How do Utrozhestan and menses interact, and how does the drug stabilize the menstrual cycle? Utrozhestan is prescribed for progesterone deficiency. The lack of this hormone in the body causes delayed menstruation. How to take the drug, and when they come monthly after it? More in the article.
Causes of menstrual disorders
Normal hormones are very important for women's health. In case of its violation, there may be abundant bleeding, absence or delay of menstruation, difficulty in conceiving or carrying a fetus. According to statistics, a normal, clear menstrual cycle in 15% of women out of 100. Delayed menstruation provokes prolonged premenstrual syndrome, chronic physical and emotional fatigue, and nervous tension. To normalize the cycle, doctors prescribe tablets Utrozhestan.
How does Utrozhestan on the cycle
The drug Utrozhestan doctors prescribed not only during pregnancy. Assign a course Utrozhestan with an irregular cycle. Progesterone deficiency can affect menstruation delay. The effect of the drug depends on the form of administration:
- Tablets - work systematically.
- Vaginal suppositories - the active ingredient accumulates in the reproductive organ.
The form of the drug is selected individually by the gynecologist. Utrozhestan affects the endometrial cover of the uterus, activating its growth and rejection. Thus Utrozhestan causes monthly. The process takes place two to three days after Utrozhestan is discontinued. This is how the patient's menstrual cycle stabilizes.
The composition of the drug and release form
The drug has one form of release - in gelatin capsules. They can be taken in the form of tablets, drinking water or vaginally, as candles. The main active ingredient of Utrogestan is natural progesterone. Each capsule contains a homogeneous whitish mass. Outside the capsule is covered with a soft gelatinous shell, which dissolves in contact with the skin. In addition to progesterone in the composition of the drug:
- peanut butter
- emulsifier (natural lecithin),
- titanium dioxide.
The dosage of the drug is one hundred and two hundred grams of active substance. Capsules of one hundred grams are round, packed in blisters of 15 cells. Capsules of two hundred grams oval, packed in blisters of 7 cells.
Indications and Contraindications
Utrozhestan with monthly delay is appointed only if there are no contraindications to use. When you can not take this tool:
- Adhesions in the uterus and fallopian tubes.
- Bleeding from the vagina of unknown origin.
- Liver and kidney disease.
- Tumor formations in the chest.
- Predisposition to thrombosis.
- Diabetes is a sugar type.
- Myomatous formations and polyps in the uterus.
- Increased blood pressure.
With any of these pathologies, it is prohibited to take Utrozhestan or similar drugs.
How to take to call monthly
How to take Utrozhestan to call monthly determined by a gynecologist after the diagnosis of the patient. The application manual indicates the standard regimen. Therefore, it is necessary to take the drug from the 16th to the 25th day of the cycle. That is, the course of treatment is ten days. Since progesterone acts after ovulation has occurred, up to this point the hormone will not work. During the reception it is necessary to strictly observe the dosage prescribed by the gynecologist and not to miss the days of taking the pills.
The doctor may schedule a five-day or ten-day course. With a ten-day course, you need to take one lozenge or a candle of the drug per day. With a five-day appointment, double the dose. That is, drink two capsules. Every 12 hours. The drug works as an endogenous hormone, and inhibits testosterone in the female body. So, cycle failure occurs much less frequently. In no case should not exceed the dose of the drug. This leads to adverse consequences.
When will monthly begin
On what day after the abolition of the pills should come monthly? Usually, monthly come a couple of days after discontinuation of the drug. But, sometimes there may be failures, despite the reception of progesterone. Menstruation may begin in the form of brownish smears after withdrawal or brownish discharge during the application of tablets.
If a woman has a hypomenstruation, or hormonal imbalance in the first part of the cycle, then taking one progesterone cannot solve the problem to the full. To understand this, the doctor prescribes an ultrasound scan of the uterus to assess the condition of the endometrium. And only then prescribes Utrozhestan. If the drug is prescribed for the treatment of polyposis or endometrial hyperplasia of a benign nature, then menstruation goes in dense blood clots. Such periods usually last four to eight weeks, at the beginning of the reception of funds. Then everything is normalized.
If the patient has an active cystic formation, then progesterone drugs are not as effective, and the cycle does not return to normal immediately. In this case, you need a large hormone dosage, or a longer course of treatment, to normalize menstruation. Full normalization of the MC occurs within three months, with regular use of Utrozhestan. During this time, the hormonal leveling off.
Monthly after taking Utrozhestan
Monthly after the course of Utrozhestan can be normal or abnormal. It all depends on the individual characteristics of the organism. Abnormal menstruation:
- Scanty periods after utrozhestan. Possible, if in the first sixteen days of the cycle, the endometrium did not have time to grow enough.
- Monthly with blood clots after drug withdrawal. During the delay, the endometrial layer grows in excess, and when rejected goes clots. This happens in the first four weeks of the progesterone course.
- The delay in menstruation after Utrozhestan indicates that there are serious pathologies in the body, a pregnancy has occurred, or the remedy has been prescribed incorrectly, the dosage should be increased or the dosage should be extended.
- If there are no periods, then it is necessary to exclude the probability of pregnancy.
I constantly had delays. I passed on hormones, and the gynecologist prescribed Utrozhestan for three months. Monthly came three days after the abolition of pills. They walked copiously, there were clots, but the doctor told me that it was normal. After three months, the cycle fully recovered.
For a long time it was impossible to get pregnant, but there were often delays. I was very nervous about that. After waiting for the pregnancy. It turned out I have a progesterone deficiency. Assigned capsules Utrozhestan, vaginally. Took two months. And on the third became pregnant. After that, she also took the drug to keep the pregnancy.
I had problems with the cycle, I ran through the Internet. I read good reviews about Utrozhestan. There are not many side effects. I consulted with my doctor. He appointed me. I drink the second month. While the monthly go daub, scarce, but go. I hope for the third month everything will be fine.
Progesterone is considered one of the main hormones pregnancy planning, and while carrying a child. Its deficiency is filled with special-purpose drugs. Utrozhestan consists of raw materials of plant origin. In structure, the progesterone contained in the drug is similar to the hormone produced female body.
Utrozhestan has a wide range of actions. Its main functions include the following:
- reduction of tubal contractility,
How does Utrozhestan help with pregnancy planning?
Progesterone is actively produced by the corpus luteum in the female body during the second phase of the menstrual cycle. In case of insufficiency of the corpus luteum, hormone is not produced in the right amount.
Against this background, there may be delays. Irregular cycle is a serious reason for seeking medical attention. Since in this case it can don't get pregnant without the support of medical devices.
Utrozhestan when planning pregnancy regulates the menstrual cycle, making the second phase of the cycle full. If problems with progesterone are due to the lack of ovulation, then other hormonal drugs are prescribed at the same time as Utrozhestan.. The indications for admission are the following phenomena:
In some cases, miscarriage can occur at the earliest possible time, even before a delay. This phenomenon is called biochemical pregnancy. Its cause is insufficient progesterone levels. Acceptance of the hormone-containing drug in the second phase of the cycle ensures the correct attachment of the embryo and its successful development.
How to use?
Utrozhestan is available in two forms with different dosages - 100 and 200 mg. The choice is due to the necessary the amount of progesteronewhich is set after passing the analysis. The required dosage is prescribed by the attending physician.
Tablets are small capsules. They can orally or use as a candle, the method of introduction into the vagina.
When planning a pregnancy, Utrozhestan is most often prescribed to drink one tablet, twice a day, in the morning and evening. Reception begins after ovulation. The classical scheme - from 16 to 25 day cycle.
Side effects and contraindications
In most cases, side effects occur only from oral administration. They occur some time after taking the last pill. Appears slight dizziness, general weakness, drowsiness. In some cases, the formation of allergic reactions.
Before you start taking, you should familiarize yourself with the contraindications indicated in the instructions. These include the following:
How to cancel reception?
Cancel Utrozhestan when planning pregnancy should be as careful as possible. You should first make sure absence of conception. This should be done before the date of the expected monthly.
The best option in this case - to pass the analysis for the presence of the hormone HCG in the body. And you can also use ultrasensitive tests. If the pregnancy has taken place, then Utrozhestan should be taken further up to 7–8 weeks of the situation, and sometimes up to 16–22.
In the absence of pregnancy, the abolition of the drug causes the arrival of menstruation. If the monthly did not come within 10 days after the cancellation, you must repeat pregnancy testand then go to the doctor.
Reviews of the drug are mostly positive. The main advantage of Utrozhestan before its analogue - Duphaston lies in its composition. Duphaston contains synthetic progesterone, and Utrozhestan is made from natural raw materials. In addition, Utrozhestan is more affordable, so many women prefer him.
The use of progesterone-based medications helps to get pregnant and successfully carry the baby. The practice of taking Utrozhestan when planning pregnancy and other similar drugs significantly reduced the rate of abortion in the first and second trimesters.
When infertility Utrozhestana when planning pregnancy in most cases gives only positive results, if the reason - the lack of a specific hormone. The fact is that the active substance of this drug is progesterone, which is essentially a hormone of the corpus luteum. It has the following features:
- promotes the active formation of the secretory endometrium in the female body,
- at conception it causes a quick and qualitative transition of the uterine mucous membrane from proliferation to the secretory phase,
- after fertilization contributes to the transition of the mucous membrane of the uterus to the state necessary for the full development of a fertilized egg,
- significantly reduces the excitability and contractility of the uterine muscles and tubes,
- further stimulates the development of the mammary glands necessary for lactation,
- with all this, it does not possess androgenic activity.
Based on such useful properties of Utrozhestan, it is prescribed in certain cases when the desired pregnancy does not occur at all. But first, a woman will need to undergo a medical examination, which should confirm that there really is not enough progesterone in her body. There are certain indications for prescribing this drug.
Urozhestan (and capsules, and candles) is prescribed for diseases that prevent successful conception of the child. So if, at the planning stage of pregnancy, women were diagnosed with similar conditions, the drug is prescribed in accordance with the following indications.
For oral administration (capsules):
- endocrine sterility
- premenstrual tension syndrome
- fibrocystic mastopathy,
- progesterone deficiency,
- hormone therapy (replacement) menopause (appointed only in combination with estrogen).
For intravaginal use (suppositories):
- hormone therapy (replacement) with missing (or non-functioning) ovaries due to the complete absence of progesterone,
- in preparation for in vitro fertilization,
- miscarriage prevention due to progestin deficiency,
- endocrine sterility
- threatened miscarriage
- premature menopause
- prevention of uterine fibroids,
- menopause and postmenopause (Utrozhestan is prescribed in this case in combination with estrogen),
All these diseases are serious causes of infertility. Eliminating them with this miraculous drug, you can conceive a child without problems. However, you need to know how to take Utrozhestan when planning a pregnancy so that it turns out to be the most useful and does not bring any harm. This will tell the doctor who prescribed the drug. The dosage is also indicated in the instructions to the drug.
The difficulty is that the regimen of Utrozhestan when planning pregnancy is established exclusively by the doctor, depending on the clinical situation. Even with the instruction in hand, it will be difficult to determine exactly how to take the drug without knowing the characteristics of its own organism.
