What are the key uses of progesterone in women’s health. How does progesterone affect fertility and pregnancy outcomes. What are the potential side effects and precautions for progesterone use. How is progesterone administered for various conditions.

Understanding Progesterone: A Crucial Hormone for Women’s Health

Progesterone is a vital hormone in women’s health, playing key roles in menstruation, fertility, and pregnancy. As a naturally occurring steroid hormone, progesterone is produced primarily by the ovaries, with smaller amounts made by the adrenal glands and placenta during pregnancy. Its synthetic forms are widely used in medicine for various reproductive and hormonal conditions.

What is Progesterone?

Progesterone belongs to a class of hormones called progestogens. It works in tandem with estrogen to regulate the menstrual cycle and support pregnancy. During the second half of the menstrual cycle, progesterone levels rise to prepare the uterus for a potential pregnancy. If fertilization occurs, progesterone helps maintain the pregnancy by supporting the developing embryo and fetus.

Key Medical Uses of Progesterone

Progesterone and its synthetic analogs have numerous applications in women’s health. Here are some of the primary medical uses:

• Menstrual disorders
• Infertility treatment
• Hormone replacement therapy
• Pregnancy support
• Endometriosis management
• Contraception

How does progesterone help with menstrual disorders?

Progesterone can help regulate menstrual cycles and treat conditions like heavy menstrual bleeding (menorrhagia). It works by stabilizing the uterine lining, preventing excessive growth and shedding. For women with irregular cycles, progesterone can help induce predictable menstrual bleeding.

Progesterone in Fertility and Assisted Reproduction

Progesterone plays a crucial role in fertility treatments, particularly in assisted reproductive technologies like in vitro fertilization (IVF).

How is progesterone used in IVF treatments?

In IVF, progesterone is often used for luteal phase support. After egg retrieval and embryo transfer, progesterone supplementation helps prepare the uterine lining for implantation and supports early pregnancy. It’s typically administered vaginally or by intramuscular injection.

A study by Ludwig et al. (2001) compared different methods of luteal phase support in IVF, including human chorionic gonadotropin (hCG), vaginal progesterone, or a combination of both. The research found that vaginal progesterone was as effective as other methods for supporting early pregnancy after IVF.

Progesterone in Pregnancy: Prevention of Preterm Birth

One of the most significant applications of progesterone in recent years has been its use in preventing preterm birth in high-risk pregnancies.

Can progesterone prevent preterm birth?

Research has shown that progesterone supplementation can reduce the risk of preterm birth in women with a history of spontaneous preterm delivery. A landmark study by Meis et al. demonstrated that weekly injections of 17-alpha-hydroxyprogesterone caproate significantly reduced the rate of recurrent preterm delivery in high-risk women.

Additionally, vaginal progesterone has been found effective in reducing preterm birth risk in women with a short cervix, a known risk factor for preterm delivery. These findings have led to progesterone becoming a standard preventive treatment for specific high-risk pregnant women.

Hormone Replacement Therapy and Progesterone

Progesterone is a key component of hormone replacement therapy (HRT) for menopausal and postmenopausal women.

Why is progesterone important in hormone replacement therapy?

In women with an intact uterus who are taking estrogen for menopausal symptoms, progesterone or a synthetic progestin is crucial to prevent endometrial hyperplasia and reduce the risk of endometrial cancer. Unlike estrogen-only therapy, combined estrogen-progesterone therapy helps maintain a balanced hormonal environment.

Leonetti et al. (2005) explored the use of transdermal progesterone cream as an alternative to oral progestins in HRT. Their study suggested that transdermal application could provide an effective and potentially safer option for some women.

Side Effects and Precautions of Progesterone Use

While progesterone is generally well-tolerated, it can cause side effects and may not be suitable for all women.

What are common side effects of progesterone?

Common side effects of progesterone include:

• Breast tenderness
• Bloating
• Mood swings
• Headaches
• Drowsiness (especially with oral formulations)

More serious but rare side effects can include blood clots, particularly in women with other risk factors. It’s crucial for women to discuss their medical history and potential risks with their healthcare provider before starting progesterone therapy.

Progesterone and Mental Health

The relationship between progesterone and mental health is complex and an area of ongoing research.

How does progesterone affect mood and mental health?

Progesterone and its metabolites interact with the GABA system in the brain, potentially influencing mood, anxiety, and sleep. Some women report mood changes related to progesterone fluctuations during their menstrual cycle or when taking exogenous progesterone.

A study by Lawrie et al. (1998) investigated the effects of postnatal progesterone on postpartum depression. While the results didn’t show a significant benefit, it highlighted the need for further research into hormonal influences on postpartum mental health.

Novel Applications and Future Directions

Ongoing research is exploring new potential applications for progesterone beyond its traditional uses in reproductive health.

What are some emerging uses for progesterone?

Researchers are investigating progesterone’s potential neuroprotective effects, particularly in traumatic brain injury. Some studies suggest that progesterone administration following brain injury may reduce swelling and improve outcomes, though more research is needed to confirm these findings.

Additionally, progesterone’s role in bone health is being explored. Lydeking-Olsen et al. (2004) conducted a study comparing soymilk (containing phytoestrogens) and progesterone for preventing bone loss in postmenopausal women, suggesting potential benefits for bone density.

As our understanding of progesterone’s diverse effects on the body grows, it’s likely that new therapeutic applications will emerge, potentially expanding its use beyond reproductive health.

Administering Progesterone: Routes and Formulations

Progesterone is available in various formulations, each with its own advantages and specific uses.

What are the different ways to administer progesterone?

Progesterone can be administered through several routes:

1. Oral capsules: Commonly used for menstrual disorders and hormone replacement therapy.
2. Vaginal suppositories or gels: Often preferred for fertility treatments and early pregnancy support due to direct delivery to the uterus.
3. Intramuscular injections: Used in some IVF protocols and for preventing preterm birth.
4. Transdermal creams: Sometimes used in hormone replacement therapy, though absorption can be variable.
5. Intrauterine devices (IUDs): Progestin-releasing IUDs like Mirena are used for contraception and treating heavy menstrual bleeding.

The choice of formulation depends on the specific condition being treated, patient preference, and the desired local or systemic effects. For instance, Lethaby et al. (2005) reviewed the effectiveness of progesterone-releasing intrauterine systems for heavy menstrual bleeding, finding them to be an effective treatment option.

Progesterone in Endometriosis Management

Endometriosis, a condition where uterine-like tissue grows outside the uterus, can be effectively managed with progesterone-based treatments.

How does progesterone help in treating endometriosis?

Progesterone and synthetic progestins can help suppress endometrial growth and reduce pain associated with endometriosis. They work by:

• Inhibiting estrogen production
• Thinning the endometrial lining
• Reducing inflammation associated with endometriosis lesions

Kauppila et al. (1988) conducted a placebo-controlled study examining the effects of high-dose medroxyprogesterone acetate on endometriosis, demonstrating its efficacy in reducing symptoms and lowering serum CA-125 levels, a marker often elevated in endometriosis.

Progesterone and Breast Cancer Risk

The relationship between progesterone and breast cancer risk is complex and has been the subject of extensive research.

Does progesterone increase or decrease breast cancer risk?

The impact of progesterone on breast cancer risk appears to depend on various factors, including the type of progesterone (natural vs. synthetic), the presence of estrogen, and individual patient characteristics. Some key points to consider:

• Combined estrogen-progestin hormone therapy has been associated with an increased risk of breast cancer in postmenopausal women.
• Natural progesterone may have a different risk profile compared to synthetic progestins, with some studies suggesting a potentially neutral or even protective effect.
• The timing and duration of progesterone exposure may influence its effects on breast tissue.

It’s crucial for women to discuss their individual risk factors with their healthcare providers when considering progesterone-containing treatments. Ongoing research continues to refine our understanding of the complex interplay between hormones and breast cancer risk.

Progesterone in Male Health

While progesterone is primarily associated with female health, it also plays a role in male physiology.

What are the functions of progesterone in men?

In men, progesterone is produced in smaller amounts by the adrenal glands and testes. Its functions include:

• Serving as a precursor for testosterone production
• Potentially influencing sperm capacitation and acrosome reaction
• Contributing to bone metabolism
• Possibly affecting mood and cognitive function

While not typically used as a primary treatment in men, some research has explored potential applications of progesterone in male health, such as its neuroprotective effects or its role in certain hormonal imbalances. However, more research is needed to fully understand the therapeutic potential of progesterone in male health conditions.

