Peaceful Pregnancy

How Progesterone Helps

By Lisa A. Goldstein

"We did not study 'progesterone,' which is the naturally-occurring hormone and until recently could only be administered by injection or via cream through the skin," she says. "We have studied synthetic forms called progestins, which is how it was delivered to most women. In general, progesterone or progestins do not assist at-risk pregnancies unless it has been proven by careful evaluation that the problem is an insufficiency of progesterone production by the corpus luteum or the placenta. This is relatively unusual and appropriate testing is rarely done by physicians."

Why is progesterone even used during pregnancy? In addition to two studies that have found that progesterone is effective in reducing the risk of preterm delivery in a select group of women with a history of spontaneous preterm delivery, Dr. Ramin says that progesterone is also used in women undergoing assisted reproductive technology who have progesterone deficiency. It supports the implantation of the embryo and helps maintain the pregnancy up to 10 to 12 weeks of gestation. The placenta assumes this function at 7 to 9 weeks of gestation.

Side effects that have been reported with progesterone gel include breast enlargement, constipation, sleepiness, nausea, headache, bloating, dizziness and perineal pain, says Dr. Ramin. Reported side effects with 17-hydroxyprogesterone caproate injections include local injection-site reactions (soreness, swelling, itching and bruising) or a lump at the injection site. The cost is $40 to $100, depending on the pharmacy, and is typically not covered by insurance.

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