- in case of insufficiency of the luteal phase, premenstrual tension syndrome, fibrocystic mastopathy, dysmenorrhea, premenopausal, the drug is administered orally (capsules) 200–300 mg (this is 2-3 pieces) in a daily dose, they need to be divided into 2 doses (morning – evening) : it is important to know from which day to drink Utrozhestan when planning pregnancy this should be done during phase II of the menstrual cycle and drink capsules for 10 days (it turns out from 16 to 25 days),
- with hormone replacement therapy, Utrozhestan is prescribed 2 capsules per day for 10–12 days (in perimenopause), in menopause, 1 capsule per day for 25 days, it is better to take the drug at bedtime, in the evening, drinking plenty of water, you should not drink capsules right before a meal or after it,
- in the absence of progesterone, intravaginal suppositories are administered 1 per day, you need to do this on the 13-14 days of the menstrual cycle, then the scheme changes - 1 candle twice a day from 15 to 25 days of the cycle, and from 26 days the dosage increases by 1 candle in every day, until the maximum threshold is reached (it is 6 candles per day, divided into 3 receptions). If at this stage the question arises, how long can Utrozhestan be taken when planning pregnancy with this pathology? This can be safely done for 60 days (2 months),
- to maintain the luteal phase (during in vitro fertilization) Utrozhestan in the candles is administered intravaginally 4-6 pieces per day, you need to start from the day of gonadotropin injection and finish only at the 20th week of pregnancy,
- to maintain the luteal phase in a spontaneous menstrual cycle, infertility Utrozhestan need to be administered intravaginally 2-3 candles per day in phase II of the menstrual cycle for 10 days: if the menstrual cycle is delayed or pregnancy is diagnosed, this treatment regimen should be continued for a period determined by a doctor
- with the threat of abortion, for the prevention of miscarriage due to progesterone deficiency, Utrogestan is administered intravaginally by 2–4 candles 2-3 times per day up to the 20th week of pregnancy.
The regimen of Utrozhestan when planning pregnancy is determined solely by the doctor, since the independent choice of dosage is fraught with undesirable consequences both for the health of the woman and for the successful conception of the child. Before taking it, you must be examined for contraindications.
Sometimes Utrozhestan is canceled when planning a pregnancy - such a decision is made by the doctor if the side effects of its use are too pronounced:
- CNS may experience drowsiness, dizziness (these side effects begin to appear 1-3 hours after taking the capsules)
- on the part of the reproductive system, a reduction in the menstrual cycle can be diagnosed, but more dangerous is intermenstrual bleeding.
Similar cases were observed only when taking Utrozhestan capsules inside. Candles more gently affect the body and are actively absorbed into the bloodstream, without disturbing the functioning of the internal organs. There are more categorical contraindications for the use of this drug in any form.
Do not use Utrozhestan when planning pregnancy in the following cases:
- pronounced disorders and pathologies in the work and functioning of the liver (especially for taking capsules inside),
- hypersensitivity and individual intolerance to the components of the drug,
- III trimester of pregnancy
In the first and second trimesters of pregnancy, Utrozhestan is even indicated for use. With regard to overdose of this drug, such information in modern medicine is not. There is no pathologically dangerous interaction with other drugs. However, there are certain recommendations that will enhance the benefits Utrozhestana during the planning of pregnancy.
To get the maximum benefit from taking Utrozhestan when planning pregnancy, you should use some tips:
- the drug is able to reduce concentration of attention, so you should not use it before you get behind the wheel or perform some responsible work,
- capsules for oral administration are also candles for intravaginal administration,
- You should not choose a dosage regimen without expert advice.
It should be borne in mind that the use of Utrozhestan in the planning of pregnancy is possible only strictly by a doctor. Otherwise, you can simply not achieve the desired results and even worsen your own condition.
The hormonal background of a woman on the eve of conception is very important (read more about hormones during pregnancy), and you should not experiment with it. Following the recommendations of physicians and accurately observing all the nuances of the above instructions, you can conceive a healthy, strong, full-fledged baby as soon as possible - the dream of any couple planning to become parents.
Composition, description, other informationRegistration number: No. JIC-000186
Trade Name: Utrozhestan®
International non-proprietary name: progesterone
Dosage Form: capsules
Composition on 1 capsule:
Active substance: micronized progesterone 100 or 200 mg.
Excipients: sunflower oil 149 mg / 298 mg, soy lecithin 1 mg / 2 mg, capsule - gelatin 76.88 mg / 153.76 mg, glycerin 31.45 mg / 62.9 mg, titanium dioxide 1.67 mg / 3.34 mg.
Description: 100 mg capsules are round, 200 mg capsules are oval, soft, shiny, yellowish gelatin capsules containing an oil whitish homogeneous suspension (without visible phase separation).
Pharmacotherapeutic group: progestin
ATX Code: G03DA04
The active ingredient of Utrozhestan® is progesterone, which is identical to the natural hormone of the corpus luteum of the ovary. By binding to receptors on the surface of target organ cells, it penetrates into the nucleus, where, by activating DNA, it stimulates RNA synthesis. It promotes the transition of the uterine mucosa from the proliferation phase, caused by the follicular hormone estradiol, to the secretory phase, and after fertilization 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. Promotes the formation of normal endometrium. Stimulates the development of the terminal elements of the breast and induces lactation.
Stimulating protein lipase, increases fat stores, increases glucose utilization, increases basal and stimulated insulin concentrations, promotes glycogen accumulation in the liver, increases pituitary gonadotropic hormone production, decreases azotemia, increases nitrogen excretion by the kidneys.
When taken orally
Micronized progesterone is well absorbed in the gastrointestinal tract (GIT). The concentration of progesterone in the blood plasma gradually increases during the first hour, the maximum concentration in the blood plasma (Сmax) is noted 1-3 h after administration. The concentration of progesterone in the blood plasma increases from 0.13 ng / ml to 4.25 ng / ml after 1 hour, to 11.75 ng / ml after 2 hours and is 8.37 ng / ml after 3 hours, 2 ng / ml 6 h and 1.64 ng / ml 8 h after administration.
The main metabolites that are determined in the blood plasma are 20-alpha-hydroxy-delta-4-alpha-pregnanolone and 5-alpha-dihydroprogesterone.
Excreted by the kidneys as metabolites, 95% of them are glucuron conjugated metabolites, mainly 3-alpha, 5-beta-pregnandiol (pregnandione). These metabolites, which are determined in the blood plasma and in the urine, are similar to substances formed during the physiological secretion of the corpus luteum.
With vaginal administration
Suction and distribution
Absorption occurs quickly, a high concentration of progesterone in the blood plasma is observed 1 hour after administration. Cax progesterone in plasma is achieved 2-6 hours after administration. With the introduction of 100 mg 2 times a day, the average plasma concentration remains at 9.7 ng / ml for 24 hours. When given in doses of more than 200 mg / day, the concentration of progesterone corresponds to the first trimester of pregnancy. Communication with plasma proteins - 90%. Progesterone builds up in the uterus.
Metabolized to form predominantly 3-alpha, 5-beta-pregnandiol. The concentration of 5-beta-pregnanolone in the blood plasma does not increase.
Excreted by the kidneys as metabolites, the main part is 3-alpha, 5-beta-pregnandiol (pregnandion). This is confirmed by a constant increase in its concentration (C max 150 ng / ml after 6 h).
Indications for use Progesteronexiety in women:
For oral administration:
- threatened abortion or the prevention of habitual abortion due to progesterone deficiency,
- infertility due to luteal insufficiency,
- premenstrual syndrome,
- menstrual disorders due to impaired ovulation or anovulation,
- fibrocystic mastopathy,
- menopausal transition period
- menopausal (replacement) hormone therapy (MHT) in peri-and postmenopause (in combination with estrogen-containing drugs).
For intravaginal use:
- MHT in case of progesterone deficiency with non-functioning (missing) ovaries (egg donation),
- prevention (prophylaxis) of preterm labor in women at risk (with shortening of the cervix and / or availability of anamnestic data of preterm labor and / or premature rupture of the membranes),
- support of the luteal phase during preparation for in vitro fertilization,
- support of the luteal phase in a spontaneous or induced menstrual cycle,
- premature menopause
- MHT (in combination with estrogen preparations),
- infertility due to luteal insufficiency,
- threatened abortion or prevention of habitual abortion due to progesterone deficiency.
Hypersensitivity to progesterone or any of the excipients of the drug, deep vein thrombosis, thrombophlebitis, thromboembolic disorders (pulmonary embolism, myocardial infarction, stroke), intracranial hemorrhage or data availability conditions / diseases in history, vaginal unclear origin bleeding, incomplete abortion , porphyria, established or suspected malignant neoplasms of the breast and genital organs, severe liver diseases (including cholestati eskaya jaundice, hepatitis, Dubin-Johnson syndrome, Rotor, malignant liver tumors) in the present or in history, children under 18 years of age (efficacy and safety have not been established) during breastfeeding.
Cardiovascular diseases, arterial hypertension, chronic renal failure, diabetes mellitus, bronchial asthma, epilepsy, migraine, depression, hyperlipoproteinemia, dysfunction of the liver of mild to moderate severity, photosensitivity.
The drug should be used with caution in the II and III trimesters of pregnancy.
Use during pregnancy and during breastfeeding The drug should be used with caution in the II and III trimesters of pregnancy because of the risk of cholestasis.
Progesterone penetrates into breast milk, so the use of the drug is contraindicated during breastfeeding.
Dosage and administrationOrally
The drug is taken orally in the evening before bedtime, drinking water.
In most cases, with progesterone deficiency, the daily dose of Utrogestan® is 200-300 mg, divided into 2 doses (200 mg in the evening before bedtime and 100 mg in the morning, if necessary).
- With a threatened abortion or to prevent habitual abortion due to progesterone deficiency: 200-600 mg per day daily in I and II trimesters of pregnancy. Further use of the drug Utrozhestan® may be prescribed by the attending physician on the basis of an assessment of the clinical data of a pregnant woman.
- In case of insufficiency of the luteal phase (premenstrual syndrome, fibrocystic mastopathy, dysmenorrhea, menopausal transition period) the daily dose is 200 or 400 mg taken within 10 days (usually from the 17th to the 26th day of the cycle).
- With MGT in perimenopause while taking estrogen, the drug Utrozhestan® is applied 200 mg per day for 12 days.
- With MGT in postmenopause in continuous mode, the drug Utrozhestan® is used in a dose of 100-200 mg from the first day of taking estrogen-containing drugs. Dose selection is carried out individually.
Capsules are inserted deep into the vagina.
- Prevention (prevention) of premature birth in women at risk (with shortening of the cervix and / or availability of anamnestic data of preterm labor and / or premature rupture of the membranes): the usual dose is 200 mg at bedtime, from the 22nd to the 34th week of pregnancy.
- Complete absence of progesterone in women with non-functioning (missing) ovaries (egg donation): during estrogen therapy, 100 mg per day on the 13th and 14th days of the cycle, then 100 mg 2 times a day from the 15th to the 25th day of the cycle, from the 26th day, and If pregnancy is determined, the dose is increased by 100 mg per day every week, reaching a maximum of 600 mg per day, divided into 3 doses. This dose may be applied for 60 days.
