INDICATIONS FOR USE

Progesterone is used for hormone replacement therapy (HRT) in postmenopausal women, managing abnormal uterine bleeding, preventing endometrial hyperplasia, and supporting pregnancy in women with luteal phase defects.

LEVEL OF EVIDENCE

✦✦✦ : Topical / Transdermal : FDA approved therapy with extensive human efficacy and safety data.

ROUTE OF ADMINISTRATION

• Available as oral capsules, topical creams, or intravaginal gels and suppositories.

COMMON INITIAL DOSING REGIMENS

• Oral: 100–200 mg daily, typically taken at bedtime to reduce side effects.

• Topical: Applied as 10–40 mg daily to thin skin areas.

• Intravaginal: Doses range from 45–400 mg daily, depending on the indication (e.g., luteal phase support or endometrial protection).

MECHANISM OF ACTION

• Progesterone binds to progesterone receptors, influencing gene expression to regulate menstrual cycles, support pregnancy, and maintain endometrial stability. It opposes the proliferative effects of estrogen on the endometrium.

COMMON SIDE EFFECTS

• Neurological: Drowsiness, dizziness, or mood changes, particularly with oral administration.

• Endocrine: Breast tenderness, bloating, or weight changes.

• Gastrointestinal: Nausea, abdominal discomfort, or diarrhea.

• Rare: Allergic reactions or severe mood disturbances such as depression.

CONTRAINDICATIONS

• Absolute: Known or suspected breast cancer, active thromboembolic disorders, undiagnosed vaginal bleeding, or pregnancy (except when used to support pregnancy).

• Relative: Use cautiously in women with a history of depression, migraines, or liver dysfunction.

LEARN MORE

• Evidence hound? Review our comprehensive listing of PubMed direct links to original research related to this medication.