Your Complete Guide to Natural Progesterone Cream

Natural Progesterone Cream Guide

There are a few things no one tells you when they give you “the talk”…

You know the one. You were about 8 years old and someone much older explained how your body was going to go through changes and how you were going to “become a woman”. In the midst of discussing bras and tampons, no one explained how big of an impact estrogen and progesterone would have on your body.

How To Use Natural Progesterone Cream?

  1. Calculate your menstrual cycle.
  2. Decide what you want to achieve by using progesterone cream.
  3. Pick the appropriate application procedure for your situation.
  4. Apply progesterone cream twice a day.
  5. Rotate your application area between your neck, face, palms of hands/feet, breasts and inner arms.
  6. Track the effects the progesterone cream is having.

 

But who could blame them?

Most people don’t fully understand how your hormones effect your body and very few know that using something as insignificant as progesterone cream twice a day could vastly improve your chances of conceiving, reduce your PMS symptoms and ease you through menopause.

Progesterone is perhaps the most important of your fertility hormones. Low progesterone levels make it hard to get pregnant and harder to carry a baby to term. If you have a progesterone deficiency, you may be feeling quite frustrated. Fortunately, there are wonderful ways to help increase low progesterone levels such as natural progesterone cream. Using progesterone cream is a safe, effective way to fully replenish your body’s natural hormones levels and have a baby. Creams have been developed that can be applied easily and act as a supplement to your body’s own natural supply of progesterone.

Before we talk about progesterone creams we should first go over the basics and talk about…

What is Progesterone?

There are two major hormones driving your reproductive system.

Estrogen

Healthy levels of estrogen are vital for a balanced menstrual cycle and good overall health. Estrogen is primarily made in the ovaries, and in lesser amounts by the adrenal glands (which lie just above the kidneys) and by your body’s fat cells. During pregnancy your placenta starts producing estrogen as well to ensure a healthy pregnancy. It is the hormone that is responsible for giving your body the signals to build the uteral lining during the follicular phase of your cycle and that maturates the follicle in your ovaries. Both of which are vital for a healthy cycle especially if you are trying to conceive. In essence estrogen is the hormone that stimulates cell growth. However, it is this tendency to stimulate cell growth that makes it dangerous. When there is excess estrogen cell growth can increase the chances of you developing cysts, fibroids, endometriosis and cancer.

Progesterone

Progesterone is the other hormone driving your reproductive system. One of its most important roles in the body is to balance or oppose the effects of estrogen. When you have balanced and healthy levels of progesterone in comparison to your estrogen levels then it counteracts the growth effects of estrogen meaning you are less likely to have PMS symptoms and develop cysts, fibroids, endometriosis and cancer.

Progesterone is primarily realised by the corpus luteum (the follicle that contained your egg) after you ovulate, but is also produced in smaller quantities by the adrenal gland. After ovulation your estrogen levels start to decline rapidly, so the thick healthy endometrial lining that your body built up in preparation for a possible pregnancy would start to shred causing your period. It is the job of progesterone to maintain the endometrial lining of your uterus for about 14 days to give the fertilised egg (if there is one) a chance to travel down your fallopian tube and imbed itself in your endometrial lining. After 14 days your body will recognise whether or not you are pregnant and if you are your placenta will start producing the progesterone needed to sustain your pregnancy. This will prevent the shedding of your endometrial lining, preserving the developing embryo.

Why Is It So Important to Maintain Your Progesterone Estrogen Balance?

natural progesterone cream - horomonal balance

The relationship between your estrogen and progesterone levels is the most important relationship for your fertility but potentially the most important your quality of life as well. When the relationship is out of whack then it can wreak havoc on your fertility and on your body. If you take the time to get to know your body and know what you are looking for there are some distinct signs of low progesterone that you may notice.

Throughout your cycle there is a delicate dance going on between your estrogen and progesterone levels.  However when the ratio of these two hormones goes out of sync then you will likely experience some pretty nasty side effects.

