Progesterone

Aka: Progesterone, Progestin

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II. Physiology

  1. See Serum Progesterone

III. Mechanism

  1. Progesterones are used in many contraceptives (e.g. Oral Contraceptives, mini pill, IUD, Depo Provera, Implanon)
    1. Progestins inhibit Ovulation
    2. Progestins thicken Cervical Mucus, preventing sperm from reaching the ovum
  2. Synthetic Progestins have Endometrial Activity, but also androgenic, Estrogenic and anti-Estrogenic Activity
    1. See Progestin Androgenic Activity
    2. See Progestin Endometrial Activity
    3. See Progestin Estrogenic Activity

IV. Types

  1. First Generation Progestin
    1. Norethindrone (e.g. Ortho-Novum)
    2. Norethynodrel (Enovid)
  2. Second Generation Progestin
    1. Norethindrone Acetate (e.g. Loestrin)
    2. Ethynodiol Diacetate (e.g. Demulen)
  3. Third Generation Progestin
    1. Levonorgestrel (e.g. Triphasil)
    2. dl-Norgestrel (e.g. Ovral)
  4. Fourth Generation Progestin
    1. Desogestrel (e.g. Desogen)
    2. Gestodene
    3. Norgestimate (e.g. Ortho-Cyclen)
  5. Pregnane Progestin
    1. Chlormadinone acetate
    2. Megestrol acetate
    3. Medroxyprogesterone acetate

V. Adverse Effects: Hyperlipidemia

  1. Overall Effect
    1. Lowers HDL-2 to Total Cholesterol ratio
  2. Factors related to unfavorable HDL effects
    1. Higher Progestational Activity
    2. Lower Estrogen to Progestin ratio
  3. Progestins most adversely effecting lipid (androgen)
    1. Levonorgestrel
  4. Progestins with most favorable lipid effects
    1. Progestin only formulations (mini pill)
    2. Desogestrel
    3. Norethindrone (low dose)

VI. References

  1. Cerel-Suhl (1999) Am Fam Physician 60(7):2073 [PubMed]
  2. Speroff (1993) Obstet Gynecol 81:1034-47 [PubMed]
  3. Dickey (1998) Managing Contraceptive Pill Patients

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Cost: Medications

progesterone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PROGESTERONE 100 MG CAPSULE Generic $0.25 each
PROGESTERONE 200 MG CAPSULE Generic $0.44 each
PROGESTERONE 500 MG/10 ML VIAL Generic $1.98 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

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