progesterone

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(prō-jĕs'tə-rōn') pronunciation
n.
  1. A steroid hormone, C21H30O2, secreted by the corpus luteum of the ovary and by the placenta, that acts to prepare the uterus for implantation of the fertilized ovum, to maintain pregnancy, and to promote development of the mammary glands.
  2. A drug prepared from natural or synthetic progesterone, used in the prevention of miscarriage, in the treatment of menstrual disorders, and as a constituent of some oral contraceptives.

[PRO-1 + GEST(ATION) + (ST)ER(OL) + -ONE.]



Steroid hormone secreted by the female reproductive system that functions mainly to regulate the condition of the endometrium ( uterus), preparing it to accept a fertilized egg. If the egg is not fertilized, the level of progesterone drops, the uterine lining breaks down, and menstruation ensues. If the egg is fertilized ( pregnancy), the placenta produces progesterone, whose effects include preparing the mammary glands for lactation. Many forms of oral contraception use a synthetic progesterone.

For more information on progesterone, visit Britannica.com.

A steroid hormone produced in the corpus luteum and placenta. The hormone has an important physiological role in the luteal phase of the menstrual cycle and in the maintenance of pregnancy. In addition, progesterone produced in the testis and adrenals has a key role as an intermediate in the biosynthesis of androgens, estrogens, and the corticoids (adrenal cortex steroids). See also Androgen; Cholesterol; Estrogen; Menstruation; Pregnancy; Steroid; Sterol.


One of the progestogens, steroid sex hormones, which are synthesized in the initial steps in the biosynthetic pathway in the gonads that converts cholesterol to androgens and to oestrogens; or any natural or synthetic steroid having a progesterone-like action. Progesterone is the main progestogen produced by the ovaries, particularly in the second half of the menstrual cycle after ovulation has occurred and the empty follicle has formed a corpus luteum. They are also important hormones in pregnancy and secreted in increasing concentrations during gestation.

— Saffron A. Whitehead

See sex hormones.

Drug Info:

Progesterone

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Brand names: Crinone®, First™-Progesterone MC 10, First™-Progesterone MC 5, First™-Progesterone VGS 100, First™-Progesterone VGS 200, First™-Progesterone VGS 25, First™-Progesterone VGS 400, First™-Progesterone VGS 50, Gesterone™, Gestrin™, Prochieve®, Prometrium®

Chemical formula:



Progesterone Vaginal gel

What is this medicine?

PROGESTERONE (proe JES ter one) is a female hormone. This medicine is used to help women who are going through an Assisted Reproductive Technology (ART) treatment program to become pregnant. It is also used to treat secondary amenorrhea. This is when a woman stops getting menstrual periods due to low levels of progesterone.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•blood vessel disease, blood clotting disorder, or suffered a stroke
•breast, cervical or vaginal cancer
•heart disease
•kidney disease
•liver disease
•miscarriage or abortion
•vaginal bleeding
•an unusual or allergic reaction to progesterone, other hormones, medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

This medicine is for use in the vagina. Do not take by mouth. Follow the directions on the prescription label. Use the applicator exactly as directed. Do not use more often than prescribed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Try not to miss a dose. Apply the medication as soon as you remember. If it is almost time for your next application, use only that dose. Do not use double the amount or apply more frequently.

What may interact with this medicine?

Interactions are not expected. Do not use any other vaginal products without asking your doctor or health care professional.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress.

If your doctor or health care professional instructs you to use any other medicines in the vagina while you are using this medicine, you should separate the doses by at least 6 hours.

You may notice a white discharge of medicine while using this medicine. This is normal. If it becomes bothersome, contact your doctor or health care professional.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•abnormal vaginal bleeding
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•breast tissue changes or discharge
•changes in vision
•chest pain
•confusion, trouble speaking or understanding
•dark urine
•general ill feeling or flu-like symptoms
•light-colored stools
•loss of appetite, nausea
•pain, swelling, warmth in the leg
•right upper belly pain
•severe headaches
•shortness of breath
•sudden numbness or weakness of the face, arm or leg
•trouble walking, dizziness, loss of balance or coordination
•unusually weak or tired
•yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•back pain
•depressed mood or mood swings
•increased appetite
•fluid retention and swelling
•nausea, vomiting
•stomach cramps or bloating

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

Last updated: 4/13/2006 7:13:00 AM

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.