Monitoring Progesterone Levels

Accurate measurement of progesterone levels is crucial for diagnosing and managing various reproductive health conditions.

How are progesterone levels measured and what do they indicate?

Progesterone levels are typically measured through blood tests. The timing of these tests is critical, as levels fluctuate throughout the menstrual cycle. Some key points about progesterone testing include:

• Mid-luteal phase testing (about 7 days before expected menstruation) can confirm ovulation.
• Early pregnancy progesterone levels can help assess the viability of a pregnancy.
• Serial measurements may be used to monitor luteal phase defects or response to progesterone supplementation.

Interpreting progesterone levels requires consideration of the patient’s menstrual cycle stage, age, and any ongoing treatments. For example, in fertility treatments, progesterone levels are often monitored to ensure adequate luteal support following procedures like IVF.

Progesterone and Sleep Quality

Progesterone’s effects on sleep have garnered increased attention in recent years, particularly in the context of menopause and sleep disorders.

How does progesterone influence sleep patterns?

Progesterone appears to have sleep-promoting effects, which may explain why some women report changes in sleep quality at different points in their menstrual cycle or during pregnancy when progesterone levels are elevated. Some ways progesterone may affect sleep include:

• Increasing production of GABA, a neurotransmitter that promotes relaxation and sleep
• Potentially improving breathing during sleep, which may be beneficial for sleep apnea
• Influencing body temperature regulation, which is important for sleep onset and maintenance

Manber et al. (2003) conducted a pilot study examining the effects of hormone replacement therapy on sleep-disordered breathing in postmenopausal women. Their findings suggested that progesterone might have beneficial effects on sleep quality, particularly in women with mild to moderate sleep-disordered breathing.

Progesterone in Premenstrual Syndrome (PMS) Management

The role of progesterone in managing premenstrual syndrome (PMS) has been a subject of debate and research.

Is progesterone effective for treating PMS symptoms?

While progesterone has been used to treat PMS symptoms, the evidence for its efficacy is mixed. Some studies have found benefits, while others show little to no effect compared to placebo. Key points to consider:

• Natural progesterone may be more effective than synthetic progestins for some women.
• Individual response to progesterone treatment can vary significantly.
• Progesterone might be more effective for certain PMS symptoms than others.

Magill (1995) conducted a study investigating the efficacy of progesterone pessaries in relieving PMS symptoms. While some women reported improvements, the overall results were not significantly different from placebo, highlighting the complex nature of PMS and the need for individualized treatment approaches.

Progesterone and Cognitive Function

The impact of progesterone on cognitive function, particularly in the context of aging and hormone therapy, is an area of ongoing research.

How does progesterone affect cognitive performance?

Progesterone’s effects on cognition appear to be complex and may vary depending on factors such as age, menopausal status, and the presence of other hormones. Some research findings include:

• Potential neuroprotective effects, particularly in the context of brain injury
• Mixed results regarding progesterone’s impact on memory and other cognitive functions
• Possible interactions with estrogen in influencing cognitive performance

Low et al. (2006) examined the relationship between hormone replacement therapy and cognition in an Australian sample of women aged 60-64 years. Their findings suggested that the effects of hormone therapy on cognition may depend on the specific cognitive domain and the type of hormone therapy used.

As research in this area continues, it’s becoming clear that the relationship between progesterone and cognitive function is nuanced and may depend on various individual and treatment-related factors.

Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

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Miles RA, Paulson RJ, Lobo RA, et al. Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertil Steril 1994;62:485-90. View abstract.

Nappi C, Affinito P, Di Carlo C, et al. Double-blind controlled trial of progesterone vaginal cream treatment for cyclical mastodynia in women with benign breast disease. J Endocrinol Invest 1992;15:801-6. View abstract.

Norman JE, Mackenzie F, Owen P, Mactier H, Hanretty K, Cooper S, et al. Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo-controlled study and meta-analysis. Lancet 2009;373(9680):2034-40. View abstract.

Norman JE, Marlow N, Messow CM, et al. Does progesterone prophylaxis to prevent preterm labour improve outcome? A randomised double-blind placebo-controlled trial (OPPTIMUM). Health Technol Assess. 2018;22(35):1-304. View abstract.

Norman JE, Marlow N, Messow CM, et al. Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial. Lancet. 2016 May 21;387(10033):2106-16. View abstract.

Perino M, Brigandi FG, Abate FG, et al. Intramuscular versus vaginal progesterone in assisted reproduction: a comparative study. Clin Exp Obstet Gynecol 1997;24:228-31. View abstract.

Phy, J. L., Weiss, W. T., Weiler, C. R., and Damario, M. A. Hypersensitivity to progesterone-in-oil after in vitro fertilization and embryo transfer. Fertil Steril 2003;80(5):1272-1275. View abstract.

Pouly JL, Bassil S, Frydman R, et al. Luteal support after in-vitro fertilization: Crinone 8%, a sustained release vaginal progesterone gel, versus Utrogestan, an oral micronized progesterone. Hum Reprod 1996;11:2085-9. View abstract.

Rai P, Rajaram S, Goel N, Ayalur Gopalakrishnan R, Agarwal R, Mehta S. Oral micronized progesterone for prevention of preterm birth. Int J Gynaecol Obstet 2009;104(1):40-3. View abstract.

Rode L, Klein K, Nicolaides KH, Krampl-Bettelheim E, Tabor A; PREDICT Group. Prevention of preterm delivery in twin gestations (PREDICT): a multicenter, randomized, placebo-controlled trial on the effect of vaginal micronized progesterone. Ultrasound Obstet Gynecol 2011;38(3):272-80. View abstract.

Romero R, Nicolaides K, Conde-Agudelo A, et al. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data. Am J Obstet Gynecol 2012;206(2):124.e1-19. View abstract.

Rosano GM, Webb CM, Chierchia S, et al. Natural progesterone, but not medroxyprogesterone acetate, enhances the beneficial effect of estrogen on exercise-induced myocardial ischemia in postmenopausal women. J Am Coll Cardiol 2000;36:2154-9.

Ross D, Cooper AJ, Pryse-Davies J, et al. Randomized, double-blind, dose-ranging study of the endometrial effects of a vaginal progesterone gel in estrogen-treated postmenopausal women. Am J Obstet Gynecol 1997;177:937-41. View abstract.

Salim R, Hakim M, Zafran N, Nachum Z, Romano S, Garmi G. Double-blind randomized trial of progesterone to prevent preterm birth in second-trimester bleeding. Acta Obstet Gynecol Scand. 2019;98(10):1318-25. View abstract.

Schüssler P, Kluge M, Adamczyk M, et al. Sleep after intranasal progesterone vs. zolpidem and placebo in postmenopausal women – A randomized, double-blind cross over study. Psychoneuroendocrinology. 2018;92:81-86. View abstract.

Schweizer E, Case WG, Garcia-Espana F, et al. Progesterone co-administration in patients discontinuing long-term benzodiazepine therapy: effects on withdrawal severity and taper outcome. Psychopharmacol (Berl) 1995;117:424-9. View abstract.

Skolnick BE, Maas AI, Narayan RK, et al.; SYNAPSE Trial Investigators. A clinical trial of progesterone for severe traumatic brain injury. N Engl J Med 2014;371(26):2467-76. View abstract.

Smitz J, Devroey P, Faguer B, et al. A prospective randomized comparison of intramuscular or intravaginal natural progesterone as a luteal phase and early pregnancy supplement. Hum Reprod 1992;7:168-75. View abstract.

Sotiriadis A, Papatheodorou S, Makrydimas G. Perinatal outcome in women treated with progesterone for the prevention of preterm birth: a meta-analysis. Ultrasound Obstet Gynecol 2012;40(3):257-66. View abstract.

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Warren MP, Biller BMK, Shangold MM. A new clinical option for hormone replacement therapy in women with secondary amenorrhea: effects of cyclic administration of progesterone from the sustained-release vaginal gel Crinone (4% and 8%) on endometrial morphologic features and withdrawal bleeding. Am J Obstet Gynecol 1999;180:42-8. View abstract.

Wright DW, Yeatts SD, Silbergleit R, et al.; NETT Investigators. Very early administration of progesterone for acute traumatic brain injury. N Engl J Med 2014;371(26):2457-66. View abstract.

Wyatt K, Dimmock P, Jones P, et al. Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review. BMJ 2001;323:776-80.. View abstract.

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Progesterone vaginal suppositories

What is this medicine?

