Systemic Progesterone Therapy – Parenteral, oral, vaginal and even transdermal?

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2015; 12 (4): 279-286

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Keywords: oral,  parenteral,  progesterone therapy,  transdermal,  vaginal

The therapeutic use of progesterone, which is identical to the female corpus luteum hormone, is becoming increasingly popular both for doctors and women. Several medicinal products containing progesterone are in widespread use orally (protection of the endometrium during concurrent estrogen treatment), parenterally or vaginally (support of luteal function in the course of assisted reproduction). These indications for progesterone have been established in extensive clinical testing programmes. In addition, the results of recent studies and meta-analyses suggest that vaginal progesterone is an effective and practical method for preventing premature births in singleton pregnancies in women with a shortened cervix. In the United States, 17alpha-hydroxyprogesterone caproate is licenzed to reduce the risk of preterm birth in women with a singleton pregnancy who have a history of singleton spontaneous preterm birth.
The administration of progesterone through the skin is also being promoted, although there is insufficient evidence from scientific studies to substantiate the transdermal application of progesterone. In particular, transdermal progesterone preparations should not be used to oppose the effects of estrogen on the endometrium, because even with comparatively low doses of estradiol (1 mg daily as a transdermal gel) a reliable progestogenic effect to protect the endometrium has not been proved. On the other hand, the application of transdermal progesterone preparations alone is not known to pose any risks to health.