Last checked September 2026 against 18 sources · Editorial policy
Progesterone supplements and OTC cream
Over-the-counter progesterone supplements, creams and wild yam products aren't FDA-approved medicines, and the evidence is weak. Wild yam cream didn't change hormone levels or menopause symptoms in a trial. Progesterone cream trials conflict: one found hot flashes improved in 83% of women vs 19% on placebo, another found no effect at 32 mg daily. Creams didn't change the uterine lining, so they can't protect it during estrogen HRT. Prescription micronized progesterone is the tested option.
Over-the-counter progesterone and wild yam creams deliver little progesterone and don't protect the uterus on HRT. What trials show, prescription alternatives, and safety.
Progesterone cream and supplements: expectation vs reality
What people often expect
“Wild yam cream is a natural source of progesterone that my body can use”
What the evidence shows
Wild yam contains diosgenin, which has been claimed to influence the body's hormone production. But in a placebo-controlled trial, wild yam cream didn't change progesterone, estradiol or FSH levels, and symptoms improved no more than on placebo. The same holds for estrogen: wild yam cream didn't raise estradiol either.
Do OTC progesterone cream and wild yam work?
Wild yam cream for menopause
In a double-blind crossover trial, 23 women with troublesome menopause symptoms used wild yam cream and placebo for 3 months each. There were no changes in weight, blood pressure, cholesterol, FSH, estradiol or progesterone. Both creams had a minor effect on hot flashes, with no difference between them. The authors concluded it was free of side effects but had little effect on symptoms.
Progesterone cream for hot flashes
Results conflict. In a US trial of 102 women, a daily quarter teaspoon of cream with 20 mg progesterone improved or resolved hot flashes in 25 of 30 women (83%) vs 5 of 26 on placebo (19%), with no effect on bone. In an Australian trial of 80 women, a 32 mg daily cream had no effect on hot flashes, mood, sexual feelings, cholesterol or bone markers.
Learn more →Progesterone cream doesn't protect the uterus
In 27 women using estrogen, progesterone cream at 16, 32 or 64 mg daily for 14 days a month didn't produce any detectable change in the uterine lining. That means cream can't replace a prescription progestogen if you take estrogen and have a uterus. Estrogen without adequate progestogen raises the risk of uterine cancer.
Learn more →How much progesterone gets into the body from cream
Skin creams raise blood progesterone only slightly: the Australian trial measured a slight rise at 32 mg a day with no biological effect. Saliva tests, which some cream sellers use to adjust doses, were so variable in one study that they were considered completely unreliable. A review titled 'more hype than hope' concluded creams can't be recommended for menopause symptoms.
Over-the-counter progesterone pills
There are no FDA-approved over-the-counter progesterone pills. Oral micronized progesterone, such as Prometrium, is prescription-only. Supplements marketed as progesterone support aren't reviewed by the FDA before sale; under US law, makers are responsible for their own safety and labeling, and the FDA acts only after products reach the market.
Learn more →Bioidentical progesterone supplements
Bioidentical means chemically identical to the body's hormone. FDA-approved micronized progesterone is bioidentical, made from plants, and prescription-only. Compounded bioidentical creams and troches from pharmacies aren't FDA-approved; a national academies review found little rigorous evidence for them and called their widespread use a public health concern.
Learn more →Benefits of taking prescription progesterone
Prescription progesterone does have proven uses: protecting the uterine lining during estrogen HRT, bringing on missed periods, and in trials improving disturbed sleep and reducing hot flashes after menopause at 300 mg nightly. Generic 100 mg capsules cost $9.45 for 30 at Cost Plus Drugs.
Learn more →Is progesterone a controlled substance?
No. Oral progesterone is a prescription-only (Rx) medicine but isn't a scheduled controlled substance; its US label has no controlled-substance schedule. The label lists risks to discuss with your prescriber, such as blood clots, drowsiness and peanut allergy.
Progesterone cream trials by the numbers
From the studies on this page
hot flash improvement with 20 mg progesterone cream vs placebo in one trial
83% vs 19%
0
23
$9.45
The progesterone cream trials were small, used different products and doses, and are more than 20 years old.
Progesterone supplements and cream compared
Wild yam cream or capsules
Good for
No side effects in the trial.Watch
Didn't change progesterone, estrogen or symptoms more than placebo.OTC progesterone cream
Good for
One small trial found fewer hot flashes at 20 mg a day.Watch
Another found no effect; creams don't change the uterine lining and doses vary.Compounded bioidentical progesterone
Learn more →Good for
Custom doses from a pharmacy.Watch
Not FDA-approved; little rigorous evidence and limited oversight of quality.Prescription micronized progesterone
Learn more →Good for
FDA-approved, body-identical, protects the uterus with estrogen and costs $9.45 for 30 capsules as a generic.Watch
Needs a prescription; causes drowsiness, so it's taken at bedtime.
Before you buy progesterone cream or supplements
- If you take estrogen and have a uterus, don't rely on a cream for protection; you need a prescription progestogen.
