A natural form of progesterone, the vaginal gel has one major benefit: Because it is applied through your vagina and goes to your uterus, the progesterone is absorbed right where you need it most.

Prochieve, currently the only natural progesterone bio-adhesive gel on the market, was introduced in 1998, then using the brand name Crinone. It comes in two different formulations -- 8%, which is used for infertility treatments, and 4% which is used for HRT. The 4% gel delivers 45 mgs. of progesterone into your system in a sustained release. The major plus of this method: Because the progesterone goes directly from the vagina to the target organ, the uterus, you don’t get high blood levels of progesterone. . . which means that you get the benefits of progesterone without the side effects. Furthermore, when you take progesterone in pill form, about 95% of it is metabolized and eliminated from your system -- which is why you often need a high dosage. The vaginal gel form, though, is more bioavailable -- that is, it is able to be used by your system more easily, and isn’t metabolized. So you don’t need as high a dosage -- again, cutting back on side effects. Studies conducted by the pharmaceutical company showed that the majority of women didn’t have side effects normally associated with progestins -- and even had fewer than women taking natural micronized progesterone.

Now for the negatives: Since it is a vaginal gel, it’s not nearly as neat or simple as swallowing a pill. But it’s not as messy as many women assume it must be. Yes, you sometimes get a pellet-like discharge, sort of like Styrofoam, but it’s minimal. It often can be completely avoided if you stay seated or lie down for a few minutes after first inserting the gel. This allows the gel to be absorbed better. The second downside to  -- it is more expensive than progestins or even oral micronized progesterone. However, these are very minor drawbacks when compared to the many positives. All in all, this is another good choice when it comes to replacing progesterone in your system.