I wasn't trying to explain the difference medically, I was explaining the "why"--according to Dr. J.--the cream can come back to cause symptoms.
I understand that but the explanation was wrong, which is why I was explaining why. Using progesterone transdermally does not create a sudden surge of progesterone as it traps in the fat cells then slowly releases. This is why the cream is supposed to be applied over fatty tissues. But because of the slow release it can also build up in the fat tissue leading to progesterone dominance.
The reason oral progesterone is less likely to cause such severe side effects is that it is metabolized readily by the liver instead of being stored in the body, so in short there is less actual progesterone in the body compared to transdermal applications.