  • Premenstrual Syndrome (PMS) – If you have a progesterone deficiency during your luteal phase (the 14 days before your period) then estrogen can become dominant. This can cause bloating, water retention, breast tenderness, headaches, cramps, fatigue, irritability, mood swings and anxiety.
  • Ability to Conceive – As we talked about above, progesterone is a vital if you want to conceive. Without it your endometrial lining would shred days before your period and the fertilised egg wouldn’t be able to survive. Low progesterone levels can cause what is called a luteal phase defect where the length of time after you ovulate till your period is shorter than 10 days making it impossible for you to get pregnant.
  • Miscarriage – Of all your hormones, progesterone is the most important hormone for the survival of the fetus during pregnancy. The rising levels of progesterone during pregnancy prevent the premature shedding of the uterine lining. However, if your levels drop too low it can cause a premature delivery or in the early trimesters a miscarriage.
  • Endometriosis, Fibroids, Cysts – Progesterone is the hormone that counteracts the growth effects of estrogen. However, if your progesterone levels are too low then the excess estrogen can cause the abnormal growth of fibroids, cysts or of the endometrial lining causing endometriosis.
  • Cancer – In a study published in the American Journal of Epidemiology, infertile women with low progesterone were found to have a much greater risk of breast cancer than the general population. Therefore, it is important for any woman to address a progesterone deficiency as soon as possible to avoid potentially serious long-term effects.

Why Progesterone Cream?

There are numerous natural ways to increase your progesterone levels but for this article we are going to focus on increasing your progesterone levels using a natural progesterone cream.

Progesterone can be prescribed in pill form or in the form of a cream. Oral progesterone tends to be an inefficient way of increasing your progesterone levels as upwards of 95 percent of the progesterone is lost in the liver 1. As a result doctors prescribing oral progesterone typically have to prescribe doses as high as 200mg per day to get results. In order for your body to have the amount it needs to make any real changes in your hormone balance, you would have to take too much for your liver to handle long-term.

This is why skin application is such an effective way to get progesterone into your system. Instead, the cream can be applied twice a day to the skin which then gets absorbed into the underlying fat where it is slowly released into the bloodstream over the course of a day, thus mimicking the body’s natural use of the hormone. This method of administration helps the body create its own “time release” feature, only releasing progesterone when it is necessary.  2

Is Progesterone Cream Safe?

Progesterone cream is made of the same progesterone hormone found in your own body. It is nearly impossible to once off overdose on progesterone. During the third trimester, the placenta produces about 300 mg of progesterone a day – more than you can get in a whole jar of progesterone cream 3. However, prolonged overdosing can have negative effects on your body. since progesterone can be stored in your fat, levels steadily increase with prolonged use of a progesterone cream. It therefore becomes essential that you follow your doctor’s recommendations in order to avoid having elevated levels of progesterone when you do not need them.

Always consult a doctor before beginning progesterone therapy and discuss your past medical history. If you have a history of liver disease, hepatitis, abnormal vaginal bleeding, or jaundice during pregnancy, you should not use progesterone creams. For women who are not trying to conceive, extra caution should be taken if you are also taking an oral contraceptive or cortisone.

Side Effects: What to Expect When Using Progesterone Cream?

Symptoms will vary from woman to woman. Some women start progesterone supplementation and suddenly everything feels wonderful. For others, the first 10-14 days are a roller coaster, complete with motion sickness. For many women, estrogen dominance actually gets worse when they first start using natural progesterone cream. When a body that has been deprived of progesterone is first reintroduced to the hormone, the estrogen receptor sites go crazy, making the estrogen reactive for a short time. While you may have breast tenderness, spotting, hot flashes, fatigue and nausea, this is actually a good thing since the body is responding to the progesterone. These symptoms should go away as the body readjusts, usually within a few months 4.

Generally, high doses are given during the first 8 weeks of therapy in order to override estrogen dominance and to allow the body to store the progesterone in your fat cells before becoming fully effective. Your body will adjust over 3 menstrual cycles or 3 months if you are menopausal. If you fail to notice any benefits after 3 months, consult your doctor for further testing. Women who are trying to conceive should allow at least four months to help them get enough progesterone and prevent miscarriages.

Severe progesterone deficiency may require longer supplementation with progesterone cream in order to increase the desired progesterone level. In women with very low progesterone levels, it can take anywhere from 4-12 months to begin noticing a difference.

