Prometrium vs. Progesterone - what are your experiences?
Question posted by Snotori on 11 June 2012
Last updated on 22 November 2021 by RickiJR
I was on Prometrium for several years and switched to the generic Progesterone when it came available a couple months back. Now I'd totally swear by Prometrium cause it worked for me and as far as side affects go there were 2 and they weren't that bad and only lasted a couple hours after I took the pill so I took it at night and everything was fine. Progesterone however I've taken for 2 months now and it doesn't work exactly like I'd hoped and the side affects are well let's just say I stopped counting almost. I'm dizzy almost all day and don't get me started on it messing with my sleep. My nails were never anything great or long but on Progesterone they grew weak and can't stand up to anything so they break off all the time. I want to know other people experiences with Prometrium vs. Progesterone and if I'm the only one who's considering switching back.
And before anyone smartalecly points out that Prometrium is actually progesterone... I'd like real answers. We all know it's all progesterone I'm talking the names of the meds not what they are made of.
The information on this page reflects personal experiences shared by our community members. It is not reviewed for medical accuracy and should not replace professional medical advice.
33 Answers
RI
RickiJR
22 Nov 2021
I have been on brand name Prometrium for 12+ years... and then my insurance wouldn't cover the cost or even partially... so... I, not expecting a problem, started the generic. The generic didn't work so I was forced, each month, to do the extensive paper work involved to get the brand name. Then, for years more I've been taking the brand and all was going well. My pharmacy closed and I was forced to find another mom-and-pop (will not fill an rx at a CVS or other big chain) pharmacy. I called about 6-7 within the county I live and none seem to carry it nor will stock it. I know it's very expensive but I'm willing to spend the money. There IS a difference between the two. I live in Westchester County, N.Y. does anyone have an idea where I can get the meds? Taking the generic made me feel weird and I bled.
Votes: +0
CL
cleverwabbit5
27 Feb 2020
Watson was bought by Activus who is now owned by Teva, so the Teva and the Activus generic are now the same. So the other choices are Akron or Virtus for generic. I have read terrible things about the Teva generic, what has been anyone's experience with Akron or Virtus?
Votes: +1
DI
dianekjs
12 April 2017
If your generic says 100% USP progesterone, it is bioidentical progesterone. And yes, the inactive ingredients can vary and some people may notice or react to these differences.
Votes: +0
IJ
Ijb
13 April 2017
But my generic does not say USP on it, yet the chemical formula is identical.
I have done some research on USP and all I can find on it is that it stands for United States Pharmacopeia, which means it adheres to high quality. However it is not as frequently printed on the labels as in the mid 1900s, since today all medicine needs to adhere to the USP standards. I have not found anywhere that it means bio-identical? Would love to know where I can find that info! :-)
DI
dianekjs
13 April 2017
If it says 100% progesterone, it's considered bioidentical. The body makes progesterone naturally, but it can also be produced in a lab. Synthetic steroid/hormones with progesterone-like properties are called progestins. The USP designation is probably stamped somewhere on the packaging received by the pharmacy but may not be on individual bottles. You can call and ask the pharmacist, but if it says 100% progesterone, that is bioidentical and you should be fine (unless the inactive ingredients don't happen to agree with you).
IJ
Ijb
12 April 2017
I wish I could edit my posts so I don't have to keep posting!
I just compared the formulas and ingredients for TEVA, Virtus and Prometrium on dailymed.nlm.nih.gov, and aside from inactive ingredients, they are exactly the same. So if you feel different on one progesterone vs another it is likely one of the inactive ingredients.
All the three drugs had this identical description "... an oral dosage form of micronized progesterone which is chemically identical to progesterone of ovarian origin. The oral bioavailability of progesterone is increased through micronization."
So it is safe to say that the generics are not a synthetic form of Prometrium, but are identical to it.
