Can high doses of progesterone hurt? Progesterone - instructions for use. How to increase progesterone naturally

The norm of progesterone during pregnancy: why is this hormone so important in the early stages? Table of normal progesterone levels

The menstrual cycle of a woman is clearly divided into two phases, each of which is dominated by its own hormone. After ovulation, the corpus luteum is formed, which synthesizes progesterone. The preparation of the endometrium for the implantation of a fertilized egg and the further progression of pregnancy depend on the activity of this temporary gland.

Any deviation in concentration can lead to unpleasant consequences.

  • The role of progesterone during pregnancy
  • Blood test: when prescribed and preparation for donating blood for progesterone
  • Progesterone levels by weeks of pregnancy and trimesters in the table
  • The norm of 17-OH progesterone during pregnancy
  • Low Progesterone: Causes and Risks for Pregnancy
  • Excess progesterone in the body of a pregnant woman: causes and consequences
  • Hormone levels during twin pregnancy
  • Progesterone deficiency and treatment during pregnancy
    • Injections
    • Candles
  • How to increase progesterone levels with food

Progesterone during pregnancy: its role in the body of a pregnant woman in the early stages

Progesterone is called the hormone of pregnancy. Its influence is shown in the following:

  • Preparation of the endometrium for the attachment of a fertilized egg. The uterine mucosa thickens, stores nutrients.
  • Strengthening the secretion of nutrient mucus in the fallopian tubes, which is necessary to maintain the vital activity of the dividing blastocyst, and for its transport from the tube to the uterine cavity.
  • An increase in the size of the uterus due to the growth of stromal and muscle cells;
  • Decreased contractile activity of the myometrium - the muscular layer of the uterus. In early pregnancy, this feature of progesterone prevents the rejection of a newly attached and implanted embryo.
  • Prepares mammary glands for milk secretion. Under its action, the lobules increase and the cells of the alveoli grow, the milk passages from the lobules are improved for the outflow of milk after childbirth.
  • Increases the elasticity of the pelvic floor muscles, the ligamentous apparatus of the pelvic bones. This is the first stage of adaptation of the body to future childbirth.
  • to prevent rejection of the ovum. After all, the embryo for the mother's body is a foreign object.
  • Retains fluid, which is necessary to increase blood volume.
  • Affects the nervous system, helps to form the dominant of pregnancy, but can lead to,.

Until the formation of the placenta, the main source of the hormone progesterone is the corpus luteum. Its activity is influenced by the developing embryo. From the first days after fertilization, its cells secrete chorionic gonadotropin (hCG). This hormone stimulates the corpus luteum and keeps it functioning. At the same time, there is an increase in the concentration of progesterone, which doubles weekly.

Analysis for progesterone during pregnancy

In clinical practice, a progesterone test is prescribed if a pathology is suspected. With a normal pregnancy, it is not necessary.

Depending on the laboratory, different methods of analysis are used, so the measurement values ​​​​are different, we have collected them in one summary table.

Table 1.

The norm of progesterone during pregnancy by weeks

Gestational age nmol/l ng/ml

Injection

Progesterone injections are used in the form of an oil solution. It is administered subcutaneously or intramuscularly. The dosage depends on individual characteristics, and ranges from 10 to 25 mg. Injections are carried out daily until the signs of a threatened abortion disappear. Women with and the drug should be used until the 20th week of pregnancy.

The analogue is oxyprogesterone capronate. It is available in a dosage of 0.125 g per ampoule. For injection, a dose is prescribed in 1 or 2 ampoules. The drug is used for threatened miscarriage in the early stages. It is administered once a week.

Candles

Vaginal forms of progesterone preparations can be used to treat progesterone deficiency. It can be capsules Utrozhestan, Susten.

Utrozhestan with the threat of abortion is prescribed according to a certain scheme. Initially, this is 400-600 mg per dose. Then 200-300 mg is used twice a day daily until the signs of threat disappear. If the dose is insufficient, then it can be increased to 800-1000 mg.

Cancellation of the drug occurs gradually, as well as in the physiology of a normal pregnancy. To do this, the weekly dose is reduced by 100 mg. But if the symptoms of a threatened miscarriage reappear in the form of blood smearing, pulling pain in the lower abdomen, then you will have to return to treatment. Otherwise, a threatened miscarriage will turn into an abortion. Therefore, abrupt withdrawal of the drug, which can provoke an abortion, is unacceptable.

The analogue of Utrozhestan is Duphaston. It comes in the form of tablets for oral administration. Unlike Utrozhestan, it does not have a sedative effect, so some doctors prefer to prescribe Duphaston.

The use of medicines in the form of suppositories or tablets is currently preferable to injections. Injections of oil solutions are very painful and require special skills. At that time, a woman can apply candles on her own.

Increasing Progesterone Naturally

With insufficiency of the corpus luteum, it will not be possible to significantly increase the level of progesterone with the help of a diet. Changing the diet can be used as an additional method. At the same time, it is recommended to increase the amount of vitamin E and group B in the diet. The first is found in vegetable oils, nuts, and seeds. B vitamins are found in large quantities in animal products:

  • meat, liver;
  • dairy products, ;
  • eggs.

They are also found in cereals, vegetables and fruits.

Traditional healers offer a variety of recipes for decoctions, infusions, which should help raise progesterone and maintain pregnancy. But the use of herbal treatment has no evidence base.

In the event of a threatened miscarriage, ignoring adequate medical care and blind faith in alternative treatment can lead to irreparable loss. Therefore, before self-medication, it is necessary to consult a doctor.

Actual video

Why is progesterone prescribed during pregnancy?

The body of a woman during conception should produce a normal amount of progesterone- a steroid hormone produced in the ovaries. If its level deviates from the norm, fixing the egg will become difficult, and there will be problems with fertilization. Often there is a deviation towards an increase, when elevated progesterone during pregnancy complicates the process of conceiving a child.

This phenomenon is dangerous for the mother and her unborn baby and can be the cause of diseases of the pelvic organs.

This steroid present in women and men. In the female sex, it is responsible for the regularity of the menstrual cycle, that is, for the sequence of ovulation and menstruation.

