Progesterone exogenous therapy side effects?common side effects which are not harmful and dies not cause any hralth risks at all. T

·  we often foget to communicate our pts about following minor but common side effects which are not harmful anddies not cause any hralth risks at all. These are :-.

·  Bloating.

·  Decreased sex drive.

·  Fatigue.

·  Headaches.

·  Low blood sugar (hypoglycemia).

·  Increased blood clotting.

·  Irritability.

·  Memory loss.

·  Thyroid problems.

·  "Foggy thinking".

·  Uterine cancer.

·  Uterine fibroids.

·  Water retention.

Weight gain. contraindiactions of Progesterone thertapy in any form is 1) Arterial disease: Don't use progesterone if one is  having  arterial disease. Avoid use unless benefits outweigh the risks BY and large Oestrogen bites the venous sytem by causing VTE whereas spares the coronary vessels. By contrast it is said that Progesterone bites the heart by promoting athermanous plaque formation but spares or licks the venous system , But Progesterone licks the liver,

2) Breast cancer: Avoid use unless benefits outweigh the risks.
3) Depression: It accelerates sleeplessness that is why before we prescribe such tab in social meets or in Exam period we prescribe minimal dose of P:rog so that her Exam is not spoiled out of sleepless ness.Or and depression.Sometimes Prog induced depression may be major(new onset) or accelaerate in women who had ahd had history of major depression.

Liver disease: Progesterone might make liver disease worse.

Vaginal bleeding: If you have undiagnosed vaginal bleeding, don't use progesterone.

·   

 Let us be acquanatied what we need to know about its side effects & complications if any:-One of the common use is as A) OCP followed by B) Voluntary / planned  initiation of menst or deferring period for social reasons, C) as a means of controlling menorrhagia &  Abnormal thickening of the endometrium (endometrial hyperplasia D) HRT alone or in varying combination with Oestrogens . It is a good news of the Prog manufactures that in Obstetrics its use & Infertility clinic, including  LPD, Pre induction inj Prog to suppress presumed raised LH are more frequently used. So also as I said  for preg support including ART clinic from day of Ovum pickup.

Routes of prog?? :-We know that Prog can be used as A) Oral contraceptives( 5 kinds of proges) : But in Obstet it is used as–mostly micronized form / but to control bleeding or regularizing one should use  Androgenic prog which are mostly  traditional whereas in Obstet it is mostly micronized. B) Sub dermal implant-(7 kinds of progesterones are used including biodegradable implants under the arm or at abdomen) , C) vaginal ring alone(VCR trial by ICMR in progress)  or with oestrogen (NUVARING) ,D) LNG-IUS  E) Combined Inj contraceptive with oestrogen(In Lunelle) F) as monthly I M contraceptive  Inj),G)  2./3 monthly Depo-Provera ,& least use is  H) creams on skin I) Vaginal gel 8%  etc. This is an incomplete list of uses but to me it appears that its use in prevention of Preterm labour & Subfertility is surpassing the Prog use as a contraceptive steroid 

·  is not a complete list of side effects and others may occur.unexpectedly stopped, treat abnormal uterine bleeding  Taking progesterone by mouth and applying progesterone gel into the vagina are effective strategies for treating absence of menstrual periods in premenopausal women. Micronized progesterone is FDA-approved for this use, as is intravaginal progesterone gel (Crinone 4%). Breast pain (mastodynia). Some research suggests that applying progesterone (Crinone) into the vagina seems to reduce breast pain and tenderness in women with non-cancerous breast disease.

•  

·  Vaginal irritation (vulval lichen sclerosis). Applying progesterone into the vagina does not seem to improve symptoms of vulval lichen sclerosis. In fact, progesterone seems to be less effective than clobetasol (Temovate) for treating this condition.

Insufficient Evidence for

·  Withdrawal symptoms from drugs such as diazepam (Valium), alprazolam (Xanax), temazepam (Restoril), and others. Some research suggests that taking micronized progesterone by mouth may not be effective for relieving symptoms of withdrawal and for helping people to abstain from taking diazepam.

·  Heart disease. Early research suggests that applying progesterone into the vagina may increase exercise endurance compared to taking a similar steroidal drug (medroxyprogesterone) by mouth in women with heart disease or women that previously experienced a heart attack.

·  Cocaine dependence. Early research suggests that taking progesterone by mouth does not decrease the risk of cocaine use in methadone-stabilized male cocaine users.

·  Preventing bone loss (osteoporosis). Some research suggests that applying progesterone to the skin is not effective for increasing bone mineral density in postmenopausal women. Other research shows that applying progesterone to the skin for 2 years may be as effective for preventing bone loss as drinking isoflavone-containing soy milk. However, the combination of soy milk plus progesterone seems to result greater bone loss than either single treatment alone.

·  Depression after childbirth (postpartum). Early research suggests that applying progesterone into the rectum does not reduce symptoms of postpartum depression.

·  High blood pressure during pregnancy (pre-eclampsia). Early research suggests that single injections of progesterone reduce blood pressure, swelling, and other symptoms in women with pre-eclampsia.

·  Injury due to brain trauma. Some research suggests that injecting progesterone soon after brain injury prevents death and disability. However, other research suggests that progesterone does not decrease the frequency of death or disability.

·  Treating or preventing allergies affected by hormones.

·  Bloating.

·  Decreased sex drive.

·  Fatigue.

·  Headaches.

·  Low blood sugar (hypoglycemia).

·  Increased blood clotting.

·  Irritability.

·  Memory loss.

·  Thyroid problems.

·  "Foggy thinking".

·  Uterine cancer.

·  Uterine fibroids.

·  Water retention.

·  Weight gain.