A steroid hormone secreted by the ovaries and placenta and also in small amounts by the adrenal glands and the testes. It is responsible for preparing the lining of the uterus (endometrium) for pregnancy. If fertilization occurs progesterone maintains the pregnancy and inhibits the further release of eggs from the ovaries. It is used therapeutically to treat abnormal vaginal bleeding, premenstrual syndrome, and postnatal depression. It is also used to maintain early pregnancies and to treat infertility in in vitro fertilization procedures. Progesterone is used as an adjunct to oestrogens in hormone replacement therapy (hormone replacement therapy). Progesterone is available, on prescription only, as a solution for intramuscular injection, a vaginal gel, capsules, or pessaries. Synthetic versions of progesterone have a variety of therapeutic uses and are major ingredients of hormonal contraceptives (see progestogens).

Side effects:
include acne, urticaria (nettle rash), fluid retention, weight changes, stomach upsets, changes in libido, breast discomfort, premenstrual symptoms, menstrual disturbances, pigmentation of the face, depression, fever, insomnia, sleepiness, loss of hair on the head, and increase in body hair. Local reactions can occur on injection; diarrhoea and flatulence can occur with rectal administration.

Precautions:
progesterone should not be given to women with undiagnosed vaginal bleeding, a history of liver tumours, or severe liver disease and should be used with caution in women with diabetes or epilepsy and in those who suffer from migraine.

Interactions with other drugs:
see progestogens.

Proprietary preparations:
Crinone (vaginal gel for infertility); Cyclogest (pessaries); Gestone (injection); Utrogestan (capsules for hormone replacement therapy).

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progesterone (prōjĕs'tərōn'), female sex hormone that induces secretory changes in the lining of the uterus essential for successful implantation of a fertilized egg. A steroid, progesterone is secreted chiefly by the corpus luteum, a group of cells formed in the ovary after the follicle ruptures during the release of the egg cell. If fertilization does not take place, the secretion of progesterone decreases and menstruation occurs. If fertilization does occur, progesterone is secreted during pregnancy by the placenta and acts to prevent spontaneous abortion; the hormone also prepares the mammary glands for milk production. Progesterone is also synthesized from cholesterol in the cortex of the adrenal gland where it is a precursor for the synthesis of other steroids including testosterone. Synthetic compounds with progesteronelike activity have been developed that, along with estrogen, are used in oral contraceptives.



the common name for pregn-4-ene-3,20-dione; the principal steroid hormone of the corpus luteum, secreted during the latter half of the estrous cycle and acting upon the endometrium to prepare it for embryo implantation. During pregnancy, secretion occurs also from the placenta, increasing markedly as pregnancy proceeds, when it acts to maintain the uterus, inhibit further release of ova, and promote proliferation of acini within the mammary gland. Progesterone occurs also in the adrenal cortex and testis, and in some plants, e.g. Hollatrhena floribunda. It is synthesized from pregnenolone by 3β-hydroxy-Δ5-steroid dehydrogenase, EC 1.1.1.145, and is an intermediate in the formation of androgens, estrogens, glucocorticoids, and mineralocorticoids.





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A steroid sex hormone that is the principal progestational hormone. Used therapeutically in the treatment of threatened abortion in some species, in estrus control in dogs and cats, and occasionally in treatment of some types of skin diseases.
During the maturation of the ovum, estrogen, the principal female sex hormone, is produced at a high rate. At ovulation estrogen production is sharply reduced and the follicle is replaced by the corpus luteum of which the main function is to produce progesterone. Unless fertilization takes place, the corpus luteum disappears when it has performed its function.
The progesterone produced by the corpus luteum is promptly carried by the blood to the uterus, as was the estrogen that preceded it. Both hormones now work to prepare the uterus for possible conception.
In pregnancy, progesterone acts in a way that protects the embryo and fosters growth of the placenta. By decreasing the frequency of uterine contractions it helps to prevent expulsion of the implanted ovum. It also promotes secretory changes in the mucosa of the uterine tubes, thereby helping to provide nutrition for the fertilized ovum as it travels through the tube on its way to the uterus.
Another function of progesterone is promotion of the development of the mammary glands in preparation for lactation. Prolactin, from the anterior lobe of the pituitary gland, stimulates production of the milk, and progesterone prepares the glands for secretion.

