take it from there.

Eligibility screening and a prescription are required for prescription treatments. Individual results vary and no specific outcome is guaranteed. A licensed clinician determines whether treatment is appropriate — treatment is not guaranteed.

Progesterone is a prescription medication, dispensed by a licensed U.S. pharmacy when prescribed; the pharmacy is named on your prescription label.