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conclusion incorrect.  blood testing is a poor testing method of transdermal progesterone therapy would be the more accurate conclusion.  Other studies have shown that transdermal progesterone therapy raises progesterone in saliva when blood levels show no change.

Transdermal progesterone levels are quickly transported to saliva.  This quick transport, while serum doesn't equally reflect progesterone, has puzzled many.  Theories have been proposed, yet no answers.   This study looked at whether 5alpha reductase expression in the skin would metabolize the progesterone  and this explain the difference in the two test mediums.  The authors of this study concluded that 5alpha reductase is the not the reason for the difference found in saliva and serum.  the same can be applied to urine as well.

serum evaluation of progesterone is not reliable method of testing following transdermal progesterone

transdermal estrogen/progesterone therapy does not increase thrombotic risk

Transdermal BHRT in the form of Progesterone found to reduce hot flashes by 83%.

Transdermal progesterone improves menopausal symptoms without an change in inflammatory markers.

salivary levels, not serum, reflect topical progesterone therapy

transdermal estradiol does not increase blood clot risk, when compared with oral estradiol

sex hormones readily carried on human red blood cells.  Reason transdermal progesterone is picked up in saliva and not serum.  Sex hormones are lipophillic and blood is water soluble.

patients prefer bioidentical progesterone vs. provera.  Both shown to protect the endometrium

bioidentical hormones do not increase stroke risk; also, route of delivery impacts stroke risk