Most of the menopause conversation is about estrogen, because estrogen is what relieves hot flashes and night sweats. Progesterone's main job is not symptom relief, it is safety: if you still have your uterus, estrogen taken alone overstimulates the lining and raises the risk of endometrial cancer. Progesterone keeps that in check. "Micronized" simply means it is ground fine enough to absorb well by mouth. Therisse dispenses a compounded oral progesterone capsule; if you have had a hysterectomy, estrogen alone is usually the standard and progesterone is not required for protection.

Source: Fournier et al., the E3N-EPIC cohort, Int J Cancer (2005). Relative risk of breast cancer with estrogen combined with micronized progesterone (0.9) versus synthetic progestins (1.4). E3N is observational, not a randomized trial, and speaks mostly to shorter-term use. It is a reason many clinicians prefer micronized progesterone, not a promise that hormone therapy is risk-free. Combined hormone therapy still carries a real breast cancer risk overall.

There is no single number that is right for everyone; the regimen depends on your estrogen dose and your history, which a board-certified physician reviews before prescribing. It is sensible not to drive right after your first few doses until you know how it affects you, and you can message your care team any time something feels off.

The most common side effects, especially in the first few weeks, are drowsiness or dizziness (the reason for bedtime dosing), breast tenderness, bloating, mood changes, and either spotting or a scheduled monthly bleed depending on the regimen. Most are mild and ease as your body adjusts.

Adding progesterone is about reducing one specific risk: endometrial cancer from unopposed estrogen. But hormone therapy as a whole still carries its own established risks, including blood clots, stroke, and breast cancer. Progesterone does not erase those; what it does is keep estrogen from creating a new problem in the uterus. A physician reviews your full history, including any personal or family history of clots, stroke, or hormone-sensitive cancers, before prescribing.

On FDA status, in plain terms: micronized progesterone does have an FDA-approved version, but the compounded capsule Therisse dispenses is made for an individual patient and is a different regulatory category, so it is not FDA-approved. The active ingredient is long-established and body-identical.