- Support of the luteal phase during the in vitro fertilization cycle: It is recommended to use from 200 to 600 mg per day, starting from the day of injection of chorionic gonadotropin during the I and II trimester of pregnancy.
- Support of the luteal phase in a spontaneous or induced menstrual cycle with infertility associated with dysfunction of the corpus luteum: It is recommended to use 200-300 mg per day, starting from the 17th day of the cycle for 10 days, in the case of delayed menstruation and diagnosis of pregnancy, treatment should be continued.
- In cases of threatened abortion or to prevent habitual abortionarising on the background of progesterone deficiency: 200-400 mg per day in 2 doses daily in the I and II trimesters of pregnancy.
Side Effects Listed below are adverse events noted when administered orally drug, distributed by frequency of occurrence in accordance with the following gradation: often:> 1/100, 1/1000, 1/10000,
Drowsiness, transient dizziness are possible, as a rule, 1-3 h after oral administration of the drug. These adverse reactions can be reduced by reducing the dose, using the drug at bedtime, or switching to a vaginal route of administration.
These unwanted reactions are usually the first signs of overdose.
Drowsiness and / or transient dizziness are observed, in particular, in the case of concomitant hypoestrogenism. Reducing the dose or restoring higher estrogenation immediately eliminates these phenomena, without reducing the therapeutic effect of progesterone.
If the treatment begins too early (in the first half of the menstrual cycle, especially before the 15th day), shortening of the menstrual cycle or acyclic bleeding is possible.
Registered changes in the menstrual cycle, amenorrhea, or acyclic bleeding are characteristic of all gestagens.
Application in clinical practice
When used in clinical practice, the following adverse events were noted. oral administration progesterone: insomnia, premenstrual syndrome, tension in the mammary glands, vaginal discharge, joint pain, hyperthermia, increased sweating at night, fluid retention, changes in body weight, acute pancreatitis, alopecia, hirsutism, changes in libido, thrombosis and thromboembolic complications when conducting MGT in combination with estrogen-containing drugs), increased blood pressure.
The drug contains soy lecithin, which can cause hypersensitivity reactions (urticaria and anaphylactic shock).
When vaginal application
It was reported on individual cases of development of reactions of local intolerance to the components of the drug (in particular, soy lecithin) in the form of hyperemia of the vaginal mucosa, burning, itching, oily discharge.
Systemic side effects with intravaginal use of the drug in the recommended doses, in particular, drowsiness or dizziness (observed with oral administration of the drug), were not observed.
OverdoseSymptoms: drowsiness, transient dizziness, euphoria, shortening of the menstrual cycle, dysmenorrhea.
In some patients, the average therapeutic dose may be excessive due to the present or unstable endogenous progesterone secretion, a particular sensitivity to the drug, or too low an estradiol concentration.
- in case of drowsiness or dizziness, it is necessary to reduce the daily dose or prescribe a drug at bedtime for 10 days of the menstrual cycle,
- in case of shortening of the menstrual cycle or "bloody" bleeding, it is recommended to transfer the treatment to a later day of the cycle (for example, on the 19th instead of the 17th),
- in perimenopause and in MHT in postmenopause, it is necessary to ensure that the estradiol concentration is optimal.
In case of overdose, if necessary, symptomatic treatment is carried out. Interaction with other drugs
Progesterone enhances the action of diuretics, antihypertensive drugs, immunosuppressants, anticoagulants. Reduces the lactogenic effect of oxytocin. Simultaneous use of CYP3A4 liver microsomal enzymes with inducer drugs, such as barbiturates, antiepileptic drugs (phenytoin, carbamazepine), rifampicin, phenylbutazone, spironolactone, griseofulvin, is accompanied by an acceleration of the metabolism of progesterone in the liver.
Simultaneous administration of progesterone with certain antibiotics (penicillins, tetracyclines) can lead to a decrease in its effectiveness due to a violation of the enterohepatic recirculation of sex hormones due to changes in the intestinal microflora.
The severity of these interactions can vary in different patients, so the prognosis of the clinical effects of these interactions is difficult.
Ketoconazole may increase the bioavailability of progesterone.
Progesterone can increase the concentration of ketoconazole and cyclosporine.
Progesterone may decrease the effectiveness of bromocriptine.
Progesterone can cause a decrease in glucose tolerance, as a result of which - to increase the need for insulin or other hypoglycemic drugs in patients with diabetes mellitus.
Bioavailability of progesterone can be reduced in patients who smoke and with excessive use of alcohol.
With intravaginal use
The interaction of progesterone with other drugs with intravaginal use was not evaluated. The simultaneous use of other drugs used intravaginally should be avoided in order to avoid impaired release and absorption of progesterone.
Specific guidance The drug Utrozhestan® can not be used for contraception.
The drug can not be taken with food, as the food intake increases the bioavailability of progesterone.
The drug Utrozhestan® should be taken with caution in patients with diseases and conditions that can be aggravated with fluid retention (arterial hypertension, cardiovascular diseases, chronic renal failure, epilepsy, migraine, bronchial asthma), in patients with diabetes mellitus, and liver dysfunction easy and moderate severity, photosensitivity.
Patients with a history of depression should be monitored, and if severe depression develops, the drug should be discontinued.
The composition of the drug Utrozhestan® includes soy lecithin, which can cause hypersensitivity reactions (urticaria and anaphylactic shock).
Patients with concomitant cardiovascular diseases or their history should also be observed periodically by a doctor.
Use of the drug Utrozhestan® after the I trimester of pregnancy can cause the development of cholestasis.
With prolonged treatment with progesterone, it is necessary to regularly conduct medical examinations (including the study of liver function), treatment should be canceled in case of deviations from normal indicators of functional liver tests or cholestatic jaundice.
When using progesterone, a decrease in glucose tolerance and an increased need for insulin and other hypoglycemic drugs in patients with diabetes mellitus is possible.
In the case of amenorrhea in the treatment process, it is necessary to exclude the presence of pregnancy.
Если курс лечения начинается слишком рано в начале менструального цикла, особенно до 15-го дня цикла, возможны укорочения цикла и/или ациклические кровотечения. In the case of acyclic bleeding should not use the drug to determine their causes, including the histological examination of the endometrium.
If you have a history of chloasma or a tendency to its development, patients are advised to avoid UV exposure.
More than 50% of cases of spontaneous abortions in early pregnancy are due to genetic disorders. In addition, the cause of spontaneous abortions in early pregnancy can be infectious processes and mechanical damage. The use of the drug Utrozhestan® in these cases can only lead to a delay in rejection and evacuation of the non-viable ovum. Use of the drug Utrozhestan® for the purpose of the prevention of threatening abortion is justified only in cases of insufficiency of progesterone.
When conducting MGT with estrogens during the period of perimenopause, the use of the drug Utrogestan® is recommended for at least 12 days of the menstrual cycle.
In the continuous mode of MHT in postmenopausal use of the drug is recommended from the first day of estrogen.
When conducting MGT increases the risk of venous thromboembolism (deep vein thrombosis or pulmonary embolism), the risk of ischemic stroke, coronary heart disease.
Due to the risk of thromboembolic complications, use of the drug should be discontinued in case of: visual impairment such as loss of vision, exophthalmos, double vision, vascular lesions of the retina, migraine, venous thromboembolism or thrombotic complications, regardless of their location.
If there is a history of thrombophlebitis, the patient should be closely monitored.
When using Utrogestan® with estrogen-containing preparations, refer to the instructions for their use regarding the risks of venous thromboembolism.
The results of the clinical study of the Women Health Initiative Study (WHI) indicate a slight increase in the risk of breast cancer with a long, more than 5 years, combined use of estrogen-containing drugs with synthetic gestagens. It is not known whether there is an increase in the risk of breast cancer in postmenopausal women with MHT estrogen preparations in combination with progesterone.
The results of the WHI study also revealed an increase in the risk of developing dementia at the onset of MHT over 65 years of age.
Before the onset of MGT and regularly during her conduct, a woman should be examined to identify contraindications for her. In the presence of clinical indications, an examination of the mammary glands and gynecological examination should be conducted.
The use of progesterone can affect the results of some laboratory tests, including indicators of liver function, thyroid gland, coagulation parameters, the concentration of pregnandiol.
Impact on the ability to drive vehicles and mechanisms
When using the drug orally, care must be taken when driving and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.
On 14 capsules in the blister from PVC / aluminum foil or PVC / PVDH / aluminum foil. 2 blisters with instructions for use in a carton box (28 capsules in consumer packaging).
On 7 capsules in the blister from PVC / aluminum foil or PVC / PVDH / aluminum foil. 2 blisters with the application instruction in a cardboard pack (14 capsules in consumer packaging).
Shelf life 3 years. Do not use after expiration date. Storage conditions Store at a temperature not exceeding 25oС.
Keep out of the reach of children.
Vacation conditions Release prescription. Manufacturer
Name and address of the legal entity in whose name the registration certificate is issued: Bezen Healtha S A
Avenue Louise 287,1050 Brussels, Belgium
Names and addresses of manufacturers (all stages of production): OLIK (Thailand) Limited
Udomsoraut Road 16th quarter, 166, Bangpain Industrial Area, Bangkrason / Bangpain 13160 Ayuthaya Province, Thailand
Sindea Pharma SL
Polygono Industrial Emiliano Revilla Sens. Avenida de Agreda, 31 Olvega, 42110 (Soria) Spain Produced by order of Bezen Healtha SA, Belgium
Secondary packaging and release control: Dobrolek LLC, Russia
115446, Russia, Moscow, Kolomenskiy passage, 13A.
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Description from the author
- Forms of release, names and composition
- Drug action
- Utrozhestan - why take it (indications for use)
- Instructions for use
- Rules for choosing the method of use of the drug (inside or in the vagina)
- Utrozhestan vaginally (candles) - the instruction
- Acceptance of Utrozhestan inside
- How much to use utrozhestan?
- How many weeks of pregnancy to use?
- Drug withdrawal
- special instructions
- Influence on ability to operate mechanisms
- Interaction with other drugs
- Use during pregnancy
- ... when planning a pregnancy
- After utrozhestan
- Discharge against the use of the drug
- Changes in the menstrual cycle under the action of the drug
- Side effects
- Duphaston or Utrozhestan?
- Drug price
Utrozhestan is a drug containing natural hormone progesterone. Most often the drug is used during pregnancy for the prevention of preterm labor and miscarriage. In addition, Utrozhestan is used to treat various conditions and diseases in which there is a shortage of progesterone, such as premenstrual syndrome (PMS), fibrocystic mastopathy and menstrual disorders (lengthening the cycle, painful, prolonged and too abundant menstruation, etc. .). Also, the drug is used in women during the period of menopause and menopause in complex hormone replacement therapy in combination with estrogen to eliminate the menopausal syndrome (sweating, hot flashes, mood swings, nervousness, etc.).
Forms of release, names and composition of Utrozhestan. Currently Utrozhestan is produced in a single dosage form. capsules. Moreover, the capsules are designed for systemic and local application, that is, they can be taken orally, as tablets, or injected into the vagina, as suppositories.