Who Should Not Use Progesterone Cream?

Some women, however, should not use the cream. Those with a history of gestational dermatosis of pregnancy or jaundice of pregnancy should not use this cream. The same is true of those with severe active liver disease and diseases, such as hepatitis and rotor syndrome or Dubin-Johnson syndrome. You should also not use the cream if you have unexplained/abnormal vaginal bleeding or have experienced any kind of reaction from using the cream in the past. Consult with your doctor before starting any treatment regimen.

Guide to Using Progesterone Cream

 

Where to Apply Progesterone Cream?

The best places to apply natural progesterone creams on your body are places that get lots of blood flow via your capillaries. This includes your:

  • Palms of hands and feet
  • Inner arms
  • Breasts
  • Neck
  • Face

You can tell which areas have capillaries by noting where you tend to blush, such as on your cheeks. Avoid putting progesterone cream on fatty parts of your body. Remember, fat stores progesterone, rather than letting it into the bloodstream so more fatty areas will store more progesterone rather than allowing it to be used.

With prolonged use of progesterone on one area can cause that area of skin to saturate, reducing the absorption of progesterone. So to help the absorption of the progesterone you should spread it on a large an area of skin as possible and rotate the areas where you apply the cream each time you use it so one area doesn’t become saturated. I would recommend that you rotate amount 3 or 4 different area on different days.

How to Apply Progesterone Cream

When it comes to dosage, more is not better. Just like too little progesterone can cause a hormonal imbalance, too much can do likewise. Always follow your prescribed dosage instructions. For women who have had months or years without ovulation cycles, a loading dose may be prescribed. Every cycle without ovulation can make estrogen dominance worse as progesterone stores are depleted. A higher dose of progesterone for the first four to eight weeks may be prescribed as a “loading dose” to help replenish the progesterone stores that were lost in the body. After that, a regular dose will be prescribed 5.

The optimal approach is to apply the cream in two doses, once in the morning and once before you go to bed. Progesterone cream only allows for 8-12 hours of sustained delivery. If you apply it all at once, there will be 12 hours of time where you are not receiving any hormone at all. By splitting the dosage in half, you are making sure you have sustained delivery, all day and all night.

Getting the amount of cream to be exactly right isn’t that important, because when you apply the cream to the skin it doesn’t get immediately absorbed into the body. Your body fat acts as a buffer, which realises the progesterone evenly throughout the day even if your dosage varies daily.

The general rule for dosage is that you should use the least amount of cream as possible that will ensure your symptoms are cured. Most premenopausal women need only 15-20mg of progesterone cream during the days she is supposed to apply it. This is about how much progesterone your body produces during luteal phase if it was producing the normal healthy amount. However, some women might use up to 40mg on a recurring basis and 80mg during a loading phase (if it is necessary).

Which Progesterone Cream Should I Use?

You should stay away from higher dosage creams as they can make it easier to over dose your body with progesterone. A higher dosage cream is a cream containing 10% progesterone. This means that a ¼ teaspoon would contain about 100mg of progesterone.

Instead, I would recommend that you use a lower dosage cream which contains about 1.5-2% progesterone, or 10 to 20mg per every ¼ teaspoon of cream. It is still possible to over dose with a lower dose cream put it is harder to do.

You Need to Cycle Your Usage

Progesterone is a cyclical hormone. This means that the amount of progesterone you have in your body varies throughout your cycle. Your body produces very little progesterone in the first half of your menstrual cycle (the days between the start of your period and the day of ovulation).

That means in order for your body to successfully use progesterone it gains from the progesterone cream you apply, it has to see a change in the concentration that will match your natural changes in progesterone. Or else you have to use it in a specific way that will help repair your hormonal imbalance.

Your doctor will give you detailed instructions about when in your menstrual cycle to use progesterone cream. Your instructions for applying the cream will vary depending on what underlying condition you are trying to treat with the progesterone cream i.e. trying to conceive, PCOS, PMS, perimenopause, etc. We will go through the usage guidelines for each next.

