Related Topics: Menopause

A Simple Weekly Routine For Applying Your Hormone Cream

Remembering when to apply your cream, and where, can sometimes be confusing but my simple guide helps make it easier to get the maximum benefit from it.

AnnA Rushton

It happens to all of us, you read the instructions, then you lose them, or can’t remember exactly what they said when you need to apply your cream.

This is one of the most common questions I am asked, so I devised a simple regime for myself that I thought would be helpful to share with you, and of course you can adapt it to suit your own needs.

Firstly, do remember that everyone is different and your response will be as unique to you as are your symptoms and their severity. Some women require more hormone cream to help alleviate severe symptoms, while others can use less, and factors such as stress will impact your hormones and mean your symptoms may need extra help.

However it does make sense that everyone starts off with the same dosage and then monitors their symptoms. So if you are new, make sure you begin with the recommended double dose of two pea sized amounts of cream twice daily for the first month of use to establish good hormone levels.

After the first month if your symptoms are coming under control you can go on to the maintenance dose of just one pea sized amount of cream twice daily on your regime and once they are fully controlled then try cutting back on the amount each month and monitor your symptoms.

If your symptoms return then go back to a slightly higher dose as that is what you need at that time and again try cutting down later in a few months.

You start using the cream from days 14-28 of your cycle if menstruating regularly (depending on your cycle length) or for 24 days on and 6 off each month if periods are irregular or stopped. You would stop using the cream during the 24 days if you get a bleed and recommence when it stops.

A simple application routine

All hormone creams should be applied with a light hand, they do not need to be rubbed in vigorously, and the latest findings indicate that it is best to use both thin skinned and fatty tissue areas for maximum hormone absorption.

Suggested application areas

The best application areas are: the face, neck, palms of the hands, inside of the upper arms, lower back or inner thighs for thin skinned areas and buttocks, lower arms, outer thighs and stomach for fatty areas.

These areas are used as they vary in absorption rate. The fatty areas have slower absorption and therefore stay longer in the body, but the thin skinned areas are absorbed faster and are effective sites to use for hot flushes in particular.

So if your flushes are mainly during the day, use the thin skinned area in the morning, but if they happen at night then apply to the fatty tissue area in the morning. It can also help if you have night sweats to try increasing the night time dose to give you an extra boost .

You need to apply to a different area each day, so you rotate round the body. Also, for maximum effectiveness, apply to a thin area in one application and a fatty area in the next one. Keep up this alternating pattern.

As an example, apply it twice to your left arm on Monday (upper arm is fatty tissue and lower inside arm is thin tissue) and then work down your body one side and back up the other as in the example below:

Monday: left arm lower inside morning and upper arm evening.

Tuesday: left thigh outside morning and inside evening.

Wednesday: left side of stomach morning, left buttock in the evening.

Thursday: right thigh outside morning and and inside evening.

Friday: right side of stomach and right buttock as before.

Saturday: right arm lower inside morning and upper arm as before.

Sunday: face and neck

You do not have to follow this routine exactly, just make sure you cover the different areas so you get the maximum hormone absorption to deal with your symptoms.

An alternative method

Many women suffering from vaginal dryness, or who have skin absorption problems, find it helpful to apply the cream internally to the vagina as either the only site to use or as as part of the above regime. This method is particularly recommended by Dr Mercola of the USA. He comments:

“If you apply the cream to your mucous epithelial membranes that line your uterus and vagina you obtain a virtually ideal administration system as hormones absorbed through your vaginal membranes enter the very same pelvic plexus of veins that your ovaries normally empty into.”

With this method you do not need to take a monthly break, and he also recommends it can be applied to the inner lips of the labia instead. You would use either your finger as far inside as is comfortable or you can put the cream on the end of an applicator tampon and leave in place for 30 minutes before withdrawing it.

Many women find they prefer to mix the two methods. By using skin in the morning and vaginally at night you can then take a much shorter break of only 3 days, rather than 6 as in the skin method.