Utrogestan capsules are available in two dosages - 100 mg each and 200 mg each of the active substance. The appearance of the capsules of both dosages is exactly the same - they are soft to the touch, oval in shape with a shiny surface painted in a yellowish color. The outer shell of the capsules consists of gelatin, which makes them soft, shiny and yellowish. Inside the casing, capsules of both dosages contain an oily homogeneous suspension, which is colored white and not phase separated.
As active substance Utrogestan capsules contain micronized natural progesterone in a dose of, respectively, 100 ml or 200 ml. The active ingredient of the drug is a natural hormone, not a synthetic one. In addition, thanks to a special technology, progesterone is micronized, which ensures its best absorption into the bloodstream.
As auxiliary components of the capsule utrozhestan both dosages contain the following substances:
- Peanut butter,
- Titanium dioxide,
- Soy lecithin.
Currently capsules Utrozhestan in everyday life is often called pills or candles. And called Candles burned women imply a dosage form that can be inserted into the vagina. Accordingly, the names Urozhestan pills or Urozhestan capsules indicated forms for oral administration. However, such everyday names are incorrect, since Utrozhestan is available only in the form of capsules, which can be taken orally, like tablets, and injected into the vagina, like candles. But often women do not know that the drug is available in one form, intended both for oral administration and for insertion into the vagina, and therefore, by analogy with other drugs, they are looking for appropriate different dosage forms.
In addition, for a brief and quick labeling of capsules with different dosages, the names are used. Utrozhestan 100 and Utrozhestan 200where the number indicates the content of the active substance.
The action of the drug The action of Utrogestan is provided by its active ingredient - natural progesterone. Accordingly, Utrogestan has the same effect on a woman’s body as progesterone, produced in the corpus luteum in the ovaries.
It is now established that Utrozhestan has the following effect:
1. Promotes the formation of a fairly thick endometrium in the second half of the menstrual cycle.2. It ensures the transition of the endometrium from the proliferative to the secretory phase, in which the mucous membrane of the uterus secretes biologically active substances that provide optimal conditions for the attachment of the ovum.3. When pregnancy occurs, the endometrium is transferred to the state necessary to maintain the development of the ovum before the formation of the placenta (up to 6-8 weeks of gestation).4. Reduces the contractility of the muscles of the uterus and fallopian tubes, which is necessary to maintain pregnancy (if the activity of uterine muscle contractions during pregnancy does not decrease under the action of progesterone, for example, when it is deficient, a spontaneous miscarriage occurs).5. It causes the development of end elements of the mammary glands necessary for breastfeeding (that is, induces lactation).6. It blocks the production of specific substances in the hypothalamus that trigger the release of luteinizing and follicle-stimulating hormone (LH and FSH).7. Increases the production of LH and FSH in the pituitary gland.8. It inhibits ovulation.9. Neutralizes the effects of androgenic hormones.10. Increases urinary frequency.11. Increases the amount of body fat in the body.12. Increases the amount of glucose used by cells.13. Increases the activity and amount of insulin required for glucose utilization.14. Accelerates the accumulation of glycogen in the liver. Dropped off - for which it is taken (indications for use) The general indication for using Utrogestan is the treatment of any conditions and diseases in which there is a shortage of progesterone, confirmed during laboratory blood tests taken on certain days of the menstrual cycle. However, due to differences in the rate of intake and concentration of progesterone in the target organs (uterus, ovaries and fallopian tubes), the indications for taking the capsules inside and for inserting them into the vagina are different.
So, utrozhestan capsules are indicated for oral administration. in the following conditions and diseases:
- Infertility caused by insufficiency of the second (luteal) phase of the menstrual cycle
- The threat of premature birth (starting from the 20th week of pregnancy),
- Prevention of habitual miscarriage in the early stages of pregnancy, which occurred against the background of the luteal phase deficiency,
- Preventing miscarriage when luteal insufficiency
- Premenstrual syndrome,
- Menstrual disorders associated with lack of ovulation or its irregular course, such as amenorrhea (absence of menstruation), oligomenorrhea (scant menstruation), dysmenorrhea (pain during menstruation), dysfunctional uterine bleeding,
- Fibrocystic breast mastopathy,
- Premenopause, menopause and postmenopause, including premature - as a means of hormone replacement therapy in combination with estrogen.
Utrogestan capsules are indicated for insertion into the vagina. in the following conditions or diseases:
- Infertility due to insufficiency of the second phase of the menstrual cycle
- Prevention of habitual miscarriage against the background of the existing failure of the second phase of the menstrual cycle,
- Prevention of threatened abortion in case of insufficiency of the second phase of the menstrual cycle,
- Climax - as a drug for hormone replacement therapy in combination with estrogen,
- Premature menopause
- Non-functioning or remote ovaries - as a drug for hormone replacement therapy,
- Support of the second (luteal) phase of the menstrual cycle during preparation for the procedure of in vitro fertilization,
- Support the second (luteal) phase in a natural or induced menstrual cycle,
- Prevention of uterine fibroids,
- Prevention of endometriosis.
Utrozhestan - instructions for useRules for choosing Utrozhestan's use method (inside or in the vagina)If Utrozhestan is used to treat the following conditions or diseases, then it can be used in the way most convenient for a woman:
- Infertility due to insufficiency of the second phase of the menstrual cycle
- Prevention of habitual miscarriage against the background of the existing failure of the second phase of the menstrual cycle,
- Prevention of threatened abortion in case of insufficiency of the second phase of the menstrual cycle,
- Climax - as a drug for hormone replacement therapy in combination with estrogen,
- Premature menopause.
That is, in the above states, Utrogestan can be used for oral administration as well as for vaginal administration. Moreover, the choice of method of use of the drug is fully determined by the preferences and usability for the woman herself. However, doctors usually recommend taking Utrozhestan inside. Vaginal administration of capsules in a situation where they can be taken orally is recommended in the following two cases:1. Great drowsiness while taking Utrozhestan inside.2. Severe abnormalities of the liver, in the presence of which Utrozhestan is not recommended to be taken inside.
With the threat of premature birth, premenstrual syndrome, fibrocystic mastopathy, and menstrual disorders (scanty menstruation, or their complete absence, pain during menstruation, dysfunctional uterine bleeding), the best way to use Utrogestan is to take the capsules orally, as tablets. However, if a woman is worried about severe drowsiness or has severe liver disease, then you can insert utrogestan into the vagina, however, we repeat that it is preferable to take the capsules inside. With the threat of premature birth (from the 20th week of pregnancy), it is necessary to refrain from vaginal administration of Utrogestan capsules, resorting to this method of using the drug only as a last resort, when for some reason it cannot be taken orally.
When using Utrozhestan to create an artificial hormonal background with non-functioning or absent ovaries, as well as to support the second phase of the menstrual cycle, it is recommended to insert the vagina into the capsule to maintain and maintain pregnancy in the early stages of the capsule. In these cases, it is optimal to introduce Utrozhestan into the vagina, since progesterone from them very quickly is absorbed through the mucous membranes into the local bloodstream and reaches target organs (ovaries, uterus and fallopian tubes).
Also, Utrozhestan capsules are better to be inserted into the vagina, rather than ingested for the prevention of uterine fibroids and endometriosis.
Thus, we can conclude that the intake of Utrozhestan inside is optimal when it is necessary to achieve the systemic effect of the hormone on all organs and systems (pituitary, ovaries, uterus, fallopian tubes, adipose tissue, etc.). And the introduction of capsules into the vagina is optimal only in those cases when a local effect on the ovaries, uterus and fallopian tubes is necessary.
Utrozhestan vaginally (candles) - instructions for use Utrogestan capsules must be inserted deep into the vagina. To facilitate insertion of the capsule, you can moisten your finger with water or use an applicator.
It must be remembered that after the introduction of the capsule utrozhestana in the vagina should lie 40 - 60 minutes. Therefore, in the evening it is better to administer the drug at bedtime, already in bed. And in the morning you need to set the alarm one hour before the time when you need to get up to insert the capsule into the vagina and lie down for 40 to 60 minutes.
Utrozhestan dosages are usually selected individually by a doctor, but standard recommended doses can be used. The average daily dosage is 200 mg, divided into 2 doses - in the morning and evening.
For violations of the menstrual cycle, due to lack of luteal phase (scanty menstruation, or their complete absence, pain during menstruation, dysfunctional uterine bleeding), it is recommended to apply Utrozhestan for 10 days, from 16-17 to 25-26 days of each cycle. However, the day from which it is necessary to apply Utrozhestan can be calculated accurately, and not rely on the average data developed for women with a menstrual cycle length of 28 days. To do this, determine the onset of ovulation with the help of tests or measurement of basal temperature. Starting to enter Utrozhestan capsules into the vagina should be on the 5th day after ovulation, and do so within 10 days. The course of therapy continues for several menstrual cycles in a row.
In the complete absence of progesterone in the body of a woman (with non-functioning or remote ovaries), the utrogestan capsules are administered vaginally according to a certain pattern, which is necessary to keep the pregnancy obtained during the replanting of embryos. Итак, на фоне продолжающегося применения эстрогенов на 13 и 14 дни цикла следует вводить по 100 мг Утрожестана по 1 разу в сутки (лучше вечером).Then from 15 to 25 days of the cycle Utrozhestan is administered 100 mg twice a day - in the morning and in the evening. Next, pregnancy is diagnosed (ultrasound, hCG), and if it has, then, starting from the 26th day of the cycle, 300 mg of utrogestan per day should be injected into the vagina (200 mg in the evening and 100 mg in the morning, or vice versa) within a week. Then, the dosage of Utrogestan is increased by 100 mg, administered 400 mg per day (200 mg in the morning and 200 mg in the evening) for one more week. In the third week, the dose of Utrogestan is adjusted to 500 mg per day, and capsules are administered three times a day at regular intervals of 8 hours. It is optimal to divide the total daily dosage of 500 mg as follows - 200 mg in the morning, 100 mg in the afternoon and 200 mg in the evening. Urozhestan at a dose of 500 mg is also administered during the week. Then, in the fourth week, the dosage of Utrozhestan is adjusted to 600 mg per day, dividing it into three doses with equal intervals between them (approximately 8 hours). That is, the capsules are introduced into the vagina in the morning, noon and evening with 200 mg. At a dose of 600 mg, Utrogestan is used for 60 days (two months), that is, until the end of the first trimester of pregnancy.
To maintain the second phase of the menstrual cycle during IVF, Utrogestan is introduced into the vagina at 400-800 mg per day in two doses (in the morning and in the evening). That is, the daily dosage is divided into two equal (200 - 400 mg), in which capsules are administered in the morning and evening. Begin the use of Utrozhestan from the first day of injection of human chorionic gonadotropin and up to 8 - 16 weeks of pregnancy. After reaching 16 weeks, Utrozhestan is used according to the same indications as for women in whom the pregnancy occurred naturally.
To maintain the second phase in a natural or induced cycle in order to eliminate infertility caused by impaired function of the corpus luteum, Utrogestan must be started up in the vagina 200-300 mg per day (200 mg in the evening and 100 mg in the morning) from 16-17 day of the cycle during 10 days. After 10 days of use of Utrozhestan, pregnancy is detected (ultrasound, hCG), and if it does, continue to use the drug at 200-400 mg 2 times a day.
