미분화 프로게스테론

孕激素 C

Micronized Progesterone (Prometrium / Utrogestan)

Micronized Progesterone

Oral

Bioidentical Micronized Progesterone is the sole progestogen that should ever be considered for transgender hormone therapy. Chemically identical to the progesterone manufactured by the human ovary, its VTE risk profile appears vastly safer than synthetic alternatives. Due to its intense sedative side-effects, it is heavily utilized off-label to correct severe insomnia.

Do Not Start This Before 12 Months

Early breast development (Tanner I-III) runs exclusively on estrogen acting to drive ductal branching. Forcing progesterone into the mix too early acts as a chemical kill-switch for branching, triggering terminal differentiation ^[1] . This will prematurely fuse the breast buds, halting overall size potential. Wait at least 12 months and ensure your breasts have reached Tanner III before swallowing a single pill of progesterone.

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Pharmacology

Bioidentical Superiority

Micronized progesterone is created by grinding pure, bioidentical progesterone into microscopic particles and suspending them in a softgel oil capsule to bypass instant destruction by the liver ^[2] .

Key characteristics:

• Structure: Physically identical to P4 (Progesterone).
• The Metabolites: When swallowed, the liver breaks a huge percentage of it down into 5α-pregnanolone (allopregnanolone). This metabolite directly hits your GABA-A receptors, acting as a massive tranquilizer and anti-anxiety agent ^[3] .
• Half-Life: Roughly 16-18 hours when taken orally.
• Bioavailability: Exceptionally poor (around 10%), rendering it relatively safe from massive liver taxation.

The VTE Profile

Early evidence strongly points to bioidentical progesterone lacking the terrifying pro-coagulant (clotting) effects that make synthetic progestins (like Medroxyprogesterone) dangerous ^[4] . While no drug is “zero risk,” it is infinitely safer to stack with Estradiol compared to taking birth control synthetics.

Dosage Recommendations

Based on sparse clinical literature and broad endocrine practitioner consensus ^{[3] [5]} :

Protocol	Dose	Administration	Notes
Starting Dose	100 mg/day	Swallowed right before bed	Hold for 4-8 weeks to gauge psych effects.
Standard Maintenance	100-200 mg/day	Swallowed right before bed	Most users max out here.
The Cycling Method	200 mg/day for 10-14 days a month	Swallowed right before bed	Simulates a cisgender menstrual cycle.

How to Take It

• Right Before Sleep: Because it forces your brain into a heavily sedated state, taking it in the morning will functionally drug you, making you lethargic, dizzy, and unsafe to drive.
• Swallow the capsule whole with water. Do not try to bite or chew the softgel; the oil tastes disgusting.
• Taking it alongside a light, extremely fatty snack (like peanut butter) heavily boosts the absorption rate.
• If you miss a dose, just go to sleep. Do not take 200mg the next night to “make up for it.”

The Cycling Debate

Many DIYers argue for “cycling” progesterone (taking it for only 2 weeks out of the month, then stopping) to emulate a cisgender ovulatory cycle. The intense drop in hormones when you pause the drug can trigger brutal PMS-like emotional crashes. There is zero clinical proof that cycling builds better breasts than taking it continuously.

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Theoretical Benefits

Breast Maturation

Dr. Jerilynn Prior famously hypothesized that progesterone acts as the final trigger for lobuloalveolar maturation (Tanner IV-V), causing the breasts to round out and fill with denser glandular tissue ^[3] .

• The Caveat: This is entirely based on patient self-reporting, not MRI volume scans. It remains “Expert Opinion” (Level C Evidence).
• Many users report their breasts swelling significantly after starting, but this is often just water retention crashing back down if the drug is stopped.

The Sleep Fix (Insomnia)

This is progesterone’s most undeniable effect. The allopregnanolone metabolite hits your GABA receptors exactly like an anti-anxiety drug or a sleep aid.

• It violently combats insomnia.
• It heavily increases deep REM sleep duration.
• The sedative effect peaks about 60 to 90 minutes after swallowing the pill.

Mood Stabilization

Some users report crippling anxiety melting away on progesterone. Others report suddenly feeling hopelessly depressed and emotionally volatile. This is highly genetic and subjective. If progesterone crushes your mental health, stop taking it immediately.

Side Effects

• Severe Drowsiness/Sedation: The entire reason you take it at night.
• Vertigo (Dizziness): Very common if you stand up too fast right after the pill kicks in.
• Bloating & Nausea: Taking it with food mitigates this.
• Breast Soreness: Hard, aching nipples are extremely common in the first few weeks of use.

Do Not Drive

Do not swallow your progesterone pill and then drive a car or operate heavy machinery. The sedative effect is authentic and impairs reaction times exactly like a mild benzodiazepine.

Monitoring Guidelines

• Run a standard blood panel 4 to 8 weeks after starting to check your P4 levels.
• Track your mental health in a journal. The psychological side-effects sneak up on people.
• If the depression becomes overwhelming, simply stop. Progesterone does not require tapering.

品牌图鉴

🇫🇷法国

安琪坦 Utrogestan

厂商

Besins Healthcare

规格

100mg / 200mg 软胶囊

外观

黄色圆形软胶囊

原研微粉化黄体酮，法国产

🇮🇳印度

Susten

厂商

Sun Pharma

规格

100mg / 200mg / 300mg / 400mg 软胶囊

外观

黄色/类白色软胶囊

印度 Sun Pharma 产微粉化黄体酮，规格齐全，价格远低于原研

🇮🇳印度

Naturogest

厂商

Zydus Cadila

规格

100mg / 200mg 软胶囊

外观

软胶囊

Zydus 产微粉化黄体酮

🇮🇳印度

Microgest

厂商

Panacea Biotec

规格

100mg / 200mg 软胶囊

外观

软胶囊

Panacea 产微粉化黄体酮

🇺🇸美国

Prometrium

厂商

AbbVie

规格

100mg / 200mg 软胶囊

外观

桃色圆形软胶囊

美国原研微粉化黄体酮

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