Calculate Your Menstrual Cycle

To use progesterone cream effectively you need to apply it at the right times of your cycle because if you don’t it could stop you ovulating for that cycle. To determine the correct day to start applying progesterone cream you note the first day of your next expected period and count back 14 days. This is the day you should start applying the progesterone cream.

However to be more accurate and to see if the progesterone cream is working you should track your cycle using basal body temperature (BBT) tracking. This is especially important if you have irregular cycles. Tracking will allow you to accurately pinpoint when you ovulated and see how the progesterone cream is increasing your progesterone levels. As BBT tracking tracks the temperature shift that occurs because of the release of progesterone after ovulation. If you start experiencing a stronger and longer temperature increase then you know the progesterone cream is having an effect.

Guide to Progesterone for Perimenopausal & Menopausal Women

natural progesterone cream - menopause 

Who Is This Guide For?

This guide is for women who are going through perimenopause or who have gone through menopause and want to relieve the symptoms of her hormonal imbalance.

Why Would a Perimenopausal or Menopausal Woman Need Progesterone Cream?

Age is inevitable. Between the ages of 35 and 50, a women’s hormone levels begin to change dramatically. During this time, until age 50, estrogen levels will drop 35 percent. However, women will also experience a 75 percent drop in progesterone levels over the same time period 6.

In fact, estrogen levels only drop by 40-60% at menopause, just enough to stop your menstrual cycle. However, progesterone levels drop to near zero. But in the ten to fifteen years before menopause, many women regularly have anovulatory cycles 7. This means they make enough estrogen to menstruate, but they don’t ovulate and end up having estrogen dominance. And what does estrogen dominance create? Mood swings, hot flashes, irritability, nausea, headaches… all of the classic PMS symptoms only worse.

How to Use Progesterone Cream When In Perimenopause

If you are in menopause you should apply progesterone cream twice a day for a maximum of 25 days per calendar. Then take a five-day break, and continue with the application of the progesterone cream. You should apply between 10-12mg of progesterone cream a day which would be a 1/8 teaspoon of cream from a 1.5-2% progesterone cream. You should be getting at least 3 months from a two ounce tub of cream.

How to Use Progesterone Cream When In Menopause

Perimenopausal women should follow the similar instructions as an ovulating woman trying to conceive. You should sync the application of progesterone cream with your natural cycle as much as possible. This means that you should start applying progesterone cream on day 14 of your cycle (or the day after you ovulate) and continue to apply cream until day 28. Once you stop applying cream your progesterone levels will drop which will encourage your menstruation to begin. You should apply between 20-40mg of progesterone per day (between ¼ and ½ teaspoon per day) and split the dose up between morning and night to ensure a constant release of progesterone.

Guide to Progesterone Cream if you are Trying to Conceive

natural progesterone cream - trying to conceive

Who Is This Guide For?

This guide is for women who are trying to conceive and ovulating normally but they have low progesterone. The purpose of using progesterone cream is to increase your progesterone levels if they are low in comparison to your estrogen levels. This should help you reduce your PMS symptoms, have a healthier pregnancy and reduce the chances of miscarriage.

How to Use Progesterone Cream When Trying to Conceive

This guide uses the example of a 28 day cycle with ovulation occurring on day 14. When using progesterone cream when you are trying to conceive you want to try and mimic your natural cycle. So you should only be applying cream on the days that you should naturally produce progesterone.

  1. Support Your Cycle: To help your body have a healthy and balanced menstrual cycle, you should start using progesterone cream on day 14 of your cycle (day of ovulation) and continue until menstruation begins. When you stop using the cream, your progesterone levels will naturally drop, helping you start a menstrual cycle. Count this day as day 1 and resume progesterone cream on day 14. This will help increase your progesterone levels from day 14 to day 28 which will help counteract any estrogen dominance that might have been making it harder for you to get pregnant.
  1. If You Get Pregnant – Each cycle you should stop using natural progesterone cream only when you have confirmed you are not pregnant on day 28, either with a home pregnancy test or the start of your period. This means if you are trying to get pregnant while using progesterone cream you should continue it until you have definitely confirmed you are not pregnant. If you are pregnant then don’t suddenly stop using the progesterone cream as the drop in progesterone could cause a miscarriage. You should request a progesterone level test from your doctor before discontinuing progesterone cream use. Your practitioner will then be able to tell you where your levels are and what dosage (if any) you need to use. If your doctor sees that your body is producing progesterone on its own, you will likely wean off the cream over a week, using less each time you use it (8).

