Progesterone Intolerance Alternatives
Haver's clinical options for women with intolerance (dizziness, mood, reflux) to standard oral micronized progesterone.
Assembled by Cited from Mary Claire Haver's recorded recommendations across multiple sources. It is not an ordered program and was not created or endorsed by them — it's our grouping of what they've said on the record.
Components
4-
In a protocol
For progesterone intolerance, use oral micronized progesterone gel cap vaginally to bypass first-pass liver metabolism.
“go vaginal progesterone and kind of skip that first pass effect
UW▶ 32:17DosageInsert oral estradiol/progesterone gel cap vaginally at bedtimeCaveatsNot formally measured for endometrial protection but works clinicallyCertaintyexplicitrecommendationUse oral progesterone capsule vaginally to bypass first-pass -
In a protocol
Progesterone-containing IUDs are an alternative for progesterone intolerance.
“doing a Mirena IUD or a Loleta
UW▶ 33:10CertaintyexplicitrecommendationProgesterone-containing IUD -
In a protocol
CombiPatch (estradiol+norethindrone) is an alternative for women intolerant of micronized progesterone.
“I was on CombiPatch for a couple of years
UW▶ 33:00Certaintyexplicitpersonal useCombination patch with norethindrone -
In a protocol
Duavee is an option for women with persistent HRT bleeding or high breast cancer risk—bazedoxifene downregulates estrogen receptors in breast/uterus.
“DUAV for those patients to bind, block, and down-regulate
UW▶ 30:30DosageOne fixed dose; no genericCaveatsDoesn't work for everyoneCertaintyexplicitrecommendationDuavee with bazedoxifene (also for persistent bleeding)