Violations of the menstrual cycle are found in almost every second girl: bleeding, daubing, or just an unreasonable delay. Stress, physical inactivity, malnutrition and bad habits affect the female body more than you might think. It is also often necessary to adjust the balance of hormones when planning a baby. In case of repeated failures, you should look for the cause together with the doctor, without sometimes engaging in dangerous self-treatment. Often, hormonal drugs are prescribed for correction, one of them is progesterone. Sometimes menstruation after utrozhestan (commercial name) does not come immediately or differ from the usual. And how should it be normal, when should you start to worry?

Read in this article

Why is Utrozhestan prescribed?

Utrozhestan - natural progesterone, made on a plant basis. Unlike other analogs of this hormone, the manufacturer claims the absolute identity of the drug in its pure form. Utrozhestan is prescribed to correct your own hormonal levels in case of insufficient production of progesterone. It is used to a greater extent in order to influence the growth of the endometrium.

Progesterone is the hormone of the second phase of the menstrual cycle. It is produced by the ovaries (in particular, most of all by the corpus luteum, which is formed after ovulation), the adrenal glands and the placenta during pregnancy.

Progesterone performs a number of important tasks in a woman's body, on which her menstrual function, the ability to become pregnant and bear children depend. With its normal amount, the endometrium of the uterine cavity is transformed in such a way that the fertilized egg can penetrate the uterine wall. In the absence of conception, progesterone promotes the further transformation of the endometrium into a secretory type and stimulates menstruation. That is why menstruation occurs after the abolition of utrozhestan.

Progesterone is involved in fixing the fetal egg in the uterus and prevents detachment. It also reduces the tone of her muscles and promotes normal growth during pregnancy. This protects the woman from premature birth.

Progesterone affects the mammary glands, promoting the growth of lobules and ducts, thus preparing the breast for subsequent lactation.

Also, this hormone is involved in metabolism and affects blood pressure. May cause slight dizziness after ingestion, this must be taken into account when driving a car or the need for a high concentration of attention. Blood pressure often drops slightly with the use of the drug.

The lack of progesterone production entails a violation of all the above processes, therefore, by prescribing utrogestan, the doctor tries to restore balance in the body and normalize all functions.

The main cases for prescribing the drug:

• in non-pregnant women, especially often in the premenopausal period, an utrogestan is prescribed to induce menstruation during their period;

• to correct the level of progesterone during pregnancy planning;
• with the threat of miscarriage or premature birth, especially in the presence of bloody discharge or an area of ​​detachment along and increased tone of the uterus;
• in combination with other drugs for hormone replacement therapy during menopause or premenopause;
• for treatment;
• for the treatment of various pathologies of the endometrium (etc.).

How does the drug affect the cycle

Utrozhestan is needed in a non-pregnant state in the second phase of the cycle. It is on the basis of this that his appointment is carried out - from 16 to 25 days. During gestation, it is administered continuously. There are two forms for use - tablets and vaginal capsules. When taken orally, the drug acts more systemically, and in the form of suppositories, the accumulation of the main substance in the uterus occurs. In different cases, preference should be given to one form or another.

The drug directly affects the endometrium, contributing to its growth and further rejection. Menstruation when taking utrogestan begins within a few days after discontinuation of the drug.

Thus, using this medicine, the woman's cycle is normalized. The likelihood of failures is also reduced due to the fact that utrogestan, like an endogenous hormone, competes with receptors for male sex hormones, thereby ultimately leading to a decrease in their production.

Many women are interested in what menstruation after utrozhestan is: as usual or with some kind of deviation. Several options are possible:

• Standard menstruation by the amount of blood lost and duration.
• , menstruation, but in speed after drug withdrawal. This is due to the fact that during the delay, the endometrium grows excessively, and then, being rejected, the inner layer of the uterus has larger volumes than usual. This phenomenon is observed (monthly clots go after utrozhestan) in most cases in the first month of taking the drug.
• Different in nature of menstruation, but longer than 10 days after the last pill. This is due to deep disturbances in the body, or the reason lies in the wrong dose or regimen of the drug.
• The delay in menstruation after utrozhestan is very long. This can sometimes be observed if the endometrium has not grown at all in the first phase, it takes more time. Also, a small dose of progesterone may not affect completely. And it is necessary to exclude pregnancy in the first place.

Possible causes of failures

But even when taking natural progesterone, deviations from the normal cycle can be observed. For example, sometimes there are minor after utrozhestan for a long time, and do not pass into normal critical days, or a brown daub is observed against the background of admission.