Votes: +0
CL
cleanne9877
1 Aug 2017
I started on hormone therapy last year and have tried many different brands. The first was Prometrium through CVS, I had never felt better. I moved to another state and didn't really notice when I went to refill the prescription through the same pharmacy that I was given the TEVA brand. Almost immediately, I noticed the sleepless nights, upset stomach, hair falling out, spotting, etc. I went to the pharmacy and spoke with the pharmacist and he said that was the brand they carried. I decided to switch to my insurance carriers home delivery service (Kaiser Permanente) they sent me the Virtus brand. The side effects I was experiencing went away. I switched insurance carriers and then needed to find another pharmacy so I went to the phones and called several pharmacies. Every pharmacy carries a different brand. I went with Walgreens which is a bionpharm brand.
My hair is back to falling out, sleepless nights, I've gained a few pounds despite not really changing my diet or exercise. I called United Healthcare (my new ins. co) for home delivery, they can't guarantee the brand because they say they are constantly changing them. I called my Walmart neighborhood pharmacy and they are using Virtus. To Walmart I go!
IJ
Ijb
12 April 2017
So, I am still not convinced that a generic can be a synthetic copy of a bio-identical progesterone. The active ingredients should be the same, and there is a very, very big difference between bio-identical and synthetic. I guess the trick would be to call the generics and ask them. In the meanwhile I have found that Walmart sells the Virtus brand. My understanding through this forum is that Virtus is as close to Prometrium as you can get. In my town Prometrium without insurance coverage is about $160 for thirty 100mg capsules.
Votes: +0
IJ
Ijb
11 April 2017
I am really confused. How can Prometrium be a bio-identical progesterone while Teva is a synthetic progestin? Should the main ingredients not be exactly the same? I am about to finish my prescription and am wondering whether to switch from Teva to the more expensive Prometrium.
Votes: +0
DA
danalouise
11 April 2017
From my experience the more expensive Prometrium is well worth the extra money. My health plan switched that only allowed me the genetic brand was on it a month and all my symptoms came back almost overnight. I have been on Prometruim for almost 6 years and when I first started taking it noticed a difference in my hotflashes , joint pain, etc within a week. The genetic did nothing but cause these to reappear along with upset stomach. I am paying the extra well worth keeping my sanity.
LE
lewandot5
16 June 2018
My mom swears the Virtus Prometrium makes her feel better than their generic progesterone but the pill is identical and now the price of the Prometrium skyrocketed from $400 for 90 day supply to $1500 which she can't afford long term and her insurance won't cover the name brand. Does anyone know if these products by the same company are the same, fillers and all? If different is there is a way to get insurance to cover the name brand?
BI
bitab
17 March 2017
I changed from Prometrium to generic progesterone and my Migraine came back after 42 years. As soon as I switched back to Promethium my Migraine was gone. They are nothing alike.
Votes: +1
HE
healthykathy
15 March 2017
I started on Progesterone in October and it was by a manufacturer called Akorn. I was taking it for menopausal symptoms. It worked very well. My sleep was back to normal: sleeping all night. My hot flashes decreased from 18 per day to zero and I had many other things improve including motivation, energy and outlook which made it easy to loose the 25 pounds which took me down to my weight in my 20's. My insurance company wanted me to change pharmacies and so I did in March. When my prescription was refilled it was by a different manufacturer, Teva. I checked that it was the right pill just different color and shape but after each dose I began to have more and more side effects or poor results that included: difficulty getting to sleep, waking up at night, hot flashes, changes in urinary habits and bowel habits, spotting, balance problems, flaking and weak fingernails, headache, eyelashes falling out and weight gain. I talked to two pharmacists who were not surprised to hear my description and my prescription was then filled with the product by Akorn. My unwanted symptoms began to subside after one dose of the Akorn brand.
Votes: +0
DA
danalouise
15 March 2017
Sounds like almost the same symptoms as me . Since i have switched back there has been a huge difference... hmmm wonder if that was why in a matter of months there was an increase in my weight just overall puffy looking with not changing anything in my diet and always being active. I threw out the Teva and started back with the one I have been on for 6 years made by Merck Canada. Feel a lot better but still having joint pain. Not worth the switch it's like I'm back at the begining.
