7 Prometrium (Micronized Progesterone) Side Effects You Should Know About
Read on to learn about the common and rare side effects of Prometrium (micronized progesterone) and how to manage them.
progesterone
Used for Endometriosis, Fertility, Irregular Menstruation
Used for Endometriosis, Fertility, Irregular Menstruation
Progesterone is an injection used to treat people who aren't getting their period or have abnormal bleeding due to hormone imbalance. It belongs to a group of medications called progestins and works by replacing progesterone hormone that's naturally made in the body. The medication is typically injected into the muscle daily for 6-8 days in a row. Potential side effects include pain at the injection site, weight gain or weight loss, and breast tenderness.
What is Progesterone?
What is Progesterone used for?
- Lack of menstrual periods due to hormone imbalance
- Abnormal bleeding from the uterus due to hormone imbalance
How Progesterone works
Progesterone is a progestin. It regulates your period by giving your body more progesterone, a hormone that helps control the menstrual cycle. This helps to balance the natural levels of progesterone in the body.
When does Progesterone start working?Time passed since treatment started:
Drug facts
| Common Brands | No brand names available |
|---|---|
| Drug Class | Progesterone |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Progesterone
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Pain, swelling, and/or redness at the injection site
- Breakthrough bleeding or spotting
- Changes in menstrual flow
- Changes in weight
- Swelling
- Vaginal discharge
- Breast tenderness
Less Common Side Effects
- Acne
- Depression
- Hair loss or hair growth
- Trouble sleeping
- Sleepiness
- Nausea
Progesterone serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reactions: trouble breathing, hives, rash, itchiness, swelling of your face, lips, tongue, or throat
- Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw, sweating, trouble breathing
- Stroke: sudden trouble talking, trouble walking, or numbness on one side of your body or face, severe headache
- Blood clot in the lungs: shortness of breath, chest pain, cough
- Blood clot in the eyes: sudden vision loss, blurry vision, changes in vision, migraine
- Pneumonia: fever, trouble breathing, fatigue, night sweats, cough
- Liver problems: nausea, yellowing of the skin or whites of the eyes, stomach pain
- Breast lumps: breast pain or soreness, swelling, rash
- Unusual vaginal bleeding: abnormal spotting or bleeding
The following Progesterone 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.
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Pros and cons of Progesterone
Pros
- Helps to regulate your menstrual period
- Only has to be taken once a day
- Might be a good option for people who can't swallow pills
Cons
- Not safe if you have liver problems
- Not a good option if you're allergic to sesame oil
- Potentially raises your risk of serious blood clots
Pharmacist tips for Progesterone
- The dosing schedule can be different depending on what you’re using progesterone for, so take it exactly the way your prescriber tells you.
- Progesterone can be given at home. You don't need to go to your prescriber's office to receive your doses. But you'll need to be taught how to correctly give yourself the injections.
- Progesterone is commonly injected in the upper outer buttock area, but your prescriber might also suggest areas. Make sure to rotate injection sites each time to lessen injection-site reactions.
- Progesterone contains sesame oil, so tell your prescriber if you're allergic to sesame oil or sesame seeds. Speak with your care team about all of your allergies so they can make sure this medication is safe for you.
- Progesterone can make you feel tired or dizzy. Don't drive or perform dangerous activities without seeing how it affects you first.
- If you're taking progesterone to regulate your period, your period should start within 3 days after the last injection. If your period doesn't start by this point, let your prescriber know. If you've been sexually active, you should also take a pregnancy test.
- Let your prescriber know if you experience unusual or heavy vaginal bleeding, lumps in your breast, changes to your vision, or severe headaches after starting progesterone. These are not typical side effects and could be a sign of more serious problems.
- Progesterone is a multi-use vial, so you'll draw up the many doses from the same vial. Make sure you use a new needle and syringe for each injection to prevent contamination.
- Throw away used syringes and needles in a sharps container, which might be provided by your prescriber or purchased at most pharmacies. Never throw needles and syringes in the regular trash.
- Store the progesterone vial at room temperature, even after it's been opened. Be sure to throw away the opened vial after 28 days, unless the product label instructs otherwise.
Risks and warnings for Progesterone
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
- Risk factors: Taking progesterone with estrogens | Personal or family history of blood clots | High blood pressure | Diabetes | High cholesterol | Smoking | Obesity | Systemic lupus erythematosus (SLE)
Progesterone can raise your risk of blood clots, especially when taken with estrogen medications. This can be very dangerous and lead to heart attack, stroke, or pulmonary embolism (life-threatening blood clot in the lungs). Be sure to discuss all your medical conditions with your prescriber before starting progesterone. Call 911 or seek immediate medical attention if you have pain in your legs or arms, chest pain, sudden severe headaches, trouble breathing, or sudden changes in your speech.
Vision problems
Progesterone can cause retinal thrombosis, or a blood clot in the eyes. Speak to your prescriber right away if you notice changes in your vision, sudden vision loss, bulging eyes, double vision, or migraine.
Fluid buildup
- Risk factors: Heart failure | Kidney problems
Progesterone can cause extra fluid to build up in your body, especially in your legs, ankles, and feet. This is more likely to happen if you have certain conditions like kidney problems or heart failure. The extra fluid can cause these other conditions to get worse. If you know you have problems with fluid buildup or swelling, tell your prescriber before you start using progesterone. Call your prescriber or seek medical help right away if you notice unexplainable swelling, unexplained weight gain, or sudden trouble breathing.
Pneumonia
Very rarely, progesterone can cause a certain type of pneumonia. In some cases, this type of pneumonia can affect your breathing, which can be life-threatening. This is most likely to happen during the first 2 to 4 weeks after you start using the medication. It usually goes away when progesterone is stopped or if corticosteroids are taken. If you have sudden shortness of breath along with a fever, cough, and chest pain that gets worse when you take a deep breath, contact your care team or seek medical care right away.
Progesterone dosage
The average cost for 30 capsules of 100mg of Progesterone is $17.46 with a free GoodRx coupon. This is 78.27% off the average retail price of $80.35. 
Vial
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10ml of 50mg/ml | 3 vials | $30.30 | $10.10 |
Interactions between Progesterone and other drugs
Progesterone may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Progesterone. Please note that only the generic name of each medication is listed below.
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 this medicine, 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 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 Progesterone cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Progesterone contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Progesterone will not be safe for you to take.
- Blood clotting problems
- Liver problems
- Breast cancer
- Cancer of any genital organ (e.g., ovarian, cervical)
- Undiagnosed vaginal bleeding
- Missed abortion
- Allergy to sesame oil/seeds
What are alternatives to Progesterone?
There are a number of medications that your doctor can prescribe in place of Progesterone. Compare a few possible alternatives below.
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