Disturbances from the normal process can occur due to the fact that pregnancy occurs. Then you should continue to drink utrozhestan as soon as this fact becomes known. Often in women with hypomenstrual syndrome or with a violation of the production of hormones of the first phase of the cycle, progesterone alone is not enough to increase the endometrium enough to cause its rejection. That is why, before prescribing the drug, an ultrasound of the small pelvis should be performed and the width and readiness of the inner layer of the uterus should be assessed.

Often, progesterone is prescribed to treat endometrial pathology, for example, with fixed polyposis or benign hyperplasia. Then after utrozhestan, monthly clots can be all critical days. As a rule, this has already been observed repeatedly in these women. You should not worry about this, as it should be in the first - second month of admission, then everything returns to normal.

The reason for the delay in menstruation in women is often functional. In its presence, the appointment of any progesterone will not always lead to the desired result, sometimes a double course or a large dose is required to induce menstruation.

After how many days of delay to worry

It is important to know how many days after utrozhestan menstruation comes. Ideally, critical days should go on 1-2 days after stopping the drug. But this is not always observed. The onset of menstruation is allowed within 7 to 10 days after the last tablet.

If after this time everything remains unchanged, you should consult a doctor again. In such situations, women begin to wonder if utrogestan can delay menstruation. No, a correctly prescribed regimen, a sufficient dose of medication and the presence of conditions for the work of natural progesterone always cause rejection of the endometrium, except in cases of pregnancy. In the opposite situation, you need to look for the cause of failure.

Utrozhestan is the only natural progesterone created on plant components. The drug is widely used in gynecological and obstetric practice. You can easily normalize the disturbed balance of hormones if you know how utrogestan affects menstruation, which schemes are used in various clinical situations. But the appointment should be carried out by a doctor, uncontrolled self-administration can lead to serious consequences.

Similar articles

Usually, after IVF, women are prescribed to take drugs with progesterone (Dufaston or Utrozhestan) to create favorable conditions for gestation.

Can Utrogestan be used to induce menstruation? Many patients are faced with the problem of delay, but not all seek the help of a specialist. Hence the development of pathological processes that complicate further diagnosis and correction of the condition.

Medication use

Utrozhestan is a drug that is produced only in the form of capsules, but they can be used both orally and intravaginally. Of course, this is convenient when compared with progesterone in an oily solution for injection, which is associated with quite a lot of discomfort during administration.

Capsules of the drug are available in dosages of 100 and 200 mg. After entering the vagina, their slow resorption begins. The maximum concentration of the active substance is reached 2-6 hours after administration. If the patient injects capsules 2 times a day, then the concentration of progesterone does not change. A distinctive feature of this drug is that progesterone accumulates in the uterus within a few hours after administration.

The result of this process is the restoration of the functionality of the endometrium and the transition to the phase of excretion (menstruation). A certain set of hormones allows the embryo to develop normally. Intravaginal administration of capsules with a delay in menstruation is not recommended, since the contractility of the uterus will be suppressed.

In case of a forced delay, the necessary measures must be taken.

With a long delay, you should immediately seek help from your doctor. It can indicate not only pregnancy, but also the formation of cysts. The dosage of the drug is selected in accordance with the current clinical picture. If the fair sex does not pay any attention to the delay, then she may have serious problems.

Utrozhestan is injected deep into the vagina. If necessary, you can use a special applicator. For a month, the doctor constantly monitors the patient's condition and, if necessary, corrects it. Of course, progesterone deficiency leaves its imprints on the work of the body. In order to induce menstruation, you can use the presented drug.

In this case, you need to follow a specific treatment regimen. Capsules of the drug should be driven into the vagina for 10 days. The patient should be guided by the calendar of her menstruation and choose the second half of the cycle in it.

Distinctive features of the drug

In case of problems with the ovaries, it is necessary to change the scheme of use. Capsules (100 mg) are administered on the 13-14th day, then the intake is doubled from the 15th to the 25th day. After this period, the dosage of the drug begins to increase by 100 mg / day for each week. At the next stage, the maximum dosage is reached - 600-800 mg. If necessary, this dosage is maintained for 2 months.

If an unwanted pregnancy is detected in the patient, then relatively large dosages (from 200 to 400 mg) can be used until the 20th week.

The drug is contraindicated in those who have:

• individual intolerance to the components;
• incomplete abortion;
• bleeding and spotting;
• tumor formations, etc.