  • p. assay — the estimation of progesterone in milk is used as a pregnancy test.
  • p.-induced lactation — see lactation induction.
  • p. milk test — assay of progesterone in milk used as a pregnancy test.
  • p. plasma test — the original pregnancy test which survives as the milk progesterone test; used in dogs as a guide in predicting the time of ovulation.
  • p. releasing intravaginal device — used as a means of synchronizing estrus in cows and sheep as an aid to structured artificial insemination programs. Called also PRID.
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(prō-jes′tə-rōn)
n

The ovarian hormone produced by the corpus luteum and responsible for preparing the endometrium for nidation and nourishment of the ovum. It also suppresses the production of the pituitary luteinizing hormone, estrus, and ovulation and stimulates the mammary glands.

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categories related to 'progesterone'

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Progesterone
Systematic (IUPAC) name
Pregn-4-ene-3,20-dione
Clinical data
Trade names Crinone, Endometrin
AHFS/Drugs.com monograph
MedlinePlus a604017
Pregnancy cat. B (USA)
Legal status  ?
Routes oral, implant
Pharmacokinetic data
Bioavailability prolonged absorption, half-life approx 25-50 hours
Protein binding 96%-99%
Metabolism hepatic to pregnanediols and pregnanolones
Half-life 34.8-55.13 hours
Excretion renal
Identifiers
CAS number 57-83-0 YesY
ATC code G03DA04
PubChem CID 5994
IUPHAR ligand 2377
DrugBank DB00396
ChemSpider 5773 YesY
UNII 4G7DS2Q64Y YesY
KEGG D00066 N
ChEBI CHEBI:17026 YesY
ChEMBL CHEMBL103 YesY
Synonyms 4-pregnene-3,20-dione
Chemical data
Formula C21H30O2 
Mol. mass 314.46
SMILES eMolecules & PubChem
Physical data
Melt. point 126 °C (259 °F)
Spec. rot [α]D
 N (what is this?)  (verify)

Progesterone also known as P4 (pregn-4-ene-3,20-dione) is a C-21 steroid hormone involved in the female menstrual cycle, pregnancy (supports gestation) and embryogenesis of humans and other species. Progesterone belongs to a class of hormones called progestogens, and is the major naturally occurring human progestogen.

Contents

Chemistry

Progesterone was independently discovered by four research groups.[1][2][3][4]

Willard Myron Allen co-discovered progesterone with his anatomy professor George Washington Corner at the University of Rochester Medical School in 1933. Allen first determined its melting point, molecular weight, and partial molecular structure. He also gave it the name Progesterone derived from Progestational Steroidal ketone.[5]

Like other steroids, progesterone consists of four interconnected cyclic hydrocarbons. Progesterone contains ketone and oxygenated functional groups, as well as two methyl branches. Like all steroid hormones, it is hydrophobic.

Sources

Animal

Progesterone is produced in the ovaries (by the corpus luteum), the adrenal glands (near the kidney), and, during pregnancy, in the placenta. Progesterone is also stored in adipose (fat) tissue.

In humans, increasing amounts of progesterone are produced during pregnancy:

  • At first, the source is the corpus luteum that has been "rescued" by the presence of human chorionic gonadotropins (hCG) from the conceptus.
  • However, after the 8th week, production of progesterone shifts to the placenta. The placenta utilizes maternal cholesterol as the initial substrate, and most of the produced progesterone enters the maternal circulation, but some is picked up by the fetal circulation and used as substrate for fetal corticosteroids. At term the placenta produces about 250 mg progesterone per day.
  • An additional source of progesterone is milk products. After consumption of milk products the level of bioavailable progesterone goes up.[6]

Plants

In at least one plant, Juglans regia, progesterone has been detected.[7] In addition, progesterone-like steroids are found in Dioscorea mexicana. Dioscorea mexicana is a plant that is part of the yam family native to Mexico.[8] It contains a steroid called diosgenin that is taken from the plant and is converted into progesterone.[9] Diosgenin and progesterone are found in other Dioscorea species as well.

Another plant that contains substances readily convertible to progesterone is Dioscorea pseudojaponica native to Taiwan. Research has shown that the Taiwanese yam contains saponins — steroids that can be converted to diosgenin and thence to progesterone.[10]

Many other Dioscorea species of the yam family contain steroidal substances from which progesterone can be produced. Among the more notable of these are Dioscorea villosa and Dioscorea polygonoides. One study showed that the Dioscorea villosa contains 3.5% diosgenin.[11] Dioscorea polygonoides has been found to contain 2.64% diosgenin as shown by gas chromatography-mass spectrometry.[12] Many of the Dioscorea species that originate from the yam family grow in countries that have tropical and subtropical climates.[13]

Synthesis

Biosynthesis

Top: Conversion of cholesterol (1) into pregnenolone (3) to progesterone (6).
Bottom: Progesterone is important for aldosterone (mineralocorticoid) synthesis, as 17-hydroxyprogesterone is for cortisol (glucocorticoid), and androstenedione for sex steroids.

