Dr Sharon Rees @reesprescribe
Day 1: Popular as part of HRT regimens, micronised progesterone e.g. #Utrogestan was developed in the 1980s to overcome issues with synthetic progestin. Derived from plants such as yam, it is bio-identical to human progesterone
Dr Sharon Rees @reesprescribe
Day 2: Depending on the HRT regimen oral micronised progesterone such as #Utrogestan may be given 200 mg nocte as part of cyclical HRT regimens or 100 mg nocte as continuous HRT
Dr Sharon Rees @reesprescribe
Day 3: The micronisation process creates tiny particles (<10 micrometres) enhancing absorption & >consistent release of progesterone/stable levels. Good oral absorption/do not take with food as can increase absorption & lead to side effects. High protein binding. Liver metabolism & mainly renal elimination/some enterohepatic recycling
Dr Sharon Rees @reesprescribe
Day 4: Chemically & structurally identical to naturally occurring progesterone (PG), #Utrogestan can act at PG receptor sites to oppose HRT related oestrogen exposure for women with a uterus. This reduces the risk of endometrial thickening/cancer
Dr Sharon Rees @reesprescribe
Day 5: ADEs: Common include headache, breast pain, insomnia. Rare, eye disorders, loss of appetite, anaphylactoid reaction (NOT exhaustive). The progesterone (PG) component of HRT can increase risk of some cancers; e.g. breast. This is dependent on duration of HRT; risk is minimised with a ‘natural’ PG such as #Utrogestan
Dr Sharon Rees @reesprescribe
Day 6: Enzyme inducers such as St John's Wort & carbamazepine can lower drug concentration while inhibitors e.g. azole anti-fungals, tacrolimus, atorvastatin can increase. May worsen type 2 diabetes (NOT exhaustive)
Dr Sharon Rees @reesprescribe
Day 7: Compared to synthetic progesterone, micronised progesterone such as #Utrogestan has better tolerance & lower VTE & cancer risks. When taken at night, sleep can improve, as progesterone is a natural sedative. Progesterone receptor activity may modulate the GABA receptor to promote sleep
Earn Your CPD Certificate
With the help of Prescribing and Therapeutics Training Ltd and the Journal of Prescribing Practice, you can earn your 1-hour CPD certificate
In addition to the posts, read the BNF monograph on progesterone and the related treatment summary on ‘Sex Hormones’. Another useful source is the Summary of Product Characteristics for Utrogestan, see links below. Once you have completed this, answer the 10 questions. Submit your answers to reesprescribe@gmail.com. If you answer at least eight out of 10 questions correctly, you will receive your CPD certificate via email.