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In any case, the patient should be especially vigilant, since the arrival of menstruation may be marked by a number of other problems. If the use of Utrozhestan does not give any results, then the treatment must be adjusted.

With a long delay, the patient should seek help from the attending physician, who will establish the true cause of the deviation. Self-use of Utrozhestan can only harm health. Dosage and method of application can be found only at the doctor's appointment. Do not self-medicate, take care of your health!

In this article, you can read the instructions for using the drug Utrozhestan. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Utrozhestan in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Utrozhestan in the presence of existing structural analogues. Use for the treatment of infertility, recurrent miscarriage, when planning pregnancy and in menopause in women, including during pregnancy and lactation. Side effects and effects of taking the drug. Menstruation after taking the medicine.

Utrozhestan- gestagenic drug. Progesterone, the active substance of the drug Utrozhestan, is a hormone of the corpus luteum. By binding to receptors on the surface of cells of target organs, it penetrates into the nucleus, where it activates DNA and stimulates RNA synthesis.

It promotes the transition of the uterine mucosa from the proliferation phase caused by the follicular hormone to the secretory phase. After fertilization, it contributes to the transition to the state necessary for the development of a fertilized egg. Reduces the excitability and contractility of the muscles of the uterus and fallopian tubes, stimulates the development of the terminal elements of the mammary gland.

By stimulating protein lipase, it increases fat reserves, increases glucose utilization. By increasing the concentration of basal and stimulated insulin, it contributes to the accumulation of glycogen in the liver, increases the production of gonadotropic hormones of the pituitary gland; reduces azotemia, increases the excretion of nitrogen in the urine.

Activates the growth of the secretory part of the acini of the mammary glands, induces lactation.

Promotes the formation of normal endometrium.

Pharmacokinetics

When taken orally

Micronized progesterone is absorbed from the gastrointestinal tract. It is excreted in the urine as metabolites, 95% of which are glucuron-conjugated metabolites, mainly 3-alpha, 5-beta-pregnanediol (pregnandione).

These metabolites, which are determined in blood plasma and urine, are similar to substances formed during the physiological secretion of the corpus luteum.

When administered vaginally

Absorption occurs quickly, progesterone accumulates in the uterus. A high level of progesterone is observed 1 hour after administration. When administered in doses of more than 200 mg per day, the concentration of progesterone corresponds to the 1st trimester of pregnancy. It is excreted in the urine as metabolites, the main part is 3-alpha, 5-beta-pregnanediol (pregnandione).

Indications

Progesterone-deficient conditions in women, including:

for oral administration

• premenstrual tension syndrome;
• menstrual disorders due to ovulation or anovulation disorders;
• fibrocystic mastopathy;
• premenopause;
• hormone replacement therapy of menopause (in combination with estrogenic drugs).

for vaginal administration

1. hormone replacement therapy for progesterone deficiency with non-functioning (absent) ovaries (with egg donation);
2. luteal phase support during preparation for in vitro fertilization;
3. support of the luteal phase in a spontaneous or induced menstrual cycle;
4. premature menopause;
5. hormone replacement therapy (in combination with estrogenic drugs);
6. infertility due to luteal insufficiency;
7. prevention of habitual or threatened abortion due to progestin deficiency;
8. prevention of uterine fibroids;
9. prevention of endometriosis.

Release forms

Capsules 100 mg and 200 mg.

Forms of reception in the form of tablets, or suppositories do not exist, only in the form of capsules. Everything else does not apply to the original drug Utrozhestan. Capsules of the drug can be administered intravaginally, which is an analogue of the form in the form of suppositories.

Instructions for use and regimen

The duration of therapy is set individually, depending on the clinical situation.

For oral administration

The drug should be taken orally with water. In most cases, with progesterone deficiency, the daily dose of Utrozhestan is 200-300 mg, divided into 2 doses (morning and evening).

In case of insufficiency of the luteal phase (premenstrual tension syndrome, menstrual irregularities, fibrocystic mastopathy, dysmenorrhea, premenopause), the daily dose of the drug is 200 or 400 mg for 10 days (usually from the 17th to the 26th day of the cycle).

With hormone replacement therapy in peri- and postmenopause while taking estrogen, Utrozhestan is used at 200 mg per day for 10-12 days.

For intravaginal administration

In the complete absence of progesterone in women with non-functioning (absent) ovaries (egg donation), the drug is administered intravaginally against the background of estrogen therapy, 200 mg per day on the 13th and 14th days of the cycle, then 100 mg 2 times a day from 15 -th to the 25th day of the cycle, from the 26th day and in case of pregnancy, the dose increases by 100 mg per day every week, reaching a maximum (600 mg per day), divided into 3 injections. This dose is usually applied for 60 days.