In mammals, progesterone (6), like all other steroid hormones, is synthesized from pregnenolone (3), which in turn is derived from cholesterol (1) (see the upper half of the figure to the right).

Cholesterol (1) undergoes double oxidation to produce 20,22-dihydroxycholesterol (2). This vicinal diol is then further oxidized with loss of the side chain starting at position C-22 to produce pregnenolone (3). This reaction is catalyzed by cytochrome P450scc. The conversion of pregnenolone to progesterone takes place in two steps. First, the 3-hydroxyl group is oxidized to a keto group (4) and second, the double bond is moved to C-4, from C-5 through a keto/enol tautomerization reaction.[14] This reaction is catalyzed by 3beta-hydroxysteroid dehydrogenase/delta(5)-delta(4)isomerase.

Progesterone in turn (see lower half of figure to the right) is the precursor of the mineralocorticoid aldosterone, and after conversion to 17-hydroxyprogesterone (another natural progestogen) of cortisol and androstenedione. Androstenedione can be converted to testosterone, estrone and estradiol.

Pregenolone and progesterone can also be synthesized by yeast.[15]

Laboratory

The Marker semisynthesis of progesterone from diosgenin.[16]

An economical semisynthesis of progesterone from the plant steroid diosgenin isolated from yams was developed by Russell Marker in 1940 for the Parke-Davis pharmaceutical company (see figure to the right).[16] This synthesis is known as the Marker degradation. Additional semisyntheses of progesterone have also been reported starting from a variety of steroids. For the example, cortisone can be simultaneously deoxygenated at the C-17 and C-21 position by treatment with iodotrimethylsilane in chloroform to produce 11-keto-progesterone (ketogestin), which in turn can be reduced at position-11 to yield progesterone.[17]

The Johnson total synthesis of progesterone.[18]

A total synthesis of progesterone was reported in 1971 by W.S. Johnson (see figure to the right).[18] The synthesis begins with reacting the phosphonium salt 7 with phenyl lithium to produce the phosphonium ylide 8. The ylide 8 is reacted with an aldehyde to produce the alkene 9. The ketal protecting groups of 9 are hydrolyzed to produce the diketone 10, which in turn is cyclized to form the cyclopentenone 11. The ketone of 11 is reacted with methyl lithium to yield the tertiary alcohol 12, which in turn is treated with acid to produce the tertiary cation 13. The key step of the synthesis is the π-cation cyclization of 13 in which the B-, C-, and D-rings of the steroid are simultaneously formed to produce 14. This step resembles the cationic cyclization reaction used in the biosynthesis of steroids and hence is referred to as biomimetic. In the next step the enol orthoester is hydrolyzed to produce the ketone 15. The cyclopentene A-ring is then opened by oxidizing with ozone to produce 16. Finally, the diketone 17 undergoes an intramolecular aldol condensation by treating with aqueous potassium hydroxide to produce progesterone.[18]

Levels

In women, progesterone levels are relatively low during the preovulatory phase of the menstrual cycle, rise after ovulation, and are elevated during the luteal phase, as shown in diagram below. Progesterone levels tend to be < 2 ng/ml prior to ovulation, and > 5 ng/ml after ovulation. If pregnancy occurs, human chorionic gonadotropin is released maintaining the corpus leuteum allowing it to maintain levels of progesterone. At around 12 weeks the placenta begins to produce progesterone in place of the corpus leuteum, this process is named the luteal-placental shift. After the luteal-placental shift progesterone levels start to rise further and may reach 100-200 ng/ml at term. Whether a decrease in progesterone levels is critical for the initiation of labor has been argued and may be species-specific. After delivery of the placenta and during lactation, progesterone levels are very low.

Progesterone levels are relatively low in children and postmenopausal women.[19] Adult males have levels similar to those in women during the follicular phase of the menstrual cycle.