PROGESTERONE (proe JES ter one) is a female hormone. This medicine is used to treat infertility and to prevent miscarriage in women with a condition called corpus luteum insufficiency. This medicine may also be used to prevent preterm delivery in some women. The suppositories are only available when compounded by your pharmacist.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): First – Progesterone VGS

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• blood vessel disease, blood clotting disorder, or suffered a stroke
• breast, cervical or vaginal cancer
• heart disease
• kidney disease
• liver disease
• miscarriage or abortion
• vaginal bleeding
• an unusual or allergic reaction to progesterone, other hormones, medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

This medicine is for vaginal use only. Do not take by mouth. Follow the directions on the prescription label. Wash your hands before and after use. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor’s advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

What may interact with this medicine?

Interactions are not expected. Do not use any other vaginal products without asking your doctor or health care professional.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress.

If your doctor or health care professional instructs you to use any other medicines in the vagina while you are using this medicine, you should separate the doses by at least 6 hours.

You may notice a white discharge of medicine while using this medicine. This is normal. If it becomes bothersome, contact your doctor or health care professional.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• abnormal vaginal bleeding
• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breast tissue changes or discharge
• changes in vision
• chest pain
• confusion
• dark urine
• general ill feeling or flu-like symptoms
• light-colored stools
• loss of appetite, nausea
• pain, swelling, warmth in the leg
• right upper belly pain
• problems with balance, talking, walking
• severe headaches
• shortness of breath
• sudden numbness or weakness of the face, arm or leg
• unusually weak or tired
• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• back pain
• depressed mood or mood swings
• increased appetite
• fluid retention and swelling
• nausea, vomiting
• stomach cramps or bloating

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store in the refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Do not freeze. Protect from light. Keep this medicine in the orginal container until ready to use. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

A Vital Connection For Growing Your Family

Why should I care about Progesterone?

Because it’s kind of a big deal and this is why: Progesterone, also referred to as “the pregnancy hormone,” is a common female hormone found naturally in a woman’s body. It also happens play an essential role for both before and during a pregnancy. When a fertility workup is suggested, there are two main sex hormones an overseeing medical provider will look test: estrogen and progesterone.

Progesterone (as a prescribed hormone supplementation) is often necessary during Assisted Reproductive Technology (ART) procedures, such as in-vitro fertilization (IVF). Partly because the medications you may use during these procedures can suppress your body’s ability to produce progesterone. Certain procedures can even, unintentionally, remove progesterone-producing cells from your ovaries.

Sometimes, there are other reasons to use progesterone supplementation, such as little or no progesterone production from the ovaries or poorly developed follicles that do not secrete enough progesterone to develop the uterine lining.

The bottom line is this — all women who wish to become pregnant need progesterone to help their uterus prepare for and maintain a pregnancy. Read below to learn more about the important connection between progesterone and how it impacts both fertility and pregnancy.

Before Becoming Pregnant

The role of progesterone in overall fertility health, is that it helps prepare the uterus for pregnancy. After ovulation occurs, the ovaries start to produce progesterone needed by the uterus. Progesterone causes the uterine lining or endometrium to thicken. The overall goal is to have a thick lining which will helps create an ideal supportive environment in your uterus for a fertilized egg/embryo.

During Pregnancy

Progesterone balance in a pregnancy is essential. A consistent supply of progesterone to the endometrium continues helps nurture the developing fetus throughout the pregnancy. Following a successful implantation, progesterone also helps maintain a supportive environment for the developing fetus. After 8 to 10 weeks of pregnancy, the placenta takes over progesterone production from the ovaries and substantially increases progesterone production.

The Different Forms of Progesterone

Not all forms of progesterone are created equal. There are several types of progesterone are available, including vaginal products that deliver progesterone directly to the uterus. The different forms include the following:

Vaginal gel:

• Used once a day for progesterone supplementation
• Unique — the only once-daily FDA-approved progesterone for ART for up to 12 weeks of pregnancy
• The only FDA-approved progesterone for replacement for donor egg recipients and frozen embryo transfers
• Over a decade of experience and over 40 million doses prescribed
  In studies where patient preference was measured, a majority of women preferred the gel for comfort and convenience over other progesterone formulations
• Some discharge reported during use

Vaginal suppositories:

• Compounded at specialty pharmacists
• Wax-based
• Widely used but not FDA-approved
• Used 2 to 3 times a day
• Leakage can be messy

Vaginal inserts:

• Designed for vaginal use
• FDA-approved for progesterone supplementation but not for progesterone replacement
• Effective in women under 35 years; no established results in women over 35 years
  Used 2 to 3 times a day

Progesterone oral capsules, used vaginally:

• Not formulated or FDA-approved for vaginal use
• Fewer side effects when capsules are used vaginally instead of orally
• Used up to 3 times a day

Injections:

• An oil-based solution (sometimes called progesterone in oil)
• Widely used; the oldest, most established method of progesterone delivery
• Injected into the buttocks once a day
• Require long, thick needle to penetrate layers of skin and fat
• Difficult to administer by yourself
• Injections may be painful
• Skin reactions are common

Which supplementation is right for you?

This is a decision that you and your health care provider can make together. Progesterone is an important part of infertility treatment because it supports implantation and pregnancy. Health care providers often have a preference for which form of progesterone they prescribe for infertility treatment. Their preference is generally based on their experience with the various methods. But patient convenience and request are also important considerations.

Most women prefer a progesterone formulation that is easy, convenient, and comfortable. So, be sure to discuss your options with your health care provider.

Progesterone and Progestins – MotherToBaby

This fact sheet talks about exposure to progesterone and progestins in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What are progesterone and progestin?

Progesterone is a hormone that is naturally made in the body by the ovaries. The body uses progesterone to build the lining of the uterus during the menstrual cycle and helps the fertilized egg attach to the wall of the uterus. During pregnancy, the placenta makes progesterone to help prevent miscarriage. Progesterone can also be made in a laboratory and is sold under many brand names including, Crinone^®, Endometrin^®, Prometrium^®, and Prochieve^®.

There are also other synthetic substances (made in a laboratory) that are similar to progesterone called progestins. Progestins are included in some forms of birth control.

Progesterone and progestins can be taken by mouth, injected, or inserted vaginally.

I take progesterone or a progestin. Can it make it harder for me to become pregnant?

Women may be given progesterone to help them get pregnant. Progestins generally prevent pregnancy It is important that you speak with your healthcare provider before beginning or discontinuing any medication.

I just found out I am pregnant. Should I stop taking progesterone or a progestin?

Talk to your healthcare providers if you are taking these medications and you are pregnant. If you are taking a progestin to prevent pregnancy (birth control) and you are now pregnant, it is no longer needed and should be stopped. If you are taking progesterone as part of a fertility treatment, to help you get/sustain a pregnancy, or to prevent miscarriage, please speak with your provider to determine how long you should continue with this medication.

Does taking progesterone or progestin increase the chance for miscarriage? 

Miscarriage can occur in any pregnancy. Progesterone use is not expected to increase the chance for a miscarriage. In fact, some women might be prescribed progesterone early in pregnancy to help prevent miscarriage.

Does taking progesterone or progestin increase the chance of birth defects?

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. It is unlikely that using progesterone or a progestin will increase the chance of birth defects above the background risk.

Some studies raised a concern about a chance for boys to be born with hypospadias after exposure to progestins. Hypospadias is when the opening where urine comes out is not at the correct location on the penis. Sometimes this can be treated with surgery. These studies have some design flaws. The majority of studies that have looked at the children of women who took progesterone or progestins during pregnancy did not report a higher chance of birth defects over the background risk.

Does taking progesterone or progestin cause other pregnancy complications?

Most research looking at the use of progesterone and progestin in pregnancy focuses on women who receive it as an injection (called 17-hydroxyprogesterone caproate or Makena^®) or as a vaginal suppository to prevent preterm labor. No negative effects have been reported in these studies.

Does taking progesterone or progestin in pregnancy cause long-term problems in behavior or learning for the baby?

Studies that have followed children up to the age of 5 have not found progesterone or progestin use in pregnancy to cause problems with the brain (neurodevelopment).

Can I breastfeed while taking progesterone or progestin?

Supplemental progesterone or progestins enter the breastmilk in low amounts. Breastfeeding while taking progesterone or progestin is not expected to be harmful to the nursing infant. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes progesterone or progestin, could it affect his fertility (ability to get partner pregnant) or increase the chance of birth defects?https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

OTIS/MotherToBaby recognizes that not all people identify as “men” or “women.” When using the term “mother,” we mean the source of the egg and/or uterus and by “father,” we mean the source of the sperm, regardless of the person’s gender identity.

