Progesterone and Wild Yam Creams for Menopause: What the Studies Found

“Natural progesterone” creams and wild yam creams are sold online and in health food stores for hot flashes, sleep and “hormone balance.” Some are marketed as a gentle alternative to hormone therapy. Here is what controlled trials found, and the safety point that matters most if you also use estrogen.

Wild yam cream

Wild yam contains plant compounds, including diosgenin, that have been claimed to influence the body’s own hormones. In a 2001 placebo-controlled trial, 23 women with menopause symptoms used wild yam cream and a placebo cream for 3 months each. Hot flash and other symptom scores improved a little with both, with no significant difference between them. Blood and saliva progesterone levels didn’t change. The authors concluded the cream had little effect on menopause symptoms.¹

Progesterone cream for hot flashes

The trials disagree:

• A 1999 trial of 102 women in early menopause found that a cream with 20 mg of progesterone a day improved hot flashes in 83% of women who had them, compared with 19% on placebo. It didn’t protect bone density over a year.²
• A 2003 trial of 80 postmenopausal women using 32 mg a day for 12 weeks found no detectable change in hot flashes, mood, cholesterol or bone markers. The authors concluded that not enough hormone seemed to get into the body to have an effect.³

Those trials used specific products at set doses. A cream you buy may contain a different amount, and labels on non-prescription products aren’t reviewed the way prescription hormone labels are.

The uterus protection question

If you still have a uterus and use estrogen, you need a progestogen to protect the lining of the uterus from overgrowth. A 2000 study gave 27 postmenopausal women estrogen patches plus progesterone cream at 16, 32 or 64 mg a day. The progesterone levels reached weren’t enough to cause any detectable change in the uterine lining.⁴

The North American Menopause⁵ Society, now called The Menopause Society, noted in 2012 that oral progestogens and combined estrogen-progestogen patches have shown endometrial protection and are government approved. A vaginal progesterone cream approved for premenopausal women wasn’t approved for use after menopause.⁵

In short, don’t rely on an over-the-counter cream to protect your uterus while you take estrogen. Any bleeding after menopause needs to be checked.

Saliva tests that go with these creams

Some sellers recommend saliva hormone tests to adjust your cream. The 2000 study found salivary progesterone levels so variable they were considered completely unreliable.⁴ Our article on saliva hormone tests covers more.

What to ask instead

If hot flashes or sleep problems are wearing you down, ask about approved treatments, both hormonal and nonhormonal. Our guides to menopause hormone therapy safety and hot flash help without hormones are good starting points.

Try: “I’ve been using an over-the-counter progesterone cream for hot flashes. Is it doing anything, and if I start estrogen, what progestogen would protect my uterus?”

My Body Changed. Now What? includes a Visit Brief. Use it to list every cream, supplement and prescription you use, and your questions about treatment. See the book.