Endometrin
Endometrin (progesterone) is a vaginal insert, or a vaginal suppository, that's used during fertility treatment for people who have trouble becoming pregnant. It's a progesterone that helps ready the uterus for embryo transfer and pregnancy. When you start and stop the medication depends on your fertility treatment and your situation. In general, Endometrin (progesterone) is inserted into the vagina 2 or 3 times a day, unless your prescriber advises you to take it a different way. Side effects include pelvic pain, stomach pain, and nausea.
What is Endometrin (progesterone)?
What is Endometrin (progesterone) used for?
How Endometrin (progesterone) works
Endometrin (progesterone) contains progesterone, an essential hormone for pregnancy. Progesterone prepares the uterus to receive and nourish an embryo.
Drug Facts
More on Endometrin (progesterone) essentials
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What are the side effects of Endometrin (progesterone)?
Common Side Effects
- Pain after egg retrieval (e.g., pelvic pain, stomach cramps; 25-28%)
- Stomach pain (12%)
- Nausea (7-8%)
- Ovarian hyperstimulation syndrome (swollen ovaries; 7%)
Other Side Effects
- Stomach bloating
- Vomiting
- Constipation
- Fatigue
- Headache
- Vaginal irritation
- Vaginal burning
- Vaginal discharge
Serious Side Effects
- Blood clot(s): pain in the lower leg that won't go away, sudden shortness of breath, coughing up blood, sudden blindness
- Heart attack: chest pain or tightness; pain that travels to your shoulder, arm, neck, or jaw
- Stroke: sudden trouble talking or walking; numbness on one side of your body or face; sudden, severe headaches
- Abnormal vaginal bleeding
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Signs of toxic shock syndrome—for cervical caps or diaphragms
Chills
confusion
dizziness
lightheadedness
muscle aches
sunburn-like skin rash that is followed by peeling of the skin
unusual redness of the inside of the nose, mouth, throat, vagina, or eyelids
Check with your doctor as soon as possible if any of the following side effects occur:
Rare
For females and males
Skin rash, redness, irritation, or itching that does not go away within a short period of time
For females only
Cloudy or bloody urine
increased frequency of urination
pain in the bladder or lower abdomen
thick, white, or curd-like vaginal discharge—with use of cervical caps or diaphragms only
vaginal irritation, redness, rash, dryness, or whitish discharge
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Vaginal discharge (temporary)—with use of creams, foams, and suppositories
vaginal dryness or odor
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Endometrin (progesterone)
Pros
Might help raise your chances of getting pregnant as part of your fertility treatment plan
Can insert the medication in any position and doesn't require you to lie down after you insert it
Cons
Inserted into the vagina 2 or 3 times a day
Inserting the applicator into the vagina can be uncomfortable
Only available as a brand-name medication; no lower-cost generic available
Pharmacist tips for Endometrin (progesterone)
It's important that you take Endometrin (progesterone) exactly as instructed and for as long as instructed. Carefully following your fertility specialist's directions can help raise your chances of getting and staying pregnant. Don't stop using this medication earlier than instructed.
It's best to spread out your Endometrin (progesterone) doses evenly throughout the day, unless your fertility specialist instructs you to take the medication at certain times of the day. For example, you could insert the medication when you wake up, around lunch time, and in the evening if you're taking it three times a day.
Some people might have extra vaginal discharge while they're taking Endometrin (progesterone). You might want to wear a panty liner to prevent the discharge from getting onto your underwear.
While weight gain isn't a typical side effect of Endometrin (progesterone), stomach bloating can be. For some, stomach bloating might make pants or other clothes feel tighter, as if you've gained weight. The bloating is temporary and should go away once you've finished taking the medication. Let your fertility specialist know if you're worried about the bloating is worrisome or if it doesn't go away.
Tell your fertility specialist right away if you have any irregular vaginal bleeding after you start using Endometrin (progesterone). This can be a sign of a possible miscarriage.
Don't use any other vaginal products when you're using Endometrin (progesterone). They can affect how well the medication works.
Wash your hands before you insert Endometrin (progesterone) into your vagina.
Find a position that's comfortable for you to insert Endometrin (progesterone) into your vagina. You can insert it while you're standing, sitting, or lying on your back with your knees bent. You don't have to keep lying down after you insert the medication.
Unwrap the applicator, and place 1 insert (the tablet) into the space at the end of the applicator.
Gently insert the applicator as far as you comfortably can into your vagina, similarly to how you would insert a tampon. Once it's inside your vagina, press the plunger down to release the insert.