With the threat of abortion or for the prevention of habitual miscarriage against the background of progesterone deficiency, it is necessary to administer utrogestan 100-200 mg twice a day (every 12 hours) during the first and second trimesters of pregnancy (that is, up to 26 weeks).
Intake of Utrozhestan inside. Capsules must be taken orally with water. It is best to take Utrozhestan 15 - 30 minutes before a meal, but if this is not possible, then you can drink the capsules at any time, regardless of the meal.
Dosages and duration of therapy are recommended to be selected individually in each case. However, standard dosages can be applied, developed and adopted as a kind of averaged standard suitable for the overwhelming majority of women. Changing the standard dosage is only necessary if they are not suitable for this particular woman.
For all diseases caused by insufficiency of the second phase of the menstrual cycle (premenstrual syndrome, fibrocystic breast mastopathy, early menopause, scanty periods, or their complete absence, pain during menstruation, dysfunctional uterine bleeding), It is recommended to take utrozhestan 200 to 300 mg day, divided into two doses - in the morning and evening. That is, in the morning it is necessary to take 100 mg of Utrozhestan and in the evening 100-200 mg. Moreover, between two methods of capsules, it is necessary to withstand an interval of 10 to 12 hours. Utrozhestan take from 16 - 17 to 25 - 26 days of each menstrual cycle for several months in a row. At the same time, if a woman tries to get pregnant, then on the 25th-26th day of each cycle it is necessary to make an early pregnancy detection (ultrasound, hCG), and if one has occurred, then utrogestan should continue to be taken in the same dose until the end of the 12th week of gestation.
To prevent miscarriage and eliminate the threat of termination of pregnancy, Utrozhestan should be taken 100 - 200 mg, 2 times a day (in the morning and in the evening) throughout the first trimester of pregnancy (up to 12 weeks inclusive). If necessary, taking Utrozhestan can be continued during the second trimester of pregnancy, that is, up to 26 weeks.
With the threat of preterm labor, Utrozhestan should be taken every 6 to 8 hours, at 400 mg, up to the normalization of the condition and the disappearance of symptoms, indicating a near onset of labor activity. After the disappearance of these symptoms, Utrozhestan is not canceled, but continues to take 200 mg 3 times a day until 36 weeks of gestation.
Urozhestan with premenopausal (a period when menstruation becomes rare and irregular, but not yet stopped) is used as a means for hormone replacement therapy, along with estrogen. The drug is prescribed 200 mg 1 time per day (preferably in the evening) for 10-14 days. For women who are already in menopause (menstruation is absent for more than a year), Utrozhestan is prescribed 100 mg once a day in a continuous mode for a long time.
How long to use Utrozhestan? Urozhestan use duration is determined by the purpose of its use. That is, in fact, Utrozhestan should be applied until the goals are achieved. For example, if a woman takes Utrozhestan on the background of insufficiency of the second phase of the menstrual cycle in order to become pregnant, then the drug should be taken until conception occurs. And after conception it is necessary to continue taking Utrozhestan without interruption until the end of the first trimester of pregnancy.
If a woman takes Utrozhestan to save pregnancy in the face of the threat of miscarriage, then the capsules should be used until the danger is completely eliminated. As a rule, the risk of miscarriage persists throughout the first trimester of pregnancy, that is, until the 13th week of gestation. This means that you need to take utrozhestan before the start of 13 weeks or even longer - up to 18 - 20 weeks of pregnancy. If Utrozhestan is used to eliminate the threat of preterm birth, it should be taken before 36 weeks of gestation.
If therapy is carried out fibrocystic mastopathy or premature menopause, you should continue to take Utrozhestan until the condition is normalized. In the period of menopause Utrozhestan can be taken for a long time (for years), as long as there is a need and an opportunity to maintain hormonal levels in the body at the level of the fertility period.
Until how many weeks of pregnancy to apply? The answer to this question depends on what occasion Utrozhestan is taken on, and what is the course of the pregnancy. So, if a woman took Utrozhestan with the purpose of becoming pregnant, then the capsules should continue to be used until the end of the 12th week of pregnancy in order to prevent a possible miscarriage. Further, at 12–13 weeks, a survey is carried out, and if there is no threat of miscarriage, then Utrozhestan is canceled. If the threat of miscarriage still persists, the drug continues to take up to 16 - 18 weeks.
If a woman becomes pregnant naturally and takes Utrozhestan to prevent the threat of miscarriage in the early stages, then it should be drunk until 7–8 weeks, since it is during this period that the placenta is formed and the probability of spontaneous abortion is reduced to almost zero. If, later on, during pregnancy, the threat of miscarriage or premature birth recurs, then Utrogestan is taken again, and continues until the state normalizes and the danger is eliminated.
If a woman takes Utrozhestan for the prevention of preterm labor, the capsules should be drunk before the beginning of the 37th week of pregnancy.
If Utrozhestan was used as support in the IVF program, then it will continue to be taken until 7–8 or 16–17 weeks of gestation. Foreign experts prescribe Utrozhestan only until the 8th week of pregnancy, because after that the placenta is fully formed and takes on the production of the required amount of progesterone. That is, the retention and development of pregnancy no longer depends on the corpus luteum, and therefore there is no point in continuing hormonal support. Doctors from the countries of the former USSR prescribe Utrozhestan before the 16th week of pregnancy, because traditionally they consider the drug to be not only hormonal support for pregnancy in the early stages, when insufficiency of the corpus luteum can cause miscarriage, but also to prevent the threat of spontaneous abortion.
Cancellation of Utrozhestan In Russia and other CIS countries there is a widespread opinion and the practice of gradual abolition of Utrozhestan is widespread, since it is a hormonal drug and the body gets used to it. However, this position is wrong and is based solely on speculative ideas. In fact, in the course of numerous clinical observations and experiments on animals, it was shown that Utrogestan is not addictive and therefore it can be canceled immediately and completely, without any gradual reduction in dosage. In Western countries, this is exactly what they do, that is, they cancel Utrozhestan immediately and completely. At the same time, it is necessary to be prepared for the fact that after drug withdrawal within 2 to 7 days, spotting may be observed, which is a normal reaction of the body. If the amount of discharge does not increase, then everything is fine, and there is no need to consult a doctor. If the amount of discharge increases over time, then you should consult a doctor.
However, in the CIS countries, traditionally, it is recommended to cancel Utrozhestan gradually, reducing the dosage by two times every 4 to 5 days. For example, if a woman took Utrozhestan 200 mg per day, then after 5 days it is necessary to reduce the dosage to 100 mg per day. After another 5 days - cancel completely, since less than 100 mg can not reduce the dosage of Utrogestan, since the capsule can not be cut because of the liquid contents.
Specific indicationsTroustan cannot be used as a contraceptive. Dosage of the drug, currently used, do not have any contraceptive effect.
At the beginning of the application of Utrozhestan in the first phase of the menstrual cycle, that is, before ovulation (especially before 15 days), bleeding or shortening of the cycle may occur.
In the presence of uterine bleeding, it is impossible to use Utrozhestan without examining the state of the endometrium and identifying the cause of this pathology.
Reception of Utrozhestan should be immediately canceled when the following symptoms appear:
- Loss of vision
- Double eyes
- Vascular lesions of the retina,
- Thrombosis or thromboembolism of any arteries and veins,
- Strong headache,
If a woman has any of the above symptoms after using Utrozhestan, then you should immediately consult a doctor.
Influence on the ability to control the mechanisms. Since oral Utrozhestan can cause drowsiness and dizziness, this method of using capsules should be refrained from any activities related to the need to have a high reaction rate and concentration. With vaginal administration, Utrozhestan does not cause drowsiness and dizziness, therefore, with this method of use of the drug, you can engage in any type of activity. Overdose Usually, the appearance of side effects of the drug is associated with its overdose. Moreover, to eliminate them, it is enough just to reduce the dose of Utrogestan, after which the side effects quickly disappear. , Tetracycline, doxycycline) the concentration of progesterone in the blood can increase significantly. Therefore, when applying Utrozhestan with these drugs, it is recommended to reduce its dosage.
Urozhestan increases the effects of diuretic and antihypertensive drugs, as well as immunosuppressants and anticoagulants (warfarin, heparin, Fraxiparin, etc.).
Utrozhestan reduces glucose tolerance, so in women with diabetes, it is necessary to increase the dosage of insulin or other antidiabetic drugs against the background of its use.
Utrozhestan during pregnancy Utrozhestan is approved for use in the I and II trimesters of pregnancy (until the 27th week). In the III trimester (from the 27th week up to the birth) it should be applied with care and strictly according to indications. When using Utrozhestan on the gestational period of more than 13 weeks, it is necessary to regularly monitor the condition of the liver by taking a blood test for the activity of AST, ALT and ALP.
In pregnancy, Utrozhestan is used to prevent miscarriage and premature birth. Currently, it is shown that the drug actually reduces the likelihood of losing a pregnancy if a woman has progesterone deficiency or complete ovarian dysfunction. However, progesterone deficiency and ovarian dysfunction are very rare in reality, and Utrozhestan is prescribed to almost every pregnant woman in the countries of the former USSR.
This means that in the overwhelming majority of cases, pregnant women in post-Soviet countries are prescribed Utrozhestan for “prevention” and for complacency. By “prevention” is meant such a widespread diagnosis as “threatened miscarriage”, which is given to almost all women and, accordingly, Utrogestan is prescribed. Naturally, in most cases there is no threat of abortion, but women are very afraid of miscarriage and, accordingly, are nervous about any unfamiliar sensation, looking for "signs" of something bad. As a result, the woman literally tormented herself with the fact that she had “the threat of miscarriage”, “micro-lacrimal egg” and other fantastic conditions that, in her opinion, would lead to loss of pregnancy, to prevent what she goes to the doctor.
The psychological state of such women is such that they need help not from a gynecologist, but from a psychologist or psychotherapist. However, doctors prefer not to engage in long conversations with women, but simply go towards patients, helping them not only physically endure the child, but also providing psychological comfort, which is also very important.
“Complacency” refers to the doctor’s desire to prescribe, and women to take something to improve pregnancy and reduce the theoretically possible risk of miscarriage. It is intuitively clear that such a position is also not correct, but from the point of view of psychological comfort it seems quite justified.
When planning pregnancy, Utrozhestan is prescribed for the purpose of hormonal support of the second phase of the menstrual cycle, if the woman has a deficiency of the corpus luteum. By deficiency of the corpus luteum implies insufficient progesterone production in the ovaries, as a result of which the second phase of the menstrual cycle is extended, the endometrium does not increase to the required level, and pregnancy does not occur or ends in miscarriage in the early stages. In this case, taking Utrozhestan provides a normal level of progesterone in the blood, which is not produced in sufficient quantities by the corpus luteum in the ovaries, and gives the woman the opportunity to become pregnant and bear the child.
When planning a pregnancy, Utrozhestan is usually taken from 16–17 to 25–26 days of each menstrual cycle. Moreover, if the pregnancy results from the test results (ultrasound, hCG), then, as a rule, Utrozhestan is continued until 7–8 or even 12 weeks of gestation, as this allows you to prevent miscarriage due to corpus luteum insufficiency.
