Prometrium contains micronized progesterone, a form of progesterone that is similar to the hormone naturally produced by the body. It is available by prescription and may be used as part of hormone therapy or to help restart menstrual bleeding in certain patients.
Progesterone plays an important role in regulating the menstrual cycle, controlling the growth of the uterine lining, and supporting the early stages of pregnancy.
Use with estrogen hormone therapy
Prometrium may be prescribed to postmenopausal women who still have a uterus and are taking estrogen hormone therapy.
Estrogen helps relieve menopausal symptoms such as hot flashes, night sweats, vaginal dryness, and discomfort during sex. However, taking estrogen by itself can cause the lining of the uterus, called the endometrium, to become too thick.
Over time, excessive thickening of the uterine lining may lead to endometrial hyperplasia. In some cases, this condition can develop into endometrial cancer.
Prometrium helps balance the effects of estrogen on the uterus. It causes the uterine lining to mature and shed rather than continuing to grow. This helps lower the risk of abnormal thickening and cancer of the uterine lining.
Prometrium does not usually provide most of the relief from hot flashes, night sweats, or vaginal dryness. Estrogen is generally the part of hormone therapy that treats these symptoms. Prometrium is mainly added to protect the uterus.
Women who have had their uterus removed usually do not need progesterone solely for protection of the uterine lining. However, individual treatment plans may vary.
Secondary amenorrhea
Prometrium may also be prescribed for secondary amenorrhea. This means menstrual periods have stopped in someone who previously had periods.
A missed or absent period can have many possible causes, including pregnancy, hormonal changes, significant changes in weight, intense exercise, thyroid problems, polycystic ovary syndrome, ovarian conditions, or certain medications.
Your healthcare provider will usually investigate the cause before prescribing treatment.
When Prometrium is used for secondary amenorrhea, it is generally taken for a limited number of days. After treatment ends, the drop in progesterone may cause the uterine lining to shed. This is called withdrawal bleeding and may resemble a menstrual period.
A withdrawal bleed does not necessarily mean that the underlying cause of the missed periods has been corrected. Additional testing or treatment may still be needed.
How Prometrium works
During a natural menstrual cycle, estrogen causes the uterine lining to grow. After ovulation, progesterone helps stabilize and prepare this lining for a possible pregnancy.
If pregnancy does not occur, progesterone levels fall and the uterine lining is shed as a menstrual period.
Prometrium produces effects similar to natural progesterone. It can:
- Limit excessive growth of the uterine lining
- Help protect the uterus during estrogen therapy
- Prepare the uterine lining for shedding
- Trigger withdrawal bleeding after a prescribed treatment course
Micronized progesterone
Prometrium contains micronized progesterone rather than a synthetic progestin. Micronization reduces the progesterone into very small particles, helping the body absorb it when it is taken by mouth.
Although progesterone and synthetic progestins have similar purposes, they are not identical. Their side effects, dosing schedules, and effects on the body may differ.
What results can you expect?
When Prometrium is used with estrogen, you may not feel it working. Its main purpose is to protect the uterine lining over time.
Depending on your schedule, you may experience monthly bleeding or spotting. Some patients take progesterone only during part of each month, while others use it every day.
When it is used for secondary amenorrhea, withdrawal bleeding may occur within several days after the final dose. Contact your healthcare provider if bleeding does not occur or if it is unusually heavy or prolonged.
Important treatment considerations
Tell your healthcare provider if you have unexplained vaginal bleeding, a history of breast cancer or another hormone-sensitive cancer, blood clots, stroke, heart attack, liver disease, or an allergy to progesterone or any ingredient in the capsules.
Prometrium may cause dizziness or drowsiness. It is often taken at bedtime to reduce the effect of these symptoms during the day.
Report any unusual vaginal bleeding promptly, especially after menopause. Attend regular follow-up appointments so your healthcare provider can review your symptoms, bleeding pattern, treatment response, and ongoing need for hormone therapy.
Take Prometrium exactly as prescribed. Do not change the dose, treatment schedule, or length of use without speaking with your healthcare provider.
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