I found a combination routine  helpful so this suggested one could also be useful:

Monday left arm lower inside morning and vaginally evening

Tuesday left thigh outside morning and and vaginally evening

Wednesday left side of stomach morning, vaginally the evening

Thursday right thigh outside morning, vaginally evening

Friday right side of stomach, vaginally evening

Saturday right arm lower inside morning, vaginally evening

Sunday face or neck morning, vaginally evening

Application routine for men

As more men are using bioidentical progesterone cream to offset the flushes from cancer treatment, or to proactively oppose oestrogen dominance, they have a slightly different method.

They would use the following sites in rotation: face, throat, back of the neck, inside thighs, inside upper and lower arms, stomach and palms of the hands.  This give you 7 sites for a different area each day and the cream only needs to be applied once daily.

Do I really need a break?

The answer to this is yes if you are using skin application. Whatever your age or circumstances, whether you have had a hysterectomy or very irregular periods, it is very important to take the break to allow the skin receptor sites time to rest and prevent the chance of you overusing any single one.

If you do not take the break you run the risk of actually absorbing less hormone to deal with your symptoms as once that site is ‘full’ it can’t take the hormone and use it as it can when applied in rotation.

If you find you are forgetful and don’t always remember to apply twice daily in rotation then perhaps vaginal or a combined application might be better for you.

You will find your own method, but I hope this proves helpful as a place to get started.

More information:

As well as our creams we have developed a range of Supplements that can be used in combination with either Serenity or 20-1.

As well as information on hormone health that you might find useful, you will find details of our other products here:


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Please feel free to discuss this article in the comments section below, but note that the author cannot respond to queries made there.
Comments 64
Sorted by:  Date | Recommended
AnnA Rushton | 2:14 pm, April 11th, 2021

Please email for individual help with your symptoms as they will be able to go into more detail than is possible here.

Caroline | 8:08 am, April 11th, 2021

Hi I have just received my serenity cream for he first time of use . I have hypothyroid and have to take my T3 twice a day morning snd late evening . Do I need to leave a gap in between applying the serenity cream and taking my T3 meds ? I don’t want any interactions
I’d also like to ask where the it’s best to apply the cream as I have read that it can be applied internally regularly but you shouldn’t apply the cream to the same spot twice which will lead to saturation and not be absorbed well . Thanks

AnnA Rushton | 4:22 pm, March 25th, 2021

Certainly you can use Serenity alongside your collagen supplements as there is no contraindication with anything other than those containing synthetic hormones such as HRT. Please email for individual help with your symptoms if you require further help as they will be able to go into more detail than is possible here.

Jaqulin | 1:26 pm, March 25th, 2021

I am 64 and finished periods 14 years ago only now am I beginning to have hot flushes across my face. Intense heat in my left thigh had been occurring in bed for several years. Now it’s happening at night in both. There has also been an outbreak of itchy skin on chin and neck. 4 weeks ago I started taking collagen supplements. Can I continue taking the pills safely once I begin applying the progesterone cream that I have ordered. Thank you.

AnnA Rushton | 2:44 pm, September 13th, 2020

We do not recommend using the coil alongside our cream if you are using that coil for contraception. The problem is that the synthetic progestin is in the coil compete for the same receptor sites in the body as the bioidentical progesterone, and this will make both of them less effective. This article will give you more information:

Jade | 10:41 pm, September 8th, 2020


I have A marina coil fitted and because of the coil I don’t have any periods so when should I start using the cream and when should I take the break.

Thank you

AnnA Rushton | 10:47 am, March 28th, 2020

If bleeding for 2 weeks this needs to be checked by your doctor for possible causes such as fibroids. On the 24 day regime you would apply twice daily for 24 days and a 6 day break, but if you get a bleed within the 24 days you stop for 6 days only, and wherever you get a bleed you only stop for 6 days and restart the cream on a complete new 24 day cycle – do not ‘use up’ the days already applied.

A Gregory | 6:52 am, March 24th, 2020

When bleeding you stop using cream.
49 only ever missed one period.
Regime 24 days 6 days off
I bleed for two weeks- do I take a 6 day break as well as not applying when I am bleeding?.3 weeks off……. confused

AnnA Rushton | 11:17 am, February 11th, 2020

Carol full application information was sent with your confirmation of shipping email, but you will find the article below also to be helpful.

