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Micronised progesterone

Shruti Shambhavi, Rashmi Bagga, Pallavi Bansal, Jasvinder Kalra, Praveen Kumar
For prevention of a recurrent preterm birth (PTB), intramuscular 17-α-hydroxy progesterone caproate (IM 17 OHPC) weekly is recommended. Vaginal progesterone is preferred for women at risk for PTB due to a short cervical length, but may be useful in women with a prior PTB. However, there is no consensus about the optimal vaginal formulation or its efficacy as compared to 17 OHPC to prevent recurrent PTB. We randomised 100 women with a singleton pregnancy between 16 and 24 weeks of gestation and ≥ one prior spontaneous PTB, of a singleton (>16 to <37 weeks of gestation) to receive the 200 mg vaginal progesterone effervescent tablet daily (Group A) or IM 17-OHPC, 250 mg weekly (Group B) till 37 weeks of gestation or delivery...
March 20, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
A van de Vijver, P Drakopoulos, N P Polyzos, L Van Landuyt, S Mackens, S Santos-Ribeiro, V Vloeberghs, H Tournaye, C Blockeel
Prospective studies comparing different durations of progesterone supplementation before transfer of vitrified-warmed blastocysts in an artificial cycle are lacking. However, in oocyte donation programmes, the sporadic available evidence demonstrates considerable differences in clinical pregnancy rates according to the duration of progesterone administration. This randomised controlled trial (RCT), included 303 patients undergoing a frozen-thawed embryo transfer (FET) of one or two vitrified-warmed blastocyst(s) in an artificial cycle...
October 2017: Gynecological Endocrinology
John Eden
For a significant minority of women, menopausal symptoms can be very unpleasant; however, many are worried about taking menopausal hormone therapy (MHT) for fear of causing breast cancer. Micronised progesterone (mP4) has been available in Europe since the 1990s and clinical trials have shown that 100 mg oral daily, 200 mg oral sequentially or 100 mg vaginal every second day effectively protect the endometrium from the stimulatory effects of oestrogen. MHT containing mP4 has a significantly lower breast cancer risk than those containing progestins...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Jaana Seikkula, Leena Anttila, Päivi Polo-Kantola, Risto Bloigu, Janne Engblom, Helena Tinkanen, Varpu Jokimaa
This prospective randomised crossover study evaluated the effect of mid-luteal single-dose gonadotropin-releasing hormone agonist (triptoreline) on pregnancy outcomes in natural-cycle frozen embryo transfers (FETs). Ninety-eight women were randomised to receive either standard luteal support with vaginal micronised progesterone or an additional single dose of 0.1 mg triptoreline at the time of implantation. The intervention group was composed of 65 FET cycles and the control group of 62 cycles. In the intervention group, there were more positive pregnancy tests, clinical pregnancies and live births, but the differences did not reach statistical significance...
December 2016: Gynecological Endocrinology
Arri Coomarasamy, Helen Williams, Ewa Truchanowicz, Paul T Seed, Rachel Small, Siobhan Quenby, Pratima Gupta, Feroza Dawood, Yvonne E Koot, Ruth Bender Atik, Kitty Wm Bloemenkamp, Rebecca Brady, Annette Briley, Rebecca Cavallaro, Ying C Cheong, Justin Chu, Abey Eapen, Holly Essex, Ayman Ewies, Annemieke Hoek, Eugenie M Kaaijk, Carolien A Koks, Tin-Chiu Li, Marjory MacLean, Ben W Mol, Judith Moore, Steve Parrott, Jackie A Ross, Lisa Sharpe, Jane Stewart, Dominic Trépel, Nirmala Vaithilingam, Roy G Farquharson, Mark David Kilby, Yacoub Khalaf, Mariëtte Goddijn, Lesley Regan, Rajendra Rai
BACKGROUND AND OBJECTIVES: Progesterone is essential to maintain a healthy pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists and a Cochrane review called for a definitive trial to test whether or not progesterone therapy in the first trimester could reduce the risk of miscarriage in women with a history of unexplained recurrent miscarriage (RM). The PROMISE trial was conducted to answer this question. A concurrent cost-effectiveness analysis was conducted...
May 2016: Health Technology Assessment: HTA
Susan R Davis, Georgia Dempster, Robin J Bell
A clinical practice audit was undertaken to share an Australian experience of the use of micronised progesterone (mP) 100 mg daily as part of menopausal hormone therapy (MHT). Ninety-nine women attending a single practitioner were offered the option of mP as a component of MHT, under the Australian Authorised Prescriber Scheme, over 2.5 years. Each of their files was independently audited. The mean age at commencement was 55.0 (SD 6.6) years. Of the 93 postmenopausal women, 7 were lost to follow-up, 18 discontinued and treatment was ongoing for 68...