During gestation, gestagen is dominant, significantly exceeding the concentration of estrogen, another type of steroid hormone.

The concentration of progestogen shows how well the process of fetal development proceeds whether there is a risk of embryo loss and the occurrence of uterine pathologies. The steroid affects the preparation of the internal cavity of the uterus for connection with the embryo. Spontaneous contractions of the uterus stop, and the fetal egg manages to securely strengthen, which ensures the normal development of the embryo before childbirth.

In addition to relaxing the uterine muscles, the steroid has a protective effect. It does not allow maternal immunity to damage the fetus, provoke its rejection.

To find out whether the content of the steroid substance corresponds to normal values, experts conduct a series of studies.

What research determines?

Ask your question to the doctor of clinical laboratory diagnostics

Anna Poniaeva. She graduated from the Nizhny Novgorod Medical Academy (2007-2014) and residency in clinical laboratory diagnostics (2014-2016).

The concentration of the steroid is determined using a study of venous blood. The girl needs to hand it over at the beginning of the process of bearing a child. To do this, you need to get a referral from a doctor and come to the laboratory in the morning without breakfast that day. The nurse should be aware of all the drugs taken, and how long the expectant mother is.

The blood test takes place within one day, so the results will be ready by the next morning.

The extract will contain numbers indicating the concentration of the steroid in the blood, which will be deciphered by the attending doctor.

In the absence of indications, it is possible to postpone the delivery of the analysis to a later date.

The body, even in its infancy, is strong enough. And yet, conditions are necessary for its development. Progesterone during early pregnancy is designed to create them. In this position, the ratio and volume of hormones is generally very important. An imbalance in this area can create conditions for termination of pregnancy, increases the likelihood of the formation of unrecoverable ones, which is why it is so important to monitor it and, in case of deviation, correct it.

Read in this article

Why you need progesterone: details

Progesterone is a steroid hormone produced by the human endocrine system. It is present in both women and men, however, it plays the greatest role in the process of conception, during the period of bearing a child. The hormone is produced by the body outside of pregnancy. It participates in the cycle, contributing to the replacement of the obsolete layer of the internal cavity of the shell with a new one.

Progesterone levels during early pregnancy are completely determined by the correct functioning of the ovaries. It is these organs that produce the hormone. Its task is to eliminate excessive activity of the uterus after the fetal egg has been fixed in it. When the organ contracts, it is rejected and brought out.

Progesterone is responsible for:

  • attachment to the walls of the uterus of a fertilized egg;
  • prevention of fetal rejection (prepares the woman's immunity to accept a protein with the genetic structure of the child's father);
  • preparing the organs and systems of the expectant mother for carrying a baby and for childbirth;
  • forms the endometrium in such a way that it becomes a reliable bed for fixing the fetal egg for a long time, which is very important at the initial stage of pregnancy, when the fetus is still weak and undeveloped, and auxiliary organs have not formed;
  • breast growth and preparation for breastfeeding;
  • stimulation of the natural growth of the uterus;
  • relaxation of the muscles of the uterus, preventing its premature contraction;
  • the state of the nervous system of a pregnant woman;
  • the accumulation of subcutaneous fat in a pregnant woman to provide the fetus with the necessary nutrition.

If there is not enough progesterone in a woman's body, fertilization may not occur at all. Progesterone also helps maintain blood viscosity and glucose levels. The first circumstance is necessary to keep the pregnancy, and the second to ensure the nutrition of the fetus.

The lack of this hormone can provoke various complications, therefore, if necessary, a woman is prescribed pills or injections of progesterone during pregnancy in the early stages. With critical levels of the hormone, hospitalization may be required.

How is the amount of progesterone determined?

The amount of "pregnancy hormone" is easy to determine through a blood test of the expectant mother. In the early stages, diagnosis is carried out only if there are indications (for example, there are chronic diseases of the genital organs, there were previously miscarriages, etc.). In the normal course of pregnancy (in the absence of risks of its interruption) progesterone test It is recommended to take in the second half of pregnancy. It is important to monitor the level of the hormone in the case.

Diagnosis is carried out on an empty stomach. There are certain guidelines
regarding the preparation for the delivery of the analysis:

  • stop taking hormonal drugs in two days;
  • for a day to eliminate stress and nervous strain;
  • do not smoke three to four hours before the diagnosis (of course, it is advisable not to smoke at all).

Before the diagnosis, you can drink clean non-carbonated water. As a last resort, it is allowed to take tests in the afternoon if the woman’s breakfast was not fatty and at least 6 hours have passed since the meal was taken.

How much progesterone should be normal

The level of progesterone during pregnancy in the early stages should adhere to certain values, but is not constant. Initially, the hormone is produced by the ovaries. His co The quantity fluctuates in the body of a non-pregnant woman at different stages of the menstrual cycle.After fertilization, the amount of progesterone becomes more or less constant in proportion to the timing.

Progesterone levels during early pregnancy and closer to delivery is significantly different: it gradually changes in the direction of increase. The adrenal glands and ovaries are responsible for the production of the hormone. In the second, third trimester, it is produced by the placenta.

Its value during the first 2 weeks is 1-1.5 n/mol. The next 14 days, the organs increase its production to 2 n / mol, which stimulates the uterus to accept a fertilized egg. After its introduction, the body increases the volume of the hormone by 3-29 n / mol per day. Progesterone levels in early pregnancy ranges from 12 ng / ml, in the later it can reach 172 ng / ml.

Progesterone table during early pregnancy provides for a certain percentage of the error in the values ​​\u200b\u200bof the indicator (about 10%), since the body of each woman is special.

The volumes of the hormone in the blood are also influenced by the unique features of the body, which can make them differ from the standard values. At the same time, for a particular woman, such progesterone values ​​​​will be normal. But only a specialist can draw conclusions about this.

Watch this video about when and why progesterone is prescribed during pregnancy:

Progesterone deficiency: what is it and why

Unfortunately, not all women are doing well with the production of the “pregnancy hormone” by the body. Before conception, this is expressed by a jumping, uneven cycle, frequent delays, meager periods.