To maintain the luteal phase during the in vitro fertilization cycle, it is recommended to administer intravaginally from 200 to 600 mg per day, starting from the day of injection of human chorionic gonadotropin during the 1st and 2nd trimesters of pregnancy.

To maintain the luteal phase in a spontaneous or induced menstrual cycle, with infertility associated with impaired function of the corpus luteum, it is recommended to administer 200-300 mg intravaginally per day, starting from the 17th day of the cycle for 10 days, in case of delayed menstruation and diagnosis pregnancy treatment should be continued.

In cases of threatened abortion or in order to prevent habitual abortions that occur against the background of progesterone deficiency, 200-400 mg intravaginally are prescribed daily in 2 doses (morning and evening) in the 1st and 2nd trimesters of pregnancy. The capsules are inserted deep into the vagina.

Side effect

• allergic reactions;
• drowsiness;
• transient dizziness (1-3 hours after taking the drug);
• intermenstrual bleeding.

Contraindications

• tendency to thrombosis;
• acute phlebitis or thromboembolism;
• bleeding of unknown etiology from the genital tract;
• incomplete abortion;
• porphyria;
• established or suspected malignant neoplasms of the mammary glands and genital organs;
• severe liver dysfunction (for oral administration);
• hypersensitivity to the components of the drug, incl. to peanut butter, soy.

Use during pregnancy and lactation

Utrozhestan is indicated for use in the 1st and 2nd trimesters of pregnancy.

Caution should be used during pregnancy (due to the risk of liver dysfunction) and during lactation.

special instructions

Utrozhestan should not be used for contraception.

Influence on the ability to drive vehicles and control mechanisms

When taking the drug inside, care should be taken when engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions.

drug interaction

When used together, Utrozhestan enhances the effect of diuretics, antihypertensive drugs, immunosuppressants, anticoagulants.

Reduces the lactogenic effect of oxytocin.

Analogues of the drug Utrozhestan

Structural analogues for the active substance:

• Iprozhin;
• Crinon;
• Prajisan;
• Progesterone;
• Progestogel;
• Utrozhestan.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Utrozhestan is a drug based on natural progesterone, which is used for the prevention and treatment of various hormone-dependent pathologies and diseases. Utrozhestan and menstruation are two interrelated concepts, because progesterone is the main hormone of the second phase of the menstrual cycle, it is under its influence that menstrual function is regulated.

How does Utrozhestan work?

A hormonal drug can be prescribed for use only after a comprehensive gynecological examination in case of confirmation of a low level of progesterone in the female body, caused by a malfunction of the corpus luteum. The regimen of taking the hormone and the duration of treatment is determined individually.

Progestins are prescribed for admission to normalize hormonal levels with:

• Prevention of possible dysfunctions in the second phase of MC
• Threatened miscarriage (both early and late)
• Severe PMS
• Severe LH deficiency, provoked by a violation of the pituitary gland
• Ovulatory dysfunction
• Complex treatment of infertility
• Available signs of the development of mastopathy
• Hormonal imbalance during menopause
• Amenorrhea (causes menstruation).

It should be noted that the drug provokes an active growth of the endometrial tissue lining the uterus in the second phase of MC. During this time, the uterine mucosa produces a special biological substance with a certain secret, which helps to secure the fetal egg. Along with this, the increased tone of the appendages themselves, as well as the muscles of the uterus, decreases, due to which it is possible to maintain pregnancy.

Utrozhestan is placed in the vagina (used intravaginally) or taken orally.

How to take Utrozhestan to induce menstruation

In accordance with the instructions for the drug, hormonal treatment should begin from 16 days. MC for 26 days. MC. Progestins should be taken after ovulation, there is no point in using the drug earlier. You can drink progestin drugs that cause menstruation for 5 or 10 days. If five-day therapy is prescribed, Utrozhestanan should be taken twice a day, with a ten-day course of administration - once for 24 hours.

In how many days will the next menstrual bleeding begin? After the abolition of Utrozhestan, menstruation will begin over the next 3-5 days. This action is explained by a sharp decline in the level of progesterone in the female body. Utrozhestan with a delay in menstruation will need to take at least 3 menstrual cycles to normalize the hormonal background.

What does the delay in menstruation after Utrozhestan mean?

