Progesterone suppositories require a prescription in the United States, so your first step is getting one from a doctor, midwife, or reproductive endocrinologist. Once you have that prescription, you can fill it at most major retail pharmacies, specialty fertility pharmacies, or compounding pharmacies depending on the formulation you need.
You Need a Prescription First
Unlike over-the-counter progesterone creams sold at drugstores, vaginal and rectal progesterone suppositories are prescription medications. Your provider will write a prescription based on why you need progesterone, which typically falls into one of a few categories: luteal phase support during IVF or other fertility treatments, prevention of miscarriage in women with recurrent pregnancy loss, management of threatened miscarriage, or hormone therapy for missed periods or abnormal bleeding.
The specific reason matters because it determines which formulation and dosage your provider prescribes, which in turn affects where you’ll fill it.
FDA-Approved Brand Options
Several brand-name products deliver progesterone vaginally, though they differ in form:
- Endometrin (100 mg vaginal inserts) is the newest FDA-approved vaginal progesterone, commonly prescribed for fertility treatment support.
- Crinone is a vaginal gel rather than a traditional suppository, and it was the first progesterone preparation approved in the U.S. specifically for IVF cycles.
- Prometrium (100 mg and 200 mg capsules) is FDA-approved as an oral capsule but is sometimes prescribed for vaginal use off-label.
Standard dosing for vaginal suppositories is typically 200 to 400 mg administered every 12 hours. At these doses, progesterone reaches blood levels consistent with a healthy mid-cycle or early pregnancy range. Your doctor will set the exact dose and schedule for your situation.
Retail and Chain Pharmacies
Major chains like CVS, Walgreens, Walmart, and Costco carry progesterone products, though stock varies by location. Grocery store pharmacies are another option. If one chain is out of stock, another may have it because they use different wholesale distributors. Calling ahead saves you a trip, and most pharmacies can order a product within a day or two if it’s not on the shelf.
For the most common generic oral progesterone capsules (which some providers prescribe for vaginal use), GoodRx lists retail prices around $22 for 30 capsules of 100 mg, with discount coupons bringing that closer to $12. Vaginal inserts are more expensive: 21 inserts of 100 mg retail for roughly $223, though coupons can bring the price down to about $91.
Specialty Fertility Pharmacies
If you’re going through IVF or working with a reproductive endocrinologist, a specialty pharmacy is often the most reliable source. These pharmacies focus on fertility medications, so they maintain better stock of vaginal inserts, gels, and injectable progesterone than general retail pharmacies do. Your fertility clinic likely has a relationship with one or two specialty pharmacies and can send your prescription directly.
Specialty pharmacies also tend to have pharmacists familiar with fertility protocols, which can be helpful if you have questions about timing or administration.
Compounding Pharmacies for Custom Formulations
Sometimes a doctor will send your prescription to a compounding pharmacy instead of a retail one. Compounding pharmacies prepare custom medications tailored to individual patients. You might need a compounded suppository if you’re allergic to an ingredient in a commercial product, need a dosage that isn’t commercially available, or require a specific base material (like cocoa butter instead of a synthetic base).
Compounded progesterone suppositories are made from scratch at the pharmacy according to your prescription, using the same bioidentical progesterone but in a formulation designed for your needs. Because each batch is custom-made, compounded products aren’t FDA-approved in the same way commercial brands are, but they’re legally prepared under a physician’s prescription. Prices vary widely between compounding pharmacies, so it’s worth calling a few for quotes. Independent compounding pharmacies exist in most metro areas, and many accept mail orders.
Insurance Coverage
Whether insurance covers your progesterone suppositories depends largely on why they’re prescribed. Generic progesterone capsules are covered by most Medicare and insurance plans. For fertility-related use, coverage depends on whether your plan includes infertility benefits. Some plans cover pharmaceutical products for infertility treatment, including progesterone, but many don’t, or they cap the benefit.
If your plan doesn’t cover the cost, or if you’re paying out of pocket, pharmacy discount programs like GoodRx can cut the price significantly. For compounded suppositories, insurance coverage is less predictable, and many patients pay cash.
Storage and Handling
Progesterone suppositories should be stored at room temperature, between 59°F and 86°F (15°C to 30°C). They can soften or melt in heat, so avoid leaving them in a hot car or near a window. If you live in a warm climate and order by mail, choose expedited shipping during summer months. Refrigeration isn’t typically required, but if a suppository has softened, placing it in the refrigerator briefly can firm it up before use.