Low progesterone during pregnancy in the early stages creates a threat of its interruption, that is, the separation of the fetal egg from the uterine mucosa and its rejection. This is due to increased contractile activity of the smooth muscles of the organ. Such an indicator may also indicate an ectopic location of the fetal egg, which should be disposed of at an early stage.

Lack of progesterone it can also signal a fetal lag in development, a missed pregnancy, the presence of complications (for example, preeclampsia, fetoplacental insufficiency, etc.). Post-term pregnancy can also provoke decrease in progesterone . Therefore, if the expected date of birth has passed, the hormone analysis will tell you whether the overgrowth is true, or there is an error in the calculations.

If the placenta is old and does not meet the needs of the child, a decision is made to stimulate delivery.

The lack of progesterone during pregnancy has clear, although not always pronounced symptoms:

  • increased tone of the uterus;
  • weak vaginal discharge with bloody impurities, having a character;
  • pulling pains in the region of the lower triangle of the abdomen, radiating to the lower back;
  • partial, noticeable by the results of ultrasound.

There are also "external" signs of a lack of progesterone, among which are:

  • mood swings, aggressiveness, irritability, depression;
  • dryness in the vagina, provoking pain during sexual intercourse;
  • increased function of the sebaceous glands;
  • excessive body hair;
  • drops in blood pressure;
  • appearance and acne;
  • bloating, constipation, flatulence;
  • violation of thermoregulation of the body (increase or decrease in temperature).

Signs can also be observed in those who previously did not know problems with the volume of this hormone. But if a woman had difficulties with a cycle, conception, she will almost certainly have a difficult bearing. In this case, low progesterone during pregnancy, the symptoms of which are not obvious, should be detected by the results of a blood test for hormones.

A pregnant woman undergoes serious changes in the body, so the appearance of the described signs may not be related to the level of hormones. Therefore, the lack of progesterone during pregnancy in the early stages should be controlled by a doctor.

If the analysis confirms the concerns, the doctor will prescribe a therapy that replenishes the volume of the substance. Using medicines unmistakably selected by a specialist, many women managed to safely endure and give birth to healthy children.

High progesterone numbers: what are they talking about

Elevated progesterone during early pregnancy is much less common. At best, this is evidence of multiple pregnancy. Naturally, two or three embryos require more effort from the body to develop than one. Hence the increase in the index of the substance.

Progesterone during pregnancy in the early stages above the norm can be a sign of kidney pathology in the mother, abnormalities in the formation of the placenta (cystic mole), and disorders in the functioning of the adrenal glands. Therefore, you should not strive to accumulate this hormone “in reserve”, this indicator also requires adjustment.

Excess progesterone during pregnancy has the following symptoms:

  • increased fatigue;
  • bleeding and a disproportionately enlarged uterus, if the cause of the increased hormone values ​​​​is a problem in the development of the placenta. This sign does not always exist;
  • drowsiness;
  • nausea;
  • heartburn, problems with digestion of food,;
  • constipation.

Most of the symptoms are ascertained in a normal pregnancy. That is why in her initial period it is so important to take tests for hormones and be examined in general. It should be remembered that taking certain medications can change the results of the diagnosis, so it is important to consult a doctor before taking the test.

Lack of progesterone during early pregnancy

Lack of progesterone during pregnancy leads to miscarriage in the early stages. Its symptoms include pain in the lower abdomen, lower back, bleeding. If progesterone has fallen, and the fetus is viable, then the hormone is prescribed in preparations to preserve the bearing of the child.

What threatens the decline

A decrease in progesterone prevents the development of pregnancy, it is interrupted both in the early and late stages. If the fall is not critical, then the fetus receives insufficient nutrition through the placenta. This impairs its growth and organ formation.

Deficiency symptoms

During pregnancy, a lack of progesterone manifests itself:

  • pain in the lower abdomen, sacrum, lower back;
  • feeling of heaviness;
  • increased tone of the uterus;
  • blood secretions - from smearing, dripping to intense at the beginning of an abortion.

What to do if progesterone drops

If progesterone has fallen, then you need to urgently contact a gynecologist. This means a threat to the preservation of pregnancy, a violation of the functions of the placenta. The tactics of action will depend entirely on the results of the survey. It is forbidden to take drugs, herbs, dietary supplements on your own.

Watch this video about the causes and correction of progesterone deficiency:

How to correct deficiency and excess of progesterone

For the successful bearing of a child, low progesterone during pregnancy in the early stages must be raised. Often, experts prescribe a drug for this, which contains the necessary substance created artificially. It will help if the figures of the indicator are not very different from normal.

Its analogue is Utrozhestan, which is of plant origin and is therefore sometimes the most preferred. Both agents can be taken either orally or vaginally.

To raise progesterone, injections during early pregnancy are more effective, especially when a high level of threat of interruption is detected. The drug quickly reaches the blood, removing dangerous symptoms. Already an hour after the injection into the muscle, the volume of the hormone returns to normal, and after 6 hours it is maximum. A specialist should prescribe injections, based not only on the existing need, but also on the possible negative consequences for the mother.

Progesterone in ampoules can harm those with high blood viscosity, diabetes, asthma, cardiovascular disease or chronic kidney failure. Otherwise, their treatment is safe, quite easily tolerated, and in order for the drug to dissolve faster, the ampoule is warmed in the hands for some time before injection.

Therapy for an increased hormone level should be focused on eliminating the cause that caused it.

Is it dangerous to take progesterone

Some women take drugs during the conception planning stage to help the body prepare for pregnancy and childbearing. It should be remembered that an increased content of this hormone can also provoke complications. For example, the likelihood of an onset increases due to a decrease in the motility of the fallopian tubes. Therefore, only a doctor should prescribe treatment.

elevated the risk of taking progesterone noted in the first 4 months of pregnancy. This hormone, entering the body artificially, can provoke various malformations of the fetus.

However, if a woman does not have enough of this hormone, the possible risks and the expected effect of the treatment should be compared. Not a single doctor will risk the possibility of a miscarriage if the hormone level in the expectant mother is significantly reduced.