June 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Michelle van der Linden, Karen Buckingham, Cindy Farquhar, Jan A M Kremer, Mostafa Metwally
BACKGROUND: Progesterone prepares the endometrium for pregnancy by stimulating proliferation in response to human chorionic gonadotropin(hCG) produced by the corpus luteum. This occurs in the luteal phase of the menstrual cycle. In assisted reproduction techniques(ART), progesterone and/or hCG levels are low, so the luteal phase is supported with progesterone, hCG or gonadotropin-releasing hormone (GnRH) agonists to improve implantation and pregnancy rates. OBJECTIVES: To determine the relative effectiveness and safety of methods of luteal phase support provided to subfertile women undergoing assisted reproduction...
July 7, 2015: Cochrane Database of Systematic Reviews
Monica Mittal, Michael Savvas, Nitish Narvekar, Nick Panay, Haitham Hamoda
OBJECTIVE: To explore the current clinical attitudes of members of the British Menopause Society to the management of premature ovarian insufficiency. DESIGN: An electronic cross-sectional questionnaire survey. SETTING: Members of the British Menopause Society. POPULATION: All members of the British Menopause Society with a valid email address. METHOD: Completion of an electronic survey. MAIN OUTCOME MEASURES: Investigations and treatment options and preferences for the management of women with premature ovarian insufficiency...
September 2014: Post Reproductive Health
Nick Panay
The adverse outcomes seen in the Women's Health Initiative (WHI) (1) were mainly due to an over-dosage of hormones in a relatively elderly population. However, fundamental differences exist between conjugated equine estrogens and 17 beta estradiol and between medroxyprogesterone acetate and natural progesterone. It is likely that these differences also contributed to the adverse outcomes in WHI, which were contrary to the cardiovascular benefits seen in previous observational trials. Recent studies of cardiovascular risk markers in younger women have been designed using predominantly estradiol and natural progesterone (transdermal and oral) as the primary interventions...
June 2014: Post Reproductive Health
Savas Karakus, Gurkan Kiran, Harun Ciralik
BACKGROUND: The vaginal route is more effective than the other drug delivery routes for some specific indications. AIM: To compare the efficacy of a vaginal progesterone preparation with that of oral dydrogesterone. METHODS: A total of 69 women with irregular dysfunctional uterine bleeding were randomly assigned into one of two groups: oral dydrogesterone group (n = 35) and vaginal progesterone group (n = 34). At the end of a three-month treatment period, the women were re-evaluated...
December 2009: Australian & New Zealand Journal of Obstetrics & Gynaecology
Faustino R Pérez-López, José L Cuadros-López, Ana M Fernández-Alonso, Angela M Cuadros-Celorrio, Rosa M Sabatel-López, Peter Chedraui
OBJECTIVE: To assess fatal cardiovascular disease (FCD) risk among women in early post-menopausal years, as evaluated with the Systematic Coronary Risk Evaluation (SCORE) scale. DESIGN: This was a retrospective study of parallel cohorts. Two hundred seventy-three healthy post-menopausal women. Participants received one of the following hormone treatment (HT) regimens: transdermal estradiol (50 microg) (n = 99), sequential cyclic HT with transdermal estradiol (50 microg/day) plus 200 mg/day natural micronised oral progesterone (cycle days 12-25) (n = 63) and combined HT using transdermal estradiol (50 microg) plus 100 mg/day of micronised oral progesterone (n = 61)...
July 2010: Gynecological Endocrinology
Angiolo Gadducci, Nicoletta Biglia, Stefania Cosio, Piero Sismondi, Andrea Riccardo Genazzani
The relevance of the progestagen component in combined hormone replacement therapy (HRT) for breast cancer risk has been long debated. In vitro studies have shown that progestins exert both genomic transcriptional and non-genomic effects that can enhance the proliferation, invasiveness and spread of breast cancer cells. According to a novel hypothesis, progestins can still activate cancer stem cells in patients with pre-existing, clinically undetected breast cancer. However, some experimental and clinical data suggest that different progestins may have a different impact on the pathophysiology of malignant breast cells...
December 2009: Gynecological Endocrinology
P Majhi, R Bagga, J Kalra, M Sharma
In a prospective, randomised trial, 100 pregnant women with >/= one prior spontaneous pre-term birth were randomised into two groups. Group 1 women received 100 mg natural micronised progesterone intravaginally once daily from 20-24 weeks' gestation until 36 weeks. Group 2 women did not receive progesterone. Both groups were regularly supervised until delivery. Pre-term birth (<37 and <34 weeks) and other maternal, neonatal outcomes were primary and secondary outcomes, respectively. Chi-square test and Fisher exact test were used to compare categorical variables...