Person type Reference range for blood test
Lower limit Upper limit Unit
Female - menstrual cycle (see diagram below)
Female - postmenopausal <0.2[20] 1[20] ng/mL
<0,6[21] 3[21] nmol/L
Female on oral contraceptives 0.34[20] 0.92[20] ng/mL
1.1[21] 2.9[21] nmol/L
Males 16 years 0.27[20] 0.9[20] ng/mL
0.86[21] 2.9[21] nmol/L
Female or male 1–9 years 0.1[20] 4.1[20] or 4.5[20] ng/mL
0.3[21] 13[21] nmol/L
Progesterone levels during the menstrual cycle.[22]
- The ranges denoted By biological stage may be used in closely monitored menstrual cycles in regard to other markers of its biological progression, with the time scale being compressed or stretched to how much faster or slower, respectively, the cycle progresses compared to an average cycle.
- The ranges denoted Inter-cycle variability are more appropriate to use in non-monitored cycles with only the beginning of menstruation known, but where the woman accurately knows her average cycle lengths and time of ovulation, and that they are somewhat averagely regular, with the time scale being compressed or stretched to how much a woman's average cycle length is shorter or longer, respectively, than the average of the population.
- The ranges denoted Inter-woman variability are more appropriate to use when the average cycle lengths and time of ovulation are unknown, but only the beginning of menstruation is given.

Effects

Micrograph showing changes to the endometrium due to progesterone (decidualization) H&E stain.

Progesterone exerts its primary action through the intracellular progesterone receptor although a distinct, membrane bound progesterone receptor has also been postulated.[23][24] In addition, progesterone is a highly potent antagonist of the mineralocorticoid receptor (MR, the receptor for aldosterone and other mineralocorticosteroids). It prevents MR activation by binding to this receptor with an affinity exceeding even those of aldosterone and other corticosteroids such as cortisol and corticosterone.[25]

Progesterone has a number of physiological effects that are amplified in the presence of estrogen. Estrogen through estrogen receptors upregulates the expression of progesterone receptors.[26] Also, elevated levels of progesterone potently reduce the sodium-retaining activity of aldosterone, resulting in natriuresis and a reduction in extracellular fluid volume. Progesterone withdrawal, on the other hand, is associated with a temporary increase in sodium retention (reduced natriuresis, with an increase in extracellular fluid volume) due to the compensatory increase in aldosterone production, which combats the blockade of the mineralocorticoid receptor by the previously elevated level of progesterone.[27]

Reproductive system

Progesterone has key effects via non-genomic signalling on human sperm as they migrate through the female tract before fertilization occurs, though the receptor(s) as yet remain unidentified.[28] Detailed characterisation of the events occurring in sperm in response to progesterone has elucidated certain events including intracellular calcium transients and maintained changes,[29] slow calcium oscillations,[30] now thought to possibly regulate motility.[31] Interestingly progesterone has also been shown to demonstrate effects on octopus spermatozoa.[32]

Progesterone modulates the activity of CatSper (cation channels of sperm) voltage-gated Ca2+ channels. Since eggs release progesterone, sperm may use progesterone as a homing signal to swim toward eggs (chemotaxis). Hence substances that block the progesterone binding site on CatSper channels could potentially be used in male contraception.[33][34]

Progesterone is sometimes called the "hormone of pregnancy",[35] and it has many roles relating to the development of the fetus:

  • Progesterone converts the endometrium to its secretory stage to prepare the uterus for implantation. At the same time progesterone affects the vaginal epithelium and cervical mucus, making it thick and impenetrable to sperm. If pregnancy does not occur, progesterone levels will decrease, leading, in the human, to menstruation. Normal menstrual bleeding is progesterone-withdrawal bleeding. If ovulation does not occur and the corpus luteum does not develop, levels of progesterone may be low, leading to anovulatory dysfunctional uterine bleeding.
  • During implantation and gestation, progesterone appears to decrease the maternal immune response to allow for the acceptance of the pregnancy.
  • Progesterone decreases contractility of the uterine smooth muscle.[35]
  • In addition progesterone inhibits lactation during pregnancy. The fall in progesterone levels following delivery is one of the triggers for milk production.
  • A drop in progesterone levels is possibly one step that facilitates the onset of labor.

The fetus metabolizes placental progesterone in the production of adrenal steroids.

Nervous system

Progesterone, like pregnenolone and dehydroepiandrosterone, belongs to the group of neurosteroids. It can be synthesized within the central nervous system and also serves as a precursor to another major neurosteroid, allopregnanolone.