Usually, after the end of taking Utrozhestan, menstruation comes for a week, this is the norm. But many women are interested in the question of whether Utrozhestan can cause a delay. Yes, it is possible if the drug does not compensate for the existing deficiency of progesterone (in this case, you can observe a delay in menstruation), so it is difficult to say on which day menstruation will begin. It is best to take tests and consult with a specialist to find out the causes of this pathology. It may be recommended to increase the dose of the tablets taken. Thus, it will be possible to cause the next menstruation with Utrozhestan.

No periods, what does that mean? A delay after Utrozhestan is possible for another reason. It should not be ruled out that the onset of menstruation delays pregnancy. That is why it is important to do a test, if the result is positive, the progesterone intake should not be interrupted, otherwise a miscarriage is possible.

Can menstruation start when taking Utrozhestan

If the menstruation began earlier than the expected date, it is quite possible that this is how side symptoms appear. In the case of mild discharge, you should not worry; with prolonged bleeding, you will have to consult a doctor.

In the case when spotting came earlier than expected, implantation bleeding should not be ruled out (when pregnancy occurs). You will need to undergo an ultrasound and gynecological examination.

Scanty periods after Utrozhestan

It is worth noting that progesterone affects menstruation (in particular, their intensity). If the discharge is scarce during the first cycle of taking hormones, this can be considered the norm (even if the patient drank the drug according to the doctor's recommendations). In subsequent menstrual cycles, the amount of discharge should be the same as before. If, during menstruation, only slight spotting is constantly observed, this is an occasion to consult a doctor, a specialist will conduct an examination and identify the cause of such a pathology. It is possible that another hormonal treatment regimen will be prescribed.

Taking Utrozhestan to delay menstruation

It must be remembered that the use of progestogen delays the onset of menstrual bleeding. While maintaining the desired level of the hormone, the body prepares for a possible pregnancy, but its sharp decline gives a signal for rejection of the endometrium and, accordingly, the onset of menstruation. If spotting began on about the same day of the MC, their arrival can be delayed by several days (equal to the number of pills taken). But at the same time, it is worth remembering that Utrozhestan is not a contraceptive, so during hormone therapy you will need to protect yourself.

Contraindications and side effects

Before starting treatment, you should carefully study the list of contraindications. The drug should not be taken with:

• The presence of an adhesive process
• Vaginal bleeding of unknown origin
• high blood pressure
• Pathologies of the liver and kidney system
• Cancer process in the mammary glands
• Tendency to develop thrombosis
• Diabetes
• Myoma of the uterus and the detection of polyps.

Among the most common side effects that develop during treatment with Utrozhestan include:

• Lengthening of the menstrual cycle
• Bleeding in the middle of the cycle
• Weight gain
• Allergic manifestations on the skin
• Mood change
• Loss of appetite, bouts of nausea
• Severe headaches.

Although the drug contains natural progesterone, its use should be strictly controlled by a gynecologist. Take care of your own health and follow the recommendations of experts.

Latin name: UTROGESTAN
ATX code: G03D A04
Active substance: Progesterone
Manufacturer: Cyndea Pharma (Spain),
Olic (Thailand)
Pharmacy leave condition: On prescription

Utrozhestan is a hormonal drug for use in gynecology and obstetrics in order to compensate for the lack of endogenous progesterone and thereby prevent the development of undesirable consequences.

Indications for use

Hormonal drugs are designed to compensate for the lack of progesterone in the female body and thereby eliminate the conditions resulting from its deficiency.

Oral administration of the hormone is indicated for:

• Infertility caused by insufficient luteinization
• Vivid manifestations of PMS
• MC disorder due to ovulation disorders or amenorrhea
• Fibrocystic mastopathy
• Premenopause (the first stage of menopause)
• Replacement HT in peri- and postmenopausal women (together with drugs containing estrogen).

Utrozhestan is vaginally used:

• As a means of HRT to correct the lack (or absence) of progesterone due to non-functioning / absent ovaries
• To prevent miscarriage or premature birth in pregnant women with various complications
• To ensure luteinization during IVF preparation
• To normalize luteinization in spontaneous or induced MC
• Premature menopause
• Together with estrogen-containing drugs in replacement HT
• Infertility due to insufficient luteal phase
• Prevention of habitual or threatened abortion due to insufficient amount of progesterone in the body.

The composition of the drug

The active ingredient is micronized natural progesterone, which is given in different concentrations: the manufacturer produces Utrozhestan capsules with 100 and 200 mg of the hormone.

