Prometrium: Natural Progesterone Support for Hormonal Balance
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Synonyms
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Prometrium is a bioidentical progesterone medication designed to support and restore hormonal balance in women. It is FDA-approved and widely prescribed to address a range of conditions related to progesterone deficiency, from menstrual irregularities to menopausal symptom management. By providing a natural, micronized form of progesterone identical to that produced by the human body, Prometrium offers a targeted and physiologically appropriate therapeutic option. Its unique formulation ensures optimal absorption and bioavailability, making it a trusted choice among healthcare providers for hormone replacement therapy and reproductive health support.
Features
- Contains 100 mg or 200 mg of micronized progesterone per soft gelatin capsule
- Bioidentical structure, identical to endogenous progesterone
- Formulated in peanut oil for enhanced absorption
- Available in oral and vaginal administration routes
- FDA-approved for use in hormone replacement therapy and amenorrhea
- Gluten-free and dye-free formulation
Benefits
- Restores natural progesterone levels to alleviate symptoms of hormonal imbalance
- Supports endometrial health and reduces the risk of hyperplasia in estrogen-treated postmenopausal women
- Helps regulate menstrual cycles and manage amenorrhea
- May improve sleep quality and reduce anxiety due to progesterone’s neurosteroid effects
- Provides a natural alternative to synthetic progestins with a favorable side effect profile
- Supports early pregnancy maintenance in cases of corpus luteum deficiency
Common use
Prometrium is commonly prescribed for women experiencing progesterone deficiency or imbalance. It is frequently used as part of hormone replacement therapy (HRT) in postmenopausal women receiving estrogen, to protect the uterine lining from hyperplasia. It is also indicated for the treatment of secondary amenorrhea, helping to restore regular menstrual cycles. In reproductive medicine, it may support luteal phase deficiency or be used in assisted reproductive technology (ART) cycles. Off-label, it is sometimes used to manage premenstrual syndrome (PMS), perimenopausal symptoms, or to prevent preterm birth in certain high-risk pregnancies, though these uses require careful medical supervision.
Dosage and direction
Dosage of Prometrium must be individualized based on the patient’s condition, response, and administration route. For secondary amenorrhea, the typical dose is 400 mg orally once daily at bedtime for 10 days. As part of postmenopausal HRT with estrogen, the usual dose is 200 mg orally daily at bedtime for 12 sequential days per 28-day cycle. For luteal phase support or ART, doses often range from 200–400 mg daily, administered either orally or vaginally, as directed by a healthcare provider. It is recommended to take oral capsules at bedtime to minimize dizziness or drowsiness. Vaginal administration may be preferred in certain contexts to reduce systemic side effects. Always follow the specific instructions provided by the prescribing physician.
Precautions
Patients using Prometrium should be monitored for potential adverse effects, particularly those related to progesterone’s physiological actions. It may cause dizziness, drowsiness, or blurred vision; avoid driving or operating machinery until the individual response is known. Use with caution in patients with a history of depression, as progesterone can affect mood. Regular clinical evaluation is advised for signs of thrombotic disorders, visual abnormalities, or severe allergic reactions. Prometrium contains peanut oil; it is contraindicated in patients with peanut allergies. It should not be used during pregnancy except under specific medical guidance for supporting early pregnancy or preventing preterm birth, and only when benefits clearly outweigh risks.
Contraindications
Prometrium is contraindicated in individuals with known hypersensitivity to progesterone, peanut oil, or any component of the formulation. It must not be used in patients with a history of current or past blood clots, including deep vein thrombosis (DVT), pulmonary embolism (PE), or stroke. Other contraindications include known or suspected progesterone-sensitive cancers (e.g., breast cancer), undiagnosed abnormal genital bleeding, missed abortion, or severe liver dysfunction. It should not be used during pregnancy without clear medical indication and supervision, except in specific circumstances such as luteal phase support under careful monitoring.
Possible side effect
Common side effects of Prometrium include drowsiness, dizziness, breast tenderness, headache, and mood changes. Gastrointestinal symptoms such as nausea, bloating, or abdominal cramping may occur. Some users report fatigue, hot flashes, or joint pain. Less frequently, it may cause allergic reactions, including rash or itching, particularly in those sensitive to peanuts. Although rare, more serious side effects can include signs of blood clots (e.g., leg pain, chest pain, sudden shortness of breath), depression, or visual disturbances. Vaginal administration may cause local irritation, discharge, or spotting. Most side effects are dose-dependent and often diminish with continued use or dose adjustment.
Drug interaction
Prometrium may interact with several medications. It can enhance the effects of CNS depressants, including alcohol, benzodiazepines, and opioids, increasing sedation. Drugs that induce liver enzymes, such as rifampin, carbamazepine, or St. John’s wort, may reduce progesterone levels by increasing its metabolism. Conversely, ketoconazole and other CYP3A4 inhibitors may increase progesterone concentrations. It may also interact with other hormone therapies, anticoagulants, or antihypertensive drugs. Always inform the healthcare provider of all current medications, including over-the-counter drugs and supplements, to avoid potential interactions.
Missed dose
If a dose of Prometrium is missed, take it as soon as remembered unless it is almost time for the next dose. In that case, skip the missed dose and resume the regular schedule. Do not double the dose to make up for a missed one. Consistency in dosing is important for maintaining stable hormone levels, particularly in cyclical regimens for HRT or fertility support. If unsure, consult a healthcare provider or pharmacist for guidance specific to the prescribed regimen.
Overdose
Overdose of Prometrium may intensify its typical side effects, such as severe drowsiness, dizziness, or nausea. There is no specific antidote for progesterone overdose. Treatment is supportive and symptomatic; ensure airway protection if drowsiness is profound and monitor vital signs. Gastric lavage or activated charcoal may be considered if ingestion was recent and the patient is alert. In cases of suspected overdose, seek immediate medical attention or contact a poison control center.
Storage
Store Prometrium at room temperature (20–25°C or 68–77°F), in a dry place away from light and moisture. Keep the capsules in their original container, tightly closed, and out of reach of children and pets. Do not freeze. Discard any unused or expired medication properly according to local guidelines, preferably through a drug take-back program.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something read here. Individual responses to Prometrium may vary, and only a licensed healthcare professional can determine the appropriate use based on a patient’s specific health status.
Reviews
Clinical studies and patient reports generally reflect positive experiences with Prometrium, particularly regarding its natural profile and efficacy in managing hormonal symptoms. Many users note improvements in sleep, reduced anxiety, and better cycle regulation. However, some report side effects like drowsiness or mood changes, which often subside with time or dose adjustment. Healthcare providers frequently prefer it over synthetic progestins due to its favorable risk-benefit ratio and physiological action. As with any hormone therapy, individual results vary, and continuous medical supervision is recommended for optimal outcomes.