August 2009: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
J E Blümel, M Del Pino, D Aprikian, S Vallejo, S Sarrá, C Castelo-Branco
AIM: To evaluate with validated instruments changes in quality of life and sexuality in women receiving hormonal replacement therapy (AHT). DESIGN: Randomised, double-blind, double-dummy study with two parallel treatment arms. PATIENTS AND METHODS: Forty-seven healthy post-menopausal women, aged 45-64 years, were evaluated using the Female Sexual Function Index (FSFI) and the menopause-specific quality of life questionnaire (MENQOL). Of them, 40 diagnosed with sexual dysfunction were randomised (1:1) to receive daily 0...
December 2008: Gynecological Endocrinology
S Bozhinova, P Bozhinov
Epilepsy is a disease, closely connected with sex-hormones and can lead to adverse repercussion on the reproductive health. The ovarial hormones influence excitation of neurocells membranes and have a lot of effects on brain, leading to provoking epileptic activity. The progesteron decrease and the estrogens increase the brain excitation, that's why estrogens (act like a proconvulsant) are proconvulsant and progesteron is anticonvulsant. The aim of this study is to evaluate therapeutic abilities of Utrogestan (micronising progesteron) for treatment of abortions and climacteric amplifications in women with epilepsy...
2005: Akusherstvo i Ginekologii︠a︡
L Andréen, O Spigset, A Andersson, S Nyberg, T Bäckström
OBJECTIVES: To investigate the pharmacokinetics of progesterone, allopregnanolone and pregnanolone after treatment with a low oral dose of progesterone. METHODS: Eight postmenopausal women were given a single oral dose of 20 mg of micronised progesterone on Day 1 and 20 mg twice daily on Days 2-7. Blood samples for the analysis of progesterone, allopregnanolone and pregnanolone were collected, and pharmacokinetic parameters were calculated. RESULTS: After ingestion of a single dose, areas under the plasma concentration-time curve (AUC) from 0 to 12 h for progesterone, allopregnanolone and pregnanolone were 127%, 196% and 119% higher than the corresponding AUCs estimated to be caused by endogenous production...
June 20, 2006: Maturitas
Baidya Nath Chakravarty, Hasibul Hasan Shirazee, Purvita Dam, Sourendra Kanta Goswami, Ratna Chatterjee, Sanghamitra Ghosh
The objective of this prospective, randomised study was to compare the efficacy, safety and tolerability of vaginal micronised progesterone with oral dydrogesterone as luteal phase support after in-vitro fertilisation (IVF). A total of 430 women underwent IVF/intracytoplasmic sperm injection (ICSI) treatment. Long protocol gonadotropin releasing hormone analogue down-regulation was followed by gonadotropin stimulation. Human chorionic gonadotropin was given when two or more follicles reached > or = 17 mm...
December 2005: Journal of Steroid Biochemistry and Molecular Biology
Attilio Di Spiezio Sardo, Sheila Radhakrishnan
BACKGROUND: Continuous combined hormone replacement therapy (HRT) has been introduced in an attempt to increase patient compliance by eliminating withdrawal bleeding which is one of the most significant and troublesome side effects of sequential HRT. Moreover, when given on a daily basis, progestin is thought to be more protective against the development of endometrial carcinoma. CASE REPORT: We describe the case of a 59-year-old woman, diagnosed with endometrial carcinoma while on continuous combined HRT...
June 15, 2004: Maturitas
Therese F Nielsen, Pernille Ravn, Yu Z Bagger, Lise Warming, Claus Christiansen
The aim of this study was to evaluate the efficacy of pulsed estrogen therapy (intranasal 17beta-estradiol) in the prevention of postmenopausal bone loss. A total of 386 women (40-65 years old), less than 5 years past menopause, were randomized to intranasal placebo, 17beta-estradiol 150 micro g, or 300 micro g daily for 2 years. Women with an intact uterus received micronised progesterone 200 mg per day, 14 days of each 28-day cycle. Women randomised to placebo-treatment received placebo progesterone. The primary endpoints were changes in BMD at the spine (L2-L4) and femoral neck...
February 2004: Osteoporosis International
M Jondet, L Dehennin
OBJECTIVES: To determine if the vascularisation of the endometrium is dependent on the administered progestin during sequential hormone replacement therapy. METHODS: Nine women received percutaneous estradiol-17 beta, 1.5 mg/day from days 1 to 24 combined with 200 mg/day micronised progesterone from days 11 to 24 of the treatment cycle. Fifteen women received percutaneous estradiol, 1.5 mg/day from days 1 to 24, combined with 10 mg/day chlormadinone acetate from days 11 to 24...
November 20, 2003: Maturitas
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