The composition of the accompanying components is the same for both forms, differing only in dosage: in Utrozhestan 200 mg pills, the content of the ingredients is doubled. The suspension is formed by sunflower oil and soy lecithin, the capsule body is gelatin, glycerol, E171.

Medicinal properties

The drug belongs to the gestagenic group. The active component of Utrozhestan is the hormone progesterone, synthesized by the corpus luteum. After penetration, it enters target cells, where it binds to DNA and stimulates the construction of RNA.

The substance transfers the mucous tissue of the uterus into the secretory phase from the stage of proliferation, which contributes to the normalization of the state of the endometrium, the formation of a layer necessary for a successful pregnancy. After fertilization, the egg ensures its proper development. The hormone reduces the contractile function of the muscles of the uterus and tubes, triggers mechanisms that prepare the mammary glands for lactation.

In addition, Utrozhestan contributes to the accumulation of fat necessary for bearing, increases the consumption of glucose, promotes the deposition of glycogen in the liver, increases the formation of gonadotropes, and reduces the nitrogen content in the body.

oral intake

After ingestion of the capsule, the active substance is absorbed from the gastrointestinal tract. Plasma concentration is formed within an hour. progesterone forms two active metabolites that have properties identical to the endogenous hormone. Derivative substances are almost completely (95%) excreted from the body with urine.

When inserted into the vagina

After being released from the capsule, progesterone is rapidly absorbed and accumulates in the uterine cavity. The highest level of the hormone is also formed an hour after the introduction of the candle. With the introduction of Utrogestan 100 mg twice a day, the average concentration is maintained throughout the day. In the case of the introduction of the drug more than 200 mg per day, the level of progesterone corresponds to the first term of pregnancy. Metabolites are also excreted from the body in the urine.

Release forms

Hormonal drugs are produced in the form of capsules, which, depending on the purpose, can be taken orally or used as suppositories for intravaginal use. Therefore, if Utrozhestan is used vaginally, it is called suppositories, and when taken orally, it is called capsules.

Capsules 100 mg - soft round pills in a pale yellow body. Filling - homogeneous, oily suspension of whitish color. The medicine is packaged in blisters. In a pack with instructions - 28 or 30 capsules.

Utrogestan suppositories (or capsules) containing 200 mg of progesterone differ from the first drug only in the shape of the capsules - they are oval. Otherwise, they are similar - they also have a pale yellow body and a whitish suspension as a filler. The product is packaged in blisters of 7 pieces. In a pack - 2 plates and instructions for use.

Mode of application

The average cost - (28 pcs.) - 394 rubles, (30 pcs.) - 396 rubles.

The duration and method of administration of Utrozhestan depends on what it is taken for, the indications of the state of the body and, in some cases, on the personal preferences of the patient.

oral intake

If the capsules are prescribed for oral administration, then the instructions for use recommend drinking Utrozhestan after meals and preferably at night. In this case, possible daytime drowsiness and dizziness can be avoided. The drug should be drunk after meals with plenty of water.

If the doctor has not made other appointments, then in determining the dosage they are guided by the recommendations of the manufacturers:

• With a deficiency of progesterone in the body, the daily amount of drugs is from 200 to 300 mg (taken in two divided doses).
• With PMS, FCM, dimenorrhea and premenopause: the course of therapy is 10 days. It is recommended to carry it out in the period from the 17th to the 26th day of the MC. The daily dosage is from 200 to 400 mg.
• Replacement HT in perimenopause (premenopause and the first year of menopause) together with estrogen-containing drugs: a 12-day course of Utrozhestan is recommended at a daily dosage of 200 mg.
• Replacement HT in the postmenopausal period involves the continuous use of drugs. Therapy begins on the first day of taking estrogen-containing drugs. Determination of the dosage of Utrozhestan is carried out personally in each individual case.

Utrozhestan vaginally

The average cost is 418 rubles.

It is desirable to insert candles before going to bed to ensure a long horizontal position of the body. If this is not possible, then after the introduction of the capsule in the daytime, a woman should lie down for at least half an hour, but an hour is better.

To facilitate the passage of the capsule into the vaginal cavity, it can be moistened or used with an applicator. It is recommended to administer the medicine to the maximum depth.

Elimination of the threat of miscarriage or premature birth: the course is carried out at 22-34 weeks of gestation. The daily dosage is 200 mg.

