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Have you heard of women using progesterone suppositories to boost their odds of a successful pregnancy? Wondering if you should give them a try too? It’s true that progesterone is a key player in getting pregnant and staying pregnant. And for some women, progesterone suppositories can be a good option when TTC.
If you’re unsure exactly what a suppository is, think of it like this. It’s just another way of introducing any medication into your body. Alternatives would be oral tablets or pills, gels, intramuscular injections, or creams.
In recent years though, suppositories have become more popular. This is because they tend to cause less discomfort, act locally, and have fewer side effects.
Keep reading, and you’ll learn everything you need to know about what progesterone suppositories are, if they’re right for you, and how to use them.
Quick Rundown on the Importance of Progesterone
Let’s get better acquainted with progesterone’s role in your cycle. This all-star hormone has a lot of important responsibilities. But the main two are regulating your menstrual periods and maintaining a healthy pregnancy. Here’s a quick look at how it does this.
In the initial phase of your cycle, your progesterone levels are actually quite low. After ovulation though, the corpus luteum (empty follicle that released the egg) begins releasing progesterone at higher levels.
At this stage, progesterone has two key functions:
- Thickening the uterine lining to ensure it is ready to nourish the fertilized egg
- Keeping uterine contractions to a minimum to avoid interference with implantation
If you get pregnant, the corpus luteum will continue to release progesterone. This happens until the placenta is able to take over the production of the hormone to maintain a healthy pregnancy.
Here are some ways progesterone helps you during pregnancy:
- Prevents you from ovulating to keep you from getting pregnant again
- Thickens your uterine lining for successful implantation
- Prevents your uterus from contracting to avoid preterm labor
- Prevents your immune system from rejecting the fetus
- Stimulates the development of breast tissue which prepares your breasts for milk production and breastfeeding
But if you don’t get pregnant, the corpus luteum breaks down. Once this happens, progesterone levels will fall and eventually trigger your next period.
As you can see, this hormone is invaluable. Without progesterone, you would have a very tough time not only getting pregnant but also staying pregnant.
What are suppositories, and how do they work?
Suppositories are a common method for drug delivery. They’re not taken orally, injected, or rubbed in like a cream. Instead, they are inserted into the vagina, rectum, or urethra. They’re shaped like cones and once inside, they melt or dissolve to release the medicine so it gets absorbed into your bloodstream.
A progesterone suppository is a type of vaginal suppository. Most commonly, they are used in women undergoing infertility treatments.
How do you know if you need a progesterone suppository?
Progesterone suppositories are not necessary for all women who are TTC. But for women with certain conditions, increasing progesterone levels may be necessary for successful conception. Research has found that suppositories help women reach progesterone levels similar to those of women with normal luteal phases. If you experience any of the conditions below, suppositories could benefit you.
Luteal phase defects
The luteal phase makes up the second half of your menstrual cycle. It’s about 12 – 14 days long. If you have a luteal phase defect, one of two issues could be at play.
Your ovaries may not release enough progesterone.
Your uterine lining may be unresponsive to progesterone.
So taking progesterone can make sure that your body has enough of the hormone. This is important for helping your uterine lining reach the ideal thickness for implantation.
Read More: Your Guide to Luteal Phase Defects
History of recurrent miscarriages or unexplained infertility
Recurrent miscarriage is when you have more than two pregnancy losses. And unexplained infertility means you have tried for a year or more to get pregnant with no luck in spite of all the tests showing that everything is normal. By increasing your progesterone levels, suppositories may help you avoid future miscarriages.
In either case, it’s a good idea to consult your doctor or fertility specialist. They can tell you if using progesterone suppositories is the best route for you.
Undergoing ART or ovulation induction
Doctors may prescribe progesterone suppositories for you if you undergo IVF or IUI. The suppositories provide extra hormonal support. And ultimately, they can enhance the success rate of your fertility treatment.
History of preterm birth or shortened cervix
A study examined 458 women with a short cervix at their 2nd-trimester scan. The results showed that vaginal progesterone led to better pregnancy outcomes. In fact, they found the rate of preterm birth in this group was reduced by 45%.