DA
danalouise
21 Feb 2017
I also was on Prometrium and about 2 months ago my health insurance switched and only paid for the Teva Progesterone (Generic Brand). I have since have had terriable dry mouth, upset stomach, Dizzy, Overall my hot flashes have returned. I was wondering if anyone else has had the same symptoms. Also have noticed a small rash that will not go away on my chest and stomach area. After reading your comments I have to agree that it is the switch to the generic brand, I am switching back to Prometrium to see if these symptoms will clear, and am paying the extra on the coverage. Was wondering if anyone switched back and found a difference. Any info would be appreciated.
Votes: +0
CN
cnsj
24 Jan 2017
I started taking Prometrium 100mg and estradiol 1 mg about 16 years ago. I have had no side effects and feel great. I had lots of menopausal symptoms before I started taking these medications. At the time, my doctor, who has since retired, emphatically told me never to switch from the brand name Prometrium, he said not to take the generic. I never asked why or maybe I can't remember what he said. My insurance now will not cover Prometrium so I am paying out of pocket. However, I am still following his advice and your experiences give me further reasons to do so. I am glad that I found your posts.
Votes: +0
GI
giraffenut
12 Nov 2016
I believe that prometrium is a "natural" form of pregesterone, which was given to me 10 years ago for post menopausal bleeding but progesterone is a synthetic form. The prometrium has worked great, and I was told that I had to take prometrium because I also have clinical depression and it does not make that worse. I just noticed that on my last prescription, they switched me to progesterone, and I have been having some dizziness I didn't have before and my depression has increased. I am off to the drug store and will call my doctor on Monday.
Votes: +0
LJ
LJE01
5 Oct 2016
I wanted to post an update on generic Watson/Actavis progesterone who owned the license to make generic Prometrium using the exact same formula. Teva, Akorn, and other generics are forced to change the "additives" while supposedly using the same amount of micronized progesterone. In all cases, it is supposed to be the same dose of micronized progesterone in a base of peanut oil in a gel cap.
Why these other generics do not work for many women including myself, when they supposedly provide the same active ingredient in the same dose (micronized progesterone) is beyond me, but this is in fact the case for many of us. So apparently it is the additives that make a dramatic difference in effectiveness for some of us. This makes no sense. I can't help but wonder if these other pharmaceutical companies are altering the dosage or perhaps they are using a cheaper, sub-standard active ingredient (micronized bio-identical progesterone).
Actavis (who took over the generic Watson line and for a short time made the same formula as Prometrium) eliminated generic Progesterone from their line up last April, 2016.
So I searched for who else was making the pill identified as SV (or specifically SV2 in the case of 200 mg which is what I take 2-3 times per week for severe hot flashes associated with menopause). Using the pill identifier is the only way of knowing you are getting either Prometrium or its identical generic - both use the SV identifier. All other generics are forced to use their own pill identifiers.
My local Walmart helped me by looking in their data base for SV2 and discovered it is now made by Virtus Pharmaceuticals. They were able to order it for me. I ordered a 90 day supply to stock up since it took me two months to find the latest true Prometruim generic.
The gel caps look identical to the Watson/Actavis/Prometrium pills and contain the SV2 ID, however they are not working the same. I have to take them nightly instead of 2-3 times per week, and even then my hot flashes have returned, albeit mildly. I also discovered a foul smell in the capsule bottle. I opened a capsule and it seems fine, but the smell when I first open the bottle is overwhelmingly bad! Granted, I have never had a bottle filled with 90 capsules so the smell might be stronger than a 30 or 60 capsule bottle - but still, it is hard to describe how bad these smell!
There is no expiration on the bottle I received so I wonder if these are old pills, and thus why they are also not working.
I will take them back to the pharmacist to see what they think.