Compensation for the lack or complete absence of progesterone. Therapy is carried out in combination with etrogens:

• Day 13-14 MC: 200 mg of drugs
• Day 15-25 MC: Utrozhestan 100 mg twice a day
• From the 26th day of MC and in case of successful conception: the dosage is increased every week by 100 mg. The daily amount is divided into two doses, upon reaching the highest dosage of 600 mg, it is divided into three procedures. The maximum daily allowance is allowed to be used no longer than 60 days.

Ensuring the luteal phase in preparation for IVF: from the day of the hCG injection, 200-600 mg per day is administered. Then, after the embryo is fixed, Utrozhestan 200 continues to be used during pregnancy at the same dosage. Duration of application - 1 and 2 terms of gestation.

Ensuring luteinization in spontaneous and induced MC or infertility therapy due to dysfunction of the corpus luteum: therapy begins on the 17th day of MC. Capsules are recommended to be administered for 10 days at 200 or 300 mg.

Abortion Prevention: Therapy is indicated in the 1st and 2nd trimesters. The daily amount is 200-400 mg in two divided doses. The drug is administered daily until the complete disappearance of the threat of miscarriage.

Cancellation of Utrozhestan during pregnancy

To date, there are several opinions on the mechanism of drug withdrawal. In Western countries, the practice of abruptly stopping the use of Utrozhestan prevails. It is substantiated by the fact that clinical observations and various studies on animals did not fix the body's addiction to the drug. Proponents of this approach should take into account that the abrupt withdrawal of the hormone can provoke a withdrawal syndrome - the appearance of spotting on the 2-3rd day. If in a few days they have not disappeared or become more intense, you should definitely contact a specialist.

Doctors of the CIS countries have a different point of view on how to cancel utrozhestan. It is believed that the body gets used to an external source of hormone intake, and therefore it must be given time to rebuild and launch its own mechanisms for synthesizing it.

During pregnancy and breastfeeding

Utrozhestan during early pregnancy helps to fix the egg and then its normal development, prevents miscarriage.

Treatment in the 2nd and 3rd trimesters is possible, but only if necessary, as the risk of developing cholestasis increases. In case of appointment, constant monitoring of the state of the liver is necessary.

In addition, if Utrozhestan is prescribed to prevent miscarriage due to insufficient luteinization, then the risk of developing hypospadias in a child (anomaly in the development of the penis due to a violation of the structure of the urethra) is not excluded.

It is advisable for lactating women to refrain from treatment with the drug, since so far there is not enough data on the intake of progesterone in women's milk.

Contraindications

Utrozhestan is prohibited to use in the presence of at least one of the following factors:

• Individual hypersensitivity to capsule ingredients
• Thromboembolic conditions, deep vein thrombosis, stroke, MI, etc.
• Intracranial hemorrhage (current or former)
• Vaginal bleeding of unknown origin
• Partial or poorly performed abortion
• porphyrin disease
• Diagnosed or suspected malignant tumors of the genital organs and breasts.

Capsules should not be taken orally with:

• Liver pathologies in severe form at the time of appointment or existing in the past
• During breastfeeding
• Under the age of 18 (due to lack of treatment experience).

A limited appointment of Utrozhestan is allowed for:

• Violations of the CCC
• hypertension
• Insufficient functioning of the liver in a chronic form
• Diabetes
• Bronchial asthma
• Hypersensitivity to UV radiation
• 2 and 3 terms of pregnancy.

In the case of appointment, it is necessary to constantly monitor the patient's condition.

Precautionary measures

Before starting treatment with Utrozhestan, a thorough check of the patient's health, determination of the level of hormones is necessary.

If Utrozhestan is prescribed for hormonal therapy to a patient undergoing estrogen treatment, then it is preferable to use it no later than the 12th day of the monthly cycle.

If Utrogestan during pregnancy is prescribed to prevent miscarriage along with beta-agonists, then the dosage of the last drug can be reduced.

Considering that the capsules, when taken orally, can cause drowsiness, dizziness and decreased alertness, you should refrain from potentially hazardous activities during Utrogestan therapy. To minimize side effects, it is better to drink tablets before going to bed.

Cross-drug interactions

When combining Utrozhestan with other drugs, it is necessary to take into account their effect on hepatic enzymes, as this affects the course of metabolic processes of progesterone. Accordingly, its concentration will decrease or increase, which will affect the therapeutic effect.

Liver-enhancing drugs include barbiturates, anticonvulsants (such as Fentitoin), anti-tuberculosis drugs (Rifampicin), the diuretic Spironolactone, and the antimycotic Griseofulvin.

