progesterone (redirected from Progesterone congeners)

progesterone /pro·ges·te·rone/ (pro-jes´ter-ōn) the principal progestational hormone liberated by the corpus luteum, adrenal cortex, and placenta, whose function is to prepare the uterus for the reception and development of the fertilized oocyte by inducing transformation of the endometrium from the proliferative to the secretory stage; used as a progestational agent in the treatment of dysfunctional uterine bleeding and abnormalities of the menstrual cycle, as part of postmenopausal hormone replacement therapy, as a test for endogenous estrogen production, and as an adjunct in infertility therapy.

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pro·ges·ter·one (pr-jst-rn)

n.

1. A steroid hormone secreted by the corpus luteum and by the placenta, that acts to prepare the uterus for implantation of the fertilized ovum, to maintain pregnancy, and to promote development of the mammary glands. Also called corpus luteum hormone, luteohormone, progestational hormone.

2. A drug prepared from natural or synthetic progesterone, used in oral contraceptives, hormone replacement therapy, and in the treatment of menstrual and other gynecologic disorders.

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Progesterone

A hormone naturally secreted by the ovary, or manufactured synthetically, that prepares the uterus for implantation of a fertilized egg.

Mentioned in: Dysfunctional Uterine Bleeding, Dysmenorrhea, Endometrial Cancer, Hormone Replacement Therapy, Menopause, Premenstrual Syndrome, Saw Palmetto

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progesterone

[prəjes′tərōn]

a natural progestational hormone.

indications It is used to prevent endometrial hyperplasia in nonhysterectomized, postmenopausal women who are receiving conjugated estrogen tablets; to treat dysfunctional uterine bleeding caused by hormonal imbalances; as a contraceptive in intrauterine devices; and in intravaginal gel for women using assisted reproductive technology.

contraindications Thrombophlebitis, liver dysfunction, breast cancer, undiagnosed uterine bleeding, pregnancy, previous stroke, or hypersensitivity to this drug prohibits its use.

adverse effects Among the more serious adverse reactions are pain at the site of injection, breast pain, dizziness, headache, fatigue, emotional lability, abdominal pain, muscle weakness, catabolic effects, and electrolyte disturbances.

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progesterone,

n hormone responsible for preparing for and maintaining pregnancy in females. A drop in progesterone levels can result in spontaneous abortion (miscarriage) or labor and delivery.

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progesterone (prōjes´trōn),

n the ovarian hormone produced by the corpus luteum and responsible for preparing the endometrium for nidation and nourishment of the ovum. It also suppresses the production of the pituitary luteinizing hormone, estrus, and ovulation and stimulates the mammary glands.

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progesterone

a steroid sex hormone that is the principal progestational hormone. Used therapeutically in the treatment of threatened abortion in some species, in estrus control in dogs and cats, and occasionally in treatment of some types of skin diseases.

During the maturation of the ovum, estrogen, the principal female sex hormone, is produced at a high rate. At ovulation estrogen production is sharply reduced and the follicle is replaced by the corpus luteum of which the main function is to produce progesterone. Unless fertilization takes place, the corpus luteum disappears when it has performed its function.

The progesterone produced by the corpus luteum is promptly carried by the blood to the uterus, as was the estrogen that preceded it. Both hormones now work to prepare the uterus for possible conception.

In pregnancy, progesterone acts in a way that protects the embryo and fosters growth of the placenta. By decreasing the frequency of uterine contractions it helps to prevent expulsion of the implanted ovum. It also promotes secretory changes in the mucosa of the uterine tubes, thereby helping to provide nutrition for the fertilized ovum as it travels through the tube on its way to the uterus.

Another function of progesterone is promotion of the development of the mammary glands in preparation for lactation. Prolactin, from the anterior lobe of the pituitary gland, stimulates production of the milk, and progesterone prepares the glands for secretion.

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progesterone assay

the estimation of progesterone in milk is used as a pregnancy test.

progesterone-induced lactation

see lactation induction.

progesterone milk test

assay of progesterone in milk used as a pregnancy test.

progesterone plasma test

the original pregnancy test which survives as the milk progesterone test; used in dogs as a guide in predicting the time of ovulation.

progesterone releasing intravaginal device

used as a means of synchronizing estrus in cows and sheep as an aid to structured artificial insemination programs. Called also PRID.

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progesterone Warning - Hazardous drug!

Crinone, Prometrium

Pharmacologic class: Progestin

Therapeutic class: Hormone

Pregnancy risk category B (oral), D (injection), NR (vaginal)

Action

Suppresses ovulation by altering the vaginal epithelium, relaxing uterine smooth muscle, and promoting mammary tissue growth. Also inhibits pituitary activity and causes withdrawal bleeding in presence of estrogen.