Other reasons
Progesterone suppositories may be prescribed for you if you have amenorrhea (no periods). They can also be used in hormone replacement therapy for perimenopause or postmenopause.
Regardless of your condition, definitely speak to your doctor. They can help you decide if progesterone suppositories are a good option for you!
What are the benefits of vaginal progesterone suppositories compared to other methods?
Suppositories have a lot of benefits. One is the rate of absorption. Vaginal suppositories are rapidly absorbed through your vaginal wall within 30 minutes. The vagina is like the next-door neighbor of your endometrium where progesterone is needed.
Remember, it’s got to help bulk up your uterine lining! So you’re basically delivering the progesterone right where it’s needed.
Another advantage of vaginal progesterone is that it involves zero pain. Other forms of administration like intramuscular (IM) injection may cause pain or irritation. IM is an equally effective way to boost your progesterone levels. But some women may pale at the thought of having to inject it into their body with a needle. According to a study of over 400 women, vaginal progesterone proved to be just as effective as IM. It was also considered more tolerable for patients.
Suppositories can be more effective than oral progesterone. When you take progesterone in pill form, a lot of it is neutralized. This is because it has to go through the metabolic processes of your liver and intestines. Hence why you typically find oral progesterone in higher doses than vaginal progesterone. And this is also why oral progesterone often leads to increased side effects.
How to use progesterone suppositories?
If taking a progesterone suppository, you would wait until after you ovulate. This is when progesterone is most needed to support your body for pregnancy. You can take a progesterone suppository by placing it in your vagina. Your doctor will give you more direction on your specific dosing.
Be sure to follow the steps below to ensure your safety and the effectiveness of the hormone administration.
- Thoroughly wash your hands and clean your vulvar area.
- Remove the suppository from the plastic covering.
- Insert the flat end of the suppository into the open end of the applicator. If using a pre-filled applicator, you can skip this step.
- Lie down on your back and draw your knees up towards your chest
- Hold the applicator by the other end of the barrel (that doesn’t contain the suppository). Gently insert it into the vagina as far as it can comfortably go
- Then, press the plunger to release the suppository into the vagina.
- Remove the applicator from the vagina.
- Lay down on your back for about 10 – 15 minutes to reduce leakage.
- After each use, clean according to package instructions. If you have a single-use applicator, be sure to dispose of it.
This may seem like a lot of steps, but it’s actually quite simple. Try not to let yourself get too overwhelmed. Think of it as being very similar to the way you insert a tampon into your vagina from an applicator.
As with any medication, there are some steps you should take to ensure your safety:
- Only take progesterone at the direction of a healthcare professional. Do not start taking it on your own.
- If you experience a missed dose, don’t panic. Just take it as soon as you remember. If it’s too close to your next dose, then just skip it and wait until the next dose. Don’t double up on your doses!
- Use the bathroom before inserting a suppository. This avoids any uncomfortable having to go after the fact. It’s recommended that you wait at least a half hour to pee after insertion and one hour before pooping.
- Watch for any discharge. Discharge after using progesterone suppositories is completely normal. It’s whitish in color, and wearing a pad or pantiliner helps absorb it. Avoid using tampons though as they can interfere with the absorption process. If you think the discharge is excessive or unusual in any way, call your doctor.
Potential side effects of vaginal progesterone
Progesterone suppositories are considered safe to use. But you could experience some side effects. This is true of any medication.
Most of the side effects are simply caused by having an increased amount of progesterone in your body than you may be used to. Here are some of the most common side effects that have been reported:
- Vaginal discomfort or irritation
- Drowsiness or dizziness
- Bloating or abdominal cramps
- Changes in sex drive
- Sleepiness
- Nausea and vomiting
- Headaches
- Breast tenderness
- Mood swings
Some more severe side effects like psychosocial disorders or blood clots are possible but rare. Talk with your doctor about concerns you have before beginning a progesterone regimen.
Using progesterone suppositories while tracking with Inito
Are you using Inito’s fertility monitor to track your fertility? If yes, here’s what you should know about using progesterone suppositories.
