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Miscarriage is a heartbreaking experience that many couples endure. And it’s more common than people may think. It happens in 26% of all pregnancies and 10% of clinically recognized pregnancies.
There are many different reasons why miscarriage happens. However, some doctors think that low progesterone in early pregnancy might be a big one to blame.
Today, we’ll dive into supplements for the hormone progesterone. We’ll learn how they may be able to help prevent miscarriage and when to start taking them.
Key takeaways
- Progesterone is essential for a healthy pregnancy.
- It helps prep the uterus for implantation, prevents contractions, and supports the development of the fetus.
- Low levels of this key hormone may lead to a threatened miscarriage.
- Women with a history of recurrent miscarriage, low progesterone levels, or those undergoing fertility treatments may benefit from progesterone supplements.
- The timing of supplementation is important.
- If you have a history of miscarriage or luteal phase defects, start 3 days after your LH surge. If you are experiencing early pregnancy bleeding, start within 4 days of bleeding. And, if you are undergoing IVF, begin the day of your egg retrieval.
- Most women take progesterone supplements for 10-12 weeks. This may be longer if there is early pregnancy bleeding.
- There are 2 main types of supplements available via prescription. They include injections and vaginal progesterone.
- Progesterone injections are effective but painful.
- Studies show that vaginal progesterone is equally effective and more convenient. This makes it a great alternative to injections.
Why is progesterone important in pregnancy?
Progesterone is a sex steroid hormone that has a key role in your menstrual cycle. It also preps your body for pregnancy.
Here are some of the vital things progesterone does during early pregnancy:
- It prevents ovulation so you can’t get pregnant again.
- It thickens the lining of your uterus to make it into a cozy home for the fertilized egg to implant.
- It keeps your uterus from contracting prematurely and prevents miscarriage or preterm delivery.
- It prevents your immune system from rejecting the fetus.
- It stimulates the development of breast tissue and preps your breasts for milk production and breastfeeding.
If you don’t have enough of the hormone progesterone in early pregnancy, it can make getting pregnant a challenge.
To help with this, doctors may suggest taking progesterone supplements.
Should I be taking progesterone supplements?
It’s important to note that a progesterone treatment won’t work for everyone. They are only fit for people who:
- Have a history of recurrent miscarriage
- Have low progesterone or luteal phase defects
- Are experiencing early pregnancy bleeding
- Are undergoing fertility treatments
If you have normal progesterone levels and are simply looking for a “boost”, thesesupplements won’t be effective.
When to start progesterone to prevent miscarriage?
There is no one-size-fits-all for the best time to start taking progesterone supplements. Itdepends on your unique situation.
History of recurrent pregnancy loss/luteal phase defects
If you have a history of recurrent miscarriages or luteal phase defects, researchers suggest thatstarting progesterone supplements 3 days after your LH surge, right after ovulation may be best.
One study looked at women with recurrent pregnancy loss (more than 2 losses in less than 10 weeks of pregnancy). Vaginal micronized progesterone supplementation was given to them 3 days after their LH surge. The dose was 100-200 mg every 12 hours.
And the result?
Pregnancy success (continuing longer than 10 weeks) was 69% vs. 51% in the placebo group.
Early pregnancy bleeding
If you experience early pregnancy bleeding (weeks 1 to 13), treatment begins as soon as possible after confirming a pregnancy, and within four days of bleeding. And, treatment will continue for longer, until the 16th week of pregnancy.
Undergoing IVF
In the case of IVF, supplementation is best timed for the day of egg retrieval and continued until at least 8-10 weeks of pregnancy.
And remember, if progesterone supplementation is started too early, it can interfere with ovulation and the implantation window.
And if it’s started too late, it may not have the desired effect.
Now that you know when to start taking progesterone, you’re probably wondering how long to take it for.
How long should I take progesterone?