View PDF Fact Sheet

List of progesterones, uses, brands, and safety recommendations

Progesterones are used in hormone replacement therapy (HRT), birth control drugs, and other medications

Progesterones list | What are progesterones? | How they work | Uses | Who can take progesterones? | Safety | Side effects | Costs

Progesterones are a class of drugs used for various conditions, including hormone replacement therapy, contraception, infertility treatment, and reintroduction of missed periods. Progesterone medications are often prescribed by OB/GYN’s, who specialize in women’s health/reproductive health.

This article will discuss progesterones—what they are used for, side effects, and warnings. To understand more fully how they work check out our ovulation guide.

Here is a list of progesterone products approved by the FDA (U.S. Food and Drug Administration): 

*Micronor (norethindrone) oral contraceptive is also available under the following branded generic names:

• Camila (norethindrone)
• Deblitane (norethindrone)
• Errin (norethindrone)
• Heather (norethindrone)
• Incassia (norethindrone)
• Jencycla (norethindrone)
• Jolivette (norethindrone)
• Lyleq (norethindrone)
• Lyza (norethindrone)
• Nora-Be (norethindrone)
• Norlyda (norethindrone)
• Norlyroc (norethindrone)
• Nor-QD (norethindrone)
• Sharobel (norethindrone)
• Tulana (norethindrone)
• Skyla (levonorgestrel-releasing intrauterine system IUD)

Other progesterones:

• Ella (ulipristal) emergency contraception
• Endometrin (progesterone) vaginal insert
• Slynd (drospirenone) oral contraceptive
• Kyleena (levonorgestrel-releasing intrauterine system IUD)
• Nexplanon (etonogestrel) contraceptive implant
• Liletta (levonorgestrel-releasing intrauterine system IUD)
• Mirena (levonorgestrel-releasing intrauterine system IUD)

What are progesterones?

The two main sex hormones in women are estrogen and progesterone. Progesterone is a steroid hormone that is involved with fertility and the menstrual cycle. Progesterones are in a class of hormones called progestogens. After ovulation, during the second half of the menstrual cycle, the female body makes a temporary hormone gland called the corpus luteum. The corpus luteum makes progesterone. 

Progestins are synthetic hormones that act like progesterones. Progestin may be used alone or in combination with estrogen. Progestins are used as contraceptives to prevent pregnancy. They also can be used as hormone replacement therapy to treat menopausal symptoms in postmenopausal women. There are many other uses for progesterone, too (see below).

Hormone replacement therapy may include estrogen alone, or estrogen and progesterone. 

In women who have a uterus, hormone therapy includes estrogen and progesterone, because estrogen alone increases the risk for endometrial cancer in women with a uterus. 

Women who have had a hysterectomy (do not have a uterus) do not need to take progesterone with estrogen, and can use estrogen-only products.

How do progesterones work?

Progesterone can work as part of hormone replacement therapy, to treat symptoms of menopause. It is used along with estrogen in women who have had menopause and have not had a hysterectomy. Estrogen alone can cause an increased risk of uterine cancer, so adding progesterone to hormone replacement therapy lowers the risk of uterine cancer.  

Progesterone may also be used in women of childbearing age who have had normal periods, and stopped menstruating. It is used to help bring periods back, as a replacement for the natural progesterone that some women are missing.

Women who have low progesterone levels and infertility may need to take progesterone to help support a pregnancy. 

When used as contraception, progesterone-only pills work by thickening the cervical mucus (making it harder for sperm to reach an egg) and causing changes in the uterus to prevent an egg from implantation if fertilization does occur. They may or may not suppress ovulation.

What are progesterones used for?

Depending on the specific formulation, progesterones have various indications. Below is a list of some of the indications for which progesterones may be used:

• Hormone replacement therapy (with estrogen)
• Birth control/pregnancy prevention (with or without estrogen)
• Infertility treatment
• Abnormal uterine bleeding
• Amenorrhea (absence of periods)
• Endometriosis
• Endometrial hyperplasia 
• Breast cancer
• Kidney cancer
• Uterine cancer
• AIDS-related appetite loss/weight loss
• Cancer-related appetite loss/weight loss
• Diagnostic aid to see if estrogen is present

Who can take progesterones?

Can men take progesterones?

Most progesterones are not approved for use in men. However, megestrol is a progesterone medication used in women or men for AIDS-related weight loss, appetite loss, or wasting.

Can women take progesterones?

Yes. Progesterones are for use in women for a variety of indications, as long as they do not fall into one of the restricted categories below. Progesterones are often used as hormone replacement therapy, birth control, or to bring back missed periods. They should not be used in women who are pregnant. If you are breastfeeding, consult your healthcare provider for medical advice. 

Can children take progesterones?

No—progesterones are not approved for use in children. 

Can seniors take progesterones?

Older adult females can take progesterones as part of hormone replacement therapy, or for other approved indications, as long as they do not fall into one of the restricted categories listed below.

Are progesterones safe?

Progesterones recalls

Progesterones alone have not been recalled. There have been several recalls of combination medications containing estrogen and progesterone.

Progesterones restrictions

When a progesterone is combined with an estrogen, there is a boxed warning, which is the strongest warning required by the FDA. 

• Estrogen plus progestin should not be used to prevent heart disease or dementia. The Women’s Health Initiative (WHI) study found higher risks of DVT (deep vein thrombosis), PE (pulmonary embolism), stroke, and MI (myocardial infarction) in postmenopausal women who took estrogen plus progestin. The study also found an increased risk of dementia in postmenopausal women who took estrogen with progestin. 
• The WHI study also found an increased risk of invasive breast cancer with estrogen plus progestin. 

Therefore, the black box warning states, “Progestins with estrogens should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.” Talk with your healthcare provider about the risks vs benefits of various types of hormone replacement therapy. 

Progesterones are contraindicated in people with/who are:

• Hypersensitivity to progesterones
• Hypersensitivity to peanuts (certain progesterone products)
• Undiagnosed vaginal bleeding
• Smokers
• Breast cancer or a history of breast cancer
• Progesterone-dependent cancer
• Venous thromboembolism or history of venous thromboembolism
• Arterial thromboembolism within the past year
• Liver disease/impairment
• Pregnancy 
• Missed abortion 

Progesterones should be used with caution in people who have/are:

• Older adults
• Kidney disease
• Heart disease 
• Cerebrovascular disease
• High blood pressure
• Diabetes
• Hypothyroidism 
• High cholesterol
• Asthma
• Seizure disorder
• Migraine 
• History of depression 
• Lupus 
• Obesity 
• Family history of venous thromboembolism
• Surgery or prolonged immobilization
• Sensitive to fluid retention

Can you take progesterones while pregnant or breastfeeding?

If you are taking a progesterone medication (birth control) to prevent pregnancy, and you get pregnant or want to become pregnant, you should stop taking the medication. 

However, if you are taking progesterone as part of fertility treatment or to prevent miscarriage, consult your healthcare professional for advice on when to stop taking the medication. 

After giving birth, under your doctor’s care, you can use progesterone-only birth control (such as Depo-Provera, an implant, IUD, or mini-pill) right away. You should not use birth control that contains estrogen for at least three weeks after giving birth.

Progesterone medications can enter breast milk in small amounts. Consult your healthcare provider for guidance on progesterone and lactation.

Are progesterones controlled substances?

No, progesterones are not controlled substances.

Common progesterones side effects

Progesterones have some common side effects. Before using a progesterone medication, talk to your healthcare professional about what kind of side effects to expect, and what to do if they occur. Side effects depend on the particular progesterone product. If side effects persist or are bothersome, contact your doctor. Some common side effects of progesterones include:

• Headache 
• Breast pain or breast tenderness 
• Stomach problems like abdominal pain, bloating, nausea, vomiting, diarrhea, or constipation
• Menstrual cramps
• Dizziness 
• Muscle or bone pain 
• Viral infection 
• Vaginal discharge 
• Anxiety, irritability, depression
• Fatigue 
• Cough 
• Chest pain 
• Acne 
• Fluid retention
• Excess hair growth 
• Weight gain
• Menstrual irregularities

Progesterones can also cause serious side effects. Serious side effects can include:

• Thrombosis (blood clots)
• Retinal thrombosis (blockage of the retina of the eye) or retinal lesions
• Optic neuritis (inflammation of the optic nerve of the eye)
• Hypertension (high blood pressure)
• Stroke 
• Myocardial infarction (heart attack)
• Breast or ovarian cancer 
• Liver tumor or other liver problems
• Depression 
• Dementia 
• Ovarian cysts
• Ectopic pregnancy 

If you have symptoms of a serious allergic reaction (anaphylaxis) such as hives, difficulty breathing, or swelling of the face, lips, or tongue, seek emergency medical attention right away.