- Inito’s monitor tells you the value of PdG (a metabolite of progesterone) in your urine. The purpose of this reading is to help you confirm ovulation.
- Remember, using a suppository may increase the amount of progesterone in your body. This may also increase the amount of PdG that is metabolized in your urine.
- So if you place a suppository before ovulation is confirmed, you could get a false positive ovulation confirmed result.
Long story short, wait until you see the rise in PdG (urine metabolite of progesterone) and ovulation confirmed on your monitor. Then you can begin your progesterone suppository protocol. Speak to your healthcare provider if you have any confusion.
FAQs
What to expect when taking progesterone suppositories?
It’s very similar to inserting a tampon. Most women don’t find suppositories to be bothersome. Instead, they are more convenient than taking painful injections every day. The side effects of progesterone suppositories are also minimal. You may experience a white discharge, but that’s common and nothing to cause concern.
How far should progesterone suppositories be inserted?
Insert the suppository as far as it can comfortably go. Again, think of it like the way you insert a tampon.
How long do you have to lay down after inserting the progesterone suppository?
After insertion, lie down for about 10 – 15 minutes. This just helps prevent any leakage while the suppository melts and dissolves.
What does discharge from progesterone look like?
After inserting a progesterone suppository, you may see a whitish discharge. This is totally normal. Wear a pad or pantyliner before inserting the suppository to help with the extra wetness. Do not use a tampon though as it can interfere with the suppository’s absorption!
Can I have sex while using a progesterone suppository?
There are a few things to consider when having sex during suppository usage. First, you will likely experience discharge shortly after using the suppository. This may be a bother for you when thinking of being intimate with your partner.
Secondly, one study researched the effects of progesterone among 20 couples. They found if you use the gel vaginal progesterone before sex, some of it could be absorbed by your male partner.
This would decrease the effectiveness of the medication for you. And your partner could experience a lower sex drive from absorbing some of the hormone.
Your best bet is to have sex before inserting the suppository.
When can I pee and poop after progesterone suppository?
It is best to wait for at least half an hour before going pee. This will give the progesterone enough time to get absorbed into your bloodstream.
If you need to poop, the ideal waiting time is an hour. This is due to intra-abdominal pressure that could cause the suppository to leak out. Ideally, you should clear your bladder and bowels BEFORE inserting the suppository. This will help you minimize any extra discomfort.
Do progesterone suppositories cause cramping?
Yes, they could cause some mild cramping along with some other side effects. Tell your healthcare professional if you feel like you’re having an extreme or allergic reaction.
When to start progesterone suppositories?
Consult your doctor for exact guidance. But typically, you will begin them after ovulation, in the luteal phase of your cycle.
What should I do if I miss a dose?
First, don’t panic. This happens. If you still have a few hours before your next dose, you can just insert the missed suppository late. But if you are nearing your next dosage, just wait until placing the next suppository. You never want to take a double dose! And if you’re unsure about the timing, you can always consult your doctor to see what they recommend.
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- Physiology, Progesterone – StatPearls – NCBI Bookshelf
- Updated Clinical Guidance for the Use of Progesterone Supplementation for the Prevention of Recurrent Preterm Birth | ACOG
- Pharmacokinetics of natural progesterone vaginal suppository
- Efficacy and tolerability of vaginal progesterone capsules (Utrogest™ 200) compared with progesterone gel (Crinone™ 8%) for luteal phase support during assisted reproduction – Fertility and Sterility
- The effects of progesterone therapy in pregnancy: vaginal and intramuscular administration
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- Full article: Vaginal progesterone and the vaginal first-pass effect
- Progesterone to prevent miscarriage in women with early pregnancy bleeding: the PRISM RCT
- Vaginal progesterone treatment and circulating progesterone levels—an association yet to be determined – Levin – 2019 – Acta Obstetricia et Gynecologica Scandinavica – Wiley Online Library
- Vaginal micronized progesterone in continuous hormone replacement therapy. A prospective randomized study
- https://academic.oup.com/humrep/article/38/4/560/7048705
- https://pubmed.ncbi.nlm.nih.gov/32609084/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987350/
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