If progesterone levels in the early stages pregnancies stabilized during treatment, it is still necessary to carefully monitor the level of the hormone until delivery.

If a woman does not want to keep the child, it is possible to use progesterone for early pregnancy termination . The procedure is called "" and is as follows: a pregnant woman takes a progesterone antagonist (mifepristone), which blocks the action of the "pregnancy hormone". Because of this, the nutrition of the fetal egg is disturbed and a miscarriage occurs.

Hemotest for progesterone during pregnancy

A hemotest for progesterone is prescribed for pregnant women with signs of miscarriage (pain in the lower abdomen, spotting), and also, if there have been miscarriages before, IVF was performed, or the woman received treatment with hormonal drugs. In order to get an accurate result by weeks, it is necessary to exclude the influence of medicines, alcohol, overvoltage.

How to take an analysis

You need to take an analysis for progesterone in compliance with the rules:

  • on an empty stomach (break in meals about 9-10 hours);
  • it is forbidden to drink alcohol the day before;
  • 2-3 days before, it is important to discuss with the gynecologist the possibility of canceling hormonal drugs, if this is not recommended, then their name and dose are indicated on the direction;
  • Arrive at the lab before 10 am.

The results are usually ready the next day after blood sampling.

Norm by week: table

Normally, the level of progesterone increases by weeks, the average values ​​\u200b\u200bof the indicators are determined according to the table. Not always in the normal course of pregnancy there is a complete correspondence of values, so most gynecologists are guided by clinical signs, as well as individual rates of increase in the hormone in the blood.

With twins

The norms of progesterone in twins and other variants of multiple pregnancy are higher, they increase approximately 1.5-2 times faster than in the presence of one child. But you can more accurately determine multiple pregnancy with the help of tests for chorionic gonadotropin and alpha-fetoprotein, ultrasound.

Reasons why not growing

Progesterone does not grow during pregnancy with its pathological course, more often the causes are:

  • risk of miscarriage;
  • ectopic fixation of the fetal egg;
  • frozen;
  • violations of the formation of the placenta.

They are based on:

  • hormonal disbalance;
  • immunological incompatibility;
  • infections, inflammatory processes;
  • age (from 35 years old);
  • anomalies in the development of the fetus, genetic diseases;
  • external factors - stress, poor nutrition, physical overload.

Not enough progesterone: what to do

If progesterone is not enough, then gynecologists prescribe its analogues in tablets - Utrozhestan, Duphaston. Injectable forms are less commonly used. Self-medication with hormones and other drugs during pregnancy is prohibited. It is also not recommended to use herbs and dietary supplements without a doctor.

It helps to increase the level of the hormone nutrition, in which there are enough animal fats (dairy products, meat, fish), vitamins (bell peppers, raspberries, whole grains, leafy greens). Stress has a negative effect on progesterone, so it is important:

  • walk outdoors for at least an hour a day;
  • sleep at night;
  • rest during the day;
  • give up coffee, smoking, drinking alcohol.

What threatens if it falls in the first trimester

A drop in progesterone in the first trimester of pregnancy threatens to terminate it. This is accompanied by soreness and heaviness in the lower abdomen, general weakness, spotting blood from the genital tract. Such signs mean the need for urgent medical attention.

If there are symptoms of the onset of spontaneous abortion, then the pain becomes intense, cramping, and spotting intensifies. In this case, you need complete rest and an immediate call for an ambulance.

Excess hormone

An excess of progesterone during pregnancy does not require correction if the examination does not reveal a hydatidiform mole and choriocarcinoma. These complications of germinal membrane formation are rare. They are characterized by the release of dark blood with bubbles, severe toxicosis.

Possible factors for the increase in progesterone include decreased kidney function and increased activity of the adrenal glands. At the same time, blood pressure often rises, and edema is possible. In such cases, the underlying disease requires treatment, since high progesterone is just its consequence.

Progesterone preparations during pregnancy

Progesterone preparations during pregnancy are prescribed in the form of injections (Progesterone, Injesta), tablets (Dufaston, Utrozhestan). Modern remedies recommended by a gynecologist are devoid of a negative effect on the fetus. Side effects include drowsiness, swelling. Overdose may cause nausea, bloating. Cancellation of medications is carried out under the control of blood tests, in the form of a gradual dose reduction.

Injections in the early stages

Progesterone injections are indicated in the early stages of pregnancy with the threat of miscarriage. They help to reduce the tone of the uterus, prevent rejection of the fetus. The hormone is effective only if the cause of miscarriage is progesterone deficiency. After normalization of the patient's condition, they are most often transferred to taking the tablet form of the hormone.

Tablets

During pregnancy, the effectiveness and safety of Utrozhestan and Duphaston have been proven. They are used to prevent miscarriage. Appointment is recommended for:

  • previously established progesterone deficiency;
  • the threat of miscarriage that first arose during the current pregnancy;
  • conception during IVF;
  • long-term treatment of hormonal and immune forms of infertility.
ECO

With habitual miscarriages, progesterone support can last up to 20 weeks.

Effect on the fetus

In a therapeutic dose, progesterone does not have a damaging effect on the fetus. This applies to the drugs Utrozhestan and Duphaston, which have passed clinical trials and are used to maintain pregnancy. For other medicines, there is no guarantee of complete safety.

Side effects

The main side effects of medicines containing progesterone, associated with the effect of the hormone on the brain:

  • drowsiness,
  • lethargy,
  • headache,
  • dizziness.

Jaundice, pruritus, and rashes rarely occur due to impaired bile secretion. If the vaginal route of administration of Utrozhestan is used, then itching in the vagina, burning, oily discharge is possible.

Overdose symptoms

With an overdose of progesterone, nausea, constant weakness, and dizziness increase. In such cases, the dose may be temporarily reduced. In the future, with increased sensitivity, it is recommended to take the drug at bedtime.

How is the cancellation

It is necessary to cancel progesterone with a gradual dose reduction. Start by reducing half a tablet every 3-5 days. A pregnant woman must be under constant medical supervision. The gynecologist controls the uterine tone, the condition of the fetus and placenta by ultrasound, prescribes blood tests for hormone levels. Abrupt discontinuation of medication can provoke a threat of miscarriage.

