Progesterone should be used with caution in:
They should not be used in:
- Women with known allergy or hypersensitivity to progesterone or to any of the ingredients in the medication
- Women with severe liver disease
- Women who have ever had liver tumour
- Women who have ever had unexpected and unexplained vaginal bleeding
- Women with a missed or incomplete miscarriage
- Women who have or have had breast cancer
- Women who have or have had cervical cancer or other cancers of the reproductive tract
- Women with severe arterial disease
Also see list of precautions and interactions
- Store in the original blister pack and in the original outer carton. The capsules are stable over a wide range of temperatures and therefore no special storage conditions are necessary.
Ampoules for injection
- Store your medicine in the original package to protect it from light. Store at room temperature (15-25°C). During storage, solid matter may form in the ampoule. This should be re-dissolved by warming the ampoule before use.
- Store below 25°C in a dry place.
What is it used for?
- Progesterone is used to replace naturally occurring progesterone in women with low levels and to help the reproductive system to function normally.
- It is a steroidhormone, sometimes known as a female sex hormone.
- It is used to treat variety of conditions involving the female reproductive system including infertility, premenstrual syndrome, disorders of the menstrual cycle, to prevent miscarriage in women who have had recurrent miscarriages, during in-vitro fertilisation (IVF) and menopausal symptoms in women as hormone replacement therapy (HRT). As a woman approaches the menopause (change of life) the levels of the female hormones oestrogen and progesterone decrease. Menopausal symptoms (e.g. hot flushes, difficulty sleeping, feeling irritable and vaginal dryness) can be reduced by taking an oestrogen and progesterone for HRT. Progesterone is used to treat premenstrual syndrome, when the symptoms can include irritability, depression, headache and breast tenderness at certain times in the cycle.
- Benefits of being on this drug can include relief from menopausal symptoms when given as HRT in combination with oestrogen. Relief from premenstrual symptoms or post-natal depression is also obtained for some women. Benefits in terms of viable pregnancies and maintaining pregnancy are seen in its use in infertility.
Listed below are the typical uses of progesterone.
- Capsules: Hormone replacement therapy (HRT) with an oestrogen in post menopausal women (with a womb)
- Injection: Uterine bleeding Maintenance of early pregnancy in certain conditions such as in those women who do not produce enough progesterone and have had three or more unexplained miscarriages To help in infertility treatment techniques such as in-vitro fertilisation (IVF) or gamete intrafallopian transfer (GIFT), in some cases
- Pessaries: Premenstrual syndrome, including premenstrual tension and depression Post-natal depression
- Vaginal gel: Treatment of infertility (due to inadequate luteal phase) During in-vitro fertilisation (IVF) for women with normal ovulatory cycles but infertility mainly due to fallopian tube problems, endometriosis, or unknown causes.
On occasion your doctor may prescribe this medicine to treat a condition not on the above list.
HOW TO USE/TAKE
Progesterone is available as oral capsules, a pessary, as ampoules for injection and as a vaginal gel.
How often do I take it?
Take this medication by mouth, preferably at bedtime without food. Swallow the capsule with a glass of water. Take the progesterone capsule at the same time as your oestrogen HRT. You normally take one progesterone capsule for 12 days at the end of each 28 day cycle (day 15 to day 26). This may then be followed by some withdrawal bleeding.
The oestrogen medication is taken every day.
- Ampoules for injection
This medication will be given to you as an injection into a muscle by a doctor or nurse.
- Abnormal uterine bleeding: The usual dose is to use this medication by injection for 5 to 10 days until 2 days before the expected start of menstruation.
- Maintenance of pregnancy: The usual dose is to take this medication by injection, twice weekly or up to daily from about day 15 until 8 to 16 weeks of pregnancy.
Take this medication by inserting a pessary usually once or twice a day, into the vagina or back passage (rectum). For premenstrual syndrome, take the medication on day 14 of the menstrual cycle and continue treatment until the start of menstruation. Follow the instructions of your doctor regarding dose and dosing frequency.
- Pessaries should be used in the back passage (rectum) and not vaginally if:
You use barrier methods of contraception with your partner (e.g. condom, diaphragm)
You suffer from any vaginal infection (abnormal discharge) or often get cystitis (a urinary tract infection with pain when urinating)
You have recently given birth
- Pessaries should be used in the vagina and not in the back passage (rectum) if:
You suffer from frequent attacks of diarrhoea due to inflammation of the colon (colitis) or you have difficulty controlling your bowel movements (faecal incontinence)
- Vaginal gel
Treatment of infertility: The usual dose is to take this medication by applying the gel inside your vagina usually every day after ovulation or on day 18 to 21 of your cycle.
