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Natural progestogen (micronised)

Progesterone

Brand names: Cyclogest, Crinone, Utrogestan, Lutigest

Adult dose

Dose: HRT (combined): 100mg PO OD continuous or 200mg ON for 12 days/cycle. Threatened miscarriage: 400mg vaginal BD. Luteal support (IVF): 400mg vaginal BD
Route: PO/Vaginal/Rectal
Frequency: per indication

Clinical pearls

  • Body-identical progesterone — preferred for HRT (lower VTE/breast risk than synthetic)
  • Threatened miscarriage with previous loss (PRISM trial / NICE NG126)

Contraindications

  • Undiagnosed vaginal bleeding
  • Severe hepatic impairment
  • Active VTE
  • Hormone-dependent cancer

Side effects

  • Drowsiness (PO)
  • Headache
  • Breast tenderness
  • Mood changes
  • Vaginal discharge

Interactions

  • Strong CYP3A4 modulators
  • Hormonal therapies

Reference: BNF; NICE NG23/NG126; https://bnf.nice.org.uk/drugs/progesterone/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.