Progesterone (Oral)

Progesterone is used to treat post-menopausal women who are also taking conjugated estrogens. It can also be useful in regulating menstrual periods of pre-menopausal women.

Overview

In the US, progesterone is sold under the brand name, Prometrium. The medicine comes in capsule form for oral use and can only be obtained with a prescription from your GP.

Progesterone is widely used as a means of preventing changes in the uterus of post-menopausal women who are also using conjugated estrogen medications. The drug can also be applied in pre-menopausal patients to help in regulating the menstrual cycle and treat amenorrhea.

Conditions treated

  • Irregular menstrual bleeding
  • Menopausal changes to the uterus

Type of medicine

  • Hormone
  • Liquid-filled capsule
  • Capsule

Side effects

In addition to the desired effects, some medicines can also cause undesirable side effects. Not every patient using progesterone will experience any ill-effects at all, but if you do notice any of the following, you should check with your GP right away:

  • Yellow eyes or skin
  • Wheezing
  • Vomiting of blood
  • Vomiting
  • Vaginal bleeding
  • Unusual tiredness or weakness
  • Unpleasant breath odor
  • Trouble speaking, thinking, or walking
  • Tightness in the chest
  • Swelling of the eyelids, face, lips, hands, or feet
  • Sweating
  • Stomach or pelvic discomfort, aching, or heaviness
  • Spontaneous abortion
  • Sore on the skin of the breast that does not heal
  • Slow heartbeat
  • Shortness of breath
  • Redness or swelling of the breast
  • Redness of the skin
  • Rash
  • Puffiness or swelling of the eyelids, face, lips, or tongue
  • Problems with urination
  • Pounding in the ears
  • Persistent crusting or scaling of nipples
  • Pains in the stomach, side, or abdomen, sometimes radiating to the back
  • Feeling of pain or pressure in the pelvis
  • Numbness or tingling in the face, arms, or legs
  • Noisy breathing
  • Nervousness
  • Nausea
  • Lump in the breast or under the arm
  • Loss of appetite
  • Lightheadedness
  • Joint pain, stiffness, or swelling
  • Itching
  • Irritation
  • Irregular heartbeat
  • Inverted nipple
  • Indigestion
  • Hives
  • Headache
  • Fever
  • Fast, irregular or pounding heartbeat or pulse
  • Fainting
  • Dizziness, faintness, or lightheadedness when rising abruptly from a lying or prone position
  • Dizziness
  • Dimpling of the breast skin
  • Difficulty walking
  • Difficulty swallowing
  • Difficult or labored breathing
  • Diarrhea
  • Darkened urine
  • Cough or hoarseness
  • Constipation
  • Confusion
  • Cold or flu-like symptoms
  • Cleft lip or palate
  • Clear or bloody discharge from the nipple
  • Clay-colored stools
  • Chills
  • Chest pain
  • Change in vaginal discharge
  • Blurred vision
  • Bloating
  • Abdominal or stomach pains

Progesterone can cause a few side effects that will correct themselves and disappear, once your body gets used to the new medication. Your GP may also be able to suggest ways of managing these effects until they disappear. However, you should speak to your doctor if any of the effects listed below persist or prove to be especially annoying:

  • Worry
  • White or brownish vaginal discharge
  • Weight changes
  • Tunnel vision
  • Suicidal thoughts
  • Swollen tongue
  • Slurred speech
  • Severe sleepiness
  • Sense of detachment from self or body
  • Sensation of spinning
  • Redness of the skin
  • Overbright appearance of lights
  • Normal menstrual bleeding occurring earlier, possibly lasting longer than usual
  • Night blindness
  • Muscle stiffness
  • Muscle or joint pain
  • Muscle cramps
  • Loss of consciousness
  • Longer or heavier menstrual periods
  • Hives or welts
  • Hearing loss
  • Halos around lights
  • Hair loss or thinning of hair
  • Feeling of unreality
  • Feeling of constant movement of self or surroundings
  • Extreme dizziness or drowsiness
  • Double vision
  • Disturbed color perception
  • Difficulty with moving
  • Depression
  • Decreased awareness or responsiveness
  • Continuing ringing or buzzing or other unexplained noise in the ears
  • Confusion about identity, place, and time
  • Clumsiness or unsteadiness
  • Choking
  • Changes in patterns and rhythms of speech
  • Changes in behavior
  • Change in walking and balance
  • Breast pain or tenderness
  • Blurred or loss of vision

There may be other effects that are not mentioned in this guide, which you may experience while taking progesterone. If you notice any other odd effects, check with your GP.