Read more about pregnancy planning.
After UtrozhestanaAfter Urozhestan cancel, women may appear brown or reddish scanty or moderate vaginal discharge. Such secretions are a normal reaction of the body to the abolition of progesterone and are usually completely stopped within 5 to 10 days. If the amount of secretions increases, or they become bloody, then you should consult a doctor, as this can be a symptom of various diseases and conditions that require medical assistance. Secrets during the use of the drug Most women with vaginal application of Uritestan show liquid or flocculent discharge, painted white. Sometimes the discharge is almost colorless, like water. In a small number of women (about 10%), brownish or slightly reddish spotting appears on the background of utrozhestan's vaginal application. Both variants of discharge are variants of the norm, therefore, when they appear, do not be afraid. Однако если количество коричневатых выделений увеличивается, то рекомендуется обратиться к врачу для обследования.Изменения менструального цикла под действием УтрожестанаУтрожестан может изменять нормальный или обычный для каждой конкретной женщины менструальный цикл. Причем цикл может как удлиняться, так и укорачиваться. У большей части женщин менструальный цикл удлиняется на 2 – 14 дней, а у меньшей, напротив, укорачивается на 2 – 10 дней или остается неизменным. В некоторых случаях при приеме Утрожестана менструации становятся более скудными или вовсе исчезают полностью.After discontinuation of the drug, the menstrual cycle, as a rule, is fully restored to the variant that was before the initiation of utrogestan.
If a woman has shortened the cycle or there was a spotting on the background of the use of Utrozhestan, then it is recommended to postpone the beginning of its reception on the 19th day and take up to the 28th day of the menstrual cycle, and not from 16-17 to 25-26.
Side Effects Surgeon may cause the following side effects:
- Allergic reactions, rash on the skin and itching,
- Drowsiness (only for taking capsules inside),
- Headaches, turning into dizziness (only for receiving capsules inside),
- Intermenstrual bleeding,
- Shortening of the menstrual cycle
- Jaundice due to cholestasis.
ContraindicationsUtrozhestan is contraindicated for oral and topical use in the following diseases or conditions:
- Hypersensitivity or allergic reaction to any components of the drug,
- Bleeding from the vagina of unknown origin,
- Incomplete miscarriage
- Suspected or diagnosed malignant neoplasms of the mammary glands and genitals.
Besides, in addition to the above for the reception of Utrozhestan inside have the following contraindications:
- Propensity for thrombosis,
- Sharp phlebitis
- Severe liver disease,
- Liver failure.
The listed contraindications are absolute, that is, if they exist, Utrozhestan cannot be taken under any circumstances. In addition to such absolute, there are relative contraindications, in the presence of which Utrozhestan can be applied, but with the observance of caution and under the supervision of a physician.
Relative contraindications The application of Utrozhestan include the following:
- Diseases of the cardiovascular system,
- Hypertonic disease,
- Chronic renal failure
- Bronchial asthma,
- Hyperlipoproteinemia (elevated levels of different lipid fractions in the blood - triglycerides, HDL, LDL, VLDL),
- Breastfeeding period.
The composition of one capsule includes 100 or 200 mg extracted from yam progesterone (in micronized form), and peanut butter (Arachis hypogaea), lecithin (Lecithin) soy, glycerol (Glycerol), gelatin (Gelatin), additive E171 (titanium dioxide).
- Capsules Utrozhestan 100 mg, packing No. 30,
- capsules utrozhestan 200 mg, pack №14.
Pharmacological action Pharmacodynamics and pharmacokinetics
Effects of Utrozhestan due to the properties contained in progesteronewhich is an analogue of natural biological progesteroneproduced by the corpus luteum of the ovaries after ovulation, and also - in pregnant women - by the placenta.
Under influence progesterone lining uterine cavity mucous thickens and becomes secretory, which contributes to the consolidation of the fertilized egg in it and the normal development of pregnancy further.
In pregnant women progesterone reduces contractility and excitability of uterine muscles and fallopian tubes.
Blocks the secretion of regulating the release of FSH and LH hormones pituitary, inhibits ovulation and gonadotropin production by the pituitary gland. Androgenic properties are not detectable.
Plasma concentration progesterone begins to rise from the first hour after taking the capsules and reaches maximum values in 1-3 hours. After an hour, this figure is 4, .25, after two hours - 11.75, after four hours - 8.37, after six hours - 2, and after eight hours - 1.64 ng / ml.
Two thirds of the dose progesterone metabolized in the liver. Mostly detected in urine pregnenolone and pregnandiol (metabolites are identical to those formed during physiological secretion).
Said derivatives progesterone play an important role in the education and exchange of other steroid hormones. From 15 to 60% of metabolic products excreted by the kidneys, a little less than a third - with feces.
Pharmacokinetics with intravaginal use
Progesterone when administered parenterally absorbed in the mucous. Absorption is fast. Plasma concentration begins to rise from the first hour after the drug. Its highest level reaches in 1-3 hours.
The use of Utrogestan capsules overnight allows you to achieve and maintain a stable and physiological concentration. progesterone in plasma, which corresponds to that in the corpus luteum phase (luteal phase) cycle in women with normal ovulation.
Thus, the drug stimulates the adequate maturation of the internal mucous membrane of the uterus and contributes to the normal implantation of the embryo.
The use of a dose exceeding 200 mg / day., Intravaginal use of Utrogestan does not allow to reach plasma levels. progesterone, which would be identical to that in the first 3 months of pregnancy.
Exchange products in urine and blood plasma identical to metabolic products that are found in body fluids during the formation of endogenous progesterone.
About 95% of the dose is excreted. metabolites (main - pregnandiol) with urine.
Indications for use
Utrozhestan: why it is taken inside?
And to obstetric practice, Utrozhestan is used for miscarriage threat warnings or common miscarriage against the background of luteal phase deficiency (NLF), as well as for prevention of the threat of preterm birth.
Also, oral administration of the drug is indicated for those associated with deficiency. progesterone gynecological disorders, including PMS, disruptions of the menstrual cycle (dysfunction or anovulation), mammary gland PCF, premenopausal conditions, infertilitycaused by luteal insufficiency, HRT in women with menopausal disorders (in combination with estrogen—Containing drugs).
Indications for use Utrozhestana vaginally
As candles, Utrozhestan applies:
- with hormone replacement therapy for non-functioning ovaries in the framework of the program oocyte donation,
- with IVF (to maintain the phase of the corpus luteum at the stage of preparation for fertilization of the egg),
- to maintain the corpus luteum phase in the induced / spontaneous cycle,
- for the prevention of conditional progestin failure spontaneous / habitual miscarriage,
- at endocrine sterility,
- at endometriosis,
- at uterine myome,
- if there are restrictions for oral administration of the drug or when it is impossible.
Contraindications to the use of Utrozhestan:
- severe disorders of the liver,
- vaginal bleeding of obscure nature,
- incomplete / unsuccessful abortion,
- cerebral hemorrhage
- thromboembolic disorders
- genital / mammary gland neoplasia (confirmed or suspected),
- hypersensitivity to any of the substances contained in the capsules.
Side effects Utrozhestana
Side effects Utrozhestana oral administration most often manifested in the form of:
- changes in the cycle of menstrual bleeding,
- bleeding starting in the middle of the cycle
- transient dizziness,
- cholestatic jaundice.
In rare cases, nausea may occur.
The category of extremely rarely occurring (no more than 1 in 10 thousand women) side effects include depression, chloasma, hives.
It also does not exclude the possibility of changes in libido, the appearance of chest discomfort and / or symptoms characteristic of PMS, hyperthermia, alopecia, insomnia, hirsutism, pulmonary embolism, venous thromboembolism, changes in body weight, gastrointestinal disorders, fluid retention, anaphylactic hypersensitivity reactions.
Transient dizziness and / or drowsiness are especially pronounced with concomitant hypoestrogenism. To eliminate these phenomena (without reducing the therapeutic effect), it is usually sufficient to increase the dosage. estrogen or reduce the dose of the drug.
If treatment is started before the 15th day of the cycle, a cycle may be shortened. There may also be occasional bleeding.
If Utrozhestan tablets are inserted into the vagina, side effects are expressed as hypersensitivity reactions (hyperemia, itching, burning) and the appearance of oily secretions.
Reviews of side effects Utrozhestana (including during pregnancy) allow us to conclude that the greatest number of unpleasant effects occur after taking the capsules inside. To reduce their severity of the capsule should be taken at bedtime or switch to intravaginal administration.
Capsules Utrozhestan: instructions for use
The method of application, as well as instructions on how best to take Utrozhestan, how long to continue the treatment and how to cancel the drug, depend on the indications for use and the clinical manifestations of the pathology.
Instructions for use utrozhestan inside
Inside, as a rule, the drug is prescribed to take a dose of 200-300 mg / day. At the main (in the evening, before going to bed) reception accounts for 200 mg, in the morning (if there is a need), another 100 mg is taken.
With luteal insufficiency (PMS, FCS, premenopause, cycle failures) tablets take ten-day courses starting from the 17th day of the cycle.
When HRT in menopause due to the fact that a separate therapy estrogen—Containing drugs is not recommended, Utrozhestan is used as an adjunct to the main treatment.
To start taking the drug should be 7 days after the start of each course of HRT. Duration of application - 2 weeks. It should be remembered that during the HRT may be withdrawal bleeding.
To prevent preterm labor (PR), the drug is taken 3-4 p. / Day., At regular intervals. Single dose - 400 mg. After the disappearance of the clinical manifestations of the threat of PR, the dose is gradually reduced to supporting — 600 mg / day: the capsules continue to be taken at one 3 p. / Day.
Regarding the week before taking the drug, the instructions include the following recommendations: taking during pregnancy at a dose of 600 mg / day. possible up to 36 weeks.
Use progesterone for periods longer than 36 weeks is not recommended.
How correctly to enter Utrozhestan intravaginal capsules?
Capsules are inserted into the vagina as deep as possible. The average daily dose of the drug for intravaginal use - 200 mg (1 capsule 200 mg 1 p. / D. Or 2 capsules 100 mg. 2 p. / D.). If necessary, for greater convenience, you can use the applicator.
Depending on the woman's response to the prescribed treatment, the dose may be increased.
With partial NLF (“ovulation syndrome”, cycle failure) Utrozhestan is applied for 10 days at a dose of 200 mg / day. Treatment begins with the 17th day of the cycle.
With full NLF in women with missing (non-functioning) ovaries (oocyte donation) prescribed 100 mg of progesterone in the morning and evening from 15 to 25 day of the menstrual cycle.
If pregnancy is confirmed on the 26th day of the cycle, from this point on, the dose is gradually increased by 100 mg / day, bringing it up to a maximum of 600 mg / day. (one capsule 200 mg per dose).
In this dosage, candles Utrozhestan continue to apply up to 60 days.
During the IVF cycle, 1 capsule of 200 mg is administered once every 8 hours.
In pregnancy, when there is a chance of interruption, as well as to prevent habitual miscarriage associated with progesterone deficiency, a woman under 12 weeks should be given every 12 hours for 100 or 200 mg of progesterone.
