QUESTION: “I see that the FDA in it’s nanny state has shut down the natural progesterone cream (and all compounds without a script that you made). I understand you are recommending the NOW brand. There appears to be a lot of brands out there. Is this the only one that passes your inspection? What about one for men? My husband has been using the one you made for men (delivered 5mg per 0.25 ml – 1 pump) and I don’t see any recommendation for a product for men. For men, It is difficult to get the right dosage with the NOW pump because how does he know what half a pump looks like until he gets the whole pumps worth out there? As far as getting your doctor to write a prescription I have found that any doctor I’ve ever gone to resists anything not made by a pharmaceutical company and they know nothing about supplements.”

ANSWER: Everything a compounding pharmacist makes (compounds) must be pursuant to a patient-specific prescription and not sold over-the-counter. This applies to all compounding pharmacists, not to us alone and is not just for progesterone.

I selected the NOW brand of topical progesterone because it is a product I will use in place of my own compound. No, I may not even make it for myself without a prescription. There are other brands but nothing superior to the NOW product. I have used NOW products for years and trust their quality. I did not compare it to any other brand as it meets my criteria for dosing and content of the cream base. NOW may have read the same research papers – or just copied my ideas (my ego prefers to believe they copied me – yuk, yuk). The important thing is that topical progesterone, USP is still available on the non-prescription market.

The “right” dosage is somewhat nebulous. Actually, I selected 10 mg per dose for men based on several articles I researched a few years back that showed dosing with 8 to 12 mg or progesterone 6 days a week helped the majority of men who tried it. I used a similar analysis when I decided to suggest 20 mg for women – and the dosing schedule. The pumper we used delivered an average of 20 mg progesterone, USP per pump in a volume of between 1 ml and 1.25 ml. There is no convenient way to make the dosing more accurate – and no particular reason to strive for such accuracy – especially as users vary in so many ways. While complete accuracy is impractical, the method we’ve promoted for decades is “good enough” for the vast majority of users. The same is true for the commercial product made by NOW.

It’s fairly easy to achieve a HALF pump from the NOW product – and if it ends up being a little more or a little less there won’t be a problem. My goal has long been 10 mg Monday through Saturday and I am confident most men can achieve that by guesstimating a half pump. No harm would arise if they miss the mark because it’s still in the ballpark. The most important aspect of dosing for women AND men is the schedule – skipping one day for men.

Today’s doctors are well trained and follow the rules they are taught. When I think of training I immediately envision Pavlov and his dogs. Doctors’ professional prerogatives have been hampered for so long that it is rare to find one today who is capable of thinking through the issues. They also don’t have the time to meet the needs of their patients (they can lose their job if they don’t see enough patient per hour).

I hope this is a satisfactory response to your email.