- Be skeptical of saliva hormone tests used to dose creams; they were unreliable in a study.
- Check the label: supplements aren't FDA-reviewed before sale.
- Compare with the cost of generic prescription progesterone, $9.45 for 30 capsules at Cost Plus Drugs.
When to see a doctor instead of using progesterone cream
You use estrogen and only an OTC cream for progesterone
See your doctor about a proven progestogen to protect the uterus.
Unexpected bleeding while using hormone creams
See a doctor; unopposed estrogen can thicken the lining.
More →Hot flashes or night sweats affecting daily life
Ask about HRT or non-hormonal medicines, which are proven to work.
Progesterone cream and wild yam: questions women ask
Does progesterone cream work for menopause?
The evidence is mixed and weak. One trial found fewer hot flashes, another found no effect, and a review concluded creams can't be recommended for menopause symptoms.
Does wild yam cream work for menopause?
No. In a placebo-controlled trial, wild yam cream didn't change hormone levels and didn't ease symptoms more than placebo.
Does wild yam increase estrogen or progesterone?
Not in the trial that measured it: estradiol, FSH and progesterone levels in blood and saliva didn't change with wild yam cream.
Can you buy progesterone over the counter?
Creams sold as progesterone are available, but they aren't FDA-approved medicines. Oral progesterone that's tested and approved, such as Prometrium, needs a prescription.
What are the benefits of taking progesterone?
Prescription progesterone protects the uterus during estrogen HRT, can bring on missed periods, and in trials improved disturbed sleep and reduced hot flashes after menopause.
Is progesterone a controlled substance?
No. It's prescription-only in pill form, but it isn't a scheduled controlled substance.
Can progesterone cream protect my uterus if I take estrogen?
No. In a trial, progesterone cream at up to 64 mg a day didn't change the uterine lining. Use a prescription progestogen.
What is the best over-the-counter progesterone?
None has good evidence. If you need progesterone, generic prescription micronized progesterone is inexpensive and proven.
Are saliva tests accurate for progesterone cream?
No. In a study of women using progesterone cream, saliva progesterone levels were so variable that researchers considered them completely unreliable for judging the cream's effect.
Is wild yam the same as progesterone?
No. Wild yam contains diosgenin, a plant compound claimed to influence hormone production, but the body doesn't turn wild yam cream into progesterone in any measurable way: blood and saliva progesterone didn't change in a trial.
Is wild yam cream safe?
In a crossover trial with 3 months on each cream, wild yam cream caused no significant side effects and no changes in weight, blood pressure or cholesterol. It also didn't help symptoms. As a supplement, it isn't FDA-approved before sale, so product quality varies.
Does progesterone cream help sleep?
There's no good trial evidence for creams. The sleep benefits seen in trials came from oral progesterone at 300 mg at bedtime, which restored disturbed sleep; creams raise blood levels only slightly.
Sources
- Komesaroff PA, Black CV, Cable V, et al. Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women. Climacteric. 2001;4(2):144-50.
- Leonetti HB, Longo S, Anasti JN. Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss. Obstet Gynecol. 1999;94(2):225-8.
- Wren BG, Champion SM, Willetts K, et al. Transdermal progesterone and its effect on vasomotor symptoms, blood lipid levels, bone metabolic markers, moods, and quality of life for postmenopausal women. Menopause. 2003;10(1):13-8.
- Wren BG, McFarland K, Edwards L, et al. Effect of sequential transdermal progesterone cream on endometrium, bleeding pattern, and plasma progesterone and salivary progesterone levels in postmenopausal women. Climacteric. 2000;3(3):155-60.
- US Food and Drug Administration. NASEM study on the clinical utility of treating patients with compounded "bioidentical" hormone therapy.
- NHS. Utrogestan (micronised progesterone): how and when to take.
- Wren BG. Transdermal progesterone creams for postmenopausal women: more hype than hope? Med J Aust. 2005;182(5):237-9.
- Prescribing information: Prometrium (progesterone capsules). Acertis Pharmaceuticals, 2026. DailyMed, US National Library of Medicine.
- US Food and Drug Administration. Dietary supplements.
- NHS. Utrogestan (micronised progesterone): common questions.
- NHS. Utrogestan (micronised progesterone): about.
- Caufriez A, Leproult R, L'Hermite-Balériaux M, et al. Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women. J Clin Endocrinol Metab. 2011;96(4):E614-23.
- Hitchcock CL, Prior JC. Oral micronized progesterone for vasomotor symptoms--a placebo-controlled randomized trial in healthy postmenopausal women. Menopause. 2012;19(8):886-93.
- Mark Cuban Cost Plus Drug Company. Hormone therapy medication prices (checked September 2026).
- NHS. Postmenopausal bleeding.
- Cleveland Clinic. High estrogen: causes, symptoms, dominance and treatment.
- NICE. Menopause: identification and management (NG23). Updated 2024.
- Crandall CJ, Mehta JM, Manson JE. Management of Menopausal Symptoms: A Review. JAMA. 2023;329(5):405-420.
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