Precautions With Progesterone Therapy

By Dr. Anita in Obstetrics And Gynaecology

Jan 25 , 2023 | 1 min read

For patients

Advise the patient about the following:

  • Anticipated menstrual and premenstrual effects of progesterone therapy
  • Dizziness or giddiness and caution when driving or operating machines, especially in the initial days of therapy.
  • Side effects such as symptoms of thromboembolism, fluid retention, irregular vaginal bleeding, headache, breast tenderness, bloating, acne, and injection site pain.

Precautions to be taken when on progesterone therapy

  • Not to use other vaginal medicines if already using progesterone gel or insert. And if necessary, then use it at a gap of 6 hours at least.

  • Inform your doctor if you are planning to get pregnant.

  • Inform if you choose to breastfeed as progesterones are secreted in breast milk.

  • Stop progesterone and immediately inform your doctor if you get migraine or vision disturbances like blurred vision, double vision, vision deterioration or loss, or bulging of eyes.

  • Inform your doctor of any pre-existing illnesses or medicines you have been on or are contemplating.

For doctors

  • Risk of cardiac disorders like MI, DVT, stroke, thromboembolism, thrombophlebitis, pulmonary embolism, and retinal thrombosis.

  • Additional risk factors - diabetes, hypercholesterolemia, hypertension, history of VTE, obesity, tobacco use, SLE

  • Diabetic patients should be carefully monitored as they cause a decrease in glucose intolerance.

  • They cause fluid retention, so use them with caution in cardiac or renal impairment, migraine, epilepsy or seizure disorders, and asthma.

Caution in depression patients

  • CNS effects - apart from those mentioned above, slurred speech, difficulty walking, vertigo, loss of consciousness, confusion, disorientation, shortness of breath

  • Geriatric patients >65 years - lower dosage in view of decreased hepatic, renal and cardiac function

  • Carcinogenesis - not associated with breast cancer when used for contraception over a long duration. A small increased risk of breast cancer in postmenopausal women on HRT using a combination of estrogen and progesterone.