How else is pregnancy regulated at the initial stage

You should not think that progesterone alone will make it possible to cope with the many months of work of the future mother. The activity of the organism in any period of life and position will not do without control of other substances. In anticipation of replenishment in the family, many of them change quantitatively. Hormones during early pregnancy are produced not only by the endocrine glands and reproductive organs.

At the initial stage, the following changes are fixed:

  • The pituitary gland works harder, suppressing the production of FSH and LH. The entire period of pregnancy, a new germ cell does not mature, there is no menstruation. But the production of prolactin increases. The substance is responsible for the subsequent production of breast milk, which contributes to changes in the mammary glands from the very beginning.
  • The hormones that ensure the work of the thyroid gland and adrenal glands also grow quantitatively in early pregnancy. And they determine the healthy gestation and development of the embryo.
  • The placenta adds free estriol and lactogen to the blood. The probability of developing chromosomal abnormalities in an infant, the blood supply to the tissues of the uterus, and the expansion of the ducts of the mammary glands depend on their level.
  • The amount of estradiol increases, which allows you to carry the child normally. It is now produced not only by the ovaries, but also by the placenta. Estradiol at the initial stage of pregnancy must be present in the body in the required amount, otherwise it will not be possible to convey it, despite the optimal amount of progesterone.

HCG and early pregnancy

According to the results of the analysis, a new substance is found - human chorionic gonadotropin. This hormone helps to determine pregnancy in the early stages accurately. It is produced by the fetal membrane immediately after implantation of a fertilized egg in the uterine cavity. The volume of progesterone and estrogen largely depends on the amount of hCG. If there is a shortage of it, the probability of interruption becomes closer than ever.

The longer the duration of the pregnancy, the higher the hCG values ​​should become. Therefore, for all the time the analysis for the hormone has to be taken more than once. Thanks to this feature, a specialist can easily establish not only the fact of the existence of a new life, but also the term.

HCG also makes you aware of the fatal malformations of the formation of the fetus, which will allow it to be interrupted in time. Its differences from normal values ​​may be evidence of multiple pregnancies, diabetes in a woman, which happens to be manifested against a new condition, or an ectopic pregnancy.

Timely tracking of hubbub HCG and progesterone in early pregnancy will help assess the general condition of the body, choose the right methods of treatment if necessary. It is not worth prescribing therapy for yourself - you can aggravate the situation and provoke various kinds of complications (up to a miscarriage). Following the doctor's recommendations will help improve the well-being of the pregnant woman and prevent unwanted consequences.

More about estradiol

This substance, in fact, makes a woman such. It is involved in the formation of her reproductive system, figure outlines, regulates the menstrual cycle and sexual desire.

Is progesterone used for early termination of pregnancy?

Progesterone is not prescribed to terminate a pregnancy, either early or late. In non-pregnant women, it is used to induce menstruation, but there is no abortive effect on conception.

And more about the purpose and how Duphaston is taken during pregnancy.

Progesterone during early pregnancy, as well as the values ​​of other hormones, are an indicator of its successful course. In the initial period, these indicators turn out to be decisive, since it is not too late to correct the mistakes of nature using modern medical capabilities.

The main hormone during pregnancy - progesterone creates the necessary conditions for the harmonious and healthy development of the fetus, it also prepares the woman's body for the upcoming birth. The ovaries and adrenal glands are involved in its production; at a later date, the placenta is involved for this. Hormonal imbalance can negatively affect the course of pregnancy: interrupt it or provoke the development of severe malformations in the fetus. It is important to prevent such a development of events, so a woman should know the rate of progesterone.

What is progesterone

It is a steroid hormone produced by the endocrine system. Progesterone is present in both men and women, but its main purpose is to help in the process of conception. Its level is important during the period of gestation and subsequent breastfeeding. The hormone also takes part in the cycle, contributing to the renewal of the layer of the uterine lining (its internal cavity).

Progesterone levels during early pregnancy depend on whether the ovaries are working properly as they produce the hormone. The function of the steroid is to eliminate the excessive activity of the uterus after fixing the fetal egg in it. When the organ contracts, it is rejected and comes out. Progesterone is an important link in the synthesis of other hormones of endogenous origin.

What is it needed for

With a lack of progesterone, a woman may not become pregnant at all. The hormone helps maintain the amount of glucose and the level of blood viscosity. The latter circumstance is important for maintaining pregnancy, and the former is necessary for the nutrition of the fetus. The lack of progesterone provokes various complications, therefore, if necessary, pregnant women are prescribed injections or pills that increase the level of the hormone. Progesterone is responsible for the following processes:

  • attachment of a fertilized egg to the uterine wall;
  • preparing the organs of a pregnant woman for gestation and childbirth;
  • prevention of premature contraction of the muscles of the uterus in order to preserve the fetus (the woman's immunity is being prepared to accept a protein with the genes of the baby's father);
  • formation of embryonic tissues;
  • preparation of the endometrium (to fix the fetal egg);
  • stimulation of uterine growth;
  • preparation for lactation of the mammary glands, stimulation of their growth;
  • a stable state of the nervous system of a woman carrying a child;
  • accumulation of subcutaneous fat (it is necessary for the nutrition of the fetus).

Progesterone test

You can determine progesterone during pregnancy by a blood test using an immunofluorescent method. Main indications: menstrual disorders, pain in the lower abdomen, brown vaginal discharge, the threat of interruption. If the pregnancy proceeds without excesses, then the study is recommended only in the second trimester.

Blood for analysis is taken in the morning on an empty stomach, the use of non-carbonated water is allowed. 48 hours before the study, medication (including hormonal) is canceled. It is recommended not to be nervous and avoid overexertion shortly before the procedure. For women who are not pregnant, such a blood test is prescribed on the 22-23rd day of the cycle. Pregnant women are tested regardless of the term. If there is a delay in menstruation, then the analysis is done on any day, checking other hormones, such as:

  • prolactin;
  • estrogens;
  • testosterone;
  • lactogen;
  • cortisol;
  • estradiol;
  • FSH (follicle stimulating hormone);
  • LH (luteinizing hormone).

