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Here’s What You Need to Know About This Commonly Prescribed Hormone

The first time my friend heard about progesterone, her gynecologist had casually mentioned that, by the looks of her cervix, she might need to take it before and during pregnancy—if and when the time came. She didn't think much of it until years later when she miscarried and was diagnosed with polycystic ovarian syndrome (PCOS). Her OB-GYN prescribed progesterone and, a year later, she was able to conceive and carry her baby near full term. It sounds like a newfangled miracle drug for women with feminine health issues, but progesterone supplements have been used to treat feminine health issues since the late 1920s.

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 An Overview of Micronized Progesterone

Micronized progesterone is a bioidentical progesterone derived from plant sources, such as yams or soy, and processed to improve absorption and bioavailability. Unlike synthetic progestins, which can have androgenic or glucocorticoid properties, micronized progesterone is structurally identical to endogenous progesterone, making it a preferred choice in many therapeutic settings.

 Progesterone supplements don’t help prevent miscarriage

In the past, women who had recurrent miscarriage were prescribed the hormone progesterone to try to prevent another miscarriage. Progesterone prepares the uterine lining for implantation of the embryo. It also helps maintains a healthy pregnancy. Giving progesterone supplements to these women was based on the idea that their progesterone levels were too low to support a pregnancy, which could therefore contribute to a miscarriage. However, a recent study of progesterone supplements found that they did not result in improved pregnancy outcomes.

Articles of Interest

Diagnostic and therapeutic use of oral micronized progesterone in endocrinology

Micronized progesterone (MP) is natural progesterone with increased bioavailability, due to its pharmacotechnical micronized structure, which makes it an attractive diagnostic and therapeutic tool. This critical literature review aims to summarize and put forward the potential diagnostic and therapeutic uses of MP in the field of endocrinology. During reproductive life, MP is used for diagnostic purposes in the evaluation of primary or secondary amenorrhea as a challenge test.

Drug To Prevent Premature Birth Divides Doctors, Insurers And FDA Experts

Doctors fear that the only drug approved to prevent preterm birth, the nation's leading cause of infant mortality and disability, will no longer be available to expectant mothers. The drug, whose brand-name version is Makena, has been in limbo since October, when an expert panel convened by the Food and Drug Administration reviewed the accumulated evidence and concluded that Makena is not effective in preventing preterm birth.

Efficacy of Micronized Progesterone for Sleep: A Systematic Review and Meta-analysis of Randomized Controlled Trial Data

Micronized progesterone improves various sleep outcomes in randomized controlled trials, predominantly in studies enrolling postmenopausal women. Further research could evaluate the efficacy of micronized progesterone monotherapy using polysomnography or validated questionnaires in larger cohorts.

Guide to Natural Progesterone

Body-identical progesterone (also called bioidentical, natural, or oral micronized progesterone) can be an effective treatment for a range of women’s health conditions, including PCOS, PMDD, migraines, endometriosis, adenomyosis, and perimenopause.

Guide to Using Progesterone for Women’s Health

Progesterone is called oral micronized progesterone and requires a doctor’s prescription. Depending on your country, brand names include Prometrium, Utrogestan, Teva, and Famenita. Alternatively, progesterone cream is available over-the-counter in some countries and can help with mild symptoms but is generally not as effective as progesterone capsules.

Oral micronized progesterone

This review sought to examine the rationale for selecting an oral micronized progesterone formulation rather than a synthetic progestin for some of the main indications for progestogens.

Preterm Birth Treatment Isn’t Effective, Study Finds

The standard treatment to prevent women from having another preterm birth isn’t effective, according to the final results of a study. The finding has already led at least one maternal medicine group to revamp its guidelines.

Progesterone May Not Help Women With History of Miscarriages, Study Finds

About 5 percent of women experience two consecutive miscarriages in the first trimester, and 1 percent go through three or more losses. Progesterone, a hormone that is crucial to bringing about and maintaining pregnancy, is often a first-line treatment for unexplained recurrent miscarriages. The negative result is sure to dismay patients, but it comes with a silver lining, experts said. Couples should take solace in the “impressive” result that “more than half of these women had a live birth,” Dr. Pfeifer said.

Prometrium: Micronized "Natural" Progesterone

Prometrium is the first FDA-approved oral progesterone. Due to its poor bioavailability, formulating an oral product has been problematic. By decreasing particle size (micronization), the bioavailability was improved sufficiently to provide adequate serum concentrations to achieve a biologic effect, although the absorption is still quite variable. Prior to Prometrium, pharmacies have been compounding oral forms from micronized progesterone using various recipes.

Updated Clinical Guidance for the Use of Progesterone Supplementation for the Prevention of Recurrent Preterm Birth

Vaginal progesterone may be considered as a treatment option for patients with a history of preterm birth, singleton gestation, and a shortened cervix. However, vaginal progesterone has not been proven effective in the absence of a shortened cervix and should not be considered as an alternative to 17-OHPC.