What is Progesterone?
Progesterone is a medication that contains micronized progesterone.
It’s indicated for use as part of a treatment plan for postmenopausal symptoms, in order to reduce the risks of endometrial hyperplasia and carcinoma from occurring.
For more resources, including a full list of the risks and benefits of Progesterone, please review the product monograph.
How does Progesterone work?
For healthy women that haven’t yet entered the menopausal transition, progesterone is a natural sex hormone that’s produced by the ovaries during the second part of the menstrual cycle.
During menopause/postmenopause, natural production of his hormone slows or stops. Progesterone works by replacing these hormones as the body stops producing them naturally.
What is Progesterone used to treat?
Progesterone is used as part of ongoing Menopause Hormone Therapy (MHT), to replace the natural hormones that are no longer being produced by the body, due to menopause.
Progesterone produced naturally by the body helps regulate the shedding of the inner lining of the uterus, as well as the menstrual bleeding that follows this.
The medication Progesterone replaces some of these missing hormones, which can reduces the risks of endometrial carcinoma or endometrial hyperplasia from occurring.
How do you take Progesterone?
Progesterone is available as capsules, which are to be taken orally.
The average recommended dosages for Progesterone is two capsules per day for the last 14 days of estrogen treatment, or 3 capsules a day for the last 12-14 days of estrogen treatment.
Dosages should be split up throughout the day (i.e., 1 capsule in the morning, 1 at night), in order to help the medication function most effectively.
The dose of Progesterone that’s recommended for you will depend on what your healthcare practitioner believes will work best for you, based on your current health and medical history.
How long does Progesterone last after you take it?
What are the common side effects of Progesterone?
Some side effects from taking Progesterone could include:
- Genital bleeding or spotting in between the normal periods (mainly during the first two months)
- Irregular menstrual periods
- Dizziness or vertigo
- Sleepiness
- Abdominal discomfort (i.e., cramps, pressure, pain)
- Nausea
- Fatigue
- Worsening migraine headaches or headaches
- Depressive mood
- Light-headedness
- Breast tenderness or swelling
- Liver disease
Other side effects that have been observed with estrogen and progestin combinations in general, but not necessarily with PMS-Progesterone could include:
- Water retention (bloating, swelling)
- Overgrowth of the lining of the uterus
- Gallbladder disorder
- Impaired liver function or jaundice (yellowing of the eyes or skin)
- Menstrual cramps
- Vaginal itching/discharge
- Pain during sexual intercourse
- Pain on urination or difficulty urinating
- Premenstrual syndrome (PMS)
- Breast tenderness
Inflammation of the bladder - Brown, blotchy spots on exposed skin (pregnancy mask)
- Skin rash, tender red lumps, nodules, or other skin reactions
- Loss of hair or hair growth
- Acne
- Heart palpitations
- Pain, swelling, or redness of the calf or leg, which may indicate a blood clot
- Chest pain or shortness of breath, which may indicate a blood clot
- Increase in blood pressure
- Depression
- Nervousness
- Irritability
- Visual disturbances
- Intolerance to contact lenses
- Changes in appetite and body weight
- Change in libido
- Pain in the joints and muscles
- Headache
MHT is the most effective treatment for menopausal symptoms and has been shown to prevent bone loss.
In menopausal women who start appropriately-dosed MHT prior to age 60 OR within 10 years of their last period, the health benefits outweigh the risks.
Risks of MHT are considered very rare (~1 case per 1000 to 10,000 women on MHT per year) and may include:
- risks of stroke or blood clots in legs or lungs with oral estrogen (much lower risk with estrogen gel or patch)
- risks of dementia in women older than 65 years,
- risk of breast cancer (less than ~1 case per 1000 women on MHT per year)
These conditions are all rare, but they highlight the importance of having a full discussion with your healthcare practitioner; especially if you’re experiencing moderate to severe side effects.
Individualization is key, and your MHT treatment plan should be reassessed (at least) once a year to monitor your health, as well as ensure that you are on the correct dosage and formulation.
Your practitioner can help you find balance between treating your symptoms safely, and avoiding increased risks.
Who shouldn't take Progesterone?
There are certain people that shouldn’t take Progesterone, including:
- People with liver disease
- People that have or have had cancer or abnormalities of the breast or uterus
- People that have endometrial hyperplasia (overgrowth of the lining of the uterus)
- People that are pregnant or suspect they may be pregnant
- People that have a history of heart disease, heart attacks, or strokes
- People that experience migraine headaches
- People that have or have had an abnormal increase in blood clotting
- People that have vision issues caused by blood vessel disease of the eye
In addition to these people, there are others that should be extra cautious about taking Progesterone, such as people who:
- Have an allergy or intolerance or any of the ingredients in Progesterone
- Have a history of liver disease or jaundice
- Have a history of itching related to estrogen use or during pregnancy
- Have a history of breast disease, breast biopsies, or a family history of breast cancer
- Have experienced undiagnosed or abnormal vaginal bleeding
- Have a history of uterine fibroids or endometriosis
- Have lupus
- Have a history or family history of blood clots or active thrombophlebitis
- Smoke
- Have a history of high blood pressure
- Have a history of kidney disease, epilepsy, or asthma
- Have a history of bone disease
- Have diabetes
- Have porphyria (a blood pigment disease)
- Have a history of high cholesterol or high triglycerides
- Have a history of depression
- Have had a hysterectomy
If any of these conditions apply to you, be sure to talk to your healthcare practitioner before starting Progesterone. They may be able to suggest an alternative dosage or medication that could work better for you.
Further reading
