During pregnancy, the female body changes dramatically, which is especially noticeable when analyzing hormonal components. Hormonal changes during pregnancy are completely normal, unless there are any disruptions. Sometimes a deficiency of progesterone, which is called the pregnancy hormone, is diagnosed: its insufficient synthesis often causes miscarriages in the early stages and premature births in the third trimester. It is to avoid such incidents that Utrozhestan is prescribed.
Indications for use
Not everyone knows why progesterone therapy is prescribed. Utrozhestan can be recommended for use by women to prevent miscarriage if she is at risk for miscarriage or has a reduced level of progesterone in the blood.
A woman is included in the risk group if:
- History of spontaneous miscarriage in early pregnancy caused by gestagen insufficiency
- Carrying out the procedure of in vitro fertilization (with IVF)
- Taking Utrozhestan or Duphaston at the planning stage
- Preterm birth in the second trimester
- Diagnosing shortening of the cervix after a woman becomes pregnant.
How exactly to take Utrozhestan during pregnancy should be checked with a gynecologist; if necessary, he will tell you why hormonal support is needed and how long it will last.
The role of progesterone during pregnancy
Progesterone belongs to the class of biologically active substances - steroids, the main place of production of which is the corpus luteum of the ovaries. Its daily level in the body depends on the phase of menstruation, the duration of pregnancy, and the use of oral contraceptives. The minimum level of progesterone occurs in the female body at the beginning of the monthly cycle, and the hormone reaches its maximum in the second half, during the release of a full-fledged egg. But now the long-awaited pregnancy has arrived, and progesterone “gets to work”:
- The hormone stops the menstrual cycle, that is, the formation of new eggs, for the entire period of bearing a child.
- Helps the uterus accept (implant) and not reject a fertilized egg in the future.
- Creates conditions for cell division and proper formation of embryonic tissue.
- Influences the emotional and mental state of a woman, preparing her for future motherhood.
- Reduces the activity of the smooth muscles of the uterus to avoid aborted pregnancy.
- Prepares the body for future childbirth by promoting the separation of the pelvic bones and relaxation of muscles and ligaments.
- Activates the growth of the mammary glands, tuning them for the process of lactation.
Throughout pregnancy, progesterone levels continuously rise. If the norm of progesterone during early pregnancy is 12-18.2 nanograms per milliliter, then in the last trimester the normal value will be 132.6-172 nanograms.
Oral administration of capsules
To prevent miscarriage, take hormonal capsules in a dosage of 100-200 mg twice a day during the 1st trimester. If there is pain in the lower abdomen, it is possible to extend the prescribed treatment. Not every woman knows how many weeks she will need to take the capsules. Usually, drug withdrawal begins no earlier than 23-28 weeks.
If there is a risk of premature labor, a woman should take a progesterone-based drug every 6-8 hours at a dosage of 400 mg until the lower abdomen stops pulling and other symptoms of uterine tone disappear.
After eliminating the pathological symptoms, pregnant women do not stop taking progesterone. It is necessary for a woman to drink 200 mg of progesterone in capsules three times a day. Therapy with Utrozhestan continues until the 36th week of pregnancy.
If a pregnant woman misses taking Utrozhestan, she will need to take the missed dose as soon as possible. In the future, you should follow the regimen prescribed by your doctor and do not miss the time of taking hormonal capsules.
Why is it prescribed during pregnancy?
Utrozhestan is indicated for women for the correction of diseases caused by inferiority of the corpus luteum. Administration can take place orally or vaginally, and depends on the pathology. Internal administration of Utrozhestan during pregnancy is carried out in the presence of the following obstetric pathologies:
- risk of miscarriage;
- prevention of premature birth.
- Outside of pregnancy, Utrozhestan is prescribed to eliminate the following gynecological pathologies:
- premenstrual disorders;
- infertility due to luteal phase disturbance;
- disturbance of the ovulatory process (anovulation, disovulation);
- gestagen deficiency in menopause;
- mastopathy;
- precimacteric period.
Vaginal use of Utrozhestan is appropriate for:
- inability to swallow capsules orally (toxicosis, diseases of internal organs);
- impossibility of conception due to infertility;
- threat of miscarriage;
- risk of premature onset of labor.
If a woman is confirmed to have a lack of progesterone, Utrozhestan during pregnancy is prescribed in any form, regardless of gestational age. The drug fully compensates for the lack of progesterone without disturbing the woman’s natural hormonal balance. Proper treatment does not cause complications, does not contribute to excess weight gain or worsening pregnancy. But the effectiveness of replacement therapy during gestation depends on the adequacy of the prescribed dose and the general dosage regimen.
