Progesterone (medication)

Progesterone is a steroid hormone medication. It is a synthetic form of the naturally occurring hormone progesterone, produced primarily by the ovaries after ovulation in females and, to a lesser extent, by the adrenal glands in both sexes. Progesterone medications are used for a variety of purposes related to hormone regulation and reproduction.

Uses:

• Hormone Replacement Therapy (HRT): Progesterone is often used in combination with estrogen in HRT for women experiencing menopause. It helps to protect the endometrium (lining of the uterus) from thickening caused by estrogen alone, thus reducing the risk of endometrial hyperplasia and cancer.
• Assisted Reproductive Technology (ART): Progesterone is frequently prescribed during in vitro fertilization (IVF) cycles and other ART procedures to support the luteal phase (the period after ovulation) and help maintain a pregnancy.
• Treatment of Amenorrhea: It can be used to induce menstruation in women who have stopped menstruating (amenorrhea) due to hormonal imbalances.
• Prevention of Preterm Birth: In some cases, progesterone is prescribed to women at risk of preterm labor to help prevent premature delivery.
• Management of Abnormal Uterine Bleeding: Progesterone can help regulate the menstrual cycle and reduce heavy or irregular bleeding.
• Support in Early Pregnancy: Progesterone supplementation may be recommended in early pregnancy to support the uterine lining and help prevent miscarriage, particularly in women with a history of recurrent pregnancy loss or those with low progesterone levels.

Forms and Administration:

Progesterone medications are available in several forms, including:

• Oral capsules or tablets: Taken by mouth.
• Vaginal inserts, gels, or suppositories: Inserted into the vagina.
• Intramuscular injections: Injected into a muscle.
• Topical creams: Applied to the skin, although these are often bioidentical progesterone and may not have the same regulated effects as prescription progesterone.

The choice of formulation and route of administration depends on the specific indication and the individual patient's needs and preferences.

Side Effects:

Common side effects of progesterone medications can include:

• Headache
• Breast tenderness
• Mood changes (irritability, depression)
• Bloating
• Nausea
• Fatigue
• Changes in menstrual bleeding

More serious side effects are rare but can include blood clots, stroke, and liver problems.

Contraindications and Precautions:

Progesterone medications are contraindicated (should not be used) in certain situations, such as:

• History of blood clots
• Unexplained vaginal bleeding
• Liver disease
• Known or suspected hormone-sensitive cancers (e.g., breast or endometrial cancer)
• Allergy to progesterone or any ingredients in the medication

Caution should be exercised when prescribing progesterone to individuals with a history of depression, migraines, asthma, or epilepsy.

Interactions:

Progesterone medications can interact with other medications, including certain antibiotics, antifungals, and herbal supplements. It is important to inform healthcare providers of all medications and supplements being taken before starting progesterone therapy.

Mechanism of Action:

Progesterone works by binding to progesterone receptors in various tissues throughout the body, including the uterus, brain, and breasts. This binding activates intracellular signaling pathways that regulate gene expression and influence a variety of physiological processes, particularly those related to reproduction and the menstrual cycle. In the uterus, progesterone helps to prepare the endometrium for implantation of a fertilized egg and to maintain the pregnancy.