Dosage

You must only use progesterone medication as you have been instructed to do by your GP. You should not use more than you have been told to, use it more often, or use it for a longer duration than advised. Doing so could cause unwanted effects.

Your prescription of progesterone will come with a medication guide. It is important that you read the guide carefully and ask your GP if you do not understand any of the content.

If you are using this medication following your menopause, you will also be told to take an estrogen drug. Be sure to take both medicines as per your doctor's directions.

Some people have difficulty with swallowing these capsules. You may find it helpful to take the capsules with water while standing up. Do not break open the capsules, suck them, or chew them. If you still have problems taking the medicine, ask your pharmacist or doctor for assistance.

The dose of progesterone that you are given to take will vary between patients. You should follow your doctor's instructions or those on the product dispensary label. The information contained here only shows the average dose that is prescribed for this drug. If your recommended dose is not the same, do not change it unless your GP tells you to.

Your daily dose of progesterone will vary, depending on how strong the preparation is. Your medical condition will also determine the number of daily doses you take and the whole duration of your course.

In order to keep the levels of progesterone in your body at constant levels, you should try to take your medication at the same time each day. Progesterone is most effective when the levels in your system do not fluctuate.

To prevent endometrial hyperplasia:

  • Adults: Take one dose of 200 mg at bedtime for 12 consecutive days in every 28-day cycle.
  • Children: Do not use progesterone to treat children.

To prevent amenorrhea:

  • Adults: Take one dose of 400 mg at bedtime for 10 consecutive days.
  • Children: Do not use progesterone to treat children.

If you forget to take your daily dose of progesterone, try to take it as quickly as you can. If it is nearly time for your next due dose, leave out the one you missed and go back to your usual medication schedule.

Do not take double doses to try to make up for any that were omitted.

Interactions

It is the case that certain medicines should not be used at the same time. However, sometimes it may be appropriate to combine some drugs in order to achieve a particular effect, even though doing so may cause an interaction. Your GP may elect to change the dose or frequency of use of one or more of the drugs, or he may recommend precautions that you can take to mitigate the effects of any interaction that does take place.

Be sure to tell your GP if you are taking any of the drugs that are mentioned below, as it is not generally recommended to use both together:

  • Eslicarbazepine Acetate
  • Dabrafenib
  • Conivaptan

Sometimes, an interaction can occur if you use tobacco, drink alcohol, or eat certain food groups whilst taking certain drugs. You should discuss this aspect of your treatment with your doctor before you begin using progesterone.

Medical history

Some historical or existing medical conditions can affect how progesterone works. Be sure to tell your doctor if you have any existing health problems for which you are being treated.

Progesterone should not be used in patients who have any of the following health problems:

Progesterone should be used with caution in patients with any of the following conditions, because it may make these conditions worse:

Warnings

When you decide to go ahead and use a particular drug, you should take into consideration the pros and cons of doing so. Discuss your treatment with progesterone with your GP before you begin using the drug so that you understand the possible effects.

You should notify your doctor if you have ever had an odd reaction when using progesterone medication or to any other form of drug, including over the counter products, vitamins, and herbal supplements. Remember to mention any bad reactions that you have had to food colors, preservatives, certain food groups, or animal derivatives.

Pediatrics

Progesterone should not be used for the treatment of children, as its efficacy and safety have not been established.

Geriatric

There have been no studies into the effect of progesterone on elderly patients, although there have been no geriatric-specific problems reported thus far. However, it is more likely that elderly people may suffer from conditions such as stroke, dementia, or breast cancer, and progesterone should, therefore, be used with caution in these patients.