This is not a full list of side effects, and other side effects may occur. Consult your healthcare provider for a full list of side effects. 

How much do progesterones cost?

The price of progesterones varies widely. The price can depend on a number of factors such as the formulation, strength, and quantity, as well as insurance coverage. You can ask your doctor to prescribe you a progesterone that is available in generic, if that is possible for your condition. For example, many “mini-pills,” or progestin-only birth control pills, are available in generic form. You can also use our free SingleCare card or coupons. Our customers can save up to 80% on their prescriptions and refills. Ask your pharmacist to compare prices between your insurance and SingleCare card.

Menopause: Medicines to Help You

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Menopause (sometimes called “the change of life”) is a normal time in a woman’s life when her period stops. During menopause, a woman’s body makes less of the hormones estrogen and progesterone. Lower hormone levels may lead to symptoms like night sweats, hot flashes, and vaginal dryness along with thin bones.

Some women choose to treat their menopause symptoms with hormone medicines sometimes called Hormone Therapy. The following lists some basic information about the FDA-approved hormone medicines for menopause. Use this information to help you talk to your healthcare provider about whether hormone medicines are right for you.

Do not take hormone therapy if you:

• have problems with vaginal bleeding
• have or have had certain cancers such as breast cancer or uterine cancer
• have or have had a blood clot, stroke or heart attack
• have a bleeding disorder
• have liver disease
• have allergic reactions to hormone medicine

Menopause Hormone Therapy

There are different types of hormone medicines used during and after menopause:

Information about non-hormone medicines for menopause is not included. Ask your healthcare provider about the FDA-approved non-hormone medicine for menopause called Brisdelle (paroxetine).

Side Effects

Hormone medicines have side effects. Serious health problems can happen in women who take menopause hormone therapy.

• For some women, hormone medicines may raise their chances of blood clots, heart attacks, strokes, and breast cancer.
• For some women who are 65 years old or older, hormone medicines may raise their chances of dementia.
• For women who still have their uterus, taking estrogen-only medicines raises their chance of getting cancer of the lining of the uterus or endometrial cancer. These women need to take progestin to prevent endometrial cancer.

All side effects and warnings for each hormone medicine are not listed. Ask your healthcare provider about all the risks of taking hormone medicines.

Estrogen-Only Medicines

Estrogen-Only Medicines

Do not use if you:

• have unusual vaginal bleeding
• have or have had certain cancers such as breast cancer or uterine cancer
• have or have had blood clots in the legs or lungs
• have a bleeding disorder
• have had a stroke or heart attack
• have liver problems
• have serious reactions to estrogen medicines
• think you are pregnant

Serious Side Effects

• Stroke or blood clots
• Endometrial Cancer in women who still have their uterus and who do not use progestin with estrogen-only medicines
• Dementia in women 65 years and older
• Gallbladder disease or high triglyceride (cholesterol) levels that could lead to problems with your pancreas
• Vision loss caused by a blood clot in the eye
• Liver Problems
• High Blood Pressure
• Severe allergic reactions

Less Serious, Common Side Effects

• Headaches
• Painful or tender breasts
• Vaginal spotting
• Stomach cramps/ Bloating  
• Nausea and vomiting
• Hair loss
• Fluid retention 
• Vaginal yeast infection

For more information about the risks and side effects for each drug, check Drugs@FDA

Progestin-Only Medicines

Progestin-Only Medicines

Estrogen-only medicines are usually taken with progestin-only medicines to lower the chance of getting endometrial cancer in women who still have their uterus.

The side effects listed below are for women who take a progestin-only medicine and an estrogen-only medicine.

Do not use if you:

• have unusual vaginal bleeding
• have or have had certain cancers such as breast cancer or uterine cancer
• have or have had blood clots in the legs or lungs
• have a bleeding disorder
• have had a stroke or heart attack
• have liver problems
• have serious reactions to estrogen medicines
• think you are pregnant

Serious Side Effects

• Heart attack or stroke
• Blood clots
• Breast cancer
• Dementia in women 65 years and older
• Gallbladder disease or high triglyceride (cholesterol) levels that could lead to problems with your pancreas
• Vision loss caused by a blood clot in the eye
• Liver problems
• High blood pressure
• Severe allergic reactions

Less Serious, Common Side Effects

• Headaches
• Painful or tender breasts
• Vaginal spotting
• Stomach cramps/bloating
• Nausea and vomiting
• Hair loss
• Fluid retention
• Vaginal yeast infection
   

For more information about the risks and side effects for each drug, check Drugs@FDA.

Combination Estrogen and Progestin Medicines

Combination Estrogen and Progestin Medicines

Do not use if you:

• have unusual vaginal bleeding
• have or have had certain cancers such as breast cancer or uterine cancer
• have or have had blood clots in the legs or lungs
• have a bleeding disorder
• have had a stroke or heart attack
• have liver problems
• have serious reactions to estrogen medicines
• think you are pregnant

Serious Side Effects

• Heart attack or stroke
• Blood clots
• Breast Cancer
• Dementia in women 65 years and older
• Gallbladder disease or high triglyceride (cholesterol) levels that could lead to problems with your pancreas
• Vision loss caused by a blood clot in the eye
• Liver problems
• High blood pressure
• Severe allergic reactions

Less Serious, Common Side Effects

• Headaches
• Painful or tender breasts
• Vaginal spotting
• Stomach cramps/bloating
• Nausea and vomiting
• Hair loss
• Fluid retention
• Vaginal yeast infection

For the most recent information about each drug, check Drugs@FDA

Combination Estrogen and Hormone Medicines

You should not use Duavee if you are taking medicines that have estrogen, progestin or both hormones.

Do not use if you:

• have unusual vaginal bleeding
• have or have had certain cancers such as breast cancer or uterine cancer
• have or have had blood clots in the legs or lungs
• have a bleeding disorder
• have or have had a stroke or heart attack
• have liver problems
• have had a serious allergic reaction to estrogen medicines
• think you are pregnant or may become pregnant
• are breastfeeding (nursing)

Serious Side Effects

• Stroke or blood clots
• Dementia in women 65 years and older
• Gallbladder disease or high triglyceride (cholesterol) levels that could lead to problems with your pancreas
• Vision loss caused by a blood clot in the eye
• Liver problems
• High blood pressure
• Severe allergic reaction

Less Serious, Common Side Effects

• Muscle spasms
• Nausea
• Diarrhea
• Upset stomach/stomach pain
• Throat pain
• Dizziness
• Neck Pain

For more information about the risks and side effects for each drug, check Drugs@FDA.

Important Questions to Ask about Menopause Hormone Medicines

• Are hormones right for me? Why?
• What are the benefits?
• What are the serious risks and common side effects?
• How long should I use hormone therapy?
• What is the lowest dose that will work for me?
• Are there any non-hormone medicines that I can take?

Want more information about menopause? Check the FDA website at: www.fda.gov/menopause

The drug and risk information in this booklet may change. Check Drugs@FDA for the latest facts on each product listed in this booklet.

Resources For You

• Content current as of:

  08/22/2019

Progesterone: Uses, Interactions, Mechanism of Action

Duphaston instructions for use: indications, contraindications, side effects – description Duphaston Film-coated tablets (1048)

Before starting treatment with dihydrosterone for abnormal uterine bleeding, it is necessary to find out the cause of the bleeding. With prolonged use of dihydrosterone, periodic examinations by a gynecologist are recommended, the frequency of which is determined individually, but at least once every 6 months. In the first months of treatment for abnormal uterine bleeding, breakthrough bleeding or spotting spotting may occur.If “breakthrough” bleeding or spotting spotting occurs after a certain period of taking dihydrosterone or continues after a course of treatment, you should consult your doctor and conduct an appropriate additional examination, if necessary, do an endometrial biopsy in order to exclude neoplasms in the endometrium.

HRT should be prescribed for the treatment of menopausal symptoms that adversely affect the patient’s quality of life. The benefit / risk ratio of HRT should be assessed annually.Therapy should be continued until the potential benefit outweighs the potential risk.

Medical examination. Before starting the use of a combination of dydrogesterone and estrogen (for HRT), a complete individual and family history should be collected. An objective examination (including examination of the pelvic organs and mammary glands) should be carried out in order to identify possible contraindications and conditions requiring precautionary measures.

During treatment, it is recommended to periodically monitor the individual tolerance of HRT.