The norm of progesterone during pregnancy by weeks

The level of progesterone varies depending on the duration of pregnancy. The study is prescribed if a hormonal imbalance is suspected. The rate of progesterone during pregnancy increases every week and has the following indicators:

Pregnancy period (by week)

Progesterone levels in ng/ml

Hormone levels in nmol/l

Elevated progesterone

In early pregnancy an increase in progesterone is rare. Elevated values ​​indicate multiple pregnancies. In the worst scenario, they signal the presence of kidney pathology, abnormalities in the functioning of the adrenal glands, and the formation of the placenta. A sudden increase in the level of the hormone is observed on the days of ovulation and in the luteal phase - up to 56.6 and 88.7 nmol / l. The body hints at readiness for conception.

In the third trimester, progesterone levels during pregnancy reach 771.5 nmol / l. The concentration decreases if conception does not occur. The endometrium is shed, menstruation begins. High rates during this period are an alarming sign. A cause for concern is the increase in progesterone during pregnancy, which means that there are deviations in the development of the placenta. Excess hormone will interfere with conception. By causing the growth of the endometrium, it leads to the fact that the fertilized egg is not attached to the walls of the uterus. Suppresses ovulation by increased levels of the hormone in the follicular phase.

Symptoms

Even with a normal pregnancy, unwanted symptoms may occur. When they occur, it is necessary to take tests for hormones and be examined. The following points indicate elevated progesterone:

  • excessive fatigue, drowsiness;
  • headaches;
  • minor bleeding from the genital tract;
  • excessive enlargement of the uterus;
  • nausea, bloating, heartburn, digestive problems;
  • constipation.

Causes

If the level of the hormone has not increased due to pregnancy, then it is worth being examined for pathologies such as a corpus luteum cyst, adrenal dysfunction, and kidney failure. The doctor will determine the exact cause of the hormonal surge by prescribing appropriate examinations. An excess of a steroid is possible due to a malfunction of the menstrual cycle, when taking hormonal drugs, with choreocarcinoma (a form of cancer), hydatidiform mole, multiple pregnancy, pathologies of placental development.

low progesterone

A woman may suspect a steroid deficiency by external signs. During pregnancy, a decrease in the hormone threatens to interrupt it, since it is possible to separate the fetal egg from the uterine mucosa. This happens due to increased activity of the organ, contractile activity of the muscles. Decreased progesterone during a missed pregnancy. The severity of the signs depends on the degree of decrease in the hormone, individual characteristics, the ratio with estrogen.

Symptoms

They are nonspecific, so the symptoms are often ignored, which in some cases leads to irreversible consequences. The main signs of low hormone levels:

  • severe bleeding during menstruation;
  • intermediate bleeding;
  • delays in menstruation;
  • miscarriage in early pregnancy;
  • swelling;
  • sudden change of mood;
  • temperature rise;
  • headaches;
  • unstable libido;
  • drowsiness, weakness, lack of energy;
  • dryness in the vagina;
  • depression;
  • breast swelling, soreness;
  • weight gain;
  • swelling of the lower abdomen.

Low progesterone during early pregnancy is dangerous not only for miscarriage. If you do not increase the level of the hormone in time, other serious consequences may occur, such as:

  • insufficiency of the function of the placenta, corpus luteum;
  • delayed intrauterine development of the embryo;
  • the birth of a baby with pathologies, low body weight;
  • gestation of the fetus;
  • bleeding.

Causes

The concentration of the hormone varies depending on the days of the cycle. The lowest value is observed from the beginning of menstruation to ovulation. Hormone levels are low in postmenopause: egg maturation does not occur, and the adrenal glands no longer maintain its required concentration. A lack of progesterone is observed in conditions such as:

  • pathology of the genital organs;
  • preeclampsia;
  • fetoplacental insufficiency;
  • delayed pregnancy;
  • frozen fruit;
  • ectopic pregnancy.

How to normalize the concentration of the hormone

In case of violation of steroid production, the gynecologist determines the treatment regimen. Therapy begins with a lifestyle change. A woman in position should devote at least 8 hours to sleep, and it is necessary to go to bed no later than 22 hours. Pregnant women should avoid stressful situations. Nutrition is corrected: the balance of fats, proteins and carbohydrates is important, the menu includes animal products, fruits and vegetables containing vitamins C and E.

Hormonal imbalance occurs as a result of a variety of physiological disorders in the functioning of organs. If you take care of your health and treat diseases in time in the early stages of development, then failure can be avoided. A visit to the gynecologist for preventive purposes is recommended once every six months. A woman with a hormonal imbalance needs to forget about bad habits (alcohol, smoking).

Traditional medicine in this state is powerless. Drug therapy involves taking hormonal drugs, which contain progesterone. Focusing on the condition of the woman, the results of the tests, the gynecologist prescribes a course of injections or suppositories (placed vaginally). Progesterone injections are given intramuscularly. The drug contained in the ampoules has an oily structure, a slight odor. The agent is instantly absorbed into the blood. The hormone reaches its maximum concentration 5–6 hours after administration.

For women with asthma, diabetes, a predisposition to blood clots, or impaired functioning of the cardiovascular system, progesterone injections during early pregnancy are prescribed with caution. To preserve the fetus, it is important to inject the hormone according to the scheme indicated by the doctor. The main drugs containing progesterone:

  • Dufaston is an artificial analogue of human progesterone. The drug is rapidly absorbed, distributed to places with specific receptors. Duphaston reduces the risk of developing placental insufficiency, abortion. Children whose mothers were treated with the drug are rarely underweight at birth. The drug is taken orally. The dosage is individual, depending on the condition of the woman.
  • Utrozhestan. The drug is made from plant materials. Produced form - capsules. The dosage is individual. The components of Utrozhestan inhibit the activity of oxytocin, support the course of pregnancy. The drug has a positive effect on the skin, reducing its greasiness and eliminating acne. In the treatment of weight gain does not occur. If side effects occur, such as dizziness, nausea, headache, the doctor cancels the oral tablets, transferring the patient to intravaginal forms.