The length of time you take a progesterone treatment also varies from person to person. Most practitioners prefer to err on the side of caution and continue progesterone for longer periods of time.
So you’ll likely need to take it for the first 10 weeks up to 12 weeks of pregnancy. But, if you’re bleeding in early pregnancy or experiencing other issues, your doctor may suggest you take it longer, until 16 weeks.
What are the different kinds of progesterone supplements?
There are a few ways you can take progesterone. But studies show that the most effective types are the injections and vaginal forms. Researchers have found that oral progesterone isn’t as effective.
| Supplement type | |||
| Efficacy for TTC | Moderate to low (not prescribed for pregnancy) | High | High |
| Side effects | High | Low | Low |
| Prescription required | Yes | Yes | Yes |
Progesterone injections
Progesterone injections are highly effective and are favored by doctors. But they are painful, which means they aren’t as popular with patients.
They’re injected right into your body, either intramuscular or subcutaneous. Due to the oily suspension of progesterone, these injections require a thicker needle, which means more pain.
You may also experience some swelling and bumps at the site of the injection. Side effects beyond that are fairly rare.
Learn more: Progesterone Injections: Who, What, When, Where, Why, and How
Vaginal progesterone
Suppositories are another great way to take progesterone. They have a rapid rate of absorption — just 30 minutes! This gets the progesterone right to where it’s needed, fast.
You also don’t have to endure pain with suppositories. And studies show they’re just as effective as intramuscular injections.
Learn More: Progesterone Suppositories: The Ultimate How-To Guide!
Choosing the right form of progesterone for you is the first step. Next is following some best-practice tips.
Tips for taking progesterone
Follow these treatment guidelines to maximize the efficiency of progesterone and minimize its side effects.
- Follow your doctor’s instructions. Don’t start taking progesterone on your own. Only take it exactly as your doctor prescribes it.
- Stay on schedule. If you accidentally miss a dose, take it as soon as you remember. If it’s too close to your next dose, skip it. Make sure you don’t double dose.
- Skip tampons if using suppositories. If you’re experiencing vaginal discharge, don’t put a tampon inside your vagina. Use a pad or pantyliner instead.
- Report side effects. If you’re facing severe discomfort or side effects, share them with your doctor.
FAQs
There is no clear-cut evidence that progesterone can stop miscarriages from happening. Supplementation may be able to help prevent miscarriages, but it is not a guarantee. More research needs to be done to better understand the role of progesterone in preventing miscarriage.
The timing varies from person to person. But generally speaking, it’s best to start progesterone supplementation right after ovulation. If you have a history of miscarriage or luteal phase defects, start supplementation 3 days after your LH surge. If you have pregnancy bleeding, start within 4 days of bleeding. And, if you’ve undergone IVF, begin the day of your egg retrieval.
In most cases, you’ll need to take the treatment during the first trimester, for the first 10 – 12 weeks of pregnancy.
Injections and vaginal progesterone are the two main forms of progesterone supplements. Each comes with its own benefits and side effects.
Injections and suppositories show the same level of efficacy. But vaginal progesterone offers fewer side effects than progesterone injections.
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- Miscarriage (Archived) | NIH
- Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology
| PubMed Central - A Randomized Trial of Progesterone in Women with Bleeding in Early Pregnancy | The New
England Journal of Medicine - Luteal start vaginal micronized progesterone improves pregnancy success in women with
recurrent pregnancy loss | Fertility and Sterility - PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent
miscarriages – a randomised, double-blind, placebo-controlled, international multicentre trial and
economic evaluation | University of Groningen - Oral versus intramuscular progesterone for in vitro fertilization: a prospective randomized study |
ScienceDirect - Vaginal progesterone and the vaginal first-pass effect | Taylor & Francis Online
- Crinone vaginal gel is equally effective and better tolerated than intramuscular progesterone for
luteal phase support in in vitro fertilization-embryo transfer cycles: a prospective randomized
study | PubMed
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