Endometrial hyperplasia and cancer. In women with an intact uterus, the risk of endometrial hyperplasia and cancer increases with prolonged estrogen monotherapy. Cyclic use of progestogens, incl. dydrogesterone (for at least 12 days of a 28-day cycle), or the use of a sequential combined HRT regimen in women with a preserved uterus may prevent the increased risk of endometrial hyperplasia and cancer with estrogen monotherapy.

Breast cancer. Available data indicate that the risk of breast cancer is increased in women who received HRT with estrogen-progestogen drugs, and possibly also with estrogen monotherapy. The level of risk depends on the duration of HRT. While taking medications for HRT, especially with combination therapy with estrogens and progestogens, there may be an increase in breast tissue density during mammography, which can complicate the diagnosis of breast cancer.

Ovarian cancer. Ovarian cancer is much less common than breast cancer. There is evidence of a slight increase in risk for women receiving HRT in the form of estrogen monotherapy or combination therapy with estrogens and progestogens. An increase in this risk becomes evident with the duration of therapy for more than 5 years, and after its termination, the risk gradually decreases over time.

Venous thromboembolism. HRT is associated with 1.3 to 3-fold increased risk of venous thromboembolism (VTE), i.e. deep vein thrombosis or pulmonary embolism. The likelihood is highest in the first year of HRT than in the following. Patients with diagnosed thrombophilia have an increased risk of developing venous thromboembolism, and HRT may increase the risk. For this reason, HRT is contraindicated in such patients.

Risk factors for venous thromboembolism include estrogen intake, advanced age, major surgery, prolonged immobilization, obesity (BMI> 30 kg / m2 ² ), pregnancy, postpartum period, systemic lupus erythematosus, cancer.There are no unambiguous data on the possible role of varicose veins in the development of venous thromboembolism.

If long-term immobilization is necessary after surgical interventions, you should stop taking medications for HRT 4-6 weeks before the operation, resuming their intake is possible after the woman’s motor activity is fully restored.

In case of detection of thrombophilia associated with thrombosis in family members or in the presence of a severe defect (for example, lack of antithrombin III, protein C, protein S, or a combination of defects), HRT is contraindicated.

If the patient is taking anticoagulants, the benefit / risk of HRT should be carefully assessed. Until a thorough assessment of the factors for the possible development of thromboembolism is completed or the initiation of anticoagulant therapy, drugs for HRT are not prescribed. If thrombosis develops after starting therapy, HRT should be discontinued.

An urgent need to consult a doctor in case of any of the symptoms indicating a possible thromboembolism (soreness or swelling of the lower extremities, sudden chest pain, shortness of breath, blurred vision).

Ischemic heart disease (IHD). There is evidence that there is no protective effect against the development of myocardial infarction in women with and without coronary artery disease, receiving HRT in the form of combination therapy with estrogens and progestogens or estrogen monotherapy.

The relative risk of coronary heart disease is slightly increased during combined HRT. The absolute risk of coronary heart disease depends on age. The number of cases of ischemic heart disease against the background of the use of HRT is less in healthy women at an age close to the onset of natural menopause, but it increases in subsequent years.

Ischemic stroke. Combination therapy with estrogens and progestogens or estrogens alone is associated with a 1.5-fold increased risk of ischemic stroke. The relative risk does not change with age and does not depend on the time of menopause. However, the incidence of stroke varies with age, and the overall risk of stroke in women receiving HRT will increase with age.

Influence on the ability to drive vehicles and mechanisms

Care should be taken when driving vehicles and mechanisms, given the possibility of adverse reactions from the nervous system (mild drowsiness and / or dizziness, especially in the first hours of admission).

Stada

STADA Arzneimittel AG is an international group of companies, one of the
the largest manufacturers of generics and products in the Consumer HealthCare segment.
The concern has more than 20 production sites around the world, in
including Russian factories – NIZHFARM (Nizhny Novgorod) and HEMOFARM
(Obninsk).

STADA’s Russian product portfolio includes medicines
of the 17 top-selling therapeutic groups in the pharmacy
retail.

STADA’s gynecological portfolio includes such well-known medicinal
funds like Tranexam, Depantol, Femileks, Geksikon, Ginestril,
Miropriston, Mirolyut and Antiadgezin. Since 2020 the company’s portfolio
was replenished with the brands Vitrum Prenatal Plus and Calcium-Dz Nycomed.
For 125 years STADA has been taking care of people’s health by building
trusting relationships with partners and consumers. STADA helps
make a confident choice in favor of high-quality and safe medicines for
fair price.

Ginestril

Ginestril® is a progesterone receptor modulator.

Used to treat uterine leiomyoma.
The greatest efficiency is observed in the treatment of symptomatic uterine fibroids with medium-sized nodes (3 – 6 cm).
The course of treatment is 3 months.

Ginestril® is the drug of choice for the treatment of symptomatic uterine fibroids.

• Ginestril® reduces the size of myomatous nodes by 46%, the volume of the uterus by 36%, which allows leveling symptoms and avoiding surgical treatment or organ-preserving intervention.
• Ginestril® does not cause symptoms of estrogen deficiency during treatment, does not increase thrombotic risk.
• Ginestril® is the only progesterone receptor blocker
that does not exhibit hepatotoxicity, which has been proven in clinical use for 15 years.
• MnN mifepristone has been used on the market for over 20 years and has been proven to be safe at various doses (including ultra-high doses: the drug Corlim in the USA for the treatment of hyperglycemia in patients with Itsenko-Cushing’s syndrome 300-900 mg mifepristone / day for a long time).

Tranexam

Tranexam® is a hemostatic agent.

Available in two dosage forms: solution for intravenous administration and tablets.
Tranexam® is used for the short-term treatment of bleeding associated with increased fibrinolysis in various fields of medicine.

In obstetrics and gynecology, Tranexam® is used for the following pathological conditions:

– abnormal uterine bleeding;
– surgical procedures on the cervix;
– obstetric-gynecological bleeding (including bleeding during gynecological surgery).
– bleeding during pregnancy.

Tranexam® is the gold standard for treating abnormal uterine bleeding.

• Level A efficacy / safety evidence.
• Tranexamic acid is included in the standards of medical care for all types of obstetric and gynecological bleeding.
• Tranexamic acid is included in international guidelines for the treatment of obstetric and gynecological bleeding.
• Tranexam® is the only brand of tranexamic acid in Russia produced from the original Japanese substance.

Birth of a tablet – analytical portal POLIT.RU

Livebook Publishing House publishes a book by American journalist Jonathan Eig “The Birth of a Pill. How four enthusiasts rediscovered sex and made a revolution ”(translated by Anna Sinyatkina).

The heroes of the book are the founder of the American League of Birth Control Margaret Sanger, physiologist Gregory Pincus, a deeply religious Catholic doctor John Rock and the determined heiress of millions, the leader of the women’s rights movement Catherine McCormick, whose joint efforts led to the birth of birth control pills.

The Birth of a Pill is an incredible story about the most radical social breakthrough of the 20th century, driven by courage, unconventional thinking and faith in what you do. About the discovery that proclaimed the sex revolution, changed the life of the whole society and gave millions of women new opportunities and freedom.

This passage describes the circumstances in which a new contraceptive was tested.

Pincus was pleased with the results of his previous tests on rabbits and rats.Equally, if not more, he was pleased with John Rock’s findings that progesterone did not harm women. Rock did not test hormones specifically as a method of protection, but Pinkus did not care much. It doesn’t matter if women could conceive or not. He needed living warm bodies; women who are ready not only to take the experimental medicine, but also to undergo daily temperature measurements, daily vaginal smears, urine tests every two days and endometrial biopsies from time to time – when the doctor takes pieces of tissue from the uterine lining.Rock’s patients had a goal – they believed that in the end Rock would help them get pregnant. Without such an incentive, Pincus would hardly have gathered volunteers. In addition, conducting his experiment ostensibly as part of Rock’s work with fertility, Pincus could claim with a blue eye that he was not involved in birth control issues. If he had frankly confessed what he was studying, he and Rock would both be found to be violators of Massachusetts’ all form of contraception law, and would receive five years in prison and a fine of up to a thousand dollars.

In an application for a new Family Planning grant, Pincus wrote that he intends to conduct trials for “two or three menstrual cycles on thirty to forty women.” In the meantime, laboratory tests on animals continued.

