HRT · Progesterone
Prometrium dosage: standard, cyclic, and continuous regimens
Prometrium is oral micronized bioidentical progesterone. It protects the endometrium from unopposed estrogen and improves sleep. Dose depends on whether you take estrogen continuously or cyclically, and whether you still have a uterus.
Standard dosing
- Continuous combined HRT: 100 mg nightly, every night
- Cyclic HRT: 200 mg nightly, days 15-28 of the cycle
- Perimenopausal sleep / mood: 100-200 mg nightly
- Heavy perimenopausal bleeding: 200 mg nightly, days 14-28
How to take it
At bedtime, with or without food. Do not take during the day due to sedation. If bedtime dose causes morning grogginess, try vaginal administration (same dose, less sedating).
When to consider a higher dose
Breakthrough bleeding on continuous 100 mg often responds to a 200 mg dose. Persistent bleeding despite that warrants ultrasound and possibly endometrial biopsy.
Frequently asked questions
What is the standard Prometrium dosage?
100 mg nightly is standard for continuous combined HRT. 200 mg nightly for 12-14 days each month is standard for cyclic (sequential) HRT in perimenopause.
Why is Prometrium taken at night?
Micronized progesterone converts to allopregnanolone, which activates GABA receptors and induces sleep. Daytime dosing causes drowsiness and dizziness in most women.
Do I need progesterone if I don't take estrogen?
Sometimes. Some clinicians use Prometrium alone for perimenopausal sleep, anxiety, and heavy bleeding without adding estrogen. Not required for endometrial protection if there is no estrogen exposure.
What if I don't have a uterus — do I still need Prometrium?
Usually no. Progesterone is added primarily for endometrial protection. Some women still benefit for sleep, mood, or breast tissue support — individualized.
What are Prometrium side effects?
Drowsiness (usually desired at bedtime), morning grogginess at higher doses, occasional dizziness, breast tenderness. Peanut oil is used as the excipient — contraindicated in peanut allergy.
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Medically reviewed by Kindr Health Clinical Team · Last reviewed 2026-06-19. Compounded medications are prepared by FDA-registered 503A pharmacies and are not FDA-approved drug products.