Progesterone Options Finder
Find Your Best Progesterone Option
Answer a few questions about your needs and priorities to see which progesterone treatment might work best for you. This tool helps you identify options discussed in our article.
When your body doesn’t make enough progesterone, it can throw off your cycle, make it harder to get pregnant, or lead to uncomfortable menopause symptoms. Prometrium is one of the most common prescriptions for this - a capsule filled with micronized progesterone that your body recognizes as its own. But it’s not the only option. Many people wonder: Is there something better? Cheaper? Easier to take? The truth is, there are several alternatives, each with different pros and cons. Knowing what’s out there helps you talk to your doctor with more confidence - and find the right fit for your life.
What Prometrium Actually Does
Prometrium contains micronized progesterone, which means the hormone is broken down into tiny particles that your body absorbs easily. It’s made from plant sources but is chemically identical to the progesterone your ovaries produce. That’s why it’s called bioidentical. Doctors prescribe it for three main reasons: to support early pregnancy in women with low progesterone, to protect the uterine lining in women taking estrogen during menopause, and to regulate periods in those with irregular cycles or PCOS.
It’s taken orally, usually once or twice a day. Most people notice side effects like dizziness, sleepiness, or breast tenderness - especially at first. These usually fade after a week or two. But if you’re someone who gets headaches easily or hates swallowing pills, Prometrium might not be the most comfortable choice.
Alternative #1: Crinone (Progesterone Gel)
Crinone is a vaginal gel that delivers progesterone right where your body needs it most. Instead of swallowing a pill, you insert the gel with an applicator once a day. It’s popular for fertility treatments because it gives high local concentrations of progesterone without relying on your digestive system to absorb it.
Compared to Prometrium, Crinone avoids the drowsiness many people feel after taking oral progesterone. But it comes with its own trade-offs: messiness, staining, and the need to use a panty liner. Some women find the application awkward or uncomfortable. It’s also more expensive than Prometrium and often requires a prescription refill every 14 days.
Studies show Crinone has similar effectiveness to oral progesterone in supporting early pregnancy, but with fewer systemic side effects. If you’re trying to conceive and want to skip the brain fog, this is a strong contender.
Alternative #2: Endometrin (Vaginal Insert)
Endometrin is another vaginal option - but instead of a gel, it’s a small, dissolvable tablet you insert into the vagina. It releases progesterone slowly over 24 hours. Like Crinone, it bypasses the liver and delivers the hormone directly to the uterus, which is why it’s often preferred in IVF cycles.
Many patients like Endometrin because it’s less messy than the gel and easier to carry around. You don’t need refrigeration, and the inserts are discreet. But some report mild irritation or spotting after insertion. It’s also more expensive than Prometrium and usually not covered as widely by insurance unless used for fertility.
One study published in Fertility and Sterility found Endometrin had comparable pregnancy rates to oral progesterone in IVF patients, but with lower blood levels of progesterone - which might sound bad, but actually means less hormone is circulating in your body overall, reducing side effects.
Alternative #3: Natural Progesterone Creams
Walk into any health store, and you’ll find creams labeled “natural progesterone.” These are often made from soy or wild yam extract. But here’s the catch: your body can’t turn wild yam into progesterone on its own. The only way these creams work is if they’re already formulated with synthetic progesterone - and many aren’t.
The FDA doesn’t regulate over-the-counter progesterone creams, so potency varies wildly. One brand might have 20 mg per pump; another might have 2 mg. There’s no standard. And because they’re absorbed through the skin, it’s hard to know how much actually enters your bloodstream.
Some women swear by them for mild menopause symptoms like hot flashes. But if you’re trying to get pregnant or need precise hormone levels for medical reasons, these creams aren’t reliable. They’re not a substitute for prescription progesterone in clinical settings.
Alternative #4: Injectable Progesterone (Oil-Based)
Injections are the old-school method - and still used in many fertility clinics. You get a shot of progesterone in oil, usually in the buttocks or thigh, every day or every other day. It’s effective, cheap, and gives very stable blood levels.
The downsides? Painful injections, bruising, and the need to store the vials properly. Many patients find the daily shots stressful, especially if they’re already dealing with fertility treatments. But for those who can handle it, injections are one of the most predictable ways to get progesterone into your system.
They’re also the only option that works well for women with malabsorption issues - like those with Crohn’s disease or who’ve had gastric bypass surgery. If your gut can’t absorb pills, injections are the gold standard.
Alternative #5: Oral Micronized Progesterone (Generic Versions)
Prometrium is a brand name. But the active ingredient - micronized progesterone - is available as a generic. Generic versions cost 70-80% less and are just as effective. Many pharmacies stock them under names like “Progesterone USP” or “Micronized Progesterone.”
The only difference? The filler ingredients. Prometrium uses peanut oil as a capsule base. That’s a problem if you have a peanut allergy. Generic versions use soybean oil or other non-allergenic carriers. If you’re not allergic, the generic is a no-brainer. It’s the same hormone, same absorption, same results - at a fraction of the price.