When planning a pregnancy
Only a doctor can prescribe a regimen for taking the drug. Here he is guided solely by the clinical picture. The use of the drug has its own characteristics:
- For premenstrual tension syndrome, insufficient luteal phase, fibrocystic mastopathy, dysmenorrhea, premenopause, the drug is taken orally. The daily dose will be 200-300 ml, add to 2 doses. Take the drug in the 2nd phase of the menstrual cycle. The duration of therapy will be 10 days.
- During hormone replacement therapy, Utrozhestan is taken 2 capsules per day. The duration of therapy will be 10-12 days. If menopause has occurred, then 1 capsule per day for 25 days. It is advisable to take it before going to bed, with plenty of water. It is forbidden to drink capsules immediately after meals or immediately before meals.
- If there is a lack of progesterone, use suppositories, 1 suppository once a day. Carry out treatment on days 13-14 of the menstrual cycle. After removal, it changes - 1 suppository 2 times a day (days 15-25 of the cycle). Starting from day 26, the dosage is increased by 1 suppository per day. And so on every week until the maximum result is obtained. The limit is 6 suppositories per day, divided into 3 doses. The duration of therapy can be 2 months.
- In order to maintain the luteal phase during IVF, the drug is used in the form of suppositories. Introduce them intravaginally, 4-6 pieces per day. Start treatment from the day of gonadotropin injection. End of therapy at 20 weeks of pregnancy.
During early pregnancy
Why is the drug prescribed during pregnancy at different stages? During pregnancy, women usually use vaginal administration of the medication. For this, special candles are used. Utrozhestan tablets or capsules are usually not used during pregnancy. More often during pregnancy, expectant mothers are prescribed suppositories. They can be used in the first, second and third trimester.
In the early stages after conception, you can use it as prescribed by your doctor.
Only a specialist can make a decision on prescribing medication based on the woman’s medical examination data. In this case, it is recommended to insert suppositories into the vagina at the same time of day. This method of administering the hormone helps prevent the negative effect of the drug on the digestive system, in particular on the liver. In the first trimester, Utrozhestan is prescribed for the following purposes:
- Prevention of increased uterine tone and elimination of this condition.
- Normalization of the central nervous system.
- Preventing miscarriage and premature birth.
Replenishment of progesterone in the body when there is a lack of it. Utrozhestan does not have side effects on the fetus. This fact is confirmed by numerous medical studies. In extremely rare cases, a child develops a disorder such as an anomaly in the urethra.
Utrozhestan 200 during early pregnancy
The readiness of the female body for pregnancy and the normal bearing of a child depend, among other factors, on the state of the hormonal system. One of the main hormones regulating this process is progesterone. Progesterone is called the “pregnancy hormone”. It is responsible for the regularity and duration of the menstrual cycle, and in pregnant women, for the normal bearing of the baby. Both a decrease and an increase in progesterone levels are fraught with serious problems. In the first case - miscarriage and spontaneous abortions, and in the second - delayed maturation of the placenta and, as a consequence, various pathologies of the fetus.
The action of Utrozhestan is to compensate for the lack of progesterone.
Utrozhestan capsules are used both as tablets and as vaginal suppositories. In both cases, the highest concentration of the hormone is formed after an hour, and the derivative substances are excreted from the body in the urine. When taken vaginally, the drug does not irritate the gastrointestinal tract and does not cause additional troubles when the tablet is difficult to swallow due to toxicosis.
This is the answer to the question why Utrozhestan suppositories are prescribed during pregnancy, and not capsules for oral administration. Typically, Utrozhestan is taken at a dose of 100 mg twice a day, and 200 mg once a day, at night. The dosage regimen and dosage depend on the method of taking the medicine. Utrozhestan tablets should be taken after meals and with plenty of liquid.
Intravaginal use
In the event of a threat of miscarriage and to prevent a habitual miscarriage due to a lack of natural progesterone, you will need to place capsules in the vagina in a dosage of 100-200 mg twice a day (the recommended interval between administration of the drug is 12 hours). It is necessary for the woman to insert the capsules as deeply as possible into the vagina. Utrozhestan is prescribed until the 2nd trimester of pregnancy. In some cases, it is recommended to discontinue the drug up to 34 weeks.
The regimen for using the drug Utrozhestan after IVF is determined individually. Intravaginal administration of capsules is prescribed from the moment of hCG injections until the end of the 2nd trimester. The highest dosage of the drug is 600 mg, which is divided into three applications. The withdrawal of Utrozhestan should be gradual.