- In-vitro fertilisation: Take this medication by applying the gel inside your vagina usually every day for 30 days if tests have shown that you are pregnant.
- Use this medication as directed by your doctor in order to get the most benefit from it.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- Progesterone capsules may cause drowsiness and dizziness in some people. Do not drive or operate machinery if you feel drowsy or dizzy after using any of the other forms of progesterone.
- Consult your doctor or pharmacist for more details.
When can I stop?
- Always complete the full course as prescribed by your doctor.
PROGESTERONE SIDE EFFECTS
- Capsules and ampoules for injection:
- Breakthrough vaginal bleeding
- Rash or hives
- Swelling of ankles due to fluid retention
- Weight changes
- Changes in sexual desire (libido)
- Stomach ache
- Tender breasts
- Premenstrual like symptoms
- Menstrual disturbances
- Skin condition with irregular tanned patches produced when skin is exposed to sun (chloasma)
- Difficulty sleeping
- Loss of head hair
- Increased body hair
- Yellowing of skin and whites of the eyes (jaundice)
- Blood clots in the leg or pelvic veins
In addition, progesterone given by injection may also cause local reactions at site of injection.
You are advised to regularly check your breast as there is a slightly higher risk of breast cancer in women taking HRT.
- Changes in time of menstruation
- Soreness (rectal insertion)
- Diarrhoea (rectal insertion)
- Bloating (rectal insertion)
- Spotting (small amounts of blood)
If any of these persist or you consider them severe then stop taking and inform your doctor or pharmacist.
Tell your doctor immediately if you develop any of the following symptoms:
- Migraine like headaches or any eye problems such as partial vision, blurred vision, double vision or you suddenly become short sighted.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.
Before taking progesterone, tell your doctor or pharmacist if you are allergic to it; or to other progestogens (progestins); or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of:
- Known allergy or hypersensitivity to progesterone or to any of the ingredients in the medication
- Severe liver disease
- Previous liver tumour
- Unexpected and unexplained vaginal bleeding
- Missed or incomplete miscarriage
- Breast cancer
- Cervical cancer or other cancers of the reproductive tract
- severe arterial disease
Before using this medication tell your doctor or pharmacist your medical history, especially any of the following
- High blood pressure or heart disease
- Kidney disease
- Liver disease
- Susceptibility to blood clots
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- Alcohol intake is not known to affect progesterone.
The elderly: progesterone capsules can be used in the elderly.
Pregnancy and breastfeeding - please ensure you read the detailed information below
Progesterone is not safe to take if you are, or are planning to become, pregnant.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Progesterone by injection may be given under the direction of a doctor for the specialist treatment of maintenance of pregnancy under certain conditions.
Progesterone is not safe to take if you are breastfeeding.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Before using this medicine, tell your prescriber of all the medicines you are taking including prescription medicines and medicines you have bought over the counter without a prescription. Tell your prescriber if you are taking vitamins or complementary remedies such as herbal products, as these can also interact with medicines.
If you are taking more than one medicine, these may interact with each other. Your prescriber may decide to use medicines which interact with each other if the benefit outweighs the risks. In these cases, the dose of your medicines may need to be adjusted or you may be monitored more closely.
The following medicines may interact with progesterone:
- Progesterone capsules or ampoules for injection
- Bromocriptine used to treat Parkinson's disease
- Ciclosporin used to treat transplant rejection and severe autoimmune skin conditions
- Ketoconazole used to treat fungal infections
- Rifampicin used to treat tuberculosis
This information does not contain all possible interactions. Therefore, tell your prescriber of all the products you are using before taking this medicine.
If you have a question or want to discuss anything about your medicine, speak to your local pharmacist.
Overdose with progesterone capsules can cause sleepiness, dizziness, 'high' feeling or you may have bleeding problems such as a painful period.
If you have taken too much of this medicine consult your doctor or hospital casualty department for further advice.
If you (or someone else) has accidentally swallowed any of the pessaries or you use too many, contact your nearest hospital casualty department or your doctor immediately for advice.
Overdose with progesterone pessaries any cause a 'high' feeling or you may have bleeding problems such as a painful period.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of progesterone or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.