Some types of antibiotics of the ampicillin and tetracycline groups can change the intestinal microflora and, then, the transformation of steroids in the liver. Due to the fact that mutual reactions are influenced by many factors and features of processes in each organism, it is impossible to foresee the consequences in advance.

Progestins have the ability to reduce glucose tolerance, so if treatment is prescribed to a patient with diabetes, dosage adjustment may be required.

Progesterone is able to increase the content of Cyclosporine and reduce the effect of Bromocriptine.

The bioavailability of progesterone may be reduced in smokers and increased in drinkers.

When combining progesterone with ketoconazole, there is a mutual enhancement of each other's action.

Features of reactions with the introduction of candles

So far, there is no data on the interaction of progesterone with other substances of medications after the introduction of Utrozhestan into the vagina, since such studies have not been conducted. In order to avoid possible reactions and difficulty in the release of progesterone, Utrogestan should not be combined with other intravaginal drugs.

Side effects

Although the drug is usually perceived by the body normally, in some women the capsules can provoke negative phenomena. The nature of side effects also depends on the way the drug is used.

When administered orally, the following disorders may occur:

• Reproductive system: menstrual cycle disorder, amenorrhea, intermenstrual bleeding or discharge, breast engorgement (swelling, soreness, induration)
• NS: headache, drowsiness, transient short-term dizziness, depression
• Gastrointestinal: vomiting, stool disorder (diarrhea or constipation), bouts of nausea, bloating
• Liver and gallbladder: intrahepatic cholestasis
• Immune system: urticaria
• Skin: itching, acne, chloasma (especially often occurs if it was before).

Side effects that are less common:

• Libido disorder
• Discomfort in the chest
• Elevated temperature
• Sleep disturbance
• Hair loss, baldness
• Hairiness in uncharacteristic places
• PE, venous thromboembolism
• Accumulation of fluid in the body
• Anaphylaxis
• Change in MC (reduction in duration or unexpected, which occur if treatment is started too early - before the 15th day of the menstrual cycle.

If Utrozhestan is used intravaginally, then side effects in the form of:

• Individual hypersensitivity reactions (burning, itching or hyperemia) as a response to the contained soy lecithin. Anaphylaxis has not been ruled out.
• Characteristic oily discharge.

Overdose

Accidental or intentional ingestion of a large number of capsules can provoke unwanted reactions, manifested in the form of:

• Drowsiness, hypersomnia
• short-term dizziness
• Reducing the duration of the MC
• Euphoric states
• Dysmenorrhea.

In some women, toxicity can occur even at the recommended dose if she has unstable progesterone secretion. Also, intoxication is promoted by individual hypersensitivity to the main substance or too low content of estradiol.

How to eliminate an overdose

If the drug causes drowsiness and dizziness, then the patient should reduce the dosage of drugs or take capsules at bedtime for 10 days of MC.

If the MC changes or if spotting occurs, it is advisable to delay the start of therapy for several days of the MC.

To cope with other manifestations of intoxication, symptomatic therapy is prescribed.

Terms and conditions of storage

The capsules are valid for 3 years from the date of issue indicated on the pack. To avoid deterioration, they must be kept away from heat, light and sources of moisture, in places not accessible to children. The storage temperature is up to 25 °С.

Analogues

Only a doctor can replace Utrozhestan with an identical remedy.

Catalent France Beinheim (France), Capsugel Ploermel (Italy)

Average cost: caps. 100 mg (30 pcs.) - 351 rubles, caps. 200 mg (15 pcs.) - 368 rubles.

Progesterone-based drugs are designed to compensate for the lack of the hormone and eliminate the complications caused by it.

Iprozhin is produced in gelatin capsules with different concentrations of the active ingredient: 100 and 200 mg each. As a filler - peanut butter and soy lecithin.

Depending on the indications, the capsules can be used orally or intravaginally.

Pros:

• Stimulates ovulation
• More affordable price compared to other drugs
• Few side effects.

Flaws:

• May cause allergies due to peanut oil content.

Fleet Laboratories (England)

Average cost:(15 pcs. 1.125 g each) - 2482 rubles, 90 g (1 pc.) - 187 rubles.

The drug is in the form of a gel for intravaginal administration. Contains progesterone. The drug is used to provide the luteal phase in preparation for artificial insemination, to eliminate MC disorders caused by insufficient hormone levels in the body. It is also prescribed for replacement HT for women with menopausal disorders.

Pros:

• Easy to insert
• No need to lie down after the procedure
• Helps well.

Flaws:

• High price
• Not sold everywhere.