It is very important to properly enter the capsules into the vagina, especially when the drug is prescribed for hormonal support in IVF. Before inserting the capsule, lie on the bed, placing a pillow under the buttocks and lower back, spread your legs wide and place the tablet as deep as possible into the vagina.
After that, in order for the active substance of the drug to be absorbed into the mucous membrane in the right amount, it is recommended to remain in bed in the same position for another 15 minutes to an hour.
Symptoms of overdose may manifest symptoms of side effects of the drug: drowsiness, euphoria, dizziness, metrorrhagiaby shortening the cycle time dysmenorrhea.
For some women, the standard dose may be too high due to existing or secondary endogenous secretion. progesterone, hypersensitivity to Utrozhestan or a concomitant reduced level estradiol at of blood.
If transient dizziness or drowsiness appears, it is enough to reduce the dose. progesterone or prescribe a drug in the evening (before bedtime).
By reducing the cycle and metrorrhagia the start of treatment is postponed to a later day of the cycle (for example, from 17 to 19 day).
In patients receiving HRT in premenopausal, it is necessary to monitor the level of estradiol.
Women who are prescribed treatment during menopause estrogen containing drugs, it is recommended to start reception no later than the 12th day of the cycle progesterone.
If the treatment of the threat of PR drug is combined with β-adrenomimeticsthe latter can be used in a lower dose.
Simultaneous use of other medicines may interfere with pharmacokinetics. progesteronewhile causing an increase or, conversely, a decrease in its concentration in the plasma and, thus, leading to a change in the action of the drug.
Drugs that Powerfully Induce enzymes liver (antiepileptic drugs, barbiturates, Phenylbutazone, Griseofulvin, Rifampicin, Spironolactone) contribute to strengthening metabolismprogesterone in the liver.
Separate antibiotics (in particular, tetracyclines, ampicillins) may upset intestinal balance microfloradue to which it may change enterohepatic steroid cycle.
It is known that these drug interactions are individual and may differ significantly in different categories of patients. Definitely predict their possible clinical manifestations can not.
Everything progestin drugs tend to reduce glucose tolerance, which may require the need to increase a single dose oral hypoglycemic agents and insulin in patients diabetes mellitus.
Smoking reduces bioavailability progesterone, alcohol - its increase.
Capsules should be stored at a temperature not exceeding 25 ° C.
Treatment in recommended doses does not provide a contraceptive effect.
Because of the likelihood of metabolic disorders and thromboembolic complications It is necessary to cancel the drug when it appears:
- visual impairment, including his loss, ghosting of visual images, retinal vascular lesions, swelling of the optic nerve head, proptosis,
- thrombotic or thromboembolic venous complications (no matter which site is affected)
- high intensity headache migraine.
Patients with thrombophlebitis history should be under constant medical supervision.
The absence of menstruation during treatment with Utrozhestan requires tests to confirm or exclude pregnancy, which may be the cause amenorrhea.
More than 50% of spontaneous abortions in early pregnancy are due to genetic complications. In addition, the cause of abortion may be mechanical disturbances and infectious diseases. In such cases, the use of drugs progesterone It is justified only in cases when there is a delay in expulsion of the ovum.
Proceeding from this, the appointment of Utrozhestan on the recommendation of the gynecologist should be provided for cases when the woman’s body produces an insufficient amount of progesterone.
Capsules should not be taken with food. The optimal reception time is at bedtime. Simultaneous consumption of food increases the bioavailability of Utrozhestan.
Some women are interested in whether the drug has an effect on the level of hCG. Doctors claim that Utrozhestan does not change the results blood test for hCG.
Utrozhestan follows - what to do?
All patients note that with intravaginal use of the drug follows. The manufacturer and doctors say that such a phenomenon is the norm. The appearance of oily secretions associated with the dosage form Utrozhestana and its composition, in which there are fatty substances - vegetable oil and soy lecithin.
Some women worry that this may reduce the effectiveness of utrozhestan. However, doctors and then rush to reassure, assuring that it is not the active substance that flows out, but only the capsule shell.
In some cases, when the drug is used several times a day, the doctor may recommend intravaginal administration of only 1 p. / Day - at bedtime, and at other times - in the morning and in the afternoon - oral administration of capsules.
Utrozhestan and monthly
Utrozhestan is prescribed for the correction of violations of the cycle, the cause of which is endogenous progesterone deficiency, as well as for the correction of violations caused by excessive production estrogen.
The delay in menstruation with the use of medication may indicate pregnancy. In this case, the woman must donate blood to determine the level of hCG or make pregnancy test.
The situation when there is no menstruation after consuming the drug can also be a consequence of the “blind” support of the 2nd phase of the cycle, when the time of ovulation is not taken into account.
Women planning pregnancy, doctors recommend taking Utrozhestan not from 16 days, but a day after ovulation.
Preparations progesterone can be used to call monthly. Menstrual bleeding is caused by the effect of the abolition of Utrozhestan. The onset of menstruation usually occurs at 2-10 days after discontinuation of capsules.
Analogs of UtrozhestanMatches for ATC code 4th level:
Structural analogues: Yiprozhin, Kraynon, Prozhestozhel, Progesterone, Prajisan.
Analogs with a close mechanism of action: Oxyprogesterone Capronate, Medroxyprogesterone LENS.
Prajisan and Utrozhestan - the difference?
Prajisan belongs to the group of drugs progesterone and is a generic of Utrozhestan. Consequently, the difference between these means is small.
Prajisan, in contrast to its structural analogue, is not only available in the form of capsules for oral administration and intravaginal use, but also in the form of a gel, which is inserted into the vagina using a disposable applicator.
Which is better - Kraynon or Utrozhestan?
A drug Kraynon - This is a vaginal gel, produced by the manufacturer in disposable applicators. Active substance - progesterone, which is contained in the drug at a concentration of 90 mg / dose (1 dose = 1.125 g of gel).
The peculiarity of the drug is that the gel is placed in the polymer delivery system, which provides a high degree of binding to the vaginal mucosa and a continuous release of the active substance for at least three days.
Iprozhin or Utrozhestan - which is better?
Iprozhin - These are capsules that contain 100 or 200 mg progesterone (micronized). The main difference of the drug from Utrozhestan is that with intravaginal use it practically does not follow from the vagina, which, in the opinion of many women, is more convenient.
In the annotation to Yprozhinu indicated that he is able to enhance the action immunosuppressants, diuretics, anticoagulants and antihypertensive drugsand also reduce lactogenic effect Oxytocin.
Compatibility with alcohol
Alcohol increases the bioavailability of the drug.
Urozhestan during pregnancy
Does Utrozhestan help pregnant?
Utrozhestan when planning pregnancy is necessary when in the course of tests revealed failure of the 2nd phase of the cycle.
The use of the drug stimulates the formation of the endometrium of the secretory type, contributes to the transition of the uterine mucosa from the proliferative to the secretory phase, and then, when fertilization takes place, to its transition to the optimal state for the development of a fertilized egg.
The endometrium that swells under the action of Utrozhestan becomes friable, making it easier for the egg to adhere to the wall of the uterus.
In addition, Wikipedia states that progestins also help reduce the excitability and contractility of the muscles of the uterus and fallopian tubes, prevent the increase in concentration estrogen in phase 2 of the cycle and contribute to nervous relaxation, thus creating conditions favorable not only for conception, but also to maintain the normal course of pregnancy.
Analyzing the reviews about whom Utrozhestan helped to get pregnant, we can conclude that the drug is effective in those situations when the cause of infertility is low endogenous progesterone. If there are no other obstacles to conception, pregnancy occurs fairly quickly with the use of the medicine.
How to take a drug when planning a pregnancy?
Recommendations on how to take Utrozhestan to get pregnant, due to the severity of deficiency endogenous progesterone.
As a rule, when trying to get pregnant, the drug is taken for ten days in each cycle, starting from day 16. On the 25-26 day should make a pregnancy test or donate blood to determine the level of hCG.
If the pregnancy is not confirmed, the drug is stopped and resumed in a new cycle, adhering to the same regimen.
If there is reason to suspect pregnancy, it is impossible to stop taking Utrozhestan - abrupt cancellation during pregnancy may cause spontaneous interruption. If the test is positive, the drug is continued for up to 12-16 weeks.
If a miscarriage is threatened, intravaginal administration of capsules is recommended, since this method of administration allows one to achieve the concentration necessary to maintain pregnancy. progesterone it is on the walls of the uterus.
Women whose ovaries do not produce at all progesteroneUtrozhestan is prescribed intravaginally according to the following scheme:
- 100 mg / day. on the 13th and 14th days of the cycle,
- 200 mg / day. Divided into 2 doses, from 15 to 25 days,
- from 200 to 800 mg / day. (daily dose increased to 100 mg to the maximum) - from day 26 (provided that the pregnancy was confirmed).
How to take utrozhestan during pregnancy?
The use of Utrozhestan during pregnancy does not adversely affect the fetus. If necessary, use after the third month of pregnancy requires monitoring the functional state of the liver.
There is evidence that the use of progestogens in pregnant women to prevent habitual / spontaneous miscarriage on the background of the NFL can lead to hypospadias.
In the early stages of the risk of miscarriage, the drug is recommended to be used vaginally, since with this method the therapeutic effect develops faster and the load on the liver is minimal. Also candles are recommended to appoint women who suffer from strong toxicosis.
The treatment regimen and dosage for each specific patient are selected by the doctor individually.
When it comes to preserving pregnancy, the initial dose is usually between 400 and 600 mg. Subsequently, a woman is transferred to maintenance treatment at a dose of 200 mg / day. up to 600 mg / day. With ineffective therapy, the dose can be increased to 0.8-1 g / day. Treatment usually lasts up to 18-20 weeks.
In the 2 nd and 3 rd trimester, the use of Utrozhestan is advisable when the clinic renews the threat of termination of pregnancy, as well as in a situation where a woman develops a CNIcervical insufficiency).
The route of administration for such a period does not matter. Reviews of doctors and their patients allow us to conclude that the use of the drug in a daily dose of up to 300 mg up to 36 weeks inclusive is equally effective as when taking the capsules inside, and when introducing them into the vagina.
Up to 34-36 weeks, until the uterine tone is removed, the capsules are ingested 1 every 8 hours. Then the woman is prescribed maintenance treatment at a dose of 200 mg.
Side effects of the drug
The most frequent side effects of Utrozhestan are manifested in the form of drowsiness, lethargy and dizziness. However, these unpleasant symptoms occur solely when taking capsules orally.
Since Utrozhestan is a hormonal agent, the question naturally arises - is it possible to recover from it? Doctors say that taking capsules does not cause changes in body weight. This is due to the fact that the drug does not affect metabolism carbohydrates and lipids, and also does not retain fluid in the body.
Discharges during pregnancy after the drug (with the intravaginal method of administration) are not a side effect if there are no bloody impurities in them, it is simply a melted capsule shell. The appearance of bleeding requires dose adjustment.
How much to take utrozhestan during pregnancy?
Just say how long to take Utrozhestan during pregnancy in one case or another, only a doctor can. If the pregnancy occurred during treatment progesterone, capsules continue to be taken on average for 2 months, starting from the 26th day of the cycle in which the conception took place.
