Prometrium

Prometrium is a bioidentical progesterone capsule, formulated to provide targeted hormonal support in conditions requiring progesterone supplementation. As a micronized oral formulation, it offers enhanced bioavailability and a safety profile aligned with endogenous hormone physiology. It is commonly prescribed in hormone replacement therapy (HRT), menstrual disorder management, and fertility support protocols under medical supervision.

Features

• Contains 100 mg or 200 mg micronized progesterone per softgel capsule
• Bioidentical structure identical to endogenous progesterone
• Packaged in blister strips to ensure stability and ease of use
• Formulated with peanut oil; suitable for oral or vaginal administration per physician guidance
• Manufactured under strict pharmaceutical compliance (cGMP)

Benefits

• Supports endometrial protection in menopausal women on estrogen therapy
• Helps regulate menstrual cycles in cases of oligomenorrhea or anovulation
• May reduce risk of endometrial hyperplasia
• Provides luteal phase support in assisted reproductive technology (ART) cycles
• Promotes neurological and cardiovascular benefits associated with progesterone activity
• Minimizes androgenic side effects compared to synthetic progestins

Common use

Prometrium is indicated for use in hormone replacement therapy (HRT) for postmenopausal women with an intact uterus, to counteract estrogen-induced endometrial proliferation. It is also used in the management of secondary amenorrhea, abnormal uterine bleeding related to hormonal imbalance, and as part of infertility treatment protocols to support the luteal phase. Off-label uses may include prevention of preterm birth in certain high-risk pregnancies, though this application requires careful obstetric oversight.

Dosage and direction

Dosage must be individualized based on indication, patient response, and clinical context. For postmenopausal HRT: 200 mg orally daily for 12 sequential days per 28-day cycle. For secondary amenorrhea: 400 mg orally once daily at bedtime for 10 days. For infertility support: varies between 200–600 mg daily, often divided, beginning after confirmed ovulation. Administration at bedtime is recommended to minimize drowsiness. Capsules should be swallowed whole; not all formulations are suited for vaginal use—confirm with prescribing information.

Precautions

Patients should be monitored for signs of depression, thrombotic events, or visual disturbances. Use with caution in patients with history of depression, hepatic impairment, or cardiovascular risk factors. May cause drowsiness—caution when driving or operating machinery. Not recommended for use during pregnancy except under specific obstetric indications. Regular breast examinations and mammograms are advised for long-term users.

Contraindications

Prometrium is contraindicated in patients with known hypersensitivity to progesterone or any component of the formulation (including peanut oil). Avoid use in individuals with current or history of thrombophlebitis or thromboembolic disorders, undiagnosed abnormal genital bleeding, known or suspected progesterone-sensitive malignancies (e.g., breast cancer), missed abortion, or active liver disease.

Possible side effects

Common side effects include drowsiness, dizziness, breast tenderness, bloating, headache, and mood swings. Less frequently reported effects include nausea, hot flashes, and fluid retention. Serious adverse effects—though rare—may include allergic reactions, thrombotic events, severe depression, jaundice, or sudden vision changes. Discontinue and seek medical attention if severe symptoms occur.

Drug interaction

Prometrium may interact with hepatic enzyme inducers (e.g., rifampin, carbamazepine, St. John’s wort), potentially reducing its efficacy. Concurrent use with other CNS depressants (e.g., benzodiazepines, alcohol) may enhance sedative effects. Monitor when used alongside other hormone therapies. Consult a healthcare provider for a comprehensive medication review.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose. Consistency in timing supports stable hormone levels, particularly in fertility or cycle-regulation contexts.

Overdose

No specific antidote exists for progesterone overdose. Symptoms may include severe drowsiness, dizziness, or nausea. Symptomatic and supportive care is recommended. In case of suspected overdose, contact a poison control center or seek emergency medical attention.

Storage

Store at room temperature (20–25°C), away from light, moisture, and heat. Keep out of reach of children. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Individual patient needs and risks must be evaluated by a clinician.

Reviews

Clinical studies and patient reports generally reflect favorable outcomes regarding cycle regulation and endometrial protection, with particular appreciation for its natural hormone profile. Some users note sedation as a limiting factor, though often managed with bedtime dosing. Long-term user satisfaction in HRT contexts remains high when appropriately prescribed and monitored.