Availability

Injection (in sesame or peanut oil with benzyl alcohol): 50 mg/ml in 10-ml vials

Micronized capsules (oral) in peanut oil: 100 mg, 200 mg

Micronized vaginal gel: 4%, 8%

⊘Indications and dosages

➣ Secondary amenorrhea

Adults: 400 mg/day P.O. in evening for 10 days, or 5 to 10 mg/day I.M. for 6 to 8 days, given 8 to 10 days before expected menstrual period. Or 45 mg (one applicatorful of 4% gel) vaginally once every other day for up to six doses; may increase to 90 mg (one applicatorful of 8% gel) once every other day for up to six doses.

➣ Dysfunctional uterine bleeding

Adults: 5 to 10 mg I.M. daily for 6 days

➣ To prevent postmenopausal estrogen-induced endometrial hyperplasia

Adults: 200 mg/day P.O. at bedtime for 14 days on days 8 to 21 of 28-day cycle or on days 12 to 25 of 30-day cycle. If patient currently receives estrogen 1.25 mg/day, 300 mg progesterone in two divided doses (100 mg 2 hours after breakfast and 200 mg at bedtime); further adjustment may be required.

➣ Corpus luteum insufficiency; assisted reproduction technology

Adults: For luteal-phase support, 90 mg (one applicatorful of 8% gel) vaginally once daily. For in vitro fertilization, 90 mg (one applicatorful of 8% gel) vaginally once daily, starting within 24 hours of embryo transfer and continued through day 30 after transfer; if pregnancy occurs, treatment may continue for up to 12 weeks. For partial or complete ovarian failure, 90 mg (one applicatorful of 8% gel) vaginally b.i.d. while patient undergoes donor oocyte transfer; if pregnancy occurs, treatment may last up to 12 weeks.

Contraindications

• Hypersensitivity to drug, peanuts (injection, micronized capsules), or sesame (injection)
• Thromboembolic disease
• Cerebrovascular disease
• Severe hepatic disease
• Porphyria
• Breast or reproductive system cancer
• Missed abortion
• Undiagnosed vaginal bleeding
• Diagnosis of pregnancy

Precautions

Use cautiously in:
• renal or cardiovascular disease, seizure disorders, fluid retention, diabetes mellitus, asthma, migraine, depression
• history of hepatic disease
• breastfeeding patients.

Administration

• Before first dose, make sure patient has read package insert regarding adverse effects. Reinforce written information with oral review.
☞ Before first I.M. dose, ask if patient has allergy to peanuts or sesame. Before giving micronized capsules, ask about peanut allergy.
• Inject I.M. dose deep into muscle. Rotate injection sites.

Route	Onset	Peak	Duration
P.O.	Unknown	2-4 hr	Unknown
I.M., vaginal	Unknown	Unknown	Unknown

Adverse reactions

CNS: depression, emotional lability, cerebrovascular accident

CV: thrombophlebitis, thromboembolism

EENT: retinal thrombosis

GI: abdominal cramps

GU: amenorrhea, breakthrough bleeding, spotting, cervical erosions, breast tenderness, menstrual flow changes, galactorrhea

Hepatic: hepatitis

Respiratory: pulmonary embolism

Skin: melasma, rash, angioedema

Other: gingival bleeding, weight gain or loss, hypersensitivity reactions including anaphylaxis

Interactions

Drug-drug. Conjugated estrogens: increased levels of both drugs

Drug-diagnostic tests. Alkaline phosphatase, amino acids, low-density lipoproteins: increased levels

Chloride and sodium excretion: reduced (with high doses)

High-density lipoproteins: decreased level

Pregnanediol excretion: reduced

Thyroid function tests: altered results

Drug-herbs. Red clover: interference with drug effects

Drug-behaviors. Smoking: increased risk of thromboembolic effects

Patient monitoring

☞ Watch for evidence of thromboembolic disorders, including cerebrovascular accident, pulmonary embolism, diplopia, proptosis, or sudden partial or complete vision loss (may signal retinal thrombosis). If these occur, discontinue drug and notify prescriber immediately.
☞ Assess for emotional lability and depression.

Patient teaching

☞ Teach patient to recognize and immediately report signs and symptoms of thromboembolic disorders.
☞ Instruct patient and significant other to stay alert for and immediately report depression.
• Advise patient to monitor weight regularly and report significant changes.
• Tell female patient that drug may cause menstrual abnormalities.
• Advise female patient to discuss breastfeeding with prescriber before taking drug.
☞ Instruct patient to immediately report possible pregnancy.
• Tell patient that smoking increases thromboembolism risk. Encourage her to stop smoking if she smokes.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.