Here’s another splash of Pincus’ improvisational genius – a scheme so bizarre it seems to have come straight from Hollywood. He was going to test a contraceptive disguised as a fertility drug. If he was still at the faculty at Harvard, and even if he was still in alliance with Clark University, he would not have gotten away with it.The head of the faculty, fearing problems with the law or a bad reputation, could simply forbid him from giving women contraceptives. But Pincus was in his own service and was not afraid to take risks. When Henshaw asked him if it was dangerous to break the law by giving birth control to women in Massachusetts, Pincus replied emphatically, “You can research the fundamental facts in either Worcester or Timbuktu [sic].” In these trials, he continued, we are not researching preservatives: “They are looking at the very specific effects of the drugs we work with, and research into the biology of those effects is not against any Massachusetts law.”It can be difficult to carry out large-scale trials on many women, but this is not the question of today. The first thing to do is find out if progesterone is working. Pincus concluded: “Thus, I would like to know from you what you think is possible in terms of your resources.”

Pincus believed it was the duty of a scientist to be aggressive. Too many of his colleagues, he complained, were content with publishing in scientific journals and thinking about how work could drive change.”Call-to-action programs,” he wrote, “mostly pass by the researcher’s laboratory.”

Pincus now saw himself as more than just a research scientist, he was an activist, fighter and businessman. He was also the creator of all kinds of coalitions, even the most implausible. He is not the first to experiment with progesterone, and he is not even the first to suggest that progesterone can work as a means of protection for women. But he was the first to establish the necessary connections, linking together pharmaceutical companies, gynecologists and biologists who have coincided interests.Pincus was not looking for a moment of insight – he was looking for the pieces of the puzzle that make up his mental image: a functioning birth control pill. Faced with another obstacle, he did not retreat from the project, did not postpone it for himself or for the future, but continued to move forward, using all the means and all allies that he had.

John Rock has already given women progesterone and estrogen to see if it helps them get pregnant. Pincus didn’t do anything else – he just did it for a different reason.

Was it dishonest? Most will say yes. However, this did not violate any laws or medical standards of the time.

In the 50s of the twentieth century, the US laws on the testing of experimental drugs were among the most progressive, and still there was still no law obliging doctors to inform patients that they were being experimented with. Rock’s patients weren’t exactly fooled. They were told that the progesterone they were given would stop the ovaries from working and make pregnancy impossible.They were told that the treatment would cause a condition similar to pregnancy and could cause nausea. And they were honestly told that, according to Rock, after the experiment was completed, their chances of getting pregnant would be much higher.

Only one detail was not said.

❍ ❍ ❍

Human trials began in 53. Pincus and Rock enrolled twenty-seven of Rock’s patients at the free women’s hospital for a three-month trial. The study was different from Rock’s earlier progesterone experiments.This time, because Pincus wanted to make sure hormones effectively prevent ovulation, the study did not include women who did not ovulate regularly. Those who entered the group were also sterile, but Rock did not know why. Instead of the mixture of progesterone and estrogen that Rock had previously used, women received only progesterone. The tablets were taken every day for three weeks, followed by a break so that menstruation could occur.

The work turned out to be laborious.Among Rock’s nurses and technicians, the new round of studies was called Pinkus’ progesterone project – PPP. Some people joked that PPP stands for pee-pee – a lot of urine samples were tested. Having collected enough bottles of urine, Rock sent a courier from Boston, and Pincus sent a courier from Shrewsbury. They met halfway, Pinkus’s messenger collecting urine and driving back to Shrewsbury.

Pincus was so delighted with this approach that he was eager to find more test subjects. In the spring of 53, when Rock’s trials were just beginning, he turned to scientists and gynecologists in Worcester, Israel and Japan with a request if they would agree to include their patients in similar studies.He also recruited members from the nurses at Worcester State Hospital. Their assistance could be extremely important for Pinkus: they, unlike Rock’s patients, were not treated for infertility. They were presumably fertile, some used contraception. Unfortunately, the nurses weren’t the best patients. Most of them came out of the experiment.

In Worcester, a forty-seven-year-old gynecologist named Henry Kirkendall agreed to help Pinkus and include some of his patients in his research.Kirkendall served at St. Vincent’s Hospital and was the chief obstetrician at Memorial Hospital, both based in Worcester. If you were born in Worcester or nearby in the 40s or early 50s of the twentieth century, it is likely that you were received by Dr. Kirkendall. Like John Rock, Kirkendall was a devout Catholic. Like John Rock, he became a proponent of family planning as a result of his work with women. Pincus met with Kirkendall and asked if the gynecologist could find thirty women willing to participate in a study like the one that Rock was doing.Women will have to take their temperature every day and record the results themselves. They will also have to take a daily swab and collect their own urine for hormone tests, or visit a doctor for a nurse to do it.

Progesterone doses were extremely high – between two hundred fifty and three hundred milligrams per day. These women were not paid to participate, nor were they informed that the results could help invent an innovative remedy. Most of them only did it because they were asked by a doctor they trusted.

Testing began in June. All summer, Dr. Kirkendall had been stuffing the trunk of his blue Pontiac with urine ampoules and slides and dropping them off to the Worcester Foundation in Shrewsbury for analysis or asking him to take them to his son.

In the first year of testing, Pincus, Rock, and Kirkendall recruited sixty women. In itself, this alone was somewhat of an achievement, given that the work had to be done in secret. But half of the participants withdrew from the experiment: some because of the complexity of the procedures, some because of too unpleasant side effects.And although Rock was pleased with the results – four out of thirty observed infertile women were able to become pregnant due to the so-called rebound effect – Pincus was disappointed: fifteen percent of women who received progesterone showed signs of ovulation – much worse than rabbits and rats. The matter was complicated by the fact that for women who received two hundred milligrams of progesterone and four hundred milligrams each, the results were the same.

Up to this point, everything has developed rapidly and inspiringly.However, a remedy that prevented pregnancy only eighty-five percent of the time was no good.

Suddenly, Pinkus had reason to doubt his own elegant decision.

90,000 What drugs are available in support after IVF?

After the in vitro fertilization procedure, there is a need for medication support. This is due to the need to maintain the optimal degree of indicators of the amount of hormones in the body: progesterone and estradiol.Their level is often amenable to disruption due to the use of hormonal drugs during the previous stages of IVF.

Do not forget that the use of the IVF method indicates the presence of certain problem factors in the reproductive sphere, and therefore an increase in the likelihood of the risk of fetal loss.

Progesterone support

The sex hormone progesterone belongs to the category of the most important hormones for the restoration of reproductive function and further pregnancy.It has a number of features and functions:

• Creates the maximum level of favorable conditions for the endometrium. This factor contributes to the reliable fixation of the embryo in the future.
• Maintains the closed state of the cervical canal.
• Reduces the risk of contraction of uterine tissue, which prevents the likelihood of termination of pregnancy.

The following essential drugs are used during the progesterone support phase:

Dufaston tablets,

Utrozhestan in the form of vaginal capsules,

oily solution of Progesterone injected intramuscularly or subcutaneously at a dosage of 1 ml 2.5 or 1%,

Lutein tablets used intravaginal or oral,

Gel preparation for vaginal use Krynon.

It should be borne in mind that the cancellation of drugs that contain progesterone should be carried out according to a scheme with a gradual decrease in the level of the dose used. A complete refusal to use the drug often occurs during pregnancy with a period of 15 weeks.

Extradiol support

The hormonal substance estradiol is secreted by the adrenal glands and, like progesterone, is responsible for the preservation of pregnancy.After the embryo transfer procedure, the hormone estradiol also controls endometrial tissue thickness. Preparations with extradiol are prescribed for:

• ensuring growth and increasing the level of stretching of uterine tissues;
• performance by the body of a function that contributes to the normal formation of the skeletal system of the embryo;
• normalization of the fetoplacental system;
• the process of stimulating all metabolic processes in the body;
• delivery of the required level of nutrients, vitamins and microelements to the displaced embryo;
• activation of the level of blood circulation in the tissues of the uterus.

In Russian medical practice, support with the help of extradiol is carried out using the following drugs:

• Proginov’s tablets and Estrofem medicines;
• Divigel or Estrogel for cutaneous gel;
• with Klimar’s medical plaster.

Cancellation of the listed drugs occurs no later than the gestational age of 15 weeks.

