Get Your Personalized Supplement StackSupplement Stack Quiz

Progesterone USP

Also known as: Progesterone, Progestogen, Progestin

Overview

Progesterone is a naturally occurring steroid hormone essential for the menstrual cycle and pregnancy. Primarily produced by the ovaries and placenta during pregnancy, it plays a crucial role in preparing the uterus for implantation and maintaining a healthy pregnancy. Progesterone is widely used in hormone replacement therapy (HRT) to manage menopausal symptoms, in fertility treatments to support the luteal phase, and as a contraceptive. It is available in various forms, including oral tablets, vaginal suppositories, and intramuscular injections. Research on progesterone is extensive, with a high level of maturity, although the quality of evidence varies depending on the specific application and study design. Its efficacy and safety are well-documented, making it a cornerstone in reproductive health and hormone therapy.

Benefits

Progesterone is primarily effective in supporting luteal phase defects, improving pregnancy outcomes, and managing menopausal symptoms. Meta-analyses have shown that progesterone supplementation can significantly increase live birth rates in women undergoing fertility treatments. For example, one meta-analysis reported a relative risk of 1.42 (95% CI, 1.15-1.75) for live birth rates with progesterone supplementation. Additionally, when used with estrogen in hormone replacement therapy, progesterone may have a lower risk of breast cancer compared to synthetic progestins, with a reported relative risk of 0.67 (95% CI 0.55–0.81). These benefits are particularly pronounced in women with luteal phase defects or those undergoing assisted reproductive technologies (ART).

How it works

Progesterone exerts its effects by binding to the progesterone receptor (PR), a nuclear receptor that regulates gene expression in reproductive tissues. Upon binding, the progesterone-PR complex influences the transcription of genes involved in endometrial preparation, inhibition of ovulation, and maintenance of pregnancy. Specifically, progesterone promotes the development of a receptive endometrium, making it suitable for embryo implantation. It also thickens cervical mucus, preventing sperm penetration and further inhibiting ovulation. The absorption and bioavailability of progesterone vary depending on the route of administration, with vaginal and intramuscular routes generally providing more consistent levels compared to oral administration.

Side effects

Progesterone is generally considered safe when used appropriately, but it can cause several side effects. Common side effects include dizziness, drowsiness, and breast tenderness. Less common side effects may involve mood changes and nausea. Rare side effects include allergic reactions. Progesterone may interact with certain antidepressants and anticonvulsants, potentially altering their effectiveness or increasing side effects. It is contraindicated in pregnancy (unless specifically indicated for medical conditions) and in individuals with a history of breast cancer. Caution is advised in patients with liver disease or a history of blood clots. Due to the potential for drowsiness, patients should exercise caution when driving or operating heavy machinery. It is crucial to use progesterone under medical supervision to monitor for adverse effects and ensure appropriate usage.

Dosage

The minimum effective dose of progesterone varies depending on the application, typically ranging from 100-300 mg for luteal support. Optimal dosage ranges for hormone replacement therapy (HRT) or fertility support are generally between 100-600 mg. The maximum safe dose is not well-defined and should be determined under medical supervision. For fertility support, progesterone is often administered in the luteal phase. Vaginal or intramuscular forms are often preferred for fertility support due to better absorption. It is important to adhere to prescribed dosages and timing to maximize efficacy and minimize potential side effects. Always consult with a healthcare provider to determine the appropriate dosage and form of progesterone for individual needs.

FAQs

How should progesterone be used?

Progesterone should be used under medical supervision, especially for hormone replacement therapy (HRT) or fertility treatments, to ensure appropriate dosage and monitoring for side effects.

Is progesterone safe?

While generally safe, progesterone can cause drowsiness and should be avoided in pregnancy unless medically indicated. Consult a healthcare provider for personalized safety advice.

When should progesterone be administered for fertility support?

Timing is crucial for fertility support; progesterone is typically administered in the luteal phase to prepare the uterine lining for implantation.

What are the common side effects of progesterone?

Common side effects include dizziness, drowsiness, and breast tenderness. If these side effects are severe or persistent, consult your healthcare provider.

Can progesterone interact with other medications?

Yes, progesterone may interact with certain antidepressants and anticonvulsants. Inform your healthcare provider of all medications you are taking to avoid potential interactions.

Research Sources

https://pmc.ncbi.nlm.nih.gov/articles/PMC4960754/ – This study reviewed the effects of progestogens on breast cancer risk in postmenopausal women using hormone therapy. It found that natural progesterone, when used with estrogen, may have a lower risk of breast cancer compared to synthetic progestins. The observational nature of the included studies limits the strength of the conclusions.
https://pubmed.ncbi.nlm.nih.gov/36574915/ – This meta-analysis investigated the impact of progestogen type on the risk of breast cancer in postmenopausal women using hormone therapy. The findings suggest that the type of progestogen used can influence breast cancer risk, with some progestogens being associated with a lower risk compared to others. However, heterogeneity in study designs should be considered when interpreting the results.
https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.16582 – This meta-analysis examined the effectiveness of progesterone supplementation in improving live birth rates in women undergoing fertility treatments. The results indicated that progesterone supplementation significantly increased live birth rates. The study acknowledges heterogeneity in study designs as a limitation.
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.15814 – This systematic review and meta-analysis assessed the long-term effects of prenatal progesterone treatment on children. The study found no evidence of long-term adverse effects on children from prenatal progesterone exposure. However, the authors noted the limited availability of long-term follow-up data as a constraint.
https://go.drugbank.com/drugs/DB00396 – DrugBank provides comprehensive information on Progesterone, including its mechanism of action, uses, and pharmacological properties. It serves as a reference for understanding the drug's interactions and effects within the body. This database is a valuable resource for healthcare professionals and researchers.