Dosage

For women who have had months or years with very low progesterone levels, a higher dose of progesterone for the first four to eight weeks may be prescribed as a “loading dose” to help replenish the progesterone stores that were lost in the body. After that, a regular dose will be prescribed. For instance:

  • Loading dose: 80mg twice a day, one 40mg application in the morning and one 40mg application at night, for a total of 80mg of natural progesterone a day. Apply for two weeks before your period (about day 14 in the cycle), up until menstruation begins.
  • Regular dose: 20mg twice a day, one 20mg application in the morning and one 20mg application at night, for a total of 40mg of natural progesterone a day. Apply for two weeks before your period (about day 14 in the cycle), up until menstruation begins.

What If I’m Undergoing a Fertility Treatment (IUI, IVF, etc.)

If you are preparing or undergoing IUI, IVF, or any other fertility treatment method you shouldn’t use progesterone cream without having it completely cleared with your doctor. In the case of IVF you are prescribed a very specific hormonal protocol which is designed to prepare your body for IVF. If you start using progesterone cream without getting approval of your doctor who is managing your treatment then the extra progesterone cream can play havoc on your hormones. If you are thinking of using progesterone cream, speak to your doctors first.

Guide to Progesterone Cream If You Are Trying to Conceive (with PCOS or Anovulatory)

 natural progesterone cream - trying to conceive - pcos

Who Is This Guide For?

This guide is for women who are trying to conceive but have PCOS or who aren’t ovulating on a regular basis. You can have regular menstrual bleeding but not be ovulating.

How to Use Progesterone Cream When Trying to Conceive (with PCOS or Anovulatory)

If you are not ovulating or have PCOS, using progesterone cream can reset your menstrual woman’s cycle and get you ovulating again. It might sound counter initiative what I’m going to tell you but bear with me. If you aren’t ovulating your body doesn’t just turn off your ovaries. Instead each cycle your ovaries ramp up the production of estrogen for ovulation but when it doesn’t occur a signal is sent to your ovaries to try harder. This causes your ovaries to double down and produce even more estrogen, which can repeat for a number of cycles. This puts huge pressure on your ovaries and can wear them out.

If you have PCOS and have every tracked your cycle you may have noticed the symptoms. You would have noticed repeated periods of fertile cervical fluid and positive OPK results in one cycle. Then because of the amount your endometrial lining had grown as a result of the large amounts of estrogen being produced, you have a very heavy period when it finally comes.

So if you are anovulatory, we will use progesterone cream first to establish a healthy cycle by purposefully preventing ovulation. This will give your ovaries a break and a chance to recover. Here are the steps you will have to take. 

  1. Establish a Cycle (Suppression Cycle). To help your body create a menstrual cycle, you would use progesterone to suppress ovulation for 2-4 months depending on your personal circumstances. To suppress your cycle you will apply cream from day 7 to 26 of your cycle. When you stop on day 26, your progesterone levels will naturally drop, helping you start a menstrual cycle. If your cycle does not start, begin counting anyway and resume progesterone cream on again day 7. A surge of progesterone prior to ovulation can make the ovaries think ovulation has already occurred, thus inhibiting actual ovulation. This gives the body a chance to rest and reset thus enhancing fertility 8.
  1. Support Ovulation. After 2-4 months you will then use progesterone cream to cause a strong ovulating. Using an ovulation test or BBT tracking begin applying progesterone cream at the time of ovulation – roughly day 14. This usually occurs 2 weeks before your period is due. After resting your ovaries for 2-4 months you will then have a very strong ovulation. At this point, you are simply topping off your body’s progesterone levels prior to pregnancy. However, do not stop using progesterone cream until pregnancy has been confirmed by your doctor 9 or you get your period as a sudden drop in progesterone could cause a early miscarriage.
  1. Consult Your Doctor About Continuing Progesterone Cream. It is important to request a progesterone level test from your doctor before discontinuing progesterone cream use. If you stop using natural progesterone cream, your progesterone levels are at a risk for dropping which could lead to miscarriage. Your practitioner will then be able to tell you where your levels are and what dosage (if any) you need to use. If your doctor sees that your body is producing progesterone on its own, you will likely wean off the cream over a week, using less each time you use it 9.

