Co je Utrogestan?
Utrogestan is a prescription medicine containing micronised progesterone — a form of the female sex hormone progesterone that is chemically identical to the progesterone naturally produced by the ovaries. “Micronised” refers to the manufacturing process in which progesterone particles are reduced to a very fine size to improve absorption.
Utrogestan is approved by the European Medicines Agency (EMA) primarily as the progestogen component of hormone replacement therapy (HRT) for postmenopausal women who have an intact uterus. It is also used clinically for period delay, luteal phase support in fertility treatment, and certain gynaecological indications.
Jak funguje Utrogestan?
Progesterone is a sex hormone produced primarily by the corpus luteum in the ovary during the second half of the menstrual cycle, and by the placenta during pregnancy. It plays critical roles in:
- Endometrial protection: In the context of HRT, progesterone counteracts the proliferative effect of oestrogen on the uterine lining, reducing the risk of endometrial hyperplasia and endometrial cancer
- Menstrual cycle regulation: Elevated progesterone in the luteal phase maintains the uterine lining; a fall in progesterone triggers menstruation
- Period delay: By maintaining progesterone levels artificially, Utrogestan can delay the hormonal drop that initiates menstruation
- Neurosteroid activity: Oral progesterone is partially metabolised to neurosteroids (including allopregnanolone) that modulate GABA-A receptors, producing mild sedating and anxiolytic effects
Unlike synthetic progestogens such as norethisterone, micronised progesterone does not appear to have the same androgenic (testosterone-like) effects, which may be relevant to certain side effect profiles such as acne.
Pro koho je určen/a Utrogestan?
Utrogestan is clinically appropriate for several groups:
Postmenopausal women on HRT: Women who have not had a hysterectomy (i.e. who still have a uterus) taking oestrogen HRT require a progestogen to protect the endometrium. Utrogestan is an EMA-approved option for this purpose.
Women seeking period delay: Utrogestan may be prescribed by a doctor for short-term period postponement in appropriate candidates.
Women undergoing fertility treatment: Utrogestan (particularly via the vaginal route) is widely used to support the luteal phase in IVF and other assisted reproduction cycles.
Utrogestan is not appropriate for:
- Women with known or suspected breast cancer
- Women with known or suspected progesterone-sensitive tumours
- Women with undiagnosed vaginal bleeding
- Women with severe liver disease
- Women with a history of thrombotic conditions (discuss risk with your doctor)
- Women who are pregnant or breastfeeding (except under specialist supervision in specific fertility indications)
Dávkování
Utrogestan dosing varies considerably by indication:
| Indication | Typical Dose | Route | Timing |
|---|---|---|---|
| HRT (cyclical) | 200 mg daily | Oral or vaginal | 12–14 days per month |
| HRT (continuous) | 100 mg daily | Oral or vaginal | Daily |
| Period delay | 200–400 mg daily | Oral or vaginal | Days before expected period; per doctor guidance |
| Luteal phase support (IVF) | 200–600 mg daily | Vaginal | As directed by fertility specialist |
For the oral route, Utrogestan is typically taken at bedtime to minimise the impact of drowsiness on daytime activities. The vaginal route bypasses first-pass liver metabolism, resulting in lower systemic levels and reduced sedation, while maintaining high local (endometrial) concentrations.
Vedlejší účinky
Common side effects (oral route)
- Drowsiness and somnolence: Due to neurosteroid conversion; taking at bedtime is recommended
- Dizziness
- Headache
- Nausea
- Breast tenderness
Common side effects (vaginal route)
- Local irritation or discharge
- Fewer systemic effects than oral route
Serious risks
- Thromboembolic events: Evidence suggests a lower VTE risk with micronised progesterone compared to some synthetic progestogens, though all hormone use carries some degree of cardiovascular consideration. Individual risk assessment is essential.
- Breast effects: Long-term progestogen use in HRT carries consideration for breast health; the comparative breast safety of micronised progesterone versus synthetic progestogens is under ongoing research.
- Mood effects: While some women report improved mood on progesterone (possibly related to the neurosteroid sedating properties), others may experience mood changes.