Pregnancy and breastfeeding

There have been studies that show the use of progesterone could cause harm to a fetus. If you are pregnant, you should tell your doctor before you begin using this medication. Throughout the course of your treatment with the drug, it is essential that you use a reliable form of contraception to avoid falling pregnant.

Studies have shown that progesterone does pass into breast milk, but it is thought to pose only a minimal risk to a nursing infant. You should discuss the implications of continuing to breastfeed your child while you are taking progesterone with your doctor or midwife. You may wish to use an alternative method of feeding your infant during the course of your treatment with progesterone.

Medical complications

You must attend progress reviews with your GP at least once a year while you are receiving treatment with this drug. These reviews will ensure that the drug is working properly and that you are not suffering any adverse effects. You may also be asked to have a mammogram, pelvic exam, or breast exam.

If you experience any of the following symptoms, you should tell your doctor immediately:

  • Pains in the groin, legs, or chest
  • Breathing difficulties
  • Sudden, severe headaches
  • Slurred speech
  • Sudden shortness of breath with no obvious cause
  • Loss of coordination
  • Visual changes

There is a very slim chance that long-term use of progesterone could cause breast or endometrial cancer in some patients. You should discuss this risk with your GP, especially if any of your family members have ever suffered from either of these conditions.

Taking progesterone in large doses, for a long period of time, or using it in combination with an estrogen medication can lead to an increased risk of blood clots, heart attack, dementia, or stroke. If you are concerned about this risk, you should discuss it with your GP before you start using progesterone. You should note that your risk of suffering from any of these conditions will be worse if you are overweight, if you smoke, or if you suffer from diabetes or high blood cholesterol. Talk to your GP about where to obtain help quitting smoking. Take steps to control your diabetes and discuss a suitable diet and exercise program to help control your weight and cholesterol.

If you are due to undergo any form of surgery, including cosmetic and dental procedures, be sure to tell the doctor or dentist in charge. Your GP will tell you if you need to stop using progesterone before you have surgery. Similarly, you should be aware that this drug can influence the results of certain medical and diagnostic tests. If you are due to have any form of medical tests carried out, be sure to mention to your treating physician that you are taking progesterone.

If you experience sudden visual changes or loss of vision, you should stop using the medication right away and consult your GP. Your doctor may refer you to an ophthalmologist for an eye test.

Some people who are taking progesterone report feeling drowsy or dizzy while they are using the drug. If you find that this medication affects you in this way, do not drive, use machinery, or undertake any other activity that could be potentially dangerous if you are not fully alert.

Storage

You should keep your prescription of progesterone in its original packaging, at room temperature. Choose a storage place that is not in direct sunlight or near to a heat source. Do not allow the medication to become damp. Do not keep your medicine in the fridge, and do not freeze it.

Put all medicines well out of the reach of small children who may mistake the capsules for candy. If a pet eats any of your progesterone medication, you should seek veterinary advice.

Do not retain any medication that has passed its use-by date. Do not use medicines that appear damaged or where the packaging appears to have been opened.

When disposing of unwanted progesterone capsules, do not throw them down the drain or flush them down the toilet. Put unused capsules into a bag, seal it, and place it in the bottom of your trash can, well away from children and animals.

Summary

Progesterone is a hormone drug that is used to help prevent changes in the uterus of post-menopausal women who are also being treated with conjugated estrogen medications. The drug is also used in pre-menopausal patients in order to help in regulating the menstrual cycle and to treat amenorrhea.

There are only a few drugs that should not be used together with progesterone, but there are a number of medical conditions that could be affected by the drug. In addition, there are quite a lot of side effects that may occur. For these reasons, it is important that you attend your GP for regular update appointments so that the effect of the drug on your body can be monitored and the dosage adjusted if necessary. You may also be asked to have various tests to make sure that the drug is not causing any unwanted effects.

Progesterone can cause harm to an unborn baby. You should therefore not use this drug if you are pregnant or if you become pregnant during your course of treatment.