Has anyone noticed any foul smell from their Prometrium? And has anyone used the Virtus generic? The Virtus now only cost me about $25-30 per 30 caps using the GoodRx discount coupon at Walmart. Watson used to cost close to $50 per 30 caps because only Walgreens sold this brand. (Walmart also wells Teva and Akorn generic for $25-30. All their generic progesterone is the same cost.) I'd love it if the Virtus worked. Otherwise I'll have to switch to Prometrium which could be as high as $200 for the 200 mg SV2.
Votes: +1
SU
Supersensitive
5 Oct 2016
I have had the same experiences as you regarding the Watson /Actavis generic being the only generic I liked. I am also as of this month unable to reorder this brand. Rite aid was able to order it for me but will also switch to Virtus based on the pill reference photo as you mentioned. I have to be proactive and investigate to try to get my pills as cheaply as possible. I take the 100 mg every night and will let you know what I think. I am very drug sensitive and I experienced headaches and first ever spotting with the Teva brand. To me that would indicate a weaker formulation but perhaps the body would eventually adjust? I don't take many medications so would rather take name brand and pay. I also had difficulty with the Mylar brand of Vivelle dot. My husband finally told me after 3 weeks that it made my breath smell bad and weirdly metallic. Yech. What's up with that? So I went back on Vivelle and cut the 100 strength patch in half to save $.
My next step if the Virtus does not work is to maybe try a Canadian pharmacy online. My next refill will be available in about 3 weeks so it will take time to see how I feel but will again let you know. Weird about the funky smell!
LJ
LJE01
5 Oct 2016
Thanks for your experiences with generic progesterone. I hope the Virtus works for you -- it IS supposed to be the exact same as Prometrium (like Watson/Actavis was).
I already looked online for a Canadian pharmacy and couldn't find real Prometrium, only generic - and the price was really expensive. I even checked France. They have completely different generics and I couldn't tell which was which. I originally purchased micronized progesterone from the UK without a prescription and it worked great but the 200 mg cost about $125 for 30 caps with shipping.
You mentioned cost... Just a note that I also tried 100 mg every day and learned it worked as well as 200 mg every-other day (sometimes even every three days!). The cost was cheaper getting 200 mg taking it less often so this was the driving factor. I also signed up with Goodrx.com and get excellent discounts off retail cost. But they do not seem to offer a coupon for the name brand Prometrium, only generic progesterone. Bummer!
Please let me know if you find Prometrium online for a good price. I might be going this way. Or perhaps, if you say the 100 mg works as good then I might give that dose a go.
Thanks again!
SU
Supersensitive
5 Oct 2016
I will definitely let you know what happens for me with Virtus but as I said it will take a little time. Like a canary in a coal mine, my body can detect an inferior generic a mile away! Thank you so much for sharing your experiences and info and I will also let you know about Canadian pharmacies if it comes to that. Best to you
CH
ChaCha25
17 Oct 2016
I'm glad you posted this about your experience with the Virtus brand because I've been doubting myself. I've been taking the Akorn generic all year with no problems. I was recently given the Virtus "SV" generic and started waking up in the night (one of my main pre-progesterone problems). I also had spotting and some nausea, which might not be related. The only other time I've woken in the night this year was once when I forgot to take the progesterone before bed. I still have some of the Akorn pills left, so I was able to go back on those for 1 week (sleep problem eliminated) and then try the Virtus brand again - and the same thing happened.
I'm doubting myself because the Virtus pills are supposed to be like the brand name, and it seems like those should work the best - but maybe it does have to do with the inactive ingredients somehow? The pharmacist said that if someone is very sensitive to hormones then they could have a different response from different inactive additives. Last year I took the Teva generic for around 6 months - that was when I first started progesterone. There was some improvement but not elimination of my sleeping and other problems. I have been attributing the elimination of the insomnia and other problems to starting the Vivelle Dot estrogen patch in January, but now I am seeing that I also got switched from Teva to Akorn progesterone in January so that makes me wonder??? I take 100mg every night. P.S. I just stuck my nose in my bottle of 90 Virtus pills and they did stink. I never tried smelling the Akorn brand so I don't know if it's just the Virtus that stink. The only other thing I noticed with the Virtus is that the "SV" on the pills is not the same size on all my pills - some big, some small. I suppose the pharmacy could have taken it from 2 different bottles. I'm getting paranoid.
