Progesterone Shortages: Why Growing Demand Reflects a Long-Overdue Shift in Women's Health

A recent Reuters report highlights an emerging issue in the United States: supplies of oral progesterone are tightening as demand for menopause treatment continues to grow.

According to the report, prescriptions for progesterone-containing hormone therapy have more than tripled since 2021, with demand accelerating further following the FDA's removal of longstanding warning labels on hormone replacement therapy in late 2025.

For decades, progesterone has been overshadowed by synthetic progestins and estrogen in discussions surrounding menopause. Yet progesterone is the first hormone to decline as ovulation becomes less frequent during the years leading up to menopause. Long before estrogen levels begin their final decline, women often experience an increasing number of anovulatory cycles—cycles in which no egg is released and little or no progesterone is produced.

This progressive loss of progesterone can contribute to many of the symptoms commonly associated with peri-menopause, including anxiety, sleep disturbances, breast tenderness, heavy bleeding, migraines, mood changes, and weight gain.

The growing demand for progesterone suggests that more women are beginning to understand the importance of natural hormonal balance, rather than focusing solely on estrogen replacement and synthetic progestins. 

A Shortage of Oral Progesterone Does Not Mean a Shortage of Options

The media attention surrounding oral progesterone shortages may understandably cause concern among women who rely on progesterone therapy. However, it is important to remember that oral capsules are only one method of delivery.

Natural progesterone cream offers a practical and effective alternative. Unlike oral progesterone, which must pass through the digestive system and liver before reaching the bloodstream, transdermal progesterone is absorbed directly through the skin and into the underlying tissues.

This avoids what is known as the "first-pass effect" of the liver, where a significant proportion of orally administered progesterone is metabolised before it can be utilised by the body. As a result, many women find that transdermal progesterone provides a more effective, and broader range of symptom relief.

Research has shown that progesterone receptors are present throughout the skin, hair follicles, sebaceous glands, brain, breast tissue, bones, blood vessels, and reproductive organs. The skin is therefore an active site for progesterone absorption and utilisation.

Women affected by supply shortages should understand that oral progesterone is not the only route available, nor necessarily the most efficient.

Natural Progesterone and Synthetic Progestins Are Not the Same

Perhaps the greatest concern arising from progesterone shortages is the possibility that women may be encouraged to substitute synthetic progestins in place of natural progesterone.

The two should never be regarded as interchangeable.

Natural progesterone is chemically identical to the hormone produced in the human body. It binds naturally to progesterone receptors throughout the body and participates in the many physiological processes for which progesterone evolved.

Synthetic progestins, by contrast, are laboratory-created molecules designed to mimic some of progesterone's effects on the uterus. Although they may activate certain progesterone receptors, they differ structurally from progesterone, (they have an altered molecular structure), and can exert very different biological effects.

Unfortunately, many women are told that progestins and progesterone are effectively the same thing. They are not.

This confusion has persisted for decades and has contributed significantly to misconceptions surrounding hormone therapy. Many of the adverse effects historically attributed to "progesterone" in fact originated from studies that used synthetic progestins rather than natural progesterone itself.

Natural progesterone has been shown to have beneficial effects on the brain, sleep, cardiovascular system, bones, immune function, and reproductive tissues. Synthetic progestins cannot automatically be assumed to share these same properties simply because their names sound similar.

Women deserve clear information about this distinction so that they can make informed decisions regarding their health.

A Wake-Up Call for Women's Healthcare

The current shortages reveal something far more important than a supply-chain issue. They demonstrate that women are actively seeking solutions that address the underlying hormonal changes occurring during peri-menopause and menopause.

For too long, progesterone has been overlooked despite being one of the body's most important hormones. The increasing demand reflects a growing awareness that declining progesterone precedes menopause by many years resulting in the host of symptom experienced as 'peri-menopause'.

The challenge now is not merely increasing production. It is ensuring that women receive accurate information about the different forms and delivery methods of hormone therapy available, and understand the distinction between natural progesterone and synthetic progestins.

The growing interest in progesterone is not a trend. It is a sign that women are finally beginning to ask a fundamental question: what happens when progesterone disappears long before estrogen does? Why are we put on synthetic, molecularly altered hormones when there are natural solutions available?

The answer may reshape how we understand menopause for generations to come and hopefully channel more funding into women’s health and natural hormonal therapy.