Are there different ‘grades’ of progesterone cream?

Hi Catherine,

We were trying progesterone from a compounding pharacy and then switched to one that was over the counter but the same dose. The over the counter does not seem to work as well and we were wondering if there are different grades. I noticed that on some sites, they advertise USP grades and others do not. If both were 2% progesterone cream and one was USP and one was not, should we expect a difference?

Thank you,

George

Dear George,

In the United States progesterone in a cream base is classified as a cosmetic as long as the manufacturing company makes no therapeutic claims for their products. This is why most commercially produced creams are called body creams or lotions. Any claims about effects on menopausal symptoms tend to be very generalised and “grey” so as not to incur the wrath of FDA . Third party claims via websites or advertising material is at arms length from manufacturers and therefore claims often represent progesterone as being the “magic bullet” for all types of ailments.

Because of the cosmetic status of commercially produced creams adherence to Good Manufacturing Practice (GMP) is not regulated in the same way and the pharmaceutical industry and to a lesser extent the “compounding pharmacy” industry.
Labelling requirements on cosmetics is also variable and the amount of progesterone actually in a preparation does not need to be stated.

It is my experience that labelling on some preparations available in the USA can often border on deception.

USP or BP grade progesterone means that the progesterone used is of United States Pharmacopeia or British Pharmacopeia standards which is extremely high quality.

In general, a good quality compounding pharmacy will only use USP or BP standard active ingredients.

Without being able to assay the two preparations your member used it is likely that the compounded product actually has 2% progesterone USP in it whereas the over the counter may not.

Dr John Lee highlighted the variation of products on the US market in his original book (page 269-272) ‘What Your Doctor May Not Tell You About Menopause‘. He expanded on the original list in subsequent editions and books.

IN general, if a company cannot give written confirmation of the amount of progesterone in their preparation then I would have serious doubts about the quality of the product.

Another important issue in progesterone cream production is the base in which the progesterone is dispersed.
Different bases will “release” at different rates and the skin is a natural barrier to permeation of drugs. Different compounded products may vary in effectiveness depending upon the type of base used in the manufacture.
If purchasing a cream from a compounding pharmacy it is best to enquire with the pharmacist as to the type of base being utilised.

An oil-in-water base will provide a far more effective delivery system than an aqueous moisturing base in terms of achieving a systemic effect.

Best wishes

Michael Buckley