Carol fee | 10:16 pm, February 6th, 2020

Hi I have received the cream but so confused on when I should put it on or how to rotate it on my body hurts

Caterina Centraco | 1:52 pm, August 21st, 2019

Hi there
I think I have vaginal atrophy, what would you suggest I use?
Many thanks

Caterina Centraco | 1:23 pm, August 21st, 2019

Hi there
I’m 59, it’s been 10 years since last period, am now only suffering from vaginal dryness, very painful sex, & occasional anxiety & teary??
What would you recommend pls
Many thanks

AnnA Rushton | 11:02 am, May 19th, 2019

Margaret the article makes it clear that if you don’t take a break you run the risk of saturating the receptor sites and so absorbing less of the cream and hormone. We suggest you switch to internal vaginal application for the next 3 months before reverting the routine for the skin outlined in the article.

Margaret Burnett | 11:26 pm, May 15th, 2019

I had a Hysterectomy 24years ago aged 35 but still have my ovaries &I tried 20-1 long time ago but didn’t help with flushes etc so have serenity but never taken a break,am I surpose to &gif yes how often.

AnnA Rushton | 5:26 pm, April 9th, 2019

Please email for individual help with your symptoms as they will be able to go into more detail than is possible here.

Geraldine mcgroary | 1:48 pm, April 9th, 2019

Hi there ..have been using the serenity cream for the past two weeks..haven’t had any hot flushes or night sweats sence I started it..I’m delighted with the cream so happy it’s working ..haven’t had a period for 7years but woke up this morning with spotting and period like this normal please ..thank you xx

AnnA Rushton | 10:48 am, March 9th, 2019

She is not alone Julie and yes women use our creams from puberty to post menopause so there is no age barrier, it just depends on whether you still have symptoms that need help. Women with osteoporosis for instance use our creams throughout their lives and many women post menopause continue for protection from heart disease, cancer and strokes.

julie gertch | 9:04 pm, March 7th, 2019

My mum is 75 and says she still gets the odd flush would she be able to use the Serenity Cream?

liz | 10:35 am, February 2nd, 2019

hi i still have regular periods and am 51.
though they have been getting really light and my sleep and mood has been poor. I have now suddenly started flooding with a very heavy period and read progesterone is the cause often. please can you advise should i do whilst bleeding or do i have to wait for this period to end as it doesn’t seem to be showing any signs of doing so… please advise asap as need to try and get back to work! thanks liz

Maryanndifolco | 4:48 am, January 9th, 2019

My friend got me the cream for a gift nor sure on how to use and when to use thanks

AnnA Rushton | 2:31 am, October 5th, 2018

Dawn the instructions for the cream were contained in our online booklet for which there was a link in your shipping confirmation email. The article you have here gives you the information you need on application and you would apply cream on the 24 day routine twice daily and a 6 day break. The Menopause capsules are taken every day with no break.

Dawn | 7:52 am, September 28th, 2018

Hi I haven’t had periods for 6 1/2years my hot flushes are day and night I don’t sleep well, I have just got ot cream and menapause tablets do I just use cream twice a day, and where is the best place for cream,? Thank you

AnnA Rushton | 3:44 pm, July 22nd, 2018

Yvonne severe symptoms usually respond best to 20-1 and you can use it vaginally or on the skin = see the application in the article. Either method is as effective, but applying to thin tissue when flushes are worst will be absorbed quicker so either skin or vagina in that case.

Yvonne McPhee | 11:31 am, July 22nd, 2018

Hi I am 55 and had a hysterectomy when I was 28. I still have my ovaries. I have recently purchased the 20-1 cream but have not used it yet. I don’t have vaginal dryness at all so do I still need to use it in my vagina? I do have horrendous hot flushes which come on throughout the day and the night which causes me to have not the best sleep. What is the best way to use the cream to suppress the flushes?

AnnA Rushton | 10:55 pm, June 26th, 2018

Becky severe symptoms usually respond best to 20-1, which is a combination of bioidentical progesterone and two natural oestrogens with the progesterone being the largest ingredient.