Progesterone: instructions for use and reviews

Latin name: Progesterone

ATX Code: G03DA04

Active substance: progesterone (progesterone)

Producer: JSC "Dalhimfarm" (Russia), ANHUI CHENGSHI MANUFACTURE MEDICINE, Co. Ltd. (China), PJSC Biopharma (Ukraine)

Description and photo update: 26.10.2018

Progesterone is a drug that has a progestogenic effect.

Release form and composition

Progesterone is produced in the form of a solution for intramuscular injection (oily): a clear oily liquid, colorless or pale yellow or golden yellow (1 ml in a colorless glass ampoule; 10 ampoules in a blister, 1 blister in a cardboard box; 5 ampoules in a contour cell packaging, 2 packs or 10 ampoules in a carton box).

Composition of 1 ml solution:

  • active substance: progesterone - 10 or 25 mg;
  • additional components: olive oil and medical benzyl benzoate or soybean oil and benzyl alcohol (depending on the manufacturer).

Pharmacological properties

Pharmacodynamics

Progesterone is a hormone of the corpus luteum and exhibits a progestogenic effect. By communicating with receptors located on the surface of cells of target organs, the agent penetrates into the nucleus, in which it activates deoxyribonucleic acid, which leads to increased synthesis of ribonucleic acid. The drug promotes the transformation of the proliferation phase of the uterine mucosa, caused by the follicular hormone, into the secretory phase, and after fertilization of the egg, provides the necessary conditions for its normal implantation and further development. Progesterone helps to reduce the excitability and contractility of the muscles of the uterus and fallopian tubes. The agent stimulates the growth of the secretory section of the acini of the mammary glands and causes lactation, ensures the development of a normal endometrium.

By enhancing the action of protein lipase, progesterone leads to an increase in fat reserves and improved glucose utilization, increasing basal and stimulated insulin secretion, creates optimal conditions for the accumulation of glycogen in the liver, and also increases aldosterone production. In small doses, the agent activates, and in large doses it suppresses the production of gonadotropic hormones of the pituitary gland. Reduces azotemia, increases the excretion of nitrogen by the kidneys.

Pharmacokinetics

After intramuscular (in / m) administration, the drug is rapidly and almost completely absorbed. The maximum plasma concentration with intramuscular injection of 10 mg of progesterone is observed approximately 8 hours after the injection and remains above the basal level for 24 hours.

The agent is characterized by high binding to plasma proteins, primarily to albumin - by 50-54% and corticosteroid-binding globulin - by 43-48%.

Biotransformation of progesterone occurs in the liver, with the formation of metabolites - pregnanolone and pregnandiol, which are conjugated with sulfuric and glucuronic acids. The CYP2C19 isoenzyme takes part in the process of metabolism.

The half-life is several minutes, 50–60% of the substance is eliminated by the kidneys, and over 10% through the intestines. The number of metabolites that are excreted by the kidneys varies depending on the phase of the corpus luteum.

Indications for use

  • endocrine infertility (including with insufficient function of the corpus luteum);
  • anovulatory metrorrhagia;
  • amenorrhea;
  • the threat of termination of pregnancy;
  • algomenorrhea, oligomenorrhea (associated with hypogenitalism);
  • diagnosis of the formation of endogenous estrogens.

Contraindications

Absolute:

  • diagnosed or suspected neoplasms of the breast and genital organs (as a monotherapy drug);
  • intracranial hemorrhage, thromboembolic disorders (stroke, myocardial infarction, pulmonary embolism) or a history of these conditions / diseases;
  • thrombophlebitis (including history), deep vein thrombosis, retinal vascular thrombosis, the presence of risk factors for blood clots;
  • severe liver disease or severe liver functional disorders (including malignant liver tumors, including history);
  • idiopathic jaundice, herpes or itching during a previous pregnancy;
  • porphyria;
  • incomplete abortion or missed miscarriage;
  • vaginal bleeding of unknown origin;
  • II-III trimesters of pregnancy;
  • the period of breastfeeding;
  • age up to 18 years;
  • hypersensitivity to any of the components of the drug.

Relative (Progesterone should be used with extreme caution):

  • chronic renal failure;
  • arterial hypertension;
  • diseases of the cardiovascular system (CVS);
  • bronchial asthma;
  • diabetes;
  • hyperlipoproteinemia;
  • migraine;
  • epilepsy;
  • depression;
  • functional disorders of the liver of mild and moderate severity;
  • I trimester of pregnancy (application is allowed only to prevent spontaneous miscarriage);
  • photosensitivity.

Instructions for the use of Progesterone: method and dosage

Progesterone is administered by intramuscular injection.

  • algomenorrhea: the course starts 6-8 days before the onset of menstruation; the drug is administered daily at 5 or 10 mg for 6-8 days;
  • algomenorrhea due to underdevelopment of the uterus: combined with estrogenic drugs at the rate of 10,000 IU every other day for 2-3 weeks, Progesterone is used for the next 6 days;
  • hypogenitalism and amenorrhea: used after the use of estrogenic drugs daily at 5 mg or every other day at 10 mg for 6-8 days;
  • bleeding associated with ovarian dysfunction: prescribed daily at 5-15 mg for 6-8 days; in the case of a preliminary curettage of the mucous membrane of the uterine cavity, the administration of the drug is started after 18-20 days, if it is impossible to carry out curettage, the solution is administered during bleeding; during therapy, a temporary increase in bleeding (for 3–5 days) is possible, as a result of which, against the background of moderate and severe anemia, it is recommended to preliminarily conduct a blood transfusion (200–250 ml); after stopping the bleeding for 6 days, the administration of Progesterone should be continued; if after 6-8 days of therapy the bleeding does not stop, further use of the drug is not advisable;
  • insufficiency of the corpus luteum: 12.5 mg per day is administered for 2 weeks from the moment of ovulation, if necessary, treatment is continued until 11 weeks of pregnancy;
  • prevention / treatment of threatening and incipient miscarriage caused by insufficiency of the corpus luteum function: daily or every other day, 10-25 mg until the symptoms of a threatened miscarriage are completely relieved; with a habitual abortion, a solution is administered before the fourth month of pregnancy;
  • diagnosis of the formation of endogenous estrogens: once 100 mg.