SU
Supersensitive
22 Oct 2016
Hello again, I picked up my Virtus brand prometrium a few days ago. I still have several bottles of the Actavis brand generic so did a smell comparison for you. Each bottle smells fishy. All three of them. Must have been the amount of pills that made you notice as you thought might be the case. So far so good ! I will let you know in a few weeks how I am feeling and my conclusions.
SU
Supersensitive
5 Nov 2016
I have been on the Virtus brand now for 17 days. This is usually long enough for me to determine the effects of a new drug. I can say that I thankfully notice no difference between the Watson/Actavis brand prometrium and the Virtus. And of course you already know they have the same markings and are virtually impossible to tell apart by looking at them. As you may recall, I could not tolerate other generics of this medication. I feel these are indeed the exact same pills as provided by the name brand makers of Prometrium. I hope you find my observations helpful to you and try again to take the Virtus brand. Best to You
I just started micronized progesterone last week. I'm irritable, hungry, and feel like I've been working out hardcore - the backs of my legs and my neck muscles are screaming at me! I just want to sleep. I hate it.
I've taken compounded progesterone in the past and it worked lovely for me. It was essentially my happy pill. For the first time in over a decade, my period was literally a 30 day cycle. No negative side effects at all.
I will note that I carry both of the MTHFR genes which can cause issues when absorbing pills. My inability to break down folic acid resulted in my child being born with a tongue tie and both lip ties. I should have taken folate. Perhaps this is my difference.
I'm going to request a change of prescription on Wednesday.
Votes: +0
NA
natolie
17 Aug 2016
Actually, it is NOT all progesterone. Many of the generic versions are progestins (which are NOT the same as progesterone) and synthetic. Prometrium is real progesterone, because it is bio-identical which means it is exactly identical to what your body makes. Your body cannot tell the difference. If you want to be sure your progesterone is bio-identical look for "USP" in the name or on the label some where. That is what guarantees it is bio-identical. You will notice it's Prometrium (Progesterone USP) on the box. If getting a generic version, ask the pharmacist to either show you the original bottle or to verify for you it is Progesterone "USP". Micronized Progesterone is another term to insure it is bio-identical, because it is the micronization of the progesterone that makes it bio-identical
Synthetics are dangerous, cancer causing, and are not recognizable by the body as progesterone, therefore, it does not and cannot relieve the symptoms you are seeking relief from, and more often than not, causes additional unwanted side effects. Synthetic estrogen and progestins wreak havoc on the body. It may be the same for testosterone and other hormones as well, but I haven't done much research on other hormones. However, I have done a TON of researching progesterone and estrogen. I have used Progesta-Care progesterone cream with wonderful results as it is USP. I also just picked up my first script of bio-identical generic compounded progesterone capsules today, since the doctor feels like I need a higher dose than the cream provides.
I hope this helps you understand why you were so miserable on the generics at the time you were taking them. :-)
Votes: +0
LU
Lucylu16
2 Sep 2016
I've been reading all through these posts and still have a question and hope someone can help. I started on generic progesterone (bioidentical) last month. It made me feel awful. So then I switched to compounded progesterone. I feel better but still side effects such as: weight gain around middle, bloating, severe headaches every morning, constipation. I do sleep well and I feel pretty good for the most part. My main concern is I always feel bloated and constipated. And the weight gain is scaring me.
So my question is this: If I switch to brand name Prometrium, does anyone think this will help my bloating, constipation and weight gain? Has anyone had the same experience? I feel like I'm losing my shape and no matter what I eat or don't eat it just doesn't help! I thought progesterone would help reduce bloating and help me lose a little weight. What are the main differences between compounded progesterone (which I am on now) and the brand name prometrium? I am taking 200mg per day and was on generic progesterone for 2 weeks and have now been on compounded progesterone for 2 weeks. I'm also on estradiol/testosterone cream.