Utrogestan vs Norethisterone
| Feature | Utrogestan (Progesterone) | Norethisterone |
|---|---|---|
| Type | Bioidentical (natural) | Synthetic progestogen |
| Androgenic activity | Minimal | Some androgenic activity |
| Sedating effect | More pronounced (oral) | Less pronounced |
| VTE risk data | Potentially lower | Class effect risk |
| Route options | Oral or vaginal | Oral only |
| Primary HRT use | Yes (EMA approved) | Used off-label for HRT in some countries |
The choice between Utrogestan and norethisterone for period delay or HRT should be made with a doctor, taking into account individual medical history, preferences, and risk factors.
Jak získat Utrogestan online v Evropě
Utrogestan is a prescription-only medicine across EU member states. A valid prescription from a qualified medical professional is required for dispensing.
Prescrivia operates as a technology intermediary, connecting patients with independent EU-registered doctors for online health assessments. We do not prescribe medicines, employ doctors, or sell medicines directly. If an independent doctor determines that Utrogestan is clinically appropriate following your assessment, they may issue a prescription, which is fulfilled by a licensed EU pharmacy partner.
Important: Prescrivia does not guarantee that a prescription will be issued. All clinical decisions are made independently by qualified medical professionals.
Důležité bezpečnostní informace
Tell your doctor if you:
- Have or have had breast cancer or hormone-sensitive cancer
- Have a history of blood clots, liver disease, or unexplained vaginal bleeding
- Are taking other hormone-containing medicines
- Are pregnant or suspect you may be pregnant (outside of supervised fertility indications)
Driving: Do not drive or operate machinery after taking oral Utrogestan until you know how it affects your alertness.
Zdroje
Lékařské informace na této stránce vycházejí z následujících zdrojů:
- European Medicines Agency (EMA). Utrogestan — Summary of Product Characteristics. ema.europa.eu
- World Health Organization (WHO). Medical eligibility criteria for contraceptive use — 5th edition. who.int
- Stanczyk FZ, et al. Progestogens used in postmenopausal hormone therapy: differences in their pharmacological properties, intracellular actions, and clinical effects. Endocr Rev. 2013;34(2):171-208.
Tento obsah je pravidelně přezkoumáván s ohledem na aktualizované klinické pokyny. Je poskytován pouze pro informační účely a nepředstavuje lékařské poradenství. Vždy se poraďte s kvalifikovaným zdravotnickým pracovníkem o radě týkající se Vašich individuálních zdravotních okolností.
Frequently asked questions
- K čemu se používá Utrogestan?
- Utrogestan contains micronised progesterone — a naturally identical form of the female hormone progesterone. It is used as the progestogen component of hormone replacement therapy (HRT) in postmenopausal women with an intact uterus, to protect the uterine lining from the effects of oestrogen. It is also used for period delay and luteal phase support in assisted reproduction.
- What makes Utrogestan different from synthetic progestogens?
- Utrogestan contains bioidentical progesterone — chemically identical to the progesterone produced naturally by the human body — whereas medicines like norethisterone contain synthetic progestogens that mimic progesterone's effects. Some evidence suggests that micronised progesterone may have a more favourable cardiovascular and breast safety profile compared to older synthetic progestogens, though research is ongoing and individual circumstances vary.
- Can Utrogestan delay my period?
- Yes. Utrogestan can be used off-label to delay menstruation, in a similar manner to norethisterone. By maintaining elevated progesterone levels, it prevents the hormonal drop that triggers menstruation. A doctor will determine whether Utrogestan or norethisterone is more appropriate for your individual circumstances.
- Does Utrogestan cause drowsiness?
- Yes, drowsiness is a commonly reported side effect of oral Utrogestan. This is thought to be related to progesterone's mild sedating properties, mediated through its conversion to neurosteroids such as allopregnanolone, which have GABA-A receptor activity. Taking Utrogestan at bedtime is often recommended to reduce the impact of this side effect on daily activities.
- Jaký je rozdíl Utrogestan taken?
- Utrogestan capsules can be taken orally (swallowed) or used vaginally (as a vaginal suppository). The vaginal route avoids first-pass liver metabolism and reduces the sedating effects associated with the oral route. For HRT use, Utrogestan 200 mg is typically taken orally or vaginally for 12–14 days per month in a cyclical regimen. Your doctor will prescribe the appropriate route, dose, and schedule for your specific use.
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