progesterone
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:
Less common
Clear or bloody discharge from the nipple
dimpling of the breast skin
inverted nipple
lump in the breast or under the arm
persistent crusting or scaling of the nipple
redness or swelling of the breast
sore on the skin of the breast that does not heal
Incidence not known
Abdominal or stomach pain
blurred vision
change in vaginal discharge
clay-colored stools
cleft lip or palate
confusion
darkened urine
difficult or labored breathing
difficulty with swallowing
difficulty with walking
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
fast, pounding, or irregular heartbeat or pulse
headache
indigestion
irregular heartbeat
irritation
joint pain, stiffness, or swelling
lightheadedness
loss of appetite
nervousness
noisy breathing
numbness or tingling in the face, arms, or legs
pain or feeling of pressure in the pelvis
pains in the stomach, side, or abdomen, possibly radiating to the back
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
redness of the skin
shortness of breath
slow heartbeat
spontaneous abortion
stomach or pelvic discomfort, aching, or heaviness
sweating
swelling of the eyelids, face, lips, hands, or feet
tightness in the chest
trouble speaking, thinking, or walking
unpleasant breath odor
unusual tiredness or weakness
vaginal bleeding
vomiting
vomiting of blood
yellow eyes or skin
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:
Incidence not known
Attack, assault, or force
blurred or loss of vision
change in walking and balance
changes in behavior
changes in patterns and rhythms of speech
choking
clumsiness or unsteadiness
confusion about identity, place, and time
continuing ringing or buzzing or other unexplained noise in the ears
decreased awareness or responsiveness
difficulty with moving
disturbed color perception
double vision
drowsiness
extreme dizziness or drowsiness
feeling drunk
feeling of constant movement of self or surroundings
feeling of unreality
hair loss or thinning of the hair
halos around lights
hearing loss
hives or welts
longer or heavier menstrual periods
loss of consciousness
muscle cramps
muscle stiffness
night blindness
normal menstrual bleeding occurring earlier, possibly lasting longer than expected
overbright appearance of lights
redness of the skin
relaxed and calm
sensation of spinning
sense of detachment from self or body
severe sleepiness
sleepiness
slurred speech
swollen tongue
thoughts of killing oneself
tunnel vision
weight changes
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 | 42 inserts | $577.20 | $13.74 |
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
Using this medicine 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.
- Abametapir
- Conivaptan
- Eslicarbazepine Acetate
- Fosnetupitant
- Netupitant
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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