What is better - Duphaston or Utrozhestan during pregnancy?
Duphaston, like its counterpart, is used to compensate for the deficit endogenous progesterone.
The main difference between drugs is that the first is a synthetic analogue progesteroneand the second - the only one to date progesteronewhich is obtained from plant materials.
Efficiency Duphaston and Utrozhestan when planning pregnancy and in pregnant women is comparable.
The advantages of Duphaston are the absence of a sedative effect, which, when using Utrogestan, is manifested by drowsiness and lethargy, as well as a long experience of use.
The advantages of utrozhestan are the ability to affect the exchange of androgens and suppress the effects oxytocinthus improving the course of pregnancy.
Use during lactation
Ability progesterone penetrate into breast milk has not been studied, and therefore the use of the drug should be avoided during breastfeeding.
Reviews about Utrozhestan
On forums, the main part of feedback on Utrozhestane is positive. The drug is effective in endometriosiscaused by deficiency progesterone cycle violations, when planning pregnancy.
It also helps to normalize the hormonal background of a woman during menopause and is used to maintain phase 2 of the cycle, when IVF is used to conceive.
Reviews about Utrozhestan during pregnancy are also extremely positive. Most women believe that only through the use of the drug in the first weeks of pregnancy, they were able to preserve and carry out the child.
The drug has a unique structure of the molecule, thanks to which it normalizes the exchange of steroid male sex hormones, which are present in the body of a pregnant woman, and thus contributes to the normal course of pregnancy and improve skin condition.
The ability to interact with the same receptors with which they interact androgens, makes it appropriate to use Utrozhestan, including in women suffering from hyperandrogenism.
Reviews of doctors and reviews of pregnant women who took Utrozhestan in the later stages of pregnancy, allow us to conclude that one of the most important properties of progesterone is its tocolytic activity.
In the later stages of pregnancy, the tocolytic effect is especially necessary for women who do not tolerate well. antiprostaglandins and β mimetics or have contraindications to the use of these drugs.
The advantages of the drug are different dosages of the active substance in capsules (100 mg and 200 mg), as well as the ability to apply them inside and as vaginal suppositories.
The only drawback is, perhaps, side effects, which manifest themselves in the form of dizziness, lethargy and increased sleepiness. It should, however, be noted that such phenomena occur exclusively upon oral administration of Utrozhestan.
How much is utrozhestan?
The cost of the drug in different cities of Ukraine is almost the same. So, for example, the price of Utrozhestan 200 mg in Kharkov, in Lugansk, in Odessa or in Dnepropetrovsk for packing No. 14 varies from 270 to 285 UAH. Buy capsules of 100 mg in Kiev and pharmacies of other regional centers can, on average, for 280 UAH.
Price Utrozhestan 100 mg in Russia - 370-400 rubles. Candles (tablets) 200 mg cost 400-450 rubles.
Price Utrozhestan 100 mg in Belarus - 150-225 thousand rubles, Utrozhestan 200 mg - 162-240 thousand rubles.
- Online pharmacy RussiaRussia
- Internet pharmacies of UkraineUkraine
- Online Pharmacy KazakhstanKazakhstan
Urozhestan capsules 200 mg 14 pcs.
Urozhestan capsules 100 mg 28 pcs.
Urozhestan 200mg №14 capsulesOlic (thailand) Ltd
Urozhestan 100mg №28 capsulesOlic (thailand) Ltd
Utrozhestan 100mg №30 capsulesLaboratoires Besins International
Utrostan caps. 100mg №30Besins Iskovesko Lab.
Utrostan caps. 100mg №30Besins Iskovesko Lab.
Utrozhestan 200 mg No. 14 caps. Bezen Manewechking Belgium (Belgium)
Utrozhestan 100 mg No. 30 caps. Bezen Manewechking Belgium (Belgium)
NOTE! Information about drugs on the site is a reference and summarizing, collected from publicly available sources and can not serve as a basis for making decisions about the use of drugs in the course of treatment. Before using the drug Utrozhestan, be sure to consult with your doctor.
Indications for use Utrozhestan at the planning stage of pregnancy
The luteal phase deficiency is the main indication of taking Utrozhestan and similar drugs (Kraynon, Susten and others) at the planning stage of pregnancy. In addition, Utrozhestan is declared by the manufacturer for the treatment of:
- Premenstrual tension syndrome (PMS), as well as algomenorrhea or painful menstruation,
- Menstrual disorders,
- Fibrocystic mastopathy, pain and engorgement of the mammary glands before menstruation,
- Hormone replacement therapy for menopause or post-sterilization syndrome with estrogen medications.
It should be noted that for the treatment of NLF, a synthetic drug didprogesterone (Duphaston) is preferable than natural progesterone. Utrozhestan and the drugs of his group are recommended by the WHO in the treatment of cervical insufficiency and threatened abortion for periods of more than 20 weeks of pregnancy. Utrozhestan is also widely used in conjunction with Duphaston in IVF protocols and in emergency aid in the event of a threatening miscarriage.
This does not mean that at the planning stage, Utrozhestan is not shown. It can be used in case of intolerance or adverse reactions to didrogesterone. There are situations in which vaginal administration of the drug is preferred, which Duphaston cannot provide.
Canceling Utrozhestan: how to stop taking the drug correctly
Before discontinuing the drug, it is necessary to clarify the presence of pregnancy with a test. High-quality pregnancy tests, performed in the morning, can show pregnancy even before the expected menstruation.
- With a negative result, the drug should be canceled and wait for the new menstrual cycle.
- In the case of pregnancy Utrozhestan abruptly does not cancel, and on the advice of the attending physician gradually reduce the dosage and frequency of use.
- If the test previously showed no pregnancy, and menstruation after discontinuation of the drug does not occur in for 10 days, you must repeat the pregnancy test or undergo an ultrasound. In the case of a positive result of the hCG test or pregnancy confirmed by ultrasound, the decision on the further admission of progesterone should be decided together with your doctor.
Alexandra Pechkovskaya, obstetrician-gynecologist, especially forMirmam.pro
Amenorrhea is the absence of a woman's menstruation (menstruation) for more than six months. This is not an independent disease. Amenorrhea can be a normal physiological state in certain periods of a woman’s life, and can also be a symptom of specific pathological disorders (genetic, anatomical, biochemical, physiological, or neurogenic).
According to medical statistics, at the fertile (child-bearing) age, a complete absence of menstrual cycles for six months or more is observed in 5-15% of women.
Classification and reasons for the absence of menstruation
There are the following types of amenorrhea:
- True, in which menstruation is absent due to hormonal imbalance, pathological processes in the ovaries.
- False, which is diagnosed in the absence of a monthly discharge of blood from the genitals, but in the presence of a normal menstrual cycle and cyclic hormonal changes. This happens because of congenital malformations of the uterus, ovaries, inability to exit the blood due to anatomical features that prevent its expiration (atresia - fusion of the cervical canal of the uterus, the girl's hymen or vagina), which are corrected by surgical methods.
Disruption of menstrual function and lack of menstruation can be:
- Physiological. It is determined by natural processes in which neither the activity of sex hormones is observed, nor changes in the ovaries and endometrium (the inner lining of the uterus). This condition is typical for adolescent girls who have not yet reached puberty, for women who are carrying a child, feeding the baby with breast milk (postpartum lactational amenorrhea), for the end of the reproductive period (menopause).
- Pathological, that is, due to internal diseases that are required to identify and cure.
- Primary amenorrhea, if the teenage girl had no monthly blood flow before the age of 14, and at the same time her secondary sexual characteristics are not developed, or up to 16 years old - with the existing signs of puberty. A similar condition is revealed in the evils of the internal reproductive organs, hereditary pathologies, childhood infectious diseases, and delayed sexual development.
- Secondary, when normal menstruation was previously, but stopped and there are no 5-6 regular cycles.
The main causes of amenorrhea
Experts identify many reasons for the absence of menstruation, including:
- polycystic ovary syndrome (26%), which is referred to as hypophormonal ovarian amenorrhea, often developing in girls at puberty (the period of development of reproductive function),
- ovarian inhibition syndrome (due to prolonged use of birth control pills), ovarian depletion and resistant ovaries that do not respond to the regulation of the pituitary-hypothalamic system (ovarian amenorrhea),
- excessive hormone secretion (hyperhommonal amenorrhea), including estrogens and prolactin (hyperprolactinemia) - 14%,
- reduction of gonadotropic hormones (follicle-stimulating, luteinizing), which are produced in the pituitary gland (hypogonadotropic amenorrhea) and are responsible for regulating the cycle,
- congenital dysgenesis of estrogen deficient gonads in the ovaries (ovarian hypoplasia),
- severe infections (tuberculosis, gonorrhea, rheumatism, typhoid, heart defects, liver disease),
- poisoning (with lead, mercury, ethanol),
- depletion or substantial weight loss due to malnutrition or nutritional disorders (28%),
- neuropsychiatric disorders (psychogenic amenorrhea) - 5% and dysfunction of the cerebral cortex (cortical amenorrhea),
- surgical interventions in the uterus (uterine amenorrhea) with the development of adhesions,
- defects of the internal reproductive organs,
- neoplasms, including cystic (especially in the hypothalamus and pituitary),
- disorders of the adrenal gland, thyroid gland,
- violations in the hypothalamus (hypothalamic form) and pituitary (pituitary form).
Despite the apparent variety of reasons, they all boil down to the main one, which experts believe are the lesions of the neuroendocrine system, including the ovaries, pituitary, the hypothalamus, thyroid and adrenal glands, the uterus (especially the endometrium).
Thus, amenorrhea, in essence, is only one of the symptoms of the pathological process that develops in the body.
How to treat primary and secondary amenorrhea
Comprehensive treatment of amenorrhea in a gynecologist-endocrinologist provides for the mandatory detection and elimination of the underlying disease provocateur, in which there is a disorder in menstrual function. The tactics of treatment and the choice of means depends on the type of pathology, severity, provoking diseases, age. Be sure to take into account the planning of conception in the coming months or at a certain time in the future.
In therapy include:
- drug correction of hormone production in case of their deficiency, or, conversely, suppression of excessive secretion,
- treatment of endocrine pathologies that cause secondary amenorrhea,
- correction of hormone production in girls during puberty,
- treatment of premature (early) menopause.
Normalization of menstrual function without the use of hormone therapy often leads to:
- good nutrition,
- prevention of neurological disorders and the development of severe stressful situations,
- rational weight loss,
- treatment of existing internal diseases
- release of the body from toxic compounds.
The complex treatment involves the use of hormone therapy (hormone replacement therapy) to stimulate ovarian function. Hormonal agents are prescribed for any form of amenorrhea, but in combination with other drugs and strictly according to an individual scheme.
The specific drug and the duration of hormonal treatment are established only by the gynecologist-endocrinologist, taking into account the characteristics of the clinical picture, the type of amenorrhea, the data of laboratory examinations and the age of the patient.. For example, such medications are prescribed to girls in short courses, for women who want to become pregnant, cyclically, in certain cases, hormonal treatment is recommended before menopause.