Neurosteroids affect synaptic functioning, are neuroprotective, and affect myelination.[36] They are investigated for their potential to improve memory and cognitive ability. Progesterone affects regulation of apoptotic genes.

Its effect as a neurosteroid works predominantly through the GSK-3 beta pathway, as an inhibitor. (Other GSK-3 beta inhibitors include bipolar mood stabilizers, lithium and valproic acid.)

Other effects

Medical applications

Prometrium 100 mg Oral Capsule

The use of progesterone and its analogues have many medical applications, both to address acute situations and to address the long-term decline of natural progesterone levels. Because of the poor bioavailability of progesterone when taken orally, many synthetic progestins have been designed with improved oral bioavailability and have been used long before progesterone formulations became available.[41] Progesterone was approved by the United States Food and Drug Administration as vaginal gel on July 31, 1997,[42] an oral capsule on May 14, 1998[43] in an injection form on April 25, 2001[44] and as a vaginal insert on June 21, 2007.[45] In Italy and Spain, Progesterone is sold under the trademark Progeffik.

Bioavailability

The route of administration impacts the effect of the drug. Given orally, progesterone has a wide person-to-person variability in absorption and bioavailability while synthetic progestins are rapidly absorbed with a longer half-life than progesterone and maintain stable levels in the blood.[46]

Progesterone does not dissolve in water and is poorly absorbed when taken orally unless micronized in oil. Products are often sold as capsules containing micronised progesterone in oil. Progesterone can also be administered through vaginal or rectal suppositories or pessaries, transdermally through a gel or cream,[47] or via injection (though the latter has a short half-life requiring daily administration).

"Natural progesterone" products derived from yams do not require a prescription, but there is no evidence that the human body can convert its active ingredient (diosgenin, the plant steroid that is chemically converted to produce progesterone industrially[16]) into progesterone.[48][49]

Specific uses

  • Progesterone is used to support pregnancy in Assisted Reproductive Technology (ART) cycles such as In-vitro Fertilization (IVF). While daily intramuscular injections of progesterone-in-oil (PIO) have been the standard route of administration, PIO injections are not FDA-approved for use in pregnancy. A recent meta-analysis showed that the intravaginal route with an appropriate dose and dosing frequency is equivalent to daily intramuscular injections.[50] In addition, a recent case-matched study comparing vaginal progesterone with PIO injections showed that live birth rates were nearly identical with both methods.[51]
  • Progesterone is used to control persistent anovulatory bleeding. It is also used to prepare uterine lining in infertility therapy and to support early pregnancy. Patients with recurrent pregnancy loss due to inadequate progesterone production may receive progesterone.
  • Progesterone is also used in nonpregnant women with a delayed menstruation of one or more weeks, in order to allow the thickened endometrial lining to slough off. This process is termed a progesterone withdrawal bleed. The progesterone is taken orally for a short time (usually one week), after which the progesterone is discontinued and bleeding should occur.[citation needed]
  • Progesterone is being investigated as potentially beneficial in treating multiple sclerosis, since the characteristic deterioration of nerve myelin insulation halts during pregnancy, when progesterone levels are raised; deterioration commences again when the levels drop.
  • Vaginally dosed progesterone is being investigated as potentially beneficial in preventing preterm birth in women at risk for preterm birth. The initial study by Fonseca suggested that vaginal progesterone could prevent preterm birth in women with a history of preterm birth.[52] According to a recent study, women with a short cervix that received hormonal treatment with a progesterone gel had their risk of prematurely giving birth reduced. The hormone treatment was administered vaginally every day during the second half of a pregnancy.[53] A subsequent and larger study showed that vaginal progesterone was no better than placebo in preventing recurrent preterm birth in women with a history of a previous preterm birth,[54] but a planned secondary analysis of the data in this trial showed that women with a short cervix at baseline in the trial had benefit in two ways: a reduction in births less than 32 weeks and a reduction in both the frequency and the time their babies were in intensive care.[55] In another trial, vaginal progesterone was shown to be better than placebo in reducing preterm birth prior to 34 weeks in women with an extremely short cervix at baseline.[56] An editorial by Roberto Romero discusses the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment.[57] A meta-analysis published in 2011 found that vaginal progesterone cut the risk of premature births by 42 percent in women with short cervixes.[58] The meta-analysis, which pooled published results of five large clinical trials, also found that the treatment cut the rate of breathing problems and reduced the need for placing a baby on a ventilator.[59]

Aging

Since most progesterone in males is created during testicular production of testosterone, and most in females by the ovaries, the shutting down (whether by natural or chemical means), or removal, of those inevitably causes a considerable reduction in progesterone levels. Previous concentration upon the role of progestagens (progesterone and molecules with similar effects) in female reproduction, when progesterone was simply considered a "female hormone", obscured the significance of progesterone elsewhere in both sexes.

