Can You Stop Taking Progesterone Cold Turkey?

Progesterone is a hormone that plays an important role in the female reproductive system. It is involved in maintaining pregnancy regulating the menstrual cycle and preparing the body for conception. Many women take progesterone supplements, often in combination with estrogen, to treat symptoms associated with menopause or peri-menopause. However, some women may wish to stop taking progesterone supplements for various reasons. A common question that arises is whether it is safe to stop progesterone therapy abruptly, known colloquially as “cold turkey”, or if it is better to taper off slowly.

Reasons for Stopping Progesterone

There are several reasons why a woman might want to stop taking progesterone:

• The treatment is no longer needed if menopausal symptoms have resolved. Progesterone is often prescribed short-term to relieve hot flashes, night sweats, vaginal dryness, and other menopausal symptoms. As women go through menopause, these symptoms tend to decrease in severity over time.

• There are concerns about side effects or health risks. Some research has linked synthetic progestins to a slightly increased risk of breast cancer, heart disease, and stroke when taken long-term. Natural progesterone does not appear to carry the same risks but more research is needed.

• The woman is planning a pregnancy. Progesterone is not recommended during pregnancy and can prevent conception.

• The treatment is not effectively managing symptoms Each woman responds differently to hormone therapy. If progesterone is not providing symptom relief, a woman may wish to explore other options

• The cost of treatment has become prohibitive. Progesterone prescriptions can be expensive depending on insurance coverage. The out-of-pocket costs may motivate some women to discontinue use.

Is It Safe to Stop Progesterone Cold Turkey?

Most doctors advise against suddenly discontinuing progesterone without medical supervision. Stopping progesterone abruptly can trigger withdrawal side effects very similar to menopausal symptoms. Hot flashes, night sweats, vaginal dryness, and mood swings are commonly reported. A sudden drop in progesterone levels essentially mimics the hormone changes that occur during natural menopause.

How severe these “cold turkey” withdrawal symptoms are varies between individuals. Women who had extremely intense menopausal symptoms prior to starting progesterone are more likely to experience severe rebound symptoms if they stop cold turkey. The duration of therapy also plays a role. The body adjusts to consistent progesterone levels over time, so the longer a woman has been on treatment, the more likely she is to have rebound symptoms if she stops abruptly.

Tapering off progesterone gradually under medical supervision allows the body to adjust more slowly, reducing the likelihood and severity of withdrawal side effects. This is the recommended approach.

Tapering Progesterone Therapy

To safely discontinue progesterone, doctors typically recommend tapering the dosage over the course of several weeks or months. The tapering schedule can vary based on the initial dosage and duration of treatment. An example taper schedule might look like:

• Take the full dosage for 1 week
• Take 2/3 of the full dosage for 2 weeks
• Take 1/3 of the full dosage for 2 weeks
• Take 1/3 dosage every other day for 2 weeks
• Discontinue treatment

The taper may be stretched out over a longer period of 6 months or more in some cases, especially if the woman was on a high therapeutic dose for an extended period of time.

The pros of tapering slowly include:

• Lower likelihood of severe rebound menopausal symptoms
• Gradual adjustment for the body
• Symptoms emerge slowly and may be more manageable
• Avoids abruptly plummeting hormone levels

The potential cons of a prolonged taper include:

• Process takes discipline and diligence over weeks/months
• Menopausal symptoms may still emerge but in a more drawn out fashion
• More time before attempting pregnancy or starting a new treatment

The taper schedule should be customized based on the individual woman’s health history and needs. Close monitoring by a doctor is recommended throughout the tapering process. Blood tests to check hormone levels may be performed periodically to ensure the body is adjusting well. If severe withdrawal symptoms do occur, the taper may be slowed down temporarily.

Other Considerations

Some key points to keep in mind when discontinuing progesterone therapy include:

• Consult your doctor about the safest way to stop. Do not quit cold turkey without medical advice.

• If finishing a prescribed course of treatment, take it as directed until completed.

• Adhere closely to the prescribed taper schedule provided by your doctor.

• Monitor symptoms and report any concerning or severe changes to your doctor promptly.

• Be patient as it may take some time for the body to adjust to lower progesterone levels.

• Lifestyle measures like stress management, exercise, and a healthy diet may help ease the transition.

• Non-hormonal treatment options are available to help manage menopausal symptoms such as SSRIs, gabapentin, cognitive behavioral therapy, and more. Discuss these with your doctor.

• If symptoms return severely after discontinuing progesterone, consult your doctor about potentially resuming treatment at the lowest effective dose.

The Bottom Line

While progesterone therapy is generally safe for short-term use, there are valid reasons a woman may wish to stop treatment. Quitting progesterone cold turkey is not advisable as it commonly causes rebound menopausal symptoms. Tapering off progesterone gradually under medical supervision is the recommended approach to safely discontinue therapy and avoid severe withdrawal side effects. Being patient with the body’s adjustment and using alternative symptom management techniques can also help during the transition process. With the right taper schedule and support, most women can stop progesterone therapy safely.