NA
natolie
2 Sep 2016
Lucylu16, in all of my research, it is my understanding that progesterone alleviates those symptoms and estradiol is usually the cause of those symptoms. If I may ask, what is the reson for taking all 3 progesterone, estradiol, and testosterone? My common sense is telling me that maybe you shouldn't be taking estradiol as most womean are estrogen dominant, but of course I am no doctor and surely am not familiar with all conditions, so my ignorance makes me curious.
LU
Lucylu16
3 Sep 2016
Hi Natolie, I tried to leave my response under the one I'm responding to but it put me here.
Anyway, I'm taking estradiol, testosterone and progesterone because I'm experiencing perimenopause. They are all bioidenticals and just trying to get my hormones back to normal levels because they start dropping in women in the mid 30's. I'm 46. I am feeling a lot better but I think it's just a matter of getting the dosages and hormone levels figured out.
As for the question I had about the progesterone, I finally got the bright idea to pick up the phone and call my pharmacist! ha! So he told me that the compounded progesterone is time released and the prometrium is not time released. This is the biggest difference. He said it should help me sleep better since it takes about 6-7 hours to release in the body while prometrium is released all at once.
LU
Lucylu16
3 Sep 2016
... so after i posted my last message i see it did indeed put it in the right spot!:)
NA
natolie
3 Sep 2016
Lucylu16 have you had you levels tested? I ask because unless you have had your levels tested, I don't recommend (in my humble opinion) continuing to take the estradiol. A woman's estrogen does not drop nearly as fast as progesterone does and the majority of women naturally become estrogen dominant because of this. In the past (and still to this day, but its slowly changing) the first thing doctors did was throw us on estrogen when we start menopause, but they should have been putting us on progesterone instead. There is SO much estrogen in the environment around us that our bodies rarely become deficient in estrogen. All of the symptoms you have described are actually caused by estrogen and relieved by progesterone. Unless you have had your hormone levels tested and show to be low in estrogen, I suggest discontinuing the the estradiol and seeing if this helps. As for the testosterone, I would be careful with that as well.
I am 38 and I have zero progesterone, high estrogen, and normal testosterone levels. Even though my testosterone levels were normal, I have experienced severe acne and facial hair growth because I didn't have enough opposing hormone since my progesterone dropped. It's not just about having "normal" levels, it's about the levels you do have being in balance with each other. I actually have to take a testosterone blocker and a supplement called DIM to help flush out the excess estrogen in order to keep those levels in check with my progesterone. I highly recommend having your levels checked and googling estrogen dominance. Unopposed/underopposed estrogen is like hell on earth (trust me it's miserable) and it sounds like you may be on the route to driving yourself down that road. I hope this is helpful.
LU
Lucylu16
27 Sep 2016
Natalie, I JUST NOW saw your reply! sorry. Thank you so much for your helpful insights. Will keep this in mind.
Name brand Prometrium(bioidentical progesterone) is wonderful and Expensive. The cost has gone up to about 120.00 per month where I live. I tried a generic by Teva brand years ago and it was very different. I had multiple side effects from it such as headache and Bad cramping with breakthrough bleeding. I went back on Prometrium and paid full price because it was worth it! Good Good news though... I read the post where someone mentioned Watson brand which is now Actavis. It was said to be the exact same medication not just a generic. I researched and found that the company that makes the name brand Prometrium has a deal with Watson/Actavis to supply them with the pills to resell as generic. I found a pharmacy that carries this generic brand ( Right Aid) and am so happy to say I believe this is the exact same medication! It even looks the same... Peach round pill with SV on it for the 100 mg oral cap. I feel normal on it and no side effects. The cost? For me it's now free. Out of pocket it would be 65% off. Had to share the good news and I so wish I had known this years ago!
