Progesterone is a medication administered by a variety of methods including injection, oral daily, or intravaginal gel or suppository. It is a naturally occurring hormone produced primarily by the ovaries. In a regular menstrual cycle, very small amounts of progesterone are present prior to ovulation (the process whereby a mature egg is released from the ovary). The progesterone levels then rise sharply shortly after ovulation. Higher levels of progesterone are required to enable this hormone to carry out one of its major responsibilities, preparing the inner lining of the uterus (womb) to receive a fertilized egg. If the body determines that an egg has not been fertilized, the ovaries stop producing progesterone and menses begins within 24 to 48 hours. If fertilization (conception) occurs, the ovaries continue to produce progesterone, which is important in maintaining the pregnancy.
Some women do not produce sufficient progesterone on their own and, therefore, may have difficulty conceiving. In these cases, supplemental administration of progesterone is required.
Another instance where supplemental administration of progesterone is needed is in women who are undergoing certain assisted reproductive technology (ART) procedures. In order to mimic a regular menstrual cycle, therapy with progesterone is usually started a few days after ovulation and is continued until either menses occurs or pregnancy is confirmed. If pregnancy is achieved, treatment with progesterone may be continued for up to 10 to 12 weeks. By this time, the placenta (the organ in the womb that nourishes the fetus) is producing sufficient amounts of progesterone for the remainder of the pregnancy.
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Some of the adverse effects associated with the use of progesterone include nausea, constipation, breast enlargement and tenderness, headache, drowsiness, vaginal discharge, joint discomfort, and depression. Progesterone may also cause fluid retention; therefore, patients with certain medical conditions such as epilepsy, migraine headaches, asthma, and cardiac or renal impairment require close observation.
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