Dosage

For women who are anovulatory or who have PCOS a higher dose of progesterone for the first four to eight weeks is often prescribed as a “loading dose” as the fact that they aren’t ovulating will result in them having very low progesterone levels. This loading dose will help replenish the progesterone stores that were lost in the body. After that, a regular dose will be prescribed (9. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p127-129). For instance:

  • Loading dose: 80mg twice a day, one 40mg application in the morning and one 40mg application at night, for a total of 80mg of natural progesterone a day. Apply for two weeks before your period (about day 14 in the cycle), up until menstruation begins.
  • Regular dose: 20mg twice a day, one 20mg application in the morning and one 20mg application at night, for a total of 40mg of natural progesterone a day. Apply for two weeks before your period (about day 14 in the cycle), up until menstruation begins.

Guide to Progesterone Cream During Pregnancy

natural progesterone cream - pregnant

Who Is This Guide For?

This guide is for women who are pregnant and who either used progesterone cream to conceive their baby or whose doctor has encouraged them to use progesterone cream.

How to Use Progesterone Cream When Pregnant

The thought of using a product that contains hormones especially progesterone is probably the scariest during pregnancy. The last thing you want to do is to do something that could harm your baby. You are not alone, I hear women expressing this exact concern the whole time.  So here is a guide that tells you exactly how much progesterone cream you should use during each week of your pregnancy:

  • Ovulation to Week 5 (40mg per day): You should apply 20mg once in the morning and 20mg once in the evening. This would be about a ¼ teaspoon of cream for both.
  • Week 5 through Week 10 (60mg per day): You should apply 30mg once in the morning and 30mg once in the evening. This would be about 1/3 of a teaspoon of cream for both.
  • Week 11 through Week 20 (80mg per day): You should apply 40mg once in the morning and 40mg once in the evening. This would be about 1/2 of a teaspoon of cream for both.
  • After Week 20 (Stop Using Progesterone Cream): If you are pregnant you should wean yourself off the cream very carefully, especially if you used it to get pregnant. It is generally recommended that you don’t stop using it until week 20 of your pregnancy as this is when your placenta starts to take over the production of progesterone. After this point your miscarriage risk is much lower as the placenta is producing large amounts of progesterone but you should wean yourself off of it by using less and less of it over the course of a week or two.

Summary

Progesterone creams are a great way to increase your progesterone levels if you they are low. They can quickly cure any PMS symptoms you might be experiencing and even help you get pregnant. If you think you are showing signs that you have low progesterone and are considering using a progesterone cream you should take a progesterone saliva test first to see what your levels are. Then if you confirm that your levels are low you can start using progesterone in the ways outlined above based after consultation with your doctor.If you would like to find out more about progesterone cream, you should check out Dr. John Lee’s Horomone Balance Made Simple.

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karenkohut
This article has been reviewed by Dr. Karen G. Kohut, MD to ensure all information presented is medically accurate. Dr. Kohut graduated from the Mount Sinai School of Medicine in 1989. She works in Los Gatos, CA and specializes in Obstetrics & Gynecology.

 

References

All facts and information provided in this article has been researched using biomedical, scientifically reviewed literature from sources such as MEDLINE and the National Center for Biotechnological Information (NCBI). We have tried to incorporate a variety of scientific perspectives to provide you a comprehensive and unbiased overview of current knowledge in the field.

 

  1. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p106
  2. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p117
  3. Lanfond, J, 2012. Pregnancy Disorders and Perinatal Outcomes . 1st ed. United States of America: Bentham Science Publishers. p50
  4. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p110-115
  5. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p127-128
  6. Progesterone – The Almost Forgotten Hormone. 2016. Progesterone – The Almost Forgotten Hormone.
  7. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p127
  8. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p126-130
  9. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p126-130
  10. Lee, J, 2006. Hormone Balance Made Simple. 1st ed. United States of America: Grand Central Life & Style. p126-130

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