In addition to the drugs listed above, after embryo transfer, the following can be used for further support:

• Hormones secreted by the adrenal cortex.These are drugs such as Dexamethasone, Prednisolone, Cortisol. They are relevant when creating links of an immune nature between the expectant mother and the embryo, help to reduce androgen levels, eliminate the risk of possible fetal hypoxia and prevent the onset of premature birth.
• Medicinal preparations for blood thinning. This category includes Aspirin, Clexane, Fraxiparine, Trombo-ass or Curantil. Their use helps to maintain the optimal level of blood density, reduces the process of platelet aggregation, which are responsible for the blood circulation in the placenta and in the uterus itself, eliminating the risk of oxygen starvation of the embryo.
• Vitamins from the group of antihypoxants: folic acid tablets, beta-carotene and vitamin preparations A, B, E. This helps to maintain the immune system at an optimal level.
• Medicines, the action of which is based on the use of human hormones of menopausal or follicle-stimulating origin. These are the drugs Menopur, Puregon, Elonva, Gonal-F. Their use is important for the physiological maintenance of all basic mechanisms during pregnancy.
• Medicines Profazi or Pregnyl, which contain an analogue of chorionic gonadotropin, which completely duplicates the natural hormones of the woman’s body, are responsible for the process of preserving the transplanted embryo.

It must be remembered that each individual case involves the use of a specific category of drugs or a combination of them in an individually selected dosage. You should not try to independently carry out treatment, which can not only worsen the condition, but also destroy the transferred embryo.

90,000 Reviews Dufaston, prices, instructions for use

Featured Products

• Victoria
  2020-11-16 16:00

  Tell me please.Are there those who took a poultice when diagnosed with uterine hypoplasia?

• Maria
  2017-03-01 14:05

  Duphaston took early in pregnancy to support her. Of course, only as prescribed by a doctor. The cost, despite the fact that the drug is specific, is low.The effectiveness of duphaston is already a legend, it helped many and, fortunately, I was no exception. An excellent drug, and the main thing is that the manufacturer’s promises are fulfilled for 100.

• Alla Leonidovna
  2017-02-28 12:16

  My diagnosis is progesterone deficiency.On the advice of a gynecologist, she began to take Dufaston as soon as she found out about her pregnancy. Its price is average, it does not bite. Everything went well, the embryo was fixed. They canceled this drug for me at 17 weeks, gradually. It was scary to interrupt the intake of these pills, there is the main hormone of pregnancy, but I was afraid in vain. The pills saved my baby’s life.

• Guzal
  2017-02-27 14:33

  For a long time, my man and I could not conceive a child, but we really wanted to.We tried for a long time, but unsuccessfully, and shyness took to go to the doctor. Well, then I had to. After we went to the doctor with our problem, he advised the hormonal drug Dufaston, 1 tablet every 4 days, with a gradual decrease in dosage. I am very grateful to the drug and the doctor who advised him, the pregnancy has finally come.

• Arina
  2017-02-27 11:26

  I have problems with the cycle and I went to the gynecologist, they said that I should always drink the drug.The reason was quite simple, hormone deficiency, so the absence of menstruation occurred. Duphaston has no side properties for me. I drink it in courses without problems. Unfortunately, I have to drink every month, as the doctor prescribed. It normalizes the cycle well, and I like the price for it.

• Helena
  2017-02-27 11:04

  Duphaston hormonal tablets.A great helper for those who postponed pregnancy for a certain period using contraceptives. The moment in life has come when I really wanted a child, but at the expense of the funds used earlier. there were difficulties in conception. But as soon as she managed to get pregnant, Dufaston was prescribed. No side effects were observed. The drug Duphaston helps in preserving the child during the entire pregnancy. Convenient to use.

• Maria
  2017-02-26 21:50

  Beginning to feel discomfort during intimacy.At first I thought it would pass, but no. As a result, I went to the doctor who discovered I had an ovarian cyst. Although I had a positive tendency, he recommended Dufaston to me. I took it 2 tablets a day for three months. As a result, after taking it, I did not find any problems with the ovaries at all, and ovulation returned to normal. In general, a good drug, it really helps.

• Maid Lyubov Viktorovna
  2017-02-26 15:52

  When they threatened to miscarry at 12 weeks, she sobbed like mad and was ready to do anything to save the baby.Duphaston was prescribed to drink. I had to take pills for a long time, a lot and often. Even at night. It is very important to observe the time break. Decently hits the wallet. But happiness at the birth of a child is not worth any money in the world. And I would also like to tell those who read this review (and many people read it who find themselves in the same situation as me) that the dose should be reduced gradually, you cannot stop taking the drug right away.

• Galina
  2017-02-26 09:50

  Visited the gynecologist when I had an irregular menstrual cycle for several months.The doctor recommended taking Duphaston, which is not expensive for the price. The composition of the drug was found to be safe for the human body. After using this drug, the menstrual cycle has completely returned to normal. The main thing is not to forget to follow the instructions.

• Anna
  2017-02-25 22:23

  I met Dyufaston when I was carrying my first child.Prescribed almost from 13 weeks, when I started to bleed slightly, in order to exclude premature birth. So I drank it throughout the pregnancy, until they put the ring at 22 weeks. Thanks to Dyufaston, a miscarriage was ruled out, even the slightest bleeding disappeared during the intake. I felt fine.

90,000 IHC DETERMINATION OF ESTROGEN AND PROGESTERONE RECEPTORS IN BREAST TUMORS (LABORATORY PREPARATIONS)

Criteria for participation: Clinical diagnostic laboratories performing this type of research are invited to participate in the proficiency testing program.

Criteria for evaluating performance are presented in the ISI Program.

Information on the frequency and timing of the transfer of samples to the ISI participants for research, the last deadline for submitting the results to the ISI participants is published in the personal account of the ISI participant.

When an ISI participant goes through a section cycle (for sections with several cycles – all cycles), he is given a Certificate of Participation.

Proficiency test item information

The laboratory transfers to the courier sent to it 4 packed in a container received from ASNP “TsVKK” 4 routine histological preparations selected by its choice and the results of their examination. After reviewing the preparations by experts, the laboratory receives a conclusion on the quality of the preparations and the correctness of the formulation of the cytological diagnosis, as well as recommendations for improving the quality of this type of research. If necessary, drugs are returned to the laboratory.

Forms are filled out in personal account

FSVOK – 2019

Program MCI

Instruction

FSVOK – 2020

Program MCI

Instruction

90,000 Progesterone – a new look at a long-known drug (Literature review)

Zygmunt Malgorzata, Sapa Jacek
Jagiellonian University, St.Krakow, Poland
Published: REPRODUCTIVE ENDOCRINOLOGY №1 (33) / BEREZEN 2017

Based on a literature review, the role of progesterone in modern medicine is presented, taking into account various routes of administration. A review of the available literature on the role of progesterone in modern obstetric and gynecological practice suggests that after 80 years of using this steroid, it has every chance of continuing to be used in clinical practice.

Replacement of exogenous progesterone is considered a recognized method of treating hormonal deficiency that occurs in phase II of the menstrual cycle and in threatened pregnancy, and its future in gynecology and obstetrics is beyond doubt.On the contrary, it can be said that it is of great interest, especially given the emergence of new possibilities for the vaginal or sublingual route of administration.

An additional advantage is the new directions of action used in medicine – anticonvulsant, neuroprotective and anti-migraine. A review of the literature confirms that the treatment of luteal malaise with natural rather than synthetic progesterone is safer, which indicates that such hormone replacement is well tolerated.

The listed various and multidirectional effects of the effects of progesterone, as well as selective modulators of progesterone receptors on the woman’s body, are possible due to specific nuclear progesterone receptors, which are located in target cells, including the mucous membrane of the uterus, mammary glands, central nervous system and pituitary gland.

Keywords : progesterone, bioavailability, route of administration, effectiveness of therapy.

BIBLIOGRAPHY

1.Al-Asmakh, M. “Reproductive functions of progesterone.” Middle East Fertility Society Journal 12 (2007): 147-52.

2. Andréen, L., Nyberg, S., Turkmen, S., et al. “Sex steroid induced negative mood may be explained by the paradoxical effect mediated by GABAa modulators.” Psychoneuroendocrinol 34 (2009): 1121-32. ”

3. Biela, A., Pacholska-Bogalska, J. “Nowotwory hormonozalezne u kobiet.” Nowa Medycyna 4 (2012) 76-81.

4. Brazert, M., Korman, M. P, Pawelczyk, L.A. “Zastosowanie selektywnych modulatorow receptora progesteronowego w leczeniu mięśniaków macicy oraz ich przyszłość w ginekologii.” Ginekol Pol 84 (2013): 794-800.

5. Bomba-Opoń, D. “Rekomendacje Polskiego Towarzystwa Ginekologicznego dotyczące stosowania progesteronu w ginekologii i położnictwie” Ginekol Pol (2012).

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