Maria | 3:32 pm, June 26th, 2018

Hi i am 44 and had hysterectomy and both ovaries removed! I am wondering if this product will help me with night flushes that are become unbearable!

AnnA Rushton | 10:40 am, May 3rd, 2018

Sharron you are post menopause so you use for 24 days twice daily, then a 6 day break each month.

Sharron Balla | 3:27 am, May 3rd, 2018

I don’t get my period (hysterectomy, but still have ovaries). When should I take a break?

AnnA Rushton | 12:07 pm, September 7th, 2017

We can’t help with sales queries as we don’t have access to their database so have forwarded your comment to them but do please email to check your order.

Rajdeep | 4:22 pm, September 5th, 2017

Hi dear last week I oder this creme I can not receive becoz my email is wrong my new email i this and old is can u help me plz

AnnA Rushton | 5:54 pm, August 14th, 2017

There is not a one month break Stephanie, but one week if on the 24 day regime and two weeks if on 14-28 so it will depend. With the initial double dose and on what regime the initial post will last 6-8 weeks, but usage does vary. All prices are on the website at as it will depend which country you are in, what currency you are using and how many jars you are ordering.

Stephanie edmonds | 3:43 pm, August 12th, 2017

Hi how long will one pot of cream last ,
Taking into consideration the one month break ?
How much is the cream including postage?

AnnA Rushton | 4:38 pm, November 27th, 2016

Angela application is inside the vagina as far as inside as you can comfortably reach. Most women use their finger, but you can buy an inexpensive applicator from a chemist.

Angela | 10:24 pm, November 26th, 2016

Could explain better where is the mucous epithelial membrane please. Do I need an applicator?

AnnA Rushton | 10:02 am, October 1st, 2016

When this occurs Joanne switch to the 24 day application routine, stopping if you get a bleed and recommencing a new 24 day cycle each time.

Joanne | 7:52 am, October 1st, 2016

Hi i started my period yesterday 3 days earlier , they do seem to be coming closer and closer ,when do i start using my cream

AnnA Rushton | 3:48 pm, September 21st, 2016

Deborah please read Dr Coope’s article below, and then email with this information for individual help with your symptoms.

Deborah | 5:50 am, September 21st, 2016

For the past 5 years I have been taking oestrogen capsules combined with a progesterone gel. These are prescribed by my GP. How do I start the 20-1 cream? I am 56 and I have one ovary. My periods stopped six & a half years ago & I went into a very difficult and traumatic menopause:( I am hoping 20-1 will enable me to come off prescription HRT.

AnnA Rushton | 10:17 am, July 14th, 2016

The coil does not contain progesterone Kathryn but a synthetic progestin and you can safely use the cream, but if you have the coil for contraception you must take additional precautions as the cream and the synthetic progestins compete for the same receptor sites in the body. This means the coil and the cream will be less effective, but if using to combat previous heavy bleeding then it is fine to use them together.

Kathryn Davies | 1:50 am, July 13th, 2016

Hi, I’m suffering with night and day flushes, I’m 51. I don’t have periods because I have the marena coil, is it safe to use the cream I’ve bought off you as I understand the marena is meant to be a progesterone coil?

AnnA Rushton | 2:27 pm, June 5th, 2016

Please email for an a specific answer to this Charlotte.

Charlotte | 8:31 am, June 5th, 2016

How do I use the cream if my cycle is varied as I can get a 25, 26 mainly but have had a 35 day one with less bleeding but had peri symptoms for a few yrs but things changing more so now aged 43 please help thanks x

AnnA Rushton | 11:46 am, May 13th, 2016

No you don’t have to take a break with internal vaginal application Nancie.

Nancie Allan | 5:16 pm, May 12th, 2016

I have just purchased 20-1 and i am using it internally as i suffer with vaginal dryness do i have to take a 6 day break i am 69 yrs old.
Thank you.
N Allan.

AnnA Rushton | 4:00 pm, March 17th, 2016

We don’t know what the progesterone content of that cream is Terry, but Serenity is 2.34% and was recommended by Dr Lee on his several visits to the UK.