Side effects

  • nervous system: dizziness, headache, drowsiness / insomnia, optic neuritis, mood lability, asthenia, apathy, depression, dysphoria;
  • digestive system: loss of appetite, bloating, vomiting, diarrhea, nausea, constipation, abdominal pain, cholecystitis, cholestatic hepatitis, cholestatic jaundice;
  • endocrine system: hirsutism;
  • immune system: urticaria, rash, pruritus, anaphylactoid reactions;
  • metabolism: increase / decrease in body weight, edema;
  • CCC: increased blood pressure, thrombophlebitis, thromboembolism (including cerebral and pulmonary arteries), retinal vein thrombosis, hemorrhagic rash;
  • organ of vision: visual impairment;
  • skin and subcutaneous tissues: alopecia, acne, erythema nodosum, erythema multiforme;
  • musculoskeletal and connective tissue: back pain;
  • urinary system: cystitis;
  • breast and genitals: change in libido, shortened menstrual cycle, premenstrual syndrome, spotting spotting or breakthrough bleeding, amenorrhea, discomfort and itching in the vagina, vaginal discharge, change in the viscosity of cervical secretion, uterine muscle spasm, cervical erosion, ovarian hyperstimulation syndrome, vulvovaginitis, breast enlargement, galactorrhea, pain and tension in the mammary glands, malignant neoplasms in the mammary gland;
  • general disorders and local reactions: general malaise, hyperthermia, hot flashes, fatigue, hyperemia, irritation, soreness, hematoma, swelling, induration and itching at the injection site.

Overdose

Overdose symptoms can be: dysmenorrhea, shortening of the menstrual cycle, transient dizziness, drowsiness, euphoria.

In some cases, the average therapeutic dose may be excessively high due to special sensitivity to the agent, too low levels of estradiol, unstable existing or emerging endogenous secretion of progesterone. With the development of gestagen-dependent adverse reactions, Progesterone therapy should be interrupted, and after the removal of these disorders, resume at a lower dosage. If necessary, symptomatic treatment is possible.

special instructions

Before starting therapy, a medical examination should be carried out, including an examination of the pelvic organs and mammary glands, and a Papanicolaou test.

In view of the possible threat of thromboembolic complications, it is required to abandon the use of Progesterone if the following disorders appear: vascular lesions of the retina, double vision, loss of vision, thrombophlebitis, venous or arterial thromboembolism, thrombosis, regardless of location.

With a history of indications of thrombophlebitis, as well as with CCC diseases at present or in history, it is necessary to carefully monitor the patient's condition.

Progesterone should be used with extreme caution in patients with a history of depression; if a severe form of this disease occurs, drug therapy should be discontinued.

With a long course of treatment, it is recommended to conduct regular medical examinations, including a study of liver activity, and in the event of cholestatic jaundice or deviations from the normal values ​​​​of liver function tests, stop the administration of Progesterone.

During therapy, there may be a violation of glucose tolerance and an increase in the need for insulin and other hypoglycemic drugs in the presence of diabetes mellitus, and therefore it is necessary to carefully monitor the concentration of glucose in the blood.

If amenorrhea occurs during treatment, it is necessary to exclude a possible pregnancy, and with the development of acyclic bleeding, the solution should not be administered until their cause is identified (including before histological examination of the endometrium).

The use of Progesterone may affect the results of laboratory tests such as coagulation parameters, thyroid and liver function, pregnandiol concentration.

When observing the precipitation of crystals in a solution, the ampoule with the drug can be heated in a boiling water bath, shaking until the crystals dissolve. If, when cooled to 36–38 ° C, the crystals do not fall out again, and the solution is transparent, it is ready for use.

Influence on the ability to drive vehicles and complex mechanisms

Since the use of Progesterone can provoke the appearance of visual impairment and dizziness, during the period of treatment, patients who drive vehicles or other complex mechanisms must be careful.

Use during pregnancy and lactation

According to the instructions, Progesterone is contraindicated in the II-III trimesters of pregnancy. In the first trimester of pregnancy, the drug can only be used to prevent spontaneous miscarriage.

During breastfeeding, it is contraindicated to administer the drug, since it penetrates into mother's milk.

Application in childhood

The safety profile of progesterone in patients under 18 years of age has not been studied. Children and adolescents are not prescribed the drug.

For impaired renal function

In the presence of chronic renal failure, the drug must be used with extreme caution.

For impaired liver function

It is contraindicated to use the drug in patients with severe liver dysfunction. For mild/moderate hepatic impairment, Progesterone should be used with caution.

Use in the elderly

Data confirming the safety and efficacy of the drug in patients older than 65 years are not available. There are no indications for the introduction of funds in the elderly.

drug interaction

  • oxytocin - its lactogenic effect decreases;
  • barbiturates - the effect of progesterone is weakened;
  • drugs that stimulate the smooth muscles of the uterus, anabolic steroids, gonadotropic hormones of the anterior pituitary gland - the intensity of the action of these drugs decreases;
  • antihypertensive drugs, diuretics, immunosuppressants, anticoagulants - their effect is enhanced;
  • antiepileptic drugs (phenytoin), griseofulvin, spironolactone, phenylbutazone, rifampicin - accelerates the metabolism of progesterone in the liver;
  • bromocriptine - the effectiveness of this agent decreases;
  • ketoconazole - an increase in the concentration of ketoconazole and an increase in the bioavailability of progesterone are possible;
  • cyclosporine - the level of its content increases;
  • ethanol (in high doses) - the bioavailability of progesterone decreases.

In different patients, the severity of these interactions can vary significantly, so the clinical effects of the latter are difficult to predict.

Analogues

Analogues of Progesterone are: Iprozhin, VANEL, Kraynon, Progestogel, Prajisan, Utrozhestan.

Terms and conditions of storage

Store in a place protected from light and out of the reach of children at a temperature of 5-25 °C.

Shelf life - 3 years or 5 years (depending on the manufacturer).