The tendency for progesterone to have a regulatory effect, the presence of progesterone receptors in many types of body tissue, and the pattern of deterioration (or tumor formation) in many of those increasing in later years when progesterone levels have dropped, is prompting widespread research into the potential value of maintaining progesterone levels in both males and females.

Brain damage

Previous studies have shown that progesterone supports the normal development of neurons in the brain, and that the hormone has a protective effect on damaged brain tissue. It has been observed in animal models that females have reduced susceptibility to traumatic brain injury and this protective effect has been hypothesized to be caused by increased circulating levels of estrogen and progesterone in females.[62] A number of additional animal studies have confirmed that progesterone has neuroprotective effects when administered shortly after traumatic brain injury.[63] Encouraging results have also been reported in human clinical trials.[64][65]

The mechanism of progesterone protective effects may be the reduction of inflammation that follows brain trauma.[66]

See also

References

  1. ^ Allen WM (1935). "The isolation of crystalline progestin". Science 82 (2118): 89–93. doi:10.1126/science.082.2118.89. PMID 17747122. 
  2. ^ Butenandt A, Westphal U (1934). "Zur Isolierung und Charakterisierung des Corpusluteum-Hormons". Berichte Deu0tsche chemische Gesellschaft 67 (8): 1440–1442. doi:10.1002/cber.19340670831. 
  3. ^ Hartmann M, Wettstein A (1934). "Ein krystallisiertes Hormon aus Corpus luteum". Helvetica Chimica Acta 17: 878–882. doi:10.1002/hlca.193401701111. 
  4. ^ Slotta KH, Ruschig H, Fels E (1934). "Reindarstellung der Hormone aus dem Corpusluteum". Berichte Deutsche chemische Gesellschaft 67 (7): 1270–1273. doi:10.1002/cber.19340670729. 
  5. ^ Allen WM (1970). "Progesterone: how did the name originate?". South. Med. J. 63 (10): 1151–5. doi:10.1097/00007611-197010000-00012. PMID 4922128. 
  6. ^ Goodson III WH, Handagama P, Moore II DH, Dairkee S (2007-12-13). "Milk products are a source of dietary progesterone". 30th Annual San Antonio Breast Cancer Symposium. pp. abstract # 2028. http://www.docguide.com/news/content.nsf/news/852571020057CCF6852573B1007803AD. Retrieved 2008-03-12. 
  7. ^ Pauli GF, Friesen JB, Gödecke T, Farnsworth NR, Glodny B (January 2010). "Occurrence of Progesterone and Related Animal Steroids in Two Higher Plants". J Nat Prod 73 (3): 338–45. doi:10.1021/np9007415. PMID 20108949. 
  8. ^ Applezweig N (May 1969). "Steroids". Chem Week 104: 57–72. PMID 12255132. 
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Additional images

Steroidogenesis, showing progesterone among the progestagens in yellow area.


External links



Translations:

Progesterone

Top

Dansk (Danish)
n. - progesteron

Nederlands (Dutch)
progesteron

Français (French)
n. - progestérone

Deutsch (German)
n. - Progesteron, Gelbkörperhormon

Ελληνική (Greek)
n. - προγεστερόνη

Italiano (Italian)
progesterone

Português (Portuguese)
n. - progesterona (f)

Русский (Russian)
прогестерон

Español (Spanish)
n. - progesterona

Svenska (Swedish)
n. - progesteron (hormon)

中文(简体)(Chinese (Simplified))
孕酮, 黄体激素

中文(繁體)(Chinese (Traditional))
n. - 孕酮, 黃體激素

한국어 (Korean)
n. - 프로게스테론

日本語 (Japanese)
n. - 黄体ホルモン, プロゲステロン

العربيه (Arabic)
‏(الاسم) زلفوان, مادة كيمياويه‏

עברית (Hebrew)
n. - ‮פרוגסטרון (הורמון מין נשי טבעי ומלאכותי)‬


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