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Progesterone
Progesterone is a natural hormone used in various prescription forms to treat hormone-related conditions. It is commonly prescribed for menstrual irregularities, hormone replacement therapy (HRT) in postmenopausal women, and to support early pregnancy in women undergoing assisted reproductive technology (ART). Progesterone helps regulate the menstrual cycle and maintains the uterine lining for pregnancy. It belongs to the class of progestins when used as a medication.
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Frequently Asked Questions
How long does it take for progesterone to work?
For conditions like secondary amenorrhea, progesterone typically induces a menstrual period within 7 to 10 days of completing treatment. For hormone therapy, it may take several weeks to notice an improvement in menopausal symptoms.
Can I take progesterone during pregnancy?
Yes, progesterone is often prescribed during early pregnancy, especially in women undergoing assisted reproductive technology (ART), to support implantation and maintain the pregnancy.
What should I do if I miss a dose of progesterone?
If you miss a dose, take it as soon as you remember unless it is close to your next scheduled dose. Do not double up on doses to make up for a missed one.
Can progesterone cause weight gain?
Yes, weight gain is a common side effect of progesterone, particularly in long-term use for hormone therapy.
Is progesterone safe for long-term use?
Progesterone is generally safe for long-term use when monitored by a healthcare provider. However, risks such as blood clots and breast cancer should be regularly evaluated, especially in combination with estrogen.
Comprehensive Drug Guide
How Does Progesterone Work?
Progesterone works by preparing the endometrium (the lining of the uterus) for the potential of pregnancy after ovulation. If pregnancy does not occur, progesterone levels drop, leading to menstruation. During pregnancy, progesterone helps maintain the uterine lining, supporting early development. When used in hormone therapy or to treat menstrual irregularities, it mimics the natural progesterone produced by the body, helping regulate hormonal balance.
Common Dosages
- Oral capsules: 100 mg, 200 mg
- Vaginal gel: 8%
- Vaginal suppositories: Various strengths
- Intramuscular injection: 50 mg/mL, 100 mg/mL
The dose depends on the condition being treated and the form of progesterone used.
Typical Dosing
- For hormone replacement therapy: The typical dose is 200 mg once daily at bedtime for 12 days of a 28-day cycle, combined with estrogen.
- For secondary amenorrhea: The dose is usually 400 mg once daily at bedtime for 10 days.
- For ART (vaginal gel): One application of 8% gel is inserted vaginally once or twice daily, as directed by the healthcare provider.
- For intramuscular injections: Dosage and frequency depend on the specific treatment plan, typically used in ART to support early pregnancy.
Typical Dosing
FDA Approved Indications
- Hormone replacement therapy (HRT): To reduce menopausal symptoms and protect the uterine lining in women taking estrogen.
- Secondary amenorrhea: To induce menstrual periods in women who have stopped menstruating due to low progesterone levels.
- Assisted reproductive technology (ART): To support embryo implantation and early pregnancy.
Who Shouldn't Take Progesterone?
- Known hypersensitivity to progesterone or any component of the formulation.
- Undiagnosed abnormal vaginal bleeding.
- Breast cancer or a history of breast cancer.
- Liver dysfunction or disease.
- Active or past blood clots, including deep vein thrombosis (DVT), pulmonary embolism (PE), or stroke.
Advice From The Pharmacist
- Take progesterone exactly as prescribed by your healthcare provider, following the specific instructions for the form you are using.
- If you are taking progesterone capsules, take them at bedtime, as they may cause drowsiness or dizziness.
- For vaginal forms, ensure you follow the instructions for insertion carefully.
- Inform your doctor if you experience unusual side effects, such as severe headaches, chest pain, shortness of breath, or vision changes, as these could indicate serious complications like blood clots.
- Store progesterone at room temperature, away from moisture and heat.
Side Effects of Progesterone
Common Side Effects
- Drowsiness or dizziness (especially with oral forms)
- Breast tenderness
- Bloating or weight changes
- Nausea
- Headache
Uncommon/Severe Side Effects
- Blood clots, which can cause symptoms like leg pain or swelling, chest pain, or shortness of breath.
- Severe allergic reactions, such as rash, itching, or swelling.
- Mood changes, including depression or anxiety.
Risks and Warnings of Progesterone
- Blood Clots: Progesterone can increase the risk of developing blood clots, especially in women with risk factors for clotting disorders or those using hormone replacement therapy. Seek medical attention if you experience symptoms of blood clots.
- Breast Cancer Risk: Progesterone, when used in combination with estrogen in hormone replacement therapy, may increase the risk of breast cancer. Discuss your risks with your doctor, especially if you have a family history of breast cancer.
- Liver Function: Progesterone may affect liver function, so liver enzymes should be monitored in patients with a history of liver disease.
Interactions with Progesterone
Common Drug Interactions
- Anticonvulsants (e.g., carbamazepine, phenytoin): These medications may reduce the effectiveness of progesterone by increasing its metabolism.
- CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): These drugs can increase the levels of progesterone in the blood, potentially increasing the risk of side effects.
- St. John's wort: This herbal supplement may reduce the effectiveness of progesterone.
Alternatives to Progesterone
- Prometrium (progesterone): Another oral form of progesterone used for hormone therapy and menstrual irregularities.
- Provera (medroxyprogesterone acetate): A synthetic progestin used for similar indications, such as hormone therapy and amenorrhea.
- Crinone (progesterone vaginal gel): Used in assisted reproductive technology (ART) to support early pregnancy.
