| Women considering progesterone therapy can choose among various forms of administration of the medication. This report describes the role of progesterone in the body, the forms of the medicaiton available, and the benefits and drawbacks of each. Progesterone - The Hormone The naturally occurring hormone progesterone means literally, ''for gestation'' - it is the hormone of pregnancy. Produced by the ovaries, progesterone prepares the lining of the uterus for the fertilized ovum and maintains pregnancy. Specifically, progesterone converts the womb lining into a soft spongy bed in order to enhance implantation of a fertilized egg. If implantation does not occur, progesterone levels fall and menstruation begins. Progesterone Also: - Affects contractions of the fallopian tubes
- Thickens the consistency of vaginal mucus
- Raises body temperature slightly
Progesterone levels in the body fluctuate in a cyclic pattern. During the first half of the menstrual cycle, the concentration of progesterone in the bloodstream is less than 1 ng/ml. During the second half, or luteal phase, progesterone in the bloodstream ranges from 3 ng/ml to 25 ng/ml. If pregnancy occurs, the placenta takes over the output of progesterone, producing very high levels of the hormone, up to 30 times greater than normal peak levels. Following birth, the progesterone level drops abruptly. Progesterone - The Medication Progesterone is prescribed by physicians to supplement a woman's production of the hormone. First isolated in 1934, progesterone is a white or creamy white crystalline powder, is odorless, stable in the air, and is nearly insoluble in water. These natural hormones (derived from soy) are molecularly identical to what your body produces. Progesterone vs. Progestin The term natural progesterone is often confused with synthetic progestin. Progestins are derivatives of progesterone used in medications like oral contraceptives or Provera. While their chemical structure is only slightly different, their effects in the body are distinctly unmatched, and these medications should not be used interchangeably. For example, synthetic progestins can inhibit ovulation, thus suppressing the body's output of its own hormone, progesterone. It is important to understand exactly which medication is being prescribed. Forms of Administration (Pertaining to Women's Health America Products Only) Physicians prescribing progesterone have several dosage forms to choose between. Progesterone is commonly prescribed for use in PMS, perimenopause, menopause and pregnancy maintenance. Important considerations for physicians when choosing the appropriate dosage include: - Absorption characteristics - how much of the medication is absorbed, how fast, and how long it lasts
- Ease of administration
- Expense
The most commonly prescribed dosage forms of Progesterone therapy include: Extended Release Oral Tablets: Contains progesterone in an extended release tablet. The table produces consistent blood levels, which is critical for symptom management in PMS or menopause, and to avoid drowsiness, erratic menstrual cycles or breakthrough bleeding. Micronized Oral Capsules: Since capsules metabolize quickly, some side effects may occur. Symptoms may include a ''peak and valley effect,'' drowsiness or a woozy light-headed feeling. Creams or Gels: Delivers continuous, consistent absorption. Not as effective as even release tablets for symptom management. Rectal Suspension: Suspended in water, progesterone in this form provides a well-tolerated, convenient method of administration. Physicians often start patients out on rectal suspension because it allows them to titrate the dose to each woman's needs. The liquid suspension is administered rectally using a small syrings with applicator. Suppository: Progesterone suppositories, administered vaginally or rectally contain progesterone in a wax base. Suppositories also provide consistent, even absorption. When used vaginally, many women complain of leakage that occurs. When used rectally, some patients report bowel stimulation. The lower dosages are most commonly used in treating ''luteal phase defects,'' and higher doses are generally used for treating premenstrual syndrome. Points To Remember - Patients and physicians should keep in mind that progesterone therapy should be individualized for each patient.
- For cycling women, typical recommended dosing is Progesterone 300 mg Extended Release Tablet two times per day, days 14-28, based on a 28-day cycle.
- For women no longer cycling or post-hysterectomy, dosing is daily.
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