Hormones are chemical messengers that affect various functions in the body and progesterone is a female sex hormone that regulates menstruation and supports pregnancy.  So, it is also called the pregnancy hormone.  The main function of progesterone is to prepare the uterus lining (endometrium) for implantation by the fertilized egg and its growth.

Ovulation or the release of the egg from the ovaries occurs during the middle of the menstrual cycle.  After this egg’s release, the corpus luteum, which housed the maturing egg in the ovary, begins producing progesterone. Progesterone helps prepare the body for pregnancy by creating a favourable environment for the implantation of the fertilized egg in the uterus by increasing the blood vessels and thus blood flow to the uterus and creating a thickened endometrial wall.  Thus, the endometrium in the uterus can receive and nourish the fertilized egg.  If the egg isn’t fertilized by sperm, the corpus luteum disintegrates causing a decrease in progesterone levels in turn leading to the shedding of the endometrium as seen by the bleeding at the beginning of your period.  If the fertilized egg implants in the endometrium, the corpus luteum continues to produce progesterone stimulating the blood vessels in the endometrium and providing oxygen and nutrients for the embryo.  After about 10 weeks, the growing placenta, which holds the developing fetus, begins producing progesterone for the rest of the pregnancy.  The high level of progesterone also prevents the production of any more eggs and it also inhibits lactation or milk production.  If the progesterone levels are low, it could cause issues with menstruation and it could also cause miscarriage, early labor and poor function of the ovaries leading to infertility.  Progesterone could also ward off infection and decrease contraction by the myometrium which is the muscle layer beneath the endometrium thus decreasing risk of early labor or miscarriage.  So, progesterone is very important for natural conception to occur and to stay successfully pregnant.  However, there is not much evidence that taking progesterone supplements could help you get pregnant naturally or reduce the risk of miscarriage if you are healthy.  Ask your doctor about recommendations on what to do under these circumstances.

Invitro fertilization(IVF) is a procedure where the woman’s ovaries are stimulated to produce several mature eggs at one time and these eggs are then retrieved, fertilized with sperm in a laboratory setting and the resulting embryo is transferred back to the uterus for implantation to occur which would then result in a pregnancy.  During IVF, medications are given to slow down the egg from being released too early and these medications could also reduce the levels of progesterone.  Also, during the time of egg retrieval, some progesterone producing cells (corpus luteum) could also be removed.  In order to make sure the progesterone levels are at the proper level for implantation of the fertilized egg in the uterus lining, most women going through IVF will be given progesterone after egg retrieval until the embryo transfer and even longer of upto 10 weeks if pregnancy is confirmed to prevent miscarriage.  Progesterone therapy poses no threat to either baby or mother.

Progesterone is usually administered by injection intramuscularly/subcutaneously(under the skin) or applied vaginally as a suppository in gel or tablet form or taken orally as a tablet. Oral tablets are less messy but they could make you feel nauseous and make you sleepy and are not as effective.  Vaginal gel or suppositories are thought to be more effective and could be more easily absorbed into the uterus although it could be more messy and might cause itchiness or yeast infections.  So, make sure you clean your hands and your vaginal area before inserting the suppository.  Lie down for 10-20 minutes after application and do not urinate or empty your bowel immediately after application.  The intramuscular injection could be painful at the injection site but it absorbs more evenly and slowly and you need only one shot a day although you might need to go to the clinic for its administration.   If you have missed a dose, speak to your doctor for instructions on what to do.  Do not double up your dosage.   

Most people have no side effects and some may have only mild side effects from progesterone therapy.  Some possible side effects of taking progesterone could include having back pain, tiredness, dizziness, fluid retention, bloating, nausea, cramps, breast tenderness, mood swings, and gastrointestinal issues although these aren’t too serious.  Some other symptoms might, allergic reactions, pain and swelling at the injection site and rarely abscess formation if long term injections are used.  See your doctor right away if you have any of these serious symptoms.  Make sure you follow your doctor’s instructions carefully about progesterone dosage and taking it at the right scheduled times. If you have any questions about taking progesterone, speak to the professionals at Xenith Advanced Fertility Centre.