Progesterone and Endometriosis

Endometriosis affects approximately 20% of women worldwide during the years from puberty to menopause, rarely after.  Research indicates that insufficient progesterone is made in someone with endometriosis and that the luteal phase is shorter than normal. In some cases the endometrium doesn't respond to progesterone stimulus from the ovaries, in which case a high dose of supplemental progesterone is needed.

Supplementing with Natpro progesterone cream can help to overcome this problem however, a high dose is needed.  In some cases 200mg/6ml per day is sufficient, but in more severe cases 400mg/12ml possibly more is needed.  The higher dose should be used to start with reducing only when symptoms clear as reducing too soon will cause your symptom to return and undo what has been done already.  Treat the symptom first, then slowly reduce.  Please read How to use Progesterone Cream to find out the correct way to reduce the cream SLOWLY.  Some experience extreme pain when first using progesterone. The pain does ease as you continue using progesterone.  It is very difficult to say when the pain will clear as each individual is different.  Some do not even experience pain when first using it.

It is recommended that progesterone is used EVERY DAY for the first 2 to 3 months or until things have improved.  Once it does you can begin to follow your a cycle, use the cream for the last 14 days only, ie from ovulation to bleeding. Some people prefer to continue using every day regardless, especially if entering the peri-menopause stage.  If the symptoms have responded to the progesterone and you prefer to follow your cycle again, stop using the cream. Bleeding should occur shortly after this, resume again on day 15 and use it for the next 14 days. Although this gives a 28 day cycle, it's something to go on while the body adjusts to the natural cycle length. Once ovulation has begun again, start using the cream from this point on for the next 14 days.  Please rub the cream on the painful areas as often as you need it as progesterone is an excellent anti-inflammatory and will help to ease the pain a little.  

Endometriosis is one of the hardest conditions to solve. Progesterone does help the pain in some women, but not all. Recent research has found endo is caused by oxidative stress, unless the Inflammation is dealt with one will battle.  So huge amounts of antioxidants are needed, in particular N-Acetyl-Cysteine (NAC) and vitamin D3. Cysteine is the rate limiting factor in the cell manufacture of glutathione, probably the most important antioxidant we make, at least 5000mg/day is needed. The other two aminos needed to make glutathione are glycine and glutamine. These are normally abundant in our diet, but when under stress not enough glutamine can be converted, so it's best to take up to 8000mg/day. If possible have a GSH:GSSG test done, this shows whether sufficient glutathione is being made. If not possible then take the three precursor amino acids: N-Acetyl-Cysteine, glutamine and glycine, in particular cysteine.

Have a vitamin D3 test done. There is now a pandemic of vitamin D3 deficiency. Over 50% of us are deficient.  It all started when we were told to stay out of the sun and use sunscreens! It's best to take a minimum of 5000IU's/day, if a severe deficiency is found 10000IU's/day is needed. 

The normal treatment for endometriosis are the progestins, but they have serious side affects and not recommended.  Progestins are synthetic, progesterone is natural, there is great confusion between the two.  Some say that they are using progesterone when in actual fact it's progestins. Please make sure that you know what you are using.

The endometrium is found growing in places other than the uterus. It is most often found in the pelvic area, on the ovaries, the fallopian tubes, the back and front of the uterus, the intestines and the bladder. But it has also been found in the eye, brain, lungs, diaphragm and skin. As the cells within the endometrium in the uterus swell and grow with the rise of estrogen in the first part of the cycle, so do all the misplaced endometrial cells, giving rise to pain, from mild to extremely severe. Other symptoms are lower back pain, painful sex, painful bowel movements or pain when urinating, spotting between periods, fatigue and infertility.

Two 'theories' have been proposed for the cause of endometriosis:

  1. Endometrial cells migrate up the fallopian tubes and embed in the pelvic area. Somewhat lacking in validity as it cannot explain how migrating cells can be found in the brain, lungs, skin etc
  2. Another line of research believes the problem starts as the foetus is forming in the uterus. Exposure to too much estrogen, either endogenous or xeno-estrogens, causes some endometrial cells to be deposited in other areas, instead of in the endometrium where they should be. When the child reaches puberty they of course develop too, with the resulting problems

Treatment usually takes the form of anti-inflammatories, aromatase inhibitors, continuous hormonal contraception to prevent the monthly bleed, surgical interventions, drugs which stimulate the production of gonadotropin releasing hormone, which causes a severe drop in both estrogen and progesterone, resulting in possible menopausal symptoms and osteoporosis.

If a woman is nearing menopause they are usually advised to wait, as with the decline in estrogen the endometrial tissue is no longer stimulated and the pain subsides too.

Endometriosis Symptoms

For unknown reasons, some of the endometrial cells migrate to other parts of the body.  Because they cannot be shed like normal uterine cells, they develop into cysts which are often called 'chocolate cysts'.  As there is no outlet for the blood, it becomes oxidised and turns brown.  As the cysts grow larger with each menstruation it causes pain in some cases.

These cells are most often found:

  • in the pelvic area
  • the bladder
  • the intestines
  • on the ovaries
  • the fallopian tubes
  • back and front of the uterus

However, they have also been found:

  • in the eyes
  • on the brain
  • on the lungs
  • on the diaphragm
  • on the skin
  • in the rectum

As the cells within the endometrium in the uterus swell and grow with the rise of estrogen in the follicular or first part of the cycle, so do all the misplaced endometrial cells.

Endometriosis symptoms that can occur are:

  • pain - from mild to severe in the pelvic region
  • lower back pain
  • painful sex
  • painful bowel movements
  • pain when urinating
  • spotting between periods
  • fatigue
  • infertility


Excellent results have been achieved by using/taking the following protocol to deal with oxidative stress, this is also good for heavy, continual bleeding:


  • NATPRO Progesterone Cream - 400-500mg per day.
  • N-Acetyl-Cysteine (NAC) - 2000mg per day. 
  • Taurine - 2000mg per day.
  • Vitamin D3 - 5000iu's per day, more if vitamin D3 level is low.  Co-factors are vital when taking vitamin D3. 
  • Bioflavanoids - 1000mg per day.



Research Papers 

Reactive oxygen species controls endometriosis progression

Progesterone and endometriosis

Female Infertility and Free Radicals: Potential Role in Adhesions and Endometriosis

Melatonin and the ovary: physiological and pathophysiological implications

Oxidative damage and mitochondrial DNA mutations with endometriosis

Pine Bark Extract Reduces Symptoms of Endometriosis

Expression of 25 hydroxyvitamin D3-1alpha-hydroxylase in human endometrial tissue

Percutaneous administration of progesterone: blood levels and endometrial protection