Terry | 3:57 pm, March 15th, 2016

Is Serenity the same as FemGest, the one recommended for use by Dr. John Lee? I am writing to Dr Shirley Bond, but thought I’d order Serenity in the meantime.
Thank you

AnnA Rushton | 11:53 am, March 13th, 2016

Janice, it is true that symptoms certainly can continue post menopause. For mood swings you would be better with a combination cream such as 20-1 which has both progesterone and oestrogen. This article may help:

Janice | 7:36 am, March 12th, 2016

I do not have sweats but am post menopause and suffering horrendous mood swings, tearful and memory fog. Will the cream work for my symptoms. I am 100% post menopause….age 53. Started these symptoms 6mths ago. Had last bleed 2 yrs ago.

AnnA Rushton | 6:22 am, September 18th, 2015

The gap is not related to whether you have a menstrual period Jacqueline it is about the absorption of hormones into the skin and taking a break ensures you do not saturate the receptor sites and so absorb less hormone to deal with your symptoms.

jacqueline | 1:03 pm, September 17th, 2015

I am fine no more hot flushes I am 68 do I have to take the 6 day gap I have not had a bleed for 8 years so just morning and night all the time is that right

AnnA Rushton | 7:35 pm, August 26th, 2015

The reason for the break Andrea is so you don’t over saturate the receptor sites and we do recommend a 6 day break when applying for 24 days, but in the first month on the double dose you can continue through the break if your symptoms are still not under control.

Andrea | 12:23 pm, August 25th, 2015

Hi there. Been using twenty to one cream for a week now. I’ve had a total hysterectomy, do I need to break for 6 days every month. Thank you.

AnnA Rushton | 11:37 am, July 22nd, 2015

It can be helpful when symptoms are severe Liz to also support with a herbs and botanicals formula so certainly worth trying.

liz | 8:55 pm, July 20th, 2015

hi I was wondering if maybe I should use the capsules as well as cream.i have seen them on the shop page then maybe it might help a bit quicker to relieve flushes and sweats as not getting much sleep. many thanks

AnnA Rushton | 7:49 pm, July 18th, 2015

No you cannot harm yourself with bioidentical hormone creams Liz, you just won’t have been absorbing enough by not rotating the application sites.

liz | 7:09 pm, July 16th, 2015

thanks for replying to my email reading booklet now.would I be doing myself any harm as I have been using cream twice a day on both arms and either stomach buttocks or thighs? think I may have been double dosing keeping this email for future information reference many thank.

AnnA Rushton | 8:57 am, July 13th, 2015

You can safely continue to use both as long as you have symptoms that need help, or for long-term support for conditions such as osteoporosis and protection from strokes and heart disease.

M Pepper | 2:48 pm, July 12th, 2015

I feel so much better using the 20-1 cream & taking the capsules. Is it ok to continue both indefinitely. I would highly recommend to anyone having problems.

Barbara Gibb | 7:03 pm, June 20th, 2015

How soon can I shower if I applied my 20-1 upon getting up and I did and took a shower about 2hrs. later. Since I have osteoporosis and am 78 to I still have to take a 6 day break? Thank you. Barb Gibb

AnnA Rushton | 9:00 am, May 1st, 2015

Mary we know progesterone is protective of oestrogen related cancers, which skin cancer is not, and we know of no information relating to it as no research has been done. However we would have thought there were no obvious contraindications but we suggest you check with your doctor or oncologist.

Mary | 11:56 am, April 30th, 2015

Good morning,
Thanks for answering my question but I have to ask again.
I had Melanoma cancer, is it safe to use this cream?

AnnA Rushton | 3:00 pm, April 21st, 2015

After a hysterectomy with vaginal dryness you need to replace both hormones so a combined cream such as 20-1 would be most helpful

A harkin | 8:48 pm, April 20th, 2015

Age61 hysterectomy with ovaries kept but extreme biginal dryness

Trish Jones | 10:09 pm, October 6th, 2014

Do you apply the cream for the 1st 30 days regardless if you are having a period or spotting?

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