Check with your pharmacist. Many insurance plans push generics first. If your doctor prescribed Prometrium by name, ask if switching is an option.
How to Choose the Right One
There’s no single “best” progesterone. The right one depends on your goals, your body, and your lifestyle.
- If you’re trying to conceive and want to avoid drowsiness: Crinone or Endometrin are top picks.
- If you’re on a budget and don’t have allergies: Go for the generic micronized progesterone capsule.
- If you have digestive issues: Injectable progesterone is the most reliable.
- If you’re managing menopause symptoms and want something low-maintenance: Talk to your doctor about low-dose creams - but only if you’re not using them for fertility or endometrial protection.
- If you have a peanut allergy: Avoid Prometrium entirely. Use the generic.
Also consider how you’ll stick with it. A perfect treatment that you forget to use isn’t helpful. If you hate injections, don’t pick them. If you can’t stand inserting gel daily, Crinone won’t work. Simplicity often wins.
What to Watch Out For
Not all progesterone products are created equal. Here are three red flags:
- **Don’t confuse progesterone with progestin.** Progestins are synthetic hormones found in birth control pills and IUDs. They’re not interchangeable with natural progesterone. If your doctor prescribes progestin for pregnancy support, ask why - it’s not the same thing.
- **Avoid compounded progesterone unless necessary.** Compounded versions are custom-made by pharmacies. They’re not FDA-tested for consistency or safety. Some contain too little hormone; others have impurities. Only use them if no commercial option works for you.
- **Don’t self-prescribe.** Progesterone isn’t harmless. Taking too much can cause dizziness, mood swings, or even affect your liver. Too little won’t protect your uterus or support pregnancy. Always use it under medical supervision.
Real-World Experience: What Patients Say
I’ve talked to dozens of patients who’ve switched between these options. One woman, 38, tried Prometrium during her IVF cycle but felt too groggy to work. She switched to Endometrin and said, “I could finally focus again. No more napping after lunch.” Another, 45, used Crinone for menopause and hated the mess - so she switched to a low-dose patch, which her doctor prescribed off-label. It worked well for her hot flashes.
One man I spoke with (yes, men can need progesterone too, for hormone imbalances) tried injections for six months. He hated the pain but stuck with it because his blood tests showed consistent levels. His doctor later switched him to a generic capsule, and his numbers stayed the same - with no more bruises.
Bottom Line: What to Ask Your Doctor
Before you start or switch, ask these five questions:
- Why are you prescribing this specific form of progesterone?
- Is there a generic version available? Can I try it?
- What side effects should I expect, and how long will they last?
- Are there any allergies or conditions I have that make one option better than another?
- How will we know if it’s working? Will I need blood tests?
Progesterone isn’t a one-size-fits-all fix. Prometrium works well for many - but it’s not the only path. The goal isn’t to use the most famous brand. It’s to find the safest, most effective, and most sustainable option for your body. Talk to your doctor. Test the options. And don’t be afraid to switch if something isn’t working.
Is Prometrium the same as generic progesterone?
Yes, the active ingredient is identical: micronized progesterone. Prometrium is just the brand name. The generic version contains the same hormone but uses different fillers - often soybean oil instead of peanut oil. If you’re not allergic to peanuts, the generic is just as effective and costs far less.
Can I use progesterone cream instead of Prometrium?
Over-the-counter progesterone creams are not reliable substitutes for Prometrium. Most don’t contain enough active hormone, and there’s no standard for absorption. If you’re using progesterone for fertility, pregnancy support, or endometrial protection, creams won’t give you the precise levels you need. Stick with FDA-approved options.
Which progesterone option is best for pregnancy?
For early pregnancy support, vaginal forms like Crinone and Endometrin are often preferred because they deliver progesterone directly to the uterus, with fewer systemic side effects. Oral progesterone like Prometrium or its generic works too, but may cause more drowsiness. Your doctor will choose based on your history and how you respond.
Does progesterone cause weight gain?
Some people report water retention or bloating when starting progesterone, especially with oral forms. This isn’t fat gain - it’s temporary fluid shift. If you notice persistent weight gain, it could be due to other factors like diet, stress, or thyroid function. Talk to your doctor before assuming it’s the hormone.
Can I switch from Prometrium to a vaginal gel mid-cycle?
Yes, but only under medical supervision. Switching delivery methods can change how much progesterone enters your bloodstream. If you’re in the middle of a fertility cycle or pregnancy, your doctor may need to adjust your dose or run a blood test to confirm levels are still adequate. Never switch on your own.
Next Steps
If you’re currently on Prometrium and unhappy with the side effects, don’t suffer in silence. Talk to your doctor about alternatives. If you’re just starting out, ask about generics first - they’re just as safe and save you hundreds a year. Keep a journal: note when you take your dose, how you feel, and any symptoms. That data helps your doctor fine-tune your treatment. Progesterone therapy isn’t about finding the perfect pill. It’s about finding the right rhythm for your body - and that’s different for everyone.
