Related Topics: Bioidentical Hormones, Features, Infertility

Bioidentical Hormone Treatment For PCOS Polycystic Ovary Syndrome

PCOS is a complex condition, but it can often be reversed with the right nutritional and hormonal support. Supplementing with bioidentical natural progesterone for a few months is often enough to shrink the cysts and no further action is required.

Dr Jeffrey Dach

Seventeen year old Alice came with her Mom into the office and told me her story.  Alice has been overweight, borderline diabetic, and has facial hair and acne caused by elevated testosterone.  At age 12, Alice started normal menstrual cycles, but her cycles began fluctuating and periods stopped at age 15.  Her doctor diagnosed PCOS (Polycystic Ovary Syndrome), and put her on birth control pills to regulate her cycles. These caused adverse side effects of weight gain and elevated blood pressure  so she stopped them.

Progesterone is the Most Logical Form of Treatment and Actually Works

Two months ago, Alice was switched over from the birth control pills to natural progesterone twice a day for 14 days on, 14 days off. The progesterone was successful, restoring a normal menstrual period, and a return to regular cycles.

BCP’s (birth control pills) are usually prescribed by the ob-gyne doctor to regulate cycles in the PCOS patient. This standard treatment is not the best one.  There is a better more logical alternative that actually works called natural progesterone. Both John R Lee MD, and JeriLynn Prior MD advocate the use of natural progesterone as a far better alternative to birth control pills.  After all, birth control pills  are a chemical form of castration, and work by inhibiting ovulation.

This article will explain the cause of PCOS and explain why natural progesterone is the best treatment, and a much better choice compared to birth control pills.

When PCOS was first described in 1935 it was fairly rare but nowadays, it is quite common, involving 6 to 10 per cent of the female population, affecting 3.5 to 5 million women.   Why the increased incidence?  Some believe that endocrine disruptor chemicals in the environment are to blame

Clinical Signs and Symptoms Of PCOS

  • Oligomenorrhea or amenorrhea (no periods)
  • Anovulation (no ovulation)
  • Weight gain and obesity,
  • Hirsutism (excessive hair growth, male pattern)
  • Insulin resistance (pre-diabetes)
  • Acne
  • Male-pattern baldness
  • Multiple small ovarian cysts
  • A darkening of the skin at the nape of the neck and under arms

What Causes PCOS?

The world’s greatest authority, Leon Speroff MD, says: “A question which has puzzled gynecologists and endocrinologists for many years is what causes polycystic ovaries. There is an answer, which is appealing in its logic and clinical applicability. The characteristic polycystic ovary emerges when a state of anovulation persists for any length of time”

PCOS is the end result of not ovulating, (no progesterone production) for a long time (a few years), resulting in a vicious cycle which self perpetuates anovulation, causing increased testosterone production by the ovary. Insulin resistant diabetes and obesity aggravate the problem.  As you might expect, PCOS is a major cause of infertility.

JeriLynn Prior MD Says:

“The fundamental problem with PCOS is not making progesterone for two weeks every cycle. This lack of progesterone leads to an imbalance in the ovary, causes the stimulation of higher male hormones and leads to the irregular periods and trouble getting pregnant. Progesterone is usually missing—replacing it therefore makes sense.”

John R Lee MD said:

“I recommend supplementation of normal physiologic doses of progesterone to treat PCOS. If progesterone levels rise each month during the luteal phase of the cycle, as they are supposed to do, this maintains the normal synchronal pattern each month, and PCOS rarely, if ever, occurs. Natural progesterone should be the basis of PCOS treatment, along with attention to stress, exercise, and nutrition.

If you have PCOS, you can use 15 to 20 mg of progesterone cream daily from day 14 to day 28 of your cycle. If you have a longer or a shorter cycle, adjust accordingly. The disappearance of facial hair and acne are usually obvious signs that hormones are becoming balanced, but to see these results, you’ll need to give the treatment at least six months, in conjunction with proper diet and exercise.”

Can PCOS be Treated with Natural Progesterone?

YES by Dr. Jerilynn Prior

“Progesterone talks back to the hypothalamic and pituitary (brain) hormones that control the ovaries and stops them from stimulating the ovaries to make too much testosterone.”

Dr Prior recognizes that the (BCP) pill, with its progestins/progestogens (synthetic types of progesterone), does help women with PCOS to a certain degree.  But her goal for PCOS patients is, “to return the brain/ovary system to a normal balance. The goal of the BCP Pill is the opposite – it must suppress the brain-ovary system to prevent pregnancy.”

To help her PCOS patients achieve a normal hormonal balance, she prescribes micronized progesterone which is a bio-identical hormone. Taking this natural progesterone for two weeks every month may help the brain to develop the normal cyclic rhythm that is missing in PCOS.

Interestingly, Dr. Prior believes there is another benefit of cyclic progesterone therapy. She explains, “most doctors don’t realize progesterone antagonizes and inhibits the enzyme (called 5-alpha reductase) that is needed to make testosterone into dihydrotestosterone. Dihydrotestosterone is the powerful male hormone that talks hair follicles into making coarse hair and too much oil that causes acne.”


There seems no doubt that bioidentical natural progesterone can help patients with PCOS and where possible to do this under the supervision of a doctor who is experiencd in natural hormone usage and prescribing.

Further reading:–-how-it-affects-your-health-and-fertility/

To read more on Dr Dach’s work please visit his website at If you have any questions or comments you can contact him via the website.

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Atoosa Ghahramani | 6:25 am, September 3rd, 2012

Dear sir/madam,

I have the same problem mentioned above. I am a PCOS and my period stopped when using birth control pills.

I need to know how to treat. First, how to start again my bleeding? then how continue treatment? what the natural progesterone is?

Many thanks,


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