Release form and analogues of Utrozhestan
This drug is available in round or oval capsules. The composition of the capsules is absolutely identical, but due to their oval shape and intravaginal administration, they are sometimes called suppositories, and round capsules are called tablets.
Analogs with the same active ingredient:
- Ginprogest (capsules);
- Ingesta (solution);
- Crinone (gel);
- Lutein (tablets);
- Progesterone (solution);
- Proginorm (capsules);
- Progestin (gel);
- Prolutex (solution);
- Endometrin (tablets).
Cancellation Features
If a woman takes the drug during the 1st and 2nd trimester of pregnancy, then its withdrawal should not be abrupt. For example, if a woman drinks 200 mg of progesterone per day, then for 5 days. the dosage must be reduced by half over the next 5 days. cancel completely. Therefore, it is recommended to start reducing the dose of Utrozhestan at 30 weeks of pregnancy. It will be possible to complete hormone therapy at approximately 31 or 32 weeks.
After discontinuation of the hormonal drug, minor bleeding may appear, which is not a pathology; it should completely stop within a few days.
At 35-37 weeks, it is necessary to undergo an ultrasound examination to assess the progress of pregnancy and determine the length of the cervix.
How is it used?
There are two ways to use the capsules - oral and vaginal. The second is more in demand during pregnancy because:
- ensures faster absorption of the hormone and its effect on the uterus;
- reduces side effects on the digestive tract;
- helps with early toxicosis.
The dosage and regimen of use are prescribed by the doctor individually. Some expectant mothers are prescribed the medicine in a daily dose of 200-400 mg, others – 600-800 mg, it all depends on the indications, symptoms and tolerability of the drug.
The dose can be taken once, then the entire daily dose is swallowed or inserted into the vagina before bedtime. However, 2-dose regimens are much more often used, when a woman takes most of the dose at night, and less in the morning.
Contraindications
You should not start hormonal therapy if:
- Excessive sensitivity to the components of Utrozhestan
- Serious violations by the SSS
- Tendency to thrombosis and with the development of thrombophlebia earlier
- Diagnosing incomplete abortion
- Oncological processes in the mammary gland and internal genital organs
- Porphyria
- Discovery of bleeding of unknown origin.
Utrozhestan should be prescribed with extreme caution in the presence of renal failure and impaired liver function. It is important to assess the likely risks and expected benefits of the treatment. During hormonal therapy, you will need to monitor basic blood counts.
Side effects during pregnancy
Like any other medicine, this drug can cause negative reactions in the body. It is worth noting that most often this occurs when the drug is used independently without a doctor’s prescription. The drug also causes an unexpected reaction in the body when overdosing or reducing the time between doses. The drug "Utrozhestan" may have the following side effects:
- Allergy.
If intolerance to any component of the drug occurs, this manifests itself as a skin rash, itching, and redness of the genitals (with vaginal administration). Nausea and vomiting may also occur. All these symptoms must be treated with appropriate medications. The hormonal medicine should be replaced with one with a similar effect. - Changes in the functioning of the excretory organs.
When used orally, the drug "Utrozhestan" has side effects in the form of increased and diluted stools. Some patients report constipation and bloating. This may be caused by the effect of the drug on smooth muscle. In addition, the drug can cause a diuretic effect on the body. This occurs especially often when using appropriate medications. Most often, treatment for such effects is not required, and therapy is not canceled. - Nervous system reaction.
Side effects of the drug may include headache, weakness and drowsiness. Most often, such symptoms appear within 1-3 hours after administration. Doctors advise in this case to choose an alternative drug. - Bleeding from the genital tract.
Very rarely, taking the drug may be accompanied by spotting and spotting. You should definitely report this side effect to your doctor and change your treatment regimen if necessary.
Why is it being phased out gradually?
When prescribing Utrozhestan to an expectant mother, the doctor will definitely tell you that you will need to discontinue the medication carefully and very slowly. It is especially important to complete the dose correctly if the reason for prescribing the capsules was the threat of miscarriage. In this case, abrupt withdrawal may cause undesirable consequences in the form of a resumption of dangerous symptoms.
If the drug was prescribed before conception, it should not be abruptly stopped when the woman is pregnant . With such actions, the activity of the muscular lining of the uterus will increase, which can provoke bleeding and rejection of the fertilized egg. Abrupt refusal of treatment in the later stages is also not recommended , because it can cause premature birth.