Gently pull out the applicator from your vagina. Throw the applicator away into the trash after each use and wash your hands.
Frequently asked questions about Endometrin (progesterone)
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What are the risks and warnings for Endometrin (progesterone)?
Endometrin (progesterone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Blood clots and potential complications, like heart attack or stroke
Before you start Endometrin (progesterone), tell your prescriber about your full medical history, especially any blood clots. You won't be able to take this medication if you've had a blood clot before.
Be aware of the following signs and symptoms of a blood clot. Blood clots can sometimes lead to serious problems like heart attack or stroke.
Clot in the leg (deep vein thrombosis, DVT): swelling, tenderness, or pain in the leg
Clot in the lung (pulmonary embolism, PE): shortness of breath
Clot in the eye: partial or complete vision loss
Heart attack: chest pain, arm pain, shortness of breath, a cold sweat, lightheadedness
Stroke: sudden weakness on one side of your body, drooping face, trouble breathing, bad headaches, trouble speaking or walking
Call 911 or seek immediate medical attention if you have any signs or symptoms of a blood clot, heart attack, or stroke.
Worsening depression
Risk factors: History of depression
It's possible for Endometrin (progesterone) to worsen depression if you already have or have had depression. Let your prescriber know right away if you notice any changes in your mood or if you have any worsening feelings of hopelessness, fear, or despair.
Don't use other vaginal products
It's not recommended to use any other vaginal products while you're using Endometrin (progesterone). Using other products that are inserted into the vagina, such as creams or medications to treat a yeast infection, can change the way your body absorbs Endometrin (progesterone). This can make Endometrin (progesterone) work less well. Speak with a healthcare professional about other options while you're using Endometrin (progesterone) if you're interested in using a vaginal product or if you have a vaginal infection.
Endometrin (progesterone) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 100mg | 21 inserts | $315.14 | $15.01 |
Typical dosing for Endometrin (progesterone)
Each vaginal insert contains 100 mg of progesterone.
The usual dose is 1 insert placed into your vagina 2 to 3 times a day. You'll typically start Endometrin (progesterone) after your egg retrieval and continue the medication for up to a total of 10 weeks.
Be sure to follow your fertility specialist's instructions because how and when you take Endometrin (progesterone) can be different depending on your fertility treatment.
Interactions between Endometrin (progesterone) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.
Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Apalutamide
- Aprepitant
- Armodafinil
- Artemether
- Bexarotene
- Bosentan
- Brigatinib
- Carbamazepine
- Cenobamate
- Clobazam
- Conivaptan
- Dabrafenib
- Darunavir
- Dexamethasone
- Efavirenz
- Elagolix
- Elvitegravir
- Encorafenib
- Enzalutamide
- Eslicarbazepine Acetate
- Etravirine
- Fosaprepitant
- Fosnetupitant
- Fosphenytoin
- Griseofulvin
- Isotretinoin
- Ivosidenib
- Lesinurad
- Lorlatinib
- Lumacaftor
- Mitotane
- Modafinil
- Mycophenolic Acid
- Nafcillin
- Netupitant
- Nevirapine
- Oxcarbazepine
- Phenylbutazone
- Phenytoin
- Pitolisant
- Prednisone
- Primidone
- Red Clover
- Rifabutin
- Rifampin
- Rifapentine
- Secobarbital
- St John's Wort
- Sugammadex
- Tazemetostat
- Topiramate
- Ulipristal
How much does Endometrin (progesterone) cost?
Endometrin (progesterone) contraindications
Abnormal vaginal bleeding that hasn't been examined by a healthcare professional
Known missed abortion or ectopic pregnancy
Liver problems
Known or possible breast cancer or genital cancer
Currently have or have had a blood clot
Allergy to other progesterone products
What are alternatives to Endometrin (progesterone)?
Lack of menstrual periods
What is the latest news about Endometrin (progesterone)?
Endometrin (progesterone) images
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References
Best studies we foundCable, J. K., et al. (2023). Physiology, progesterone. StatPearls.
Ferring Pharmaceuticals. (2019). Endometrin® administration guide.
Ferring Pharmaceuticals. (2021). How to use Endometrin® (progesterone) vaginal insert 100 mg.
Ferring Pharmaceuticals Inc. (2022). Endometrin- progesterone insert [package insert]. DailyMed.
Kumar, P., et al. (2011). Ovarian hyperstimulation syndrome. Journal of Human Reproductive Sciences.
World Health Organization. (n.d.). Clinical services Recommendation 31: Medical management of missed abortion at gestational ages < 14 weeks (3.4.3).
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